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Fibula and tibia fusion with cancellous allograft vitalised with autologous bone marrow: first results for infected tibial non-union.

作者信息

Ateschrang Atesch, Ochs Björn Gunnar, Lüdemann Martin, Weise Kuno, Albrecht Dirk

机构信息

Berufsgenossenschaftliche Unfallklinik Tübingen der Eberhard-Karls Universität Tübingen, Abteilung für Unfall- und Wiederherstellungschirurgie, Schnarrenbergstr. 95, 72076, Tübingen, Germany.

出版信息

Arch Orthop Trauma Surg. 2009 Jan;129(1):97-104. doi: 10.1007/s00402-008-0699-2. Epub 2008 Aug 2.


DOI:10.1007/s00402-008-0699-2
PMID:18677497
Abstract

BACKGROUND AND AIMS: Autogenous bone grafting has been used in reconstructing bone defects and in stimulating fracture healing, producing high healing rates in the treatment of infected tibial non-unions. A novel therapeutic alternative is now available known as "vitalised allograft", a cancellous bone graft procured from femoral heads from living human donors and "vitalised" through the injection of autologous bone marrow. The aim of this study is to summarise the initial results of the fibula and tibia fusion using vitalised cancellous allograft in the treatment of infected tibial non-unions. PATIENTS AND METHODS: We initiated a follow-up of 15 prospective non-randomized patients who received a vitalised allograft in the treatment of infected tibial non-unions in order to produce bony union. The patients included 13 men and 2 women with an average age of 48 years. All patients received a multi-stage surgical approach. After establishing an infection-free environment, allogenic cancellous bone grafting was performed, intended as the final surgical procedure in fibula and tibia fusion. Our follow-up included a clinical and radiographic investigation of the calf in four planes. We analysed union-rate and time required for bony consolidation, as well as recurrent infections, re-fractures, potential graft-resorption, and time needed for graft and bone remodelling. RESULTS: With an average follow-up of 17.1 months, infection control was obtained in 14 of 15 patients, producing an infection arrest rate of 93.3%. Radiographs indicated consolidation in 11 out of 15 cases, with a union rate of 73.3%. Bone union was achieved on average in 17.1 weeks. CONCLUSIONS: Fibula and tibia fusion with allogenic cancellous bone grafting, vitalised through autogenic bone marrow, could well become an innovative treatment option for infected tibial non-unions. We need, however, to analyse a higher number of cases over a longer follow-up period in order to assess more accurately recurrent infections and re-fractures.

摘要

相似文献

[1]
Fibula and tibia fusion with cancellous allograft vitalised with autologous bone marrow: first results for infected tibial non-union.

Arch Orthop Trauma Surg. 2009-1

[2]
[Treatment of traumatic bone defect with graft material of allogenic cancellous combined with autologous red marrow].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008-10

[3]
[Muscle flap transfer of the treatment of infected tibial and malleolar fractures and chronic osteomyelitis of the tibia].

Acta Chir Orthop Traumatol Cech. 2007-6

[4]
The infected nonunion of the tibia.

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[5]
Results of vancomycin-impregnated cancellous bone grafting for infected tibial nonunion.

Arch Orthop Trauma Surg. 2005-7

[6]
[A novel therapeutic approach to bone replacement: vitalisation of industrial processed allogenic bone graft with autologous bone marrow].

Z Orthop Unfall. 2007

[7]
[Septic leg fractures. Value of cancellous bone grafting without skin closure, aligned on the fibula].

Rev Chir Orthop Reparatrice Appar Mot. 1985

[8]
[Tibial fracture with intact fibula treated by reamed nailing].

Rev Chir Orthop Reparatrice Appar Mot. 2000-2

[9]
[Effect of interlocking intramedullary nail in treatment of open tibial and fibula fractures].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009-3

[10]
Autologous marrow injection in the treatment of delayed and non-union in long bones.

Singapore Med J. 1993-10

引用本文的文献

[1]
Bone marrow aspirate and bone marrow aspirate concentrate: Does the literature support use in long-bone nonunion and provide new insights into mechanism of action?

Eur J Orthop Surg Traumatol. 2024-8

[2]
Ilizarov method and its combined methods in the treatment of long bone defects of the lower extremity: systematic review and meta-analysis.

BMC Musculoskelet Disord. 2023-11-16

[3]
Fibula pro tibia and cancellous allograft vitalised with autologous bone for non-union of the distal tibia diaphysis: Surgical technique.

J Orthop. 2023-3-10

[4]
Bone Marrow-Derived Cell Therapies to Heal Long-Bone Nonunions: A Systematic Review and Meta-Analysis-Which Is the Best Available Treatment?

Stem Cells Int. 2019-12-27

[5]
Novel Lipid Signaling Mediators for Mesenchymal Stem Cell Mobilization during Bone Repair.

Cell Mol Bioeng. 2018-8

[6]
First mid-term results after cancellous allograft vitalized with autologous bone marrow for infected femoral non-union.

Wien Klin Wochenschr. 2016-11

[7]
Effect of nanocrystalline hydroxyapatite socket preservation on orthodontically induced inflammatory root resorption.

Cell J. 2015-1-13

[8]
Exchange reamed nailing compared to augmentation compression plating leaving the inserted nail in situ in the treatment of aseptic tibial non-union: a two-centre study.

Wien Klin Wochenschr. 2013-5-15

[9]
Bone regeneration: stem cell therapies and clinical studies in orthopaedics and traumatology.

J Cell Mol Med. 2011-6

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