A Shoulder Fracture Nonunion and AVN Update

It’s always good to follow-up with our patients to see how they did long-term. This morning I’d like to update you on a patient whose shoulder fractures were so severe, surgeons had nothing to offer. I gave you a short look at her Fracture Nonunion and Shoulder AVN treatment results back in 2015; this is where she is today.

Fracture Nonunion and AVN

Fractures usually heal within a few months. When they don’t, it’s called fracture delayed or nonunion. On the other end of the bone problem spectrum is a disease called avascular necrosis (AVN), or osteonecrosis (ON). This is when the bone doesn’t have the ability to take care of itself and begins to die off. This patient had both problems, a one-two punch of bone disease.

Both of these diseases involve stem cells at some level. For example, we know through multiple studies that the stem cell content of the bone correlates with the ability for it to heal. Fewer stem cells equal bone that is more likely to have issues like nonunion and AVN. Hence, injecting stem cells into bone is a logical way to try to heal this damaged tissue.

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So Where Is Our Nonunion Fracture and Shoulder AVN Treatment Patient Today?

This patient now reports that despite these fractures that surgeons wouldn’t touch and ripped up rotator cuff tendons, she’s 95% improved. The progression of her MRIs is shown above. On the left, the before-treatment image shows bright bone, which means the bone is fractured and dying. The images to the right, after treatment, show more healthy dark bone. While she still does have two areas where the bone never fully healed, given that she’s dramatically better, it remains to be seen whether this area will need another treatment at some point.

The upshot? This was a patient I wasn’t sure we could help. It’s still amazing to see most of this bone heal without surgery. No screws, plates, incisions, bone plugs, grafts, or other invasive procedures. Only a precise injection of the patient’s own stem cells in a fracture nonunion and Shoulder AVN treatment.

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile