Allogeneic cortical bone complex for fracture nonunion and bone defects

Wang Bin; L Hao-ran; Wang Wei-xiong; Li Sheng

doi:10.3969/j.issn.2095-4344.2013.51.007

Abstract：BACKGROUND:Dried al ogeneic cortical bone has a porous structure, with uniform and interconnected holes at an aperture of about 200μm, and the morphological structure is very similar to human bone. <br> OBJECTIVE:To study the clinical effects of the compound graft of al ogeneic cortical bone, bone marrow mesenchymal stem cells and bone morphogenetic protein in the treatment of fracture nonunion and traumatic bone defects. <br> METHODS:Thirty-three patients with traumatic bone defects were enrol ed, including 19 males and 14 females, aged 26-85 years. First, autologous bone marrow mesenchymal stem cells were isolated and cultured. Then al ogeneic cortical bone as scaffold material was implanted with bone marrow mesenchymal stem cells and bone morphogenetic protein to synthesize al ogeneic cortical bone complex that was grafted into bone defects (20-45 g per case). <br> RESULTS AND CONCLUSION:Al the patients were fol owed up for 6 months to 2.5 years. According to the Mankin and Komender standard evaluation of al ogeneic bone transplantation, there were 32 cases with satisfaction and one case with dissatisfaction. The X-ray films at reexamination showed that 32 patients had bone healing, with fresh fracture healing time of 2-7 months and old fracture healing time of 4-9 months. The al ogeneic cortical bone complex began to be fused with autologous bone through creeping substitution 6-9 weeks after transplantation. One case, which had delayed infection, had bone union by removing internal fixation, placing irrigating tube and grafting after local stability. During the fol ow-up of 25 months, no relapse was found. Another case had nonunion because of plate loosening, and received secondary internal fixation and autogenous bone graft. The al ogeneic cortical bone complex exhibits no evident side effects and is effective in the treatment of fracture nonunion and traumatic bone defects.