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Chen J, Li J, Zhang H, Feng W, Ye P, Qi X, Li J, Deng P, Li Y, Huang Y, Zeng J, Zeng Y. Bone Healing and Clinical Outcome Following Medial Opening-wedge High Tibial Osteotomy Using Wedge-Shaped Cancellous Allograft. Orthop Surg 2024; 16:86-93. [PMID: 38014470 PMCID: PMC10782265 DOI: 10.1111/os.13939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVE Medial opening-wedge high tibial osteotomy (MOWHTO) is considered to be an effective treatment for symptomatic knee osteoarthritis (KOA) of isolated the medial compartment with varus alignment of the lower extremity. However, the choice of material to fill the void remains controversial. This study aims to evaluate the bone union of the osteotomy gap using a novel wedge-shaped cancellous allograft after MOWHTO and its effect on clinical outcomes. METHODS All patients who underwent MOWHTO using a novel wedge-shaped cancellous allograft combined with TomoFix locking compression plate (LCP) fixation between January 2016 and July 2020 were enrolled. The radiographic parameters including hip-knee-ankle angle (HKAA), medial proximal tibial angle (MPTA), femorotibial angle (FTA) and posterior tibial slope angle (PTSA) were measured between pre-operative and post-operative radiographs. Knee Society score (KSS) and range of motion (ROM) were assessed preoperatively and at last follow-up. Patients included in this study were divided into two groups according to the correction angle: small correction group (< 10°; SC group) and large correction group (≥ 10°; LC group). The modified Radiographic Union score for tibial fractures (mRUST) was used to assess the difference in bone healing between the two groups at 1, 3, 6, and 12 months postoperatively and at the final follow-up. A paired student's t test was conducted for comparison of differences of the relevant data pre-operatively and post-operatively. RESULTS A total of 82 patients (88 knees) were included in this study. The HKAA, MPTA, FTA and PTSA increased from -6.4° ± 3.0°, 85.1° ± 2.6°, 180.1° ± 3.2° and 7.7° ± 4.4° preoperatively to 1.2° ± 4.3° (p < 0.001), 94.4° ± 3.3° (p < 0.001), 171.0° ± 2.8° and 11.8° ± 5.8° (p < 0.001) immediately postoperatively, respectively. However, no significant statistic difference was found in above-mentioned parameters at last follow-up compared to immediate postoperative data (p > 0.05). All patients in this study achieved good bone healing at the final follow-up and no significant differences in mRUST scores were seen between the SC group and LC group. The KSS-Knee score and KSS-Function score improved significantly from 55.4 ± 3.7 and 63.3 ± 4.6 preoperatively to 86.4 ± 2.8 (p < 0.001) and 89.6 ± 2.9 (p < 0.001) at last follow-up, respectively. Nevertheless, there was no significant difference in ROM between pre-operation and last follow-up (p > 0.05). CONCLUSION For MOWHTO, the wedge-shaped cancellous allograft was a reliable choice for providing good bone healing and clinical outcomes.
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Affiliation(s)
- Jinlun Chen
- The First Clinical Medical CollegeGuangzhou University of Chinese MedicineGuangzhouChina
- Department of OrthopaedicsThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Jiahao Li
- Department of OrthopaedicsPanyu Hospital of Chinese MedicineGuangzhouChina
| | - Haitao Zhang
- Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Wenjun Feng
- Department of OrthopaedicsThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Pengcheng Ye
- Department of OrthopaedicsThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Xinyu Qi
- Department of OrthopaedicsThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Jie Li
- Department of OrthopaedicsThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Peng Deng
- Department of OrthopaedicsGuangdong Second Traditional Chinese Medicine HospitalGuangzhouChina
| | - Yijin Li
- The First Clinical Medical CollegeGuangzhou University of Chinese MedicineGuangzhouChina
| | - Yiwei Huang
- The First Clinical Medical CollegeGuangzhou University of Chinese MedicineGuangzhouChina
| | - Jianchun Zeng
- Department of OrthopaedicsThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Yirong Zeng
- Department of OrthopaedicsThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
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Limelette M, De Fourmestraux C, Despas C, Lafragette A, Veziers J, Le Guennec Y, Touzot-Jourde G, Lefevre FX, Verron E, Bouler JM, Bujoli B, Gauthier O. Calcium Phosphate Cements Combined with Blood as a Promising Tool for the Treatment of Bone Marrow Lesions. J Funct Biomater 2023; 14:jfb14040204. [PMID: 37103294 PMCID: PMC10143268 DOI: 10.3390/jfb14040204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 04/28/2023] Open
Abstract
The solid phase of a commercial calcium phosphate (Graftys® HBS) was combined with ovine or human blood stabilized either with sodium citrate or sodium heparin. The presence of blood delayed the setting reaction of the cement by ca. 7-15 h, depending on the nature of the blood and blood stabilizer. This phenomenon was found to be directly related to the particle size of the HBS solid phase, since prolonged grinding of the latter resulted in a shortened setting time (10-30 min). Even though ca. 10 h were necessary for the HBS blood composite to harden, its cohesion right after injection was improved when compared to the HBS reference as well as its injectability. A fibrin-based material was gradually formed in the HBS blood composite to end-up, after ca. 100 h, with a dense 3D organic network present in the intergranular space, thus affecting the microstructure of the composite. Indeed, SEM analyses of polished cross-sections showed areas of low mineral density (over 10-20 µm) spread in the whole volume of the HBS blood composite. Most importantly, when the two cement formulations were injected in the tibial subchondral cancellous bone in a bone marrow lesion ovine model, quantitative SEM analyses showed a highly significant difference between the HBS reference versus its analogue combined with blood. After a 4-month implantation, histological analyses clearly showed that the HBS blood composite underwent high resorption (remaining cement: ca. 13.1 ± 7.3%) and new bone formation (newly formed bone: 41.8 ± 14.7%). This was in sharp contrast with the case of the HBS reference for which a low resorption rate was observed (remaining cement: 79.0 ± 6.9%; newly formed bone: 8.6 ± 4.8%). This study suggested that the particular microstructure, induced by the use of blood as the HBS liquid phase, favored quicker colonization of the implant and acceleration of its replacement by newly formed bone. For this reason, the HBS blood composite might be worth considering as a potentially suitable material for subchondroplasty.
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Affiliation(s)
- Maxence Limelette
- CNRS, CEISAM, UMR 6230, Nantes Université, 44000 Nantes, France
- Graftys SA, Eiffel Park, Pôle d'activités d'Aix en Provence, 13080 Aix en Provence, France
| | - Claire De Fourmestraux
- Department of Small Animal and Equine Surgery and Anesthesia, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering (ONIRIS), 44307 Nantes, France
- Regenerative Medicine and Skeleton, INSERM, University Hospital (CHU), UMR 1229-RMeS, Nantes University, 44000 Nantes, France
| | - Christelle Despas
- LCPME, CNRS UMR 7564, Université de Lorraine, 54800 Villers Lès Nancy, France
| | - Audrey Lafragette
- Department of Small Animal and Equine Surgery and Anesthesia, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering (ONIRIS), 44307 Nantes, France
| | - Joelle Veziers
- Regenerative Medicine and Skeleton, INSERM, University Hospital (CHU), UMR 1229-RMeS, Nantes University, 44000 Nantes, France
| | - Yohan Le Guennec
- Regenerative Medicine and Skeleton, INSERM, University Hospital (CHU), UMR 1229-RMeS, Nantes University, 44000 Nantes, France
| | - Gwenola Touzot-Jourde
- Department of Small Animal and Equine Surgery and Anesthesia, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering (ONIRIS), 44307 Nantes, France
- Regenerative Medicine and Skeleton, INSERM, University Hospital (CHU), UMR 1229-RMeS, Nantes University, 44000 Nantes, France
| | | | - Elise Verron
- CNRS, CEISAM, UMR 6230, Nantes Université, 44000 Nantes, France
| | | | - Bruno Bujoli
- CNRS, CEISAM, UMR 6230, Nantes Université, 44000 Nantes, France
| | - Olivier Gauthier
- Department of Small Animal and Equine Surgery and Anesthesia, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering (ONIRIS), 44307 Nantes, France
- Regenerative Medicine and Skeleton, INSERM, University Hospital (CHU), UMR 1229-RMeS, Nantes University, 44000 Nantes, France
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Glowacki J, Epperly MW, Bellare A, Wipf P, Greenberger JS. Combined injury: irradiation with skin or bone wounds in rodent models. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2021; 41:S561-S577. [PMID: 34233299 DOI: 10.1088/1361-6498/ac125b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
A radiation combined injury is defined as an injury that occurs in the setting of irradiation, such as those expected after a nuclear accident, radiation dispersal device release (a 'dirty bomb'), or a nuclear weapon detonation. There is much research on irradiation-associated burns and their healing, but there is less known about other injuries sustained in the context of irradiation. Animal models are limited in their correlations to clinical situations but can support research on specific questions about injuries and their healing. Mouse models of irradiation with skin or bone wounds are validated as highly reproducible and quantitative. They show dose-dependent impairment of wound healing, with later recovery. Irradiation-induced delay of bone wound healing was mitigated to different extents by single doses of gramicidin S-nitroxide JP4-039, a plasmid expressing manganese superoxide dismutase, amifostine/WR2721, or the bifunctional sulfoxide MMS-350. These models should be useful for research on mechanisms of radiation dermal and osseous damage and for further development of new radioprotectors. They also provide information of potential relevance to the effects of clinical radiation therapies.
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Affiliation(s)
- Julie Glowacki
- Department of Orthopedic Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Michael W Epperly
- Department of Radiation Oncology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, United States of America
| | - Anuj Bellare
- Department of Orthopedic Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Peter Wipf
- Department of Chemistry, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Joel S Greenberger
- Department of Radiation Oncology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, United States of America
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J Hill M, Qi B, Bayaniahangar R, Araban V, Bakhtiary Z, Doschak M, Goh B, Shokouhimehr M, Vali H, Presley J, Zadpoor A, Harris M, Abadi P, Mahmoudi M. Nanomaterials for bone tissue regeneration: updates and future perspectives. Nanomedicine (Lond) 2019; 14:2987-3006. [DOI: 10.2217/nnm-2018-0445] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Joint replacement and bone reconstructive surgeries are on the rise globally. Current strategies for implants and bone regeneration are associated with poor integration and healing resulting in repeated surgeries. A multidisciplinary approach involving basic biological sciences, tissue engineering, regenerative medicine and clinical research is required to overcome this problem. Considering the nanostructured nature of bone, expertise and resources available through recent advancements in nanobiotechnology enable researchers to design and fabricate devices and drug delivery systems at the nanoscale to be more compatible with the bone tissue environment. The focus of this review is to present the recent progress made in the rationale and design of nanomaterials for tissue engineering and drug delivery relevant to bone regeneration.
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Affiliation(s)
- Michael J Hill
- Department of Mechanical Engineering – Engineering Mechanics, Michigan Technological University, Houghton, MI 49931, USA
| | - Baowen Qi
- Center for Nanomedicine & Department of Anesthesiology, Brigham & Women's Hospital Harvard Medical School, Boston, MA 02115, USA
| | - Rasoul Bayaniahangar
- Department of Mechanical Engineering – Engineering Mechanics, Michigan Technological University, Houghton, MI 49931, USA
| | - Vida Araban
- School of Engineering, University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Zahra Bakhtiary
- Research Center for Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Michael R Doschak
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Brian C Goh
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Mohammadreza Shokouhimehr
- Department of Materials Science & Engineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Hojatollah Vali
- Department of Anatomy & Cell Biology & Facility for Electron Microscopy Research, McGill University, Montreal, QC H3A 0G4, Canada
| | - John F Presley
- Department of Anatomy & Cell Biology & Facility for Electron Microscopy Research, McGill University, Montreal, QC H3A 0G4, Canada
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | - Mitchel B Harris
- Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Parisa PSS Abadi
- Department of Mechanical Engineering – Engineering Mechanics, Michigan Technological University, Houghton, MI 49931, USA
| | - Morteza Mahmoudi
- Precision Health Program & Department of Radiology, Michigan State University, East Lansing, MI 48824, USA
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Zeng LR, Zhu FB, Wang JY, Hou Q, Yue ZS, Yan SG, Quan RF, Zhang YL. Local influence of high molecular polyethylene particles on heterotopic ossification. Exp Ther Med 2017; 13:2934-2938. [PMID: 28587363 PMCID: PMC5450723 DOI: 10.3892/etm.2017.4327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 03/06/2017] [Indexed: 11/06/2022] Open
Abstract
We studied the effect of molecular polyethylene particles on local heterotopic ossification. A total of 36 healthy Sprague-Dawley rats were randomly divided into the control group (n=18) and the observation group (n=18). High molecular polyethylene particles were injected to rupture Achilles tendon position in the observation group, and normal saline was injected in the control group. X-ray examinations were conducted on Achilles tendon in the 4th, 8th and 12th week after operation. The incidence rate of heterotopic ossification was evaluated, and bone trabecula morphological structure was studied under optical microscope after hematoxylin and eosin staining. Bone morphogenetic protein 2 (BMP-2), transforming growth factor-β (TGF-β), interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), runt-related transcription factor 2 (Runx2) and matrix metalloproteinase-9 (MMP-9) expression levels were also measured. Our results showed that heterotopic ossification incidence in the observation group was significantly lower than that in the control group. Achilles tendon structure in the control group increased in volume, and its texture was harder and cartilage-like. In the observation group, trabecular bone volume, thickness and quantity were more than those observed in the control group. BMP-2, TGF-β, IL-1, TNF-α, Runx2 and MMP-9 levels in the observation group were significantly lower than those in the control group. We concluded that, high molecular polyethylene particles had a significant inhibiting effect on local heterotopic ossification.
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Affiliation(s)
- Lin-Ru Zeng
- Department of Orthopaedic Surgery, Xiaoshan Traditional Chinese Medical Hospital, Hangzhou, Zhejiang 311200, P.R. China
| | - Fang-Bing Zhu
- Department of Orthopaedic Surgery, Xiaoshan Traditional Chinese Medical Hospital, Hangzhou, Zhejiang 311200, P.R. China
| | - Jian-Yue Wang
- Department of Orthopaedic Surgery, Xiaoshan Traditional Chinese Medical Hospital, Hangzhou, Zhejiang 311200, P.R. China
| | - Qiao Hou
- Department of Orthopaedic Surgery, Xiaoshan Traditional Chinese Medical Hospital, Hangzhou, Zhejiang 311200, P.R. China
| | - Zhen-Shuang Yue
- Department of Orthopaedic Surgery, Xiaoshan Traditional Chinese Medical Hospital, Hangzhou, Zhejiang 311200, P.R. China
| | - Shi-Gui Yan
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, P.R. China
| | - Ren-Fu Quan
- Department of Orthopaedic Surgery, Xiaoshan Traditional Chinese Medical Hospital, Hangzhou, Zhejiang 311200, P.R. China
| | - Ying-Liang Zhang
- Department of Orthopaedic Surgery, Xiaoshan Traditional Chinese Medical Hospital, Hangzhou, Zhejiang 311200, P.R. China
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Guided Self-Generation of Vascularized Neo-Bone for Autologous Reconstruction of Large Mandibular Defects. J Craniofac Surg 2017; 27:958-62. [PMID: 27213741 DOI: 10.1097/scs.0000000000002680] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Reconstruction of large mandibular defects is complex and challenging. The authors aimed to individually self-generate a large vascularized bone construct for autologous transplantation without the use of exogenous additives based on the concept of guided self-generation. Using computer-aided design and manufacturing a large size goat mandibular bone was reconstructed in 3 dimensions. Its negative mold printed from hydroxylapatite was temporarily embedded into the costal periosteum along with a contralateral demineralized bone matrix scaffold as control. After 3 months, a mandibular bone construct was obtained and used for autologous transplantation. Osteogenesis and angiogenesis were assessed by real-time imaging, histology, and biomechanical tests during neo-bone formation and up to 6 months after transplantation surgery. A total of 20 animals received implantation of a mandibular bone negative mold along with a contralateral demineralized bone matrix scaffold. Resulting negative mold mandibular bone constructs showed anatomically, histologically, and functionally similar characteristics compared with native controls. Only 1 goat presented partial fibrosis during construct generation with subsequent absorbtion after reconstruction. The absence of exogenous cells, growth factors, and scaffolds facilitated direct translation of this novel concept into clinical application. Further studies are needed to determine functional long-term outcomes and possible extensions to other tissues and organs.
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Li JJ, Roohani-Esfahani SI, Dunstan CR, Quach T, Steck R, Saifzadeh S, Pivonka P, Zreiqat H. Efficacy of novel synthetic bone substitutes in the reconstruction of large segmental bone defects in sheep tibiae. ACTA ACUST UNITED AC 2016; 11:015016. [PMID: 26894676 DOI: 10.1088/1748-6041/11/1/015016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The treatment of large bone defects, particularly those with segmental bone loss, remains a significant clinical challenge as current approaches involving surgery or bone grafting often do not yield satisfactory long-term outcomes. This study reports the evaluation of novel ceramic scaffolds applied as bone graft substitutes in a clinically relevant in vivo model. Baghdadite scaffolds, unmodified or modified with a polycaprolactone coating containing bioactive glass nanoparticles, were implanted into critical-sized segmental bone defects in sheep tibiae for 26 weeks. Radiographic, biomechanical, μ-CT and histological analyses showed that both unmodified and modified baghdadite scaffolds were able to withstand physiological loads at the defect site, and induced substantial bone formation in the absence of supplementation with cells or growth factors. Notably, all samples showed significant bridging of the critical-sized defect (average 80%) with evidence of bone infiltration and remodelling within the scaffold implant. The unmodified and modified baghdadite scaffolds achieved similar outcomes of defect repair, although the latter may have an initial mechanical advantage due to the nanocomposite coating. The baghdadite scaffolds evaluated in this study hold potential for use as purely synthetic bone graft substitutes in the treatment of large bone defects while circumventing the drawbacks of autografts and allografts.
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Affiliation(s)
- Jiao Jiao Li
- Biomaterials and Tissue Engineering Research Unit, School of AMME, University of Sydney, Sydney, NSW 2006, Australia. These authors contributed equally
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He F, Zhang J, Yang F, Zhu J, Tian X, Chen X. In vitro degradation and cell response of calcium carbonate composite ceramic in comparison with other synthetic bone substitute materials. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 50:257-65. [PMID: 25746269 DOI: 10.1016/j.msec.2015.02.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/05/2015] [Accepted: 02/13/2015] [Indexed: 12/31/2022]
Abstract
The robust calcium carbonate composite ceramics (CC/PG) can be acquired by fast sintering calcium carbonate at a low temperature (650 °C) using a biocompatible, degradable phosphate-based glass (PG) as sintering agent. In the present study, the in vitro degradation and cell response of CC/PG were assessed and compared with 4 synthetic bone substitute materials, calcium carbonate ceramic (CC), PG, hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) ceramics. The degradation rates in decreasing order were as follows: PG, CC, CC/PG, β-TCP, and HA. The proliferation of rat bone mesenchymal stem cells (rMSCs) cultured on the CC/PG was comparable with that on CC and PG, but inferior to HA and β-TCP. The alkaline phosphatase (ALP) activity of rMSCs on CC/PG was lower than PG, comparable with β-TCP, but higher than HA. The rMSCs on CC/PG and PG had enhanced gene expression in specific osteogenic markers, respectively. Compared to HA and β-TCP, the rMSCs on the CC/PG expressed relatively lower level of collagen I and runt-related transcription factor 2, but showed more considerable expression of osteopontin. Although CC, PG, HA, and β-TCP possessed impressive performances in some specific aspects, they faced extant intrinsic drawbacks in either degradation rate or mechanical strength. Based on considerable compressive strength, moderate degradation rate, good cell response, and being free of obvious shortcoming, the CC/PG is promising as another choice for bone substitute materials.
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Affiliation(s)
- Fupo He
- Department of Biomedical Engineering, School of Basic Sciences, Guangzhou Medical University, Guangzhou 510182, China
| | - Jing Zhang
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510641, China
| | - Fanwen Yang
- Department of Biomedical Engineering, School of Basic Sciences, Guangzhou Medical University, Guangzhou 510182, China
| | - Jixiang Zhu
- Department of Biomedical Engineering, School of Basic Sciences, Guangzhou Medical University, Guangzhou 510182, China
| | - Xiumei Tian
- Department of Biomedical Engineering, School of Basic Sciences, Guangzhou Medical University, Guangzhou 510182, China
| | - Xiaoming Chen
- Department of Biomedical Engineering, School of Basic Sciences, Guangzhou Medical University, Guangzhou 510182, China.
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Short-term in vivo evaluation of zinc-containing calcium phosphate using a normalized procedure. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 41:309-19. [DOI: 10.1016/j.msec.2014.04.054] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 04/04/2014] [Accepted: 04/23/2014] [Indexed: 11/22/2022]
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Clinical evaluation of β-TCP in the treatment of lacunar bone defects: A prospective, randomized controlled study. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 33:1894-9. [DOI: 10.1016/j.msec.2012.12.041] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 10/31/2012] [Accepted: 12/05/2012] [Indexed: 11/24/2022]
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Ghanaati S, Udeabor SE, Barbeck M, Willershausen I, Kuenzel O, Sader RA, Kirkpatrick CJ. Implantation of silicon dioxide-based nanocrystalline hydroxyapatite and pure phase beta-tricalciumphosphate bone substitute granules in caprine muscle tissue does not induce new bone formation. Head Face Med 2013; 9:1. [PMID: 23286366 PMCID: PMC3563579 DOI: 10.1186/1746-160x-9-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 12/10/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoinductive bone substitutes are defined by their ability to induce new bone formation even at heterotopic implantation sites. The present study was designed to analyze the potential osteoinductivity of two different bone substitute materials in caprine muscle tissue. MATERIALS AND METHODS One gram each of either a porous beta-tricalcium phosphate (β-TCP) or an hydroxyapatite/silicon dioxide (HA/SiO2)-based nanocrystalline bone substitute material was implanted in several muscle pouches of goats. The biomaterials were explanted at 29, 91 and 181 days after implantation. Conventional histology and special histochemical stains were performed to detect osteoblast precursor cells as well as mineralized and unmineralized bone matrix. RESULTS Both materials underwent cellular degradation in which tartrate-resistant acid phosphatase (TRAP)-positive osteoclast-like cells and TRAP-negative multinucleated giant cells were involved. The ß-TCP was completely resorbed within the observation period, whereas some granules of the HA-groups were still detectable after 180 days. Neither osteoblasts, osteoblast precursor cells nor extracellular bone matrix were found within the implantation bed of any of the analyzed biomaterials at any of the observed time points. CONCLUSIONS This study showed that ß-TCP underwent a faster degradation than the HA-based material. The lack of osteoinductivity for both materials might be due to their granular shape, as osteoinductivity in goat muscle has been mainly attributed to cylindrical or disc-shaped bone substitute materials. This hypothesis however requires further investigation to systematically analyze various materials with comparable characteristics in the same experimental setting.
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Affiliation(s)
- Shahram Ghanaati
- Institute of Pathology, REPAIR-Lab, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany.
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Chan RC, Marino V, Bartold PM. The effect of Emdogain and platelet-derived growth factor on the osteoinductive potential of hydroxyapatite tricalcium phosphate. Clin Oral Investig 2011; 16:1217-27. [PMID: 22033661 DOI: 10.1007/s00784-011-0629-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 10/05/2011] [Indexed: 11/27/2022]
Abstract
The aim of this study was to determine whether hydroxyapatite β-tricalcium phosphate (HA-TCP) either alone or coated with Emdogain (EMD) or recombinant human platelet-derived growth factor-BB (rhPDGF-BB) becomes osteoinductive in the murine thigh muscle model for osteoinduction. Twenty CD1 adult male mice had gelatin capsules implanted into the thigh muscle of both hind limbs. The capsules were either empty or contained one of the following: uncoated particulate HA-TCP, EMD-coated HA-TCP or rhPDGF-BB-coated HA-TCP. The implant sites were assessed histologically at 4 and 8 weeks. A semi-quantitative histological examination was performed to assess the inflammatory changes, reparative processes and osteoinduction within the graft site. At both 4 and 8 weeks, histological analysis failed to demonstrate any osteoinductive activity in any of the specimens from the experimental groups. A minimal chronic inflammatory response and foreign body reaction around the implanted materials was seen which reduced over time. The HA-TCP particles were embedded within fibrous connective tissue and were encapsulated by a dense cellular layer consisting of active fibroblasts and occasional macrophages with the thickness of this layer decreasing over time. The results of this study suggest that the use of commercially available HA-TCP alone or in combination with EMD or rhPDGF-BB is biocompatible but not osteoinductive in the murine thigh muscle model of osteoinduction. Coating HA-TCP with EMD or rhPDGF-BB does not enhance its osteoinductive potential.
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Affiliation(s)
- R C Chan
- Colgate Australian Clinical Dental Research Centre, School of Dentistry, University of Adelaide, Frome Road, Adelaide, South Australia 5005, Australia
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Xu W, Ganz C, Weber U, Adam M, Holzhüter G, Wolter D, Frerich B, Vollmar B, Gerber T. Evaluation of injectable silica-embedded nanohydroxyapatite bone substitute in a rat tibia defect model. Int J Nanomedicine 2011; 6:1543-52. [PMID: 21845044 PMCID: PMC3152472 DOI: 10.2147/ijn.s19743] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In clinical practice, vertebral compression fractures occur after trauma and osteoporosis. Kyphoplasty is a minimally invasive procedure using bone filler material for the treatment of such fractures. A full synthetic injectable bone substitute (SIBS) was manufactured by means of spray drying. The aim of this study was to characterize the SIBS and to analyze the remodelling process during degradation of the biomaterial and new bone formation after implantation. SIBS is an aqueous suspension of donut-like microparticles. These microparticles consist of nanocrystallites of synthetic hydroxyapatite embedded in amorphous silica gel. After implantation of SIBS in a proximal tibial diaphyseal defect in 52 rats, grafts were harvested for subsequent analysis on different days. Newly formed bone originating from endosteum was observed on day 6. Hematomas in the medullary space and cortical wounds disappeared on day 12. The wound region was completely replaced by a composite of newly formed cancellous bone, extracellular matrix, and SIBS. At day 63 the cortical defect was fully healed by bone, while newly formed bone in the medullary space almost disappeared and was replaced with bone marrow. In conclusion, SIBS demonstrated a unique structure with osteoinductive and bioresorbable properties, which induced fast bone regeneration. Therefore, a clinical application of SIBS for kyphoplasty is promising.
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Affiliation(s)
- Weiguo Xu
- Institute for Experimental Surgery, University of Rostock, Rostock, Germany
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14
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Effect of coating Straumann Bone Ceramic with Emdogain on mesenchymal stromal cell hard tissue formation. Clin Oral Investig 2011; 16:867-78. [PMID: 21584694 DOI: 10.1007/s00784-011-0558-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 04/18/2011] [Indexed: 12/25/2022]
Abstract
Periodontal tissue engineering requires a suitable biocompatible scaffold, cells with regenerative capacity, and instructional molecules. In this study, we investigated the capacity of Straumann Bone Ceramic coated with Straumann Emdogain, a clinical preparation of enamel matrix protein (EMP), to aid in hard tissue formation by post-natal mesenchymal stromal cells (MSCs) including bone marrow stromal cells (BMSCs) and periodontal ligament fibroblasts (PDLFs). MSCs were isolated and ex vivo-expanded from human bone marrow and periodontal ligament and, in culture, allowed to attach to Bone Ceramic in the presence or absence of Emdogain. Gene expression of bone-related proteins was investigated by real time RT-PCR for 72 h, and ectopic bone formation was assessed histologically in subcutaneous implants of Bone Ceramic containing MSCs with or without Emdogain in NOD/SCID mice. Alkaline phosphatase activity was also assessed in vitro, in the presence or absence of Emdogain. Collagen-I mRNA was up-regulated in both MSC populations over the 72-h time course with Emdogain. Expression of BMP-2 and the osteogenic transcription factor Cbfa-1 showed early stimulation in both MSC types after 24 h. In contrast, expression of BMP-4 was consistently down-regulated in both MSC types with Emdogain. Up-regulation of osteopontin and periostin mRNA was restricted to BMSCs, while higher levels of bone sialoprotein-II were observed in PDLFs with Emdogain. Furthermore, alkaline phosphatase activity levels were reduced in both BMSCs and PDLFs in the presence of Emdogain. Very little evidence was found for ectopic bone formation following subcutaneous implantation of MSCs with Emdogain-coated or -uncoated Bone Ceramic in NOD/SCID mice. The early up-regulation of several important bone-related genes suggests that Emdogain may have a significant stimulatory effect in the commitment of mesenchymal cells to osteogenic differentiation in vitro. While Emdogain inhibited AP activity and appeared not to induce ectopic bone formation, longer-term studies are required to determine whether it promotes the final stages of osteoblast formation and mineralization at gene and protein levels. While used in clinical applications, whether Emdogain and other commercial preparations of EMPs truly possess the capacity to induce the regeneration of bone or other components of the periodontium remains to be established.
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Gupta G, Kirakodu S, El-Ghannam A. Effects of exogenous phosphorus and silicon on osteoblast differentiation at the interface with bioactive ceramics. J Biomed Mater Res A 2010; 95:882-90. [DOI: 10.1002/jbm.a.32915] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
The clinical augmentation of bone currently involves the use of autogenous or allogeneic bone grafts and synthetic materials, all of which are associated with limitations. Research on the safe enhancement of bone formation concerns the potential value of scaffolds, stem cells, gene therapy, and chemical and mechanical signals. Optimal scaffolds are engineered to provide mechanical stability while supporting osteogenesis, osteoconduction and/or osteoinduction. Scaffold materials include natural or synthetic polymers, ceramics, and composites. The resorption, mechanical strength and efficacy of these materials can be manipulated through structural and chemical design parameters. Cell-seeded scaffolds contain stem cells or progenitor cells, such as culture-expanded marrow stromal cells and multipotent skeletal progenitor cells sourced from other tissues. Despite extensive evidence from proof-of-principle studies, bone tissue engineering has not translated to clinical practice. Much of the research involves in vitro and animal models that do not replicate potential clinical applications. Problem areas include cell sources and numbers, over-reliance on existing scaffold materials, optimum delivery of factors, control of transgene expression, vascularization, integration with host bone, and the capacity to form bone and marrow structures in vivo. Current thinking re-emphasizes the potential of biomimetic materials to stimulate, enhance, or control bone's innate regenerative capacity at the implantation site.
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Affiliation(s)
- Ericka M Bueno
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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18
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Xu W, Holzhüter G, Sorg H, Wolter D, Lenz S, Gerber T, Vollmar B. Early matrix change of a nanostructured bone grafting substitute in the rat. J Biomed Mater Res B Appl Biomater 2009; 91:692-699. [PMID: 19572294 DOI: 10.1002/jbm.b.31445] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A nanocrystalline bone substitute embedded in a highly porous silica gel matrix (NanoBone) has previously been shown to bridge bone defects by an organic matrix. As the initial host response on the bone graft substitute might be a determinant for subsequent bone formation, our present purpose was to characterize the early tissue reaction on this biomaterial. After implantation of 80 mg of NanoBone into the adipose neck tissue of a total of 35 rats, grafts were harvested for subsequent analysis at days 3, 6, 9, 12, and 21. The biomaterial was found encapsulated by granulation tissue which partly penetrated the implant at day 3 and completely pervaded the graft at day 12 on implantation. Histology revealed tartrate-resistant acid phosphatase (TRAP)-positive giant cells covering the biomaterial. ED1 (CD68) immunopositivity of these cells further indicated their osteoclast-like phenotype. Scanning electron microscopy revealed organic tissue components within the periphery of the graft already at day 9, whereas the central hematoma region still presented the silica-surface of the biomaterial. Energy dispersive X-ray spectroscopy further demonstrated that the silica gel was degraded faster in the peripheral granulation tissue than in the central hematoma and was replaced by organic host components by day 12. In conclusion, the silica gel matrix is rapidly replaced by carbohydrate macromolecules. This might represent a key step in the process of graft degradation on its way toward induction of bone formation. The unique composition and structure of this nanoscaled biomaterial seem to support its degradation by host osteoclast-like giant cells.
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Affiliation(s)
- Weiguo Xu
- Institute for Experimental Surgery, University of Rostock, Rostock 18057, Germany
| | - Gerd Holzhüter
- Institute for Physics, Department for Materials Research, University of Rostock, Rostock 18055, Germany
| | - Heiko Sorg
- Institute for Experimental Surgery, University of Rostock, Rostock 18057, Germany
| | - Daniel Wolter
- Department of Oral, Maxillofacial and Plastic Surgery, University of Rostock, Rostock 18055, Germany
| | - Solvig Lenz
- Institute for Physics, Department for Materials Research, University of Rostock, Rostock 18055, Germany
| | - Thomas Gerber
- Institute for Physics, Department for Materials Research, University of Rostock, Rostock 18055, Germany
| | - Brigitte Vollmar
- Institute for Experimental Surgery, University of Rostock, Rostock 18057, Germany
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Amendola A, Bonasia DE. Results of high tibial osteotomy: review of the literature. INTERNATIONAL ORTHOPAEDICS 2009; 34:155-60. [PMID: 19838706 DOI: 10.1007/s00264-009-0889-8] [Citation(s) in RCA: 251] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2009] [Accepted: 09/23/2009] [Indexed: 01/09/2023]
Abstract
The aim of this review is to evaluate long-term follow-up and survival analysis studies regarding high tibial osteotomies (HTO) for the treatment of medial knee arthritis. Despite the good number of studies available, comparison and pooling of the results are challenging because of the different evaluation systems and techniques used. However, in general, published studies on HTO report good long-term results with a correct patient selection and a precise surgical technique. Based on our findings, the ideal candidate for an HTO is a young patient (<60 years of age), with isolated medial osteoarthritis, with good range of motion and without ligamentous instability. Furthermore, the literature review shows that the outcomes gradually deteriorate with time. Nevertheless, some issues remain that need resolution; these include the choice between opening or closing wedge tibial osteotomy, the graft selection in opening wedge osteotomies, the type of fixation, the comparison with unicompartmental knee arthroplasty and whether HTO significantly affects a subsequent total joint replacement.
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Affiliation(s)
- Annunziato Amendola
- Orthopaedic Surgery, University of Iowa Sports Medicine Center, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, USA.
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20
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Evidenced-based review of clinical studies on periodontics. J Endod 2009; 35:1135-8. [PMID: 19631849 DOI: 10.1016/j.joen.2009.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Periodontal diseases have several implications for the practice of endodontics. First, advanced periodontitis often has direct implications for the long-term prognosis of the case and requires careful evaluation and coordinated treatment of both the periodontic and endodontic diseases. Second, the potential for functional interactions between odontogenic pathoses and marginal periodontitis requires careful collection of clinical observations and monitoring the outcome of various treatments. In this section, we provide an analysis of recent clinical studies in this area.
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Calasans-Maia MD, Ascoli FO, Novellino ATNA, Rossi AM, Granjeiro JM. Avaliação histológica comparativa de reparo ósseo em tíbia de coelho tratada com xenoenxertos. ACTA ORTOPEDICA BRASILEIRA 2009. [DOI: 10.1590/s1413-78522009000600005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Os xenoenxertos são uma alternativa aos enxertos autogênicos e devem ser osteocondutores e biocompatíveis. Um estudo recente demonstrou que as características físicas e químicas das hidroxiapatitas encontradas no comércio não são condizentes com as descrições dos fabricantes. Este estudo avalia a biocompatibilidade e a osteocondução de um xenoenxerto derivado de osso medular bovino. MÉTODOS: Quinze coelhos adultos, pesando entre 2.500g e 3.000g cada um, foram anestesiados e submetidos a procedimentos cirúrgicos para criar três perfurações na tíbia, com 2 mm de diâmetro. Esses orifícios foram preenchidos com coágulo sanguineo, Osseus® e Bio-Oss®. Os animais foram sacrificados depois de 7, 14 e 28 dias. RESULTADOS: A análise histopatológica da interface de osso e biomaterial mostrou ligeira resposta inflamatória depois de 7 dias, que esteve ausente nos períodos subsequentes. Ambos os materiais foram parcialmente substituídos por tecido ósseo diretamente em contato com a superfície dos materiais, sem ocorrência de fibrose. CONCLUSÃO: Concluímos que ambos os materiais são biocompatíveis e absorvíveis, o que permite progressiva aposição óssea na superfície durante todo o período de avaliação.
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Affiliation(s)
| | | | | | | | - José Mauro Granjeiro
- Universidade Federal Fluminense, Brasil; Universidade Federal Fluminense, Brasil
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22
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Nuss KMR, von Rechenberg B. Biocompatibility issues with modern implants in bone - a review for clinical orthopedics. Open Orthop J 2008; 2:66-78. [PMID: 19506701 PMCID: PMC2687115 DOI: 10.2174/1874325000802010066] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Revised: 03/13/2008] [Accepted: 04/07/2008] [Indexed: 11/22/2022] Open
Abstract
Skeletal defects may result from traumatic, infectious, congenital or neoplastic processes and are considered to be a challenge for reconstructive surgery. Although the autologous bone graft is still the “gold standard”, there is continuing demand for bone substitutes because of associated disadvantages, such as limited supply and potential donor side morbidity [1]. This is not only true for indications in orthopedic and craniomaxillofacial surgeries, but also in repairing endodontic defects and in dental implantology. Before clinical use all new bone substitute materials have to be validated for their osseoconductive and - depending on the composition of the material also –inductive ability, as well as for their long-term biocompatibility in bone. Serving this purpose various bone healing models to test osteocompatibility and inflammatory potential of a novel material on one hand and, on the other hand, non-healing osseous defects to assess the healing potential of a bone substitute material have been developed. Sometimes the use of more than one implantation site can be helpful to provide a wide range of information about a new material [2]. Important markers for biocompatibility and inflammatory responses are the cell types appearing after the implantation of foreign material. There, especially the role of foreign body giant cells (FBGC) is discussed controversial in the pertinent literature, such that it is not clear whether their presence marks an incompatibility of the biomaterial, or whether it belongs to a normal degradation behavior of modern, resorbable biomaterials. This publication is highlighting the different views currently existing about the function of FBGC that appear in response to biomaterials at the implantation sites. A short overview of the general classes of biomaterials, where FBGC may appear as cellular response, is added for clarity, but may not be complete.
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Affiliation(s)
- Katja M R Nuss
- Musculoskeletal Research Unit, Vetsuisse Faculty, University of Zurich, Switzerland
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23
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Yoon SJ, Kim SH, Ha HJ, Ko YK, So JW, Kim MS, Yang YI, Khang G, Rhee JM, Lee HB. Reduction of Inflammatory Reaction of Poly(D,L-Lactic-Co-Glycolic Acid) Using Demineralized Bone Particles. Tissue Eng Part A 2008; 14:539-47. [DOI: 10.1089/tea.2007.0129] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sun Jung Yoon
- BK-21 Polymer BIN Fusion Research Team, Chonbuk National University, Jeonju, Korea
| | - Soon Hee Kim
- BK-21 Polymer BIN Fusion Research Team, Chonbuk National University, Jeonju, Korea
| | - Hyun Jung Ha
- BK-21 Polymer BIN Fusion Research Team, Chonbuk National University, Jeonju, Korea
| | - Youn Kyung Ko
- BK-21 Polymer BIN Fusion Research Team, Chonbuk National University, Jeonju, Korea
| | - Jung Won So
- BK-21 Polymer BIN Fusion Research Team, Chonbuk National University, Jeonju, Korea
| | - Moon Suk Kim
- NanoBiomaterials Lab, Korea Research Institute of Chemical Technology, Daejeon, Korea
| | - Young Il Yang
- Department of Pathology, College of Medicine, Inje University, Busan, Korea
| | - Gilson Khang
- BK-21 Polymer BIN Fusion Research Team, Chonbuk National University, Jeonju, Korea
| | - John M. Rhee
- BK-21 Polymer BIN Fusion Research Team, Chonbuk National University, Jeonju, Korea
| | - Hai Bang Lee
- NanoBiomaterials Lab, Korea Research Institute of Chemical Technology, Daejeon, Korea
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Fellah BH, Josselin N, Chappard D, Weiss P, Layrolle P. Inflammatory reaction in rats muscle after implantation of biphasic calcium phosphate micro particles. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2007; 18:287-94. [PMID: 17323160 DOI: 10.1007/s10856-006-0691-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2006] [Accepted: 09/19/2006] [Indexed: 05/14/2023]
Abstract
Several studies have shown that macro micro porous bioceramics ectopically implanted promote bone tissue formation. This study aims at investigating the inflammatory response towards biphasic calcium phosphate (BCP) ceramic micro particles. BCP composed of hydroxyapatite (HA) and beta-tricalcium phosphate, HA/beta -TCP ratio of 50/50, were prepared by sintering at 1200 degrees C for 5 h. After crushing, 3 fractions of BCP micro particles < 20, 40-80 and 80-200 micro m were sieved. The micro particles were carefully characterized by using X-ray diffraction (XRD), scanning electron microscopy (SEM) and laser scattering. The inflammatory reactions induced by BCP micro particles implanted in quadriceps muscles of rats for 7, 14 and 21 days were studied by histology (n = 8/group). A fibrous tissue encapsulation of the BCP micro particles implanted in muscle tissue was observed and fibrosis was similar for the 3 groups of micro particles. The comparison of the cellular response indicated that the total number of cells was significantly higher for BCP < 20 micro m than for 40-80 and 80-200 micro m (p < 0.0001). The number of macrophages was relatively higher for the smallest than for the intermediate and largest fractions (p < 0.0001). The relative percentage of giant cells was higher for the intermediate and largest size of particles than for the smallest. The number of lymphocytes was comparable for the 3 fractions and after the 3 delays. Therefore, the BCP micro particles < 20 micro m initiated an inflammatory response which might play an important role in osteogenesis.
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Affiliation(s)
- Borhane H Fellah
- INSERM U791, Laboratory for Osteoarticular and Dental Tissue Engineering, Place Alexis Ricordeau, 44042 Nantes, France.
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25
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Blouin S, Moreau MF, Weiss P, Daculsi G, Baslé MF, Chappard D. Evaluation of an injectable bone substitute (betaTCP/hydroxyapatite/hydroxy-propyl-methyl-cellulose) in severely osteopenic and aged rats. J Biomed Mater Res A 2006; 78:570-80. [PMID: 16739169 DOI: 10.1002/jbm.a.30721] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The use of injectable biomaterials is of interest in osteoporotic patients to locally restore bone mass in sites at risk of fracture. An injectable bone substitute (IBS1 made of betaTCP/hydroxyapatite as a calcium phosphate substitute and hydroxy-propyl-methyl-cellulose as a polymer carrier) was used in a severely osteopenic rat model obtained by combining orchidectomy (ORX) and disuse (paralysis induced by botulinum toxin - BTX). Fifty-six aged male rats were randomized into three groups: 18 were SHAM operated; 38 were ORX and BTX injected in the right hindlimb; they constituted the OP (osteoporotic) group. One month after ORX-BTX surgery, 20 of these OP rats received a IBS1 injection in the right femur (OP-IBS1 rats). Animals were studied at the time of IBS1 injection 1 month post ORX-BTX (M1), 1 month (M2) and 2 months (M3) after IBS1 injection. Bone mass (BV/TV) and microarchitectural parameters were measured by microCT. BV/TV was decreased after ORX-BTX; ORX and BTX had cumulative effects on bone loss (differences maximized on the right femur). BV/TV (combining the volume of both bone and material in OP-IBS1 rats) was elevated at M1 but decreased at M2. Marked bone formation was found onto the biomaterial granules but bone had a woven texture. A marked increase in the number of nonosteoclastic TRAcP+ cells was found in the implanted area. IBS1 induced new bone formation shortly after implantation but both IBS1 and woven bone were resorbed without inducing lamellar bone. Biomaterial trials must be conducted with long-term implantation periods, in aged osteoporotic animals.
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Affiliation(s)
- S Blouin
- INSERM, EMI 0335 - LHEA, Faculté de Médecine, 49045 ANGERS Cedex, France
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26
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Gaasbeek RDA, Toonen HG, van Heerwaarden RJ, Buma P. Mechanism of bone incorporation of β-TCP bone substitute in open wedge tibial osteotomy in patients. Biomaterials 2005; 26:6713-9. [PMID: 15950278 DOI: 10.1016/j.biomaterials.2005.04.056] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2005] [Accepted: 04/12/2005] [Indexed: 10/25/2022]
Abstract
A histological study was performed of bone biopsies from 16 patients (17 biopsies) treated with open wedge high tibial osteotomies for medial knee osteoarthritis. The open wedge osteotomies were filled with a wedge of osteoconductive beta tricalcium phosphate (beta-TCP) ceramic bone replacement. At the time of removal of the fixation material, core biopsies of the area where the beta-TCP was located were taken at different follow-up periods (6-25 months). beta-TCP resorption, bone ingrowth and bone remodelling were studied. We hypothesized that the incorporation and remodelling process occurs similarly as in animals. Histology showed a good resorption of the beta-TCP with complete incorporation and remodelling into new bone. The different phases as described in animal studies were found. A correlation was found between histological findings and radiological assessment. In conclusion, beta-TCP appeared to be a bone replacement material with optimal biocompatibility, resorption characteristics and bone conduction properties for the clinical use.
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Affiliation(s)
- Robert D A Gaasbeek
- Laboratory of Orthopaedic Research, Department Orthopaedics, University Hospital Nijmegen, Th. Craanenlaan 7, 6525 GH, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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27
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Franchi M, Fini M, Martini D, Orsini E, Leonardi L, Ruggeri A, Giavaresi G, Ottani V. Biological fixation of endosseous implants. Micron 2005; 36:665-71. [PMID: 16233979 DOI: 10.1016/j.micron.2005.05.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2005] [Revised: 05/18/2005] [Accepted: 05/20/2005] [Indexed: 01/09/2023]
Abstract
Primary implant stability is ensured by a mechanical fixation of implants. However, during implant healing a biological anchorage is necessary to achieve final osseointegration. Aim of this study was to investigate the histological aspects of biological fixation around titanium screws. Forty-eight titanium screws with different surfaces (smooth, plasma sprayed, sand blasted) were inserted in tibiae and femura of sheep and analyzed by light microscope and SEM 1 hour, 14 and 90 days after implantation. One hour after implantation the implant-bone gap was filled with a blood clot and host bone chips arising from burr surgical preparation or friction during implant insertion. Fourteen days after implantation new trabecular bone and enveloped bone chips were observed in the gap: no osteogenesis developed where implant threads were in contact with host bone. Ninety days after surgery all trabecular bone and most of the bone chips were substituted by a mature lamellar bone with few marrow spaces. Our results suggest that the trabecular bone and bone chips represent a three-dimensional network ensuring a biological implant fixation in all different implant surfaces 2 weeks after surgery. Host bone chips could favour the peri-implant osteogenesis. Inter-trabecular and implant-trabecular marrow spaces of both trabecular and lamellar bone may favour the peri-implant bone turnover.
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Affiliation(s)
- M Franchi
- Dipartimento di Scienze Anatomiche Umane e Fisiopatologia dell'Apparato Locomotore, Università di Bologna, Via Irnerio 48, 40126 Bologna, Italy.
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28
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Liang G, Yang Y, Oh S, Ong JL, Zheng C, Ran J, Yin G, Zhou D. Ectopic osteoinduction and early degradation of recombinant human bone morphogenetic protein-2-loaded porous β-tricalcium phosphate in mice. Biomaterials 2005; 26:4265-71. [PMID: 15683650 DOI: 10.1016/j.biomaterials.2004.10.035] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2004] [Accepted: 10/28/2004] [Indexed: 10/26/2022]
Abstract
The present study investigated the ectopic osteoinduction and early degradation of recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded porous beta-tricalcium phosphate (beta-TCP) in mice. The porous beta-TCP with 50 microg of rhBMP-2 (n = 25) and porous beta-TCP (control group, n = 25) were implanted into muscle pouches in the right and left thigh of 28-day-old mice (n = 25), respectively. At every time point (3, 7, 14, 21 and 28 days after implantation), five mice were euthanized and the histological examinations of implantation sites were performed. In addition, the alkaline phosphatase (ALP) activity was also quantitatively analyzed. For the rhBMP-2-loaded group, blood vessel formation and immature cartilage was observed within the porous beta-TCP 3 days after implantation. Mature cartilage was observed 7 days after implantation of rhBMP-2-loaded porous beta-TCP. Newly formed woven bone, lamellar bone as well as marrow were observed 14 and 21 days after implantation of the rhBMP-2-loaded porous beta-TCP. Lamellar bone and marrow were observed 28 days after implantation of the rhBMP-2-loaded porous beta-TCP. For the control group, no bone or cartilage was observed at all time points. However, multinucleated giant cells and fibrous tissues were observed in the control group at 7 and 28 days after implantation, respectively. At 21 and 28 days after implantation, porous beta-TCP was observed to fragment indicating early degradation of the porous beta-TCP in both groups. In addition, ALP was observed to be significantly higher in the rhBMP-2-loaded beta-TCP as compared to the control beta-TCP. It was concluded from this study that the rhBMP-2-loaded porous beta-TCP induced blood vessel and ectopic bone formation.
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Affiliation(s)
- Ge Liang
- Department of Orthopedic Surgery, Navy General Hospital, Beijing 100037, China
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29
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Ma S, Yang Y, Carnes DL, Kim K, Park S, Oh SH, Ong JL. Effects of dissolved calcium and phosphorous on osteoblast responses. J ORAL IMPLANTOL 2005; 31:61-7. [PMID: 15871524 DOI: 10.1563/0-742.1] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The dissolution behavior of hydroxyapatite (HA) and its effect on the initial cellular response is of both fundamental and clinical importance. In this study, plasma-sprayed HA coatings were characterized by X-ray diffraction and Fourier transform infrared spectroscopy (FTIR). Calcium (Ca) and inorganic phosphorous (Pi) ions released from plasma-sprayed HA coatings within 3 weeks were measured by flame atomic absorption and colorimetrically molybdenum blue complex, respectively. To investigate the effect of dissolution of HA coatings on osteoblast response, additional Ca and Pi were added into the cell culture media to simulate the dissolution concentrations. Human embryonic palatal mesenchyme cells, an osteoblast precursor cell line, were used to evaluate the biological responses to enhanced Ca and Pi media over 2 weeks. Osteoblast differentiation and mineralization were measured by alkaline phosphatase-specific assay and 1,25 (OH)2 vitamin D3 stimulated osteocalcin production. The coatings exhibited an HA-type structure. FTIR indicated the possible presence of carbonates on the coatings. A dissolution study indicated a continual increase in Ca and Pi over time. In the cell culture study, enhanced osteoblast differentiation occurred in the presence of additional Ca concentration in the cell culture media. However, additional Pi concentration in the cell culture media was suggested to slow down osteoblast differentiation and mineralization.
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Affiliation(s)
- S Ma
- School of Dentistry, University of Texas Health Science Center at San Antonio, USA
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Glowacki J. A review of osteoinductive testing methods and sterilization processes for demineralized bone. Cell Tissue Bank 2005; 6:3-12. [PMID: 15735896 DOI: 10.1007/s10561-005-4252-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2004] [Accepted: 10/05/2004] [Indexed: 11/30/2022]
Abstract
Allogeneic demineralized bone has been used extensively as a clinical graft material because it has osteoinductive and osteoconductive properties. Concerns over processing and terminal sterilization procedures that may reduce performance have led clinicians to call for assurances of product potency. There is extensive experience on effects of demineralized bone in animal and cell culture models with the possibility for future evidence-based standards for release of products. Evaluation of the current state of knowledge leads to the fact that we cannot conclude that performance of different lots of demineralized bone allografts in in vivo or in vitro test systems can be used as a measure of clinical performance. It may be possible to adopt an osteoinductivity standard for release-to-market, but it should be followed by clinical monitoring and further research.
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Affiliation(s)
- Julie Glowacki
- Department of Orthopedic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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Franchi M, Bacchelli B, Martini D, Pasquale VD, Orsini E, Ottani V, Fini M, Giavaresi G, Giardino R, Ruggeri A. Early detachment of titanium particles from various different surfaces of endosseous dental implants. Biomaterials 2004; 25:2239-46. [PMID: 14741589 DOI: 10.1016/j.biomaterials.2003.09.017] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Titanium (Ti) endosseous dental screws with different surfaces (smooth titanium--STi, titanium plasma-sprayed-TPS, alumina oxide sandblasted and acid-etched--Al-SLA, zirconium oxide sandblasted and acid etched--Zr-SLA) were implanted in femura and tibiae of sheep to investigate the biological evolution of the peri-implant tissues and detachment of Ti debris from the implant surfaces in early healing. Implants were not loaded. Sections of the screws and the peri-implant tissues obtained by sawing and grinding were analysed by light microscopy immediately after implantation (time 0) and after 14 days. All samples showed new bone trabeculae and vascularised medullary spaces in those areas where gaps between the implants and host bone were visible. In contrast, no osteogenesis was induced in the areas where the implants were initially positioned in close contact with the host bone. Chips of the pre-existing bone inducing new peri-implant neo-osteogenesis were surrounded by new bone trabeculae. The threads of some screws appeared to be deformed where the host bone showed fractures. Ti granules of 3-60 microm were detectable only in the peri-implant tissues of TPS implants both immediately after surgery and after 14 days, thus suggesting that this phenomenon may be related to the friction of the TPS coating during surgical insertion.
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Affiliation(s)
- M Franchi
- Istituto di Anatomia Umana Normale, Via Irnerio 48, Bologna 40126, Italy.
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Petroianu A, Corsetti RA, Alberti LR. The effect of the presence of muscle tissue in a bone healing site. REVISTA DO HOSPITAL DAS CLINICAS 2004; 59:193-7. [PMID: 15361984 DOI: 10.1590/s0041-87812004000400007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
PURPOSE The recovery of a bone fracture is a process that is not yet fully understood. The literature conflicts on the results obtained by the interposition of foreign tissue inside a damaged bone. The objective of the present study was to ascertain the effect of placing muscle tissue between the stumps of a fractured bone. METHOD The study was carried out on 10 rabbits divided into 2 groups (n = 5): Group 1--partial fracture of the humerus and interposition of muscle tissue; Group 2--complete fracture of the humerus and interposition of muscle tissue. The fractured limb of all animals was immobilized for 8 weeks. At the end of this time, the rabbits were killed and their operated humeri were carefully removed for roentgenological and histological assessment. RESULTS All humeri of Group 1 recovered their integrity and normal aspect. However, the healing of the humeri of Group 2 was not perfect. Gross angulation of the bone diaphysis occurred in all animals, and immature trabecular bone, osteochondral tissue, and persistence of muscle tissue substituted normal bone. CONCLUSIONS Interposed muscle does not affect partial bone fracture healing but causes instability in a complete fracture.
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Affiliation(s)
- Andy Petroianu
- Department of Surgery, Medical School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
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Freeman CB, Adin CA, Lewis DD, Ginn PE. Intrapelvic granuloma formation six years after total hip arthroplasty in a dog. J Am Vet Med Assoc 2003; 223:1446-9, 1433. [PMID: 14627094 DOI: 10.2460/javma.2003.223.1446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 9-year-old Golden Retriever that had undergone left total hip arthroplasty 6 years previously was evaluated because of constipation and tenesmus. Abdominal radiography and ultrasonography revealed a large intrapelvic mass that was contiguous with a mass of polymethyl methacrylate that had been extruded through a defect in the medial wall of the acetabulum at the time of total hip arthroplasty. Clinical signs resolved following resection of the mass and associated polymethyl methacrylate from the pelvic canal. Results of histologic examination of the mass were consistent with a diagnosis of foreign body granuloma, most likely secondary to particulate debris. There was no clinical or radiographic evidence of aseptic loosening of the acetabular or femoral components, and the mass may have represented a response to wear debris.
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Affiliation(s)
- Calista B Freeman
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126, USA
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