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Morbidity of graft harvesting versus bone marrow aspiration in cell regenerative therapy

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Abstract

Purpose

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.

Method

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.

Result

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).

Conclusion

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.

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Acknowledgments

We thank Ted Sand and Richard Suzuki and Celling Biosciences for the review of the final manuscript and their help in translation.

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Authors and Affiliations

  1. Orthopaedic Surgery, Hopital Henri Mondor, Créteil, France

    Philippe Hernigou, Asuka Desroches, Steffen Queinnec, Charles Henri Flouzat Lachaniette, Alexandre Poignard, Jerome Allain, Nathalie Chevallier & Helene Rouard

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  1. Philippe Hernigou
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  2. Asuka Desroches
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  3. Steffen Queinnec
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  4. Charles Henri Flouzat Lachaniette
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  5. Alexandre Poignard
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  7. Nathalie Chevallier
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  8. Helene Rouard
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Correspondence to Philippe Hernigou.

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Hernigou, P., Desroches, A., Queinnec, S. et al. Morbidity of graft harvesting versus bone marrow aspiration in cell regenerative therapy. International Orthopaedics (SICOT) 38, 1855–1860 (2014). https://doi.org/10.1007/s00264-014-2318-x

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  • DOI: https://doi.org/10.1007/s00264-014-2318-x

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