A Systematic Review of Clinical Studies Investigating Mesenchymal Stem Cells for Fracture Non-Union and Bone Defects.

Background: Fracture non-union is a significant problem with a wide demographic and massive economic and social elements, as well as the clinical difficulties it presents. Conventional treatments with autograft and allograft bone grafting poses serious difficulties, thus, it is necessary to develop novel techniques with our ever increasing knowledge of bioengineering using natural materials. Methods: Papers were searched from a variety of sources. The search was not limited to English-language studies. Unpublished papers were also searched. Papers had to meet the definition of fracture non-union or bone defect and had to be clinical trials, using human MSCs. The individual merit of the mesenchymal stem cells needed to be noted. Results: The results presented in this review show that the use of mesenchymal stem cells for the treatment of non-union and bone defects is optimistic. Several papers had positive outcomes to report. There is a need for higher level evidence. Discussion: A strong need of clinical results is required to further progress in cell therapy. Launched trials will hopefully provide this information in the near future. If clinical trials are positive, further development of complex tissue engineering techniques may be developed to treat large bone defects. A cost-benefit analysis and economical evaluation to identify the best indications for bone repair cell therapy as a standard procedure is vital