{[ promptMessage ]}

Bookmark it

{[ promptMessage ]}

Marcacci - TISSUE ENGINEERING Volume 13 Number 5 2007 Mary...

Info icon This preview shows pages 1–2. Sign up to view the full content.

View Full Document Right Arrow Icon
Stem Cells Associated with Macroporous Bioceramics for Long Bone Repair: 6- to 7-Year Outcome of a Pilot Clinical Study MAURILIO MARCACCI, M.D., 1 ELIZAVETA KON, M.D., 1 VLADIMIR MOUKHACHEV, M.D., 2 ANDREI LAVROUKOV, M.D., 2, { SERGEJ KUTEPOV, M.D., 3 RODOLFO QUARTO, M.D., 4,* MADDALENA MASTROGIACOMO, Ph.D., 4 and RANIERI CANCEDDA, M.D. 4 ABSTRACT Extensive bone loss is still a major problem in orthopedics. A number of different therapeutic approaches have been developed and proposed, but so far none have proven to be fully satisfactory. We used a new tissue engineering approach to treat four patients with large bone diaphysis defects and poor therapeutic alternatives. To obtain implantable three-dimensional (3D) living constructs, cells isolated from the pa- tients’ bone marrow stroma were expanded in culture and seeded onto porous hydroxyapatite (HA) ceramic scaffolds designed to match the bone deficit in terms of size and shape. During the surgical session, an Ilizarov apparatus or a monoaxial external fixator was positioned on the patient’s affected limb and the ceramic cylinder seeded with cells was placed in the bone defect. Patients were evaluated at different postsurgery time intervals by conventional radiographs and computed tomography (CT) scans. In one patient, an angiographic evaluation was performed at 6.5 years follow-up. In this study we analyze the long-term outcome of these patients following therapy. No major complications occurred in the early or late postoperative periods, nor were major complaints reported by the patients. No signs of pain, swelling, or infection were observed at the implantation site. Complete fusion between the implant and the host bone occurred 5 to 7 months after surgery. In all patients at the last follow-up (6 to 7 years postsurgery in patients 1 to 3), a good integration of the implants was maintained. No late fractures in the implant zone were observed. The present study shows the long-term durability of bone regeneration achieved by a bone engineering approach. We consider the obtained results very promising and propose the use of culture- expanded osteoprogenitor cells in conjunction with porous bioceramics as a real and significant im- provement in the repair of critical-sized long bone defects. INTRODUCTION E XTENSIVE BONE LOSS OR DESTRUCTION is still a major problem in orthopedics, due in large part to the lack of predictability in obtaining functional bone reconstruction. Present therapeutic approaches to repair large bone defects can be divided into two groups: excluding graft transplant (Ilizarov bone transport) or including graft transplant (auto- logous, homologous, or heterologous bone grafts using dif- ferent biomaterial implants). TheIlizarovtechnique,osteotomyfollowedbybonedistrac- tion, relies on the bone regeneration potential, thus avoiding 1 Istituti Ortopedici Rizzoli, Bologna, Italy.
Image of page 1

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 2
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern