Evaluation of bone marrow aspirate concentrate in non-union and delayed union of fractures

ABSTRACT Introduction: Bone Marrow Aspirate Concentrate (BMAC) belongs to a class of materials known as Orthobiologics. When used in higher concentrations will enhance the bone healing. The aspirate is rich in mononuclear cells, of which bone marrow stem cells form an integral part, which develop into osteogenic cell lines and form bone at the site of injection. BMAC gives results similar to surgical methods of treating non-union such as bone grafting. The objective of our study is to investigate the efficacy of Bone marrow aspirate concentrate injection in delayed and nonunion of fractures, to assess the outcome as well as the complications of the procedure. Materials and Methods: We performed a multi Centre study by including twenty-one patients who are diagnosed with non-union and delayed union of fractures. This is a non-randomized study. Bone Marrow is aspirated from the iliac crest. Ficoll solution is used for density gradient centrifugation for isolation of mononuclear stem cells. Later the concentrate is injected into the defect site. Bone formation was evaluated by X-rays in two standard planes. Level of significance was set at P < 0.05. Results: The critical osseous defect reached observable union by a mean of 38 ± 1.38 weeks from the time of fracture. A distance of 5 mm or less between the fractures ends resulted in healing. Conclusion: Our study results indicate that the method is feasible and effective in the management of Nonunion and delayed union of fractures.