PDF(Pubmed)
Abstract：
UNASSIGNED: Fracture healing poses a significant challenge in orthopedics. Successful regeneration of bone is provided by mechanical stability and a favorable biological microenvironment. This systematic review aims to explore the clinical application of orthobiologics in treating aseptic delayed union and non-union of long bones in adults.
UNASSIGNED: A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Three databases were explored, with no date restrictions, using keywords related to orthobiologics and delayed union and non-union. Eligible studies included human clinical studies in English, with available full texts, examining orthobiologics such as platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), and bone morphogenetic protein (BMPs) for treating aseptic delayed unions and non-unions in adults. Animal studies, in vitro research, and studies on non-unions due to congenital defects, tumors or infections were excluded.
UNASSIGNED: The initial search identified 9417 studies, with 20 ultimately included in the review. These studies involved 493 patients affected by non-union and 256 patients affected by delayed union, with an average age respectively of 40.62 years and 41.7 years. The mean follow-up period was 15.55 months for non-unions and 8.07 months for delayed unions. PRP was the most used orthobiologic, and outcomes were evaluated through time to union, functional scores, and clinical examinations. The results indicated that orthobiologics, especially PRP, tended to yield better outcomes compared to surgical procedures without biological factors.
UNASSIGNED: This systematic review suggests that orthobiologics, such as PRP, BMPs, and MSCs, can be effective and safe in the management of delayed union and non-union fractures. These biological treatments have the potential to improve union rates, reduce healing times, and enhance functional outcomes in patients with non-union fractures. Further research is essential to refine treatment protocols and determine the most suitable orthobiologic for specific patient populations and fracture types.
UNASSIGNED: A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Three databases were explored, with no date restrictions, using keywords related to orthobiologics and delayed union and non-union. Eligible studies included human clinical studies in English, with available full texts, examining orthobiologics such as platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), and bone morphogenetic protein (BMPs) for treating aseptic delayed unions and non-unions in adults. Animal studies, in vitro research, and studies on non-unions due to congenital defects, tumors or infections were excluded.
UNASSIGNED: The initial search identified 9417 studies, with 20 ultimately included in the review. These studies involved 493 patients affected by non-union and 256 patients affected by delayed union, with an average age respectively of 40.62 years and 41.7 years. The mean follow-up period was 15.55 months for non-unions and 8.07 months for delayed unions. PRP was the most used orthobiologic, and outcomes were evaluated through time to union, functional scores, and clinical examinations. The results indicated that orthobiologics, especially PRP, tended to yield better outcomes compared to surgical procedures without biological factors.
UNASSIGNED: This systematic review suggests that orthobiologics, such as PRP, BMPs, and MSCs, can be effective and safe in the management of delayed union and non-union fractures. These biological treatments have the potential to improve union rates, reduce healing times, and enhance functional outcomes in patients with non-union fractures. Further research is essential to refine treatment protocols and determine the most suitable orthobiologic for specific patient populations and fracture types.
摘要：
■骨折愈合对骨科构成了重大挑战。骨的成功再生由机械稳定性和有利的生物微环境提供。本系统评价旨在探讨直系生物制剂在成人长骨无菌性延迟愈合和不愈合中的临床应用。
根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行系统评价。探索了三个数据库，没有日期限制，使用与直视生物学、延迟联合和不联合相关的关键词。符合条件的研究包括英语的人体临床研究，有可用的全文，检查直系生物制剂，如富血小板血浆（PRP），间充质干细胞(MSCs),和骨形态发生蛋白（BMPs）用于治疗成人无菌性延迟愈合和不愈合。动物研究,体外研究，以及对先天性缺陷导致的不结合的研究，肿瘤或感染被排除。
■最初的搜索确定了9417项研究，其中20人最终被纳入审查。这些研究涉及493名受不愈合影响的患者和256名受延迟愈合影响的患者，平均年龄分别为40.62岁和41.7岁。非工会的平均随访期为15.55个月，延迟工会的平均随访期为8.07个月。PRP是最常用的矫正生物学，结果是通过联合时间来评估的，功能分数，和临床检查。结果表明，直向生物学，尤其是PRP,与没有生物学因素的外科手术相比，倾向于产生更好的结果。
■这项系统评价表明，直系生物学，如PRP,BMPs,和MSC，可以有效和安全地管理延迟愈合和不愈合骨折。这些生物治疗有可能提高结合率，减少愈合时间，并提高不愈合骨折患者的功能预后。进一步的研究对于完善治疗方案并确定针对特定患者人群和骨折类型的最合适的骨科生物至关重要。
根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行系统评价。探索了三个数据库，没有日期限制，使用与直视生物学、延迟联合和不联合相关的关键词。符合条件的研究包括英语的人体临床研究，有可用的全文，检查直系生物制剂，如富血小板血浆（PRP），间充质干细胞(MSCs),和骨形态发生蛋白（BMPs）用于治疗成人无菌性延迟愈合和不愈合。动物研究,体外研究，以及对先天性缺陷导致的不结合的研究，肿瘤或感染被排除。
■最初的搜索确定了9417项研究，其中20人最终被纳入审查。这些研究涉及493名受不愈合影响的患者和256名受延迟愈合影响的患者，平均年龄分别为40.62岁和41.7岁。非工会的平均随访期为15.55个月，延迟工会的平均随访期为8.07个月。PRP是最常用的矫正生物学，结果是通过联合时间来评估的，功能分数，和临床检查。结果表明，直向生物学，尤其是PRP,与没有生物学因素的外科手术相比，倾向于产生更好的结果。
■这项系统评价表明，直系生物学，如PRP,BMPs,和MSC，可以有效和安全地管理延迟愈合和不愈合骨折。这些生物治疗有可能提高结合率，减少愈合时间，并提高不愈合骨折患者的功能预后。进一步的研究对于完善治疗方案并确定针对特定患者人群和骨折类型的最合适的骨科生物至关重要。
