Research Laboratory for Regenerative Medicine and Biomaterials, Department of Orthopaedics, Heinrich-Heine University Medical School, Moorenstr. 5, D-40225 Duesseldorf, Germany.
J Orthop Res. 2011 Feb;29(2):173-80. doi: 10.1002/jor.21230. Epub 2010 Aug 25.
Although autologous bone grafting represents an effective tool to induce osteogenic regeneration in local bone defects or pseudarthroses, it is associated with significant donor site morbidity and limited by the amount available for grafting. We investigate the potency of bone marrow aspiration concentrate (BMAC) to augment bone grafting and support bone healing. The functional and radiographic outcome of 39 patients with volumetric bone deficiencies treated with BMAC are presented and evaluated in a prospective clinical trial. A collagen sponge (Col) served as scaffold in 12 patients and a bovine hydroxyapatite (HA) was applied in the other 27 individuals. The minimal follow-up was 6 months. Clinical and radiographic findings were completed by in vitro data. All patients showed new bone formation in radiographs during follow-up. However, two patients underwent revision surgery due to a lack in bone healing. In contrast to the Col group, the postoperative bone formation appeared earlier in the HA group (HA group: 6.8 weeks vs. Col group 13.6 weeks). Complete bone healing was achieved in the HA group after 17.3 weeks compared to 22.4 weeks in the Col group. The average concentration factor of BMAC was 5.2 (SD 1.3). Flow cytometry confirmed the mesenchymal nature of the cells. Cells from BMAC created earlier and larger colonies of forming units fibroblasts (CFU-F) compared to cells from bone marrow aspirate. BMAC combined with HA can reduce the time needed for healing of bone defects when compared to BMAC in combination with collagen sponge.
虽然自体骨移植是一种有效的工具，可以在局部骨缺损或假关节处诱导成骨再生，但它与明显的供体部位发病率有关，并且受到可用于移植的骨量的限制。我们研究了骨髓抽吸浓缩物（BMAC）增强骨移植和支持骨愈合的潜力。在一项前瞻性临床试验中，我们介绍并评估了 39 例接受 BMAC 治疗的体积骨缺损患者的功能和影像学结果。在 12 例患者中，胶原海绵（Col）作为支架，在另外 27 例患者中应用牛羟磷灰石（HA）。最小随访时间为 6 个月。临床和影像学结果通过体外数据完成。所有患者在随访过程中均在影像学上显示出新骨形成。然而，由于骨愈合不良，有 2 名患者接受了 revision surgery。与 Col 组相比，HA 组术后骨形成出现更早（HA 组：6.8 周 vs. Col 组：13.6 周）。HA 组在 17.3 周后完全愈合，而 Col 组在 22.4 周后完全愈合。BMAC 的平均浓缩因子为 5.2（SD 1.3）。流式细胞术证实了细胞的间充质性质。与骨髓抽吸物中的细胞相比，BMAC 中的细胞形成的成纤维细胞集落形成单位（CFU-F）更早且更大。与 BMAC 联合胶原海绵相比，BMAC 联合 HA 可缩短骨缺损愈合所需的时间。
