Autologous bone grafting on steroids: Preliminary clinical results. A novel treatment for nonunions and segmental bone defects

Micah A. Miller, Alan Ivkovic, Ryan Porter, Mitchel B. Harris, Daniel M. Estok, R. Malcolm Smith, Christopher H Evans, Mark S. Vrahas

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Clinical management of delayed healing or nonunion of long bone fractures and segmental bone defects poses a substantial orthopaedic challenge. Surgical advances and bone tissue engineering are providing new avenues to stimulate bone growth in cases of bone loss and nonunion. The reamer-irrigator-aspirator (RIA) device allows surgeons to aspirate the medullary contents of long bones and use the progenitor-rich "flow-through" fraction in autologous bone grafting. Dexamethasone (DEX) is a synthetic steroid that has been shown to induce osteoblastic differentiation. A series of 13 patients treated with RIA bone grafting enhanced with DEX for nonunion or segmental defect was examined retrospectively to assess the quality of bony union and clinical outcomes. Despite the initial poor prognoses, promising results were achieved using this technique; and given the complexity of these cases the observed success is of great value and warrants controlled study into both standardisation of the procedure and concentration of the grafting material.

Original languageEnglish (US)
Pages (from-to)599-605
Number of pages7
JournalInternational Orthopaedics
Volume35
Issue number4
DOIs
StatePublished - Apr 2011
Externally publishedYes

Fingerprint

Bone Transplantation
Steroids
Bone and Bones
Dexamethasone
Bone Development
Bone Fractures
Therapeutics
Tissue Engineering
Orthopedics
Equipment and Supplies

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Miller, M. A., Ivkovic, A., Porter, R., Harris, M. B., Estok, D. M., Smith, R. M., ... Vrahas, M. S. (2011). Autologous bone grafting on steroids: Preliminary clinical results. A novel treatment for nonunions and segmental bone defects. International Orthopaedics, 35(4), 599-605. https://doi.org/10.1007/s00264-010-1013-9

Autologous bone grafting on steroids : Preliminary clinical results. A novel treatment for nonunions and segmental bone defects. / Miller, Micah A.; Ivkovic, Alan; Porter, Ryan; Harris, Mitchel B.; Estok, Daniel M.; Smith, R. Malcolm; Evans, Christopher H; Vrahas, Mark S.

In: International Orthopaedics, Vol. 35, No. 4, 04.2011, p. 599-605.

Research output: Contribution to journalArticle

Miller, Micah A. ; Ivkovic, Alan ; Porter, Ryan ; Harris, Mitchel B. ; Estok, Daniel M. ; Smith, R. Malcolm ; Evans, Christopher H ; Vrahas, Mark S. / Autologous bone grafting on steroids : Preliminary clinical results. A novel treatment for nonunions and segmental bone defects. In: International Orthopaedics. 2011 ; Vol. 35, No. 4. pp. 599-605.
@article{6dac1ddf971e4d638b1bd817148b7e7e,
title = "Autologous bone grafting on steroids: Preliminary clinical results. A novel treatment for nonunions and segmental bone defects",
abstract = "Clinical management of delayed healing or nonunion of long bone fractures and segmental bone defects poses a substantial orthopaedic challenge. Surgical advances and bone tissue engineering are providing new avenues to stimulate bone growth in cases of bone loss and nonunion. The reamer-irrigator-aspirator (RIA) device allows surgeons to aspirate the medullary contents of long bones and use the progenitor-rich {"}flow-through{"} fraction in autologous bone grafting. Dexamethasone (DEX) is a synthetic steroid that has been shown to induce osteoblastic differentiation. A series of 13 patients treated with RIA bone grafting enhanced with DEX for nonunion or segmental defect was examined retrospectively to assess the quality of bony union and clinical outcomes. Despite the initial poor prognoses, promising results were achieved using this technique; and given the complexity of these cases the observed success is of great value and warrants controlled study into both standardisation of the procedure and concentration of the grafting material.",
author = "Miller, {Micah A.} and Alan Ivkovic and Ryan Porter and Harris, {Mitchel B.} and Estok, {Daniel M.} and Smith, {R. Malcolm} and Evans, {Christopher H} and Vrahas, {Mark S.}",
year = "2011",
month = "4",
doi = "10.1007/s00264-010-1013-9",
language = "English (US)",
volume = "35",
pages = "599--605",
journal = "International Orthopaedics",
issn = "0341-2695",
publisher = "Springer Verlag",
number = "4",

}

TY - JOUR

T1 - Autologous bone grafting on steroids

T2 - Preliminary clinical results. A novel treatment for nonunions and segmental bone defects

AU - Miller, Micah A.

AU - Ivkovic, Alan

AU - Porter, Ryan

AU - Harris, Mitchel B.

AU - Estok, Daniel M.

AU - Smith, R. Malcolm

AU - Evans, Christopher H

AU - Vrahas, Mark S.

PY - 2011/4

Y1 - 2011/4

N2 - Clinical management of delayed healing or nonunion of long bone fractures and segmental bone defects poses a substantial orthopaedic challenge. Surgical advances and bone tissue engineering are providing new avenues to stimulate bone growth in cases of bone loss and nonunion. The reamer-irrigator-aspirator (RIA) device allows surgeons to aspirate the medullary contents of long bones and use the progenitor-rich "flow-through" fraction in autologous bone grafting. Dexamethasone (DEX) is a synthetic steroid that has been shown to induce osteoblastic differentiation. A series of 13 patients treated with RIA bone grafting enhanced with DEX for nonunion or segmental defect was examined retrospectively to assess the quality of bony union and clinical outcomes. Despite the initial poor prognoses, promising results were achieved using this technique; and given the complexity of these cases the observed success is of great value and warrants controlled study into both standardisation of the procedure and concentration of the grafting material.

AB - Clinical management of delayed healing or nonunion of long bone fractures and segmental bone defects poses a substantial orthopaedic challenge. Surgical advances and bone tissue engineering are providing new avenues to stimulate bone growth in cases of bone loss and nonunion. The reamer-irrigator-aspirator (RIA) device allows surgeons to aspirate the medullary contents of long bones and use the progenitor-rich "flow-through" fraction in autologous bone grafting. Dexamethasone (DEX) is a synthetic steroid that has been shown to induce osteoblastic differentiation. A series of 13 patients treated with RIA bone grafting enhanced with DEX for nonunion or segmental defect was examined retrospectively to assess the quality of bony union and clinical outcomes. Despite the initial poor prognoses, promising results were achieved using this technique; and given the complexity of these cases the observed success is of great value and warrants controlled study into both standardisation of the procedure and concentration of the grafting material.

UR - http://www.scopus.com/inward/record.url?scp=79955611380&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955611380&partnerID=8YFLogxK

U2 - 10.1007/s00264-010-1013-9

DO - 10.1007/s00264-010-1013-9

M3 - Article

C2 - 20414656

AN - SCOPUS:79955611380

VL - 35

SP - 599

EP - 605

JO - International Orthopaedics

JF - International Orthopaedics

SN - 0341-2695

IS - 4

ER -