Abstract
Introduction
Stem cells have the capacity for self renewal and capability of differentiation into various cell lineages. Non union remains a clinically important problem in orthopaedic surgery.
Method
We randomly assigned 45 patients into 3 groups. Test group: 15 patients in which mesenchymal stem cells prepared by conventional density-gradient centrifugation using ficoll-hypaque solution were injected (n=15), control A: 15 patients in which autogenous bone marrow aspirate were injected (n=15), control B: 15 patients in which neither the stem cell nor bone marrow injection given, symptomatically treated(n=15). Ultra sound and x rays were performed at follow up of 6, 12, 18, 24 weeks and comparison done.
Results
Stem cell group: 12 patients out of 13 followed showed excellent results and 1 patient showed good result. Control A bone marrow injection group: 6/15 patients showed excellent results and 3 patients showed good results. Control B: only 2/15 patients showed excellent results. In fracture gap 4–5mm the stem cell group showed union in most of the patients. In control A and control B patients with same fracture gap failed to unite.
Conclusion
In fracture situations, in which a manipulation or augmentation of natural healing mechanisms is needed to regenerate larger quantities of new bone Stem cells play a part. This technique of percutaneous stem cell injection provides a very safe, easy, non immunogenic, non invasive and reliable alternative to open bone grafting. This one-stage isolation procedure in comparison to the ex-vivo expansion of autologous cells from bone marrow/embryonic cells reduces the cost and infection rates related to the extra personal need and extended time required for the expansion.
Summary
Stem cells have potential to enhance bone healing in non union of fractures.
