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Stem Cells International
Volume 2010, Article ID 410170, 4 pages
Review Article

Phases 1–3 Clinical Trials Using Adult Stem Cells in Osteonecrosis and Nonunion Fractures

1Department of Rheumatology, CHU Sart Tilman, B35, 4000 Liège, Belgium
2Rheumatology and Rehabilitation Medicine Department, Erasme Hospital, Free University of Brussels, 1070 Brussels, Belgium

Received 10 May 2010; Accepted 10 October 2010

Academic Editor: Kotaro Yoshimura

Copyright © 2010 Jean-Philippe Hauzeur and Valérie Gangji. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Nonunion fractures and aseptic bone necrosis are two pathological conditions having some impairment of the cellular part of the repair: a reduction of MSC and of the osteoblastic activation. Both are good candidates for cell-based therapies using stem cells. We made a review of the published human trials. Only autologous bone marrow aspirate implantation was until now used. In Nonunion, a direct injection—15 to 150 ml—was made in 4 case series studies. In another, the bone marrow aspirate was concentrated before injection. The results were good. In bone necrosis, only one level 1 study was published. The results at 24 months were positive in terms of reduction of the necrosis and appearance of collapse. In 3 case series studies, a treatment with concentrated bone marrow aspirates was deemed useful with good results in 76 to 96%. These results are interesting but need confirmation by controlled studies.