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Wong KW, Chen YS, Lin CL. Evaluation optimum ratio of synthetic bone graft material and platelet rich fibrin mixture in a metal 3D printed implant to enhance bone regeneration. J Orthop Surg Res 2024; 19:299. [PMID: 38755635 PMCID: PMC11097440 DOI: 10.1186/s13018-024-04784-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND This study aims to evaluate the optimal ratio of synthetic bone graft (SBG) material and platelet rich fibrin (PRF) mixed in a metal 3D-printed implant to enhance bone regeneration. METHODS Specialized titanium hollow implants (5 mm in diameter and 6 mm in height for rabbit; 6 mm in diameter and 5 mm in height for pig) were designed and manufactured using 3D printing technology. The implants were divided into three groups and filled with different bone graft combinations, namely (1) SBG alone; (2) PRF to SBG in 1:1 ratio; (3) PRF to SBG in 2:1 ratio. These three groups were replicated tightly into each bone defect in distal femurs of rabbits (nine implants, n = 3) and femoral shafts of pigs (fifteen implants, n = 5). Animal tissue sections were obtained after euthanasia at the 8th postoperative week. The rabbit specimens were stained with analine blue, while the pig specimens were stained with Masson-Goldner's trichrome stain to perform histologically examination. All titanium hollow implants were well anchored, except in fracture specimens (three in the rabbit and one fracture in the pig). RESULT Rabbit specimens under analine blue staining showed that collagen tissue increased by about 20% and 40% in the 1:1 ratio group and the 2:1 ratio group, respectively. Masson-Goldner's trichrome stain results showed that new bone growth increased by 32% in the 1:1 ratio PRF to SBG, while - 8% in the 2:1 ratio group. CONCLUSION This study demonstrated that placing a 1:1 ratio combination of PRF and SBG in a stabilized titanium 3D printed implant resulted in an optimal increase in bone growth.
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Affiliation(s)
- Kin Weng Wong
- Department of Orthopaedic Surgery, Chi-Mei Medical Center, Tainan, 710, Taiwan
| | - Yu-San Chen
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, 2 No.155, Sec.2, Linong Street, Taipei, 112, Taiwan
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, 2 No.155, Sec.2, Linong Street, Taipei, 112, Taiwan.
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Steyl SK, Jeyapalina S, Griffin A, Krishnamoorthi V, Beck JP, Agarwal J, Shea J. Efficacy of sintered Zinc-doped fluorapatite scaffold as an antimicrobial regenerative bone filler for dental applications. J Dent 2024; 146:105070. [PMID: 38740251 DOI: 10.1016/j.jdent.2024.105070] [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: 02/15/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES The objective of this study was to assess whether zinc-doped fluorapatite (ZnFA) could serve as an effective antimicrobial dental bone filler for bone regeneration compared to autografts. METHODS FA and 2 % zinc-doped FA (2ZnFA) were synthesized and characterized in-house. Compressed and sintered FA and 2ZnFA disks were incubated with bacteria to assess antimicrobial properties. Adipose-derived stem cells were cultured on these discs to evaluate the surfaces' ability to support cell growth and promote osteogenic differentiation. Surfaces exhibiting the highest expressions of the bone markers osteopontin and osteocalcin were selected for an in vivo study in a rat mandibular defect model. Twenty rats were divided into 5 groups, equally, and a 5 mm surgical defect of the jaw was left untreated or filled with 2ZnFA, FA, autograft, or demineralized bone matrix (DBM). At 12 weeks, the defects and surrounding tissues were harvested and subjected to microCT and histological evaluations. RESULTS Standard techniques such as FTIR, ICP-MS, fluoride probe, and XRD revealed the sintered FA and ZnFA's chemical compositions and structures. Bacterial studies revealed no significant differences in surface bacterial adhesion properties between FA and 2ZnFA, but significantly fewer bacterial loads than control titanium discs (p < 0.05). Cell culture data confirmed that both surfaces could support cell growth and promote the osteogenic differentiation of stem cells. MicroCT analysis confirmed statistical similarities in bone regeneration within FA, 2ZnFA, and autograft groups. CONCLUSION The data suggests that both FA and 2ZnFA could serve as alternatives to autograft materials, which are the current gold standard. Moreover, these bone fillers outperformed DBM, an allograft material commonly used as a dental bone void filler. CLINICAL SIGNIFICANCE The use of FA or 2ZnFA for treating mandibular defects led to bone regeneration statistically similar to autograft repair and significantly outperformed the widely used dental bone filler, DBM. Additional translational research may confirm FA-based materials as superior substitutes for existing synthetic bone fillers, ultimately enhancing patient outcomes.
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Affiliation(s)
- Samantha K Steyl
- Orthopaedic and Plastic Surgery Research Laboratory, George E. Wahlen Department of Veterans Affairs Medical Center, 500 Foothill Drive Salt Lake City, UT 84148, USA; Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, USA; Department of Biomedical Engineering, University of Utah, 36 S. Wasatch Drive, Rm. 3100. Salt Lake City, UT 84112, USA
| | - Sujee Jeyapalina
- Orthopaedic and Plastic Surgery Research Laboratory, George E. Wahlen Department of Veterans Affairs Medical Center, 500 Foothill Drive Salt Lake City, UT 84148, USA; Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, USA; Department of Biomedical Engineering, University of Utah, 36 S. Wasatch Drive, Rm. 3100. Salt Lake City, UT 84112, USA
| | - Alec Griffin
- Orthopaedic and Plastic Surgery Research Laboratory, George E. Wahlen Department of Veterans Affairs Medical Center, 500 Foothill Drive Salt Lake City, UT 84148, USA
| | - Vishnu Krishnamoorthi
- Orthopaedic and Plastic Surgery Research Laboratory, George E. Wahlen Department of Veterans Affairs Medical Center, 500 Foothill Drive Salt Lake City, UT 84148, USA
| | - James Peter Beck
- Orthopaedic and Plastic Surgery Research Laboratory, George E. Wahlen Department of Veterans Affairs Medical Center, 500 Foothill Drive Salt Lake City, UT 84148, USA; Department of Orthopaedics, University of Utah School of Medicine, 590 Wakara Way Salt Lake City, UT 84108, USA
| | - Jay Agarwal
- Orthopaedic and Plastic Surgery Research Laboratory, George E. Wahlen Department of Veterans Affairs Medical Center, 500 Foothill Drive Salt Lake City, UT 84148, USA; Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, USA
| | - Jill Shea
- Orthopaedic and Plastic Surgery Research Laboratory, George E. Wahlen Department of Veterans Affairs Medical Center, 500 Foothill Drive Salt Lake City, UT 84148, USA; Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, USA; Department of Biomedical Engineering, University of Utah, 36 S. Wasatch Drive, Rm. 3100. Salt Lake City, UT 84112, USA.
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Lisan RA, Mahyudin F, Edward M, Buwana DS. Role of preservation methods using deep-freezing and liquid nitrogen in bone allograft characteristics: An in vitro study. NARRA J 2024; 4:e757. [PMID: 38798850 PMCID: PMC11125383 DOI: 10.52225/narra.v4i1.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 04/27/2024] [Indexed: 05/29/2024]
Abstract
Bone grafting has emerged as a key solution in bone defect management such as allograft, graft of bone from another individual. However, bone allografts usually undergo rigorous preparation to eliminate immune-triggering elements. The deep-freezing methods may delay graft use, while cryopreservation using liquid nitrogen allows rapid freezing but may alter graft characteristics. The aim of this study was to investigate the post-preservation changes in bone allograft characteristics and to compare the effectiveness of deep-freezing and liquid nitrogen methods using animal model. An experimental study using a post-test only control group design was conducted. Fresh-frozen femoral cortical bone was obtained from male New Zealand white rabbits. Preservation by deep-freezing involved placing bone samples in a -80°C freezer for 30 days. For liquid nitrogen preservation, bone grafts were immersed in liquid nitrogen for 20 min, followed by a 15-min rest at room temperature and a final immersion in 0.9% sodium chloride at 30°C for 15 min. Bone samples then underwent evaluation of cell viability, compression, and bending tests. Cell viability test employed the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and the compression and bending tests used the Universal Testing Machine (UTM). Independent Student t-test or Mann-Whitney U test were used to compare the methods as appropriate. Our study found that the use of deep-freezing and liquid nitrogen resulted in similar outcomes for cell viability, compression, and bending tests, with p-values of 0.302, 0.745, and 0.512, respectively. Further exploration with larger sample sizes may help to optimize the methods for specific applications.
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Affiliation(s)
- Rizal A. Lisan
- Department of Orthopedic and Traumatology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Orthopedic and Traumatology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Ferdiansyah Mahyudin
- Department of Orthopedic and Traumatology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Orthopedic and Traumatology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Mouli Edward
- Department of Orthopedic and Traumatology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Orthopedic and Traumatology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Dewan S. Buwana
- General Practitioner, Bajawa General Hospital, Ngada, Indonesia
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Sayeed A, Jawad A, Zakko P, Lee M, Park DK. Radiographic Fusion Outcomes for Trinity Cellular Based Allograft versus Local Bone in Posterolateral Lumbar Fusion. J Am Acad Orthop Surg Glob Res Rev 2024; 8:01979360-202404000-00018. [PMID: 38648399 PMCID: PMC11037727 DOI: 10.5435/jaaosglobal-d-23-00196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Cellular-based autograft (CBA) is being used in posterolateral lumbar arthrodesis as a fusion supplementation alternative. OBJECTIVE To assess radiographic fusion in patients undergoing posterolateral lumbar fusion with unilateral Trinity CBA compared with contralateral local bone autograft as an internal control. METHODS A single surgeon's practice database was interrogated for consecutive patients undergoing primary posterolateral lumbar fusion with Trinity from 2018 to 2021. Patients had Trinity applied unilaterally, with local bone autograft applied contralaterally. Fusion was assessed postoperatively by using CT after 9 months. Demographics and patient-reported outcome measures were collected preoperatively and up to 12 months postoperatively. RESULTS Thirty-nine patients were included. There were 81 attempted fusion levels. Overall fusion rate, defined as bony bridging on at least one side of a given level for all levels fused, was 85.2% of patients. No statistically significant difference was observed in fusion rates between CBA versus local bone (79.0% versus 76.54% of levels attempted, respectively, P = 0.3527). Oswestry Disability Index improved by 3 months (P = 0.0152) and was maintained. Two patients required revision for symptomatic nonunion. CONCLUSIONS Similar radiographic fusion rates were achieved with Trinity and local bone. Trinity is a viable alternative to local bone in posterolateral lumbar fusion.
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Affiliation(s)
- Aatif Sayeed
- From the Corewell Health William Beaumont University Hospital, Royal Oak, MI (Dr. Sayeed, Dr. Jawad, Dr. Zakko and Dr. Park); The Ohio State University School of Medicine, Columbus, OH (Dr. Lee)
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Volarić D, Žauhar G, Chen J, Jerbić Radetić AT, Omrčen H, Raič A, Pirović R, Cvijanović Peloza O. The Effect of Low-Intensity Pulsed Ultrasound on Bone Regeneration and the Expression of Osterix and Cyclooxygenase-2 during Critical-Size Bone Defect Repair. Int J Mol Sci 2024; 25:3882. [PMID: 38612693 PMCID: PMC11012169 DOI: 10.3390/ijms25073882] [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: 03/09/2024] [Revised: 03/23/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Low-intensity pulsed ultrasound (LIPUS) is a form of ultrasound that utilizes low-intensity pulsed waves. Its effect on bones that heal by intramembranous ossification has not been sufficiently investigated. In this study, we examined LIPUS and the autologous bone, to determine their effect on the healing of the critical-size bone defect (CSBD) of the rat calvaria. The bone samples underwent histological, histomorphometric and immunohistochemical analyses. Both LIPUS and autologous bone promoted osteogenesis, leading to almost complete closure of the bone defect. On day 30, the bone volume was the highest in the autologous bone group (20.35%), followed by the LIPUS group (19.12%), and the lowest value was in the control group (5.11%). The autologous bone group exhibited the highest intensities of COX-2 (167.7 ± 1.1) and Osx (177.1 ± 0.9) expression on day 30. In the LIPUS group, the highest intensity of COX-2 expression was found on day 7 (169.7 ±1.6) and day 15 (92.7 ± 2.2), while the highest Osx expression was on day 7 (131.9 ± 0.9). In conclusion, this study suggests that LIPUS could represent a viable alternative to autologous bone grafts in repairing bone defects that are ossified by intramembranous ossification.
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Affiliation(s)
- Darian Volarić
- Department of Physical Medicine and Rehabilitation, Thalassotherapia Crikvenica—Special Hospital for Medical Rehabilitation, Gajevo Šetalište 21, 51260 Crikvenica, Croatia;
- Doctoral School of Biomedicine and Health, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia
| | - Gordana Žauhar
- Department of Medical Physics and Biophysics, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia
- Faculty of Physics, University of Rijeka, Radmile Matejčić 2, 51000 Rijeka, Croatia
| | - Jie Chen
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB T6G 2V4, Canada;
- Academy for Engineering and Technology, Fudan University, Shanghai 200433, China
| | - Ana Terezija Jerbić Radetić
- Department of Anatomy, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia; (A.T.J.R.); (O.C.P.)
| | - Hrvoje Omrčen
- Department of Clinical Microbiology, Teaching Institute of Public Health of Primorsko-Goranska County, Krešimirova 52a, 51000 Rijeka, Croatia;
| | - Antonio Raič
- University Integrated Undergraduate and Graduate Study Programme of Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia; (A.R.); (R.P.)
| | - Roko Pirović
- University Integrated Undergraduate and Graduate Study Programme of Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia; (A.R.); (R.P.)
| | - Olga Cvijanović Peloza
- Department of Anatomy, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia; (A.T.J.R.); (O.C.P.)
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Zhang J, Li S, He H, Han L, Zhang S, Yang L, Han W, Wang X, Gao J, Zhao J, Shi W, Wu Z, Wang H, Zhang Z, Zhang L, Chen W, Zhu Q, Sun T, Tang P, Zhang Y. Clinical guidelines for indications, techniques, and complications of autogenous bone grafting. Chin Med J (Engl) 2024; 137:5-7. [PMID: 37462050 PMCID: PMC10766296 DOI: 10.1097/cm9.0000000000002691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Indexed: 01/06/2024] Open
Affiliation(s)
- Jianzheng Zhang
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
- The National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100048, China
- The Trauma Orthopedic Branch of Chinese Orthopedic Association, Shijiazhuang, Hebei 050051, China
| | - Shaoguang Li
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
- The National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100048, China
| | - Hongying He
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Li Han
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Simeng Zhang
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Lin Yang
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Wenxing Han
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Xiaowei Wang
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Jie Gao
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Jianwen Zhao
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
- The National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100048, China
| | - Weidong Shi
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Zhuo Wu
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Hao Wang
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Zhicheng Zhang
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
| | - Licheng Zhang
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
- The National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100048, China
- The Trauma Orthopedic Branch of Chinese Orthopedic Association, Shijiazhuang, Hebei 050051, China
| | - Wei Chen
- The Trauma Orthopedic Branch of Chinese Orthopedic Association, Shijiazhuang, Hebei 050051, China
- Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Qingtang Zhu
- Department of Microsurgical Trauma, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Tiansheng Sun
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
- The National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100048, China
| | - Peifu Tang
- Senior Department of Orthopedics, PLA General Hospital, Beijing 100048, China
- The National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100048, China
- The Trauma Orthopedic Branch of Chinese Orthopedic Association, Shijiazhuang, Hebei 050051, China
| | - Yingze Zhang
- The Trauma Orthopedic Branch of Chinese Orthopedic Association, Shijiazhuang, Hebei 050051, China
- Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
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Zheng C, Zhang M. 3D-printed PCL/β-TCP/CS composite artificial bone and histocompatibility study. J Orthop Surg Res 2023; 18:981. [PMID: 38129861 PMCID: PMC10734195 DOI: 10.1186/s13018-023-04489-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 12/17/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Tissue-engineered bone materials are an effective tool to repair bone defects. In this study, a novel biodegradable polycaprolactone (PCL)/β-tricalcium phosphate (β-TCP)/calcium sulfate (CS) composite scaffold was prepared by using three-dimensional (3D) printing technology. METHODS Scanning electron microscopy, gas expansion displacement, and contact goniometry were used to examine the 3D-printed PCL/β-TCP/CS composite scaffolds. The results showed that the PCL/β-TCP/CS scaffolds possessed controllable porosity, hydrophobicity, biodegradability, and suitable apatite mineralization ability. To confirm the bone regenerative properties of the fabricated composite scaffolds, scaffold extracts were prepared and evaluated for their cytotoxicity to bone marrow mesenchymal stem cells (BMSCs) and their ability to induce and osteogenic differentiation in BMSCs. RESULTS The PCL/β-TCP/CS composite scaffolds induced a higher level of differentiation of BMSCs than the PCL scaffolds, which occurred through the expression of bone metastasis-related genes. The New Zealand white rabbit radial defect experiment further demonstrated that PCL/β-TCP/CS scaffolds could promote bone regeneration. CONCLUSIONS In summary, the 3D-printed PCL/β-TCP/CS composite porous artificial bone has good cytocompatibility, osteoinductivity, and histocompatibility, which make it an ideal bone material for tissue engineering.
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Affiliation(s)
- Chao Zheng
- Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Engineering Research Center of Stem Cell Therapy, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Mingman Zhang
- Department of Pediatric Liver Transplantation, Children's Hospital of Chongqing Medical University, 136 Zhongshan 2nd Rd., Chongqing, 400014, People's Republic of China.
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Engineering Research Center of Stem Cell Therapy, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
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Gargano G, Asparago G, Spiezia F, Oliva F, Maffulli N. Small interfering RNAs in the management of human osteoporosis. Br Med Bull 2023; 148:58-69. [PMID: 37675799 PMCID: PMC10788844 DOI: 10.1093/bmb/ldad023] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Osteoporosis results in reduced bone mass and consequent bone fragility. Small interfering RNAs (siRNAs) can be used for therapeutic purposes, as molecular targets or as useful markers to test new therapies. SOURCES OF DATA A systematic search of different databases to May 2023 was performed to define the role of siRNAs in osteoporosis therapy. Fourteen suitable studies were identified. AREAS OF AGREEMENT SiRNAs may be useful in studying metabolic processes in osteoporosis and identify possible therapeutic targets for novel drug therapies. AREAS OF CONTROVERSY The metabolic processes of osteoporosis are regulated by many genes and cytokines that can be targeted by siRNAs. However, it is not easy to predict whether the in vitro responses of the studied siRNAs and drugs are applicable in vivo. GROWING POINTS Metabolic processes can be affected by the effect of gene dysregulation mediated by siRNAs on various growth factors. AREAS TIMELY FOR DEVELOPING RESEARCH Despite the predictability of pharmacological response of siRNA in vitro, similar responses cannot be expected in vivo.
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Affiliation(s)
- Giuseppe Gargano
- Department of Trauma and Orthopaedic Surgery, AOU San Giovanni di Dio e Ruggi D’Aragona, Via San Leonardo 1, 84131 Salerno, Italy
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy
- Department of Trauma and Orthopaedic Surgery, AOR San Carlo, Via Potito Petrone, 85100 Potenza, Italy
| | - Giovanni Asparago
- Department of Trauma and Orthopaedic Surgery, AOU San Giovanni di Dio e Ruggi D’Aragona, Via San Leonardo 1, 84131 Salerno, Italy
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy
| | - Filippo Spiezia
- Department of Trauma and Orthopaedic Surgery, AOR San Carlo, Via Potito Petrone, 85100 Potenza, Italy
| | - Francesco Oliva
- Department of Trauma and Orthopaedic Surgery, AOU San Giovanni di Dio e Ruggi D’Aragona, Via San Leonardo 1, 84131 Salerno, Italy
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy
| | - Nicola Maffulli
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK
- School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, UK
- Department of Orthopaedic Surgery and Traumatology, University of Rome La Sapienza, Hospital Sant’Andrea, Rome, Italy
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Park DK, Wind JJ, Lansford T, Nunley P, Peppers TA, Russo A, Hassanzadeh H, Sembrano J, Yoo J, Sales J. Twenty-four-month interim results from a prospective, single-arm clinical trial evaluating the performance and safety of cellular bone allograft in patients undergoing lumbar spinal fusion. BMC Musculoskelet Disord 2023; 24:895. [PMID: 37978378 PMCID: PMC10656884 DOI: 10.1186/s12891-023-06996-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Autologous bone grafts are the gold standard for spinal fusion; however, harvesting autologous bone can result in donor site infection, hematomas, increased operative time, and prolonged pain. Cellular bone allografts (CBAs) are a viable alternative that avoids the need for bone harvesting and may increase fusion success alone or when used as an adjunct material. The present study examined the efficacy and safety of CBA when used as an adjunct graft material to lumbar arthrodesis. METHODS A prospective, single-arm, multicenter clinical trial (NCT02969616) was conducted in adult subjects (> 18 years of age) undergoing lumbar spinal fusion with CBA graft (CBA used as primary (≥ 50% by volume), with augmentation up to 50%). Radiographic fusion status was assessed by an independent review of dynamic radiographs and CT scans. Clinical outcomes were assessed with the Oswestry Disability Index (ODI), and Visual Analog Scales (VAS) score for back and leg pain. Adverse events were assessed through the 24-month follow-up period. The presented data represents an analysis of available subjects (n = 86) who completed 24 months of postoperative follow-up at the time the data was locked for analysis. RESULTS Postoperative 24-month fusion success was achieved in 95.3% of subjects (n = 82/86) undergoing lumbar spinal surgery. Clinical outcomes showed statistically significant improvements in ODI (46.3% improvement), VAS-Back pain (75.5% improvement), and VAS-Leg pain (85.5% improvement) (p < 0.01) scores at Month 24. No subject characteristics or surgical factors were associated with pseudoarthrosis. A favorable safety profile with a limited number of adverse events was observed. CONCLUSIONS The use of CBA as an adjunct graft material showed high rates of successful lumbar arthrodesis and significant improvements in pain and disability scores. CBA provides an alternative to autograft with comparable fusion success rates and clinical benefits. TRIAL REGISTRATION NCT02969616.
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Affiliation(s)
- Daniel K Park
- Beaumont Hospital, 3601 W 13 Mile Rd., Royal Oak, MI, USA.
| | - Joshua J Wind
- Sibley Memorial Hospital, 5255 Loughboro Rd. NW, Washington DC, USA
| | - Todd Lansford
- South Carolina Sports Medicine, 9100 Medcom, N Charleston, SC, USA
| | - Pierce Nunley
- Spine Institute of Louisiana, 1500 Line Ave, Shreveport, LA, USA
| | - Timothy A Peppers
- Scripps Memorial Hospital Encinitas, 354 Santa Fe Drive, Encinitas, CA, USA
| | - Anthony Russo
- Yellowstone Orthopedic and Spine Institute, Billings Clinic Bozeman , 3905 Wellness Way, Bozeman, MT , MT, USA
| | | | | | - Jung Yoo
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA
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Kubiak J, Farng E, Gust M, Sharpe F. Treatment of an Ulnar Fracture Bone Defect Using Heterotopic Bone Autograft: A Case Report. JBJS Case Connect 2023; 13:01709767-202312000-00046. [PMID: 38096335 DOI: 10.2106/jbjs.cc.23.00477] [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: 12/18/2023]
Abstract
CASE Autologous bone grafting has wide applications for the treatment of bony defects. Generally, cancellous or corticocancellous bone grafts are used depending on the characteristics and size of the bony defect and wound bed. The use of heterotopic bone as a potential source of bone graft has not been widely reported. We present a 56-year-old right-hand-dominant male victim of dog mauling who sustained a right ulnar fracture with a 5-cm bony defect, treated with the use of heterotopic bone autograft. CONCLUSION Heterotopic bone can be successfully used as an autograft in the treatment of bony defects.
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Affiliation(s)
- Jeremy Kubiak
- Department of Plastic Surgery, Loma Linda University, Loma Linda, California
| | - Eugene Farng
- Department of Orthopedic Surgery, Kaiser Permanente Fontana, Fontana, California
| | - Madeleine Gust
- Department of Plastic Surgery, Kaiser Permanente Ontario, Ontario, California
| | - Frances Sharpe
- Department of Orthopedic Surgery, Kaiser Permanente Fontana, Fontana, California
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Inchingolo AM, Patano A, Di Pede C, Inchingolo AD, Palmieri G, de Ruvo E, Campanelli M, Buongiorno S, Carpentiere V, Piras F, Settanni V, Viapiano F, Hazballa D, Rapone B, Mancini A, Di Venere D, Inchingolo F, Fatone MC, Palermo A, Minetti E, Lorusso F, Scarano A, Sauro S, Tartaglia GM, Bordea IR, Dipalma G, Malcangi G. Autologous Tooth Graft: Innovative Biomaterial for Bone Regeneration. Tooth Transformer® and the Role of Microbiota in Regenerative Dentistry. A Systematic Review. J Funct Biomater 2023; 14:jfb14030132. [PMID: 36976056 PMCID: PMC10058341 DOI: 10.3390/jfb14030132] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
Different biomaterials, from synthetic products to autologous or heterologous grafts, have been suggested for the preservation and regeneration of bone. The aim of this study is to evaluate the effectiveness of autologous tooth as a grafting material and examine the properties of this material and its interactions with bone metabolism. PubMed, Scopus, Cochrane Library, and Web of Science were searched to find articles addressing our topic published from 1 January 2012 up to 22 November 2022, and a total of 1516 studies were identified. Eighteen papers in all were considered in this review for qualitative analysis. Demineralized dentin can be used as a graft material, since it shows high cell compatibility and promotes rapid bone regeneration by striking an ideal balance between bone resorption and production; it also has several benefits, such as quick recovery times, high-quality newly formed bone, low costs, no risk of disease transmission, the ability to be performed as an outpatient procedure, and no donor-related postoperative complications. Demineralization is a crucial step in the tooth treatment process, which includes cleaning, grinding, and demineralization. Since the presence of hydroxyapatite crystals prevents the release of growth factors, demineralization is essential for effective regenerative surgery. Even though the relationship between the bone system and dysbiosis has not yet been fully explored, this study highlights an association between bone and gut microbes. The creation of additional scientific studies to build upon and enhance the findings of this study should be a future objective of scientific research.
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Affiliation(s)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Chiara Di Pede
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Elisabetta de Ruvo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Merigrazia Campanelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Silvio Buongiorno
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vito Settanni
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Correspondence: (F.I.); (M.C.F.); Tel.: +39-331-211-1104 (F.I.); +39-3479914635 (M.C.F.)
| | - Maria Celeste Fatone
- PTA Trani-ASL BT, Viale Padre Pio, 76125 Trani, Italy
- Correspondence: (F.I.); (M.C.F.); Tel.: +39-331-211-1104 (F.I.); +39-3479914635 (M.C.F.)
| | - Andrea Palermo
- College of Medicine and Dentistry Birmingham, University of Birmingham, Birmingham B4 6BN, UK
| | - Elio Minetti
- Department of Biomedical, Surgical, and Dental Science, Università Degli Studi di Milano, 20122 Milan, Italy
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Salvatore Sauro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy
- UOC Maxillo-Facial Surgery and Dentistry Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
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Wang F, Metzner F, Zheng L, Osterhoff G, Schleifenbaum S. Selected mechanical properties of human cancellous bone subjected to different treatments: short-term immersion in physiological saline and acetone treatment with subsequent immersion in physiological saline. J Orthop Surg Res 2022; 17:376. [PMID: 35933396 PMCID: PMC9357305 DOI: 10.1186/s13018-022-03265-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Physiological saline (0.9% NaCl) and acetone are extensively used for storage (as well as hydration) and removal of bone marrow, respectively, of cancellous bone during preparation and mechanical testing. Our study aimed to investigate the mechanical properties of cancellous bone subjected to short-term immersion in saline and acetone treatment with subsequent immersion in saline. Methods Cylindrical samples (Ø6 × 12 mm) were harvested from three positions (left, middle, and right) of 1 thoracic vertebral body, 19 lumbar vertebral bodies, and 5 sacral bones, as well as from 9 femoral heads. All samples were divided into two groups according to the different treatments, (i) samples from the left and middle sides were immersed in saline at 4℃ for 43 h (saline-immersed group, n = 48); (ii) samples from the respective right side were treated with a combination of acetone and ultrasonic bath (4 h), air-dried at room temperature (21℃, 15 h), and then immersed in saline at room temperature (21℃, 24 h) (acetone and saline-treated group, n = 38). All samples were subjected, both before and after treatment, to a non-destructive compression test with a strain of 0.45%, and finally destructive tests with a strain of 50%. Actual density (ρact), initial modulus (E0), maximum stress (σmax), energy absorption (W), and plateau stress (σp) were calculated as evaluation indicators. Results Based on visual observation, a combination of acetone and ultrasonic bath for 4 h failed to completely remove bone marrow from cancellous bone samples. The mean values of ρact, σmax, W, and σp were significantly higher in the femoral head than in the spine. There was no significant difference in E0 between non-treated and saline-immersed samples (non-treated 63.98 ± 20.23 vs. saline-immersed 66.29 ± 20.61, p = 0.132). The average E0 of acetone and saline-treated samples was significantly higher than that of non-treated ones (non-treated 62.17 ± 21.08 vs. acetone and saline-treated 74.97 ± 23.98, p = 0.043). Conclusion Short-term storage in physiological saline is an appropriate choice and has no effect on the E0 of cancellous bone. Treatment of cancellous bone with acetone resulted in changes in mechanical properties that could not be reversed by subsequent immersion in physiological saline. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-022-03265-4.
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Affiliation(s)
- Fangxing Wang
- ZESBO - Center for Research on Musculoskeletal Systems, Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Semmelweisstraße 14, 04103, Leipzig, Germany. .,Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße. 20 Haus 4, 04103, Leipzig, Germany.
| | - Florian Metzner
- ZESBO - Center for Research on Musculoskeletal Systems, Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Semmelweisstraße 14, 04103, Leipzig, Germany.,Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße. 20 Haus 4, 04103, Leipzig, Germany
| | - Leyu Zheng
- Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße. 20 Haus 4, 04103, Leipzig, Germany
| | - Georg Osterhoff
- Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße. 20 Haus 4, 04103, Leipzig, Germany
| | - Stefan Schleifenbaum
- ZESBO - Center for Research on Musculoskeletal Systems, Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Semmelweisstraße 14, 04103, Leipzig, Germany.,Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße. 20 Haus 4, 04103, Leipzig, Germany
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Amann P, Pastl K, Neunteufel E, Bock P. Clinical and Radiologic Results of a Human Bone Graft Screw in Tarsometatarsal II/+III Arthrodesis. Foot Ankle Int 2022; 43:913-922. [PMID: 35373594 DOI: 10.1177/10711007221081533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND For arthrodesis of the tarsometatarsal joints, there is the possibility of using a transplant screw made of allogenic human bone material (Shark Screw). This article investigates the clinical outcome and radiologic integration of the allogenic bone screw for arthrodesis of the tarsometatarsal joints II/+III. METHODS This is a prospective study involving 20 feet of 17 patients who received TMT II/+III arthrodesis with an allogenic bone screw. A visual analog scale (VAS pain and function), Foot Function Index (FFI), American Orthopaedic Foot & Ankle Society (AOFAS) midfoot score, and Foot and Ankle Outcome Score (FAOS) were used as measures to compare preoperative with postoperative results. Radiologic integration in the recipient bone was also evaluated. RESULTS A significant mean pre- to postoperative improvement of all evaluated scores has been observed (P < .05) after a mean follow-up of 15.87 months (minimum 12 months, maximum 33 months). VAS score (pain) decreased from 7.6 to 1.4 points as well as a decrease of the VAS (function) from 7.25 to 1.8 points. Further, a reduction of the FFI from 62.3% to 16.7% and an increase from 29.7 to 79.9 points of the AOFAS was detected. Analyzing the FAOS score, in all surveyed subscales, there was an increase in the score (Symptoms: 55.2 to 85.6 points; Pain: 30.5 to 86.9 points; Function: 33.1 to 88.3 points; Quality of life: 27.8 to 79.7 points). Moreover, in all cases, a complete radiologic integration into the receiving bone was appreciated, and after a minimum follow-up time from 12 months, the screw in 19 feet (95%) was no longer distinguishable from the original bone. CONCLUSION With these first results of the allogenic bone screw in TMT II/+III arthrodesis, a significant improvement from preoperative to postoperative was confirmed in the collected scores, and a full radiographic integration was demonstrated in all feet.
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Affiliation(s)
| | - Klaus Pastl
- Orthopedic Departement Klinik Diakonissen Linz, Linz, Austria
| | | | - Peter Bock
- Speising Orthopedic Hospital, Vienna, Austria
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