title: Bone Marrow Aspirate Concentrate in Animal Long Bone Healing: An Analysis of Basic Science Evidence.
abstract: OBJECTIVE
  Long bone fractures that fail to heal or show a delay in healing can lead to increased morbidity. Bone marrow aspirate concentrate (BMAC) containing bone mesenchymal stem cells (BMSCs) has been suggested as an autologous biologic adjunct to aid long bone healing. The purpose of this study was to systematically review the basic science in vivo evidence for the use of BMAC with BMSCs in the treatment of segmental defects in animal long bones.
  
  
  METHODS
  The PubMed/MEDLINE and EMBASE databases were screened in July 14-25, 2014.
  
  
  METHODS
  The following search criteria were used: [("bmac" OR "bone marrow aspirate concentrate" OR "bmc" OR "bone marrow concentrate" OR "mesenchymal stem cells") AND ("bone" OR "osteogenesis" OR "fracture healing" OR "nonunion" OR "delayed union")].
  
  
  METHODS
  Three authors extracted data and analyzed for trends. Quality of evidence score was given to each study.
  
  
  RESULTS
  Results are presented as Hedge G standardized effect sizes with 95% confidence intervals.
  
  
  RESULTS
  The search yielded 35 articles for inclusion. Of studies reporting statistics, 100% showed significant increase in bone formation in the BMAC group on radiograph. Ninety percent reported significant improvement in earlier bone healing on histologic/histomorphometric assessment. Eighty-one percent reported a significant increase in bone area on micro-computed tomography. Seventy-eight percent showed a higher torsional stiffness for the BMAC-treated defects.
  
  
  CONCLUSIONS
  In the in vivo studies evaluated, BMAC confer beneficial effects on the healing of segmental defects in animal long bone models when compared with a control. Proof-of-concept has been established for BMAC in the treatment of animal segmental bone defects.
authors.affiliation: Hospital for Special Surgery, New York, NY.
authors.forename: Arianna
authors.initials: A
authors.lastname: Gianakos
authors.forename: Amelia
authors.initials: A
authors.lastname: Ni
authors.forename: Lester
authors.initials: L
authors.lastname: Zambrana
authors.forename: John G
authors.initials: JG
authors.lastname: Kennedy
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Lane
mesh_terms: D000818:Animals; D001707:Biopsy, Needle; D016026:Bone Marrow Transplantation / Q000379:methods* / Q000706:statistics & numerical data*; D004195:Disease Models, Animal; D019317:Evidence-Based Medicine; D017102:Fracture Healing; D050723:Fractures, Bone / Q000175:diagnosis / Q000628:therapy*; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods* / Q000706:statistics & numerical data*; D016896:Treatment Outcome