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Siddiqui AM, Thiele F, Stewart RN, Rangnick S, Weiss GJ, Chen BK, Silvernail JL, Strickland T, Nesbitt JJ, Lim K, Schwarzbauer JE, Schwartz J, Yaszemski MJ, Windebank AJ, Madigan NN. Open-Spaced Ridged Hydrogel Scaffolds Containing TiO 2-Self-Assembled Monolayer of Phosphonates Promote Regeneration and Recovery Following Spinal Cord Injury. Int J Mol Sci 2023; 24:10250. [PMID: 37373396 DOI: 10.3390/ijms241210250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/31/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
The spinal cord has a poor ability to regenerate after an injury, which may be due to cell loss, cyst formation, inflammation, and scarring. A promising approach to treating a spinal cord injury (SCI) is the use of biomaterials. We have developed a novel hydrogel scaffold fabricated from oligo(poly(ethylene glycol) fumarate) (OPF) as a 0.08 mm thick sheet containing polymer ridges and a cell-attractive surface on the other side. When the cells are cultured on OPF via chemical patterning, the cells attach, align, and deposit ECM along the direction of the pattern. Animals implanted with the rolled scaffold sheets had greater hindlimb recovery compared to that of the multichannel scaffold control, which is likely due to the greater number of axons growing across it. The immune cell number (microglia or hemopoietic cells: 50-120 cells/mm2 in all conditions), scarring (5-10% in all conditions), and ECM deposits (Laminin or Fibronectin: approximately 10-20% in all conditions) were equal in all conditions. Overall, the results suggest that the scaffold sheets promote axon outgrowth that can be guided across the scaffold, thereby promoting hindlimb recovery. This study provides a hydrogel scaffold construct that can be used in vitro for cell characterization or in vivo for future neuroprosthetics, devices, or cell and ECM delivery.
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Affiliation(s)
- Ahad M Siddiqui
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Frederic Thiele
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
- Program in Human Medicine, Paracelsus Medical Private University, 5020 Salzburg, Austria
| | - Rachel N Stewart
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
- Regenerative Medicine Institute (REMEDI), National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Simone Rangnick
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
- Program in Human Medicine, Paracelsus Medical Private University, 5020 Salzburg, Austria
| | - Georgina J Weiss
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
- Program in Human Medicine, Paracelsus Medical Private University, 90419 Nuremberg, Germany
| | - Bingkun K Chen
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Tammy Strickland
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
- Regenerative Medicine Institute (REMEDI), National University of Ireland Galway, H91 TK33 Galway, Ireland
| | | | - Kelly Lim
- Department of Chemistry, Princeton University, Princeton, NJ 08544, USA
| | - Jean E Schwarzbauer
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544, USA
| | - Jeffrey Schwartz
- Department of Chemistry, Princeton University, Princeton, NJ 08544, USA
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Levy HA, Pinter ZW, Hobson SL, Yaszemski MJ. Delayed open treatment of aortic penetration by a thoracic pedicle screw: illustrative case. J Neurosurg Case Lessons 2023; 5:CASE22533. [PMID: 36852772 PMCID: PMC10550580 DOI: 10.3171/case22533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/30/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Iatrogenic aortic injury from pedicle screw malpositioning or anterior prominence in posterior spinal fusion represents a rare but potentially devasting complication. While intraoperative aortic injury is associated with hemodynamic instability, delayed presentations of pedicle screw aortic impingement or violation often present insidiously with pseudoaneurysm or vascular remodeling in clinically asymptomatic patients. Currently, there is a lack of guidance in the field for the recommended surveillance, urgency of operative intervention, and optimal surgical management of delayed pedicle screw aortic injuries. OBSERVATIONS The following case study discusses the open treatment of delayed thoracic aortic penetration from an excessively long T12 pedicle screw in an asymptomatic adolescent patient with idiopathic scoliosis. The pedicle screw prominence anteriorly was corrected by burring the screw tip until it was flush with the vertebral body. The associated aortic injury was addressed with open vascular repair via primary anastomosis supplemented with a bovine pericardial patch. LESSONS Complete aortic wall penetration from an excessively long thoracic pedicle screw with otherwise stable screw positioning may be addressed most effectively with a single anterior surgical approach for open aortic repair and screw tip burring.
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Affiliation(s)
- Hannah A. Levy
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota; and
| | | | - Sandra L. Hobson
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota; and
- Department of Orthopedic Surgery, Emory University, Atlanta, Georgia
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Jakub JW, Hesley GK, Larson NB, Yaszemski MJ, Lee Miller A, Greenleaf JF, Urban MW, Lee CU. Ultrasonographic Detection and Surgical Retrieval of a Nonmetallic Twinkle Marker in Breast Cancer: Pilot Study. Radiol Imaging Cancer 2022; 4:e220053. [PMID: 36367449 PMCID: PMC9713596 DOI: 10.1148/rycan.220053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/29/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Purpose To evaluate the short-term safety of a nonmetallic twinkle marker and compare its conspicuity at color Doppler US with that of standard breast biopsy clips and radioactive seeds by using B-mode US in axillary lymph nodes. Materials and Methods This prospective study (November 2020-July 2021) of participants with node-positive breast cancer who completed chemotherapy involved placing a twinkle marker at the time of preoperative radioactive seed localization. A five-point scoring system (1 = easiest, 5 = most difficult) was used to rate the ease of identifying the clip, seed, and twinkle marker on postlocalization sonograms, mammograms, specimen radiographs, and gross pathologic specimens. Descriptive statistics were used. Results Eight women (mean age, 57 years ± 16 [SD]) were enrolled. The median scores for US conspicuity of each device were 3.9 (range, 3.7-5.0) for the radioactive seed, 2.4 (range, 1.0-5.0) for the clip, and 2.0 (range, 1.0-4.3) for the twinkle marker. In six of eight participants, the twinkle marker was the most identifiable at US. The seeds, clips, and twinkle markers were scored "very easy" to identify on seven of eight postlocalization mammograms. The surgeon retrieved all eight twinkle markers 1-3 days after localization. In all 16 interpretations, the seeds, clips, and twinkle markers were rated as very easy to identify on specimen radiographs. The clip was the most difficult device to identify at pathologic examination in all participants, and the twinkle marker was the easiest to identify in seven of eight participants. Conclusion This pilot study demonstrates that the safety and ease of US detection of a twinkling tissue marker may be comparable to a biopsy clip. Keywords: Ultrasonography, US-Doppler, Breast, Localization, Surgery Clinical trial registration no. NCT04674852 © RSNA, 2022.
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Lee CU, Urban MW, Lee Miller A, Uthamaraj S, Jakub JW, Hesley GK, Wood BG, Brinkman NJ, Herrick JL, Larson NB, Yaszemski MJ, Greenleaf JF. Twinkling-guided ultrasound detection of polymethyl methacrylate as a potential breast biopsy marker: a comparative investigation. Eur Radiol Exp 2022; 6:26. [PMID: 35711010 PMCID: PMC9203632 DOI: 10.1186/s41747-022-00283-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
Since its first description 25 years ago, color Doppler twinkling has been a compelling ultrasound feature in diagnosing urinary stones. While the fundamental cause of twinkling remains elusive, the distinctive twinkling signature is diagnostically valuable in clinical practice. It can be inferred that if an entity twinkles, it empirically has certain physical features. This work investigates a manipulable polymeric material, polymethyl methacrylate (PMMA), which twinkles and has measurable surface roughness and porosity that likely contribute to twinkling. Comparative investigation of these structural properties and of the twinkling signatures of breast biopsy markers made from PMMA and selected commercially available markers showed how twinkling can improve ultrasound detection of devices intentionally designed to twinkle. While this specific application of detecting breast biopsy markers by twinkling may provide a way to approach an unmet need in the care of patients with breast cancer, this work ultimately provides a platform from which the keys to unlocking the fundamental physics of twinkling can be rigorously explored.
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Affiliation(s)
- Christine U Lee
- Department of Radiology, Division of Breast Imaging and Intervention, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA.
| | - Matthew W Urban
- Department of Radiology, Division of Radiology Research, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA
| | - A Lee Miller
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA
| | - Susheil Uthamaraj
- Division of Engineering, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA
| | - James W Jakub
- Department of Surgery, Division of Surgical Oncology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA
| | - Gina K Hesley
- Department of Radiology, Division of Breast Imaging and Intervention, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA
| | - Benjamin G Wood
- Mayo Graduate School of Biomedical Sciences, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA
| | - Nathan J Brinkman
- Department of Pharmacy, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA
| | - James L Herrick
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA
| | - Nicholas B Larson
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA
| | - Michael J Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA
| | - James F Greenleaf
- Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 First St, SW, Rochester, MN, 55905, USA
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Xu J, Ji Y, Shogren KL, Okuno SH, Yaszemski MJ, Maran A. RNA-dependent protein kinase is required for interferon-γ-induced autophagy in MG63 osteosarcoma cells. Gene 2021; 802:145865. [PMID: 34352301 DOI: 10.1016/j.gene.2021.145865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/30/2021] [Indexed: 02/08/2023]
Abstract
Osteosarcoma is a bone tumor that mainly affects children and adolescents. Interferons (IFNs) have been shown to exert antitumor effects in osteosarcoma cells, although the molecular mechanisms have not been fully realized. We investigated IFN-γ actions on osteosarcoma cells. Our results show that IFN-γ induces the accumulation of autophagosomes in osteosarcoma cells. IFN-γ treatment leads to the conversion of autophagy marker light chain 3 (LC3)-I to LC3-II in osteosarcoma cells, and this conversion is accompanied by puncta formation. Also, IFN-γ-mediated induction of autophagosome formation and autophagic flux require RNA-dependent protein kinase (PKR) activity. In addition, our findings show that IFN-γ-mediated osteosarcoma cell death is not dependent on PKR. Our study suggests that IFN-γ has differential effects that lead to induction of cell death and autophagy in osteosarcoma cells. Further evaluation of the IFN-γ-mediated molecular mechanism could lead to improved understanding of and targeted treatment strategies for osteosarcoma.
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Affiliation(s)
- Jie Xu
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Center, Peking University People's Hospital, Beijing, China
| | - Yuqing Ji
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Oncology, Qilu Hospital (Qingdao), Shandong University, Qingdao, China
| | | | - Scott H Okuno
- Department of Oncology, Mayo Clinic, Rochester, MN, USA
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Siddiqui AM, Islam R, Cuellar CA, Silvernail JL, Knudsen B, Curley DE, Strickland T, Manske E, Suwan PT, Latypov T, Akhmetov N, Zhang S, Summer P, Nesbitt JJ, Chen BK, Grahn PJ, Madigan NN, Yaszemski MJ, Windebank AJ, Lavrov IA. Newly regenerated axons via scaffolds promote sub-lesional reorganization and motor recovery with epidural electrical stimulation. NPJ Regen Med 2021; 6:66. [PMID: 34671050 PMCID: PMC8528837 DOI: 10.1038/s41536-021-00176-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 08/31/2021] [Indexed: 01/10/2023] Open
Abstract
Here, we report the effect of newly regenerated axons via scaffolds on reorganization of spinal circuitry and restoration of motor functions with epidural electrical stimulation (EES). Motor recovery was evaluated for 7 weeks after spinal transection and following implantation with scaffolds seeded with neurotrophin producing Schwann cell and with rapamycin microspheres. Combined treatment with scaffolds and EES-enabled stepping led to functional improvement compared to groups with scaffold or EES, although, the number of axons across scaffolds was not different between groups. Re-transection through the scaffold at week 6 reduced EES-enabled stepping, still demonstrating better performance compared to the other groups. Greater synaptic reorganization in the presence of regenerated axons was found in group with combined therapy. These findings suggest that newly regenerated axons through cell-containing scaffolds with EES-enabled motor training reorganize the sub-lesional circuitry improving motor recovery, demonstrating that neuroregenerative and neuromodulatory therapies cumulatively enhancing motor function after complete SCI.
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Affiliation(s)
- Ahad M. Siddiqui
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA
| | - Riazul Islam
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA
| | - Carlos A. Cuellar
- grid.440977.90000 0004 0483 7094School of Sport Sciences, Universidad Anáhuac México, Campus Norte, Huixquilucan, State of Mexico Mexico
| | - Jodi L. Silvernail
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA
| | - Bruce Knudsen
- grid.66875.3a0000 0004 0459 167XDepartment of Neurologic Surgery, Mayo Clinic, Rochester, MN USA
| | - Dallece E. Curley
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA ,grid.40263.330000 0004 1936 9094Department of Neuroscience, Brown University, Providence, Rhode Island USA
| | - Tammy Strickland
- grid.9344.a0000 0004 0488 240XNational University of Ireland Gallway, Gallway, Ireland
| | - Emilee Manske
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA ,grid.421979.00000 0001 2158 754XDepartment of Neuroscience, Scripps College, Claremont, CA USA
| | | | - Timur Latypov
- grid.231844.80000 0004 0474 0428Division of Brain, Imaging, and Behaviour – Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Nafis Akhmetov
- grid.77268.3c0000 0004 0543 9688Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Shuya Zhang
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA
| | - Priska Summer
- Paracelsus Medical Private University, Salzburg, Austria
| | - Jarred J. Nesbitt
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA
| | - Bingkun K. Chen
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA
| | - Peter J. Grahn
- grid.66875.3a0000 0004 0459 167XDepartment of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN USA
| | - Nicolas N. Madigan
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA
| | - Michael J. Yaszemski
- grid.66875.3a0000 0004 0459 167XDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN USA
| | - Anthony J. Windebank
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA
| | - Igor A. Lavrov
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic, Rochester, MN USA ,grid.77268.3c0000 0004 0543 9688Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia ,grid.66875.3a0000 0004 0459 167XDepartment of Biomedical Engineering, Mayo Clinic, Rochester, MN USA
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Rezaei A, Tilton M, Li Y, Yaszemski MJ, Lu L. Single-level subject-specific finite element model can predict fracture outcomes in three-level spine segments under different loading rates. Comput Biol Med 2021; 137:104833. [PMID: 34534795 DOI: 10.1016/j.compbiomed.2021.104833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/16/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022]
Abstract
Osteoporosis-related vertebral compression fracture can occur under normal physiological activities. Bone metastasis is another source of vertebral fracture. Different loading rates, either high-energy traumas such as falls or low-energy traumas under normal physiological activities, can result in different fracture outcomes. The aim of the current study was to develop a quantitative computed tomography-based finite element analysis (QCT/FEA) technique for single vertebral bodies to predict fracture strength of three-level spine segments. Developed QCT/FEA technique was also used to characterize vertebral elastic moduli at two loading rates of 5 mm/min, representing a physiologic loading condition, and 12000 mm/min, representing a high-energy trauma. To this end, a cohort of human spine segments divided into three groups of intact, defect, and augmented were mechanically tested to fracture; then, experimental stiffness and fracture strength values were measured. Outcomes of this study showed no significant difference between the elastic modulus equations at the two testing speeds. Areal bone mineral density measured by dual x-ray absorptiometry (DXA/BMD) explained only 53% variability (R2 = 0.53) in fracture strength outcomes. However, QCT/FEA could explain 70% of the variability (R2 = 0.70) in experimentally measured fracture strength values. Adding disk degeneration grading, testing speed, and sex to QCT/FEA-estimated fracture strength values further increased the performance of our statistical model by 14% (adjusted R2 of 0.84 between the prediction and experimental fracture forces). In summary, our results indicated that a single-vertebra model, which is computationally less expensive and more time efficient, is capable of estimating fracture outcomes with acceptable performance (range: 70-84%).
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Affiliation(s)
- Asghar Rezaei
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Maryam Tilton
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Yong Li
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Michael J Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
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Wellings EP, Houdek MT, Owen AR, Bakri K, Yaszemski MJ, Sim FH, Moran SL, Rose PS. Comparison of free vascularized fibular flaps and allograft fibular strut grafts to supplement spinopelvic reconstruction for sacral malignancies. Bone Joint J 2021; 103-B:1414-1420. [PMID: 34334037 DOI: 10.1302/0301-620x.103b8.bjj-2020-2302.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Orthopaedic and reconstructive surgeons are faced with large defects after the resection of malignant tumours of the sacrum. Spinopelvic reconstruction is advocated for resections above the level of the S1 neural foramina or involving the sacroiliac joint. Fixation may be augmented with either free vascularized fibular flaps (FVFs) or allograft fibular struts (AFSs) in a cathedral style. However, there are no studies comparing these reconstructive techniques. METHODS We reviewed 44 patients (23 female, 21 male) with a mean age of 40 years (SD 17), who underwent en bloc sacrectomy for a malignant tumour of the sacrum with a reconstruction using a total (n = 20), subtotal (n = 2), or hemicathedral (n = 25) technique. The reconstructions were supplemented with a FVF in 25 patients (57%) and an AFS in 19 patients (43%). The mean length of the strut graft was 13 cm (SD 4). The mean follow-up was seven years (SD 5). RESULTS There was no difference in the mean age, sex, length of graft, size of the tumour, or the proportion of patients with a history of treatment with radiotherapy in the two groups. Reconstruction using an AFS was associated with nonunion (odds ratio 7.464 (95% confidence interval (CI) 1.77 to 31.36); p = 0.007) and a significantly longer mean time to union (12 months (SD 3) vs eight (SD 3); p = 0.001) compared with a reconstruction using a FVF. Revision for a pseudoarthrosis was more likely to occur in the AFS group compared with the FVF group (hazard ratio 3.84 (95% CI 0.74 to 19.80); p = 0.109); however, this was not significant. Following the procedure, 32 patients (78%) were mobile with a mean Musculoskeletal Tumor Society Score 93 of 52% (SD 24%). There was a significantly higher mean score in patients reconstructed with a FVF compared with an AFS (62% vs 42%; p = 0.003). CONCLUSION Supplementation of spinopelvic reconstruction with a FVF was associated with a shorter time to union and a trend towards a reduced risk of hardware failure secondary to nonunion compared with reconstruction using an AFS. Spinopelvic fixation supplemented with a FVF is our preferred technique for reconstruction following resection of a sacral tumour. Cite this article: Bone Joint J 2021;103-B(8):1414-1420.
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Affiliation(s)
| | - Matthew T Houdek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Aaron R Owen
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Karim Bakri
- Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Franklin H Sim
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Steven L Moran
- Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Peter S Rose
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Mikula AL, St Jeor JD, Naylor RM, Bernatz JT, Patel NP, Fogelson JL, Larson AN, Nassr A, Sebastian AS, Freedman B, Currier BL, Bydon M, Kennel KA, Yaszemski MJ, Anderson PA, Elder BD. Teriparatide Treatment Increases Hounsfield Units in the Thoracic Spine, Lumbar Spine, Sacrum, and Ilium Out of Proportion to the Cervical Spine. Clin Spine Surg 2021; 34:E370-E376. [PMID: 34029261 DOI: 10.1097/bsd.0000000000001203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/14/2021] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN This was a retrospective chart review. OBJECTIVE The objective of this study was to compare the effect of teriparatide on Hounsfield Units (HU) in the cervical spine, thoracic spine, lumbar spine, sacrum, and pelvis. Second, to correlate HU changes at each spinal level with bone mineral density (BMD) on dual-energy x-ray absorptiometry (DXA). SUMMARY OF BACKGROUND DATA HU represent a method to estimate BMD and can be used either separately or in conjunction with BMD from DXA. MATERIALS AND METHODS A retrospective chart review included patients who had been treated with at least 6 months of teriparatide. HU were measured in the vertebral bodies of the cervical, thoracic, and lumbosacral spine and iliac crests. Lumbar and femoral neck BMD as measured on DXA was collected when available. RESULTS One hundred twenty-five patients were identified for analysis with an average age of 67 years who underwent a mean (±SD) of 22±8 months of teriparatide therapy. HU improvement in the cervical spine was 11% (P=0.19), 25% in the thoracic spine (P=0.002), 23% in the lumbar spine (P=0.027), 17% in the sacrum (P=0.11), and 29% in the iliac crests (P=0.09). Lumbar HU correlated better than cervical HU with BMD as measured on DXA. CONCLUSIONS Teriparatide increased average HU in the thoracolumbar spine to a proportionally greater extent than the cervical spine. The cervical spine had a higher baseline starting HU than the thoracolumbar spine. Lumbar HU correlated better than cervical and thoracic HU with BMD as measured on DXA.
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Affiliation(s)
| | | | | | - James T Bernatz
- Department of Orthopedics and Rehabilitative Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | | | | | | | | | | | | | | | | | - Kurt A Kennel
- Endocrinology, Diabetes, and Metabolism, Mayo Clinic, Rochester, MN
| | | | - Paul A Anderson
- Department of Orthopedics and Rehabilitative Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Liu X, Camilleri ET, Li L, Gaihre B, Rezaei A, Park S, Miller Ii AL, Tilton M, Waletzki BE, Terzic A, Elder BD, Yaszemski MJ, Lu L. Injectable catalyst-free "click" organic-inorganic nanohybrid (click-ON) cement for minimally invasive in vivo bone repair. Biomaterials 2021; 276:121014. [PMID: 34280821 DOI: 10.1016/j.biomaterials.2021.121014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/20/2021] [Accepted: 07/05/2021] [Indexed: 12/16/2022]
Abstract
Injectable polymers have attracted intensive attention in tissue engineering and drug delivery applications. Current injectable polymer systems often require free-radical or heavy-metal initiators and catalysts for the crosslinking process, which may be extremely toxic to the human body. Here, we report a novel polyhedral oligomeric silsesquioxane (POSS) based strain-promoted alkyne-azide cycloaddition (SPAAC) "click" organic-inorganic nanohybrids (click-ON) system that can be click-crosslinked without any toxic initiators or catalysts. The click-ON scaffolds supported excellent adhesion, proliferation, and osteogenesis of stem cells. In vivo evaluation using a rat cranial defect model showed outstanding bone formation with minimum cytotoxicity. Essential osteogenic alkaline phosphatase (ALP) and vascular CD31 marker expression were detected on the defect site, indicating excellent support of in vivo osteogenesis and vascularization. Using salt leaching techniques, an injectable porous click-ON cement was developed to create porous structures and support better in vivo bone regeneration. Beyond defect filling, the click-ON cement also showed promising application for spinal fusion using rabbits as a model. Compared to the current clinically used poly (methyl methacrylate) (PMMA) cement, this click-ON cement showed great advantages of low heat generation, better biocompatibility and biodegradability, and thus has great potential for bone and related tissue engineering applications.
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Affiliation(s)
- Xifeng Liu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Emily T Camilleri
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Linli Li
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Bipin Gaihre
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Asghar Rezaei
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Sungjo Park
- Department of Cardiovascular Diseases and Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - A Lee Miller Ii
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Maryam Tilton
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Brian E Waletzki
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Andre Terzic
- Department of Cardiovascular Diseases and Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Benjamin D Elder
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Michael J Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
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11
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Siddiqui AM, Oswald D, Papamichalopoulos S, Kelly D, Summer P, Polzin M, Hakim J, Schmeichel AM, Chen B, Yaszemski MJ, Windebank AJ, Madigan NN. Defining Spatial Relationships Between Spinal Cord Axons and Blood Vessels in Hydrogel Scaffolds. Tissue Eng Part A 2021; 27:648-664. [PMID: 33764164 DOI: 10.1089/ten.tea.2020.0316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Positively charged oligo(poly(ethylene glycol) fumarate) (OPF+) hydrogel scaffolds, implanted into a complete transection spinal cord injury (SCI), facilitate a permissive regenerative environment and provide a platform for controlled observation of repair mechanisms. Axonal regeneration after SCI is critically dependent upon nutrients and oxygen from a newly formed blood supply. Our objective was to investigate fundamental characteristics of revascularization in association with the ingrowth of axons into hydrogel scaffolds, thereby defining spatial relationships between axons and the neovasculature. A novel combination of stereologic estimates and precision image analysis techniques quantitate neurovascular regeneration in rats. Multichannel hydrogel scaffolds containing Matrigel-only (MG), Schwann cells (SCs), or SCs with rapamycin-eluting poly(lactic co-glycolic acid) microspheres (RAPA) were implanted for 6 weeks following complete spinal cord transection. Image analysis of 72 scaffold channels identified a total of 2494 myelinated and 4173 unmyelinated axons at 10 μm circumferential intervals centered around 708 individual blood vessel profiles. Blood vessel number, density, volume, diameter, intervessel distances, total vessel surface and cross-sectional areas, and radial diffusion distances were compared. Axon number and density, blood vessel surface area, and vessel cross-sectional areas in the SC group exceeded that in the MG and RAPA groups. Individual axons were concentrated within a concentric radius of 200-250 μm from blood vessel walls, in Gaussian distributions, which identified a peak axonal number (Mean Peak Amplitude) corresponding to defined distances (Mean Peak Distance) from each vessel, the highest concentrations of axons were relatively excluded from a 25-30 μm zone immediately adjacent to the vessel, and from vessel distances >150 μm. Higher axonal densities correlated with smaller vessel cross-sectional areas. A statistical spatial algorithm was used to generate cumulative distribution F- and G-functions of axonal distribution in the reference channel space. Axons located around blood vessels were definitively organized as clusters and were not randomly distributed. A scoring system stratifies 5 direct measurements and 12 derivative parameters influencing regeneration outcomes. By providing methods to quantify the axonal-vessel relationships, these results may refine spinal cord tissue engineering strategies to optimize the regeneration of complete neurovascular bundles in their relevant spatial relationships after SCI. Impact statement Vascular disruption and impaired neovascularization contribute critically to the poor regenerative capacity of the spinal cord after injury. In this study, hydrogel scaffolds provide a detailed model system to investigate the regeneration of spinal cord axons as they directly associate with individual blood vessels, using novel methods to define their spatial relationships and the physiologic implications of that organization. These results refine future tissue engineering strategies for spinal cord repair to optimize the re-development of complete neurovascular bundles in their relevant spatial architectures.
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Affiliation(s)
- Ahad M Siddiqui
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States
| | - David Oswald
- Program in Human Medicine, Paracelsus Medical University, Salzburg, Austria
| | | | - Domnhall Kelly
- Regenerative Medicine Institute (REMEDI), National University of Ireland Galway, Galway, Ireland
| | - Priska Summer
- Program in Human Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Michael Polzin
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States
| | - Jeffrey Hakim
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States
| | - Ann M Schmeichel
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States
| | - Bingkun Chen
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States
| | - Michael J Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, Unites States
| | | | - Nicolas N Madigan
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States
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12
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Mitra I, Bose S, Dernell WS, Dasgupta N, Eckstrand C, Herrick J, Yaszemski MJ, Goodman SB, Bandyopadhyay A. 3D Printing in alloy design to improve biocompatibility in metallic implants. Mater Today (Kidlington) 2021; 45:20-34. [PMID: 34220288 PMCID: PMC8248902 DOI: 10.1016/j.mattod.2020.11.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
3D Printing (3DP) or additive manufacturing (AM) enables parts with complex shapes, design flexibility, and customization opportunities for defect specific patient-matched implants. 3DP or AM also offers a design platform that can be used to innovate novel alloys for application-specific compositional modifications. In medical applications, the biological response from a host tissue depends on a biomaterial's structural and compositional properties in the physiological environment. Application of 3DP can pave the way towards manufacturing innovative metallic implants, combining structural variations at different length scales and tailored compositions designed for specific biological responses. This study shows how 3DP can be used to design metallic alloys for orthopedic and dental applications with improved biocompatibility using in vitro and in vivo studies. Titanium (Ti) and its alloys are used extensively in biomedical devices due to excellent fatigue and corrosion resistance and good strength to weight ratio. However, Ti alloys' in vivo biological response is poor due to its bioinert surface. Different coatings and surface modification techniques are currently being used to improve the biocompatibility of Ti implants. We focused our efforts on improving Ti's biocompatibility via a combination of tantalum (Ta) chemistry in Ti, the addition of designed micro-porosity, and nanoscale surface modification to enhance both in vitro cytocompatibility and early stage in vivo osseointegration, which was studied in rat and rabbit distal femur models.
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Affiliation(s)
- Indranath Mitra
- W. M. Keck Biomedical Materials Research Laboratory, School
of Mechanical and Materials Engineering, Washington State University, Pullman, WA
99164 2920, USA
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School
of Mechanical and Materials Engineering, Washington State University, Pullman, WA
99164 2920, USA
| | - William S. Dernell
- College of Veterinary Medicine, Washington State
University, Pullman, WA 99164, USA
| | - Nairanjana Dasgupta
- Department of Mathematics and Statistics, Washington State
University, Pullman, WA 99164, USA
| | - Chrissy Eckstrand
- College of Veterinary Medicine, Washington State
University, Pullman, WA 99164, USA
| | - Jim Herrick
- Department of Orthopedic Surgery, Mayo Clinic, Rochester,
MN, USA
| | | | - Stuart B. Goodman
- Department of Orthopedic Surgery, Stanford University
Medical Center, Redwood City, CA 94063, USA
| | - Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School
of Mechanical and Materials Engineering, Washington State University, Pullman, WA
99164 2920, USA
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13
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Siddiqui AM, Brunner R, Harris GM, Miller AL, Waletzki BE, Schmeichel AM, Schwarzbauer JE, Schwartz J, Yaszemski MJ, Windebank AJ, Madigan NN. Promoting Neuronal Outgrowth Using Ridged Scaffolds Coated with Extracellular Matrix Proteins. Biomedicines 2021; 9:biomedicines9050479. [PMID: 33925613 PMCID: PMC8146557 DOI: 10.3390/biomedicines9050479] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 12/25/2022] Open
Abstract
Spinal cord injury (SCI) results in cell death, demyelination, and axonal loss. The spinal cord has a limited ability to regenerate, and current clinical therapies for SCI are not effective in helping promote neurologic recovery. We have developed a novel scaffold biomaterial that is fabricated from the biodegradable hydrogel oligo(poly(ethylene glycol)fumarate) (OPF). We have previously shown that positively charged OPF scaffolds (OPF+) in an open spaced, multichannel design can be loaded with Schwann cells to support axonal generation and functional recovery following SCI. We have now developed a hybrid OPF+ biomaterial that increases the surface area available for cell attachment and that contains an aligned microarchitecture and extracellular matrix (ECM) proteins to better support axonal regeneration. OPF+ was fabricated as 0.08 mm thick sheets containing 100 μm high polymer ridges that self-assemble into a spiral shape when hydrated. Laminin, fibronectin, or collagen I coating promoted neuron attachment and axonal outgrowth on the scaffold surface. In addition, the ridges aligned axons in a longitudinal bipolar orientation. Decreasing the space between the ridges increased the number of cells and neurites aligned in the direction of the ridge. Schwann cells seeded on laminin coated OPF+ sheets aligned along the ridges over a 6-day period and could myelinate dorsal root ganglion neurons over 4 weeks. This novel scaffold design, with closer spaced ridges and Schwann cells, is a novel biomaterial construct to promote regeneration after SCI.
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Affiliation(s)
- Ahad M. Siddiqui
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.S.); (A.M.S.); (A.J.W.)
| | - Rosa Brunner
- Program in Human Medicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria;
| | - Gregory M. Harris
- Department of Molecular Biology, Princeton University, Princeton, NJ 08540, USA; (G.M.H.); (J.E.S.)
| | - Alan Lee Miller
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA; (A.L.M.II); (B.E.W.)
| | - Brian E. Waletzki
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA; (A.L.M.II); (B.E.W.)
| | - Ann M. Schmeichel
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.S.); (A.M.S.); (A.J.W.)
| | - Jean E. Schwarzbauer
- Department of Molecular Biology, Princeton University, Princeton, NJ 08540, USA; (G.M.H.); (J.E.S.)
| | - Jeffrey Schwartz
- Department of Chemistry, Princeton University, Princeton, NJ 08544, USA; (J.S.); (M.J.Y.)
| | - Michael J. Yaszemski
- Department of Chemistry, Princeton University, Princeton, NJ 08544, USA; (J.S.); (M.J.Y.)
| | - Anthony J. Windebank
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.S.); (A.M.S.); (A.J.W.)
| | - Nicolas N. Madigan
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA; (A.M.S.); (A.M.S.); (A.J.W.)
- Correspondence:
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14
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Rezaei A, Tilton M, Giambini H, Li Y, Hooke A, Miller Ii AL, Yaszemski MJ, Lu L. Three-dimensional surface strain analyses of simulated defect and augmented spine segments: A biomechanical cadaveric study. J Mech Behav Biomed Mater 2021; 119:104559. [PMID: 33915439 DOI: 10.1016/j.jmbbm.2021.104559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/09/2021] [Accepted: 04/19/2021] [Indexed: 11/19/2022]
Abstract
While several studies have investigated fracture outcomes of intact vertebrae, fracture properties in metastatically-involved and augmented vertebrae are still far from understood. Consequently, this study was aimed to use 3D digital image correlation (3D-DIC) method to investigate the failure properties of spine segments with simulated metastatic lesions, segments augmented with poly(propylene fumarate) (PPF), and compare the outcomes with intact spines. To this end, biomechanical experiments accompanied by 3D-DIC were performed on spine segments consisting of three vertebrae and two intervertebral discs (IVDs) at loading rates of 0.083 mm/s, mimicking a physiological loading condition, and 200 mm/s, mimicking an impact-type loading condition such as a fall or an accident. Full-field surface strain analysis indicated PPF augmentation reduces the superior/inferior strain when compared with the defect specimens; Presence of a defect in the middle vertebra resulted in shear band fracture pattern. Failure of the superior endplates was confirmed in several defect specimens as the superior IVDs were protruding out of defects. The augmenting PPF showed lower superior/inferior surface strain values at the fast speed as compared to the slow speed. The results of our study showed a significant increase in the fracture force from slow to fast speeds (p = 0.0246). The significance of the study was to determine the fracture properties of normal, pathological, and augmented spinal segments under physiologically-relevant loading conditions. Understanding failure properties associated with either defect (i.e., metastasis lesion) or augmented (i.e., post-treatment) spine segments could potentially provide new insights on the outcome prediction and treatment planning. Additionally, this study provides new knowledge on the effect of PPF augmentation in improving fracture properties, potentially decreasing the risk of fracture in osteoporotic and metastatic spines.
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Affiliation(s)
- Asghar Rezaei
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Maryam Tilton
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Hugo Giambini
- Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
| | - Yong Li
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Alexander Hooke
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Alan L Miller Ii
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Michael J Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
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15
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Liu X, Gaihre B, George MN, Li Y, Tilton M, Yaszemski MJ, Lu L. 2D phosphorene nanosheets, quantum dots, nanoribbons: synthesis and biomedical applications. Biomater Sci 2021; 9:2768-2803. [PMID: 33620047 PMCID: PMC9009269 DOI: 10.1039/d0bm01972k] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Phosphorene, also known as black phosphorus (BP), is a two-dimensional (2D) material that has gained significant attention in several areas of current research. Its unique properties such as outstanding surface activity, an adjustable bandgap width, favorable on/off current ratios, infrared-light responsiveness, good biocompatibility, and fast biodegradation differentiate this material from other two-dimensional materials. The application of BP in the biomedical field has been rapidly emerging over the past few years. This article aimed to provide a comprehensive review of the recent progress on the unique properties and extensive medical applications for BP in bone, nerve, skin, kidney, cancer, and biosensing related treatment. The details of applications of BP in these fields were summarized and discussed.
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Affiliation(s)
- Xifeng Liu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA. and Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Bipin Gaihre
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA. and Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Matthew N George
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA. and Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Yong Li
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA. and Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Maryam Tilton
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA. and Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Michael J Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA. and Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA. and Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
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16
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Rezaei A, Giambini H, Miller Ii AL, Xu H, Xu H, Li Y, Yaszemski MJ, Lu L. CT-based structural analyses of vertebral fractures with polymeric augmentation: A study of cadaveric three-level spine segments. Comput Biol Med 2021; 133:104395. [PMID: 33872967 DOI: 10.1016/j.compbiomed.2021.104395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 12/27/2022]
Abstract
Pathologic vertebral fractures due to metastasis can occur under normal physiologic activities, leading to pain and neurologic deficit. Prophylactic vertebroplasty is a technique used to augment vertebral strength and reduce the risk of fracture. Currently, no technique is available to objectively assess vertebral fracture risk in metastatically-involved vertebral bodies. The aim of the current study was to develop an image-based computational technique to estimate fracture force outcomes during bending. To this end, mechanical testing was performed on intact, simulated defect, PMMA-augmented, and PPF-augmented 3-level spine segments from both sexes under a compression/flexion-type loading condition. The augmentation performance of poly(methyl methacrylate) (PMMA) and poly(propylene fumarate) (PPF) were also evaluated and compared. Cylindrical defects were created in 3-level spine segments with attached posterior elements and ligaments. Using CT images of each segment, a rigidity analysis technique was developed and used for predicting fracture forces during bending. On average, PPF strengthened the segments by about 630 N, resulting in fracture forces similar to those observed in the intact and PMMA-augmented groups. Female spines fractured at about 1150 N smaller force than did male spines. Rigidity analysis, along with age, explained 66% variability in experimental outcomes. This number increased to 74% when vertebral size and age were added to the rigidity analysis as explanatory variables. Both PPF and PMMA similarly increased fracture strength to the level of intact specimens. The results suggest that PPF can be a suitable candidate for augmentation purposes and rigidity analysis can be a promising predicting tool for vertebral fracture forces.
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Affiliation(s)
- Asghar Rezaei
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Hugo Giambini
- Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
| | - Alan L Miller Ii
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Hao Xu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Haocheng Xu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Yong Li
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Michael J Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
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17
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Hanson K, Isder C, Shogren K, Mikula AL, Lu L, Yaszemski MJ, Elder BD. The inhibitory effects of vancomycin on rat bone marrow-derived mesenchymal stem cell differentiation. J Neurosurg Spine 2021:1-5. [PMID: 33799299 DOI: 10.3171/2020.10.spine201511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/12/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The use of intrawound vancomycin powder in spine surgery has been shown to decrease the rate of surgical site infections; however, the optimal dose is unknown. High-dose vancomycin inhibits osteoblast proliferation in vitro and may decrease the rate of solid arthrodesis. Bone marrow-derived mesenchymal stem cells (BMSCs) are multipotent cells that are a source of osteogenesis in spine fusions. The purpose of this study was to determine the effects of vancomycin on rat BMSC viability and differentiation in vitro. METHODS BMSCs were isolated from the femurs of immature female rats, cultured, and then split into two equal groups; half were treated to stimulate osteoblastic differentiation and half were not. Osteogenesis was stimulated by the addition of 50 µg/mL l-ascorbic acid, 10 mM β-glycerol phosphate, and 0.1 µM dexamethasone. Vancomycin was added to cell culture medium at concentrations of 0, 0.04, 0.4, or 4 mg/mL. Early differentiation was determined by alkaline phosphatase activity (4 days posttreatment) and late differentiation by alizarin red staining for mineralization (9 days posttreatment). Cell viability was determined at both the early and late time points by measurement of formazan colorimetric product. RESULTS Viability within the first 4 days decreased with high-dose vancomycin treatment, with cells receiving 4 mg/mL vancomycin having 40%-60% viability compared to the control. A gradual decrease in alizarin red staining and nodule formation was observed with increasing vancomycin doses. In the presence of the osteogenic factors, vancomycin did not have deleterious effects on alkaline phosphatase activity, whereas a trend toward reduced activity was seen in the absence of osteogenic factors when compared to osteogenically treated cells. CONCLUSIONS Vancomycin reduced BMSC viability and impaired late osteogenic differentiation with high-dose treatment. Therefore, the inhibitory effects of high-dose vancomycin on spinal fusion may result from both reduced BMSC viability and some impairment of osteogenic differentiation.
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Affiliation(s)
- Kari Hanson
- Departments of1Neurologic Surgery.,2Orthopedic Surgery, and
| | | | | | | | - Lichun Lu
- 2Orthopedic Surgery, and.,3Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Michael J Yaszemski
- 2Orthopedic Surgery, and.,3Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Benjamin D Elder
- Departments of1Neurologic Surgery.,2Orthopedic Surgery, and.,3Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
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18
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Kolz JM, Wellings EP, Houdek MT, Clarke MJ, Yaszemski MJ, Rose PS. Surgical treatment of primary mobile spine chordoma. J Surg Oncol 2021; 123:1284-1291. [PMID: 33567141 DOI: 10.1002/jso.26423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES Chordomas of the mobile spine (C1-L5) are rare malignant tumors. The purpose of this study was to review the outcome of surgical treatment for patients with primary mobile spine chordomas. METHODS The oncologic outcomes and survival of 26 patients undergoing surgical resection for a primary mobile spine chordoma were assessed over a 25-year period. The mean follow-up was 12 ± 6 years. RESULTS The 2-, 5-, and 10-year disease-free survivals were 95%, 61%, and 55%. The local recurrence-free survival was improved in patients receiving en bloc resection with negative margins (83% vs. 35%, p = 0.02) and similar in patients receiving adjuvant radiation therapy (43% vs. 45%, p = 0.30) at 10 years. Debulking of the tumor (hazard ratio [HR] = 6.41, p = 0.01) and a local recurrence (HR = 9.52, p = 0.005) were associated with death due to disease. Complications occurred in 19 (73%) patients, leading to reoperation in 9 (35%) patients; this rate was similar in intralesional and en bloc procedures. CONCLUSION Surgical resection of mobile spine chordomas is associated with a high rate of complications; however, en bloc resection can provide a hope for cure and appears to confer better oncologic outcomes for these tumors without an increase in complications compared to lesser resections.
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Affiliation(s)
- Joshua M Kolz
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Matthew T Houdek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Peter S Rose
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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19
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Swany L, Larson AN, Shah SA, Grabala P, Milbrandt T, Yaszemski MJ. Outcomes of pregnancy in operative vs. nonoperative adolescent idiopathic scoliosis patients at mean 30-year follow-up. Spine Deform 2020; 8:1169-1174. [PMID: 32578160 DOI: 10.1007/s43390-020-00158-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 06/08/2020] [Indexed: 10/24/2022]
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVE To determine whether patients who underwent surgical treatment of adolescent idiopathic scoliosis (AIS) in childhood would have an increased C-section risk in adulthood. Although the impact of scoliosis on future pregnancy and child delivery is a common question for patients and parents, there is limited data regarding pregnancy outcomes following childhood treatment of AIS. METHODS Between 1975 and 1992, 60 female patients underwent treatment for AIS with bracing, surgery, or observation and had data available regarding obstetrical history in the electronic medical record or in paper charts. In childhood, 28 had nonoperative treatment and 32 had fusion surgery. During the follow-up period, 2 nonoperative patients and 1 operative patient had fusion surgery in adulthood, but after childbearing years. Mean age at latest follow-up was 43 years (CI 38, 48). Meantime to follow-up since childhood treatment was 31 years (CI 26, 35). RESULTS 29% of nonoperative patients had a C-section with at least one live birth compared to 38% of operative patients (p = 0.464). For surgical patients fused to L3 or lower, 46% required at least one C-section, compared to 32% of patients fused to L2 or higher (p = 0.40). Overall, 33% of the cohort of patients-including those with all scoliosis treatment methods-required at least one C-section, compared to the state weighted C-section rate of 20.5% (p = 0.014). The percentage of patients with operative treatment-including all levels of fusion-requiring at least one C-section was statistically different than the weighted state C-section rate (p = 0.020). CONCLUSION In this long-term cohort of 60 US scoliosis patients, childhood operative fusion treatment was associated with a statistically significant increased incidence of C-section compared to the state incidence at both the patient level and the delivery level. LEVEL OF EVIDENCE III, comparative cohort study.
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Affiliation(s)
- Lauren Swany
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 200 1st St SW, USA
| | - A Noelle Larson
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 200 1st St SW, USA.
| | - Suken A Shah
- Department of Orthopaedic Surgery, Nemours Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA
| | - Pawel Grabala
- Department of Pediatric Orthopaedic Surgery and Traumatology, Medical University of Bialystok, Bialystok, Poland
| | - Todd Milbrandt
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 200 1st St SW, USA
| | - Michael J Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 200 1st St SW, USA
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20
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Kasperbauer JL, Creppel NH, Gutierrez C, Lehrke HD, Prummer C, Yaszemski MJ, Wismayer DS, Janus JR. Mandibular Defect Reconstitution: A Contaminated Caprine Model of Bone Regeneration. J Oral Maxillofac Surg 2020; 79:1044.e1-1044.e12. [PMID: 33359103 DOI: 10.1016/j.joms.2020.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/09/2020] [Accepted: 11/24/2020] [Indexed: 11/15/2022]
Abstract
PURPOSE Mandibular reconstitution with bioabsorbable scaffolds seems feasible with the application of 3-dimensional printing combined with bioactive proteins. As yet, previous studies have been limited in number of animals and have avoided a contaminated defect. We present a caprine model of mandibular defect bone regeneration with a 3-dimensionally printed bioabsorbable scaffold contaminated with oral secretions and explore the impact of bone morphogenic protein in mandibular bone reconstitution. METHODS A 3-cm, contaminated mandibular defect was generated in 18 goats and stabilized with 2 mandibular reconstruction plates. An uncoated scaffold was placed in 6 goats, and in the final 6 goats, the scaffold was coated with bone morphogenic protein-2. In 6 goats, the defect was left empty. After 12 weeks, the operative site, scaffold, and adjacent mandible were plasticized, sectioned, and evaluated histologically to assess for bone regeneration. RESULTS The specimens revealed only focal (average of 5.8% of the scaffold pores) and early bone formation in the scaffold-only group. In the scaffold + bone morphogenic protein-2 group, there was more (average of 51.4% of the pores) bone formation. In the periosteum-only group, the ratio of the bone thickness of the defect to that of the normal bone ranged from 0.16 to 0.78. No major infections occurred. CONCLUSIONS This caprine model serves as an excellent method to assess reconstructive options for contaminated mandibular deficits. Bone regeneration was documented in a 3-cm contaminated caprine mandibular defect reconstructed with a 3-dimensionally printed synthetic scaffold with or without the addition of bone morphogenic protein-2. Bone morphogenic protein-2 significantly augments bone generation in the synthetic scaffold. Residual mandibular periosteum generated bone. Future studies will focus on optimizing vascularization.
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Affiliation(s)
- Jan L Kasperbauer
- Professor, Assistant Professor, Departments of Otolaryngology and Anatomy, Mayo Clinic, Rochester, MN.
| | | | | | - Heidi D Lehrke
- Private Practitioner, Division of Anatomic Pathology, Hospital Pathology Associates, St. Paul, MN
| | | | - Michael J Yaszemski
- Professor, Biomedical Engineering and Orthopedics, Mayo Clinic, Rochester, MN
| | - Dj Schembri Wismayer
- Assistant Professor, Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Jeffrey R Janus
- Associate Professor of Otolaryngology, Chair Department of Otolaryngology, Mayo Clinic, Jacksonville, FL
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21
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Houdek MT, Wellings EP, Moran SL, Bakri K, Dozois EJ, Mathis KL, Yaszemski MJ, Sim FH, Rose PS. Outcome of Sacropelvic Resection and Reconstruction Based on a Novel Classification System. J Bone Joint Surg Am 2020; 102:1956-1965. [PMID: 32941308 DOI: 10.2106/jbjs.20.00135] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Sacral tumor resections require a multidisciplinary approach to achieve a cure and a functional outcome. Currently, there is no accepted classification system that provides a means to communicate among the multidisciplinary teams in terms of approach, osseous resection, reconstruction, and acceptable functional outcome. The purpose of this study was to report the outcome of sacral tumor resection based on our classification system. METHODS In this study, 196 patients (71 female and 125 male) undergoing an oncologic en bloc sacrectomy were reviewed. The mean age (and standard deviation) was 49 ± 16 years, and the mean body mass index was 27.2 ± 6.4 kg/m. The resections included 130 sarcomas (66%). The mean follow-up was 7 ± 5 years. RESULTS Resections included total sacrectomy (Type 1A: 20 patients [10%]) requiring reconstruction, subtotal sacrectomy (Type 1B: 5 patients [3%]) requiring reconstruction, subtotal sacrectomy (Type 1C: 104 patients [53%]) not requiring reconstruction, hemisacrectomy (Type 2: 29 patients [15%]), external hemipelvectomy and hemisacrectomy (Type 3: 32 patients [16%]), total sacrectomy and external hemipelvectomy (Type 4: 5 patients [3%]), and hemicorporectomy (Type 5: 1 patient [1%]). The disease-specific survival was 66% at 5 years and 52% at 10 years. Based on the classification, the 5-year disease-specific survival was 34% for Type 1A, 100% for Type 1B, 71% for Type 1C, 65% for Type 2, 57% for Type 3, 100% for Type 4, and 100% for Type 5 (p < 0.001). Tumor recurrence occurred in 67 patients, including isolated local recurrence (14 patients), isolated metastatic disease (31 patients), and combined local and metastatic disease (22 patients). At 5 years, the local recurrence-free survival was 77% and the metastasis-free survival was 68%. Complications occurred in 153 patients (78%), most commonly wound complications (95 patients [48%]). Following the procedure, 154 patients (79%) were ambulatory, and the mean Musculoskeletal Tumor Society (MSTS93) score was 60% ± 23%. CONCLUSIONS Although resections of sacral malignancies are associated with complications, they can be curative in a majority of patients, with a majority of patients ambulatory with an acceptable functional outcome considering the extent of the resection. At our institution, this classification allows for communication between surgical teams and implies a surgical approach, staging, reconstruction, and potential functional outcomes. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Matthew T Houdek
- Divisions of Plastic and Reconstructive Surgery (S.L.M. and K.B.) and Colorectal Surgery (E.J.D. and K.L.M.) and Department of Orthopedic Surgery (M.T.H., E.P.W., M.J.Y., F.H.S., and P.S.R.), Mayo Clinic, Rochester, Minnesota
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22
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Rezaei A, Giambini H, Miller AL, Liu X, Elder BD, Yaszemski MJ, Lu L. OPF/PMMA cage system as an alternative approach for the treatment of vertebral corpectomy. Appl Sci (Basel) 2020; 10:6912. [PMID: 33986953 PMCID: PMC8115301 DOI: 10.3390/app10196912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The spinal column is the most common site for bone metastasis. Vertebral metastases with instability have historically been treated with corpectomy of the affected vertebral body and adjacent intervertebral discs, and are more recently treated with separation surgery. With demographics shifting towards an elderly population, a less invasive surgical approach is necessary for the repair of vertebral defects. We have modified a previously reported expandable hollow cage composed of an oligo[poly(ethylene glycol) fumarate] (OPF) containment system that could be delivered via a posterior-only approach. Then, the polymer of interest, poly(methyl methacrylate) (PMMA) bone cement, was injected into the lumen of the cage after expansion to form an OPF/PMMA cage. We compared six different cage formulations to account for vertebral body and defect size, and performed a cage characterization via expansion kinetics and mechanical testing evaluations. Additionally, we investigated the feasibility of the OPF/PMMA cage in providing spine stability via kinematic analyses. The in-vitro placement of the implant using our OPF/PMMA cage system showed improvement and mechanical stability in a flexion motion. The results demonstrated that the formulation and technique presented in the current study have the potential to improve surgical outcomes in minimally invasive procedures on the spine.
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Affiliation(s)
- Asghar Rezaei
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Hugo Giambini
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Alan L. Miller
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Xifeng Liu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Benjamin D. Elder
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Michael J. Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
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23
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Wojda SJ, Marozas IA, Anseth KS, Yaszemski MJ, Donahue SW. Impact of Release Kinetics on Efficacy of Locally Delivered Parathyroid Hormone for Bone Regeneration Applications. Tissue Eng Part A 2020; 27:246-255. [PMID: 32615861 DOI: 10.1089/ten.tea.2020.0119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Characterizing the release profile for materials-directed local delivery of bioactive molecules and its effect on bone regeneration is an important step to improve our understanding of, and ability to optimize, the bone healing response. This study examined the local delivery of parathyroid hormone (PTH) using a thiol-ene hydrogel embedded in a porous poly(propylene fumarate) (PPF) scaffold for bone regeneration applications. The aim of this study was to characterize the degradation-controlled in vitro release kinetics of PTH from the thiol-ene hydrogels, in vivo hydrogel degradation in a subcutaneous implant model, and bone healing in a rat critical size bone defect. Tethering PTH to the hydrogel matrix eliminated the early timepoint burst release that was observed in previous in vitro work where PTH was free to diffuse out of the matrix. Only 8% of the tethered PTH was released from the hydrogel during the first 2 weeks, but by day 21, 80% of the PTH was released, and complete release was achieved by day 28. In vivo implantation revealed that complete degradation of the hydrogel alone occurred by day 21; however, when incorporated in a three-dimensional printed osteoconductive PPF scaffold, the hydrogel persisted for >56 days. Treatment of bone defects with the composite thiol-ene hydrogel-PPF scaffold, delivering either 3 or 10 μg of tethered PTH 1-84, was found to increase bridging of critical size bone defects, whereas treatment with 30 μg of tethered PTH resulted in less bone ingrowth into the defect area. Continued development of this biomaterial delivery system for PTH could lead to improved therapies for treatment of nonunion fractures and critical size bone defects.
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Affiliation(s)
- Samantha J Wojda
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Ian A Marozas
- Department of Chemical and Biological Engineering and the BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
| | - Kristi S Anseth
- Department of Chemical and Biological Engineering and the BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
| | | | - Seth W Donahue
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, Massachusetts, USA.,Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado, USA
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24
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Liu X, George MN, Park S, Miller Ii AL, Gaihre B, Li L, Waletzki BE, Terzic A, Yaszemski MJ, Lu L. 3D-printed scaffolds with carbon nanotubes for bone tissue engineering: Fast and homogeneous one-step functionalization. Acta Biomater 2020; 111:129-140. [PMID: 32428680 DOI: 10.1016/j.actbio.2020.04.047] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/29/2020] [Accepted: 04/25/2020] [Indexed: 02/03/2023]
Abstract
Three-dimensional (3D) printing is a promising technology for tissue engineering. However, 3D-printing methods are limited in their ability to produce desired microscale features or electrochemical properties in support of robust cell adhesion, proliferation, and differentiation. This study addresses this deficiency by proposing an integrated, one-step, method to increase the cytocompatibility of 3D-printed scaffolds through functionalization leveraging conductive carbon nanotubes (CNTs). To this end, CNTs were first sonicated with water-soluble single-stranded deoxyribonucleic acid (ssDNA) to generate a negatively charged ssDNA@CNT nano-complex. Concomitantly, 3D-printed poly(propylene fumarate) (PPF) scaffolds were ammonolyzed to introduce free amine groups, which can take on a positive surface charge in water. The ssDNA@CNT nano-complex was then applied to 3D-printed scaffolds through a simple one-step coating utilizing electric-static force. This fast and facile functionalization step resulted in a homogenous and non-toxic coating of CNTs to the surface, which significantly improved the adhesion, proliferation, and differentiation of pre-osteoblast cells. In addition, the CNT based conductive coating layer enabled modulation of cell behavior through electrical stimuli (ES) leading to cellular proliferation and osteogenic gene marker expression, including alkaline phosphatase (ALP), osteocalcin (OCN), and osteopontin (OPN). Collectively, these data provide the foundation for a one-step functionalization method for simple, fast, and effective functionalization of 3D printed scaffolds that support enhanced cell adhesion, proliferation, and differentiation, especially when employed in conjunction with ES. STATEMENT OF SIGNIFICANCE: Three-dimensional (3D) printing is a promising technology for tissue engineering. However, 3D-printing methods have limited ability to produce desired features or electrochemical properties in support of robust cell behavior. To address this deficiency, the current study proposed an integrated, one-step method to increase the cytocompatibility of 3D-printed scaffolds through functionalization leveraging conductive carbon nanotubes (CNTs). This fast and facile functionalization resulted in a homogenous and non-toxic coating of CNTs to the surface, which significantly improved the adhesion, proliferation, and differentiation of cells on the 3D-printed scaffolds.
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Affiliation(s)
- Xifeng Liu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Matthew N George
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Sungjo Park
- Department of Cardiovascular Diseases and Center for Regenerative Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - A Lee Miller Ii
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Bipin Gaihre
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Linli Li
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Brian E Waletzki
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Andre Terzic
- Department of Cardiovascular Diseases and Center for Regenerative Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Michael J Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
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25
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Ji Y, Okuno MN, Shogren KL, Fritchie K, Okuno SH, Yaszemski MJ, Maran A. Autophagy markers and RNA-dependent protein kinase (PKR) activity in osteosarcoma diagnosis and treatment. Ann Joint 2020. [DOI: 10.21037/aoj.2020.02.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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26
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Bures Z, Mamo T, Vlcek M, Lu L, Yaszemski MJ. Signal protein-functionalized gold nanoparticles for nuclear targeting into osteosarcoma cells for use in radiosensitization experiments. Neoplasma 2020; 67:576-583. [PMID: 32182087 DOI: 10.4149/neo_2020_190710n620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/29/2019] [Indexed: 11/08/2022]
Abstract
The standard therapy for malignant primary bone tumors such as osteosarcoma involves major surgeries. For tumors located in difficult regions such as the pelvis, surgical intervention could lead to serious side effects for example loss of a limb and/or function, loss of bowel, bladder and sexual function as well as problems with wound healing and surgical complications. Therefore, exploring other approaches that can improve or complement current surgical techniques is important. Hence, sensitizing primary bone tumors to radiation could offer an additional strategy that could complement surgery and significantly improve survival and quality of life. Gold nanoparticles (AuNPs) have been shown to enhance radiosensitivity by increasing the local dose of radiation inside tumors. Therefore, the referred procedure of preparation and functionalization of gold nanoparticles may be used for investigation whether DNA repair inhibition in the presence of AuNPs leads to an effective radiosensitizing strategy for primary bone tumor cells and explore the mechanism of how this may be happening. In our work, we prepared gold nanoparticles and verified the relation between the size of the AuNPs and their uptake in tumor 143B cells and also investigated whether the optimal size of the AuNPs should not be smaller than the size of nuclear envelope pores (20-50 nm). Hence, two different AuNPs systems were prepared: the first one with AuNPs core size of about 5 nm (BS) and the second one with AuNPs core size of about 50 nm (ZA). For cellular AuNPs uptake enhancement, we functionalized the AuNPs with signaling peptides. For this purpose we prepared PEG-coated AuNPs functionalized with signal peptides for targeted transport into the cytoplasm (CPP) and into the cell nucleus (CPP + NLS). The toxicity of the AuNPs systems was assessed by MTS assay. We prepared stable functionalized AuNPs systems of both sizes. With the functionalizing of the AuNPs using signal peptides (CPP, NLS), the AuNPs penetrated into the cell nucleus. The referred procedure of preparation and functionalization of gold nanoparticles may be used for investigating inhibition of DNA repair in the presence of AuNPs and it could lead to new understanding in overcoming radioresistance in primary bone tumor cells.
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Affiliation(s)
- Z Bures
- 3rd Department of Internal Medicine, University Hospital and Faculty of Medicine, Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.,Department of General and Inorganic Chemistry, Faculty of Chemical Technology, University of Pardubice, Pardubice, Czech Republic
| | - T Mamo
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, United States
| | - M Vlcek
- Center of Materials and Nanotechnology, Faculty of Chemical Technology, University of Pardubice, Pardubice, Czech Republic
| | - L Lu
- Department of Orthopedic Surgery, Mayo Clinic, Mayo Clinic School of Graduate Medical Education, Rochester, United States.,Department of Physiology and Biomedical Engineering, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, United States
| | - M J Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic, Mayo Clinic School of Graduate Medical Education, Rochester, United States.,Department of Physiology and Biomedical Engineering, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, United States
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27
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Wojda SJ, Marozas IA, Anseth KS, Yaszemski MJ, Donahue SW. Thiol-ene Hydrogels for Local Delivery of PTH for Bone Regeneration in Critical Size defects. J Orthop Res 2020; 38:536-544. [PMID: 31709588 DOI: 10.1002/jor.24502] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 10/14/2019] [Indexed: 02/04/2023]
Abstract
Neither allograft nor commercially available bone graft substitutes provide the same quality of bone healing as autograft. Incorporation of bioactive molecules like parathyroid hormone (PTH) within bone graft substitute materials may provide similar, if not better treatment options to grafting. The goal of this work was to develop a biomaterial system for the local delivery of PTH to large bone defects for promoting bone regeneration. PTH was loaded in a thiol-ene hydrogel at several concentrations and polymerized in and around an osteoconductive poly(propylene fumarate) (PPF) scaffold. PTH was shown to be bioactive when released from the hydrogel for up to 21 days. Eighty percent of the PTH was released by day 3 with the remaining 20% released by day 14. Bone healing was quantified in rat critical size femoral defects that were treated with hydrogel/PPF and 0, 1, 3, 10, or 30 µg of PTH. Although complete osseous healing was not observed in all samples in any one treatment group, all samples in the 10 µg PTH group were bridged fully by bone or a combination of bone and cartilage containing hypertrophic chondrocytes and endochondral ossification. Outcome measures indicated improved defect bridging by a combination of bony and cartilaginous tissue in the 10 μg treatment group compared with empty bone defects and defects treated with only hydrogel/PPF (i.e., without PTH). Given the tailorability of the hydrogel, future studies will investigate the effects of prolonged gradual PTH release on bone healing. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:536-544, 2020.
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Affiliation(s)
- Samantha J Wojda
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Ian A Marozas
- Department of Chemical and Biological Engineering and the BioFrontiers Institute, University of Colorado, Boulder, Colorado
| | - Kristi S Anseth
- Department of Chemical and Biological Engineering and the BioFrontiers Institute, University of Colorado, Boulder, Colorado
| | | | - Seth W Donahue
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, Massachusetts
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28
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Houdek MT, Hevesi M, Griffin AM, Yaszemski MJ, Sim FH, Ferguson PC, Rose PS, Wunder JS. Can the ACS-NSQIP surgical risk calculator predict postoperative complications in patients undergoing sacral tumor resection for chordoma? J Surg Oncol 2020; 121:1036-1041. [PMID: 32034772 DOI: 10.1002/jso.25865] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 01/28/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES The ACS-NSQIP surgical risk calculator is an online tool that estimates the risk of postoperative complications. Sacrectomies for chordoma are associated with a high rate of complications. This study was to determine if the ACS-NSQIP calculator can predict postoperative complications following sacrectomy. METHODS Sixty-five (42 male, 23 female) patients who underwent sacrectomy were analyzed using the Current Procedural Terminology (CPT) codes: 49215 (excision of presacral/sacral tumor), 63001 (laminectomy of sacral vertebrae), 63728 (laminectomy for biopsy/excision of sacral neoplasm) and 63307 (sacral vertebral corpectomy for intraspinal lesion). The predicted rates of complications were compared to the observed rates. RESULTS Complications were noted in 44 (68%) patients. Of the risk factors available to input to the ACS-NSQIP calculator, tobacco use (OR, 20.4; P < .001) was predictive of complications. The predicted risk of complications based off the CPT codes were: 49215 (16%); 63011 (6%); 63278 (11%) and 63307 (15%). Based on ROC curves, the use of the ACS-NSQIP score were poor predictors of complications (49215, AUC 0.65); (63011, AUC 0.66); (63307, AUC 0.67); (63278, AUC 0.64). CONCLUSION The ACS-NSQIP calculator was a poor predictor of complications and was marginally better than a coin flip in its ability to predict complications following sacrectomy for chordoma.
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Affiliation(s)
- Matthew T Houdek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Mario Hevesi
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Anthony M Griffin
- University Musculoskeletal Oncology Unit Mount Sinai Hospital, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | | | - Franklin H Sim
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Peter C Ferguson
- University Musculoskeletal Oncology Unit Mount Sinai Hospital, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - Peter S Rose
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Jay S Wunder
- University Musculoskeletal Oncology Unit Mount Sinai Hospital, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
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29
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Houdek MT, Hevesi M, Schwab JH, Yaszemski MJ, Griffin AM, Healey JH, Ferguson PC, Hornicek FJ, Boland PJ, Sim FH, Rose PS, Wunder JS. Association between patient age and the risk of mortality following local recurrence of a sacral chordoma. J Surg Oncol 2020; 121:267-271. [PMID: 31758570 PMCID: PMC7242148 DOI: 10.1002/jso.25774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Local recurrence (LR) of sacral chordoma is a difficult problem and the mortality risk associated with LR remains poorly described. The purpose of this study was to evaluate the risk of mortality in patients with LR and determine if patient age is associated with mortality. METHODS A total of 218 patients (144 male, 69 female; mean age 59 ± 15 years) with sacrococcygeal chordomas were reviewed. Cumulative incidence functions and competing risks for death due to disease and nondisease mortality were employed to analyze mortality trends following LR. RESULTS The 10-year overall survival (OS) was 55%. Patients with LR had 44% 10-year OS, similar to patients without (59%; P = .38). The 10-year OS between those less than 55 compared with ≥55 years were similar (69% vs 48%; P = .52). The 10-year death due to disease was worse in patients with LR compared with those without (44% vs 84%; P < .001). In patients without LR, patients ≥55 years were 1.6-fold more likely to experience death due to other causes. CONCLUSIONS Patients with an LR are more likely to die due to disease. Advanced patient age was associated with higher all-cause mortality following resection of sacral chordoma. LR of chordoma was associated with increased disease-specific mortality, regardless of age.
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Affiliation(s)
- Matthew T. Houdek
- Mayo Clinic, Department of Orthopedic Surgery, Rochester, MN,Corresponding Author: , 200 First St. SW, Rochester, MN 55905, (507) 284-2511
| | - Mario Hevesi
- Mayo Clinic, Department of Orthopedic Surgery, Rochester, MN
| | - Joseph H. Schwab
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Boston, MA
| | | | - Anthony M. Griffin
- University Musculoskeletal Oncology Unit Mount Sinai Hospital, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - John H. Healey
- Orthopaedic Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center and Weill College of Medicine, Cornell University, New York, NY
| | - Peter C. Ferguson
- University Musculoskeletal Oncology Unit Mount Sinai Hospital, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - Francis J. Hornicek
- Department of Orthopedic Surgery, University of California Los Angeles, Los Angeles, CA
| | - Patrick J. Boland
- Orthopaedic Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center and Weill College of Medicine, Cornell University, New York, NY
| | - Franklin H. Sim
- Mayo Clinic, Department of Orthopedic Surgery, Rochester, MN
| | - Peter S. Rose
- Mayo Clinic, Department of Orthopedic Surgery, Rochester, MN
| | - Jay S. Wunder
- University Musculoskeletal Oncology Unit Mount Sinai Hospital, Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
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Rubin JP, Gurtner GC, Liu W, March KL, Seppänen-Kaijansinkko R, Yaszemski MJ, Yoo JJ. Tissue Engineering Clinical Council Roundtable Discussion: Opportunities and Challenges in Clinical Translation. Tissue Eng Part A 2020; 26:113-119. [PMID: 31977299 DOI: 10.1089/ten.tea.2019.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Peter Rubin
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.,Chair of the Clinical Council of the Editorial Board, Tissue Engineering
| | - Geoffrey C Gurtner
- Division of Plastic Surgery, Department of Surgery, Stanford University, Stanford, California
| | - Wei Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Keith L March
- Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, Florida
| | - Riitta Seppänen-Kaijansinkko
- Department of Oral and Maxillofacial Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Michael J Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - James J Yoo
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Garcia L, Soliman S, Francis MP, Yaszemski MJ, Doshi J, Simon CG, Robinson-Zeigler R. Workshop on the characterization of fiber-based scaffolds: Challenges, progress, and future directions. J Biomed Mater Res B Appl Biomater 2019; 108:2063-2072. [PMID: 31880376 DOI: 10.1002/jbm.b.34545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/05/2019] [Accepted: 12/08/2019] [Indexed: 02/05/2023]
Abstract
A critical component of many tissue-engineered medical products (TEMPs) is the scaffold or biomaterial. The industry's understanding of scaffold properties and their influence on cell behavior has advanced, but our technical capability to reliably characterize scaffolds requires improvement, especially to enable large-scale manufacturing. In response to the key findings from the 2013 ASTM International Workshop of Standards and Measurements for Tissue Engineering Scaffolds, the National Institute of Standards and Technology (NIST), ASTM International, BiofabUSA, and the Standards Coordinating Body (SCB) organized a workshop in 2018 titled, "Characterization of Fiber-Based Scaffolds". The goal was to convene a group of 40 key industry stakeholders to identify major roadblocks in measurements of fiber-based scaffold properties. This report provides an overview of the findings from this collaborative workshop. The four major consensus findings were that (a) there is need for a documentary standard guide that would aid developers in the selection of test methods for characterizing fiber-based scaffolds; (b) there is a need for a strategy to assess the quality of porosity and pore size measurements, which could potentially be ameliorated by the development of a reference material; (b) there are challenges with the lexicon used to describe and assess scaffolds; and (d) the vast array of product applications makes it challenging to identify consensus test methods. As a result of these findings, a working group was formed to develop an ASTM Standard Guide for Characterizing Fiber-Based Constructs that will provide developers guidance on selecting measurements for characterizing fiber-based scaffolds.
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Affiliation(s)
- Lexi Garcia
- BioFabUSA, Advanced Regenerative Manufacturing Institute, Manchester, New Hampshire
| | | | - Michael P Francis
- Embody, Inc, Norfolk, Virginia.,Eastern Virginia Medical School, Norfolk, Virginia
| | - Michael J Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.,Department of Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | | | - Carl G Simon
- Biosystems & Biomaterials Division, National Institute of Standards & Technology, Gaithersburg, Maryland
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Mikula AL, Puffer RC, Jeor JDS, Bernatz JT, Fogelson JL, Larson AN, Nassr A, Sebastian AS, Freedman BA, Currier BL, Bydon M, Yaszemski MJ, Anderson PA, Elder BD. Teriparatide treatment increases Hounsfield units in the lumbar spine out of proportion to DEXA changes. J Neurosurg Spine 2019; 32:1-6. [PMID: 31628287 DOI: 10.3171/2019.7.spine19654] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 07/22/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The authors sought to assess whether Hounsfield units (HU) increase following teriparatide treatment and to compare HU increases with changes in bone mineral density (BMD) as measured by dual-energy x-ray absorptiometry (DEXA). METHODS A retrospective chart review was performed from 1997 to 2018 across all campuses at our institution. The authors identified patients who had been treated with at least 6 months of teriparatide and compared HU and BMD as measured on DEXA scans before and after treatment. RESULTS Fifty-two patients were identified for analysis (46 women and 6 men, average age 67 years) who underwent an average of 20.9 ± 6.5 months of teriparatide therapy. The mean ± standard deviation HU increase throughout the lumbar spine (L1-4) was from 109.8 ± 53 to 133.9 ± 61 HU (+22%, 95% CI 1.2-46, p value = 0.039). Based on DEXA results, lumbar spine BMD increased from 0.85 to 0.93 g/cm2 (+9%, p value = 0.044). Lumbar spine T-scores improved from -2.4 ± 1.5 to -1.7 ± 1.5 (p value = 0.03). Average femoral neck T-scores improved from -2.5 ± 1.1 to -2.3 ± 1.0 (p value = 0.31). CONCLUSIONS Teriparatide treatment increased both HU and BMD on DEXA in the lumbar spine, without a change in femoral BMD. The 22% improvement in HU surpassed the 9% improvement determined with DEXA. These results support some surgeons' subjective sense that intraoperative bone quality following teriparatide treatment is better than indicated by DEXA results. To the authors' knowledge, this is the first study demonstrating an increase in HU with teriparatide treatment.
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Affiliation(s)
| | - Ross C Puffer
- 1Department of Neurological Surgery, Mayo Clinic, Rochester
| | | | - James T Bernatz
- 3Department of Orthopedics and Rehabilitative Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; and
| | | | - A Noelle Larson
- 4Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Ahmad Nassr
- 4Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Arjun S Sebastian
- 4Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Brett A Freedman
- 4Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - Mohamad Bydon
- 1Department of Neurological Surgery, Mayo Clinic, Rochester
| | | | - Paul A Anderson
- 3Department of Orthopedics and Rehabilitative Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; and
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Rezaei A, Giambini H, Carlson KD, Xu H, Uthamaraj S, Dragomir-Daescu D, Yaszemski MJ, Lu L. Mechanical testing setups affect spine segment fracture outcomes. J Mech Behav Biomed Mater 2019; 100:103399. [PMID: 31479817 DOI: 10.1016/j.jmbbm.2019.103399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/10/2019] [Accepted: 08/16/2019] [Indexed: 11/19/2022]
Abstract
The purpose of the work presented here was to establish an experimental testing configuration that would generate a bending compression fracture in a laboratory setting. To this end, we designed and fabricated a fixture to accommodate a three level spine segment and to be able to perform mechanical testing by applying an off-centric compressive loading to create a flexion-type motion. Forces and moments occurring during testing were measured with a six-channel load cell. The initial testing configuration (Fixture A) included plates connected to the superior potted vertebral body and to the ball-socket joint of the testing system ram. Surprisingly, while all cadaveric specimens underwent a similar off-centric compressive loading, most of the specimens showed extension outcomes as opposed to the intended pure-flexion motion. The extension was due to fixture size and weight; by applying an off-centric load directly on the top plate, unintended large shear forces were generated. To resolve the issue, several modifications were made to the original fixture configuration. These modifications included the removal of the superior plates and the implementation of wedges at the superior surface of the fixture (Fixture B). A synthetic sample was used during this modification phase to minimize the number of cadaveric specimens while optimizing the process. The best outcomes were consistently observed when a 15°-wedge was used to provide flexion-type loading. Cadaveric specimens were then experimentally tested to fracture using the modified testing configuration (Fixture B). A comparison between both fixtures, A and B, revealed that almost all biomechanical parameters, including force, moment, and displacement data, were affected by the testing setup. These results suggest that fixture design and implementation for testing is of extreme importance, and can influence the fracture properties and affect the intended motion.
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Affiliation(s)
- Asghar Rezaei
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Hugo Giambini
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
| | - Kent D Carlson
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Hao Xu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Dan Dragomir-Daescu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Michael J Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
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35
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Olthof MGL, Kempen DHR, Liu X, Dadsetan M, Tryfonidou MA, Yaszemski MJ, Dhert WJA, Lu L. Effect of Biomaterial Electrical Charge on Bone Morphogenetic Protein-2-Induced In Vivo Bone Formation. Tissue Eng Part A 2019; 25:1037-1052. [PMID: 30612538 DOI: 10.1089/ten.tea.2018.0140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
IMPACT STATEMENT Biomaterials can play a dual role in bone regeneration: they enable local sustained delivery of growth factors, such as bone morphogenetic protein-2 (BMP-2), while they provide structural support as scaffold. By better imitating the properties of native bone tissue, scaffolds may be both osteoconductive and osteoinductive. The latter can be achieved by modifying the electrical charge of the surface. The present work uses tunable oligo[(polyethylene glycol) fumarate] hydrogel and demonstrates that negative charge enhances BMP-2-induced bone formation compared with neutral or positive charge. Altogether, this indicates that tissue-specific surface charge modifications of biomaterials hold great promise in the field of tissue regeneration.
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Affiliation(s)
- Maurits G L Olthof
- 1Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota.,2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.,3Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,4Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | | | - Xifeng Liu
- 1Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota.,2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Mahrokh Dadsetan
- 1Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota.,2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
| | | | - Michael J Yaszemski
- 1Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota.,2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Wouter J A Dhert
- 3Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,4Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | - Lichun Lu
- 1Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota.,2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
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Larson AN, Baky F, Ashraf A, Baghdadi YM, Treder V, Polly DW, Yaszemski MJ. Minimum 20-Year Health-Related Quality of Life and Surgical Rates After the Treatment of Adolescent Idiopathic Scoliosis. Spine Deform 2019; 7:417-427. [PMID: 31053312 DOI: 10.1016/j.jspd.2018.09.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/28/2018] [Accepted: 09/02/2018] [Indexed: 10/26/2022]
Abstract
STUDY DESIGN Longitudinal cohort. OBJECTIVES To determine the patient-reported functional outcomes and need for related surgical procedures in a US cohort of adolescent idiopathic scoliosis (AIS) patients with minimum 20-year follow-up. SUMMARY OF BACKGROUND DATA There is limited information regarding the long-term outcomes of scoliosis treatment in the US population. METHODS A novel population of patients who underwent pediatric treatment for AIS with minimum 20-year follow-up was identified. Search of a single-center diagnostic registry generated 337 patients who fulfilled the inclusion criteria (AIS, curve magnitude >35°, and childhood treatment with bracing, surgery, or observation from 1975 to 1992). Any additional spine surgery as well as EQ5D, ODI, SRS 22, SAQ were determined. A total of 180 patients were included (mean of 30-year follow-up, range 20-37). Childhood treatment entailed bracing (41 patients), surgery (103 patients), and observation (36 patients). RESULTS During the study period, only 1 of the 41 bracing patients underwent additional scoliosis-related spine surgery, whereas 5 of the 36 patients in the observation cohort underwent scoliosis surgery as adults. Seven of 103 childhood surgical patients required additional revision surgery as adults. Fifteen patients (4 braced, 7 fusion, and 4 observed) underwent chest wall surgery as adults. SRS scores were around 10% worse compared to population-based controls, with the exception of SRS mental health scores, which were similar to controls. Overall, 5.6% of patients were on disability, with no difference between operative and nonoperative groups. CONCLUSION We found a low rate of adult scoliosis surgery in the braced population, and a low rate of revision surgery at the 30-year follow-up in patients undergoing spine fusion for AIS between 1975 and 1992. No detected differences in patient-reported outcomes were found between the braced, surgical, and observed populations at a mean of 30 years' follow-up. LEVEL OF EVIDENCE Level III, therapeutic.
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Affiliation(s)
- A Noelle Larson
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
| | - Fady Baky
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Ali Ashraf
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Yaser M Baghdadi
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Vickie Treder
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - David W Polly
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN 55455, USA
| | - Michael J Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
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Hakim JS, Rodysill BR, Chen BK, Schmeichel AM, Yaszemski MJ, Windebank AJ, Madigan NN. Combinatorial tissue engineering partially restores function after spinal cord injury. J Tissue Eng Regen Med 2019; 13:857-873. [PMID: 30808065 DOI: 10.1002/term.2840] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 01/23/2019] [Accepted: 02/21/2019] [Indexed: 12/13/2022]
Abstract
Hydrogel scaffolds provide a beneficial microenvironment in transected rat spinal cord. A combinatorial biomaterials-based strategy provided a microenvironment that facilitated regeneration while reducing foreign body reaction to the three-dimensional spinal cord construct. We used poly lactic-co-glycolic acid microspheres to provide sustained release of rapamycin from Schwann cell (SC)-loaded, positively charged oligo-polyethylene glycol fumarate scaffolds. The biological activity and dose-release characteristics of rapamycin from microspheres alone and from microspheres embedded in the scaffold were determined in vitro. Three dose formulations of rapamycin were compared with controls in 53 rats. We observed a dose-dependent reduction in the fibrotic reaction to the scaffold and improved functional recovery over 6 weeks. Recovery was replicated in a second cohort of 28 animals that included retransection injury. Immunohistochemical and stereological analysis demonstrated that blood vessel number, surface area, vessel diameter, basement membrane collagen, and microvessel phenotype within the regenerated tissue was dependent on the presence of SCs and rapamycin. TRITC-dextran injection demonstrated enhanced perfusion into scaffold channels. Rapamycin also increased the number of descending regenerated axons, as assessed by Fast Blue retrograde axonal tracing. These results demonstrate that normalization of the neovasculature was associated with enhanced axonal regeneration and improved function after spinal cord transection.
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Affiliation(s)
- Jeffrey S Hakim
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Bingkun K Chen
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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Olthof MGL, Tryfonidou MA, Dadsetan M, Dhert WJA, Yaszemski MJ, Kempen DHR, Lu L. In Vitro and In Vivo Correlation of Bone Morphogenetic Protein-2 Release Profiles from Complex Delivery Vehicles. Tissue Eng Part C Methods 2019; 24:379-390. [PMID: 29756545 DOI: 10.1089/ten.tec.2018.0024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Local sustained delivery of bioactive molecules from biomaterials is a promising strategy to enhance bone regeneration. To optimize delivery vehicles for bone formation, the design characteristics are tailored with consequential effect on bone morphogenetic protein-2 (BMP-2) release and bone regeneration. Complying with the 3R principles (Replacement, Reduction, and Refinement), the growth factor release is often investigated in vitro using several buffers to mimic the in vivo physiological environment. However, this remains an unmet need. Therefore, this study investigates the in vitro-in vivo correlation (IVIVC) of BMP-2 release from complex delivery vehicles in several commonly used in vitro buffers: cell culture model, phosphate buffered saline, and a strong desorption buffer. The results from this study showed that the release environment affected the BMP-2 release profiles, creating distinct relationships between release versus time and differences in extent of release. According to the guidance set by the U.S. Food and Drug Administration (FDA), IVIVC resulted in level A internal predictability for individual composites. Since the IVIVC was influenced by the BMP-2 loading method and composite surface chemistry, the external predictive value of the IVIVCs was limited. These results show that the IVIVCs can be used for predicting the release of an individual composite. However, the models cannot be used for predicting in vivo release for different composite formulations since they lack external predictability. Potential confounding effects of drug type, delivery vehicle formulations, and application site should be added to the equation to develop one single IVIVC applicable for complex delivery vehicles. Altogether, these results imply that more sophisticated in vitro systems should be used in bone regeneration to accurately discriminate and predict in vivo BMP-2 release from different complex delivery vehicles.
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Affiliation(s)
- Maurits G L Olthof
- 1 Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine , Rochester, Minnesota.,2 Department of Orthopedic Surgery, Mayo Clinic College of Medicine , Rochester, Minnesota.,3 Department of Orthopaedics, University Medical Center Utrecht , Utrecht, The Netherlands .,4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University , Utrecht, The Netherlands
| | - Marianna A Tryfonidou
- 4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University , Utrecht, The Netherlands
| | - Mahrokh Dadsetan
- 1 Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine , Rochester, Minnesota.,2 Department of Orthopedic Surgery, Mayo Clinic College of Medicine , Rochester, Minnesota
| | - Wouter J A Dhert
- 4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University , Utrecht, The Netherlands
| | - Michael J Yaszemski
- 1 Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine , Rochester, Minnesota.,2 Department of Orthopedic Surgery, Mayo Clinic College of Medicine , Rochester, Minnesota
| | - Diederik H R Kempen
- 5 Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Lichun Lu
- 1 Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine , Rochester, Minnesota.,2 Department of Orthopedic Surgery, Mayo Clinic College of Medicine , Rochester, Minnesota
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Houdek MT, Rose PS, Hevesi M, Schwab JH, Griffin AM, Healey JH, Petersen IA, DeLaney TF, Chung PW, Yaszemski MJ, Wunder JS, Hornicek FJ, Boland PJ, Sim FH, Ferguson PC. Low dose radiotherapy is associated with local complications but not disease control in sacral chordoma. J Surg Oncol 2019; 119:856-863. [PMID: 30734292 DOI: 10.1002/jso.25399] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 01/20/2019] [Accepted: 01/23/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND We reviewed the disease control and complications of the treatment of sacrococcygeal chordoma from four tertiary cancer centers with emphasis on the effects of radiotherapy in surgically treated patients. METHODS A total of 193 patients with primary sacrococcygeal chordoma from 1990 to 2015 were reviewed. There were 124 males, with a mean age of 59 ± 15 years and a mean follow-up of 7 ± 4 years. Eighty-nine patients received radiotherapy with a mean total dose of 61.8 ± 10.9 Gy. RESULTS The 10-year disease-free and disease-specific survival was 58% and 72%, respectively. Radiation was not associated with local recurrence (hazard ratio [HR], 1.13; 95% confidence interval [CI], 0.59-2.17; P = 0.71), metastases (HR, 0.93; 95% CI, 0.45-1.91; P = 0.85) or disease-specific survival (HR, 0.96; 95% CI, 0.46-2.00; P = 0.91). Higher doses (≥70 Gy; HR, 0.52; 95% CI, 0.20-1.32; P = 0.17) may be associated with reduced local recurrence. Radiotherapy was associated with wound complications (HR, 2.76; 95% CI, 1.64-4.82;, P < 0.001) and sacral stress fractures (HR, 4.73; 95% CI, 1.88-14.38; P < 0.001). CONCLUSIONS In this multicenter review, radiotherapy was not associated with tumor outcome but associated with complications. The routine use of radiotherapy with en-bloc resection of sacrococcygeal chordomas should be reconsidered in favor of a selective, individualized approach with a radiation dose of ≥70 Gy.
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Affiliation(s)
- Matthew T Houdek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Peter S Rose
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Mario Hevesi
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Joseph H Schwab
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Boston, Massachusetts
| | - Anthony M Griffin
- Division of Orthopaedic Surgery, Department of Surgery, University Musculoskeletal Oncology Unit Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - John H Healey
- Orthopaedic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center and Weill College of Medicine, Cornell University, New York, New York
| | - Ivy A Petersen
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Thomas F DeLaney
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Peter W Chung
- Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Canada
| | | | - Jay S Wunder
- Division of Orthopaedic Surgery, Department of Surgery, University Musculoskeletal Oncology Unit Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Francis J Hornicek
- Department of Orthopedic Surgery, University of California Los Angeles, Los Angeles, California
| | - Patrick J Boland
- Orthopaedic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center and Weill College of Medicine, Cornell University, New York, New York
| | - Franklin H Sim
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Peter C Ferguson
- Division of Orthopaedic Surgery, Department of Surgery, University Musculoskeletal Oncology Unit Mount Sinai Hospital, University of Toronto, Toronto, Canada
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Zang J, Zuo D, Shogren KL, Gustafson CT, Zhou Z, Thompson MA, Guo R, Prakash YS, Lu L, Guo W, Maran A, Yaszemski MJ. STIM1 expression is associated with osteosarcoma cell survival. Chin J Cancer Res 2019; 31:203-211. [PMID: 30996578 PMCID: PMC6433589 DOI: 10.21147/j.issn.1000-9604.2019.01.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objective To examine the role of store-operated calcium entry (SOCE) and stromal interaction molecule 1 (STIM1) in survival and migration of osteosarcoma cells and investigate what blockade of store-operated Ca2+ contributes to the regulation of osteosarcoma cells.
Methods First, we examined the expression levels of STIM1 in osteosarcoma cell lines by Western analysis and in tissue specimens by immunohistochemistry. Second, we investigated the effect of SOCE and STIM1 on osteosarcoma cell viability using MTS assays and on cell proliferation using colony formation. Third, we investigated the role of SOCE and STIM1 in cell migration using wound healing assays and Boyden chamber assays. Finally, we studied the effect of SOCE on the nuclear factor of activated T-cells cytoplasmic 1 (NFATc1) activity by luciferase assays. Results STIM1 was overexpressed in osteosarcoma cell lines and tissue specimens and was associated with poor survival of osteosarcoma patients. Also, inhibition of SOCE and STIM1 decreased the cell viability and migration of osteosarcoma cells. Furthermore, our results showed that blockade of store-operated Ca2+ channels involved down-regulation of NFATc1 in osteosarcoma cells.
Conclusions STIM1 is essential for osteosarcoma cell functions, and STIM1 and Ca2+ entry pathway could be further explored as molecular targets in the treatment of osteosarcoma.
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Affiliation(s)
- Jie Zang
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.,Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing 100044, China
| | - Dongqing Zuo
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.,Department of Orthopaedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Kristen L Shogren
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Carl T Gustafson
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Zifei Zhou
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Ruiwei Guo
- Department of Cardiology, Kunming General Hospital of Chengdu Military Command of PLA, Kunming 650032, China
| | - Y S Prakash
- Department of Orthopaedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Lichun Lu
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Wei Guo
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing 100044, China
| | - Avudaiappan Maran
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Michael J Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
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41
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Wagner ER, Parry J, Dadsetan M, Bravo D, Riester SM, Van Wijnen AJ, Yaszemski MJ, Kakar S. VEGF-mediated angiogenesis and vascularization of a fumarate-crosslinked polycaprolactone (PCLF) scaffold. Connect Tissue Res 2018. [PMID: 29513041 DOI: 10.1080/03008207.2018.1424145] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE Revascularization of natural and synthetic scaffolds is a critical part of the scaffold's incorporation and tissue ingrowth. Our goals were to create a biocompatible polymer scaffold with 3D-printing technology, capable of sustaining vascularization and tissue ingrowth. METHODS We synthesized biodegradable polycaprolactone fumarate (PCLF) scaffolds to allow tissue ingrowth via large interconnected pores. The scaffolds were prepared with Poly(lactic-co-glycolic acid)(PLGA) microspheres seeded with or without different growth factors including VEGF,FGF-2, and/or BMP-2. Scaffolds were implanted into the subcutaneous tissues of rats before undergoing histologic and microCT angiographic analysis. RESULTS At harvest after 12 weeks, scaffolds had tissue infiltrating into their pores without signs of scar tissue formation, fibrous capsule formation, or immune responses against PCLF. Histology for M1/M2 macrophage phenotypes confirmed that there were no overt signs of immune responses. Both microCT angiography and histologic analysis demonstrated marked tissue and vessel ingrowth throughout the pores traversing the body of the scaffolds. Scaffolds seeded with microspheres containing VEGF or VEGF with either BMP-2 or FGF-2 had significantly higher vascular ingrowth and vessel penetration than controls. All VEGF-augmented scaffolds were positive for Factor-VIII and exhibited collagen tissue infiltration throughout the pores. Furthermore, scaffolds with VEGF and BMP-2 had high levels of mineral deposition throughout the scaffold that are attributable to BMP-2. CONCLUSIONS PCLF polymer scaffold can be utilized as a framework for vascular ingrowth and regeneration of multiple types of tissues. This novel scaffold material has promise in tissue regeneration across all types of tissues from soft tissue to bone.
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Affiliation(s)
- Eric R Wagner
- a Mayo Clinic , Department of Orthopedic Surgery , Rochester , MN
| | - Joshua Parry
- a Mayo Clinic , Department of Orthopedic Surgery , Rochester , MN
| | - Mahrokh Dadsetan
- a Mayo Clinic , Department of Orthopedic Surgery , Rochester , MN
| | - Dalibel Bravo
- a Mayo Clinic , Department of Orthopedic Surgery , Rochester , MN
| | - Scott M Riester
- a Mayo Clinic , Department of Orthopedic Surgery , Rochester , MN
| | | | | | - Sanjeev Kakar
- a Mayo Clinic , Department of Orthopedic Surgery , Rochester , MN
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42
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Arsoy D, Salib CG, Trousdale WH, Tibbo ME, Limberg AK, Viste A, Lewallen EA, Reina N, Yaszemski MJ, Berry DJ, van Wijnen AJ, Morrey ME, Sanchez-Sotelo J, Abdel MP. Joint contracture is reduced by intra-articular implantation of rosiglitazone-loaded hydrogels in a rabbit model of arthrofibrosis. J Orthop Res 2018; 36:2949-2955. [PMID: 29901247 PMCID: PMC6347955 DOI: 10.1002/jor.24068] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 06/03/2018] [Indexed: 02/04/2023]
Abstract
Trauma, surgery, and other inflammatory conditions can lead to debilitating joint contractures. Adjunct pharmacologic modalities may permit clinical prevention and treatment of recalcitrant joint contractures. We investigated the therapeutic potential of rosiglitazone by intra-articular delivery via oligo[poly(ethylene glycol)fumarate] (OPF) hydrogels in an established rabbit model of arthrofibrosis. OPF hydrogels loaded with rosiglitazone were characterized for drug elution properties upon soaking in minimum essential media (MEM) with 10% fetal bovine serum and measurements of drug concentrations via High Performance Liquid Chromatography (HPLC). Drug-loaded scaffolds were surgically implanted into 24 skeletally mature female New Zealand White rabbits that were divided into equal groups receiving OPF hydrogels loaded with rosiglitazone (1.67 mg), or vehicle control (10 µl DMSO). After 8 weeks of joint immobilization, rabbits were allowed unrestricted cage activity for 16 weeks. Contracture angles of rabbit limbs treated with rosiglitazone showed statistically significant improvements in flexion compared to control animals (mean angles, respectively, 64.4° vs. 53.3°, p < 0.03). At time of sacrifice (week 24), animals in the rosiglitazone group continued to exhibit less joint contracture than controls (119.0° vs. 99.5°, p = 0.014). The intra-articular delivery of rosiglitazone using implanted OPF hydrogels decreases flexion contractures in a rabbit model of arthrofibrosis without causing adverse effects (e.g., gross inflammation or arthritis). Statement of Clinical Significance: Post-traumatic joint contractures are common and debilitating, with limited available treatment options. Pharmacologic interventions can potentially prevent and treat such contractures. This study is translational in that a commercially approved medication has been repurposed through a novel delivery device. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2949-2955, 2018.
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Affiliation(s)
- Diren Arsoy
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Christopher G. Salib
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - William H. Trousdale
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Meagan E. Tibbo
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Afton K. Limberg
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Anthony Viste
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Eric A. Lewallen
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Nicolas Reina
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Michael J. Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Daniel J. Berry
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Andre J. van Wijnen
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Mark E. Morrey
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Joaquin Sanchez-Sotelo
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234
| | - Matthew P. Abdel
- Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 Phone: (507) 284-2884, Fax: (507) 266-4234,Corresponding author and requests for reprints author (Matthew P. Abdel, M.D.)
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43
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Zuo D, Shogren KL, Zang J, Jewison DE, Waletzki BE, Miller AL, Okuno SH, Cai Z, Yaszemski MJ, Maran A. Inhibition of STAT3 blocks protein synthesis and tumor metastasis in osteosarcoma cells. J Exp Clin Cancer Res 2018; 37:244. [PMID: 30286779 PMCID: PMC6172747 DOI: 10.1186/s13046-018-0914-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/20/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Osteosarcoma is the most common bone cancer. Despite advances, molecular mechanisms associated with osteosarcoma have not been fully understood. Hence, an effective treatment for osteosarcoma has yet to be developed. Even though signal transducer and activator of transcription3 (STAT3) has been implicated, its role in pathogenesis of osteosarcoma is not fully determined. In this study, we investigated the antitumor effect of napabucasin (NP) (BBI608), an inhibitor of STAT3 on osteosarcoma in vitro and in vivo and studied the underlying molecular mechanism. METHODS Cell viability, colony formation, apoptosis, tumor growth and metastasis assays were performed to examine the effect of NP on osteosarcoma in vitro and in vivo. Real-time RT-PCR, western analysis, immunofluorescence and reporter assays were used to monitor the expression and activity of proteins and underlying molecular pathways. Protein synthesis, co-immunoprecipitation and CAP binding assays were carried out to understand NP-mediated mechanism of actions in osteosarcoma cells. RESULTS Our results show that NP treatment decreases cell viability and induces apoptosis in several osteosarcoma cell lines. NP treatment suppresses both expression and phosphorylation of STAT3 in addition to blocking STAT3-mediated transcription and downstream target proteins in osteosarcoma cells. Furthermore, NP inhibits protein synthesis through regulation of the eukaryotic initiation factor 4E (eIF4E) and eIF4E-binding protein 1 (4E-BP1). NP also inhibits the progression of osteosarcoma tumors and metastasis in vivo in an orthotopic tibial model of osteosarcoma. CONCLUSIONS Taken together, our investigation reveals that NP acts through a novel mechanism and inhibits osteosarcoma growth and metastasis, and could be investigated clinically for treating osteosarcoma patients alone or in combination with other drugs.
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Affiliation(s)
- Dongqing Zuo
- Department of Orthopedic Surgery, 2-69 Medical Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.,Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Kristen L Shogren
- Department of Orthopedic Surgery, 2-69 Medical Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Jie Zang
- Musculoskeletal Tumor Center, People's Hospital, Peking University, Beijing, 100044, China
| | - Donna E Jewison
- Department of Orthopedic Surgery, 2-69 Medical Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Brian E Waletzki
- Department of Orthopedic Surgery, 2-69 Medical Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | | | - Scott H Okuno
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Zhengdong Cai
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Michael J Yaszemski
- Department of Orthopedic Surgery, 2-69 Medical Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Avudaiappan Maran
- Department of Orthopedic Surgery, 2-69 Medical Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
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44
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Greenberg-Worisek AJ, Runge BK, Solyntjes SA, St Helene-Kraft J, Glass SL, Waletzki BE, Herrick JL, Miller AL, Yaszemski MJ, Windebank AJ, Wang H. Establishing a Current Good Manufacturing Practice Facility for Biomaterials and Biomolecules in an Academic Medical Center. Tissue Eng Part B Rev 2018; 24:493-498. [PMID: 30084747 DOI: 10.1089/ten.teb.2018.0114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
IMPACT STATEMENT This article describes the feasibility and path to establishing a current good manufacturing practice biomaterial facility in an academic medical center. It presents a solution to overcome the "Valley of Death" in bench to bedside translation of biomaterials-based medical devices. It sets a good and feasible example to those who are interested in joining the path toward clinical practice/commercialization, and helps to spur other institutions and investigators to think about how they could incorporate in-house processes and facilities to help speed up the translation of their work into first-in-human trials.
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Affiliation(s)
- Alexandra J Greenberg-Worisek
- 1 Center for Regenerative Medicine, Mayo Clinic , Rochester, Minnesota.,2 Department of Neurology, Mayo Clinic , Rochester, Minnesota
| | | | - Sarah A Solyntjes
- 3 Manufacturing Compliance Office, Mayo Clinic , Rochester, Minnesota
| | | | - Suzanne L Glass
- 4 Department of Orthopedic Surgery and Mayo Clinic , Rochester, Minnesota
| | - Brian E Waletzki
- 4 Department of Orthopedic Surgery and Mayo Clinic , Rochester, Minnesota
| | - James L Herrick
- 4 Department of Orthopedic Surgery and Mayo Clinic , Rochester, Minnesota
| | - Alan Lee Miller
- 4 Department of Orthopedic Surgery and Mayo Clinic , Rochester, Minnesota
| | - Michael J Yaszemski
- 1 Center for Regenerative Medicine, Mayo Clinic , Rochester, Minnesota.,4 Department of Orthopedic Surgery and Mayo Clinic , Rochester, Minnesota
| | - Anthony J Windebank
- 1 Center for Regenerative Medicine, Mayo Clinic , Rochester, Minnesota.,2 Department of Neurology, Mayo Clinic , Rochester, Minnesota
| | - Huan Wang
- 1 Center for Regenerative Medicine, Mayo Clinic , Rochester, Minnesota.,5 Department of Neurologic Surgery, Mayo Clinic , Rochester, Minnesota
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45
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Carlson BC, Robinson WA, Wanderman NR, Nassr AN, Huddleston PM, Yaszemski MJ, Currier BL, Jeray KJ, Kirk KL, Bunta AD, Murphy S, Patel B, Watkins CM, Sietsema DL, Edwards BJ, Tosi LL, Anderson PA, Freedman BA. The American Orthopaedic Association's Own the Bone® database: a national quality improvement project for the treatment of bone health in fragility fracture patients. Osteoporos Int 2018; 29:2101-2109. [PMID: 29858634 DOI: 10.1007/s00198-018-4585-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 05/21/2018] [Indexed: 01/22/2023]
Abstract
UNLABELLED The American Orthopaedic Association initiated the Own the Bone (OTB) quality improvement program in 2009. Herein we show that the data collected through this program is similar to that collected in other large studies. Thus, the OTB registry functions as an externally valid cohort for studying fragility fracture patients. INTRODUCTION The American Orthopedic Association initiated the Own the Bone (OTB) quality improvement program in 2009 to improve secondary prevention of fragility fractures. In this study, we present a summary of the data collected by the OTB program and compare it to data from other large fragility fracture registries with an aim to externally validate the OTB registry. METHODS The OTB registry contained 35,038 unique cases of fragility fracture as of September, 2016. We report the demographics, presenting fracture characteristics, past fracture history, and bone mineral density (BMD) data and compare these to data from large fragility fracture studies across the world. RESULTS Seventy-three percent of the patients in the OTB registry were female, Caucasian, and post-menopausal. In 54.4% of cases, patients had a hip fracture; spine fractures were the second most common fracture type occurring in 11.1% of patients. Thirty-four percent of the patients had a past history of fragility fracture, and the most common sites were the spine and hip. The average femoral neck T-score was - 2.06. When compared to other studies, the OTB database showed similar findings with regard to patient age, gender, race, BMI, BMD profile, prior fracture history, and family history of fragility fractures. CONCLUSION OTB is the first and largest multi-center voluntary fragility fracture registry in the USA. The data collected through the OTB program is comparable to that collected in international studies. Thus, the OTB registry functions as an externally valid cohort for further studies assessing the clinical characteristics, interventions, and outcomes achieved in patients who present with a fragility fracture in the USA.
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Affiliation(s)
| | | | | | | | | | | | | | - K J Jeray
- Greenville Health System, Greenville, SC, USA
| | - K L Kirk
- San Antonio Orthopedic Group, San Antonio, TX, USA
| | - A D Bunta
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Murphy
- The American Orthopaedic Association, Rosemont, IL, USA
| | - B Patel
- The American Orthopaedic Association, Rosemont, IL, USA
| | - C M Watkins
- West Virginia University, Morgantown, WV, USA
| | | | - B J Edwards
- Central Texas Veteran Healthcare System, Temple, TX, USA
| | - L L Tosi
- Children's National Health System, Washington, DC, USA
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46
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Olthof MGL, Lu L, Tryfonidou MA, Loozen LD, Pouran B, Yaszemski MJ, Meij BP, Dhert WJA, Alblas J, Kempen DHR. The Osteoinductive Effect of Controlled Bone Morphogenic Protein 2 Release Is Location Dependent. Tissue Eng Part A 2018; 25:193-202. [PMID: 30101676 DOI: 10.1089/ten.tea.2017.0427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
IMPACT STATEMENT The main challenge in bone morphogenic protein 2 (BMP-2)-based application lies in finding strategies to prolong its biologic activity as it has a short biological half-life. The present study uses a phosphate-modified oligo[(polyethylene glycol) fumarate] hydrogel that can be tuned to achieve differential release profiles of biologically active BMP-2 release. We demonstrate that this platform outperforms Infuse®, currently used in the clinic and that the osteoinductive effect of BMP-2 is location dependent. Altogether, this study stresses the importance of evaluating efficacy of bone tissue engineering strategies at an orthotopic location rather than subcutaneously. Even more so, it emphasizes the role of biomaterials as a scaffold to achieve proper bone tissue engineering.
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Affiliation(s)
- Maurits G L Olthof
- 1 Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands.,2 Department of Physiology and Biomedical Engineering and Mayo Clinic College of Medicine, Rochester, Michigan.,3 Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Michigan.,4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,5 Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Lichun Lu
- 2 Department of Physiology and Biomedical Engineering and Mayo Clinic College of Medicine, Rochester, Michigan.,3 Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Michigan
| | - Marianna A Tryfonidou
- 4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Loek D Loozen
- 1 Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | - Behdad Pouran
- 1 Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands.,6 Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | - Michael J Yaszemski
- 2 Department of Physiology and Biomedical Engineering and Mayo Clinic College of Medicine, Rochester, Michigan.,3 Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Michigan
| | - Björn P Meij
- 4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Wouter J A Dhert
- 1 Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands.,4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Jacqueline Alblas
- 1 Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | - Diederik H R Kempen
- 7 Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
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47
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Bravo D, Salduz A, Shogren KL, Okuno MN, Herrick JL, Okuno SH, Galindo M, van Wijnen AJ, Yaszemski MJ, Maran A. Decreased local and systemic levels of sFRP3 protein in osteosarcoma patients. Gene 2018; 674:1-7. [PMID: 29933019 DOI: 10.1016/j.gene.2018.06.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 06/19/2018] [Indexed: 12/18/2022]
Abstract
Osteosarcoma is a malignant bone tumor that occurs mainly in children and adolescents. Because Wnt signaling has been implicated in the pathogenesis of osteosarcoma, we have investigated the circulating and local levels of the Wnt antagonist protein, Secreted Frizzled Related Protein (sFRP) 3, in osteosarcoma patients. Enzyme linked immunosorbent assay (ELISA) analysis of 67 osteosarcoma and age-matched non-diseased control sera showed that sFPR3 protein levels were significantly lower in osteosarcoma than in normal. Analysis of tumor and adjacent normal tissues (9 pairs) from osteosarcoma patients showed a decrease in sFRP3 expression in 5 out of 9 tumor samples compared to normal tissues. Furthermore, immunohistochemical analysis of tissue microarray revealed a significant decrease in sFRP3 levels in tumor compared to normal bone. RNA sequencing analysis in osteosarcoma cells shows suppression of sFRP3 and concomitant expression of multiple Wnt family members mediating canonical or non-canonical Wnt signaling. Taken together, our findings show that the systemic and local levels of sFRP3 protein are downregulated in osteosarcoma and sFRP3 levels could be explored further in the diagnosis and the care of osteosarcoma patients.
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Affiliation(s)
- Dalibel Bravo
- Dept. of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Ahmet Salduz
- Dept. of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Madison N Okuno
- Dept. of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - James L Herrick
- Dept. of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Mario Galindo
- Program of Cellular and Molecular Biology, Institute of Biomedical Sciences (ICBM), Faculty of Medicine, University of Chile, Santiago 8380453, Chile
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48
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Olthof MGL, Kempen DHR, Liu X, Dadsetan M, Tryfonidou MA, Yaszemski MJ, Dhert WJA, Lu L. Bone morphogenetic protein-2 release profile modulates bone formation in phosphorylated hydrogel. J Tissue Eng Regen Med 2018; 12:1339-1351. [PMID: 29603878 DOI: 10.1002/term.2664] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/30/2017] [Accepted: 03/13/2018] [Indexed: 11/05/2022]
Abstract
The optimal release profile of locally delivered bone morphogenetic protein-2 (BMP-2) for safe and effective clinical application is unknown. In this work, the effect of differential BMP-2 release on bone formation was investigated using a novel biomaterial oligo[(polyethylene glycol) fumarate] bis[2-(methacryloyloxy) ethyl] phosphate hydrogel (OPF-BP) containing poly(lactic-co-glycolic acid) microspheres. Three composite implants with the same biomaterial chemistry and structure but different BMP-loading methods were created: BMP-2 encapsulated in microspheres (OPF-BP-Msp), BMP-2 encapsulated in microspheres and adsorbed on the phosphorylated hydrogel (OPF-BP-Cmb), and BMP-2 adsorbed on the phosphorylated hydrogel (OPF-BP-Ads). These composites were compared with the clinically used BMP-2 carrier, Infuse® absorbable collagen sponge (ACS). Differential release profiles of bioactive BMP-2 were achieved by these composites. In a rat subcutaneous implantation model, OPF-BP-Ads and ACS generated a large BMP-2 burst release (>75%), whereas a more sustained release was seen for OPF-BP-Msp and OPF-BP-Cmb (~25% and 50% burst, respectively). OPF-BP-Ads generated significantly more bone than did all other composites, and the bone formation was 12-fold higher than that of the clinically used ACS. Overall, this study clearly shows that BMP-2 burst release generates more subcutaneous bone than do sustained release in OPF-BP-microsphere composites. Furthermore, composites should not only function as a delivery vehicle but also provide a proper framework to achieve appropriate bone formation.
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Affiliation(s)
- Maurits G L Olthof
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA.,Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | - Diederik H R Kempen
- Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Xifeng Liu
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Mahrokh Dadsetan
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Michael J Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Wouter J A Dhert
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Department of Orthopaedics, University Medical Center, Utrecht, The Netherlands
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA
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Riester SM, Lin Y, Wang W, Cong L, Ali AMM, Peck SH, Smith LJ, Currier BL, Clark M, Huddleston P, Krauss W, Yaszemski MJ, Morrey ME, Abdel MP, Bydon M, Qu W, Larson AN, van Wijnen AJ, Nassr A. RNA sequencing identifies gene regulatory networks controlling extracellular matrix synthesis in intervertebral disk tissues. J Orthop Res 2018; 36:1356-1369. [PMID: 29227558 PMCID: PMC5990467 DOI: 10.1002/jor.23834] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 12/04/2017] [Indexed: 02/04/2023]
Abstract
UNLABELLED Degenerative disk disease of the spine is a major cause of back pain and disability. Optimization of regenerative medical therapies for degenerative disk disease requires a deep mechanistic understanding of the factors controlling the structural integrity of spinal tissues. In this investigation, we sought to identify candidate regulatory genes controlling extracellular matrix synthesis in spinal tissues. To achieve this goal we performed high throughput next generation RNA sequencing on 39 annulus fibrosus and 21 nucleus pulposus human tissue samples. Specimens were collected from patients undergoing surgical discectomy for the treatment of degenerative disk disease. Our studies identified associations between extracellular matrix genes, growth factors, and other important regulatory molecules. The fibrous matrix characteristic of annulus fibrosus was associated with expression of the growth factors platelet derived growth factor beta (PDGFB), vascular endothelial growth factor C (VEGFC), and fibroblast growth factor 9 (FGF9). Additionally we observed high expression of multiple signaling proteins involved in the NOTCH and WNT signaling cascades. Nucleus pulposus extracellular matrix related genes were associated with the expression of numerous diffusible growth factors largely associated with the transforming growth signaling cascade, including transforming factor alpha (TGFA), inhibin alpha (INHA), inhibin beta A (INHBA), bone morphogenetic proteins (BMP2, BMP6), and others. CLINICAL SIGNIFICANCE this investigation provides important data on extracellular matrix gene regulatory networks in disk tissues. This information can be used to optimize pharmacologic, stem cell, and tissue engineering strategies for regeneration of the intervertebral disk and the treatment of back pain. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1356-1369, 2018.
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Affiliation(s)
- Scott M. Riester
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA,Department of Occupational and Environmental Medicine, HealthPartners, MN, USA
| | - Yang Lin
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA,Department of Orthopedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Wei Wang
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA,Department of Orthopedic Surgery, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Lin Cong
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA,Department of Orthopedic Surgery, The First Hospital of China Medical University, No.155, Nanjing Bei Street, Shenyang, 110001, P. R. China
| | | | - Sun H. Peck
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, PA, USA,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, PA, USA
| | - Lachlan J. Smith
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, PA, USA,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, PA, USA
| | | | - Michelle Clark
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Paul Huddleston
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - William Krauss
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | | | - Mark E. Morrey
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Matthew P. Abdel
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Mohamad Bydon
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Wenchun Qu
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA,Department of Anesthesiology Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA,Spine Center, Mayo Clinic, Rochester, MN, USA
| | - A. Noelle Larson
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Andre J. van Wijnen
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA,Corresponding Authors: Ahmad Nassr, M.D. & Andre J. van Wijnen, Ph.D., Mayo Clinic, 200 First Street SW, Rochester, MN 55905, Phone: 507- 538-0514, ;
| | - Ahmad Nassr
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA,Corresponding Authors: Ahmad Nassr, M.D. & Andre J. van Wijnen, Ph.D., Mayo Clinic, 200 First Street SW, Rochester, MN 55905, Phone: 507- 538-0514, ;
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50
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Olthof MGL, Tryfonidou MA, Liu X, Pouran B, Meij BP, Dhert WJA, Yaszemski MJ, Lu L, Alblas J, Kempen DHR. Phosphate Functional Groups Improve Oligo[(Polyethylene Glycol) Fumarate] Osteoconduction and BMP-2 Osteoinductive Efficacy. Tissue Eng Part A 2018; 24:819-829. [PMID: 29065776 DOI: 10.1089/ten.tea.2017.0229] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Off-the-shelf availability in large quantities, drug delivery functionality, and modifiable chemistry and mechanical properties make synthetic polymers highly suitable candidates for bone grafting. However, most synthetic polymers lack the ability to support cell attachment, proliferation, migration, and differentiation, and ultimately tissue formation. Incorporating anionic peptides into the polymer that mimics acidic proteins, which contribute to biomineralization and cellular attachment, could enhance bone formation. Therefore, this study investigates the effect of a phosphate functional group on osteoconductivity and BMP-2-induced bone formation in an injectable and biodegradable oligo[(polyethylene glycol) fumarate] (OPF) hydrogel. Three types of OPF hydrogels were fabricated using 0%, 20%, or 40% Bis(2-(methacryloyloxy)ethyl) phosphate creating unmodified OPF-noBP and phosphate-modified OPF-BP20 and OPF-BP40, respectively. To account for the osteoinductive effect of various BMP-2 release profiles, two different release profiles (i.e., different ratios of burst and sustained release) were obtained by varying the BMP-2 loading method. To investigate the osteoconductive effect of phosphate modification, unloaded OPF composites were assessed for bone formation in a bone defect model after 3, 6, and 9 weeks. To determine the effect of the hydrogel phosphate modification on BMP-2-induced bone formation, BMP-2 loaded OPF composites with differential BMP-2 release were analyzed after 9 weeks of subcutaneous implantation in rats. The phosphate-modified OPF hydrogels (OPF-BP20 and OPF-BP40) generated significantly more bone in an orthotopic defect compared to the unmodified hydrogel (OPF-noBP). Furthermore, the phosphate functionalized surface-enhanced BMP-2-induced ectopic bone formation regardless of the BMP-2 release profile. In conclusion, this study clearly shows that phosphate functional groups improve the osteoconductive properties of OPF and enhanced BMP-2-induced bone formation. Therefore, functionalizing hydrogels with phosphate groups by crosslinking monomers into the hydrogel matrix could provide a valuable method for improving polymer characteristics and holds great promise for bone tissue engineering.
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Affiliation(s)
- Maurits G L Olthof
- 1 Department of Orthopedics, University Medical Center , Utrecht, The Netherlands .,2 Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine , Rochester, Minnesota.,3 Department of Orthopedics, Mayo Clinic College of Medicine , Rochester, Minnesota.,4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University , Utrecht, The Netherlands
| | - Marianna A Tryfonidou
- 4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University , Utrecht, The Netherlands
| | - Xifeng Liu
- 2 Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine , Rochester, Minnesota.,3 Department of Orthopedics, Mayo Clinic College of Medicine , Rochester, Minnesota
| | - Behdad Pouran
- 1 Department of Orthopedics, University Medical Center , Utrecht, The Netherlands .,5 Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft) , Delft, The Netherlands
| | - Björn P Meij
- 4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University , Utrecht, The Netherlands
| | - Wouter J A Dhert
- 1 Department of Orthopedics, University Medical Center , Utrecht, The Netherlands .,4 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University , Utrecht, The Netherlands
| | - Michael J Yaszemski
- 2 Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine , Rochester, Minnesota.,3 Department of Orthopedics, Mayo Clinic College of Medicine , Rochester, Minnesota
| | - Lichun Lu
- 2 Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine , Rochester, Minnesota.,3 Department of Orthopedics, Mayo Clinic College of Medicine , Rochester, Minnesota
| | - Jacqueline Alblas
- 1 Department of Orthopedics, University Medical Center , Utrecht, The Netherlands
| | - Diederik H R Kempen
- 6 Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis , Amsterdam, The Netherlands
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