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Cellular Therapies

  1. Non Union Fractures (Orthopadics): Non-union is the permanent failure of a bone to heal or join after it has been fractured. It is a serious complication and can occur due to too much friction/movement of the bone, lack of blood supply or the presence of an infection. When the normal process of bone formation is interrupted due to the mentioned factors, the region develops tissue that is considered as scar tissue and lacks healing. Fracture healing is a multidimensional process consisting of four well established stages. Five to ten percent of the complications that arise in fracture healing are delayed union or non-union. Thus, development of a novel therapeutic method to treat non-union fractures’ becomes a clinical necessity.

     

    As bone marrow contains osteogenic progenitor cells, its implantation was proposed in order to potentially lead to efficient bone regeneration. In clinical practice, autologous bone marrow cells are harvested from the iliac crest and immediately transplanted into the site that is in need of skeletal repair. This type of marrow-cell transfer or grafting is a relatively simple procedure that is inexpensive and can be performed intraoperatively at the bedside in a single sitting. With the advent of technology, bedside therapy for stem cells has become possible where the extraction, processing, as well as the injection of bone marrow cell concentrate can be done quickly. Bone marrow is aspirated from the iliac crest and then processed using our intraoperative point-of-care device. Following Bone Marrow processing, the aBMC collected is preconditioned for 5-10 minutes with synthetic graft material i.e. tricalcium phosphate making a semisolid “putty” which is infused between the non-union bones following ORIF.

  2. Avascular Necrosis: Avascular necrosis (AVN), also known as osteonecrosis, aseptic necrosis or ischemic bone necrosis is a disease that may affect several different bones as a result of temporary or permanent loss of the blood supply to these bones (Valérie Gangji).The ischemia causes the death and eventual collapse of the bone tissue, with its overlying joint surface. The femoral head is most commonly affected by this disease (Horia Bogdan ORBAN).Non traumatic osteonecrosis of the femoral head is a painful disorder of the hip that affects young patients with risk factors such as glucocorticoids or alcohol abuse. Initially, patients are asymptomatic, but later there is painful limitation of hip motion, which ultimately, if untreated, leads to joint destruction, requiring surgical treatment and, in latter stages, total hip replacement (THR).

     

    The blood cells present in the bone marrow have potential capability to improve blood supply in the femoral head joint in AVN patients. These potential bone marrow cells when injected can repopulate the trabecular bone structure and subsequently revitalize and remodel the necrotic bone. For this technique, a bone marrow aspirate is harvested from the iliac crest and the mononuclear cell fraction

  3. Spinal Fusion: spinal fusion is a surgical technique used to join two or more vertebrae and involves placing autograft bone from pelvis. However, harvesting bone from the pelvis is associated with severe postoperative pain, and atients experience more pain at the harvest site than at the graft site, thus resulting in poor patient satisfaction (Yoshikawa et al., 2011).

     

    Bone marrow cell concentrate contains a heterogeneous population of endothelial progenitor cells, mesenchymal  stem cells, and hematopoietic stem cells that stimulate angiogenesis to treat disorders of inadequate tissue perfusion. Bone marrow is aspirated from the iliac crest and then processed using our intraoperative point-of-care device. Following Bone Marrow processing, the a BMC collected is infused between the fused bones.