Transplantation of artificial bone with autologous bone marrow combined with iliac periosteum for treatment of refractory bone nonunion in limbs Comparison to artificial bone with autologous bone marrow transplantation and simple iliac periosterum transpl
10.3969/j.issn.1673-8225.2010.18.045
- VernacularTitle:自体骨髓复合人工骨联合髂骨骨膜移植修复四肢难治性骨不连:与单纯骨膜移植及骨髓联合人工骨移植的比较
- Author:
Jianhua GE
;
Naiqiang ZHUO
;
Xiaobo LU
;
Zhongjie ZHANG
;
Ge CHEN
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2010;14(18):3412-3416
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Autologous bone marrow is the only tissue that contains abundant osteoinductive osteogenitor cells and is the first-choice transplantation materials for treatment of bone nonunion. Artificial bone with osteoinductive capacity can provide a supporting effect for the in-growth of osteocytes. Iliac periosteum can be used for treatment of bone nonunion due to the advantages including abundant blood circulation, easy harvesting, and able to improve local arterial blood supply. BJECTIVE: To treat refractory bone nonunion in limbs using artificial bone with autologous bone marrow combined with iliac periosteum transplantation, and to compare the therapeutic efficacy to artificial bone with autologous bone marrow transplantation and simple iliac periosterum transplantation. METHOD: Thirty-nine refractory bone nonunion limbs from 36 patients were assigned to three groups: artificial bone with autologous bone marrow combined with iliac periosteum transplantation (combination group, n = 19), artificial bone with autologous bone marrow (bone marrow group, n = 9), and autologous iliac periosteum (iliac periosteum group, n = 11). The time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score were evaluated. RESULTS AND CONCLUSION: All initial 39 limbs acquired bone union and were followed up for an average period of 18.5 months. The combination group yielded better therapeutic effects than the bone marrow group and the iliac periosteum group in terms of the time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score (P < 0.05). These findings indicate that artificial bone with autologous bone marrow combined with iliac periosteum transplantation exhibits better clinical therapeutic effects in treatment of refractory bone nonunion in limbs.