title: Morbidity of graft harvesting versus bone marrow aspiration in cell regenerative therapy.
abstract: OBJECTIVE
  Using bone marrow mesenchymal stem cells (MSCs) with aspiration from the iliac crest is commonly used in reconstructive orthopaedic surgery. Because bone marrow aspiration is a percutaneous technique, the morbidity as compared with the classical bone graft should be decreased.
  
  
  METHODS
  Therefore in a retrospective review of 523 consecutive cases of bone marrow aspiration performed at the Henri Mondor Hospital from 1990 to 2006 for the treatment of fractures, minor and major complications were identified and compared to the number of complications observed during the same period with 435 classical iliac crest bone graft procedures performed for the same indications of treatment of fractures. Minor complications included superficial infections, superficial seromas, and minor haematomas. Major complications included herniation of abdominal contents through massive bone graft donor sites, vascular injuries, deep infections at the donor site, neurologic injuries, deep haematoma formation requiring surgical intervention or transfusion, and iliac wing fractures.
  
  
  RESULTS
  Bone marrow aspiration decreased significantly the number of complications as compared with harvesting classical iliac crest bone graft that was associated with significant morbidity. Adverse events were significantly lower (p < 0.01) in the 523 procedures with bone marrow aspiration as compared with the 435 bone iliac crest piece harvesting. This was true for anaemia (16 cases versus 87 cases), for early pain (six versus 152), persistent pain (two versus 21), neuralgia (three versus 11), minor complications (ten versus 56), and major complications (three cases versus 22 cases).
  
  
  CONCLUSIONS
  In our series the number of complications with bone marrow aspiration was ten times less than the complications observed with the classical technique of bone piece harvesting from the iliac crest, and the complications were clearly less severe.
authors.forename: Philippe
authors.initials: P
authors.lastname: Hernigou
authors.forename: Asuka
authors.initials: A
authors.lastname: Desroches
authors.forename: Steffen
authors.initials: S
authors.lastname: Queinnec
authors.forename: Charles Henri
authors.initials: CH
authors.lastname: Flouzat Lachaniette
authors.forename: Alexandre
authors.initials: A
authors.lastname: Poignard
authors.forename: Jerome
authors.initials: J
authors.lastname: Allain
authors.forename: Nathalie
authors.initials: N
authors.lastname: Chevallier
authors.forename: Helene
authors.initials: H
authors.lastname: Rouard
mesh_terms: D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods*; D001861:Bone Regeneration; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D050723:Fractures, Bone / Q000453:epidemiology / Q000628:therapy*; D006406:Hematoma / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D009017:Morbidity; D044968:Regenerative Medicine / Q000379:methods*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome