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Yong KW, Wu K, Elliott JAW, Jomha NM. The effect of sucrose supplementation on chondrocyte viability in porcine articular cartilage following vitrification. Cryobiology 2022; 109:53-61. [PMID: 36155184 DOI: 10.1016/j.cryobiol.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 02/05/2023]
Abstract
Vitrification can extend the banking life of articular cartilage (AC) and improve osteochondral transplantation success. Current vitrification protocols require optimization to enable them to be implemented in clinical practice. Sucrose as a non-permeating cryoprotective agent (CPA) and clinical grade chondroitin sulfate (CS) and ascorbic acid (AA) as antioxidants were investigated for their ability to improve a current vitrification protocol for AC. The aim of this study was to assess the impact of sucrose and CS/AA supplementation on post-warming chondrocyte viability in vitrified AC. Porcine osteochondral dowels were randomly vitrified and warmed with one established protocol (Protocol 1) and seven modified protocols (Protocols 2-8) followed by chondrocyte viability assessment. Sucrose supplementation in both vitrification and warming media (Protocol 4) resulted in significantly higher (p = 0.018) post-warming chondrocyte viability compared to the protocol without sucrose (Protocol 1). There was no significant difference (p = 0.298) in terms of post-warming chondrocyte viability between sucrose-supplemented DMEM + CS solution (Protocol 4) and Unisol-CV (UCV) + CS (Protocol 6) solution. Clinical grade CS and AA contributed to similar post-warming chondrocyte viability to previous studies using research grade CS and AA, indicating their suitability for clinical use. The addition of an initial step (step 0) to reduce the initial concentration of CPAs to minimize osmotic effects did not enhance chondrocyte viability in the superficial layer of AC. In conclusion, sucrose-supplemented DMEM + clinical grade CS (Protocol 4) could be an ideal protocol to be investigated for future use in clinical applications involving vitrified AC.
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Affiliation(s)
- Kar Wey Yong
- Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Kezhou Wu
- Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada
- Department of Orthopedic Surgery, First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China
| | - Janet A W Elliott
- Department of Chemical and Materials Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, T6G 1H9, Canada; Department of Laboratory Medicine and Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2R7, Canada
| | - Nadr M Jomha
- Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada
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Chen CM, Chen YC, Wang JY, Chen CF, Chao KY, Wu PK, Chen WM. A Cryoprotectant-Gel Composite Designed to Preserve Articular Cartilage during Frozen Osteoarticular Autograft Reconstruction for Malignant Bone Tumors: An Animal-Based Study. Cartilage 2022; 13:19476035221109228. [PMID: 35979907 PMCID: PMC9393690 DOI: 10.1177/19476035221109228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We designed a highly adhesive cryoprotectant-gel composite (CGC), based on regular liquid-form cryoprotectant base (CB), aiming to protect cartilage tissue during frozen osteoarticular autograft reconstruction for high-grade sarcoma around the joint. This study aimed to evaluate its effectiveness in rat and porcine distal femur models. DESIGN Fresh articular cartilage samples harvested from distal rat and porcine femurs were divided into 4 test groups: untreated control group, liquid nitrogen (LN) freezing group, LN freezing group pretreated with CB (CB group), and LN freezing group pretreated with CGC (CGC group). Microscopic and macroscopic evaluation of cartilage condition, TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assay, and apoptotic protein analysis of chondrocytes were performed to confirm our results. RESULTS In the rat model, CGC could prevent articular cartilage from roughness and preserve more proteoglycans when compared with the LN freezing and CB groups. Western blot analysis showed CGC could prevent cartilage from LN-induced apoptosis supported by caspase-3/8 apoptotic signaling cascade. Macroscopically, we observed CGC could reduce both articular clefting and loss of articular luminance after freezing in the porcine model. In both models, CGC could reduce articular chondrocytes from degeneration. Fewer TUNEL-positive apoptotic and more viable chondrocytes in cartilage tissue were observed in the CGC group in our animal models. CONCLUSION Our study proved that CGC could effectively prevent cartilage surface and chondrocytes from cryoinjury after LN freezing. Freezing articular cartilage surrounded with high concentration of CGC can be a better alternative to preserve articular cartilage during limb salvage surgery for malignant bone tumor.
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Affiliation(s)
- Chao-Ming Chen
- Department of Orthopaedic &
Traumatology, Taipei Veterans General Hospital, Taipei City, Taiwan,Therapeutical and Research Center of
Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei City, Taiwan,Institute of Clinical Medicine, School
of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,Department of Orthopaedic, School of
Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yi-Chun Chen
- Department of Orthopaedic &
Traumatology, Taipei Veterans General Hospital, Taipei City, Taiwan,Therapeutical and Research Center of
Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Jir-You Wang
- Department of Orthopaedic &
Traumatology, Taipei Veterans General Hospital, Taipei City, Taiwan,Therapeutical and Research Center of
Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei City, Taiwan,Institute of Traditional Medicine,
School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Cheng-Fong Chen
- Department of Orthopaedic &
Traumatology, Taipei Veterans General Hospital, Taipei City, Taiwan,Therapeutical and Research Center of
Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei City, Taiwan,Department of Orthopaedic, School of
Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Kuang-Yu Chao
- Department of Orthopaedic &
Traumatology, Taipei Veterans General Hospital, Taipei City, Taiwan,Therapeutical and Research Center of
Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Po-Kuei Wu
- Department of Orthopaedic &
Traumatology, Taipei Veterans General Hospital, Taipei City, Taiwan,Therapeutical and Research Center of
Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei City, Taiwan,Department of Orthopaedic, School of
Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,Po-Kuei Wu, Department of Orthopaedic &
Traumatology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road,
Taipei City 112, Taiwan.
| | - Wei-Ming Chen
- Department of Orthopaedic &
Traumatology, Taipei Veterans General Hospital, Taipei City, Taiwan,Therapeutical and Research Center of
Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei City, Taiwan,Department of Orthopaedic, School of
Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
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3
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Chen CM, Chen CF, Wang JY, Chen TH, Wu PK, Chen WM. Patella cryo-free technique with recycled frozen autograft reconstruction preserves extensor mechanism for proximal tibial malignancy. J Chin Med Assoc 2022; 85:453-461. [PMID: 35019865 DOI: 10.1097/jcma.0000000000000692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUNDS We designed a patella cryo-free method to protect patella from cryoinjury during recycled frozen bone-prosthesis-composite reconstruction for proximal tibial malignancy. This study aimed to use animal model to ensure safety and efficacy of this method and reported our clinical outcomes. METHODS Six swine proximal tibias along with patella and patellar tendon were harvested and dived into group A (n = 3, traditional patella freezing) and group B (n = 3, patella cryo-free). Temperature curve measurement, histological analysis, and TUNEL assay were performed in both groups. Clinically, we retrospectively reviewed 23 patients with proximal tibia malignant bone tumor (13: traditional patella freezing method; 10: patella cryo-free method). The clinical and functional outcomes were reported and compared in both groups. RESULTS Temperature curve of the group B showed that ideal therapeutic temperature (<-60°C) required to kill tumor cells can be achieved in the proximal tibia while the innocent patella can be kept in room temperature at all time. Histological analysis showed better preservation of the cartilage tissue in patella of group B. TUNEL assay showed significantly more apoptotic cells in the frozen tibia of both groups and frozen patella of group A. When reviewing our clinical results, less complication of the patella as well as better functional preservation were found in patients subjecting to patella cryo-free method. No local recurrence was observed in either group. CONCLUSION Patellar cryo-free technique could protect patella from cryoinjury during freezing and therefore preserve more extensor functions for patients with proximal tibial malignant bone tumors.
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Affiliation(s)
- Chao-Ming Chen
- Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Orthopaedic Department, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Cheng-Fong Chen
- Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Orthopaedic Department, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Jir-You Wang
- Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Tain-Hsiung Chen
- Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Orthopaedic Department, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Po-Kuei Wu
- Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Orthopaedic Department, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Wei-Ming Chen
- Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Orthopaedic Department, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Yong KW, Laouar L, Elliott JAW, Jomha NM. Review of non-permeating cryoprotectants as supplements for vitrification of mammalian tissues. Cryobiology 2020; 96:1-11. [PMID: 32910946 DOI: 10.1016/j.cryobiol.2020.08.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 12/30/2022]
Abstract
Vitrification of mammalian tissues is important in the areas of human assisted reproduction, animal reproduction, and regenerative medicine. Non-permeating cryoprotectants (CPAs), particularly sucrose, are increasingly used in conjunction with permeating CPAs for vitrification of mammalian tissues. Combining non-permeating and permeating CPAs was found to further improve post-thaw viability and functionalities of vitrified mammalian tissues, showing the potential applications of such tissues in various clinical and veterinary settings. With the rising demand for the use of non-permeating CPAs in vitrification of mammalian tissues, there is a strong need for a timely and comprehensive review on the supplemental effects of non-permeating CPAs toward vitrification outcomes of mammalian tissues. In this review, we first discuss the roles of non-permeating CPAs including sugars and high molecular weight polymers in vitrification. We then summarize the supplemental effects of non-permeating CPAs on viability and functionalities of mammalian embryos, and ovarian, testicular, articular cartilage, tracheal, and kidney tissues following vitrification. Lastly, challenges associated with the use of non-permeating CPAs in vitrification of mammalian tissues are briefly discussed.
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Affiliation(s)
- Kar Wey Yong
- Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Leila Laouar
- Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Janet A W Elliott
- Department of Chemical and Materials Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, T6G 1H9, Canada; Department of Laboratory Medicine and Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2R7, Canada
| | - Nadr M Jomha
- Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada.
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Hayashi K, Yamamoto N, Takeuchi A, Miwa S, Igarashi K, Higuchi T, Abe K, Taniguchi Y, Aiba H, Araki Y, Yonezawa H, Morinaga S, Tsuchiya H. Clinical course of grafted cartilage in osteoarticular frozen autografts for reconstruction after resection of malignant bone and soft-tissue tumor involving an epiphysis. J Bone Oncol 2020; 24:100310. [PMID: 32802735 PMCID: PMC7419662 DOI: 10.1016/j.jbo.2020.100310] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/23/2020] [Accepted: 07/25/2020] [Indexed: 11/24/2022] Open
Abstract
Frozen autograft of tumour-bearing bone using liquid nitrogen as a recycling autograft has various advantages. This paper is the first report focusing on the fate of grafted cartilage in recycled autograft after bone tumour excision. We found hemicondylar frozen autograft is promising reconstruction method.
There are several options for biological reconstruction after bone tumor resection. If the tumor invades an epiphysis, the reconstruction is far more complicated because there is no option to restore large joint cartilage using currently available medical techniques. Frozen autograft with liquid nitrogen has been used as recycled autologous bone graft and the purpose of the present study was to assess the outcome of grafted cartilage in osteoarticular frozen autografts used in the treatment of patients with bone and soft-tissue sarcoma. We have treated 27 patients with cases of bone tumor resection involving an epiphysis where frozen autografts were used for reconstruction. If the tumor was located in a limited part of the epiphysis, partial resection of the epiphysis was performed to preserve the healthy part of the cartilage in 4 cases. The survival of grafted frozen cartilage was assessed by X-ray imaging. The end point was defined as grade IV of the Kellgren and Lawrence osteoarthritis grading system and was recorded using the Kaplan–Meier method. In case of removal of grafted bone after the surgery, pathological findings were assessed by hematoxylin and eosin staining of sections of resected cartilage in available cases to observe the fate of grafted cartilage over time. The postoperative mean follow-up period was 94.0 months. Grade IV osteoarthritis occurred in 12 patients. All patients in the partial epiphyseal freezing group survived compared with only 1 patient in the total epiphyseal freezing group who had survived to the final follow up (p < 0.01). Resected specimens with grafted cartilage were examined histologically. A sample excised after 14 months had dead cartilage with empty lacunae and the surface of the cartilage had reactive fibrous tissue. Grafted cartilage of frozen osteoarticular autografts was worn out over time. However, intraepiphyseal resection preserving partial healthy cartilage resulted in excellent survival. This technique requires careful planning of the surgery but might be an alternative to megaprosthesis.
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Affiliation(s)
- Katsuhiro Hayashi
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Norio Yamamoto
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Akihiko Takeuchi
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Shinji Miwa
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Kentaro Igarashi
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Takashi Higuchi
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Kensaku Abe
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Yuta Taniguchi
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Hisaki Aiba
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Yoshihiro Araki
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Hirotaka Yonezawa
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Sei Morinaga
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedics, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
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6
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Xu G, Yamamoto N, Nojima T, Hayashi K, Takeuchi A, Miwa S, Igarashi K, Tsuchiya H. The process of bone regeneration from devitalization to revitalization after pedicle freezing with immunohistochemical and histological examination in rabbits. Cryobiology 2019; 92:130-137. [PMID: 31875528 DOI: 10.1016/j.cryobiol.2019.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/13/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
Abstract
The pedicle freezing procedure by liquid nitrogen is a method for the reconstruction of tumor-bearing bone after malignant tumor resection. However, the regenerative mechanism of bone after the pedicle freezing procedure is unclear. We investigated the complete process from devitalization to revitalization of bone after the pedicle freezing procedure in 13 rabbits. After osteotomy the 5 mm distal femurs were immersed in liquid nitrogen, and the specimens were divided into frozen area and sub-frozen area. The bilateral femurs were harvested for evaluation of bone regeneration by histological and immunohistochemical examination (VEGF, CD31, BMP-2 and Runx2) from 1 week to 52 weeks. The diameter of operating femurs was compared with contralateral femurs from 6 weeks to 52 weeks. No viable cells could be found from 1 to 8 weeks in the frozen area, and a mean 1.83 cm necrotic range were detected in the sub-frozen area. The periosteal reaction, massive fibrous tissue and immature bone matrix invaded from the normal area to the necrotic area from 12 weeks. Subsequently, the necrotic bone was gradually replaced by newly formed bone by creeping substitution, with endochondral and intramembrane bone formation. The diameter of frozen femurs was significantly larger than the contralateral femur at the same period from 8 weeks to 52 weeks (P < 0.01). All immunohistochemical factors were positively expressed in both areas at different time points. The active osteoblasts and microvessel migrated from marrow cavity and periosteum into dead bone. This study suggested that the frozen bone not only provides a scaffold but also possesses excellent osteoinductive properties.
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Affiliation(s)
- Gang Xu
- Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan.
| | - Takayuki Nojima
- Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan; Section of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan
| | - Akihiko Takeuchi
- Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan
| | - Kentaro Igarashi
- Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan
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Chen CM, Chen CF, Wang JY, Madda R, Tsai SW, Wu PK, Chen WM. Bone morphogenetic protein activity preservation with extracorporeal irradiation- and liquid nitrogen freezing-treated recycled autografts for biological reconstruction in malignant bone tumor. Cryobiology 2019; 89:82-89. [DOI: 10.1016/j.cryobiol.2019.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 02/06/2023]
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Cao F, Qi J, Song H, Xie D, Zhou L, Han Y, Li H, Wu Q, Dong J, Zhang Y. Tsmu solution improves rabbit osteochondral allograft preservation and transplantation outcome. Cell Tissue Bank 2018; 19:549-558. [PMID: 29876883 DOI: 10.1007/s10561-018-9703-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 05/25/2018] [Indexed: 12/20/2022]
Abstract
To compare the effects of Tsmu solution with vitrification on chondrocyte viability and examine histological and biomechanical properties of osteochondral allografts (OCAs) after storage, OCAs from femoral condyles of New Zealand rabbits were harvested, stored for 35 days in Tsmu solution or by in vitro vitrification, and subjected to in vivo and in vitro assays. Stored OCAs were transplanted into knee femoral condyle cartilage defects in recipient rabbits. Chondrocyte viability and histological changes of cartilage grafts were assessed in vitro. Gross assessment, chondrocyte viability, histological assessment, OCA biomechanics, and immunological markers were evaluated in vivo 6 months after transplantation. Fresh OCAs served as in vitro and in vivo controls. Chondrocyte viability and scores for cartilage surface and histological quantitative assessment were superior for Tsmu solution compared with vitrification, but inferior compared with fresh OCAs in vitro and in vivo. With the exception of interleukin 6 content, biomechanical features of samples stored in Tsmu solution were superior to vitrification, and inferior to fresh OCAs in vivo. Thus, Tsmu solution provided suitable storage that improved chondrocyte viability, intact OCA cartilage matrix architecture, and transplantation outcomes.
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Affiliation(s)
- Famin Cao
- Institute of Sports Medicine, Taishan Medical University, 619 Great Wall Road, Tai'an, 271016, Shandong, China
| | - Jianhong Qi
- Institute of Sports Medicine, Taishan Medical University, 619 Great Wall Road, Tai'an, 271016, Shandong, China. .,Institute of Sports Medicine, Taishan Medical University, 619 Changcheng Road, Tai'an, 271016, Shandong, China.
| | - Hongqiang Song
- Institute of Sports Medicine, Taishan Medical University, 619 Great Wall Road, Tai'an, 271016, Shandong, China
| | - Di Xie
- Institute of Sports Medicine, Taishan Medical University, 619 Great Wall Road, Tai'an, 271016, Shandong, China
| | - Lu Zhou
- Institute of Sports Medicine, Taishan Medical University, 619 Great Wall Road, Tai'an, 271016, Shandong, China
| | - Yunning Han
- Institute of Sports Medicine, Taishan Medical University, 619 Great Wall Road, Tai'an, 271016, Shandong, China
| | - Hao Li
- Institute of Sports Medicine, Taishan Medical University, 619 Great Wall Road, Tai'an, 271016, Shandong, China
| | - Qi Wu
- Institute of Sports Medicine, Taishan Medical University, 619 Great Wall Road, Tai'an, 271016, Shandong, China
| | - Jun Dong
- Institute of Sports Medicine, Taishan Medical University, 619 Great Wall Road, Tai'an, 271016, Shandong, China
| | - Yanming Zhang
- Institute of Sports Medicine, Taishan Medical University, 619 Great Wall Road, Tai'an, 271016, Shandong, China
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Abstract
Reconstruction options in children after bone tumor resection are as varied as they are challenging. Advances in biologic and endoprosthetic design have led to many choices, all of which must be considered in the context of prognosis, treatment limitations, and patient/family expectations. The current experience and results of limb-sparing surgery following bone sarcoma resection in growing children are discussed, including allograft, autograft, and metallic prostheses alone and in combination, especially as they pertain to the knee. In some cases, the ablative options of amputation and rotationplasty must be seen as equal and, at times, superior choices to limb salvage.
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Takroni TA, Yu H, Laouar L, Adesida AB, Elliott JA, Jomha NM. Ethylene glycol and glycerol loading and unloading in porcine meniscal tissue. Cryobiology 2017; 74:50-60. [DOI: 10.1016/j.cryobiol.2016.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 10/19/2016] [Accepted: 12/08/2016] [Indexed: 11/26/2022]
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Shimozaki S, Yamamoto N, Shirai T, Nishida H, Hayashi K, Tanzawa Y, Kimura H, Takeuchi A, Igarashi K, Inatani H, Kato T, Tsuchiya H. Pedicle versus free frozen autograft for reconstruction in malignant bone and soft tissue tumors of the lower extremities. J Orthop Sci 2014; 19:156-63. [PMID: 24158433 DOI: 10.1007/s00776-013-0487-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 10/10/2013] [Indexed: 02/09/2023]
Abstract
BACKGROUND Of the biological reconstruction methods for malignant bone and soft tissue tumors, reconstruction with liquid nitrogen has the advantage of maintaining continuity on the distal side of the tumor bone site (pedicle freezing procedure; PFP). This method is expected to result in early blood flow recovery, with early union and low complication rate. The purpose of this study was to compare the outcomes of the PFP and free freezing procedure (FFP) in the lower extremities. METHODS The study included 20 patients (12 men and 8 women) with frozen autografts (FFP, 13 cases; PFP, 7 cases). The mean age of the subjects was 36.3 years (range 11-79 years), and the mean follow-up period was 56.4 months (range 12-142 months). RESULTS Final bone union occurred in 11 patients in the FFP group (84.6%) and in 7 patients in the PFP group (100%). The mean union period in patients who did not need additional surgery was 9.8 months (range 4-21 months) in the FFP group and 4.8 months (range 2-7 months) in the PFP group. Postoperative complications occurred in 8 cases: infection in 3 cases, fracture in 3 cases, and joint destruction in 2 cases. Six FFP patients, and 2 PFP patients (two cases of fracture), developed postoperative complications. CONCLUSIONS The union period was shorter and the rate of postoperative complications was lower with the PFP than with the FFP. We considered that early blood flow recovery might have led to the above results in the PFP.
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Affiliation(s)
- Shingo Shimozaki
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan
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12
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Vitreous preservation of articular cartilage from cryoinjury in rabbits. Cryobiology 2012; 65:98-103. [DOI: 10.1016/j.cryobiol.2012.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 05/08/2012] [Accepted: 05/14/2012] [Indexed: 11/17/2022]
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13
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Activity of bone morphogenetic protein-7 after treatment at various temperatures: Freezing vs. pasteurization vs. allograft. Cryobiology 2011; 63:235-9. [DOI: 10.1016/j.cryobiol.2011.09.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 09/06/2011] [Accepted: 09/06/2011] [Indexed: 11/19/2022]
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Lawson A, Mukherjee IN, Sambanis A. Mathematical modeling of cryoprotectant addition and removal for the cryopreservation of engineered or natural tissues. Cryobiology 2011; 64:1-11. [PMID: 22142903 DOI: 10.1016/j.cryobiol.2011.11.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 10/26/2011] [Accepted: 11/19/2011] [Indexed: 10/14/2022]
Abstract
Long-term storage of natural tissues or tissue-engineered constructs is critical to allow off-the-shelf availability. Vitrification is a method of cryopreservation that eliminates ice formation, as ice may be detrimental to the function of natural or bioartificial tissues. In order to achieve the vitreous state, high concentrations of CPAs must be added and later removed. The high concentrations may be deleterious to cells as the CPAs are cytotoxic and single-step addition or removal will result in excessive osmotic excursions and cell death. A previously described mathematical model accounting for the mass transfer of CPAs through the sample matrix and cell membrane was expanded to incorporate heat transfer and CPA cytotoxicity. Simulations were performed for two systems, an encapsulated system of insulin-secreting cells and articular cartilage, each with different transport properties, geometry and size. Cytotoxicity and mass transfer are dependent on temperature, with a higher temperature allowing more rapid mass transfer but also causing increased cytotoxicity. The effects of temperature are exacerbated for articular cartilage, which has larger dimensions and slower mass transport through the matrix. Simulations indicate that addition and removal at 4°C is preferable to 25°C, as cell death is higher at 25°C due to increased cytotoxicity in spite of the faster mass transport. Additionally, the model indicates that less cytotoxic CPAs, especially at high temperature, would significantly improve the cryopreservation outcome. Overall, the mathematical model allows the design of addition and removal protocols that insure CPA equilibration throughout the sample while still minimizing CPA exposure and maximizing cell survival.
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Affiliation(s)
- Alison Lawson
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA 30332, United States
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Muramatsu K, Yoshida K, Fujii K, Okazaki T, Moriya A, Taguchi T. Anatomical reconstruction of the knee extensor apparatus for prepatellar myxofibrosarcoma. Orthopedics 2010; 33:773. [PMID: 20954649 DOI: 10.3928/01477447-20100826-32] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A novel reconstruction of the knee extensor apparatus was attempted in a 69-year-old patient with prepatellar myxoid fibrosarcoma. The skin (35×25 cm), subcutaneous tumor, quadriceps tendon, patella, anterior capsule, and patella tendon were widely resected en-bloc. Following wide resection, the excised quadriceps tendon, patella, and patella tendon were anatomically reimplanted into the original site after being devitalized in liquid nitrogen. These complexes were covered by a free vascularized latissimus dorsi myocutaneous flap. At 18-month follow-up, the strength of active knee extension was 4+ of 5 in the muscle manual test. The active range of motion was 110° in flexion and -10° in extension. The tumor showed no evidence of disease. The patella and femur joint showed no osteoarthritis on plain radiographs. This procedure is the only way to achieve anatomical reconstruction. Reattachment of patella tendon to the tibial tuberosity was possible. The use of liquid nitrogen to devitalize is straightforward and the operation time can be shortened. To our knowledge, this type of reconstructive procedure has never been reported in the English literature.
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Affiliation(s)
- Keiichi Muramatsu
- Department of Orthopedic Surgery, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. muramatu@ yamaguchi-u.ac.jp
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Brockbank KGM, Chen ZZ, Song YC. Vitrification of porcine articular cartilage. Cryobiology 2009; 60:217-21. [PMID: 20026102 DOI: 10.1016/j.cryobiol.2009.12.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Revised: 11/12/2009] [Accepted: 12/08/2009] [Indexed: 10/20/2022]
Abstract
The limited availability of fresh osteochondral allograft tissues necessitates the use of banking for long-term storage. A vitrification solution containing a 55% cryoprotectant formulation, VS55, previously studied using rabbit articular cartilage, was evaluated using porcine articular cartilage. Specimens ranging from 2 to 6 mm in thickness were obtained from 6mm distal femoral cartilage cores and cryopreserved by vitrification or freezing. The results of post-rewarming viability assessments employing alamarBlue demonstrated a large decrease (p<0.001) in viability in all three sizes of cartilage specimen vitrified with VS55. This is in marked contrast with prior experience with full thickness, 0.6 mm rabbit cartilage. Microscopic examination following cryosubstitution confirmed ice formation in the chondrocytes of porcine cartilage vitrified using VS55. Experiments using a more concentrated vitrification formulation (83%), VS83, showed a significant treatment benefit for larger segments of articular cartilage. Differences between the VS55 and the VS83 treatment groups were significant at p<0.001 for 2 mm and 4 mm plugs, and at p<0.01 for full thickness, 6 mm plugs. The percentage viability in fresh controls, compared to VS55 and VS83, was 24.7% and 80.7% in the 2 mm size group, 18.2% and 55.5% in the 4 mm size group, and 5.2% and 43.6% in the 6 mm group, respectively. The results of this study continue to indicate that vitrification is superior to conventional cryopreservation with low concentrations of dimethyl sulfoxide by freezing for cartilage. The vitrification technology presented here may, with further process development, enable the long-term storage and transportation of living cartilage for repair of human articular surfaces.
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