Percutaneous autologous concentrated bone marrow grafting in the treatment for nonunion

Eur J Orthop Surg Traumatol. 2014 Jul;24(5):671-8. doi: 10.1007/s00590-013-1369-9. Epub 2013 Nov 26.

Abstract

The purpose of this study was to evaluate the clinical and radiographic treatment effects of percutaneous autologous concentrated bone marrow grafting in nonunion cases and to evaluate the effectiveness of this grafting procedure. We enrolled 17 cases those had atrophic changes due to continuous nonunion for over 9 months after injury and had undergone low-intensity pulsed ultrasound treatment for more than 3 months. The site of nonunion was the femur in 10 cases, the tibia in 5 cases, the humerus in 1 case, and the ulna in 1 case. They underwent percutaneous autologous concentrated bone marrow grafting and continued low-intensity pulsed ultrasound stimulation treatment after grafting. Patients were evaluated using the visual analogue scale for pain at immediately before the procedure, 3, 6, and 12 months after grafting. Plain radiographs of the affected site were taken and evaluated about the healing of the nonunion site at each clinical evaluation. As quantitative assessment, CT scans were undertaken before the procedure and 6 months after grafting. The visual analogue scale pain score was reduced consistently after grafting in all patients. About the healing at the nonunion site, 11 and 13 cases of bone union were observed at 6 and 12 months after grafting. The mean volume of callus formation based on CT images was 4,147 (262-27,392) mm3 total between grafting and 6 months. Percutaneous autologous concentrated bone marrow grafting is an effective procedure for the treatment of patients with nonunion.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Marrow Transplantation / methods*
  • Bone Marrow Transplantation / rehabilitation
  • Combined Modality Therapy
  • Female
  • Femoral Fractures / diagnostic imaging
  • Femoral Fractures / rehabilitation
  • Femoral Fractures / surgery
  • Fractures, Ununited / diagnostic imaging
  • Fractures, Ununited / rehabilitation
  • Fractures, Ununited / surgery*
  • Humans
  • Humeral Fractures / diagnostic imaging
  • Humeral Fractures / rehabilitation
  • Humeral Fractures / surgery
  • Injections, Intralesional
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / etiology
  • Postoperative Care / methods
  • Retrospective Studies
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / rehabilitation
  • Tibial Fractures / surgery
  • Tomography, X-Ray Computed
  • Transplantation, Autologous / methods
  • Transplantation, Autologous / rehabilitation
  • Treatment Outcome
  • Ulna Fractures / diagnostic imaging
  • Ulna Fractures / rehabilitation
  • Ulna Fractures / surgery
  • Ultrasonic Therapy / methods
  • Young Adult