Novel bone marrow stem cell Screen-Enrich-Combine (-Biomaterials) Circulating System for limb bone nonunion

Objective To evaluate the validity and security of our self-designed bone marrow stem cell Screen-Enrich-Combine (-Biomaterials) Circulating System (SECCS) for bone non-union of limbs. Methods From May 2013 to December 2015, 24 patients with limb non-union were treated at our department. They were aged from 20 to 65 years (mean, 42.8 years) . Their non-union involved femur in 17 cases, tibia in 4, radius in one, humerus in one and fibula in one. In surgery, 80 mL bone marrow blood was aspirated from the anterior superior iliac spine for rapid preparation of bone substitute (β-TCP) composite with bone marrow stem cells by SECCS which was then implanted at the non-union locations. The bone marrow blood was collected before and after enrichment for stem cell counts. The bone union, clinical union time and related complications were evaluated by follow-up X-rays at 1, 3, 6 and 9 months after surgery. Results Each collection of bone marrow blood took 13.5 minutes on average. The enrichment rate of stem cells was 81.2%.11, 751±1, 011 stem cells were implanted per patient on average. All the patients were followed up for 9 to 48 months (mean, 19.2 months) . Twenty-two patients acquired clinical union 9 months after operation and the other 2 suffered from malunion due to insufficient bone implant, yielding a union rate of 91.6% and an average union time of 6.5 months. No graft infection or internal fixation failure occurred and no severe complications happened at the donor or implant sites. Conclusion The bioactive bone substitute manufactured by our self-designed SECCS can be used as a novel therapy for limb non-union, and this device is moreover characterized with convenience, limited invasion and satisfactory osteogenesis so that complications of autologous bone transplantation can be avoided. Key words: Stem cells; Fractures, ununited; Extremities; Enrichment