Distraction osteogenesis after post-traumatic segmental bone loss of the tibia is a complex and time-consuming procedure that is often complicated due to prolonged consolidation or complete insufficiency of the regenerate. The aim of this feasibility study was to investigate the potential of bone marrow aspiration concentrate (BMAC) for percutaneous regenerate augmentation to accelerate bony consolidation of the regenerate. Eight patients (age 22–64) with an average posttraumatic bone defect of 82.4 mm and concomitant risk factors (nicotine abuse, soft-tissue defects, obesity and/or circulatory disorders) were treated with a modified Ilizarov external frame using an intramedullary cable transportation system. At the end of the distraction phase, each patient was treated with a percutaneously injection of autologous BMAC into the centre of the regenerate. The concentration factor was analysed using flow cytometry. The mean follow up after frame removal was 10 (4–15) months. With a mean healing index (HI) of 36.9 d/cm, bony consolidation of the regenerate was achieved in all eight cases. The mean concentration factor of the bone marrow aspirate was 4.6 (SD 1.23). No further operations concerning the regenerate were needed and no adverse effects were observed with the BMAC procedure. This procedure can be used for augmentation of the regenerate in cases of segmental bone transport. Further studies with a larger number of patients and control groups are needed to evaluate a possible higher success rate and accelerating effects on regenerate healing.
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机译:胫骨创伤后节段性骨丢失后分心成骨是一个复杂且耗时的过程,由于再生的延长固结或完全不足,通常会使其复杂化。这项可行性研究的目的是研究骨髓抽吸浓缩液(BMAC)促进经皮再生的潜力,以加速再生的骨整合。八名平均年龄为82.4 mm的创伤后骨缺损并伴有危险因素(尼古丁滥用,软组织缺损,肥胖和/或循环系统疾病)的患者(22-64岁)接受了改良的Ilizarov外部框架内髓内电缆运输治疗系统。在分心阶段结束时,对每位患者进行经皮自体BMAC注射至再生中心。使用流式细胞仪分析浓度因子。去除框架后的平均随访时间为10(4-15)个月。平均愈合指数(HI)为36.9 d / cm,在所有八例病例中均实现了再生的骨质巩固。骨髓抽吸物的平均浓缩系数为4.6(SD 1.23)。不需要有关再生的进一步操作,并且使用BMAC程序也未观察到不良影响。在节段性骨运输的情况下,该程序可用于增强再生。需要对大量患者和对照组进行进一步研究,以评估可能更高的成功率和对再生愈合的加速作用。
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