Treatment of Nonunion Fractures With Mesenchymal Stromal Cells (MSCs)

Treatment of Nonunion After Fractures (Pseudoartrosis) Using Mesenchymal Stromal Cells (MSCs)

The goal of this study is to evaluate the bone regeneration capacity of BM-MSC (Bone marrow mesenchymal stromal cells), in patients with nonunion. BM-MSC cultured are seeded on a collagen scaffold, included into autologous platelet-rich plasma (PRP) clot, and implanted in the nonunion bone defect.

Nonunion (pseudoarthrosis) is one of the most serious complications of bone fracture. Even though different treatments have been used to repair nonunion bone defects, most of them have limitations, like morbidities, limited supply, frequent treatment failure, and high cost.

Based on the knowledge that MSC have multipotential capacity of differentiation into bone, cartilage, fat, and endothelial cells, and also, play a key role in the process of bone formation and fracture repair. In this study, we evaluated the use the bone regeneration capacity of autologous or allogeneic BM-MSC, as a potential therapeutic strategy to induce formation of new bone tissue and fracture healing.

A bioengineering construct, constituted by MSCs and a collagen scaffold, is incorporated into platelet rich plasma (PRP) clot, wich is implanted at the nonunion site defect.

Inclusion Criteria:

• Post-traumatic nonunion diagnosis (Pseudoarthrosis) with or without previous ortopaedic treatment
• Patients with or without previous orthopaedic treatment
• Presence of nonunion 9 month or more
• Ossification failure in the non-union area, with an approximate size of 0.5 to 4 cm length

Exclusion Criteria:

• Evidence of infection at the nonunion site (Osteomielitis)
• Evidence of cutaneous lesion at the site of pseudoartrosis
• Viral hepatitis B and C, HIV infection, syphilis and other viral and bacterial infections
• Autoimmune diseases
• Neoplastic diseases
• Pregnancy
• Major metabolic disorders
• Treatment with steroids
• Other conditions or circumstances that compromise the study participation according to medical criteria