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- Title
Percutaneous autologous concentrated bone marrow grafting in the treatment for nonunion.
- Authors
Sugaya, Hisashi; Mishima, Hajime; Aoto, Katsuya; Li, Meihua; Shimizu, Yukiyo; Yoshioka, Tomokazu; Sakai, Shinsuke; Akaogi, Hiroshi; Ochiai, Naoyuki; Yamazaki, Masashi
- 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) mm total between grafting and 6 months. Percutaneous autologous concentrated bone marrow grafting is an effective procedure for the treatment of patients with nonunion.
- Subjects
TREATMENT of fractures; FEMUR injuries; ULNA injuries; TIBIA injuries; HUMERUS injuries; ANALYSIS of variance; BIOLOGICAL assay; BONE marrow transplantation; COLONIES (Biology); BONE fractures; HEALTH outcome assessment; UNUNITED fractures; STATISTICS; T-test (Statistics); TOMOGRAPHY; ULTRASONIC therapy; WOUND healing; DATA analysis; PAIN measurement; VISUAL analog scale; TREATMENT effectiveness; DATA analysis software; DESCRIPTIVE statistics; THERAPEUTICS
- Publication
European Journal of Orthopaedic Surgery & Traumatology, 2014, Vol 24, Issue 5, p671
- ISSN
1633-8065
- Publication type
Article
- DOI
10.1007/s00590-013-1369-9