Chinese Journal of Tissue Engineering Research ›› 2010, Vol. 14 ›› Issue (18): 3412-3416.doi: 10.3969/j.issn.1673-8225.2010.18.045

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Transplantation of artificial bone with autologous bone marrow combined with iliac periosteum for treatment of refractory bone nonunion in limbs Comparison to artificial bone with autologous bone marrow transplantation and simple iliac periosterum transplantation

Ge Jian-hua, Zhuo Nai-qiang, Lu Xiao-bo, Zhang Zhong-jie, Chen Ge   

  1. Department of Bone and Joint Surgery, Affiliated Hospital of Luzhou Medical College, Luzhou   646000, Sichuan Province, Chin
  • Online:2010-04-30 Published:2010-04-30
  • Contact: Lu Xiao-bo, Master, Professor, Master’s supervisor, Department of Bone and Joint Surgery, Affiliated Hospital of Luzhou Medical College, Luzhou 646000, Sichuan Province, China luxiaobo1963@126.com
  • About author:Ge jian-hua★, Master, Attending physician, Department of Bone and Joint Surgery, Affiliated Hospital of Luzhou Medical College, Luzhou 646000, Sichuan Province, China gjhua2328@126.com
  • Supported by:

    A Grant from the Health Department of Sichuan Province, No. (chuan) 080201*; Science and Technology Bureau of Luzhou City, No. (lu)2008-50*

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Abstract:

BACKGROUND: Autologous bone marrow is the only tissue that contains abundant osteoinductive osteogenitor cells and is the first-choice transplantation materials for treatment of bone nonunion. Artificial bone with osteoinductive capacity can provide a supporting effect for the in-growth of osteocytes. Iliac periosteum can be used for treatment of bone nonunion due to the advantages including abundant blood circulation, easy harvesting, and able to improve local arterial blood supply. 
OBJECTIVE: To treat refractory bone nonunion in limbs using artificial bone with autologous bone marrow combined with iliac periosteum transplantation, and to compare the therapeutic efficacy to artificial bone with autologous bone marrow transplantation and simple iliac periosterum transplantation. 
METHOD: Thirty-nine refractory bone nonunion limbs from 36 patients were assigned to three groups: artificial bone with autologous bone marrow combined with iliac periosteum transplantation (combination group, n = 19), artificial bone with autologous bone marrow (bone marrow group, n = 9), and autologous iliac periosteum (iliac periosteum group, n = 11). The time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score were evaluated.
RESULTS AND CONCLUSION: All initial 39 limbs acquired bone union and were followed up for an average period of 18.5 months. The combination group yielded better therapeutic effects than the bone marrow group and the iliac periosteum group in terms of the time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score (P < 0.05). These findings indicate that artificial bone with autologous bone marrow combined with iliac periosteum transplantation exhibits better clinical therapeutic effects in treatment of refractory bone nonunion in limbs.

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