Could nonunion tissue be transformed capable of bone formation by negative pressure: A new alternative to treat bone nonunion?

Abstract Despite substantial advances in orthopaedic surgery, bone nonunion is still a matter of debate for orthopaedic surgeon to provide optimal options on treatment of nonunion. Negative pressure therapy has already been successfully used in dealing with complex kinds of soft tissue healing. Some studies show that negative pressure can induce mesenchymal stem cells to differentiate into osteoblasts and others suggest that there are some mesenchymal-like cells existing in the nonunion tissue which can be re-activated and transformed into osteoblasts under some circumstance. We hypothesized that under negative pressure the mesenchymal-like cells can be transformed into osteoblasts in nonunion site. Under negative pressure, both "seeds" and "soils" can be made for new bone formation. If our hypothesis is proved to be corrected, it could be an innovative method to treat the bone nonunion.