"Biological and clinical interest in MSC has increased dramatically over the past two decades, as demonstrated by the ever-growing number of research teams studying these cells."

M. Scaglione, L. Fabbri, D. Dell‘ Omo, F. Gambini, G. Guido – Long bone nonunions treated with autologous concentrated bone marrow- derived cells comined with dried bone allograft


Nowadays, the treatment of pseudoarthrosis remains one of the most complex and debated topics due to the large number of failures. For several years, three factors have been considered essential for the healing process in the relevant literature: Growth factors and hormones, osteoprogenitor cells (mesenchymal stem cells) and extracellular matrix. The mechanical stability of the fracture site is considered the fourth element of the "diamond concept theory".

The aim of our study was to evaluate the validity of biological adjuvants of mechanical synthesis in facilitating a faster healing process of nonunions.

Materials and methods:

We dealt with 19 patients with pseudoarthrosis of the long bone. All patients were treated with concentrated mesenchymal stem cells without autologous bone graft. We used the Extracell BMC aspiration protocol from Regen Lab. The radiological parameters considered for the diagnosis of successful healing were the presence of a bridging callus, fracture line obliteration and bony cortical continuity. Clinically, pain was assessed using the VAS (visual analogue scale) score, where 0 means no pain and 10 means the worst possible pain.


Radiographic examination showed complete healing in 78.9% (15 cases) with an average time to healing of 6.5 months (minimum healing time 80 days), which also corresponds to complete remission of clinical symptoms.


The use of growth factors and autologous mesenchymal stem cells by enforcing the tissue regeneration system is a valid and innovative biotechnological technique for the treatment of long bone pseudoarthrosis.

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