A case series utilizing bone marrow aspirate concentrate, cancellous bone autograft, platelet-rich plasma and autologous fibrin for the treatment of femur nonunions

References

• Ebraheim NA, Martin A, Sochacki, et al. Nonunion of distal femoral fractures: a systematic review. Orthop Surg. 2013;5(1):46–50. doi:10.1111/os.12017
   PubMed Web of Science ®Google Scholar
• Magida N, Myezwa H, Mudzi W. Factors informing the development of a clinical pathway and patients' quality of life after a nonunion fracture of the lower limb. In: Healthcare. Basel, Switzerland: MDPI; 2023. p. 1810. doi:10.20944/preprints202305.0679.v1
   Google Scholar
• Brinker MR, Trivedi A, O'Connor DP. Debilitating effects of femoral nonunion on health-related quality of life. J Orthop Trauma 2017;31(2):e37–42. doi:10.1097/BOT.0000000000000736
   PubMed Web of Science ®Google Scholar
• Johnson L, Igoe E, Kleftouris G, et al. Physical health and psychological outcomes in adult patients with long-bone fracture nonunions: evidence today. J Clin Med. 2019;8(11):1998. doi:10.3390/jcm8111998
   PubMed Web of Science ®Google Scholar
• Quan K, Xu Q, Zhu M, et al. Analysis of risk factors for nonunion after surgery for limb fractures: a case-control study of 669 subjects. Front Surg. 2021;8:754150. doi:10.3389/fsurg.2021.754150
   PubMed Web of Science ®Google Scholar
• Moghaddam A, Ermisch C, Schmidmaier G. Nonunion current treatment concept. J Res Orthop Sci. 2016;3(1):e4546. doi:10.17795/soj-4546
   Google Scholar
• Gomez-Barrena E, Rosset P, Gebhard F, et al. Feasibility and safety of treating nonunions in tibia, femur and humerus with autologous, expanded, bone marrow-derived mesenchymal stromal cells associated with biphasic calcium phosphate biomaterials in a multicentric, non-comparative trial. Biomaterials. 2019;196:100–108. doi:10.1016/j.biomaterials.2018.03.033
   PubMed Web of Science ®Google Scholar
• Dulic O, Rasovic P, Lalic I, et al. Bone marrow aspirate concentrate versus platelet rich plasma or hyaluronic acid for the treatment of knee osteoarthritis. Medicina (B Aires). 2021;57(11):1193. doi:10.3390/medicina57111193
   Google Scholar
• Dulic O, Lalic I, Kecojevic V, et al. Do knee injection portals affect clinical results of bone marrow aspirate concentrate injection in the treatment of osteoarthritis? A prospective randomized controlled study. Regen Med. 2020;15(8):1987–2000. doi:10.2217/rme-2020-0020
   PubMed Web of Science ®Google Scholar
• Rasovic P, Dulic O, Lalic I, et al. The role of osteoarthritis severity, BMI and age on clinical efficacy of bone marrow aspirate concentrate in the treatment of knee osteoarthritis. Regen Med. 2023;18(9):735–747. doi:10.2217/rme-2023-0042
   PubMedGoogle Scholar
• Yamaguchi FSM, Shams S, Silva EA, et al. PRP and BMAC for musculoskeletal conditions via biomaterial carriers. Int J Mol Sci. 2019;20(21):5328. doi:10.3390/ijms20215328
   PubMed Web of Science ®Google Scholar
• Han Y, Li X, Zhang Y, et al. Mesenchymal stem cells for regenerative medicine. Cells. 2019;8(8):886. doi:10.3390/cells8080886
   PubMed Web of Science ®Google Scholar
• Lana JFSD, da Fonseca LF, da Rocha Macedo R, et al. Platelet-rich plasma vs bone marrow aspirate concentrate: an overview of mechanisms of action and orthobiologic synergistic effects. World J Stem Cells. 2021;13(2):155. doi:10.4252/wjsc.v13.i2.155
   PubMed Web of Science ®Google Scholar
• Everts P, Onishi K, Jayaram P, et al. Platelet-rich plasma: new performance understandings and therapeutic considerations in 2020. Int J Mol Sci. 2020;21(20):7794. doi:10.3390/ijms21207794
   PubMed Web of Science ®Google Scholar
• Dulić O, Lalić I, Janjić N, et al. In step with contemporary trends-stem-celltherapy as a key driver of regenerative orthopedics at the Clinical Center of Vojvodina-preliminary data for the treatment of knee osteoarthritis and osteochondral lesions. Med Pregl. 2016;69(Suppl. 1):77–84. doi:10.2298/MPNS16S1077D
   Google Scholar
• Andia I, Maffulli N. Anti-inflammatory and Matrix Restorative Mechanisms of Platelet-Rich Plasma in Osteoarthritis: Letter to the Editor. Am J Sports Med [Internet]. 2014;42(6):NP32. doi:10.1177/0363546514536690
   PubMedGoogle Scholar
• Andersen C, Wragg NM, Shariatzadeh M, et al. The use of platelet-rich plasma (PRP) for the management of nonunion fractures. Curr Osteoporos Rep. 2021;19:1–14. doi:10.1007/s11914-020-00643-x
   PubMed Web of Science ®Google Scholar
• Ghaffarpasand F, Shahrezaei M, Dehghankhalili M. Effects of platelet rich plasma on healing rate of long bone nonunion fractures: a randomized double-blind placebo controlled clinical trial. Bull Emerg Trauma. 2016;4(3):134.
   PubMedGoogle Scholar
• Yoon B-H, Park IK, Kim Y, et al. Incidence of nonunion after surgery of distal femoral fractures using contemporary fixation device: a meta-analysis. Arch Orthop Trauma Surg. 2021;141:225–233. doi:10.1007/s00402-020-03463-x
   PubMed Web of Science ®Google Scholar
• Singh SP, Bhalodiya HP. Outcome and incidence of periprosthetic supracondylar femoral fractures in TKA. Indian J Orthop. 2013;47:591–597. doi:10.4103/0019-5413.121586
   PubMed Web of Science ®Google Scholar
• Biasibetti A, Aloj D, Di Gregorio G, et al. Mechanical and biological treatment of long bone nonunions. Injury. 2005;36(4):S45–S50. doi:10.1016/j.injury.2005.10.013
   PubMedGoogle Scholar
• Gobbi A, Dallo I, D'Ambrosi R. Autologous microfragmented adipose tissue and leukocyte-poor platelet-rich plasma combined with hyaluronic acid show comparable clinical outcomes for symptomatic early knee osteoarthritis over a two-year follow-up period: a prospective randomized clinical. Eur J Orthop Surg Traumatol. 2023;33(5):1895–1904. doi:10.1007/s00590-022-03356-2
   PubMedGoogle Scholar
• D'Ambrosi R, Biancardi E, Massari G, et al. Survival analysis after core decompression in association with platelet-rich plasma, mesenchymal stem cells, and synthetic bone graft in patients with osteonecrosis of the femoral head. Joints. 2018;6(01):16–22. doi:10.1055/s-0038-1626740
   PubMedGoogle Scholar
• Nicholson JA, Makaram N, Simpson A, et al. Fracture nonunion in long bones: a literature review of risk factors and surgical management. Injury. 2021;52:S3–S11. doi:10.1016/j.injury.2020.11.029
   PubMed Web of Science ®Google Scholar
• Friedrich JB, Moran SL, Bishop AT, et al. Free vascularized fibula grafts for salvage of failed oncologic long bone reconstruction and pathologic fractures. Microsurg Off J Int Microsurg Soc Eur Fed Soc Microsurg. 2009;29(5):385–392. doi:10.1002/micr.20624
   Google Scholar
• Ilizarov GA. The principles of the Ilizarov method. Bull Hosp Jt Dis Orthop Inst. 1988;48(1):1–11.
   PubMedGoogle Scholar
• Mercado-Pagán ÁE, Stahl AM, Shanjani Y, Yang Y. Vascularization in bone tissue engineering constructs. Ann Biomed Eng. 2015;43:718–729. doi:10.1007/s10439-015-1253-3
   PubMed Web of Science ®Google Scholar
• Wakefield SM, Papakostidis C, Giannoudis VP, et al. Distraction osteogenesis versus induced membrane technique for infected tibial nonunions with segmental bone loss: a systematic review of the literature and meta-analysis of available studies. Eur J Trauma Emerg Surg. 2023;1–17. doi:10.1007/s00068-023-02375-w
   Web of Science ®Google Scholar
• Xie L, Huang Y, Zhang L, et al. Ilizarov method and its combined methods in the treatment of long bone defects of the lower extremity: systematic review and meta-analysis. BMC Musculoskelet Disord. 2023;24(1):891. doi:10.1186/s12891-023-07001-9
   PubMed Web of Science ®Google Scholar
• Masquelet A, Kanakaris NK, Obert L, et al. Bone repair using the Masquelet technique. JBJS. 2019;101(11):1024–1036. doi:10.2106/JBJS.18.00842
   PubMed Web of Science ®Google Scholar
• Wang P, Wu Y, Rui Y, et al. Masquelet technique for reconstructing bone defects in open lower limb fracture: analysis of the relationship between bone defect and bone graft. Injury. 2021;52(4):988–995. doi:10.1016/j.injury.2020.12.009
   PubMed Web of Science ®Google Scholar
• Mi M, Papakostidis C, Wu X, Giannoudis PV. Mixed results with the Masquelet technique: a fact or a myth? Injury. 2020;51(2):132–135. doi:10.1016/j.injury.2019.12.032
   PubMed Web of Science ®Google Scholar
• Morelli I, Drago L, George DA, et al. Masquelet technique: myth or reality? A systematic review and meta-analysis. Injury. 2016;47:S68–S76. doi:10.1016/S0020-1383(16)30842-7
   PubMed Web of Science ®Google Scholar
• Panteli M, Vun JSH, Pountos I, et al. Biological and molecular profile of fracture nonunion tissue: a systematic review and an update on current insights. J Cell Mol Med. 2022;26(3):601–623. doi:10.1111/jcmm.17096
   PubMed Web of Science ®Google Scholar
• Kanakaris NK, Lasanianos N, Calori GM, et al. Application of bone morphogenetic proteins to femoral nonunions: a 4-year multicentre experience. Injury. 2009;40:S54–S61. doi:10.1016/S0020-1383(09)70013-0
   PubMed Web of Science ®Google Scholar
• Emara KM, Diab RA, Emara AK. Recent biological trends in management of fracture nonunion. World J Orthop. 2015;6(8):623. doi:10.5312/wjo.v6.i8.623
   PubMedGoogle Scholar
• Utomo DN, Hernugrahanto KD, Edward M, et al. Combination of bone marrow aspirate, cancellous bone allograft, and platelet-rich plasma as an alternative solution to critical-sized diaphyseal bone defect: a case series. Int J Surg Case Rep. 2019;58:178–185. doi:10.1016/j.ijscr.2019.04.028
   PubMed Web of Science ®Google Scholar
• Laubach M, Suresh S, Herath B, et al. Clinical translation of a patient-specific scaffold-guided bone regeneration concept in four cases with large long bone defects. J Orthop Transl. 2022;34:73–84. doi:10.1016/j.jot.2022.04.004
   PubMed Web of Science ®Google Scholar
• Laubach M, Hildebrand F, Suresh S, et al. The concept of scaffold-guided bone regeneration for the treatment of long bone defects: current clinical application and future perspective. J Funct Biomater. 2023;14(7):341. doi:10.3390/jfb14070341
   PubMed Web of Science ®Google Scholar
• Chu W. Treatment of nonunion with autologous bone transplantation combined with platelet-rich plasma and extracorporeal shock wave. Zhongguo gu Shang= China J Orthop Traumatol. 2019;32(5):434–439. doi:10.3969/j.issn.1003-0034.2019.05.009
   PubMedGoogle Scholar
• Desai P, Hasan SM, Zambrana L, et al. Bone mesenchymal stem cells with growth factors successfully treat nonunions and delayed unions. HSS Journal^®. 2015;11(2):104–111. doi:10.1007/s11420-015-9432-1
   PubMedGoogle Scholar
• Imam MA, Holton J, Ernstbrunner L, et al. A systematic review of the clinical application and complication of bone marrow aspirate concentrate in management of bone defects and nonunions. International Orthopedics. 2017;41:2213–2220. doi:10.1007/s00264-017-3597-9
   PubMed Web of Science ®Google Scholar