Riishede Hansen Mads, Ding Ming, Søndergaard Folkvardsen Steffen, Gjørup Sækmose Susanne, Kold Søren, Viberg Bjarke, Halling Dreyer Chris
Næstved, Slagelse and Ringsted Hospitals, Næstved, Denmark.
Odense University Hospital, Odense, Denmark.
Arch Orthop Trauma Surg. 2025 Jul 23;145(1):384. doi: 10.1007/s00402-025-05922-9.
This scoping-review aims to highlight the current modalities of sole use of stem cells in treating fracture nonunion updating a previous systematic review from 2013. We report solitary stem cell stimulation in literature in vivo studies to obtain current knowledge in understanding the crucial role of stem cells in enhancing fracture nonunion healing.
This scoping review was conducted by systematical search in PubMed, Medline and clinicaltrials.gov with a timeframe from October 2012 to September 2024. Two authors independently screened all articles, and when included, the following information was extracted: type of nonunion, localization, type of stem cells, administered dose of stem cells, surgical information, type of scaffold, control group, evaluation method, time of evaluation post intervention, and adverse events.
Of 4710 articles screened, 27 articles met the criteria for inclusion. In the reviewed articles, 2 out of 5 human studies, and 8 out of 12 animal studies with a control group reported a statistically significant effect of stem cells on bone healing when used in the treatment of fracture nonunion. Comparison of the studies was difficult due to heterogeneity. The administration of mesenchymal stem cells regarding adverse events was investigated in eight human studies.
Based on our reporting, the articles suggest that the perspectives of the sole use of mesenchymal stem cells in the management of fracture nonunion might be promising but remain inconclusive. Future research should be inspired by existing literature and focus on the development of well-standardized methodologies and results published.
本综述旨在突出当前单独使用干细胞治疗骨折不愈合的方式，更新2013年的一项系统评价。我们报告了文献中体内研究中单独的干细胞刺激情况，以获取当前关于理解干细胞在促进骨折不愈合愈合中关键作用的知识。
本综述通过在PubMed、Medline和clinicaltrials.gov上进行系统检索，时间范围为2012年10月至2024年9月。两位作者独立筛选所有文章，纳入时提取以下信息：不愈合类型、部位、干细胞类型、干细胞给药剂量、手术信息、支架类型、对照组、评估方法、干预后评估时间以及不良事件。
在筛选的4710篇文章中，27篇符合纳入标准。在纳入综述的文章中，5项人体研究中的2项以及12项有对照组的动物研究中的8项报告称，干细胞用于治疗骨折不愈合时对骨愈合有统计学显著效果。由于异质性，研究间的比较困难。8项人体研究调查了间充质干细胞给药的不良事件。
根据我们的报告，文章表明单独使用间充质干细胞治疗骨折不愈合的前景可能广阔，但仍无定论。未来的研究应以现有文献为灵感，专注于开发标准化良好的方法并发表结果。
