Biological and mechanical enhancement of impacted allograft seeded with human bone marrow stromal cells: potential clinical role in impaction bone grafting.
With the demographics of an aging population the incidence of revision surgery is rapidly increasing. Clinical imperatives to augment skeletal tissue loss have brought mesenchymal stem cells to the fore in combination with the emerging discipline of tissue engineering. Impaction bone grafting for revision hip surgery is a recognized technique to reconstitute bone, the success of which relies on a combination of mechanical and biological factors. The use of morsellized allograft is currently the accepted clinical standard providing a good mechanical scaffold with little osteoinductive biological potential. We propose that applying the principles of a tissue engineering paradigm, the combination of human bone marrow stromal cells (hBMSCs) with allograft to produce a living composite, offers a biological and mechanical advantage over the current gold standard of allograft alone. This study demonstrates that hBMSCs combined with allograft can withstand the forces equivalent to a standard femoral impaction and continue to differentiate and proliferate along the bony lineage. In addition, the living composite provides a biomechanical advantage, with increased interparticulate cohesion and shear strength when compared with allograft alone.
Bolland
Benjamin J R F
BJ
Bone & Joint Research Group, Developmental Origins of Health and Disease, University of Southampton, Southampton, SO16 6YD, UK.
Partridge
Kris
K
Tilley
Simon
S
New
Andrew M R
AM
Dunlop
Douglas G
DG
Oreffo
Richard O C
RO
D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000378:metabolism; D001696:Biomechanical Phenomena; D001854:Bone Marrow Cells / Q000201:enzymology / Q000378:metabolism; D016025:Bone Transplantation; D002470:Cell Survival; D004247:DNA / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D017154:Stromal Cells / Q000201:enzymology / Q000378:metabolism; D014184:Transplantation, Homologous
D004247:DNA; D000469:Alkaline Phosphatase