Abstract
Background
Bone demonstrates good healing capacity, with a variety of strategies being utilised to enhance this healing. One potential strategy that has been suggested is the use of stem cells to accelerate healing.
Objectives
Identify and assess the current evidence for the use of stem cells in fracture healing, focussing on the intervention procedure and outcome measurement.
Data Sources
MEDLINE, CENTRAL, EMBASE, Cochrane Database of Systematic Reviews, WHO-ICTRP, ClinicalTrials.gov, and reference checking of included studies.
Study Eligibility Criteria
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. Control: Fracture healing without the use of stem cells. Studies without a comparator were also included. Outcome: Any reported outcomes. Study design: Randomised Controlled Trials (RCTs), non-randomised or observational studies, and case series.
Synthesis
Ninety-four 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, application) and outcomes.
Conclusions: 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.
Registration ID: CRD42019142041
Bone demonstrates good healing capacity, with a variety of strategies being utilised to enhance this healing. One potential strategy that has been suggested is the use of stem cells to accelerate healing.
Objectives
Identify and assess the current evidence for the use of stem cells in fracture healing, focussing on the intervention procedure and outcome measurement.
Data Sources
MEDLINE, CENTRAL, EMBASE, Cochrane Database of Systematic Reviews, WHO-ICTRP, ClinicalTrials.gov, and reference checking of included studies.
Study Eligibility Criteria
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. Control: Fracture healing without the use of stem cells. Studies without a comparator were also included. Outcome: Any reported outcomes. Study design: Randomised Controlled Trials (RCTs), non-randomised or observational studies, and case series.
Synthesis
Ninety-four 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, application) and outcomes.
Conclusions: 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.
Registration ID: CRD42019142041
| Original language | English |
|---|---|
| Pages (from-to) | 1-2 |
| Number of pages | 2 |
| Journal | The Bone and Joint journal |
| Early online date | 6 Oct 2020 |
| Publication status | E-pub ahead of print - 6 Oct 2020 |