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Phases 1-3 clinical trials using adult stem cells in osteonecrosis and nonunion fractures

Hauzeur JP, Gangji V

Stem cells international, 2010

Abstract

NONUNION FRACTURES AND ASEPTIC BONE NECROSIS ARE TWO PATHOLOGICAL CONDITIONS HAVING SOME IMPAIRMENT OF THE CELLULAR PART OF THE REPAIR: a reduction of MSC and of the osteoblastic activation. Both are good candidates for cell-based therapies using stem cells. We made a review of the published human trials. Only autologous bone marrow aspirate implantation was until now used. In Nonunion, a direct injection-15 to 150 ml-was made in 4 case series studies. In another, the bone marrow aspirate was concentrated before injection. The results were good. In bone necrosis, only one level 1 study was published. The results at 24 months were positive in terms of reduction of the necrosis and appearance of collapse. In 3 case series studies, a treatment with concentrated bone marrow aspirates was deemed useful with good results in 76 to 96%. These results are interesting but need confirmation by controlled studies.

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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