Jäger Marcus, Hernigou Philippe, Zilkens Christoph, Herten Monika, Li Xinning, Fischer Johannes, Krauspe Rüdiger
Dept. of Orthopaedics, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr Düsseldorf, Germany;
Orthop Rev (Pavia). 2010 Sep 23;2(2):e20. doi: 10.4081/or.2010.e20.
In addition to osteosynthetic stabilizing techniques and autologous bone transplantations, so-called orthobiologics play an increasing role in the treatment of bone healing disorders. Besides the use of various growth factors, more and more new data suggest that cell-based therapies promote local bone regeneration. For ethical and biological reasons, clinical application of progenitor cells on the musculoskeletal system is limited to autologous, postpartum stem cells. Intraoperative one-step treatment with autologous progenitor cells, in particular, delivered promising results in preliminary clinical studies. This article provides an overview of the rationale for, and characteristics of the clinical application of cell-based therapy to treat osseous defects based on a review of existing literature and our own experience with more than 100 patients. Most clinical trials report successful bone regeneration after the application of mixed cell populations from bone marrow. The autologous application of human bone marrow cells which are not expanded ex vivo has medico-legal advantages. However, there is a lack of prospective randomized studies including controls for cell therapy for bone defects. Autologous bone marrow cell therapy seems to be a promising treatment option which may reduce the amount of bone grafting in future.
除了骨合成稳定技术和自体骨移植外，所谓的骨生物制剂在骨愈合障碍的治疗中发挥着越来越重要的作用。除了使用各种生长因子外，越来越多的新数据表明基于细胞的疗法可促进局部骨再生。出于伦理和生物学原因，祖细胞在肌肉骨骼系统上的临床应用仅限于自体产后干细胞。特别是，术中自体祖细胞一步治疗在初步临床研究中取得了有前景的结果。本文基于对现有文献的回顾以及我们对100多名患者的经验，概述了基于细胞的疗法治疗骨缺损的临床应用原理和特点。大多数临床试验报告了应用来自骨髓的混合细胞群后成功的骨再生。未在体外扩增的人骨髓细胞的自体应用具有医学法律优势。然而，缺乏包括骨缺损细胞治疗对照的前瞻性随机研究。自体骨髓细胞疗法似乎是一种有前景的治疗选择，未来可能会减少骨移植的量。
