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Introduction: Nonunion is a challenging condition in orthopaedics as its etiology is not fully understood. Clinical interventions currently aim to stimulate both the biological and mechanical aspects of the bone healing process by using bone autografts and surgical fixation. However, recent observations showed that atrophic nonunion tissues contain putative osteoprogenitors, raising the hypothesis that its reactivation could be explored to achieve bone repair.
Methods: Here we characterized atrophic nonunion stromal cells (NUSC) in vitro, using bone marrow stromal cells (BMSC) and osteoblasts as controls cells of the osteoblastic lineage, and evaluated its ability to form bone in vivo.
Results: NUSC had proliferative and senescence rates comparable to BMSC and osteoblasts, and homogeneously expressed the osteolineage markers CD90 and CD73. Regarding CD105 and CD146 expression, NUSC were closely related to osteoblasts, both with an inferior percentage of CD105/CD146 cells as compared to BMSC. Despite this, NUSC differentiated along the osteogenic and adipogenic lineages in vitro; and when transplanted subcutaneously into immunocompromised mice, new bone formation and hematopoietic marrow were established.
Conclusions: This study demonstrates that NUSC are osteogenically competent, supporting the hypothesis that their endogenous reactivation could be a strategy to stimulate the bone formation while reducing the amount of bone autograft requirements.
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http://dx.doi.org/10.1097/OI9.0000000000000008 | DOI Listing |
JBJS Case Connect
October 2024
Cedars Sinai Medical Center Department of Orthopaedic Surgery, Los Angeles, California.
Case: A 14-year-old adolescent boy sustained a Gustilo-Anderson Type 3A tibia fracture treated with medullary nailing. He developed an atrophic nonunion with a 10.5-cm defect after debridement.
View Article and Find Full Text PDFIndian J Orthop
December 2024
Department of Orthopaedics, PARAS HMRI Hospital, Patna, Bihar 800014 India.
Aseptic nonunion is prevalent in orthopedic practice, causing persistent pain and functional impairment. Humeral shaft fractures, accounting for 3-5% of all fractures, have nonunion rates of 2-33% in nonoperative and 5-10% in surgical management. This study, the largest case series on operative management of humeral shaft nonunion, examines surgical techniques and outcomes.
View Article and Find Full Text PDFJB JS Open Access
December 2024
Orthopedic Surgery Department, Hospital Cl 50, Mexican Social Security Institute (I.M.S.S), San Luis Potosí, México.
Background: Bone transport in distraction osteogenesis is an effective, well-known procedure. However, bone compression is an aspect of this technique for which there is no objective information. The lack of direct bone compression measurements may result in a lack of uniformity in the bone transport process, which can result in its ineffective application and may be contributing to its underutilization.
View Article and Find Full Text PDFJ Wrist Surg
December 2024
Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
We hypothesized a treatment guideline for ulna/radius nonunion after failed surgical treatment and propose to verify it in a prospective study. Herein, we report our preliminary findings and review the current trend. Six patients who met the criteria were retrospectively investigated, and we further categorized "nonunion of both the radius/ulna" into four subcategories.
View Article and Find Full Text PDFJ Orthop Case Rep
November 2024
BETIC, Mechanical Engineering Department, Indian Institute of Technology Bombay, Mumbai, Maharashtra, India.
Introduction: Critical-size bone defects in distal tibial open wounds pose a formidable challenge, requiring interventions that can address osseous reconstruction with less number of surgeries. Current treatment modalities may fall short in achieving optimal outcomes, with respect to early weight bearing due to the inability of the graft to sustain weight, graft-related infections, non-union in large defects, donor site morbidity, and non-availability of bone grafts due to earlier harvest. This case report explores the potential application of a 3D-printed mesh implant to this complex clinical scenario.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!