Open AccessSystematic review assessing the evidence for the use of stem cells in fracture healing
Author(s) -
Andrew Mott,
Alex Mitchell,
Catriona McDaid,
Melissa Harden,
Rachael Grupping,
Alexandra Dean,
Ailish Byrne,
Laura Doherty,
Hemant Sharma
Publication year - 2020
Publication title -
bone and joint open
Language(s) - English
Resource type - Journals
ISSN - 2633-1462
DOI - 10.1302/2633-1462.110.bjo-2020-0129
Subject(s) - medicine , bone healing , observational study , meta analysis , stem cell , population , randomized controlled trial , systematic review , medline , surgery , biology , genetics , environmental health , political science , law
Aims Bone demonstrates good healing capacity, with a variety of strategies being utilized to enhance this healing. One potential strategy that has been suggested is the use of stem cells to accelerate healing.Methods The following databases were searched: MEDLINE, CENTRAL, EMBASE, Cochrane Database of Systematic Reviews, WHO-ICTRP, ClinicalTrials.gov, as well as reference checking of included studies. The inclusion criteria for the study were: population (any adults who have sustained a fracture, not including those with pre-existing bone defects); intervention (use of stem cells from any source in the fracture site by any mechanism); and control (fracture healing without the use of stem cells). Studies without a comparator were also included. The outcome was any reported outcomes. The study design was randomized controlled trials, non-randomized or observational studies, and case series.Results In all, 94 eligible studies were identified. The clinical and methodological aspects of the studies were too heterogeneous for a meta-analysis to be undertaken. A narrative synthesis examined study characteristics, stem cell methods (source, aspiration, concentration, and application) and outcomes.Conclusion Insufficient high-quality evidence is available to determine the efficacy of stem cells for fracture healing. The studies were heterogeneous in population, methods, and outcomes. Work to address these issues and establish standards for future research should be undertaken. Cite this article: Bone Joint Open 2020;1-10:628–638.