Display options
Cite
Hogendoorn S, Duijnisveld BJ, van Duinen SG, et al. Local injection of autologous bone marrow cells to regenerate muscle in patients with traumatic brachial plexus injury: a pilot study. Bone Joint Res. 2014;3(2):38-47doi: 10.1302/2046-3758.32.2000229.
Hogendoorn, S., Duijnisveld, B. J., van Duinen, S. G., Stoel, B. C., van Dijk, J. G., Fibbe, W. E., & Nelissen, R. G. (2014). Local injection of autologous bone marrow cells to regenerate muscle in patients with traumatic brachial plexus injury: a pilot study. Bone & joint research, 3(2), 38-47. https://doi.org/10.1302/2046-3758.32.2000229
Hogendoorn, S, et al. "Local injection of autologous bone marrow cells to regenerate muscle in patients with traumatic brachial plexus injury: a pilot study." Bone & joint research vol. 3,2 (2014): 38-47. doi: https://doi.org/10.1302/2046-3758.32.2000229
Hogendoorn S, Duijnisveld BJ, van Duinen SG, Stoel BC, van Dijk JG, Fibbe WE, Nelissen RG. Local injection of autologous bone marrow cells to regenerate muscle in patients with traumatic brachial plexus injury: a pilot study. Bone Joint Res. 2014 Feb 24;3(2):38-47. doi: 10.1302/2046-3758.32.2000229. Print 2014. PMID: 24565688; PMCID: PMC3942869.
Copy Download .nbib Format: NLM
Share it on

Bone Joint Res. 2014 Feb 24;3(2):38-47. doi: 10.1302/2046-3758.32.2000229. Print 2014.

Local injection of autologous bone marrow cells to regenerate muscle in patients with traumatic brachial plexus injury: a pilot study.

Bone & joint research

S Hogendoorn, B J Duijnisveld, S G van Duinen, B C Stoel, J G van Dijk, W E Fibbe, R G H H Nelissen

Affiliations

  1. Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

PMID: 24565688 PMCID: PMC3942869 DOI: 10.1302/2046-3758.32.2000229

Abstract

OBJECTIVES: Traumatic brachial plexus injury causes severe functional impairment of the arm. Elbow flexion is often affected. Nerve surgery or tendon transfers provide the only means to obtain improved elbow flexion. Unfortunately, the functionality of the arm often remains insufficient. Stem cell therapy could potentially improve muscle strength and avoid muscle-tendon transfer. This pilot study assesses the safety and regenerative potential of autologous bone marrow-derived mononuclear cell injection in partially denervated biceps.

METHODS: Nine brachial plexus patients with insufficient elbow flexion (i.e., partial denervation) received intramuscular escalating doses of autologous bone marrow-derived mononuclear cells, combined with tendon transfers. Effect parameters included biceps biopsies, motor unit analysis on needle electromyography and computerised muscle tomography, before and after cell therapy.

RESULTS: No adverse effects in vital signs, bone marrow aspiration sites, injection sites, or surgical wound were seen. After cell therapy there was a 52% decrease in muscle fibrosis (p = 0.01), an 80% increase in myofibre diameter (p = 0.007), a 50% increase in satellite cells (p = 0.045) and an 83% increase in capillary-to-myofibre ratio (p < 0.001) was shown. CT analysis demonstrated a 48% decrease in mean muscle density (p = 0.009). Motor unit analysis showed a mean increase of 36% in motor unit amplitude (p = 0.045), 22% increase in duration (p = 0.005) and 29% increase in number of phases (p = 0.002).

CONCLUSIONS: Mononuclear cell injection in partly denervated muscle of brachial plexus patients is safe. The results suggest enhanced muscle reinnervation and regeneration. Cite this article: Bone Joint Res 2014;3:38-47.

Keywords: Autologous bone marrow injection; Brachial plexus; Partial muscle denervation

References

  1. J Clin Neurosci. 2009 Sep;16(9):1211-7 - PubMed
  2. Electroencephalogr Clin Neurophysiol. 1995 Jun;97(3):145-54 - PubMed
  3. Neurol Res. 2004 Mar;26(2):230-2 - PubMed
  4. Am J Physiol Cell Physiol. 2007 Jan;292(1):C440-51 - PubMed
  5. J Pediatr Orthop B. 2005 Jul;14(4):233-44 - PubMed
  6. J Cell Biol. 1999 Mar 22;144(6):1113-22 - PubMed
  7. Nature. 2005 Feb 17;433(7027):760-4 - PubMed
  8. Dev Dyn. 2006 Dec;235(12):3230-9 - PubMed
  9. Neurosurgery. 2008 Apr;62(4):873-85; discussion 885-6 - PubMed
  10. J Brachial Plex Peripher Nerve Inj. 2007 Jul 11;2:15 - PubMed
  11. Muscle Nerve. 1995 Oct;18(10):1155-66 - PubMed
  12. Neuroepidemiology. 2009;32(3):217-28 - PubMed
  13. Nat Med. 2005 Apr;11(4):367-8 - PubMed
  14. Circulation. 2001 Aug 28;104(9):1046-52 - PubMed
  15. Arch Orthop Trauma Surg. 2006 Jan;126(1):63-5 - PubMed
  16. Anat Embryol (Berl). 2005 Apr;209(4):269-79 - PubMed
  17. Electroencephalogr Clin Neurophysiol. 1994 Feb;93(1):15-20 - PubMed
  18. Invest Radiol. 2005 May;40(5):313-9 - PubMed
  19. Med Care. 1994 Jan;32(1):40-66 - PubMed
  20. Tissue Eng. 2006 Feb;12(2):361-7 - PubMed
  21. Histochem Cell Biol. 2005 Jul;124(1):13-23 - PubMed
  22. Am J Cardiol. 2007 Oct 1;100(7):1094-8 - PubMed
  23. J Rheumatol. 2001 Jul;28(7):1591-9 - PubMed
  24. Exp Clin Transplant. 2009 Dec;7(4):241-8 - PubMed
  25. J Neurosurg. 2004 Sep;101(3):377-89 - PubMed
  26. Exp Hematol. 2004 May;32(5):426-34 - PubMed
  27. J Orthop Sci. 1998;3(1):71-80 - PubMed
  28. J Cardiovasc Surg (Torino). 2008 Feb;49(1):51-8 - PubMed
  29. J Hand Surg Am. 2008 Mar;33(3):308-12 - PubMed
  30. J Hand Surg Eur Vol. 2008 Aug;33(4):488-93 - PubMed
  31. Expert Opin Biol Ther. 2004 Dec;4(12):1871-85 - PubMed
  32. Arthritis Res Ther. 2011;13(6):R207 - PubMed
  33. J Orthop Res. 2010 Oct;28(10):1391-8 - PubMed
  34. J Hand Surg Am. 1995 Sep;20(5):743-6 - PubMed
  35. J Neurosurg. 2003 May;98(5):1005-16 - PubMed
  36. Anat Rec. 1997 Jul;248(3):346-54 - PubMed
  37. Anat Rec. 2000 Mar 1;258(3):292-304 - PubMed
  38. Neurosurgery. 1997 Jun;40(6):1182-8; discussion 1188-9 - PubMed
  39. Circ Res. 2004 Mar 19;94(5):573-4 - PubMed
  40. J Appl Physiol (1985). 2001 Aug;91(2):534-51 - PubMed
  41. Lancet. 2002 Aug 10;360(9331):427-35 - PubMed
  42. Science. 1998 Mar 6;279(5356):1528-30 - PubMed
  43. Anat Rec. 2001 Jun 1;263(2):139-54 - PubMed
  44. Anat Rec. 1997 Jul;248(3):355-65 - PubMed
  45. J Hand Ther. 2002 Oct-Dec;15(4):347-54 - PubMed
  46. Muscle Nerve. 2004 Feb;29(2):218-26 - PubMed

Publication Types