title: Bone fracture healing: cell therapy in delayed unions and nonunions.
abstract: Bone fracture healing impairment related to mechanical problems has been largely corrected by advances in fracture management. Better protocols, more strict controls of time and function, and hardware and surgical technique evolution have contributed to better prognosis, even in complex fractures. However, atrophic nonunion persists in clinical cases where, for different reasons, the osteogenic capability is impaired. When this is the case, a better understanding of the basic mechanisms under bone repair and augmentation techniques may put in perspective the current possibilities and future opportunities. Among those, cell therapy particularly aims to correct this insufficient osteogenesis. However, the launching of safe and efficacious cell therapies still requires substantial amount of research, especially clinical trials. This review will envisage the current clinical trials on bone healing augmentation based on cell therapy, with the experience provided by the REBORNE Project, and the insight from investigator-driven clinical trials on advanced therapies towards the future. This article is part of a Special Issue entitled Stem Cells and Bone.
authors.affiliation: Dept. of Orthopaedic Surgery and Traumatology, Hospital La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain. Electronic address: enrique.gomezbarrena@uam.es.
authors.forename: Enrique
authors.initials: E
authors.lastname: Gómez-Barrena
authors.affiliation: Service of Orthopaedic Surgery and Traumatology, CHU Tours, Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours, France; Inserm U957, Laboratoire de Physiopathologie de la Résorption Osseuse et Thérapie des Tumeurs Osseuses Primitives (LPRO), Faculté de Médecine, Université de Nantes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Rosset
authors.affiliation: Metabolic Bone Research Unit, Instituto de Investigación Sanitaria FJD, Madrid, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lozano
authors.affiliation: Service of Orthopaedic Surgery and Traumatology, CHU Tours, Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours, France; Inserm U957, Laboratoire de Physiopathologie de la Résorption Osseuse et Thérapie des Tumeurs Osseuses Primitives (LPRO), Faculté de Médecine, Université de Nantes, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Stanovici
authors.affiliation: Klinik für Unfallchirurgie-, Hand-, Plastische und Wiederherstellungschirurgie Zentrum für Chirurgie Universitätsklinikum Ulm, Ulm, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Ermthaller
authors.affiliation: Klinik für Unfallchirurgie-, Hand-, Plastische und Wiederherstellungschirurgie Zentrum für Chirurgie Universitätsklinikum Ulm, Ulm, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Gerbhard
mesh_terms: D001672:Biocompatible Materials / Q000494:pharmacology; D002986:Clinical Trials as Topic; D017102:Fracture Healing / Q000187:drug effects; D005599:Fractures, Ununited / Q000628:therapy*; D006801:Humans; D033581:Stem Cell Transplantation
chemical_list: D001672:Biocompatible Materials
keywords: Bone healing; Cell therapy; Clinical trials; MSCs; Nonunion