Toosi Shirin, Naderi-Meshkin Hojjat, Moradi Ali, Daliri Mahla, Moghimi Vahid, Majd Hasan-Mehrad, Sahebkar Amir Hossein, Heirani-Tabasi Asieh, Behravan Javad
Department of Pharmaceutical Biotechnology, School of Pharmacy, Mashhad University of Medical Science, Mahhad 9177899191, Iran.
Stem Cells and Regenerative Medicine Research Group, Academic Center for Education Culture and Research (ACECR), Khorasan Razavi Branch, Mashhad 91775-1376, Iran.
ACS Biomater Sci Eng. 2023 Apr 10;9(4):1928-1939. doi: 10.1021/acsbiomaterials.2c00677. Epub 2023 Mar 20.
In this study, the procedure for treating the nonunion complication of scaphoid fractures using collagen/poly glycolic acid (CPGA) scaffolds with bone marrow mesenchymal stem cell (BM-MSC) therapy was adopted and compared with the commonly employed autologous bone tissue graft. With conducting a two-armed clinical trial, 10 patients with scaphoid nonunions were enrolled in this investigation. Patients were randomly assigned to two groups treated with (1) CPGA + cell therapy and (2) autologous iliac crest bone graft standard therapy. Treatment outcomes were evaluated three months after surgery, measuring the grip and pinch strengths and wrist range of motion, with two questionnaires: Patient-Rated Wrist Evaluation (PRWE) and Quick form of Disabilities of the Arm, Shoulder, and Hand (QDASH). We have also assessed the union rate using clinical and radiologic healing criteria one and three months post-operatively. Restorative effects of CPGA + cell therapy were similar to those of the autologous bone graft standard therapy, except for the grip strength ( = 0.048) and QDASH score ( = 0.044) changes, which were higher in the CPGA + cell therapy group. Three months following the surgery, radiographic images and computed tomography (CT) scans also demonstrated that the scaphoid union rate in the test group was comparable to that of scaphoids treated with the standard autograft method. Our findings demonstrate that the CPGA + cell therapy is a potential alternative for bone grafting in the treatment of bone nonunions.
在本研究中，采用了使用胶原蛋白/聚乙醇酸（CPGA）支架结合骨髓间充质干细胞（BM-MSC）疗法治疗舟骨骨折骨不连并发症的方法，并与常用的自体骨组织移植进行比较。通过开展双臂临床试验，10例舟骨骨不连患者参与了本研究。患者被随机分为两组，分别接受（1）CPGA+细胞疗法和（2）自体髂骨移植标准疗法。术后三个月评估治疗效果，使用两份问卷测量握力、捏力和腕关节活动范围：患者自评腕关节评估（PRWE）和手臂、肩部和手部残疾快速评估表（QDASH）。我们还在术后1个月和3个月使用临床和影像学愈合标准评估骨愈合率。CPGA+细胞疗法的修复效果与自体骨移植标准疗法相似，但CPGA+细胞疗法组的握力（P=0.048）和QDASH评分（P=0.044）变化更高。术后三个月，X线图像和计算机断层扫描（CT）也显示，试验组舟骨愈合率与标准自体移植方法治疗的舟骨相当。我们的研究结果表明，CPGA+细胞疗法是治疗骨不连的一种潜在的骨移植替代方法。
