Use of MSC in the Treatment of the Congenital Pseudoarthrosis in Children


Congenital pseudoatrhrosis of the tibia is one of the most frustrating conditions encountered in paediatric orthopaedic surgery because of the difficulty in achieving healing; There are different methods of treatment the most commonly used are: External fixator according Ilizarov’s technique, vascularised fibular grafting, bone grafting with intramedullary fixation, Boyd’s double bone grafting and also after several operation go bad and a significant shortening of the leg even the amputation has to be considered [1] [2]. Numerous treatment options have been explored with several degree of success. In this paper we show a combinated surgical technique using autogenous mesenchymal stem cells (MSC) by precursor of osteogenic differensation at the same time as adjuvant to the surgical stabilization by an external fixator or an intramedullary nailing. We used these combined technique in tibia congenital pseudoarthrosis with and without neurofibromatosis in children. In fact Bone Marrow has been shown to contain a population of rare mesenchymal stem cells that are capable of forming bone, cartilage and other connective tissues enhancing bone repair and regeneration.

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Magnani, M. , Racano, C. , Abati, C. , Granchi, D. , Vescovi, V. and Stilli, S. (2014) Use of MSC in the Treatment of the Congenital Pseudoarthrosis in Children. Surgical Science, 5, 555-561. doi: 10.4236/ss.2014.512085.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Boero, S., Catagni, M., Donzelli, O., Facchini, R. and Freudiani, V. (1997) Congenital Pseudoarthrosis of the Tibia Associated with Neurofibromatosis-1: Treatment with Ilizarov’s Device. Journal of Pediatric Orthopaedics, 17, 675- 684.
[2] Leskelä, H.V., Kuorilehto, T., Risteli, J., Koivunen, J., Nissinen, M., Peltonen, S., Kinnunen, P., Messiaen, L. and Lehenkari, P. (2009) Congenital Pseudarthrosis of Neurofibromatosis Type 1: Impaired Osteoblast Differentiation and Function and Altered NF1 Gene Expression. Bone, 44, 243-250.
[3] Johnston II, C.E. (2002) Congenital Pseudoarthrosis of the Tibia: Results of Technical Variations in the Charnley-Williams Procedure. Journal of Bone and Joint Surgery, 84, 1799-1810.
[4] Rust, P.A., Kalsi, P. and Briges, T.W. (2007) Regulation of Human Stem Cells Differensation into Osteoblasts on Allograft? Clinical Orthopaedics and Related Research, 457, 220-226.
[5] Abdakkah, B.M., Jensen, C.H., Leslie, R.G.Q., Jensen, T.G. and Kassem, M. (2004) Regulation of Human Skeletal Stem Cells Differentiation by D1K1/Pref-1. Journal of Bone and Mineral Research, 19, 841-852.
[6] De Girolamo, L., Sartori, M.F., Arrigoni, E., Rimondini, L., Albisetti, W., Weinstein, R.L. and Brini, A.T. (2008) Human Adipose-Derived Stem Cells as Future Tools in Tissue Regeneration: Osteogenic Differentiation and Cell-Scaffold Interaction. Regenerative Medicine, The International Journal of Artificial Organs, 31, 467-479.
[7] Granchi, D., Devescovi, V., Baglio, S.R., Magnani, M., Donzelli, O. and Baldini, N. (2012) A Regenerative Approach for Bone Repair in Congenital Pseudarthrosis of the Tibia Associated or Not Associated with Type 1 Neurofibromatosis: Correlation between Laboratory Findings and Clinical Outcome. Cytotherapy, 14, 306-314.
[8] Kakudo, N., Shimotsuma, A. and Miyake, S. (2007) Bone Tissue Engineering Using Human Adipose-Derived Stem Cells and Honeycomb Collagen Scaffold. Kansai Medical University, Osaka.
[9] Johnston, C.E. and Birch, J.G. (2008) A Tale of Two Tibias: A Review of Treatment Options for Congenital Pseudoar-throsis of the Tibia. Journal of Children’s Orthopaedics, 2, 133-149.
[10] Erni, D., de Kerviler, S., Hertel, R. and Slongo, T. (2009) Vascularised Fibula Graft for Early Tibia Reconstruction in Infants with Congenital Pseudoarthrosis. Journal of Plastic, Reconstructive Aestetic Surgery, 20, 1-6.

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