间充质干细胞植入治疗长骨萎缩性骨不连：一项转化研究。
Mesenchymal stem cell implantation in atrophic nonunion of the long bones: A translational study.
作者信息
Ismail H D, Phedy P, Kholinne E, Djaja Y P, Kusnadi Y, Merlina M, Yulisa N D
机构信息
Stem Cell Medical Technology Integrated Service Unit, Cipto Mangunkusumo General Hospital-Faculty of Medicine, Universitas Indonesia, and Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Otista 3/36, RT 1 RW 8, East Jakarta 13330, Indonesia
Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo General Hospital, Salemba 6, Jakarta Pusat 10430, Indonesia.
出版信息
Bone Joint Res. 2016 Jul;5(7):287-93. doi: 10.1302/2046-3758.57.2000587.
OBJECTIVES
To explore the therapeutic potential of combining bone marrow-derived mesenchymal stem cells (BM-MSCs) and hydroxyapatite (HA) granules to treat nonunion of the long bone.
METHODS
Ten patients with an atrophic nonunion of a long bone fracture were selectively divided into two groups. Five subjects in the treatment group were treated with the combination of 15 million autologous BM-MSCs, 5g/cm(3) (HA) granules and internal fixation. Control subjects were treated with iliac crest autograft, 5g/cm(3) HA granules and internal fixation. The outcomes measured were post-operative pain (visual analogue scale), level of functionality (LEFS and DASH), and radiograph assessment.
RESULTS
Post-operative pain evaluation showed no significant differences between the two groups. The treatment group demonstrated faster initial radiographic and functional improvements. Statistically significant differences in functional scores were present during the first (p = 0.002), second (p = 0.005) and third (p = 0.01) month. Both groups achieved similar outcomes by the end of one-year follow-up. No immunologic or neoplastic side effects were reported.
CONCLUSIONS
All cases of nonunion of a long bone presented in this study were successfully treated using autologous BM-MSCs. The combination of autologous BM-MSCs and HA granules is a safe method for treating nonunion. Patients treated with BM-MSCs had faster initial radiographic and functional improvements. By the end of 12 months, both groups had similar outcomes.Cite this article: H.D. Ismail, P. Phedy, E. Kholinne, Y. P. Djaja, Y. Kusnadi, M. Merlina, N. D. Yulisa. Mesenchymal stem cell implantation in atrophic nonunion of the long bones: A translational study. Bone Joint Res 2016;5:287-293. DOI: 10.1302/2046-3758.57.2000587.
目的
探讨骨髓间充质干细胞（BM-MSCs）与羟基磷灰石（HA）颗粒联合应用治疗长骨骨不连的潜在疗效。
方法
将10例长骨骨折萎缩性骨不连患者选择性分为两组。治疗组5例患者接受1500万个自体BM-MSCs、5g/cm(3)（HA）颗粒及内固定联合治疗。对照组患者接受髂骨自体骨移植、5g/cm(3) HA颗粒及内固定治疗。测量的结果包括术后疼痛（视觉模拟评分）、功能水平（LEFS和DASH）及影像学评估。
结果
术后疼痛评估显示两组间无显著差异。治疗组在影像学和功能方面最初改善更快。在第1个月（p = 0.002）、第2个月（p = 0.005）和第3个月（p = 0.01）时，功能评分存在统计学显著差异。到1年随访结束时，两组取得了相似的结果。未报告免疫或肿瘤相关副作用。
结论
本研究中所有长骨骨不连病例均使用自体BM-MSCs成功治疗。自体BM-MSCs与HA颗粒联合是治疗骨不连的一种安全方法。接受BM-MSCs治疗的患者在影像学和功能方面最初改善更快。到12个月结束时，两组结果相似。引用本文：H.D.伊斯梅尔，P.费迪，E.霍林内，Y.P.贾贾，Y.库斯纳迪，M.梅尔利纳，N.D.尤利萨。间充质干细胞植入治疗长骨萎缩性骨不连：一项转化研究。骨关节研究2016；5：287 - 293。DOI：10.1302/2046 - 3758.57.2000587。
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