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. 2014:2014:451781.
doi: 10.1155/2014/451781. Epub 2014 May 14.

Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures

Joao Torres  1 , Manuel Gutierres  1 , M Ascenção Lopes  2 , J Domingos Santos  2 , A T Cabral  1 , R Pinto  3 , Carola van Eck  4
Affiliations

Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures

Joao Torres et al. Biomed Res Int. 2014.

Abstract

Introduction: Intertrochanteric hip fractures occur in the proximal femur. They are very common in the elderly and are responsible for high rates of morbidity and mortality. The authors hypothesized that adding an autologous bone marrow stem cells concentrate (ABMC) to a hydroxyapatite scaffold and placing it in the fracture site would improve the outcome after surgical fixation of intertrochanteric hip fractures.

Material and methods: 30 patients were randomly selected and divided into 2 groups of 15 patients, to receive either the scaffold enriched with the ABMC (Group A) during the surgical procedure, or fracture fixation alone (Group B).

Results: There was a statistically significant difference in favor of group A at days 30, 60, and 90 for Harris Hip Scores (HHS), at days 30 and 60 for VAS pain scales, for bedridden period and time taken to start partial and total weight bearing (P < 0.05).

Discussion: These results show a significant benefit of adding a bone marrow enriched scaffold to surgical fixation in intertrochanteric hip fractures, which can significantly reduce the associated morbidity and mortality rates.

Conclusion: Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures.

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Figures

Figure 1
Figure 1
There was no statistical difference for the tested characteristics of both groups. (DM: diabetes mellitus; HT: hypertension; DLP: dyslipidemia; CP: cardiac pathology; Ins: insulin; OAD: oral antidiabetic drugs; DLPd: dyslipidemia drugs; HTd: hypertension drugs; AAgr: antiaggregants; Hcoag: hypocoagulation; AMB: ambulatory patient; DPD: dependent patient.)
Figure 2
Figure 2
An X-Ray at 0 and 90 days of a patient from group A, showing higher density on the region where the ABMC/GRHC was added. ABMC: autologous bone marrow concentrate; GRHC: glass reinforced hydroxyapatite composite.
Figure 3
Figure 3
Harris Hip Score (HHS) and VAS pain scale comparison between Groups A and B at 30, 60, and 90 days (*P < 0.05).
Figure 4
Figure 4
Mean bedridden period and time to partial and total weight bearing comparison between Groups A and B at 30, 60, and 90 days (*P < 0.05).
See this image and copyright information in PMC

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