Mesenchymal stem cells (MSCs) are adult stem cells traditionally found in the bone marrow. These stem cells are used to cure non-unions.
The way it works is - these stem cells are extracted from bone marrow (hip bone) under local anesthesia. Once collected, these stem cells are injected into the target region (fracture or non-union) for consolidation.
This approach could potentially help in reducing the consolidation period. This can be extremely beneficial for Tibia lengthening, where complete external procedure can take as much as one year. My question is why haven't anyone (I mean LLers) done this procedure, even though this has been available fore quite some time now. Are there any side effects ? Is this not going to significantly impact consolidation time ? Thanks in advance for your response.
Stem cells for faster bone consolidation
Anyone have more info, it seems too good to be true
Yes theoretically, they can greatly improve consolidation. The problem is finding a reasonable price and method of injecting said stem cells. From what I can tell I don't think that type of technology is so easily available to the public.
I consulted with one doctor in Delhi and he quoted price of 1.5 - 2 lac Rupees (which is about 2000 - 3000 USD). So pricing seams reasonable, especially when you consider the value it offers - significantly shortens consolidation.
Since this procedure relies on accelerating body's natural bone formation ability, and not on some external bone like materials like resorbable bone cement or other grafting materials, I'm tempted to think there are no side effects involved with stem cell procedure. I'm however skeptical as it sounds too good to be true, and want to know more from experts and veteran LLers on this forum. thanks.
How much time would it be supposed to save ?
Quote from: fujitora on September 12, 2016, 07:21:41 PMMesenchymal stem cells (MSCs) are adult stem cells traditionally found in the bone marrow. These stem cells are used to cure non-unions.
The way it works is - these stem cells are extracted from bone marrow (hip bone) under local anesthesia. Once collected, these stem cells are injected into the target region (fracture or non-union) for consolidation.
This approach could potentially help in reducing the consolidation period. This can be extremely beneficial for Tibia lengthening, where complete external procedure can take as much as one year. My question is why haven't anyone (I mean LLers) done this procedure, even though this has been available fore quite some time now. Are there any side effects ? Is this not going to significantly impact consolidation time ? Thanks in advance for your response.
I had stem cell therapy last week Friday. I have no clue how it works so im as curious as everyone else. My consolidation was disgustingly poor and i had literally no time left to stay in turkey (where i'vebeen doing my LL) so the hospital just said they would do it. And free of extra charge. I didn't know it was done under local anaesthetic as well, i just woke up and my frames were off and some kind of plaster was on my hip. I guess they decided to do both in one hit.
As for whether it works, definitely!! My bones aren't fully consolidated but they've grown so rapidly to close the gap. So there is a thin sheet of bone unifying the fracture. This is my understanding, of what has been explained to me, I haven't even seen my own xray as im still in my hospital bedroom learning to walk without frames. I am expected to wait 4 weeks until full consolidation (maximum density).
As for it sounding too good to be true, I completely agree. Honestly im in disbelief. But i've broken a tibia before so I know there is no way of full weight bearing without pain until there is at least some consolidation. I am full weight bearing without pain, 5 days after frame removal and stem cell therapy, when my previous xray taken a few days before therapy showed no consolidation at all. So something must have worked. I'll know exactly what the state of my legs are when i see the xrays for myself. They are on a disk but my macbook doesn't have a disk drive!! So it really is annoying but i know somethings definitely working.
It's relatively new technology in that it isn't so accessible atm and it's also apparently quite expensive. How expensive i have no idea as I didn't pay anything extra. But that's probably the reason most LL doctors haven't utilised it yet. I mean, im under the care of multiple experts within an entire organisation, not just one doctor. The doctor that specialised in my LL didn't have an in depth understanding of how the stem cell therapy worked as he's a LL doctor, not the stem cell specialist (or whatever they are called). I don't think you will find a LL doctor that does both. I never got to meet the doctor who did my stem cell therapy i was under general anaesthetic.
There is a clinical study (albeit on rabbits) which shows that bone marrow stem cells show promise in bone regeneration in limb lengthening:
http://www.ncbi.nlm.nih.gov/pubmed/20036345
bFGF-Modified BMMSCs enhance bone regeneration following distraction osteogenesis in rabbits.
Jiang X1, Zou S, Ye B, Zhu S, Liu Y, Hu J.
Author information
Abstract
Distraction osteogenesis (DO), which induces new bone formation along the vector of pull without requiring the use of bone graft, has become a valuable surgical method for patients with limb discrepancy or craniofacial microsomia. However, the long treatment period and possible fibrous union or nonunion hampers its further clinical application. Bone marrow mesenchymal stem cells (BMMSCs) have been widely used as a source of cell therapy or a vector for gene transfer. Basic fibroblast growth factor (bFGF) has high potential for promotion of bone regeneration. However, bFGF has a short half value period in vivo. In this study, osteodistraction was applied in craniofacial bone of rabbit to observe the effects of BMMSCs with or without bFGF gene transfected on bone regeneration in the distracted zone. Mandibular lengthening (10 mm) was performed in 42 New Zealand white rabbits using a rapid distraction rate (2 mm/day). The animals were then randomly divided into group A, group B and group C (n=14 for each group). At the end of distraction, physiological saline, autologous BMMSCs and BMMSCs transfected with bFGF were injected into the distraction gaps in groups A, B, and C, respectively. Eight weeks after DO, the rabbits were sacrificed, and the distracted mandibles were harvested and processed for radiography, dual energy x-ray absorptiometry (DXA), micro-CT, histology and three-point bend testing. Under a rapid distraction, immature or poor bone healing was observed in the distracted callus from group A. However, better bone formation and higher bone mineral density (BMD) and bone mineral content (BMC) in the distracted callus were observed in group B and group C, the latter showed excellent bone formation and highest BMD and BMC. Such finding was confirmed by histological and micro-CT examinations. The values of BT/TV in group C were highest and the micro-architecture presented more mature characteristics. The mechanical strength in group C was 1.63-fold and 1.28-fold greater than that in group A and B by three-point bending testing. The results of this study suggest that BMMSCs transplantation can promote bone formation in DO, and bFGF-modified BMMSCs were more effective in this enhancement.
http://www.ynet.co.il/articles/0,7340,L-4797867,00.html
There is also this Israeli innovation which is called "lipograft" which is basically like a bone graft but instead of taking parts of your already existing bones or taking stem cells from inside the hips, they take fat cells and turn them into osteoblasts. The research has reached clinical trials on humans last year. If it will be a success as it was on animals (in the report they say that the bone grows back after a max of 2-3 weeks) this could be a revolution in LL and CLL.
The article is in hebrew... If anyone knows a good method to translate it to english that would be nice
Quote from: Quilox on September 13, 2016, 10:06:00 AM
I had stem cell therapy last week Friday. I have no clue how it works so im as curious as everyone else. My consolidation was disgustingly poor and i had literally no time left to stay in turkey (where i'vebeen doing my LL) so the hospital just said they would do it. And free of extra charge. I didn't know it was done under local anaesthetic as well, i just woke up and my frames were off and some kind of plaster was on my hip. I guess they decided to do both in one hit.
As for whether it works, definitely!! My bones aren't fully consolidated but they've grown so rapidly to close the gap. So there is a thin sheet of bone unifying the fracture. This is my understanding, of what has been explained to me, I haven't even seen my own xray as im still in my hospital bedroom learning to walk without frames. I am expected to wait 4 weeks until full consolidation (maximum density).
As for it sounding too good to be true, I completely agree. Honestly im in disbelief. But i've broken a tibia before so I know there is no way of full weight bearing without pain until there is at least some consolidation. I am full weight bearing without pain, 5 days after frame removal and stem cell therapy, when my previous xray taken a few days before therapy showed no consolidation at all. So something must have worked. I'll know exactly what the state of my legs are when i see the xrays for myself. They are on a disk but my macbook doesn't have a disk drive!! So it really is annoying but i know somethings definitely working.
It's relatively new technology in that it isn't so accessible atm and it's also apparently quite expensive. How expensive i have no idea as I didn't pay anything extra. But that's probably the reason most LL doctors haven't utilised it yet. I mean, im under the care of multiple experts within an entire organisation, not just one doctor. The doctor that specialised in my LL didn't have an in depth understanding of how the stem cell therapy worked as he's a LL doctor, not the stem cell specialist (or whatever they are called). I don't think you will find a LL doctor that does both. I never got to meet the doctor who did my stem cell therapy i was under general anaesthetic.
If this is true.. may I ask you to post your x-rays here? I feel like then all we would need to do is just find another person at relatively the same period as you and compare the results.
Thank you all for your responses. Very helpful.
I also found some doctors in delhi offering Platelet Rick Plasma (PRP) procedure to accelerate bone healing. This is a technique where your blood is collected and ran through centrifuge for 15 mins, for platelets to concentrate. The platelets are then injected into the target region.
Over coming days, I'll consult with doctors about these two techniques and decide something.
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