The Management of Bone Defects in Periarticular Knee Injuries: A Review Article

Condylar femoral arthroplasty with bone cement as a salvage measure in open fracture with articular bone defect in a young patient

Open fractures often require complex treatments, especially those with joint involvement or critical bone defects. Managing both combined injuries present even greater challenges and is not without complications. We present the case of a young patient with an open fracture of the femoral condyle and loss of bone stock in the articular surface. In this case, a combined osteosynthesis approach was employed, utilizing cannulated screws and a femoral condyle arthroplasty with bone cement as a salvage measure, allowing a favorable clinical and functional outcome at the 3-year follow-up. This technique serves as a simple, reproducible, and cost-effective alternative for transient or potentially definitive management in such cases.

Propolis extract a new reinforcement material in improving bone healing: An in vivo study

BACKGROUND

Propolis is known for its antioxidant, immune response modulating, and wound healing effects. In the present study in order to determine the bone healing capacity of the propolis extract, a critical sized, nonunion, radial bone defect model was repaired in rat, using chitosan and demineralized bone matrix (DBM) scaffolds along with propolis extract.

MATERIALS AND METHODS

Seventy-two radial bone defects in 36 healthy male rats were randomly divided into 6 groups (n = 12/group). The groups included autograft, defect or untreated group, chitosan, DBM, chitosan and propolis (chitosan-propolis), and DBM and propolis (DBM-propolis). The bone repairing capability was characterized using radiography at 28th, 42nd and 56th postoperative days. Gross morphologic, histopathologic, histomorphometric and biomechanical examinations were performed following euthanasia at the 56th post-operative day.

RESULTS

The DBM-propolis group, showed better structural and biomechanical properties compared to the untreated, DBM, chitosan and chitosan-propolis groups. The defect site in the chitosan and untreated groups were mainly restored by fibrous connective tissue while the lesions in the autograft group were mostly filled by cartilage and a lesser amount of woven bone. The woven bone, and the hyaline cartilage were the main constituents of the newly formed tissues in the DBM-propolis group, at the 56th day after injury.

CONCLUSION

The results of this study showed that percutaneous injection of diluted aqueous propolis extract in the bone defect (25 mg/defect) can improve bone formation in the critical radial bone defect in rat. Since there was no significant difference between the autograft and DBM-propolis group, probably this therapeutic strategy has high potential in augmentation of autologous bone grafting.