metatarsal pseudarthrosis (9)

Patient with rheumatoid arthritis being treated with cortisone. Some time ago, the patient underwent forefoot surgery and during the post-operative period sustained a fracture that did not consolidate due to overload of the bases of the 2nd, 3rd, 4th and 5th metatarsals, progressing to pseudarthrosis. The patient presented with significant inflammation of the foot and incapacitating pain.
Leukocyte-free PRP was initially injected into the pseudoarthritic sites, which completely eliminated pain and oedema and consolidated the 5th metatarsal (images on the left).

Due to persistent pseudarthrosis at the base of the central metatarsals and the recurrence of very acute pain and oedema after a few months, treatment consisting of focal curettage and bone graft insertion comprising autologous bone marrow stem cells cultured with the Aastrom Replicell bioreactor at the Barcelona Blood and Tissue Bank, with granules of tricalcium phosphate and autologous plasma clot, was administered.

The patient's progression was very satisfactory: the oedema resolved immediately and consolidation was achieved at 3 months.