[Platelet-rich plasma combined with autologous cancellous bone :  An alternative therapy for persistent non-union?].
BACKGROUND
In addition to a stabile osteosynthesis autologous cancellous bone graft remains an essential therapy option in persistent non-union. Despite this therapy regimen persistent non-union can occasionally occur. The aim of this study was to evaluate the treatment of persistent non-union with a combination of platelet-rich plasma (PRP) and autologous cancellous bone.


METHODS
In this prospective study 17 patients with persistent non-union of long bones were treated by a combination of PRP and autologous iliac crest bone. Inclusion criteria were a minimum of one previously failed cancellous bone transplantation and an atrophic non-union persisting for 6-14 months (mean 9 months). The patients were examined clinically and radiologically at intervals of 3, 6 and 9 months postoperatively.


RESULTS
After an average time of 17 months (range 15-23 months) the patients were treated by a combination of PRP and autologous cancellous bone. In all cases the non-union was successfully treated and osseous bridging was found radiologically after an average of 5 months (range 4-7 months) without any complications.


CONCLUSIONS
The combination of PRP and autologous cancellous bone appears to be a safe and effective method for treatment of persistent non-union. The use of PRP does not result in substantial additional costs. Allergies and graft versus host reactions are not expected because of the autologous origin.
Hakimi
M
M
Klinik für Unfall- und Handchirurgie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
Jungbluth
P
P
Thelen
S
S
Betsch
M
M
Linhart
W
W
Flohé
S
S
Windolf
J
J
Wild
M
M
D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D017759:Fractures, Malunited / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000379:methods*; D053657:Platelet-Rich Plasma; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult
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