Скачать с ютуб Stem Cells and Bone Healing - Everything You Need to Know - Dr. Nabil Ebraheim в хорошем качестве

Stem Cells and Bone Healing - Everything You Need to Know - Dr. Nabil Ebraheim

Educational video describing important conditions in orthopaedic medical associated with the treatment and study of fracture healing using stem cells. Stem cells may help tissues that are injured or damaged to renew and regenerate themselves. Depending upon the treatment and the medium, stem cells have the ability to become different types of cells such as bone, cartilage and blood vessels. Conditions where stem cells are used in orthopedics: AVN, arthritis and nonunion. Avascular necrosis of the femoral head and Creating a channel for new blood vessels to form into the area that lacks blood supply from AVN. Injection of stem cells into the necrotic femoral head. Stem cell treatments for joint pain and arthritis is not proven yet. There is some use in knee arthritis for cartilage regeneration. Stem cell treatment for fracture nonunion is the best use. Fractures that do not heal after a reasonable period of time are considered to be nonunion. Failure in fixation of the fracture indicates nonunion. Nonunion may also be due to the motion of the bony ends and incomplete healing of the fracture. Two elements needed for treatment: 1-Vascularity: improve the local conditions to facilitate healing. 2-Stability: a form of fixation such as a rod or plate. Common causes on nonunion: •Smoking: 5 times more common •Diabetes •Obesity •Osteoporosis •Unstable fixation •Infection: most common •Oper fracture •Severe displacement of the fracture. Treatment of nonunion: 1-Bone morphogenetic protein: very expensive. 2-Bone graft: donor site morbidity 3-Stem cells: bone marrow aspirate, iliac crest is the best sire for bone marrow extraction. •Tools : fluoroscopic (c-arm) . •Harvesting marrow from the anterior iliac crest. •Extraction of the bone marrow from iliac crest. •The bone marrow is prepared to be centrifuged. •After centrifuging the bone marrow, the good sample is extracted for injection. •Mark and localize area for injection and place a trocar. •Sample injected into the fracture area. Occasionally two area of nonunion is treated. •Injection area after the procedure is complete. Adult mesenchymal stem cells are special cells that can copy themselves, divide and multiply. They can differentiate into bone cells that heal the nonunion and lay down new bone. Patient example of failed fixation leading to nonunion of the fracture. Patient example after stem cell treatment which leads to healing of the fracture. Adult mesenchymal stem cells are not embryonic stem cells. There is a large information about stem cells that are lacking. Cells should probably be combined with some type of matrix. Need a better delivery system and better localization during the injection (the dye kills the cells). It is beneficial to allow the cells to expand and grow to larger numbers in culture before they are injected. The effect of certain medications such as aspirin, Plavix and Coumadin should be observed.