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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 10, 1382-1386.
doi: 10.1302/0301-620X.89B10.19103  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Successful treatment of refractory tibial nonunion using calcium sulphate and bone marrow stromal cell implantation

S. Bajada, MD, Research Fellow1; P. E. Harrison, MMedSci, Principal Clinical Scientist1; B. A. Ashton, DPhil, Head Arthritis Research Centre1; V. N. Cassar-Pullicino, FRCR, Consultant Radiologist & Director of Diagnostic Imaging1; N. Ashammakhi, MD, FRCS(Ed), PhD, Professor of Regenerative Medicine2; and J. B. Richardson, FRCS, MD, Professor of Orthopaedics1

1 Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7AG, UK.
2 Institute for Science and Technology in Medicine Keele University, Huxley Building, Staffordshire ST5 5BG, UK.

Correspondence should be sent to Dr S. Bajada; e-mail: stefan_bajada{at}yahoo.com

Successful healing of a nine-year tibial nonunion resistant to six previous surgical procedures was achieved by tissue engineering. We used autologous bone marrow stromal cells (BMSCs) expanded to 5 x 106 cells after three weeks’ tissue culture. Calcium sulphate (CaSO4) in pellet form was combined with these cells at operation. The nonunion was clinically and radiologically healed two months after implantation.

This is the description of on healing of a long-standing tibial nonunion by tissue engineering. The successful combination of BMSCs and CaSO4 has not to our knowledge been reported in a clinical setting.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General