ABSTRACT
PURPOSE: There is evidence showing that mesenchymal stromal cells (MSC) may constitute a potential therapeutic strategy to induce bone regeneration. In this work, we investigate the capacity of autologous bone marrow (BM) MSC loaded on collagen microspheres (CM) and included into autologous platelet-rich plasma (PRP) clots (MSC/CM/PRP) to induce bone formation in patients with nonunion lesions. METHODS: MSC were isolated from BM cells of patients with nonunion lesions. Phenotypical (marker expression) and functional studies (osteogenic differentiation) were performed. MSC were seeded on CM and included into autologous PRP clot (MSC/CM/PRP). The capacity of MSC/CM/PRP to induce bone formation was evaluated in three patients diagnosed with nonunion. RESULTS: MSC loaded on CM/PRP clots maintain their biological functions, in vitro. After three months, post-MSC transplantation, all patients showed evidence of osteogenesis at the site of nonunion. After one year, all patients showed a complete healing of the nonunion. CONCLUSIONS: Our results support the use of autologous MSC transplanted as MSC/CM/PRP for the treatment of nonunion fractures. Future studies incorporating a larger number of patients may confirm the results obtained in this work.
Subject(s)
Bone Regeneration/drug effects , Fractures, Ununited/drug therapy , Mesenchymal Stem Cell Transplantation/methods , Wound Healing/drug effects , Adult , Aged, 80 and over , Collagen/metabolism , Female , Humans , Male , Mesenchymal Stem Cells/cytology , Microspheres , Osteogenesis/drug effects , Platelet-Rich Plasma/drug effectsABSTRACT
Se presenta una revisión sobre 102 intervenciones de Chiari, indicadas como rescate de situaciones complejas derivadas de displasias con incongruencia articular, sublujaciones severas que no pueden ser solucionadas por otras técnicas o lujaciones en niños mayores. Se presentan los requisitos, indicaciones y errores en la técnica. Se hace énfasis en los aspectos biomecánicos favorables de la misma. Igualmente, se realizó la valoración de los casos revisados. Se presenta una revisión de 20 caderas con lujación invertebrada, alta y eventual solución mediante la técnica de Klisic. Se presentan los resultados clínicos y radiológicos en ambos procedimientos
