Purpose
Autologous bone grafts demonstrate osteoconductive, osteoinductive, and osteogenic
properties. Hand surgeons commonly augment surgical fixation with autografts to promote
fracture healing. This study compared the intrinsic stem cell-like properties of 2
commonly used autograft sources in hand surgery: the iliac crest and distal radius.
Methods
A total of 9 subjects who received an iliac crest bone graft and distal radius bone
graft harvest as a part of the standard care of distal radius malunion or nonunion
correction or scaphoid nonunion open reduction and internal fixation were enrolled
in the study. Cells were isolated by serial collagenase digestion and subjected to
fibroblast colony-forming units, osteogenesis, and adipogenesis assays. The expression
levels of genes involved in osteogenesis and adipogenesis were confirmed using quantitative
polymerase chain reaction.
Results
The cells isolated from the iliac crest bone graft compared with those isolated from
the distal radius bone graft demonstrated significantly higher mean fibroblast colony-forming
unit efficiency; increased osteogenesis, as measured using alizarin red quantification;
increased adipogenesis, as measured using oil red O quantification; and higher expression
levels of genes involved in osteogenesis and adipogenesis under the respective differentiation
conditions.
Conclusions
The cells isolated from the iliac crest bone graft demonstrated a higher fibroblast
colony-forming unit capacity and an increased capability to undergo both osteogenesis
and adipogenesis.
Clinical relevance
Limited evidence exists comparing the intrinsic stem cell-like properties of the iliac
crest and distal radius despite the widespread use of each source in hand and wrist
surgery. The information from this investigation may assist hand and wrist surgeons
with the selection of a source of autograft.
Key words
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Article info
Publication history
Published online: August 03, 2022
Accepted:
June 7,
2022
Received:
July 16,
2021
Publication stage
In Press Corrected ProofFootnotes
D.D.M., J.F.D., J.H.H., and P.L. contributed equally to this manuscript.
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
