Autologous cell therapy of fracture nonunion - cell phenotype as a predictor of outcome

这项研究是关于利用病人？他们自己的干细胞，以帮助他们愈合他们的骨骼缺陷-通常是在高能量事故中持续骨折的后果。我们将研究的特定组是那些接受Ilizarov技术治疗的患者，通过使用外部框架（骨运输）逐渐拉伸骨中的切口来再生缺失的骨。这项技术是强大的，解决了骨丢失的其他棘手问题，但患者一致表示，他们会重视减少他们需要在框架中花费的时间。速度限制步骤之一是愈合两个骨端相遇的部位。我们目前试图通过钻孔并注射骨髓来加快这一速度。我们将测试我们是否通过首先培养骨髓干细胞并大量注射它们来实现更好的刺激。我们将使用CT扫描来测量结果，CT扫描可以量化骨形成。然而，我们也将研究来自不同患者的干细胞之间的差异，并试图确定导致更活跃的骨形成的特征。这将为我们如何制定培养过程中使用的方案提供指导，以在使用前优化细胞。这些问题的答案将有助于接受骨转移的患者，但它们也将对其他骨缺损或骨折无法愈合的患者产生影响。

This study is about using patients? own stem cells to help them heal defects in their bones - usually the consequence of fractures sustained in high energy accidents. The particular group we will study are those receiving treatment by the Ilizarov technique, where missing bone is regenerated by gradually stretching a cut in the bone using an external frame(bone transport). This technique is powerful, resolving otherwise intractable problems of bone loss, but patients consistently say they would value a reduction in the time they need to spend in the frame. One of the rate-limiting steps is healing of the site where the two bone ends meet. We currently try to speed this up by drilling across it and injecting bone marrow. We will test whether we achieve better stimulation by first culturing the stem cells from the bone marrow and injecting them in large numbers. We will measure the result using CT scans, which can quantify bone formation. However we will also study the variation between stem cells from different patients and try to identify features that lead to more vigorous bone formation. This will provide guidance as to how we should develop the protocols used in the culture process, to optimise the cells before use. The answers to these questions will be useful to patients undergoing bone transport, but they will also have implications for other patients with bone defects or fractures that will not heal.