Percutaneous injection of bone marrow mesenchymal stem cells for ankle non-unions decreases complications in patients with diabetes
Purpose Clinical studies in diabetic patients have demonstrated that there is a high incidence of complications in distal tibia and ankle fracture treatments. One strategy to mitigate issues with wound healing and infection in diabetic patients is to use a percutaneous technique in which autologous,...
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| Veröffentlicht in: | International orthopaedics 2015-08, Vol.39 (8), p.1639-1643 |
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| container_title | International orthopaedics |
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| creator | Hernigou, Philippe Guissou, Isaac Homma, Yasuhiro Poignard, Alexandre Chevallier, Nathalie Rouard, Helene Flouzat Lachaniette, Charles Henri |
| description | Purpose
Clinical studies in diabetic patients have demonstrated that there is a high incidence of complications in distal tibia and ankle fracture treatments. One strategy to mitigate issues with wound healing and infection in diabetic patients is to use a percutaneous technique in which autologous, bone marrow-derived, concentrated cells are injected at the site of non-unions.
Methods
Eighty-six ankle non-union in diabetic patients were treated with bone marrow mesenchymal stem cells (BM-MSCs) delivered in an autologous bone marrow concentrate (BMC). Clinical outcomes of the 86 diabetic non-union patients treated with BMC were compared with 86 diabetic matched non-unions treated with a standard bone iliac crest autograft.
Results
Treatment with BMC promoted non-union healing in 70 among 86 diabetic patients (82.1 %) with a low number of complications. Of the 86 diabetic patients treated with iliac bone graft, 53 (62.3 %) had healing; major complications were observed: 5 amputations, 11 osteonecroses of the fracture wound edge and 17 infections.
Conclusions
In diabetic patients with ankle non-unions, treatment with BM-MSCs from bone marrow concentrate may be preferable in view of the high risks of major complications after open surgery and iliac bone grafting, and improved healing rates compared with standard iliac bone autograft treatment. |
| doi_str_mv | 10.1007/s00264-015-2738-2 |
| format | Article |
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Clinical studies in diabetic patients have demonstrated that there is a high incidence of complications in distal tibia and ankle fracture treatments. One strategy to mitigate issues with wound healing and infection in diabetic patients is to use a percutaneous technique in which autologous, bone marrow-derived, concentrated cells are injected at the site of non-unions.
Methods
Eighty-six ankle non-union in diabetic patients were treated with bone marrow mesenchymal stem cells (BM-MSCs) delivered in an autologous bone marrow concentrate (BMC). Clinical outcomes of the 86 diabetic non-union patients treated with BMC were compared with 86 diabetic matched non-unions treated with a standard bone iliac crest autograft.
Results
Treatment with BMC promoted non-union healing in 70 among 86 diabetic patients (82.1 %) with a low number of complications. Of the 86 diabetic patients treated with iliac bone graft, 53 (62.3 %) had healing; major complications were observed: 5 amputations, 11 osteonecroses of the fracture wound edge and 17 infections.
Conclusions
In diabetic patients with ankle non-unions, treatment with BM-MSCs from bone marrow concentrate may be preferable in view of the high risks of major complications after open surgery and iliac bone grafting, and improved healing rates compared with standard iliac bone autograft treatment.</description><identifier>ISSN: 0341-2695</identifier><identifier>EISSN: 1432-5195</identifier><identifier>DOI: 10.1007/s00264-015-2738-2</identifier><identifier>PMID: 25795249</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Ankle ; Ankle Injuries - epidemiology ; Ankle Injuries - surgery ; Ankle Injuries - therapy ; Bone Transplantation ; Diabetes Mellitus - epidemiology ; Female ; Fractures, Ununited - epidemiology ; Fractures, Ununited - surgery ; Fractures, Ununited - therapy ; Humans ; Ilium - transplantation ; Incidence ; Injections ; Medicine ; Medicine & Public Health ; Mesenchymal Stem Cell Transplantation ; Middle Aged ; Original Paper ; Orthopedics ; Specimen Handling - adverse effects ; Tissue and Organ Harvesting - adverse effects ; Transplantation, Autologous ; Treatment Outcome ; Wound Healing</subject><ispartof>International orthopaedics, 2015-08, Vol.39 (8), p.1639-1643</ispartof><rights>SICOT aisbl 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-b7e28e9bf869b8850115e50a661ef901b4fef2a9189bae69324ebdbb052229463</citedby><cites>FETCH-LOGICAL-c414t-b7e28e9bf869b8850115e50a661ef901b4fef2a9189bae69324ebdbb052229463</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00264-015-2738-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00264-015-2738-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27907,27908,41471,42540,51302</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25795249$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hernigou, Philippe</creatorcontrib><creatorcontrib>Guissou, Isaac</creatorcontrib><creatorcontrib>Homma, Yasuhiro</creatorcontrib><creatorcontrib>Poignard, Alexandre</creatorcontrib><creatorcontrib>Chevallier, Nathalie</creatorcontrib><creatorcontrib>Rouard, Helene</creatorcontrib><creatorcontrib>Flouzat Lachaniette, Charles Henri</creatorcontrib><title>Percutaneous injection of bone marrow mesenchymal stem cells for ankle non-unions decreases complications in patients with diabetes</title><title>International orthopaedics</title><addtitle>International Orthopaedics (SICOT)</addtitle><addtitle>Int Orthop</addtitle><description>Purpose
Clinical studies in diabetic patients have demonstrated that there is a high incidence of complications in distal tibia and ankle fracture treatments. One strategy to mitigate issues with wound healing and infection in diabetic patients is to use a percutaneous technique in which autologous, bone marrow-derived, concentrated cells are injected at the site of non-unions.
Methods
Eighty-six ankle non-union in diabetic patients were treated with bone marrow mesenchymal stem cells (BM-MSCs) delivered in an autologous bone marrow concentrate (BMC). Clinical outcomes of the 86 diabetic non-union patients treated with BMC were compared with 86 diabetic matched non-unions treated with a standard bone iliac crest autograft.
Results
Treatment with BMC promoted non-union healing in 70 among 86 diabetic patients (82.1 %) with a low number of complications. Of the 86 diabetic patients treated with iliac bone graft, 53 (62.3 %) had healing; major complications were observed: 5 amputations, 11 osteonecroses of the fracture wound edge and 17 infections.
Conclusions
In diabetic patients with ankle non-unions, treatment with BM-MSCs from bone marrow concentrate may be preferable in view of the high risks of major complications after open surgery and iliac bone grafting, and improved healing rates compared with standard iliac bone autograft treatment.</description><subject>Adult</subject><subject>Aged</subject><subject>Ankle</subject><subject>Ankle Injuries - epidemiology</subject><subject>Ankle Injuries - surgery</subject><subject>Ankle Injuries - therapy</subject><subject>Bone Transplantation</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Female</subject><subject>Fractures, Ununited - epidemiology</subject><subject>Fractures, Ununited - surgery</subject><subject>Fractures, Ununited - therapy</subject><subject>Humans</subject><subject>Ilium - transplantation</subject><subject>Incidence</subject><subject>Injections</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mesenchymal Stem Cell Transplantation</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Orthopedics</subject><subject>Specimen Handling - adverse effects</subject><subject>Tissue and Organ Harvesting - adverse effects</subject><subject>Transplantation, Autologous</subject><subject>Treatment Outcome</subject><subject>Wound Healing</subject><issn>0341-2695</issn><issn>1432-5195</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kDFvFDEQhS1ERI7AD6BBLmkMHq_ttUsUEUCKBEVSW_beLNlj1z5sr6LU-eP42EBJNaOZ9570PkLeAH8PnPcfCudCS8ZBMdF3holnZAeyE0yBVc_JjncSmNBWnZOXpRw4h14beEHOheqtEtLuyON3zMNafcS0FjrFAw51SpGmkYYUkS4-53RPFywYh7uHxc-0VFzogPNc6Jgy9fHnjDSmyNbYnIXuccjoCxY6pOU4T4Ovf-5TpMe2YqyF3k_1ju4nH7BieUXORj8XfP00L8jt1aebyy_s-tvnr5cfr9kgQVYWehQGbRiNtsEYxQEUKu61BhwthyBHHIW3YGzwqG0nJIZ9CFwJIazU3QV5t-Uec_q1YqlumcqpyNbegbbGai7ANCls0iGnUjKO7pinxuLBAXcn9m5j7xp7d2LvRPO8fYpfw4L7f46_sJtAbILSXvEHZndIa46t8n9SfwMss5H-</recordid><startdate>20150801</startdate><enddate>20150801</enddate><creator>Hernigou, Philippe</creator><creator>Guissou, Isaac</creator><creator>Homma, Yasuhiro</creator><creator>Poignard, Alexandre</creator><creator>Chevallier, Nathalie</creator><creator>Rouard, Helene</creator><creator>Flouzat Lachaniette, Charles Henri</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150801</creationdate><title>Percutaneous injection of bone marrow mesenchymal stem cells for ankle non-unions decreases complications in patients with diabetes</title><author>Hernigou, Philippe ; Guissou, Isaac ; Homma, Yasuhiro ; Poignard, Alexandre ; Chevallier, Nathalie ; Rouard, Helene ; Flouzat Lachaniette, Charles Henri</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-b7e28e9bf869b8850115e50a661ef901b4fef2a9189bae69324ebdbb052229463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Ankle</topic><topic>Ankle Injuries - epidemiology</topic><topic>Ankle Injuries - surgery</topic><topic>Ankle Injuries - therapy</topic><topic>Bone Transplantation</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Female</topic><topic>Fractures, Ununited - epidemiology</topic><topic>Fractures, Ununited - surgery</topic><topic>Fractures, Ununited - therapy</topic><topic>Humans</topic><topic>Ilium - transplantation</topic><topic>Incidence</topic><topic>Injections</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mesenchymal Stem Cell Transplantation</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Orthopedics</topic><topic>Specimen Handling - adverse effects</topic><topic>Tissue and Organ Harvesting - adverse effects</topic><topic>Transplantation, Autologous</topic><topic>Treatment Outcome</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hernigou, Philippe</creatorcontrib><creatorcontrib>Guissou, Isaac</creatorcontrib><creatorcontrib>Homma, Yasuhiro</creatorcontrib><creatorcontrib>Poignard, Alexandre</creatorcontrib><creatorcontrib>Chevallier, Nathalie</creatorcontrib><creatorcontrib>Rouard, Helene</creatorcontrib><creatorcontrib>Flouzat Lachaniette, Charles Henri</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hernigou, Philippe</au><au>Guissou, Isaac</au><au>Homma, Yasuhiro</au><au>Poignard, Alexandre</au><au>Chevallier, Nathalie</au><au>Rouard, Helene</au><au>Flouzat Lachaniette, Charles Henri</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Percutaneous injection of bone marrow mesenchymal stem cells for ankle non-unions decreases complications in patients with diabetes</atitle><jtitle>International orthopaedics</jtitle><stitle>International Orthopaedics (SICOT)</stitle><addtitle>Int Orthop</addtitle><date>2015-08-01</date><risdate>2015</risdate><volume>39</volume><issue>8</issue><spage>1639</spage><epage>1643</epage><pages>1639-1643</pages><issn>0341-2695</issn><eissn>1432-5195</eissn><abstract>Purpose
Clinical studies in diabetic patients have demonstrated that there is a high incidence of complications in distal tibia and ankle fracture treatments. One strategy to mitigate issues with wound healing and infection in diabetic patients is to use a percutaneous technique in which autologous, bone marrow-derived, concentrated cells are injected at the site of non-unions.
Methods
Eighty-six ankle non-union in diabetic patients were treated with bone marrow mesenchymal stem cells (BM-MSCs) delivered in an autologous bone marrow concentrate (BMC). Clinical outcomes of the 86 diabetic non-union patients treated with BMC were compared with 86 diabetic matched non-unions treated with a standard bone iliac crest autograft.
Results
Treatment with BMC promoted non-union healing in 70 among 86 diabetic patients (82.1 %) with a low number of complications. Of the 86 diabetic patients treated with iliac bone graft, 53 (62.3 %) had healing; major complications were observed: 5 amputations, 11 osteonecroses of the fracture wound edge and 17 infections.
Conclusions
In diabetic patients with ankle non-unions, treatment with BM-MSCs from bone marrow concentrate may be preferable in view of the high risks of major complications after open surgery and iliac bone grafting, and improved healing rates compared with standard iliac bone autograft treatment.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25795249</pmid><doi>10.1007/s00264-015-2738-2</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Ankle Ankle Injuries - epidemiology Ankle Injuries - surgery Ankle Injuries - therapy Bone Transplantation Diabetes Mellitus - epidemiology Female Fractures, Ununited - epidemiology Fractures, Ununited - surgery Fractures, Ununited - therapy Humans Ilium - transplantation Incidence Injections Medicine Medicine & Public Health Mesenchymal Stem Cell Transplantation Middle Aged Original Paper Orthopedics Specimen Handling - adverse effects Tissue and Organ Harvesting - adverse effects Transplantation, Autologous Treatment Outcome Wound Healing |
| title | Percutaneous injection of bone marrow mesenchymal stem cells for ankle non-unions decreases complications in patients with diabetes |
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