Aim: This study aimed to assess the efficacy of a novel bioregenerative scaffold comprising bone marrow aspirate, cancellous bone autograft, platelet-rich plasma, and autologous fibrin in the treatment of supracondylar femur non-unions.
Methods & Materials: Four patients with non-unions following multiple unsuccessful surgical interventions underwent bone stabilization surgery along with the application of the innovative bioregenerative scaffold. Evaluation of outcomes was conducted through preoperative and postoperative assessments at 6, 12, and 24 months, utilizing X-rays for radiological confirmation and subjective assessment scales to gauge functional improvements.
Results: Radiographic analysis demonstrated successful healing of all non-unions with adequate callus formation evident within the specified timeframe. Notably, within 6 months post-surgery, all patients achieved the milestone of full weight-bearing walking without experiencing pain or discomfort. Statistical analysis revealed highly significant improvements across all subjective assessment scales compared to baseline values, indicating robust functional recovery and symptom relief.
Conclusions: This study underscores the potential of the novel bioregenerative scaffold as a promising therapeutic option for managing supracondylar femur non-unions refractory to conventional treatments. The observed successful outcomes, including prompt healing and restoration of functional abilities, highlight the clinical efficacy and potential utility of this approach in addressing challenging cases of non-union following multiple surgical failures. Further investigation and validation in larger cohorts are warranted to establish its broader applicability and long-term efficacy.
Keywords: femur non-union, bone marrow aspirate, platelet rich plasma, autologous bone graft, autologous fibrin, regenerative orthopedics

Purpose: to evaluate the short-term clinical follow-up results of treatment patients with early stages osteonecrosis of the femoral head (ONFH) core decompression combined with bone marrow aspirate concentrate. Methods: Single-center prospective comparative cohort study. Ninety-five (161 hips) patients with early ONFH from 2019 to 2023 were divided into 2 groups. Patients in I group were treated by autologous bone marrow aspirate concentrate instillation into the core tract after core decompression; II group were treated by core decompression alone. Parameters assessed before surgery and after 3 months: gender, age, BMI, Harris Hip Score (HHS), VAS, WOMAC, SF-36. Results: At 3 months, 60 patients (63.2%) (103 hips (64%)) were available for analysis. After 3 months, I group in comparison with II group was statistically significant difference in functional ability HHS (73.5 [65.75;81.5] vs 57[43.25;72. 25], p=0.003), WOMAC (53 [31;79] vs 94 [43;136.5], p=0.01), improvement of pain VAS (3 [2;4] vs 5[3 ;7], p=0.005), and quality of life SF-36 (89.4 [75.7;97.6] vs 73.9 [67.5;86.2], p=0.008). Conclusion: The short-term clinical follow-up results showed that core decompression combined with bone marrow aspirate concentrate was more effective than the use of core decompression alone.

Inflammatory infiltration and inappropriate friction remain the two main challenges in treating osteoarthritis (OA). Hydrogel microspheres function as ball bearings, minimize friction during interfacial contact and effectively deliver drugs to the injury sites. However, the weak tissue adhesion associated with commonly used microsphere materials often diminishes drug effectiveness. Macrophages are among the plentiful non-specific immune cells in the synovium, and they are integral to the initiation and exacerbation of OA through the initial inflammatory response. Thus, an effective delivery system is necessary to ameliorate intra-articular inflammation, adhere to and lubricate the cartilage, and improve cartilage dysfunction. Herein, biologically- and physically-coupled matrix metallopeptidase (MMP)-responsive hydrogel delivery microspheres with cartilage adhesion, intelligent targeting of M1-type (M1) macrophages, and cartilage lubrication were developed. The microspheres (78c@Lipo-FA-DPG@Chs/SerMA [LFDCS]) had sericin methacryloyl (SerMA) as their core blended with chondroitin sulfate (Chs), and 78c@liposomes- folic acid (78c@Lipo-FA) was attached to Chs/SerMA via the MMP-responsive degraded peptide, DSPE-PEG2k-GPLGLAGQC (DPG). In vivo and in vitro studies, when LFDCS exerted lubrication and adhesion functions, Chs was released to ameliorate chondrocyte dysfunction. DPG enzymatically released 78c@Lipo-FA to inhibit M1 macrophage-mediated inflammation in a high MMP9 environment. That indicated that LFDCS alleviated OA via biologically- and physically-coupled. In addition, an RNA sequencing analysis revealed that the LFDCS ameliorated chondrocyte dysfunction by down-regulating inflammation (i.e., the PI3K/AKT signaling pathway). In conclusion, this novel M1-type macrophage-targeted drug delivery system addresses the unfavorable factors of both the biological and physical microenvironments in macrophage-mediated diseases, effectively “killing two birds with one stone”.