Department of Orthopaedic and Traumatology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Stem Cell Medical Technology Integrated Service Unit, Cipto Mangunkusumo Central Hospital, Faculty of Medicine, Universitas Indonesia, CMU 2 Building 5th Floor, Jl. Diponegoro 71, Jakarta Pusat, Indonesia.
Eur J Orthop Surg Traumatol. 2021 Feb;31(2):265-273. doi: 10.1007/s00590-020-02765-5. Epub 2020 Aug 17.
The current 'gold-standard' treatment of critical-sized bone defects (CSBDs) is autografts; however, they have drawbacks including lack of massive bone source donor site morbidity, incomplete remodeling, and the risk of infection. One potential treatment for treating CSBDs is bone marrow-derived mesenchymal stem cells (BM-MSCs). Previously, there were no studies regarding the use of human umbilical cord-mesenchymal stem cells (hUC-MSCs) for treating BDs. We aim to investigate the use of allogeneic hUC-MSCs for treating CSBDs.
We included subjects who were diagnosed with non-union fracture with CSBDs who agreed to undergo hUC-MSCs implantation. All patients were given allogeneic hUC-MSCs. All MSCs were obtained and cultured using the multiple-harvest explant method. Subjects were evaluated functionally using the Lower Extremity Functional Scale (LEFS) and radiologically by volume defect reduction.
A total of seven (3 male, 4 female) subjects were recruited for this study. The subjects age ranged from 14 to 62 years. All seven subjects had increased LEFS during the end of the follow-up period, indicating improved functional ability. The follow-up period ranged from 12 to 36 months. One subject had wound dehiscence and infection, and two subjects developed partial union.
Umbilical cord mesenchymal stem cells are a potential new treatment for CSBDs. Additional studies with larger samples and control groups are required to further investigate the safety and efficacy of umbilical cord-derived mesenchymal stem cells for treating CSBDs.
目前治疗临界尺寸骨缺损（CSBD）的“金标准”治疗方法是自体移植物；然而，它们存在一些缺点，包括缺乏大量的骨源供体部位发病率、不完全重塑和感染的风险。一种治疗 CSBD 的潜在方法是骨髓间充质干细胞（BM-MSCs）。以前，没有关于使用人脐带间充质干细胞（hUC-MSCs）治疗 BD 的研究。我们旨在研究使用同种异体 hUC-MSCs 治疗 CSBD。
我们纳入了诊断为 CSBD 非愈合骨折并同意接受 hUC-MSCs 植入的患者。所有患者均给予同种异体 hUC-MSCs。所有 MSC 均采用多收获外植体法获得和培养。通过下肢功能评分（LEFS）和体积缺损减少进行功能评估。
共有 7 名（3 名男性，4 名女性）患者入组本研究。患者年龄为 14 至 62 岁。所有 7 名患者在随访期末的 LEFS 均增加，表明功能能力得到改善。随访时间为 12 至 36 个月。1 名患者出现伤口裂开和感染，2 名患者发生部分愈合。
脐带间充质干细胞是治疗 CSBD 的一种有潜力的新方法。需要进行更多的研究，包括更大的样本量和对照组，以进一步研究脐带源性间充质干细胞治疗 CSBD 的安全性和有效性。
