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[Bone marrow in patients with pseudarthrosis. A study of progenitor cells by in vitro cloning]
1Service d'Orthopédie, Hôpital Henri Mondor, Créteil.
Purpose Of The Study:
The recent observations that osteoblasts develop from a stem cell found in the medullary stroma suggest that, as already suspected in classical histological studies, many consolidation mechanisms are based on bone marrow. Since cells characteristics can now be studied in tissue culture, it has become possible to investigate the activity of the bone marrow in non union. The working hypothesis for this study was: if the bone marrow plays a part in bony callus formation, bone marrow from non union site should manifest anomalous activity whatever the origin of the focus sampled. Therefore, the aim of this study was to seek in vitro, using cell cloning techniques, anomalies of bone marrow from non union site.
Materials:
The study characterizes the bone marrow from 35 non union sites, not only with respect to the medullary stroma but also the hematopoietic compartment. In this study, we look for systemic anomalies which could explain susceptibility to non union, we also compare in vitro activity of bone marrow taken from non union with others samples taken from the iliac crest of the same patient.
Methods:
The cell density in the bone marrow in these sites was studied in vitro with material taken from the non union site. Samples were taken by aspiration with a trocar located by image intensification. Assays of CFU-GM were chosen to quantify the hematopoietic activity of the marrow, and of CFU-F to quantify stroma cells activity. Cell densities in the non union site were compared to those in patients' own iliac crests, and also to iliac crests densities of a control population of bone marrow donors.
Results:
The bone marrow of non union site contained low levels of progenitor cells. Especially surprising was that progenitors were also sparse in the bone marrow of the iliac crest of patients with non union, compared with control bone marrow donors. In several cases, certain general factors are probably responsible for the abnormally low levels of progenitor cells, not only in the non union site, but also in the iliac crest.