title: Cranioplasty with adipose-derived stem cells and biomaterial: a novel method for cranial reconstruction.
abstract: BACKGROUND
  There is no optimal method for reconstruction of large calvarial defects. Because of the limitations of autologous bone grafts and alloplastic materials, new methods for performing cranioplasties are needed.
  
  
  OBJECTIVE
  To create autologous bone to repair cranial defects.
  
  
  METHODS
  We performed a cranioplasty procedure with this new method in 4 patients who had large calvarial defects of different etiologies. We used autologous adipose-derived stem cells seeded in beta-tricalcium phosphate granules. For 2 patients, we used a bilaminate technique with resorbable mesh.
  
  
  RESULTS
  During follow-up, there were no clinically relevant postoperative complications. The computed tomography scans revealed satisfactory outcome in ossification, and in the clinical examinations, the outcomes were good. The cranioplasty was measured in Hounsfield units from each computed tomography scan. The Hounsfield units increased gradually to equal the value of bone.
  
  
  CONCLUSIONS
  The combination of scaffold material such as beta-tricalcium phosphate and autologous adipose-derived stem cells constitutes a promising model for reconstruction of human large cranial defects. The success of these clinical cases paves way for further studies and clinical applications to turn this method into a reliable treatment regimen.
authors.affiliation: Department of Neurosurgery, Tampere University Hospital, PO Box 2000, 33521 Tampere, Finland. tuomo.thesleff@pshp.fi
authors.forename: Tuomo
authors.initials: T
authors.lastname: Thesleff
authors.forename: Kai
authors.initials: K
authors.lastname: Lehtimäki
authors.forename: Tero
authors.initials: T
authors.lastname: Niskakangas
authors.forename: Bettina
authors.initials: B
authors.lastname: Mannerström
authors.forename: Susanna
authors.initials: S
authors.lastname: Miettinen
authors.forename: Riitta
authors.initials: R
authors.lastname: Suuronen
authors.forename: Juha
authors.initials: J
authors.lastname: Öhman
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000368:Aged; D002130:Calcium Phosphates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012886:Skull / Q000601:surgery*; D033581:Stem Cell Transplantation / Q000379:methods*; D023822:Tissue Engineering / Q000379:methods*; D014182:Transplantation, Autologous
chemical_list: D002130:Calcium Phosphates; C485817:beta-tricalcium phosphate