New Treatment for Broken Bones, Using Stem Cells (Osteoblasts)
If you've ever had a broken bone, you know that there are several ways to repair the fracture. One way is to splint or cast the bone and wait for it to heal on it's own, or if the fracture is complex, surgery may be necessary where the option's for internal fixation would be, rods and screws, plates and screws, or pins and wires, and some require bone transplantation obtained usually from the hip (iliac crest) to fill the non union portion of the fracture. All of these approaches, aside from casting, involve surgery, a hospital stay of several days, physical therapy, bone graft site and surgical site healing.
When your surgeon harvests bone from your hip, an incision is made above the bone and then they extract and collect the bone with a drilling device. This approach has to heal just like the fracture repair portion and sometimes problems occur, like bone infection, delayed incision healing, and additional pain from the process of removing the necessary bone from your hip to transplant to the fracture site. Generally you have to be careful applying weight to the site, during the healing process, to prevent the possible blockage of blood flow to the area. If you've had this procedure you are well aware of the additional pain this part of the procedure causes, and the additional physical limitations since you are trying to heal two separate areas of the body at the same time.
After the doctor cuts the incision and the muscles, the internal fixation is placed into the bone and then the bone grafting pieces are place into the gap between the two ends of the broken bone. Once all of this is accomplished the surgeon closes the incision with various types of sutures.
You will be given certain physical restrictions and advice on proper exercise to speed the recovery process. A physical therapist will show you what to do in the hospital and send you home with instructions on how to shower, dress, drive, walk, and sit correctly. The doctor usual orders crutches to aid in walking during the recovery phase.
If the incision heals properly the stitches will be removed when the epidermis heals completely. Occasionally drainage tubes are used to collect excess bleeding from the surgical site, but generally this only happens if you have trouble with bleeding. This blood collection process helps to remove excess blood from the surgical site so clots don't develop.
Healing time depends on the individual, but the average amount of time for a long bone fracture to heal is approximately three to six months. There is another option to this long recovery time and surgery, explained by a study done in Korea.
Doctors in Korea recently studied stem cell injection's of osteoblasts for accelerated fracture healing. Dr. Seok-Jung Kim led this study of stem cell injections on patients with simple long bone fractures, at the Catholic University College of Medicine in Seoul.
Dr. Kim divided his patients into two groups ranging from fifteen to sixty-five years of age and neither age nor sex had any affect on healing. The study, in Seoul, didn't show any adverse events from the injection.
The first group of patients, with fractures, would be left to heal on their own, and the other group received stem cell injections harvested from their own bone marrow. The group that received the stem cells healed sooner and produced more bone in the fracture site. Bone growth was measured by callus formation at the fracture site, so the recipients of stem cells showed faster healing and bone union between the two areas of the broken bone.
Harvesting osteoblasts stem cells:
Doctors in the study obtained the stem cells from the patients' iliac crest, using a syringe that is inserted into the bone and subsequently into the marrow and collected a pre-determined amount that would later be cultured in the lab with other bone agents, like bone alkaline phosphatase and bone-specific monoclonal antibody, Type I collagen. During this process, the osteoblast's are isolated out of the stem cells and used in the injection.
Which bones are long bones?
We have many long bones in the body, the most commonly known are the femur, tibia, radius, ulna, and humerus.
Simple fractures are the type that don't require internal fixation where the bone breaks into two segments without complex shattering or multiple fracture sites in one bone. This study utilized patients with these two criteria's, simple long bone fractures.
After the Doctors obtain the stem cells they are transplanted with the use of a syringe guided by an X-ray into the fracture site. The Doctor's used local anesthesia to transplant the stem cells, and the patient can return to their normal routine immediately following the injection with no hospital stay.
With these injections patients didn't have to undergo surgery with internal fixation, anesthesia, or lengthy recovery with physical therapy.
The patient's progress was assessed over a two month period where they visited the hospital at one week, one month and two month intervals post injection. The Doctor used X-rays to evaluate the progress of bone growth and callus formation, which eventually led to full fracture healing.
Benefits of this procedure:
• Fracture repair without surgery
• Local anesthesia used
• Performed out-patient
• Eliminate recovery from damage to skin and muscle cutting
• Eliminate internal fixation
• Eliminate bone grafting
• Recovery time reduced
• Less expensive
• Pain is greatly reduced
• Prevention of complications from surgery
Since this procedure is relatively simple, compared to traditional surgery, this type of repair for simple long bone fractures seems far superior to surgical intervention.