Bioactive β-tricalcium phosphate modified by stem cell screen-and-enrich-and-combine circulating system for regeneration of bone defects

Objective To introduce a new method for preparation of bioactive β-tricalcium phosphate (β-TCP) by rapid stem cell screen-and-enrich-and-combine circulating system (SECCS) and evaluate its efficacy in the treatment of fresh fractures and bone defects. Methods Twenty-two patients with fresh fracture and bone defects were treated with SECCS from July 2013 to April 2016. They were 16 males and 6 females with an average age of 52.2 years (from 27 to 81 years). There were 15 tibial plateau fractures and 7 calcaneal fractures. The average size of bone defects was 12.5 mL. Bioactive β-TCP was prepared by SECCS intraoperatively and implanted back immediately into the bone defects. Radiographic examination, Lysholm knee scoring and Maryland foot scoring were used for assessment of curative efficacy. Results The 22 patients were followed up for an average of 25.7 months (from 12 to 46 months). By SECCS, the enrichment efficiency of bone marrow stromal cells (BMSCs) reached up to 82.4% and the cell viability was not affected. The tibial plateau fractures were re-transplanted with 13,381.3 BMSCs on average and healed after an average of 8.9 weeks (from 6 to 15 weeks). The Lysholm knee scores at one year postoperatively averaged 93.6 points (from 84 to 100 points), yielding 10 excellent cases, 4 good cases and one fair case. The calcaneal fractures were implanted back with 16,677.7 BMSCs on average and healed after an average of 9.4 weeks (from 8 to 13 weeks). The average Maryland foot score at one year after operation was 93.6 points (from 85 to 98 points), yielding 6 excellent cases and one good case. Conclusion Bioactive materials prepared by SECCS are good bone grafts for fresh fractures and bone defects. Key words: Fractures, bone; Bone defects; Stem cell transplantation; Enrichment technology; Biomaterials