Radical bid to grow new bone
A MELBOURNE man is the first person in the world whose own stem cells are being used to try to mend a broken leg.
The cutting-edge stem-cell technology has helped Jamie Stevens, 21, back on his feet.
A motorcycle crash nine months ago left him with a severely broken left thigh bone. Part of the femur stuck through his leg, and other parts of the bone were missing.
The bone failed to heal and Mr Stevens’s leg was held together by a large titanium plate.
Royal Melbourne Hospital orthopedics director Richard de Steiger decided Mr Stevens was the ideal first patient for a revolutionary stem-cell trial at the hospital.
About seven weeks ago, Mr de Steiger harvested bone marrow from Mr Stevens’ pelvis.
The adult stem cells were then separated from the other cells.
A sub-group of stem cells called mesenchymal precursor cells — those that can transform into tissues including bone, cartilage and heart — were isolated and grown.
Last week, about 30 million of these cells were implanted into the 5cm x 3cm hole in Mr Stevens’ thigh bone.
The cells were coated on to pieces of calcium phosphate that act as a scaffold for the cells when they are placed inside the bone.
The cells are expected to regenerate new bone and grow through the calcium phosphate.
Yesterday, just four days after surgery, Mr Stevens went home.
"It’s good to be part of something that is on the brink," he said. "I wouldn’t say I understand it. It’s all pretty cool."
It will be three to four months before the result of the operation is known.
"This is radical, and the first procedure in the world to use a patient’s own stem cells and make them turn into bone-forming cells that are the patients’ own cells, to stimulate healing of a fracture," Mr de Steiger said.
The cells are harvested, cultured and expanded using Australian biotechnology company Mesoblast’s specialist adult-stem-cell technology.
Mr de Steiger hopes that eventually the technique will be refined to a simple injection, avoiding further surgery.
Using a patient’s own cells avoids the potential problem of the body’s rejection of foreign cells.
The only other alternative to repair Mr Stevens’ leg would have been a painful bone graft, taking a chunk of bone from his hip and plugging it into the hole in his thigh.
"The conventional way used over many years involves a large incision at the pelvis and taking out quite a large amount of bone in Jamie’s case," Mr de Steiger said.
"In this situation there is the risk of a separate incision, reported continuing pain from that incision, and separate infection risk at that site."
Mr de Steiger said orthopedic specialists at the Royal Melbourne hospital treated about 200 fractures of the long leg bones each year.
About 10 per cent become "non-union" fractures that fail to heal; 10 of these patients will be recruited to be part of the year-long trial.
Mr Stevens said he was no more nervous about being the first patient in the world to have the procedure than he would have been having a graft.
"I think the benefit outweighs the old procedure, and being able to avoid having a big chunk of bone taken out of the hip . . . the recovery period of it was a lot quicker."
After living in limbo for nine months, Mr Stevens said he was looking forward to resuming the life he enjoyed before his accident.
