New approach to treating non-healing bone fractures

Stem cell procedure aims to heal in a less painful manner.

Mark Lee, UC Davis

A method for producing a type of natural stem-cell grout that can be used to treat patients whose fractured bones fail to fully heal is being tested as part of a clinical trial by UC Davis orthopedic surgeons. The surgeons are using a specialized syringe and new cell separation equipment to extract stem-cell-rich bone marrow from the pelvises of patients. Called bone marrow aspiration, the surgical team considers it a less-invasive procedure for obtaining the stem cells needed to repair non-healing bones. They say the technique could enable people to avoid the current standard procedure, which involves surgically removing bone and bone marrow from the pelvis and transplanting it to the fracture site.

“We are offering a promising new alternative for augmenting bone regeneration,” said Mark A. Lee, associate professor of orthopedic surgery and principal investigator of the study. “Surgically removing bone and marrow from a patient’s hip can involve considerable pain and a long recovery. We’re hoping to avoid these problems while remaining at least as effective.”

For most people who have suffered a fracture in one of their long bones — the femur or tibia in the upper and lower leg, respectively, or the humerus in the upper arm — recovery normally takes from three to six months for the broken ends of the bone to grow back together. Although most fractures respond well to surgery, some cases defy the best efforts of surgeons and do not fully heal, leaving a gap between the broken ends and causing serious complications.

According to the American Academy of Orthopaedic Surgeons, about 6 million individuals suffer fractures each year in North America. In about 5 to 10 percent of cases, patients suffer either delayed healing or fractures that do not heal. The problem is especially troubling for the elderly, many of whom suffer from osteoporosis, a condition in which bones become weak and break more easily. For an older person, a fracture affects quality of life because it significantly reduces function and mobility, and requires an extended period of recuperation.

Lee and his colleagues are working with Rancho Cordova-based ThermoGenesis and Texas-based Celling Technologies to evaluate the effectiveness of a new cell processing device made by the companies that enables the sterile transfer of bone marrow during surgery. The device separates out bone-forming cells — including stem cells — and produces a concentrated solution of cells the surgeons mix with tiny pieces of donor bone to create the grout-like mixture that serves as the framework for new bone formation. Surgeons pack the mixture into the fracture area before suturing the incision site closed.

“Dr. Lee’s clinical trial is the culmination of five years of collaboration with a high-tech firm, the UC Davis School of Veterinary Medicine and our Department of Orthopaedics,” said Jan Nolta, director of the UC Davis Institute for Regenerative Cures. “It is a great model for bringing together industry, academics and medicine to rapidly develop and test important new technology to improve clinical care for patients.”

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