Usefulness of autologous growth factors in orthopaedic surgery

Pichon Riviere A, Augustovski F, Ferrante D, Regueiro A, Garcia Marti S, Glujovsky D
Record ID 32005000657
Spanish
Authors' objectives:

The aim of this review was to assess the usefulness of autologous growth factors in orthopaedic surgery

Authors' results and conclusions: Autologous growth factors (AGF) has been used for orthodontic procedures, in chronic skin lesion healing and in some orthopedic surgeries, especially in spinal fusion. Spinal fusion (arthrodesis) is a method frequently used to improve the spine stability and it is used in patients presenting instability or degenerative processes: spondylolisthesis, disc herniation associated with instability factors, narrow lumbar spine channel, scoliosis and vertebral fractures, among others. Spinal arthrodesis eliminates all movement possibilities as it achieves proper fusion among the spine elements. However, this fusion is not always accomplished and pseudoarthrosis turns into a significant clinical problem.
Authors' recomendations: AGF are obtained from the patient's blood unit prior to surgery. A fraction with platelets and white cells is processed until an autologous growth factor concentrate with platelet ultraconcentrations (between 6 and 10 times higher than the base line) is obtained. Then, this concentrate is combined with thrombin and it is applied to autologous bone tissue habitually taken from the iliac crest thus making up a cohesive material. No clinical trials assessing the use of AGF in orthopedic surgeries have been found. The publications found are mostly series of cases compared with historical controls. Some of these studies described a quicker short-term spinal fusion with the use of AGF (96% vs. 64% after 6 months) but without significant long-term differences, fusion being observed in almost all the patients after two years (96% vs. 94%). In addition, a study of consecutive series of cases showed a lower efficacy with the use of AGF (fusion at two years with AGF 62% vs. 91% without AGF).
Details
Project Status: Completed
URL for project: http://www.iecs.org.ar/
Year Published: 2004
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Blood Transfusion, Autologous
  • Erythropoietin
  • Growth Substances
  • Orthopedic Procedures
Contact
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.