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Sample records for cancellous bone graft

  1. Postoperative irradiation of fresh autogenic cancellous bone grafts

    SciTech Connect

    Schwartz, H.C.; Leake, D.L.; Kagan, A.R.; Snow, H.; Pizzoferrato, A.

    1986-01-01

    Discontinuity defects were created in the mandibles of dogs and then reconstructed immediately with fresh autogenic cancellous bone grafts and Dacron-urethane prostheses. The grafts were irradiated to a total dose of 5000 rads after waiting intervals of between 3 and 12 weeks. Nonirradiated grafts served as controls. The grafts were evaluated clinically, radiographically, and histologically. There was complete incorporation of all grafts, regardless of the interval between surgery and radiotherapy. There were no soft-tissue complications. The controls were distinguishable from the irradiated grafts only by the presence of hematopoietic bone marrow. Fibrofatty marrow was observed in the irradiated grafts. Theoretical support for this technique is found in the biology of cancellous bone grafting and the pathology of radiation injury. In view of the difficulties associated with mandibular bone grafting in preoperatively irradiated patients, a new method of reconstructing selected cancer patients who require both mandibular resection and radiotherapy is suggested.

  2. The use of bone graft substitutes in large cancellous voids: any specific needs?

    PubMed

    Faour, Omar; Dimitriou, Rozalia; Cousins, Charlotte A; Giannoudis, Peter V

    2011-09-01

    Bone graft is the second most common transplantation tissue, with blood being by far the commonest. Autograft is considered ideal for grafting procedures, providing osteoinductive growth factors, osteogenic cells and an osteoconductive scaffold. Limitations, however, exist regarding donor site morbidity and graft availability. Allograft on the other hand poses the risk of disease transmission. Synthetic graft substitutes lack osteoinductive or osteogenic properties. Composite grafts combine scaffolding properties with biological elements to stimulate cell proliferation and differentiation and eventually osteogenesis. We present here an overview of bone graft substitutes available for clinical application in large cancellous voids.

  3. Defect nonunion of a metatarsal bone fracture in a cow: successful management with bone plating and autogenous cancellous bone graft.

    PubMed

    Raghunath, M; Singh, N; Singh, T; Gopinathan, A; Mohindroo, J; Atri, K

    2013-01-01

    A two-and-half-year-old cow was presented with a defect nonunion of the right metatarsal III/IV bone following a severely comminuted open fracture two months previously. The animal underwent open fixation using a 4.5 mm, broad, 10-hole, dynamic compression plate and autogenous cancellous bone graft collected from the contralateral iliac shaft. The animal started partial weight bearing after the third postoperative day and resumed complete weight bearing after the 10th day. Fracture healing was complete and the implants were removed after the 120th postoperative day. Stable fixation by means of a bone plate in conjunction with a cancellous bone graft facilitated complete healing and restoration of the bone column of the defect and the metatarsal fracture. The animal made a complete recovery.

  4. Isolation, cultivation and characterisation of pigeon osteoblasts seeded on xenogeneic demineralised cancellous bone scaffold for bone grafting.

    PubMed

    Harvanová, Denisa; Hornák, Slavomír; Amrichová, Judita; Spaková, Tímea; Mikes, Jaromír; Plsíková, Jana; Ledecký, Valent; Rosocha, Ján

    2014-09-01

    Avian osteoblasts have been isolated particularly from chicken embryo, but data about other functional tissue sources of adult avian osteoblast precursors are missing. The method of preparation of pigeon osteoblasts is described in this study. We demonstrate that pigeon cancellous bone derived osteoblasts have particular proliferative capacity in vitro in comparison to mammalian species and developed endogenous ALP. Calcium deposits formation in vitro was confirmed by alizarin red staining. Only a few studies have attempted to investigate bone grafting and treatment of bone loss in birds. Lack of autologous bone grafts in birds has prompted investigation into the use of avian xenografts for bone augmentation. Here we present a method of xenografting of ostrich demineralised cancellous bone scaffold seeded with allogeneic adult pigeon osteoblasts. Ostrich demineralised cancellous bone scaffold supported proliferation of pigeon osteoblasts during two weeks of co - cultivation in vitro. Scanning electron microscopy demonstrated homogeneous adult pigeon osteoblasts attachment and distribution on the surface of xenogeneic ostrich demineralised cancellous bone. Our preliminary in vitro results indicate that demineralised cancellous bone from ostrich tibia could provide an effective biological support for growth and proliferation of allogeneic osteoblasts derived from cancellous bone of pigeons. PMID:24915787

  5. Isolation, cultivation and characterisation of pigeon osteoblasts seeded on xenogeneic demineralised cancellous bone scaffold for bone grafting.

    PubMed

    Harvanová, Denisa; Hornák, Slavomír; Amrichová, Judita; Spaková, Tímea; Mikes, Jaromír; Plsíková, Jana; Ledecký, Valent; Rosocha, Ján

    2014-09-01

    Avian osteoblasts have been isolated particularly from chicken embryo, but data about other functional tissue sources of adult avian osteoblast precursors are missing. The method of preparation of pigeon osteoblasts is described in this study. We demonstrate that pigeon cancellous bone derived osteoblasts have particular proliferative capacity in vitro in comparison to mammalian species and developed endogenous ALP. Calcium deposits formation in vitro was confirmed by alizarin red staining. Only a few studies have attempted to investigate bone grafting and treatment of bone loss in birds. Lack of autologous bone grafts in birds has prompted investigation into the use of avian xenografts for bone augmentation. Here we present a method of xenografting of ostrich demineralised cancellous bone scaffold seeded with allogeneic adult pigeon osteoblasts. Ostrich demineralised cancellous bone scaffold supported proliferation of pigeon osteoblasts during two weeks of co - cultivation in vitro. Scanning electron microscopy demonstrated homogeneous adult pigeon osteoblasts attachment and distribution on the surface of xenogeneic ostrich demineralised cancellous bone. Our preliminary in vitro results indicate that demineralised cancellous bone from ostrich tibia could provide an effective biological support for growth and proliferation of allogeneic osteoblasts derived from cancellous bone of pigeons.

  6. Comparative biomechanical and microstructural analysis of native versus peracetic acid-ethanol treated cancellous bone graft.

    PubMed

    Rauh, Juliane; Despang, Florian; Baas, Jorgen; Liebers, Cornelia; Pruss, Axel; Gelinsky, Michael; Günther, Klaus-Peter; Stiehler, Maik

    2014-01-01

    Bone transplantation is frequently used for the treatment of large osseous defects. The availability of autologous bone grafts as the current biological gold standard is limited and there is a risk of donor site morbidity. Allogenic bone grafts are an appealing alternative, but disinfection should be considered to reduce transmission of infection disorders. Peracetic acid-ethanol (PE) treatment has been proven reliable and effective for disinfection of human bone allografts. The purpose of this study was to evaluate the effects of PE treatment on the biomechanical properties and microstructure of cancellous bone grafts (CBG). Forty-eight human CBG cylinders were either treated by PE or frozen at -20 °C and subjected to compression testing and histological and scanning electron microscopy (SEM) analysis. The levels of compressive strength, stiffness (Young's modulus), and fracture energy were significantly decreased upon PE treatment by 54%, 59%, and 36%, respectively. Furthermore, PE-treated CBG demonstrated a 42% increase in ultimate strain. SEM revealed a modified microstructure of CBG with an exposed collagen fiber network after PE treatment. We conclude that the observed reduced compressive strength and reduced stiffness may be beneficial during tissue remodeling thereby explaining the excellent clinical performance of PE-treated CBG.

  7. Comparative biomechanical and microstructural analysis of native versus peracetic acid-ethanol treated cancellous bone graft.

    PubMed

    Rauh, Juliane; Despang, Florian; Baas, Jorgen; Liebers, Cornelia; Pruss, Axel; Gelinsky, Michael; Günther, Klaus-Peter; Stiehler, Maik

    2014-01-01

    Bone transplantation is frequently used for the treatment of large osseous defects. The availability of autologous bone grafts as the current biological gold standard is limited and there is a risk of donor site morbidity. Allogenic bone grafts are an appealing alternative, but disinfection should be considered to reduce transmission of infection disorders. Peracetic acid-ethanol (PE) treatment has been proven reliable and effective for disinfection of human bone allografts. The purpose of this study was to evaluate the effects of PE treatment on the biomechanical properties and microstructure of cancellous bone grafts (CBG). Forty-eight human CBG cylinders were either treated by PE or frozen at -20 °C and subjected to compression testing and histological and scanning electron microscopy (SEM) analysis. The levels of compressive strength, stiffness (Young's modulus), and fracture energy were significantly decreased upon PE treatment by 54%, 59%, and 36%, respectively. Furthermore, PE-treated CBG demonstrated a 42% increase in ultimate strain. SEM revealed a modified microstructure of CBG with an exposed collagen fiber network after PE treatment. We conclude that the observed reduced compressive strength and reduced stiffness may be beneficial during tissue remodeling thereby explaining the excellent clinical performance of PE-treated CBG. PMID:24678514

  8. Comparative Biomechanical and Microstructural Analysis of Native versus Peracetic Acid-Ethanol Treated Cancellous Bone Graft

    PubMed Central

    Rauh, Juliane; Despang, Florian; Baas, Jorgen; Liebers, Cornelia; Pruss, Axel; Günther, Klaus-Peter; Stiehler, Maik

    2014-01-01

    Bone transplantation is frequently used for the treatment of large osseous defects. The availability of autologous bone grafts as the current biological gold standard is limited and there is a risk of donor site morbidity. Allogenic bone grafts are an appealing alternative, but disinfection should be considered to reduce transmission of infection disorders. Peracetic acid-ethanol (PE) treatment has been proven reliable and effective for disinfection of human bone allografts. The purpose of this study was to evaluate the effects of PE treatment on the biomechanical properties and microstructure of cancellous bone grafts (CBG). Forty-eight human CBG cylinders were either treated by PE or frozen at −20°C and subjected to compression testing and histological and scanning electron microscopy (SEM) analysis. The levels of compressive strength, stiffness (Young's modulus), and fracture energy were significantly decreased upon PE treatment by 54%, 59%, and 36%, respectively. Furthermore, PE-treated CBG demonstrated a 42% increase in ultimate strain. SEM revealed a modified microstructure of CBG with an exposed collagen fiber network after PE treatment. We conclude that the observed reduced compressive strength and reduced stiffness may be beneficial during tissue remodeling thereby explaining the excellent clinical performance of PE-treated CBG. PMID:24678514

  9. Bone Grafts

    MedlinePlus

    A bone graft transplants bone tissue. Surgeons use bone grafts to repair and rebuild diseased bones in your hips, knees, ... fractures or cancers. Once your body accepts the bone graft, it provides a framework for growth of new, ...

  10. Anatomically safe and minimally invasive transcrestal technique for procurement of autogenous cancellous bone graft from the mid-iliac crest

    PubMed Central

    Missiuna, Paul C.; Gandhi, Harjeet S.; Farrokhyar, Forough; Harnett, Barry E.; Dore, Edward M.G.; Roberts, Barbara

    2011-01-01

    Background Open iliac bone harvesting techniques can result in significant complications and residual morbidity. In reconstructive procedures where a small volume of autogenous cancellous bone graft is required, a minimally invasive technique for bone harvesting applied at the mid-iliac crest has been deemed satisfactory. We sought to assess the application of a well-established surgical technique to procure adequate volume of autogenous cancellous iliac bone graft with minimal trauma to adjacent structures. Methods We retrospectively reviewed the cases of patients who underwent a minimally invasive transcrestal mid-iliac bone graft procurement technique between May 2003 and December 2007. The technique was performed using a 3.5-mm Steinmann pin as a trocar and a 4.5-mm AO drill sleeve as a trephine. We administered a questionnaire, either in the clinic or by mail, to assess a number of parameters, including postoperative pain, dysthesia, parasthesia, status of the donor site wound and patient satisfaction. Results Of the 37 consecutive patients who underwent the procedure, data from 26 patients were available for assessment. Donor site pain resolved within a few days of the surgery, and none of the patients experienced symptoms of chronic pain. At the final review, none of the patients reported any unpleasant signs and symptoms related to the residual scar. Conclusion We recommend that the described minimally invasive trephine method be used when a small cancellous bone graft is needed. We found that patient morbidity was significantly lower with the trephine harvest technique than with open bone harvesting methods at the anterior iliac crest. PMID:21933526

  11. Delayed Union of a Sacral Fracture: Percutaneous Navigated Autologous Cancellous Bone Grafting and Screw Fixation

    SciTech Connect

    Huegli, R. W. Messmer, P.; Jacob, A. L.; Regazzoni, P.; Styger, S.; Gross, T.

    2003-09-15

    Delayed or non-union of a sacral fracture is a serious clinical condition that may include chronic pain, sitting discomfort, gait disturbances, neurological problems, and inability to work. It is also a difficult reconstruction problem. Late correction of the deformity is technically more demanding than the primary treatment of acute pelvic injuries. Open reduction, internal fixation (ORIF), excision of scar tissue, and bone grafting often in a multi-step approach are considered to be the treatment of choice in delayed unions of the pelvic ring. This procedure implies the risk of neurological and vascular injuries, infection, repeated failure of union, incomplete correction of the deformity, and incomplete pain relief as the most important complications. We report a new approach for minimally invasive treatment of a delayed union of the sacrum without vertical displacement. A patient who suffered a Malgaigne fracture (Tile C1.3) was initially treated with closed reduction and percutaneous screw fixation (CRPF) of the posterior pelvic ring under CT navigation and plating of the anterior pelvic ring. Three months after surgery he presented with increasing hip pain caused by a delayed union of the sacral fracture. The lesion was successfully treated percutaneously in a single step procedure using CT navigation for drilling of the delayed union, autologous bone grafting, and screw fixation.

  12. Bone grafts in dentistry

    PubMed Central

    Kumar, Prasanna; Vinitha, Belliappa; Fathima, Ghousia

    2013-01-01

    Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation. PMID:23946565

  13. Onlay Bone Grafts in Head and Neck Reconstruction

    PubMed Central

    Yazar, Sukru

    2010-01-01

    Bone grafts are used in a variety of clinical situations and can be divided into two categories: treatment of bone gaps (inlay bone grafting) and bone projection (onlay bone grafting). Cortical grafts are useful in situations requiring immediate mechanical strength. These grafts can survive with or without complete revascularization or resorption and are primarily used by plastic surgeons in the treatment of bone volume deficiency. Cancellous grafts, in contrast, have no mechanical strength and therefore require additional support to bridge bone defects. Thus, they are used primarily for the treatment of bone gaps and in general revascularize quickly, resorb completely, and stimulate significant new bone formation. PMID:22550447

  14. Vascularized tail bone grafts in rats.

    PubMed

    Sempuku, T; Tamai, S; Mizumoto, S; Yajima, H

    1993-03-01

    A new experimental model for vascularized corticocancellous bone grafts was established by investigation of vascular anatomy of the tail in 15 adult Fischer 344 rats and determination of the viability of vascularized tail bone grafts into the abdominal wall in 22 7-week-old rats. The tail bones of 40 rats were then raised on the pedicle of the caudal artery and its venae comitantes, transferred to a resected portion in the femur, and observed for 16 weeks. The vascularized graft showed marked reactive periosteal bone formation during the first and second weeks following transfer, and thereafter, the graft continued to show active bone formation. In transverse section, the sharp processes became rounded. In the cancellous bone, both bone resorption and bone formation were noticeably activated early after transfer, although resorption predominated and the amount of the cancellous bone consequently diminished. The nonvascularized grafts showed "creeping substitution." The results suggest that morphologic adaptation occurs if living (i.e., vascularized) tail bones are transferred to long-bone femurs.

  15. Calcar bone graft

    SciTech Connect

    Bargar, W.L.; Paul, H.A.; Merritt, K.; Sharkey, N.

    1986-01-01

    A canine model was developed to investigate the use of an autogeneic iliac bone graft to treat the calcar deficiency commonly found at the time of revision surgery for femoral component loosening. Five large male mixed-breed dogs had bilateral total hip arthroplasty staged at three-month intervals, and were sacrificed at six months. Prior to cementing the femoral component, an experimental calcar defect was made, and a bicortical iliac bone graft was fashioned to fill the defect. Serial roentgenograms showed the grafts had united with no resorption. Technetium-99 bone scans showed more uptake at three months than at six months in the graft region. Disulfine blue injection indicated all grafts were perfused at both three and six months. Thin section histology, fluorochromes, and microradiographs confirmed graft viability in all dogs. Semiquantitative grading of the fluorochromes indicated new bone deposition in 20%-50% of each graft at three months and 50%-80% at six months. Although the calcar bone graft was uniformly successful in this canine study, the clinical application of this technique should be evaluated by long-term results in humans.

  16. Proximal Tibial Bone Graft

    MedlinePlus

    ... Complications Potential problems after a PTBG include infection, fracture of the proximal tibia and pain related to the procedure. Frequently Asked Questions If proximal tibial bone graft is taken from my knee, will this prevent me from being able to ...

  17. Bone Grafting the Cleft Maxilla

    MedlinePlus

    ... amount of bone from one place (usually the hip, head, ribs, or leg) and placing it in ... adjacent teeth into the bone graft; 2) prosthetic replacement (dental bridge); or 3) dental metallic bone implants. ...

  18. [Bone grafts in orthopedic surgery].

    PubMed

    Zárate-Kalfópulos, Barón; Reyes-Sánchez, Alejandro

    2006-01-01

    In orthopedic surgery the demand for the use of bone grafts increases daily because of the increasing quantity and complexity of surgical procedures. At present, the gold standard is the autologous bone graft but the failure rate, morbidity of the donor site and limited availability have stimulated a proliferation for finding materials that work as bone graft substitutes. In order to have good success, we must know the different properties of these choices and the environment where the graft is going to be used. As bone graft substitutes and growth factors become clinical realities, a new gold standard will be defined. Tissue engineering and gene therapy techniques have the objective to create an optimum bone graft substitute with a combination of substances with properties of osteconduction, osteogenesis and osteoinduction. PMID:16875525

  19. [Bone grafts in orthopedic surgery].

    PubMed

    Zárate-Kalfópulos, Barón; Reyes-Sánchez, Alejandro

    2006-01-01

    In orthopedic surgery the demand for the use of bone grafts increases daily because of the increasing quantity and complexity of surgical procedures. At present, the gold standard is the autologous bone graft but the failure rate, morbidity of the donor site and limited availability have stimulated a proliferation for finding materials that work as bone graft substitutes. In order to have good success, we must know the different properties of these choices and the environment where the graft is going to be used. As bone graft substitutes and growth factors become clinical realities, a new gold standard will be defined. Tissue engineering and gene therapy techniques have the objective to create an optimum bone graft substitute with a combination of substances with properties of osteconduction, osteogenesis and osteoinduction.

  20. Effect of thermodisinfection on mechanic parameters of cancellous bone.

    PubMed

    Fölsch, Christian; Kellotat, Andreas; Rickert, Markus; Ishaque, Bernd; Ahmed, Gafar; Pruss, Axel; Jahnke, Alexander

    2016-09-01

    Revision surgery of joint replacements is increasing and raises the demand for allograft bone since restoration of bone stock is crucial for longevity of implants. Proceedings of bone grafts influence the biological and mechanic properties differently. This study examines the effect of thermodisinfection on mechanic properties of cancellous bone. Bone cylinders from both femoral heads with length 45 mm were taken from twenty-three 6-8 months-old piglets, thermodisinfected at 82.5 °C according to bone bank guidelines and control remained native. The specimens were stored at -20 °C immediately and were put into 21 °C Ringer's solution for 3 h before testing. Shear and pressure modulus were tested since three point bending force was examined until destruction. Statistical analysis was done with non-parametric Wilcoxon, t test and SPSS since p < 0.05 was significant. Shear modulus was significantly reduced by thermodisinfection to 1.02 ± 0.31 GPa from 1.28 ± 0.68 GPa for unprocessed cancellous bone (p = 0.029) since thermodisinfection reduced pressure modulus not significantly from 6.30 ± 4.72 GPa for native specimens to 4.97 ± 2.23 GPa and maximum bending force was 270.03 ± 116.68 N for native and 228.80 ± 70.49 N for thermodisinfected cancellous bone. Shear and pressure modulus were reduced by thermodisinfection around 20 % and maximum bending force was impaired by about 15 % compared with native cancellous bone since only the reduction of shear modulus reached significance. The results suggest that thermodisinfection similarly affects different mechanic properties of cancellous bone and the reduction of mechanic properties should not relevantly impair clinical use of thermodisinfected cancellous bone. PMID:27344440

  1. Nonallograft osteoconductive bone graft substitutes.

    PubMed

    Bucholz, Robert W

    2002-02-01

    An estimated 500,000 to 600,000 bone grafting procedures are done annually in the United States. Approximately (1/2) of these surgeries involve spinal arthrodesis whereas 35% to 40% are used for general orthopaedic applications. Synthetic bone graft substitutes currently represent only 10% of the bone graft market, but their share is increasing as experience and confidence in their use are accrued. Despite 15 to 20 years of clinical experience with various synthetic substitutes, there have been few welldesigned, controlled clinical trials of these implants. Synthetic bone graft substitutes consist of hydroxyapatite, tricalcium phosphate, calcium sulfate, or a combination of these minerals. Their fabrication technique, crystallinity, pore dimensions, mechanical properties, and resorption rate vary. All synthetic porous substitutes share numerous advantages over autografts and allografts including their unlimited supply, easy sterilization, and storage. However, the degree to which the substitute provides an osteoconductive structural framework or matrix for new bone ingrowth differs among implants. Disadvantages of ceramic implants include brittle handling properties, variable rates of resorption, poor performance in diaphyseal defects, and potentially adverse effects on normal bone remodeling. These inherent weaknesses have refocused their primary use to bone graft extenders and carriers for pharmaceuticals. The composition, histologic features, indications, and clinical experience of several of the synthetic bone graft substitutes approved for orthopaedic use in the United States are reviewed. PMID:11937865

  2. Cancellous bone repair using bovine trabecular bone matrix particulates.

    PubMed

    Mushipe, M T; Revell, P A; Shelton, J C

    2002-01-01

    At 5 and 15 weeks post-surgery, biomechanical and histological analyses of cancellous bone defects filled with the bovine trabecular bone matrix (BBM) and hydroxyapatite (Hap) particulates of dimensions 106-150 microm were investigated. It was observed that at 5 weeks post-surgery the stiffness properties of the BBM filled defects were significantly higher than those observed in the Hap filled defects (p < 0.01) but comparable to those recorded in intact cancellous bone from the same anatomical position. Histologically, no significant differences were observed in the percentage of new bone contact with the particles. The biomechanical properties of the Hap filled defects mirrored those in intact cancellous bone only at 15 weeks post-surgery. BBM particles thus appeared to accelerate the early healing of osteotomies. It is therefore suggested that particles of this bioceramic be the subject of intense research for more usage in both periodontal osseous defects and orthopaedic fractures.

  3. Hardness, an indicator of the mechanical competence of cancellous bone.

    PubMed

    Hodgskinson, R; Currey, J D; Evans, G P

    1989-01-01

    Hardness and calcium content in compact bone are strongly related. Variation in Young's modulus is produced mainly by variations in mineralisation. Therefore, there should be a relationship between hardness and Young's modulus. We demonstrate this. The calcium content of cancellous bone and adjacent compact bone in several species shows little difference, the cancellous bone having approximately 10% less calcium. The hardness of cancellous bone in Bos is approximately 12% less than that of adjacent compact bone, and the calcium is approximately 2% less. These lines of evidence make it unlikely that the Young modulus of cancellous bone material is much different from that of compact bone. Similar evidence suggests that the yield stress of cancellous bone is similar to that of adjacent compact bone.

  4. Quantitative Comparison of Volume Maintenance between Inlay and Onlay Bone Grafts in the Craniofacial Skeleton

    PubMed Central

    Sugg, Kristoffer B.; Rosenthal, Andrew H.; Ozaki, Wayne; Buchman, Steven R.

    2015-01-01

    Background Nonvascularized autologous bone grafts are the criterion standard in craniofacial reconstruction for bony defects involving the craniofacial skeleton. The authors have previously demonstrated that graft microarchitecture is the major determinant of volume maintenance for both inlay and onlay bone grafts following transplantation. This study performs a head-to-head quantitative analysis of volume maintenance between inlay and onlay bone grafts in the craniofacial skeleton using a rabbit model to comparatively determine their resorptive kinetics over time. Methods Fifty rabbits were divided randomly into six experimental groups: 3-week inlay, 3-week onlay, 8-week inlay, 8-week onlay, 16-week inlay, and 16-week onlay. Cortical bone from the lateral mandible and both cortical and cancellous bone from the ilium were harvested from each animal and placed either in or on the cranium. All bone grafts underwent micro–computed tomographic analysis at 3, 8, and 16 weeks. Results All bone graft types in the inlay position increased their volume over time, with the greatest increase in endochondral cancellous bone. All bone graft types in the onlay position decreased their volume over time, with the greatest decrease in endochondral cancellous bone. Inlay bone grafts demonstrated increased volume compared with onlay bone grafts of identical embryologic origin and microarchitecture at all time points (p < 0.05). Conclusions Inlay bone grafts, irrespective of their embryologic origin, consistently display less resorption over time compared with onlay bone grafts in the craniofacial skeleton. Both inlay and onlay bone grafts are driven by the local mechanical environment to recapitulate the recipient bed. PMID:23629083

  5. Craniofacial Bone Grafting: Wolff's Law Revisited

    PubMed Central

    Oppenheimer, Adam J.; Tong, Lawrence; Buchman, Steven R.

    2008-01-01

    Bone grafts are used for the reconstruction of congenital and acquired deformities of the facial skeleton and, as such, comprise a vital component of the craniofacial surgeon's armamentarium. A thorough understanding of bone graft physiology and the factors that affect graft behavior is therefore essential in developing a more intelligent use of bone grafts in clinical practice. This article presents a review of the basic physiology of bone grafting along with a survey of pertinent concepts and current research. The factors responsible for bone graft survival are emphasized. PMID:22110789

  6. Cadmium content of human cancellous bone

    SciTech Connect

    Knuuttila, M.; Lappalainen, R.; Olkkonen, H.; Lammi, S.; Albava, E.M.

    1982-09-01

    The cadmium content of human cancellous bone was related to age, sex, bone loss, physical properties, and elemental composition. Bone specimens from the anterior iliac crest were collected from 88 cadavers with a normal mineral status, and from 50 cadavers which had bone loss from chronic diseases and immobilization. The element concentrations were analyzed using atomic absorption spectrophotometry. Bone fluoride levels were determined with the ion specific electrode, the mineral density with the gamma ray attenuation method, and the compressive strength with a strain transducer. The data were analyzed using multiple linear regression analysis. The mean cadmium content of 0.22 +/- 0.16 ..mu..g/g dry weight (+/- SD) in the samples did not change with age and its content was slightly greater in males than in females. Furthermore, no statistically significant relationship was found in cadmium content to bone loss changes or to the calcium content of bone. The cadmium content had a high statistically significant positive correlation with the strontium and nickel content.

  7. Cadmium content of human cancellous bone.

    PubMed

    Knuuttila, M; Lappalainen, R; Olkkonen, H; Lammi, S; Alhava, E M

    1982-01-01

    The cadmium content of human cancellous bone was related to age, sex, bone loss, physical properties, and elemental composition. Bone specimens from the anterior iliac crest were collected from 889 cadavers with a normal mineral status, and from 50 cadavers which had bone loss from chronic diseases and immobilization. The element concentrations were analyzed using atomic absorption spectrophotometry. Bone fluoride levels ere determined with the ion specific electrode, the mineral density with the gamma ray attenuation method, and the compressive strength with a strain transducer. The data were analyzed using multiple linear regression analysis. The mean cadmium content of 0.22 +/- 9.16 micrograms/g dry weight (+/- SD) in the samples did not change with age and its content was slightly greater in males than in females. Furthermore, no statistically significant relation was found in cadmium content to bone loss changes or to the calcium content of bone. The cadmium content had a high statistically significant positive correlation with the strontium and nickel content. PMID:7138079

  8. Placement of endosteal implants combined with chin bone onlay graft for dental reconstruction in patients with grafted alveolar clefts.

    PubMed

    Fukuda, M; Takahashi, T; Yamaguchi, T; Kochi, S

    1998-12-01

    Endosteal implants were inserted into grafted alveoli after particulate cancellous bone and marrow grafting in seven patients with cleft lip or palate in conjunction with simultaneous chin bone onlay grafting. In these patients, the alveolar bone height of the bony bridge was insufficient when evaluated by both computed tomographic and periapical radiographic images. The age at first implant surgery ranged from 14 to 28 years. Although four of the seven patients had an uneventful course, three had wound dehiscence, and in all but one of them the exposed chin bone underwent partial or total necrosis. Ultimately all seven implants integrated into the bone, and the alveolar bone height was increased in all but one patient. The results indicate that chin bone onlay grafting with simultaneous implant insertion is useful in patients with cleft lip or palate with insufficient alveolar bone height.

  9. Cancellous bone homograft storage with aluminium-polyethylene bags.

    PubMed

    Meana, A; Martinez, R; Cañal, P; Arriaga, M J; Román, F San; Llames, S; Orós, C; Moreno, A; Fernandez, C

    2006-01-01

    In order to transport and cryopreserve human tissues, it is essential to have an easy-to-use recipient where tissues can be kept in sterile conditions. Here we show the results obtained by using Macopharma's tissue freezing bags, an aluminium-polyethylene multilayer bag, in our tissue bank of the Centro Comunitario de Sangre y Tejidos de Asturias. Five hundred and twenty-seven cancellous bone homografts were obtained from hospitals located 120 km around our Bank. The homografts were submitted to bacteriological controls and sent to our bank in these bags. They were stored at -70 degrees C and sent in dry ice to about 50 hospitals, where the tissue was bacteriologically controlled and grafted. Furthermore, the behaviour of these bags at -140 degrees C (vapour nitrogen) or -196 degrees C (liquid nitrogen) was tested. Our results indicate that Macopharma aluminium-polyethylene bags are suitable for the transporting and cryopreserving of cancellous bone homografts. These bags could also be used for keeping tissues in nitrogen containers.

  10. Bone graft substitute: allograft and xenograft.

    PubMed

    Shibuya, Naohiro; Jupiter, Daniel C

    2015-01-01

    Rapid bone graft incorporation for structural rigidity is essential. Early range of motion, exercise, and weight-bearing are keys to rehabilitation. Structural and nonstructural bone grafts add length, height, and volume to alter alignment, function, and appearance. Bone graft types include: corticocancellous autograft, allograft, xenograft, and synthetic graft. Autogenic grafts are harvested from the patient, less likely to be rejected, and more likely to be incorporated; however, harvesting adds a procedure and donor site complication is common. Allografts, xenografts, and synthetic grafts eliminate secondary procedures and donor site complications; however, rejection and slower incorporation can occur.

  11. Socket preservation and sinus augmentation using a medical grade calcium sulfate hemihydrate and mineralized irradiated cancellous bone allograft composite.

    PubMed

    Bagoff, Robert; Mamidwar, Sachin; Chesnoiu-Matei, Ioana; Ricci, John L; Alexander, Harold; Tovar, Nick M

    2013-06-01

    Regeneration and preservation of bone after the extraction of a tooth are necessary for the placement of a dental implant. The goal is to regenerate alveolar bone with minimal postoperative pain. Medical grade calcium sulfate hemihydrate (MGCSH) can be used alone or in combination with other bone grafts; it improves graft handling characteristics and particle containment of particle-based bone grafts. In this case series, a 1:1 ratio mix of MGCSH and mineralized irradiated cancellous bone allograft (MICBA) was mixed with saline and grafted into an extraction socket in an effort to maintain alveolar height and width for future implant placement. MGCSH can be used in combination with other bone grafts and can improve handling characteristics and graft particle containment of particle-based bone grafts. In the cases described, we found that an MGCSH:MICBA graft can potentially be an effective bone graft composite. It has the ability to act as a space maintainer and as an osteoconductive trellis for bone cells, thereby promoting bone regeneration in the extraction socket. MGCSH, a cost-effective option, successfully improved MICBA handling characteristics, prevented soft tissue ingrowth, and assisted in the regeneration of bone.

  12. A minimum 2-year comparative study of autologous cancellous bone grafting versus beta-tricalcium phosphate in anterior cervical discectomy and fusion using a rectangular titanium stand-alone cage.

    PubMed

    Yamagata, Toru; Naito, Kentaro; Arima, Hironori; Yoshimura, Masaki; Ohata, Kenji; Takami, Toshihiro

    2016-07-01

    Although titanium stand-alone cages are commonly used in anterior cervical discectomy and fusion (ACDF), there are several concerns such as cage subsidence after surgery. The efficacy of β-tricalcium phosphate (β-TCP) granules as a packing material in 1- or 2-level ACDF using a rectangular titanium stand-alone cage is not fully understood. The purpose of this study is to investigate the validity of rectangular titanium stand-alone cages in 1- and 2-level ACDF with β-TCP. This retrospective study included 55 consecutive patients who underwent ACDF with autologous iliac cancellous bone grafting and 45 consecutive patients with β-TCP grafting. All patients completed at least 2-year postoperative follow-up. Univariate and multivariate analyses were performed to examine the associations between study variables and nonunion after surgery. Significant neurological recovery after surgery was obtained in both groups. Cage subsidence was noted in 14 of 72 cages (19.4 %) in the autograft group and 12 of 64 cages (18.8 %) in the β-TCP group. A total of 66 cages (91.7 %) in the autograft group showed osseous or partial union, and 58 cages (90.6 %) in the β-TCP group showed osseous or partial union by 2 years after surgery. There were no significant differences in cage subsidence and the bony fusion rate between the two groups. Multivariate analysis using a logistic regression model showed that fusion level at C6/7, 2-level fusion, and cage subsidence of grades 2-3 were significantly associated with nonunion at 2 years after surgery. Although an acceptable surgical outcome with negligible complication appears to justify the use of rectangular titanium stand-alone cages in 1- and 2-level ACDF with β-TCP, cage subsidence after surgery needs to be avoided to achieve acceptable bony fusion at the fused segments. Fusion level at C6/7 or 2-level fusion may be another risk factor of nonunion. PMID:27098659

  13. A minimum 2-year comparative study of autologous cancellous bone grafting versus beta-tricalcium phosphate in anterior cervical discectomy and fusion using a rectangular titanium stand-alone cage.

    PubMed

    Yamagata, Toru; Naito, Kentaro; Arima, Hironori; Yoshimura, Masaki; Ohata, Kenji; Takami, Toshihiro

    2016-07-01

    Although titanium stand-alone cages are commonly used in anterior cervical discectomy and fusion (ACDF), there are several concerns such as cage subsidence after surgery. The efficacy of β-tricalcium phosphate (β-TCP) granules as a packing material in 1- or 2-level ACDF using a rectangular titanium stand-alone cage is not fully understood. The purpose of this study is to investigate the validity of rectangular titanium stand-alone cages in 1- and 2-level ACDF with β-TCP. This retrospective study included 55 consecutive patients who underwent ACDF with autologous iliac cancellous bone grafting and 45 consecutive patients with β-TCP grafting. All patients completed at least 2-year postoperative follow-up. Univariate and multivariate analyses were performed to examine the associations between study variables and nonunion after surgery. Significant neurological recovery after surgery was obtained in both groups. Cage subsidence was noted in 14 of 72 cages (19.4 %) in the autograft group and 12 of 64 cages (18.8 %) in the β-TCP group. A total of 66 cages (91.7 %) in the autograft group showed osseous or partial union, and 58 cages (90.6 %) in the β-TCP group showed osseous or partial union by 2 years after surgery. There were no significant differences in cage subsidence and the bony fusion rate between the two groups. Multivariate analysis using a logistic regression model showed that fusion level at C6/7, 2-level fusion, and cage subsidence of grades 2-3 were significantly associated with nonunion at 2 years after surgery. Although an acceptable surgical outcome with negligible complication appears to justify the use of rectangular titanium stand-alone cages in 1- and 2-level ACDF with β-TCP, cage subsidence after surgery needs to be avoided to achieve acceptable bony fusion at the fused segments. Fusion level at C6/7 or 2-level fusion may be another risk factor of nonunion.

  14. Transversely isotropic elasticity imaging of cancellous bone.

    PubMed

    Shore, Spencer W; Barbone, Paul E; Oberai, Assad A; Morgan, Elise F

    2011-06-01

    To measure spatial variations in mechanical properties of biological materials, prior studies have typically performed mechanical tests on excised specimens of tissue. Less invasive measurements, however, are preferable in many applications, such as patient-specific modeling, disease diagnosis, and tracking of age- or damage-related degradation of mechanical properties. Elasticity imaging (elastography) is a nondestructive imaging method in which the distribution of elastic properties throughout a specimen can be reconstructed from measured strain or displacement fields. To date, most work in elasticity imaging has concerned incompressible, isotropic materials. This study presents an extension of elasticity imaging to three-dimensional, compressible, transversely isotropic materials. The formulation and solution of an inverse problem for an anisotropic tissue subjected to a combination of quasi-static loads is described, and an optimization and regularization strategy that indirectly obtains the solution to the inverse problem is presented. Several applications of transversely isotropic elasticity imaging to cancellous bone from the human vertebra are then considered. The feasibility of using isotropic elasticity imaging to obtain meaningful reconstructions of the distribution of material properties for vertebral cancellous bone from experiment is established. However, using simulation, it is shown that an isotropic reconstruction is not appropriate for anisotropic materials. It is further shown that the transversely isotropic method identifies a solution that predicts the measured displacements, reveals regions of low stiffness, and recovers all five elastic parameters with approximately 10% error. The recovery of a given elastic parameter is found to require the presence of its corresponding strain (e.g., a deformation that generates ɛ₁₂ is necessary to reconstruct C₁₂₁₂), and the application of regularization is shown to improve accuracy. Finally

  15. Three-dimensional microarchitecture of adolescent cancellous bone.

    PubMed

    Ding, Ming; Danielsen, Carl Christian; Hvid, Ivan; Overgaard, Søren

    2012-11-01

    This study investigated microarchitectural, mechanical, collagen and mineral properties of normal adolescent cancellous bone, and compared them with adult and aging cancellous bone, to obtain more insight into the subchondral bone adaptations during development and growth. Twenty-three human proximal tibiae were harvested and divided into 3 groups according to their ages: adolescence (9 to 17 years, n=6), young adult (18 to 24 years, n=9), and adult (25 to 30 years, n=8). Twelve cubic cancellous bone samples with dimensions of 8×8×8 mm(3) were produced from each tibia, 6 from each medial and lateral condyle. These samples were micro-CT scanned (vivaCT 40, Scanco Medical AG, Switzerland) resulting in cubic voxel sizes of 10.5*10.5*10.5 μm(3). Microarchitectural properties were calculated. The samples were then tested in compression followed by collagen and mineral determination. Interestingly, the adolescent cancellous bone had similar bone volume fraction (BV/TV), structure type (plate, rod or mixtures), and connectivity (3-D trabecular networks) as the adult cancellous bone. The adolescent cancellous bone had significantly lower bone surface density (bone surface per total volume of specimen) but higher collagen concentration (collagen weight per dry weight of specimen) than the adult cancellous bone; and significant greater trabecular separation (mean distance between trabeculae), significant lower trabecular number (number of trabeculae per volume), tissue density (dry weight per volume of bone matrix excluding marrow space) and mineral concentration (ash weight per dry weight of specimen) than the young adult and adult cancellous bones. Despite these differences, ultimate stress and failure energy were not significantly different among the three groups, only the Young's modulus in anterior-posterior direction was significantly lower in adolescence. Apparent density appears to be the single best predictor of mechanical properties. In conclusion, adolescent

  16. Imaging characteristics of bone graft materials.

    PubMed

    Beaman, Francesca D; Bancroft, Laura W; Peterson, Jeffrey J; Kransdorf, Mark J; Menke, David M; DeOrio, James K

    2006-01-01

    Bone graft materials are widely used in reconstructive orthopedic procedures to promote new bone formation and bone healing, provide a substrate and scaffolding for development of bone structure, and function as a means for direct antibiotic delivery. Bone graft materials include autografts, allografts, and synthetic substitutes. An autograft (from the patient's own bone) supplies both bone volume and osteogenic cells capable of new bone formation. The imaging appearance of an autograft depends on its type, composition, and age. Autografts often appear as osseous fragments at radiography. At computed tomography (CT), autografts appear similar to the adjacent cortical bone. At magnetic resonance (MR) imaging, however, autografts have a variable appearance as a consequence of the viable marrow inside them, a feature not present in other graft materials. An allograft (from cadaveric bone) has an appearance similar to that of cortical bone on radiographs and CT images. An allograft in the form of bone chips or morsels does not show those features on radiographs and CT images, but instead appears as a conglomerate with medium to high opacity and attenuation within the bone defect. In the immediate postoperative period, allografts appear hypointense on both T1- and T2-weighted MR images. Hematopoietic tissue replaces the normal fatty marrow in the later phases of graft incorporation. Synthetic bone substitutes are much more variable in imaging appearance. As the use of bone allografts and synthetic substitutes increases, familiarity with postoperative imaging features is essential for differentiation between grafts and residual or recurrent disease.

  17. Orthogonal cutting of cancellous bone with application to the harvesting of bone autograft.

    PubMed

    Malak, Sharif F F; Anderson, Iain A

    2008-07-01

    Autogenous bone graft harvesting results in cell death within the graft and trauma at the donor site. The latter can be mitigated by using minimally invasive tools and techniques, while cell morbidity may be reduced by improving cutter design and cutting parameters. We have performed orthogonal cutting experiments on bovine cancellous bone samples, to gain a basic understanding of the cutting mechanism and to determine design guidelines for tooling. Measurements were performed at cutting speeds from 11.2 to 5000 mm/min, with tool rake angles of 23 degrees, 45 degrees and 60 degrees, and depths of cut in the range of 0.1-3.0 mm. Horizontal and vertical cutting forces were measured, and the chip formation process video recorded. Continuous chip formation was observed for rake angles of 45 degrees and 60 degrees , and depths of cut greater than 0.8 mm. Chip formation for depths of cut greater than 1.0 mm was accompanied by bone marrow extruding out of the free surfaces and away from the rake face. Specific cutting energies decreased with increasing rake angle, increasing depth of cut and increasing cutting speed. Our orthogonal cutting experiments showed that a rake angle of 60 degrees and a depth of cut of 1mm, will avoid excessive fragmentation, keep specific cutting energy low and promote bone marrow extrusion, which may be beneficial for cell survival. We demonstrate how drill bit clearance angle and feed rate can be calculated facilitating a 1mm depth of cut.

  18. Alveolar bone graft with Platelet Rich Plasma in cleft alveolus

    PubMed Central

    Gupta, Chandan; Mehrotra, Divya; Mohammad, Shadab; Khanna, Vaibhav; Kumar Singh, Gulshan; Singh, Geeta; Chellappa, Arul A.L.; Passi, Deepak

    2013-01-01

    Introduction Cleft of the lip, palate and alveolus are the commonest congenital anomaly to affect the orofacial region. Currently, there is great interest in the alveolar bone grafting procedures that involve use of platelet-rich-plasma (PRP), to enhance bone formation and specifically to promote bone graft healing. Materials and methods 20 patients with residual alveolar cleft, in the age group of 9–29 years, having unilateral or bilateral cleft lip and palate were selected. They were randomly assigned in either group A (with PRP) or group B (without PRP). Results Primary healing was observed in 90% patients in group A. Secondary healing was seen in 30% patients in group B. There was no graft rejection in group A but was seen in one patient (10%) in group B. Pain and swelling persisted longer in group B then group A. Bone grafts with added PRP presented with increased bone density (1028.00 ± 11.30 HU) in comparison to grafts without PRP (859.50 ± 27.73 HU) at end of 6-month postoperative. However, the mean bone density (as determined by the Dentascan image analyzer software) was 1.04 times more in the PRP group than non PRP group at 3-month and 1.2 times more at 6 months. Conclusion We conclude that on preliminary investigations, PRP seems to enhance bone formation in alveolar clefts when admixed with autologous cancellous bone harvested from the iliac crest. PMID:25737872

  19. Acetabular Reconstruction with Human and Bovine Freeze- Dried Bone Grafts and a Reinforcement Device

    PubMed Central

    Rosito, Ricardo; Galia, Carlos Roberto; Macedo, Carlos Alberto Souza; Moreira, Luis Fernando; Quaresma, Lourdes Maria Araújo C.; Palma, Humberto Moreira

    2008-01-01

    BACKGROUND This is a cohort trial (1997–2005) of 49 patients submitted to an acetabular component revision of a total hip arthroplasty, using impacted human and bovine freeze-dried cancellous bone grafts (H&FDBG) and a reinforcement device. OBJECTIVE To compare clinical/radiographic graft incorporation capability between cancellous bone grafts. PATIENTS/METHODS There were two groups: I (n=26) receiving human grafts and II (n=25) receiving bovine grafts. The average follow-up times were 55 and 49 months, respectively. Clinical analysis was based on the Merle d’Aubigné and Postel score, and the radiographic analysis involved an established score based on Conn’s et al. criteria for radiographic bone incorporation. RESULTS No clinical/radiographic differences were found between the groups and both showed an overall rate of 88.5% and 76% of graft incorporation (p=0.424). CONCLUSION The results presented here are comparable to those in the literature with the use of deep-FG. Therefore, cancellous bone grafts can be safely and adequately used in acetabular component revision in total hip arthroplasty. PMID:18719763

  20. The reconstruction of bilateral clefts using endosseous implants after bone grafting.

    PubMed

    Isono, Hiroaki; Kaida, Kiyokazu; Hamada, Yoshiki; Kokubo, Yuji; Ishihara, Masataka; Hirashita, Ayao; Kuwahara, Yosuke

    2002-04-01

    This article presents the orthodontic reconstruction of an adult bilateral cleft patient with a severe Class III malocclusion in which endosseous implants were inserted after secondary alveolar bone grafting. The patient was a 21-year-old Japanese male whose lateral incisors were congenitally missing and whose premaxilla was inclined lingually. The occlusion was classified as Angle Class III with an overjet of -8 mm. Orthodontic alignment was initiated to correct the position of the maxillary incisors before bone grafting. After the anterior occlusal relationship was corrected, bilateral alveolar clefts were reconstructed by bone grafting with autogenous particulate marrow and cancellous bone harvested from the iliac crest. ITI-SLA fixtures (Institute Straumann, Waldenburg, Switzerland) (length, 10 mm; diameter, 4.1 mm) were placed into the grafted bone for prosthetic restoration of the missing lateral incisors. The results illustrate that this protocol can be expected to provide an acceptable occlusion and good dentoalveolar stability in adult cleft patients.

  1. Effect of different sterilization processing methods on the mechanical properties of human cancellous bone allografts.

    PubMed

    Vastel, L; Meunier, A; Siney, H; Sedel, L; Courpied, J-P

    2004-05-01

    Use of new sterilization methods applied to human bone is likely to affect both the mechanical and biological properties of human cancellous grafts. The mechanical properties of the transplanted bone inevitably determine the short- and mid-term results of the orthopedic procedure performed. The aim of this study was to compare, under similar conditions, the mechanical effects of gamma irradiation, lipid extraction, and treatment with 6M urea on trabecular bone samples, through conventional mechanical tests and measurement of the ultrasound wave propagation rate. Deteriorations measured for gamma irradiation and lipid extraction were low: 2.4% and 2.5%, respectively, for ultrasound propagation wave measurements. They were clearly significant for protocol including 6M urea, corresponding to a loss of 30% in values measured in the control sample for the stress to failure, inciting prudence when grafted bone is used for support in orthopedic assembly. High consistency in the results obtained between travel time of the ultrasound wave, easily done, and measurement of stress to failure through conventional tests, favor the use of ultrasound protocol, described as a quality test performed on bone grafts in the tissue bank before distribution and implantation. PMID:14741625

  2. [Use of the calvarium for bone grafting in cranio-maxillo-facial surgery].

    PubMed

    Raulo, Y; Baruch, J

    1990-01-01

    Bone grafts's traditional donor sites in cranio-maxillo-facial surgery have been for many years and are still in some occasions the ribs, iliac crest and tibia. Bone grafts taken from the calvaria have been used by some surgeons in the past but its wide acceptance was only achieved after Paul Tessier had reported his own experience. The calvaria is composed of inner and outer tables that encloses a layer of cancellous bone called the diploe. A high degree of variability exist with respect to skull thickness. Nevertheless parietal bones is the preferable site for the harvesting of the graft. The embryonic origin of the cranium should be responsible for greater survival of the graft. Membranous bone would maintain its volume to a greater extent than endochondral bone when autografted in the cranio-facial region. However this remains controversial. Two techniques can be used for the harvesting of a calvarial bone grafts. A split thickness calvarial graft involves removal of the outer table while leaving the inner layer in place. Its main disadvantage is the relatively thinness of the bone transferred. A full thickness segment of skull involves the cranium cavity be entered. A half of the graft can be split along the diploe space and returned to fill the donor site. The other half is used for reconstruction. It is a more complicated procedure. Cranial grafts have been used in the following cases. Correction of contour defect of the forehead and zygomatic bones, orbital floor reconstruction, restoration of the nasal bridge, bone grafting of the maxilla and mandibule. The advantages are the following: the donor and recipient sites are in adjacent surgical fields, the donor site scar is hidden in the scalp, morbidity associated with removing the graft is almost inexistent. (ABSTRACT TRUNCATED AT 250 WORDS)

  3. Inter-trabecular bone formation: a specific mechanism for healing of cancellous bone

    PubMed Central

    Sandberg, Olof H; Aspenberg, Per

    2016-01-01

    Background and purpose Studies of fracture healing have mainly dealt with shaft fractures, both experimentally and clinically. In contrast, most patients have metaphyseal fractures. There is an increasing awareness that metaphyseal fractures heal partly through mechanisms specific to cancellous bone. Several new models for the study of cancellous bone healing have recently been presented. This review summarizes our current knowledge of cancellous fracture healing. Methods We performed a review of the literature after doing a systematic literature search. Results Cancellous bone appears to heal mainly via direct, membranous bone formation that occurs freely in the marrow, probably mostly arising from local stem cells. This mechanism appears to be specific for cancellous bone, and could be named inter-trabecular bone formation. This kind of bone formation is spatially restricted and does not extend more than a few mm outside the injured region. Usually no cartilage is seen, although external callus and cartilage formation can be induced in meta­physeal fractures by mechanical instability. Inter-trabecular bone formation seems to be less sensitive to anti-inflammatory treatment than shaft fractures. Interpretation The unique characteristics of inter-trabecular bone formation in metaphyseal fractures can lead to differences from shaft healing regarding the effects of age, loading, or drug treatment. This casts doubt on generalizations about fracture healing based solely on shaft fracture models. PMID:27357416

  4. Bone graft materials in fixation of orthopaedic implants in sheep.

    PubMed

    Babiker, Hassan

    2013-07-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking skeletal bones. The osteoconductive properties of the composite might be improved by adding bone marrow aspirate (BMA), which can be harvested during surgery. Other alternatives to bone graft are demineralised bone matrix (DBM) and human cancellous bone (CB). DBM is prepared by acid extraction of human bone and includes bone collagen, morphogenetic proteins and growth factors. The combination of DBM with CB and with allograft might improve the healing potential of these grafts around non-cemented orthopaedic implants and thereby the implant fixation. Study I investigates the effect of HA/Collagen composite alone and in combination with BMA on the early fixation of porous coated titanium implants. In addition, the study compares also the effect of autograft with the gold standard allograft. By using a sheep model, the implants were inserted in the trabecular bone of femoral condyles. The test biomaterials were placed in a well defined peri-implant gap. After the observation period, the bone-implant specimens were harvested and evaluated mechanically by a destructive push

  5. Tooth-derived bone graft material

    PubMed Central

    Kim, Young-Kyun; Lee, Junho; Kim, Kyung-Wook; Murata, Masaru; Akazawa, Toshiyuki; Mitsugi, Masaharu

    2013-01-01

    With successful extraction of growth factors and bone morphogenic proteins (BMPs) from mammalian teeth, many researchers have supported development of a bone substitute using tooth-derived substances. Some studies have also expanded the potential use of teeth as a carrier for growth factors and stem cells. A broad overview of the published findings with regard to tooth-derived regenerative tissue engineering technique is outlined. Considering more than 100 published papers, our team has developed the protocols and techniques for processing of bone graft material using extracted teeth. Based on current studies and studies that will be needed in the future, we can anticipate development of scaffolds, homogenous and xenogenous tooth bone grafts, and dental restorative materials using extracted teeth. PMID:24471027

  6. A retrospective analysis evaluating allogeneic cancellous bone sponge for foot and ankle arthrodesis.

    PubMed

    Brigido, Stephen A; Bleazey, Scott T; Protzman, Nicole M; D'Angelantonio, Albert; Schoenhaus, Harold D

    2013-01-01

    The present retrospective case crossover study was conducted to determine the effectiveness and safety data associated with the use of an allogeneic, cancellous bone sponge in an orthopedic foot and ankle population. We reviewed the medical records of 47 subjects (80 joints) who had undergone foot and/or ankle fusion with the cancellous bone sponge. The records were reviewed up to 12 months postoperatively. The joints included in the present study were 12 ankles, 3 ankle syndesmotic fusions (with concurrent total ankle arthroplasty), 17 subtalar joints, 17 talonavicular joints, 9 calcaneocubiod joints, 1 naviculocuneiform joint, 13 first tarsometatarsal joints, 6 lesser tarsometatarsal joints, and 2 first metatarsophalangeal joints. The endpoints of the present study were solid, sustained foot and ankle fusion, as demonstrated radiographically, and the occurrence of unexpected adverse effects related to the graft. The fusion rates were compared with those reported in other studies. The patient-reported outcome variables for the present study included the visual analog pain scale and the American Orthopaedic Foot and Ankle Score. The use of a cancellous sponge showed statistically significant improvements in pain and function and comparable or better fusion rates compared with outcomes reported in other published reports.

  7. Repair of tegmen defect using cranial particulate bone graft.

    PubMed

    Greene, Arin K; Poe, Dennis S

    2015-01-01

    Bone paté is used to repair cranial bone defects. This material contains bone-dust collected during the high-speed burring of the cranium. Clinical and experimental studies of bone dust, however, have shown that it does not have biological activity and is resorbed. We describe the use of bone paté using particulate bone graft. Particulate graft is harvested with a hand-driven brace and 16mm bit; it is not subjected to thermal injury and its large size resists resorption. Bone paté containing particulate graft is much more likely than bone dust to contain viable osteoblasts capable of producing new bone.

  8. Predicting Bone Mechanical Properties of Cancellous Bone from DXA, MRI, and Fractal Dimensional Measurements

    NASA Technical Reports Server (NTRS)

    Harrigan, Timothy P.; Ambrose, Catherine G.; Hogan, Harry A.; Shackleford, Linda; Webster, Laurie; LeBlanc, Adrian; Lin, Chen; Evans, Harlan

    1997-01-01

    This project was aimed at making predictions of bone mechanical properties from non-invasive DXA and MRI measurements. Given the bone mechanical properties, stress calculations can be made to compare normal bone stresses to the stresses developed in exercise countermeasures against bone loss during space flight. These calculations in turn will be used to assess whether mechanical factors can explain bone loss in space. In this study we assessed the use of T2(sup *) MRI imaging, DXA, and fractal dimensional analysis to predict strength and stiffness in cancellous bone.

  9. Microhardness of human cancellous bone tissue in progressive hip osteoarthritis.

    PubMed

    Tomanik, Magdalena; Nikodem, Anna; Filipiak, Jarosław

    2016-12-01

    Bone tissue is a biological system in which the dynamic processes of, among others, bone formation or internal reconstruction will determine the spatial structure of the tissue and its mechanical properties. The appearance of a factor disturbing the balance between biological processes, e.g. a disease, will cause changes in the spatial structure of bones, thus affecting its mechanical properties. One of the bone diseases most common in an increasingly ageing population is osteoarthritis, also referred to as degenerative joint disease. It is estimated that in 2050 about 1300 million people will show symptoms of OA. The appearance of a pathological stimulus disturbs the balance of the processes of degradation and synthesis of articular cartilage, chondrocytes and the extracellular matrix, and the subchondral bone layer. As osteoarthritis progresses, study of the epiphysis reveals increasingly widespread changes of the articular surface and the internal structure of bone tissue. In this paper, the authors point out the differences in the mechanical properties of cancellous bone tissue forming the proximal epiphysis of the femoral bone during the progressive stages of OA. In order to determine microproperties of bone trabeculae, specimens from different stages of the disease (N=9) were subjected to microindentation testing, which made it possible to determine the material properties of bone tissue, such as microhardness HV and Young׳s modulus E. In addition, mechanical tests were supplemented with Raman spectroscopy, which determine the degree of bone mineralization, and measurements of structural properties based on analysis using microCT. The conducted tests were used to establish both quantitative and quantitative description of changes in the structural and mechanical properties connected with reorganization of trabeculae making up the bone in the various stages of osteoarthritis. The proposed description will supplement existing knowledge in the literature about

  10. Microhardness of human cancellous bone tissue in progressive hip osteoarthritis.

    PubMed

    Tomanik, Magdalena; Nikodem, Anna; Filipiak, Jarosław

    2016-12-01

    Bone tissue is a biological system in which the dynamic processes of, among others, bone formation or internal reconstruction will determine the spatial structure of the tissue and its mechanical properties. The appearance of a factor disturbing the balance between biological processes, e.g. a disease, will cause changes in the spatial structure of bones, thus affecting its mechanical properties. One of the bone diseases most common in an increasingly ageing population is osteoarthritis, also referred to as degenerative joint disease. It is estimated that in 2050 about 1300 million people will show symptoms of OA. The appearance of a pathological stimulus disturbs the balance of the processes of degradation and synthesis of articular cartilage, chondrocytes and the extracellular matrix, and the subchondral bone layer. As osteoarthritis progresses, study of the epiphysis reveals increasingly widespread changes of the articular surface and the internal structure of bone tissue. In this paper, the authors point out the differences in the mechanical properties of cancellous bone tissue forming the proximal epiphysis of the femoral bone during the progressive stages of OA. In order to determine microproperties of bone trabeculae, specimens from different stages of the disease (N=9) were subjected to microindentation testing, which made it possible to determine the material properties of bone tissue, such as microhardness HV and Young׳s modulus E. In addition, mechanical tests were supplemented with Raman spectroscopy, which determine the degree of bone mineralization, and measurements of structural properties based on analysis using microCT. The conducted tests were used to establish both quantitative and quantitative description of changes in the structural and mechanical properties connected with reorganization of trabeculae making up the bone in the various stages of osteoarthritis. The proposed description will supplement existing knowledge in the literature about

  11. Cancellous Screws Are Biomechanically Superior to Cortical Screws in Metaphyseal Bone.

    PubMed

    Wang, Tim; Boone, Christopher; Behn, Anthony W; Ledesma, Justin B; Bishop, Julius A

    2016-09-01

    Cancellous screws are designed to optimize fixation in metaphyseal bone environments; however, certain clinical situations may require the substitution of cortical screws for use in cancellous bone, such as anatomic constraints, fragment size, or available instrumentation. This study compares the biomechanical properties of commercially available cortical and cancellous screw designs in a synthetic model representing various bone densities. Commercially available, fully threaded, 4.0-mm outer-diameter cortical and cancellous screws were tested in terms of pullout strength and maximum insertion torque in standard-density and osteoporotic cancellous bone models. Pullout strength and maximum insertion torque were both found to be greater for cancellous screws than cortical screws in all synthetic densities tested. The magnitude of difference in pullout strength between cortical and cancellous screws increased with decreasing synthetic bone density. Screw displacement prior to failure and total energy absorbed during pullout strength testing were also significantly greater for cancellous screws in osteoporotic models. Stiffness was greater for cancellous screws in standard and osteoporotic models. Cancellous screws have biomechanical advantages over cortical screws when used in metaphyseal bone, implying the ability to both achieve greater compression and resist displacement at the screw-plate interface. Surgeons should preferentially use cancellous over cortical screws in metaphyseal environments where cortical bone is insufficient for fixation. [Orthopedics.2016; 39(5):e828-e832.].

  12. Trends in bone graft use in the United States.

    PubMed

    Kinaci, Ahmet; Neuhaus, Valentin; Ring, David C

    2014-09-01

    Bone graft and bone graft substitutes are used to provide structural support and enhance bone healing. Autogenous, allogeneic, and artificial bone grafts each have advantages and drawbacks. The development of allografts, synthetic bone grafts, and new operative techniques may have influenced the use of bone grafts in recent years. The goal of this study was to analyze the use of bone grafts and bone graft substitutes in the United States during a 16-year period. Using data from the National Hospital Discharge Survey, the authors analyzed the use of autogenous and artificial bone grafts in almost 2 million patients in the United States between 1992 and 2007 using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes in 4 periods (1992-1995, 1996-1999, 2000-2003, and 2004-2007). Among an estimated almost 2 million bone graft procedures (83% autogenous, 17% artificial), the use of both types of grafts decreased. The main diagnoses for which bone grafts were used did not change; however, cervical spine diseases and lower-limb fractures decreased more remarkably. Although sex (52% male in the early 1990s to 47% in 2000-2003) and discharge status (more discharges to a short-term or long-term-care facility) significantly changed, age increased from 47 to 53 years and inpatient days decreased significantly from 6 to 5 days during the study period. The use of bone grafts and bone graft substitutes is decreasing in the United States, with a slight shift from autogenous to substitute grafts. PMID:25350620

  13. Lung function after bone marrow grafting

    SciTech Connect

    Depledge, M.H.; Barrett, A.; Powles, R.L.

    1983-02-01

    Results of a prospective lung function study are presented for 48 patients with acute myeloid leukemia (AML) treated with total body irradiation (TBI) and bone marrow transplantation (BMT) at the Royal Marsden Hospital between 1978 and 1980. Patients with active disease or who were in remission following cytoreductive chemotherapy had mildly impaired gas exchange prior to grafting. After TBI and BMT all patients studied developed progressive deterioration of lung function during the first 100 days, although these changes were subclinical. Infection and graft-versus-host disease (GvHD) were associated with further worsening of restrictive ventilatory defects and diffusing capacity (D/sub L/CO). Beyond 100 days, ventilatory ability returned to normal and gas transfer improved, although it failed to reach pre-transplant levels. There was no evidence of progressive pulmonary fibrosis during the first year after grafting.

  14. Ultrasonic backscatter from cancellous bone: the apparent backscatter transfer function.

    PubMed

    Hoffmeister, Brent K; Mcpherson, Joseph A; Smathers, Morgan R; Spinolo, P Luke; Sellers, Mark E

    2015-12-01

    Ultrasonic backscatter techniques are being developed to detect changes in cancellous bone caused by osteoporosis. Many techniques are based on measurements of the apparent backscatter transfer function (ABTF), which represents the backscattered power from bone corrected for the frequency response of the measurement system. The ABTF is determined from a portion of the backscatter signal selected by an analysis gate of width τw delayed by an amount τd from the start of the signal. The goal of this study was to characterize the ABTF for a wide range of gate delays (1 μs ≤ τd ≤ 6 μs) and gate widths (1 μs ≤ τw ≤ 6 μs). Measurements were performed on 29 specimens of human cancellous bone in the frequency range 1.5 to 6.0 MHz using a broadband 5-MHz transducer. The ABTF was found to be an approximately linear function of frequency for most choices of τd and τw. Changes in τd and τw caused the frequency-averaged ABTF [quantified by apparent integrated backscatter (AIB)] and the frequency dependence of the ABTF [quantified by frequency slope of apparent backscatter (FSAB)] to change by as much as 24.6 dB and 6.7 dB/MHz, respectively. τd strongly influenced the measured values of AIB and FSAB and the correlation of AIB with bone density (-0.95 ≤ R ≤ +0.68). The correlation of FSAB with bone density was influenced less strongly by τd (-0.97 ≤ R ≤ -0.87). τw had a weaker influence than τd on the measured values of AIB and FSAB and the correlation of these parameters with bone density.

  15. Experimental study of the participation of the vertebral endplate in the integration of bone grafts.

    PubMed

    Porto Filho, M R; Pastorello, M T; Defino, H L A

    2005-12-01

    The surgical technique of anterior vertebral arthrodesis has been modified by the introduction of cages in spinal surgery. The classical technique recommends removal of the vertebral endplate and exposure of bleeding cancellous bone. However, after the observation of cage subsidence during postoperative follow-up, the vertebral endplate is no longer removed, due to its greater mechanical resistance which can prevent cage subsidence. The mechanical characteristics of the vertebral endplate are well known, in contrast to its osteogenic potential, which was investigated in the present experimental study. The study was conducted on mongrel dogs of both sexes, which were submitted to anterior corpectomy at the cervical spine level. A cortico-cancellous bone graft removed from the tibia was used for the reconstruction of the vertebral segment, which was used with osteosynthesis plates. At the site of contact between the surface of the vertebral body and the bone graft, the vertebral endplate was completely removed and cancellous bone was exposed in the inferior vertebra, whereas in the superior vertebra of the arthrodesed vertebral segment only curettage was performed, and the vertebral endplate was preserved, as recommended for cage implantation. Twenty adult dogs of both sexes were divided into four experimental groups according to time of sacrifice (15, 30, 90, and 180 days). The consolidation of the bone graft with the vertebral body was evaluated by histology using hematoxilin-eosin and Gomori trichrome staining. In the interface between the bone graft and the vertebral body surface in which the vertebral endplate was not removed, graft consolidation was not observed in any of the group I animals (sacrificed after 15 days), and was observed in 1/5 animals of group II (30 days), in 2/5 animals of group III (90 days), and in 4/5 animals of group IV (180 days). In the interface between the graft and the vertebral body in which the vertebral endplate was removed, bone-graft

  16. PHYSICOCHEMICAL CHARACTERIZATION OF LYOPHILIZED BOVINE BONE GRAFTS

    PubMed Central

    Galia, Carlos Roberto; Lourenço, André Luis; Rosito, Ricardo; Souza Macedo, Carlos Alberto; Camargo, Lourdes Maria Araujo Quaresma

    2015-01-01

    To evaluate the physicochemical characteristics of lyophilized bovine grafts manufactured on a semi-industrial scale (Orthogen; Baumer S/A*) in accordance with a protocol previously developed by the authors. Methods: The lyophilized bovine bone grafts were characterized by means of scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffractometry (XRD), thermogravimetric (TG) analysis, differential exploratory scanning calorimetry (DSC) and Fourier-transform infrared (FT-IR) spectroscopy. Results: Ca was the main component (60%) found in the samples, followed by P (28%) and O (5%). The mean (sd) pore size was 316 μm (146.7), ranging from 91.2 to 497.8 μm, and 333.5 μm (304.8), ranging from 87.2 to 963.9 μm, at 50x and 150x magnification, respectively. The hydroxyapatite peaks were at 26°C and 32°C, and mass losses were observed between 250°C and 640°C, corresponding to organic material and water. Two temperature transitions (45.67°C and 91.89°C) showed denaturation of type 1 collagen and dehydration of hydroxyapatite. Conclusion: The physicochemical assessment of lyophilized bovine bone grafts in accordance with the protocol developed at semi-industrial scale confirmed that this product presents excellent biocompatibility, with characteristics similar to natural bone. PMID:27027036

  17. A prospective study on the effectiveness of newly developed autogenous tooth bone graft material for sinus bone graft procedure

    PubMed Central

    Jun, Sang-Ho; Ahn, Jin-Soo; Lee, Jae-Il; Ahn, Kyo-Jin; Yun, Pil-Young

    2014-01-01

    PURPOSE The purpose of this prospective study was to evaluate the effectiveness of newly developed autogenous tooth bone graft material (AutoBT)application for sinus bone graft procedure. MATERIALS AND METHODS The patients with less than 5.0 mm of residual bone height in maxillary posterior area were enrolled. For the sinus bone graft procedure, Bio-Oss was grafted in control group and AutoBT powder was grafted in experimental group. Clinical and radiographic examination were done for the comparison of grafted materials in sinus cavity between groups. At 4 months after sinus bone graft procedure, biopsy specimens were analyzed by microcomputed tomography and histomorphometric examination for the evaluation of healing state of bone graft site. RESULTS In CT evaluation, there was no difference in bone density, bone height and sinus membrane thickness between groups. In microCT analysis, there was no difference in total bone volume, new bone volume, bone mineral density of new bone between groups. There was significant difference trabecular thickness (0.07 µm in Bio-Oss group Vs. 0.08 µm in AutoBT group) (P=.006). In histomorphometric analysis, there was no difference in new bone formation, residual graft material, bone marrow space between groups. There was significant difference osteoid thickness (8.35 µm in Bio-Oss group Vs. 13.12 µm in AutoBT group) (P=.025). CONCLUSION AutoBT could be considered a viable alternative to the autogenous bone or other bone graft materials in sinus bone graft procedure. PMID:25551014

  18. Free bone graft reconstruction of irradiated facial tissue: Experimental effects of basic fibroblast growth factor stimulation

    SciTech Connect

    Eppley, B.L.; Connolly, D.T.; Winkelmann, T.; Sadove, A.M.; Heuvelman, D.; Feder, J. )

    1991-07-01

    A study was undertaken to evaluate the potential utility of basic fibroblast growth factor in the induction of angiogenesis and osseous healing in bone previously exposed to high doses of irradiation. Thirty New Zealand rabbits were evaluated by introducing basic fibroblast growth factor into irradiated mandibular resection sites either prior to or simultaneous with reconstruction by corticocancellous autografts harvested from the ilium. The fate of the free bone grafts was then evaluated at 90 days postoperatively by microangiographic, histologic, and fluorochrome bone-labeling techniques. Sequestration, necrosis, and failure to heal to recipient osseous margins was observed both clinically and histologically in all nontreated irradiated graft sites as well as those receiving simultaneous angiogenic stimulation at the time of graft placement. No fluorescent activity was seen in these graft groups. In the recipient sites pretreated with basic fibroblast growth factor prior to placement of the graft, healing and reestablishment of mandibular contour occurred in nearly 50 percent of the animals. Active bone formation was evident at cortical margins adjacent to the recipient sites but was absent in the more central cancellous regions of the grafts.

  19. Experimental Comparison of Cranial Particulate Bone Graft, rhBMP-2, and Split Cranial Bone Graft for Inlay Cranioplasty.

    PubMed

    Hassanein, Aladdin H; Couto, Rafael A; Kurek, Kyle C; Rogers, Gary F; Mulliken, John B; Greene, Arin K

    2013-05-01

    Background :  Particulate bone graft and recombinant human bone morphogenetic protein-2 (rhBMP-2) are options for inlay cranioplasty in children who have not developed a diploic space. The purpose of this study was to determine whether particulate bone graft or rhBMP-2 has superior efficacy for inlay cranioplasty and to compare these substances to split cranial bone. Methods :  A 17 mm × 17 mm critical-sized defect was made in the parietal bones of 22 rabbits and managed in four ways: Group I (no implant; n=5), Group II (particulate bone graft; n=5), Group III (rhBMP-2; n=7), and Group IV (split cranial bone graft; n=5). Animals underwent microcomputed tomography and histologic analysis 16 weeks after cranioplasty. Results :  Defects without an implant (Group I) demonstrated inferior ossification (41.4%; interquartile range [IQR], 28.9% to 42.5%) compared to those treated with particulate bone graft (Group II: 99.5%; IQR, 97.8% to 100%), rhBMP-2 (Group III: 99.6%; IQR, 99.5% to 100%), or split cranial bone (Group IV: 100%) (P < .0001). There was no difference between Groups II, III, and IV (P = .1). Defects treated with rhBMP-2 exhibited thinner bone (0.90 mm; IQR, 0.64 to 0.98) than particulate bone graft (1.95 mm; IQR, 1.09 to 2.83) or split cranial bone (1.72 mm; IQR, 1.54 to 1.88) (P = .006); particulate and split cranial bone grafted defects had a similar thicknesses (P = .6). Conclusions :  Particulate bone graft, rhBMP-2, and split cranial bone close inlay calvarial defect areas equally, although the thickness of bone healed with rhBMP-2 is inferior. Clinically, particulate bone graft or split cranial bone graft may be superior to rhBMP-2 for inlay cranioplasty.

  20. Bone scintigraphy in evaluating the viability of composite bone grafts revascularized by microvascular anastomoses, conventional autogenous bone grafts, and free non-revascularized periosteal grafts

    SciTech Connect

    Berggren, A.; Weiland, A.J.; Ostrup, L.T.

    1982-07-01

    Researchers studied the value of bone scintigraphy in the assessment of anastomotic patency and bone-cell viability in free bone grafts revascularized by microvascular anastomoses in twenty-seven dogs. The dogs were divided into three different groups, and scintigraphy was carried out using technetium-labeled methylene diphosphonate in composite bone grafts revascularized by microvascular anastomoses, conventional autogenous bone grafts, and periosteal grafts placed in different recipient beds. The viability of the grafts were evaluated by histological examination and fluorescence microscopy after triple labeling with oxytetracycline on the first postoperative day, alizarin complexone on the fourth postoperative day, and DCAF on the eleventh postoperative day. A positive scintiscan within the first week following surgery indicated patent microvascular anastomoses, and histological study and fluorescence microscopy confirmed that bone throughout the graft was viable. A positive scintiscan one week after surgery or later does not necessarily indicate microvascular patency or bone-cell survival, because new bone formed by creeping substitution on the surface of a dead bone graft can result in this finding.

  1. Early secondary bone grafting of alveolar cleft defects. A comparison between chin and rib grafts.

    PubMed

    Borstlap, W A; Heidbuchel, K L; Freihofer, H P; Kuijpers-Jagtman, A M

    1990-07-01

    Since 1981 in cleft lip and palate patients a combined surgical-orthodontic procedure has been performed to eliminate the residual alveolar cleft. For early secondary bone grafting (before the eruption of the canine tooth) initially the graft tissue of choice was rib. Since 1984 chin bone has also been used. Sixty one patients with complete unilateral clefts were reviewed (mean age 9.5 years). 15.7% of the rib graft cases showed resorption of the graft of 50% and more. Such resorption was not found in any of the chin graft cases. No complications such as wound dehiscence, sequestration, excessive resorption of bone or recurrence of an oro-nasal fistula were found in the chin graft group. This leads to the conclusion that if enough bone is available in the chin region to bridge the defect, this graft is preferable to a rib graft.

  2. A method for isolating high quality RNA from mouse cortical and cancellous bone.

    PubMed

    Kelly, Natalie H; Schimenti, John C; Patrick Ross, F; van der Meulen, Marjolein C H

    2014-11-01

    The high incidence of fragility fractures in cortico-cancellous bone locations, plus the fact that individual skeletal sites exhibit different responsiveness to load and disease, emphasizes the need to document separately gene expression in cortical and cancellous bone. A further confounding factor is marrow contamination since its high cellularity may effect gene expression measurements. We isolated RNA from cortical and cancellous bone of intact mouse tibiae, and also after marrow removal by flushing or centrifugation. RNA isolated from cancellous bone by each method was sufficient for gene expression analysis. Centrifugation removed contaminating cells more efficiently than flushing, as indexed by histology and decreased expression of Icam4, a highly expressed erythroid gene. In contrast, centrifuged cortical bone had 12- and 13- fold higher expression of the bone-related genes Col1a1 and Bglap, while levels in marrow-free cancellous bone were 30- and 31-fold higher when compared to bone where marrow was left intact. Furthermore, cortical bone had higher expression of Col1a1 and Bglap than cancellous bone. Thus, RNA isolated by this novel approach can reveal site-specific changes in gene expression in cortical and cancellous bone sites. PMID:25073031

  3. Improved osteoconduction of cortical bone grafts by biodegradable foam coating.

    PubMed

    Lewandrowski, K U; Bondre, S P; Gresser, J D; Wise, D L; Tomford, W W; Trantolo, D J

    1999-01-01

    Alteration of the geometrical surface configuration of cortical bone allografts may improve incorporation into host bone. A porous biodegradable coating that would maintain immediate structural recovery and subsequently allow normal graft healing and remodeling by promoting bony ingrowth could provide an osteoconductive surface scaffold. We investigated the feasibility of augmenting cortical bone grafts with osteoconductive biodegradable polymeric scaffold coatings. Three types of bone grafts were prepared: Type I--cortical bone without coating (control), Type II--cortical bone coated with PLGA-foam, Type III--cortical bone coated with PPF-foam. The grafts were implanted into the rat tibial metaphysis (16 animals for each type of bone graft). Post-operatively the animals were sacrificed at 2 weeks and 4 weeks (8 animals for each type of bone graft at each time point). Histologic and histomorphometric analysis of grafts showed that the amount of new bone forming around the foam-coated grafts was significantly higher than in the control group (uncoated; p < 0.02). Although both foam formulations were initially equally osteoconductive, PLGA-based foam coatings appeared to have degraded at two weeks postoperatively, whereas PPF-based foam coatings were still present at 4 weeks postoperatively. While significant resorption was present in control allografts with little accompanying reactive new bone formation, PLGA-coated bone grafts showed evidence of bone resorption and subsequent bony ingrowth earlier than those coated with PPF-based foams suggesting that PPF-coated cortical bone grafts were longer protected against host reactions resulting in bone resorption.

  4. 21 CFR 872.3930 - Bone grafting material.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .... Bone grafting material is a material such as hydroxyapatite, tricalcium phosphate, polylactic and polyglycolic acids, or collagen, that is intended to fill, augment, or reconstruct periodontal or bony...

  5. 21 CFR 872.3930 - Bone grafting material.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .... Bone grafting material is a material such as hydroxyapatite, tricalcium phosphate, polylactic and polyglycolic acids, or collagen, that is intended to fill, augment, or reconstruct periodontal or bony...

  6. 21 CFR 872.3930 - Bone grafting material.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... Bone grafting material is a material such as hydroxyapatite, tricalcium phosphate, polylactic and polyglycolic acids, or collagen, that is intended to fill, augment, or reconstruct periodontal or bony...

  7. Mechanical Properties of a Single Cancellous Bone Trabeculae Taken from Bovine Femur

    NASA Astrophysics Data System (ADS)

    Enoki, Shinichi; Sato, Mitsuhiro; Tanaka, Kazuto; Katayama, Tsutao

    The increase of patients with osteoporosis is becoming a social problem, thus it is an urgent issue to find its prevention and treatment methods. Since cancellous bone is metabolically more active than cortical bone, cancellous bone is often used for diagnosis of osteoporosis and has received much attention within the study of bone. Bone is a hierarchically structured material and its mechanical properties vary at different structural levels, therefore it is important to break down the mechanical testing of bone according to the various levels within bone material. Mechanical properties of cancellous bone is said to be depended on quantities and orientation of trabecular bone. It is supposed that mechanical properties of trabecular bone are constant without depending on any structural arrangement and parts. However, such assumption has not been established in studies of trabecular bone. Furthermore test results have a large margin of error caused by insufficient shape assessment. In this study, three point bending tests of single cancellous bone trabeculae extracted from bovine femur were conducted to evaluate the effects of directions to the femur major axis direction on the mechanical properties. X-ray μCT was used to obtain shape of trabecular bone specimens. Furthermore compression tests of cancellous bone specimens, which were extracted in 10mm cubic geometry, were conducted for evaluation of directional properties.There were small difference in the elastic modulus of the trabecular bones which were extracted in parallel and in perpendicular to the major axis of femur. Considering from the results that the cancellous bone specimens, which were extracted in 10mm cubic geometry, have different elastic properties depending on the tested directions; the bone structure has larger influence than bone material property on the mechanical properties of cancellous bone.

  8. Engineering bone grafts with enhanced bone marrow and native scaffolds.

    PubMed

    Hung, Ben P; Salter, Erin K; Temple, Josh; Mundinger, Gerhard S; Brown, Emile N; Brazio, Philip; Rodriguez, Eduardo D; Grayson, Warren L

    2013-01-01

    The translation of tissue engineering approaches to the clinic has been hampered by the inability to find suitable multipotent cell sources requiring minimal in vitro expansion. Enhanced bone marrow (eBM), which is obtained by reaming long bone medullary canals and isolating the solid marrow putty, has large quantities of stem cells and demonstrates significant potential to regenerate bone tissues. eBM, however, cannot impart immediate load-bearing mechanical integrity or maintain the gross anatomical structure to guide bone healing. Yet, its putty-like consistency creates a challenge for obtaining the uniform seeding necessary to effectively combine it with porous scaffolds. In this study, we examined the potential for combining eBM with mechanically strong, osteoinductive trabecular bone scaffolds for bone regeneration by creating channels into scaffolds for seeding the eBM. eBM was extracted from the femurs of adult Yorkshire pigs using a Synthes reamer-irrigator-aspirator device, analyzed histologically, and digested to extract cells and characterize their differentiation potential. To evaluate bone tissue formation, eBM was seeded into the channels in collagen-coated or noncoated scaffolds, cultured in osteogenic conditions for 4 weeks, harvested and assessed for tissue distribution and bone formation. Our data demonstrates that eBM is a heterogenous tissue containing multipotent cell populations. Furthermore, coating scaffolds with a collagen hydrogel significantly enhanced cellular migration, promoted uniform tissue development and increased bone mineral deposition. These findings suggest the potential for generating customized autologous bone grafts for treating critical-sized bone defects by combining a readily available eBM cell source with decellularized trabecular bone scaffolds.

  9. Free and microvascular bone grafting in the irradiated dog mandible

    SciTech Connect

    Altobelli, D.E.; Lorente, C.A.; Handren, J.H. Jr.; Young, J.; Donoff, R.B.; May, J.W. Jr.

    1987-01-01

    Microvascular and free rib grafts were placed in 4.5 cm defects in an edentate mandibular body defect 18 to 28 days after completion of 50 Gy of irradiation from a /sup 60/Co source. The animals were sacrificed from two to forty weeks postoperatively and evaluated clinically, radiographically, and histologically. There was a marked difference in the alveolar mucosal viability with the two grafts. Mucosal dehiscence was not observed over any of the microvascular grafts, but was present in seven-eighths of the free grafts. Union of the microvascular bone graft to the host bone occurred within six weeks. In contrast, after six weeks the free graft was sequestered in all the animals. An unexpected finding with both types of graft was the marked subperiosteal bone formation. This bone appeared to be derived from the host bed, stabilizing and bridging the defects bilaterally. The results suggest that radiated periosteum may play an important role in osteogenesis.

  10. Transforaminal lumbar interbody fusion rates in patients using a novel titanium implant and demineralized cancellous allograft bone sponge

    PubMed Central

    Girasole, Gerard; Muro, Gerard; Mintz, Abraham; Chertoff, Jason

    2013-01-01

    Background Transforaminal lumbar interbody fusion (TLIF) with grafting and implant options like iliac crest bone graft (ICBG), recombinant bone morphogenetic protein (rhBMP), and polyetheretherketone (PEEK) cages have been reported to achieve extremely high fusion rates. Unfortunately, these options have also been frequently cited in the literature as causing postoperative morbidity and complications at a high cost. Knowing this, we sought to investigate TLIF using an acid-etched, roughened titanium cage that upregulates osteogenesis to see if similar fusion rates to those cited for ICBG, rhBMP, and PEEK cages could be safely achieved with minimal morbidity and complications. Materials and methods A radiographic fusion study of 82 patients who underwent TLIF using an acid-etched, roughened titanium cage with demineralized cancellous bone graft was conducted. Fusion was assessed and graded by an independent radiologist using computed tomography scan with sagittal and coronal reconstructions. Results Fusion rates at 6 months were 41 of 44 (93.2%) and at 12 months were 37 of 38 (97.4%). There were no radiographic device-related complications. Conclusions TLIF with an acid-etched, roughened titanium cage filled with a decalcified bone graft achieved similar fusion rates to historical controls using ICBG, rhBMP, and PEEK. PMID:25580378

  11. The effects of early postoperative radiation on vascularized bone grafts

    SciTech Connect

    Evans, H.B.; Brown, S.; Hurst, L.N. )

    1991-06-01

    The effects of early postoperative radiation were assessed in free nonvascularized and free vascularized rib grafts in the canine model. The mandibles of one-half of the dogs were exposed to a cobalt 60 radiation dose of 4080 cGy over a 4-week period, starting 2 weeks postoperatively. The patency of vascularized grafts was confirmed with bone scintigraphy. Histological studies, including ultraviolet microscopy with trifluorochrome labeling, and histomorphometric analyses were performed. Osteocytes persist within the cortex of the vascularized nonradiated grafts to a much greater extent than in nonvascularized, nonradiated grafts. Cortical osteocytes do not persist in either vascularized or nonvascularized grafts subjected to radiation. New bone formation is significantly retarded in radiated grafts compared with nonradiated grafts. Periosteum and endosteum remained viable in the radiated vascularized grafts, producing both bone union and increased bone turnover, neither of which were evident to any significant extent in nonvascularized grafts. Bone union was achieved in vascularized and non-vascularized nonradiated bone. In the radiated group of dogs, union was only seen in the vascularized bone grafts.

  12. Assessment of the autogenous bone graft for sinus elevation

    PubMed Central

    Peng, Wang; Cho, Hyun-Young; Pae, Sang-Pill; Jung, Bum-Sang; Cho, Hyun-Woo; Seo, Ji-Hoon

    2013-01-01

    Objectives The posterior maxillary region often provides a limited bone volume for dental implants. Maxillary sinus elevation via inserting a bone graft through a window opened in the lateral sinus wall has become the most common surgical procedure for increasing the alveolar bone height in place of dental implants in the posterior maxillary region. The purpose of this article is to assess the change of bone volume and the clinical effects of dental implant placement in sites with maxillary sinus floor elevation and autogenous bone graft through the lateral window approach. Materials and Methods In this article, the analysis data were collected from 64 dental implants that were placed in 24 patients with 29 lacks of the bone volume posterior maxillary region from June 2004 to April 2011, at the Department of Oral and Maxillofacial Surgery, Inha University Hospital. Panoramic views were taken before the surgery, after the surgery, 6 months after the surgery, and at the time of the final follow-up. The influence of the factors on the grafted bone material resorption rate was evaluated according to the patient characteristics (age and gender), graft material, implant installation stage, implant size, implant placement region, local infection, surgical complication, and residual alveolar bone height. Results The bone graft resorption rate of male patients at the final follow-up was significantly higher than the rate of female patients. The single autogenous bone-grafted site was significantly more resorbed than the autogenous bone combined with the Bio-Oss grafted site. The implant installation stage and residual alveolar height showed a significant correlation with the resorption rate of maxillary sinus bone graft material. The success rate and survival rate of the implant were 92.2% and 100%, respectively. Conclusion Maxillary sinus elevation procedure with autogenous bone graft or autogenous bone in combination with Bio-Oss is a predictable treatment method for

  13. Finite element prediction of fatigue damage growth in cancellous bone.

    PubMed

    Hambli, Ridha; Frikha, Sana; Toumi, Hechmi; Tavares, João Manuel R S

    2016-01-01

    Cyclic stresses applied to bones generate fatigue damage that affects the bone stiffness and its elastic modulus. This paper proposes a finite element model for the prediction of fatigue damage accumulation and failure in cancellous bone at continuum scale. The model is based on continuum damage mechanics and incorporates crack closure effects in compression. The propagation of the cracks is completely simulated throughout the damaged area. In this case, the stiffness of the broken element is reduced by 98% to ensure no stress-carrying capacities of completely damaged elements. Once a crack is initiated, the propagation direction is simulated by the propagation of the broken elements of the mesh. The proposed model suggests that damage evolves over a real physical time variable (cycles). In order to reduce the computation time, the integration of the damage growth rate is based on the cycle blocks approach. In this approach, the real number of cycles is reduced (divided) into equivalent blocks of cycles. Damage accumulation is computed over the cycle blocks and then extrapolated over the corresponding real cycles. The results show a clear difference between local tensile and compressive stresses on damage accumulation. Incorporating stiffness reduction also produces a redistribution of the peak stresses in the damaged region, which results in a delay in damage fracture.

  14. Novel Approaches to Bone Grafting: Porosity, Bone Morphogenetic Proteins, Stem Cells, and the Periosteum

    PubMed Central

    Petrochenko, Peter; Narayan, Roger J.

    2011-01-01

    The disadvantages involving the use of a patient’s own bone as graft material have led surgeons to search for alternative materials. In this review, several characteristics of a successful bone graft material are discussed. In addition, novel synthetic materials and natural bone graft materials are being considered. Various factors can determine the success of a bone graft substitute. For example, design considerations such as porosity, pore shape, and interconnection play significant roles in determining graft performance. The effective delivery of bone morphogenetic proteins and the ability to restore vascularization also play significant roles in determining the success of a bone graft material. Among current approaches, shorter bone morphogenetic protein sequences, more efficient delivery methods, and periosteal graft supplements have shown significant promise for use in autograft substitutes or autograft extenders. PMID:21488823

  15. 21 CFR 872.3930 - Bone grafting material.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bone grafting material. 872.3930 Section 872.3930 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3930 Bone grafting material. (a)...

  16. 21 CFR 872.3930 - Bone grafting material.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Bone grafting material. 872.3930 Section 872.3930 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3930 Bone grafting material. (a)...

  17. An investigation into the feasibility of implementing fractal paradigms to simulate cancellous bone structure.

    PubMed

    Haire, T J; Ganney, P S; Langton, C M

    2001-01-01

    Cancellous bone consists of a framework of solid trabeculae interspersed with bone marrow. The structure of the bone tissue framework is highly convoluted and complex, being fractal and statistically self-similar over a limited range of magnifications. To date, the structure of natural cancellous bone tissue has been defined using 2D and 3D imaging, with no facility to modify and control the structure. The potential of four computer-generated paradigms has been reviewed based upon knowledge of other fractal structures and chaotic systems, namely Diffusion Limited Aggregation (DLA), Percolation and Epidemics, Cellular Automata, and a regular Grid with randomly relocated nodes. The resulting structures were compared for their ability to create realistic structures of cancellous bone rather than reflecting growth and form processes. Although the creation of realistic computer-generated cancellous bone structures is difficult, it should not be impossible. Future work considering the combination of fractal and chaotic paradigms is underway. PMID:11328644

  18. The effects of PTH, loading and surgical insult on cancellous bone at the bone-implant interface in the rabbit

    PubMed Central

    Fahlgren, Anna; Yang, Xu; Ciani, Cesare; Ryan, James A.; Kelly, Natalie; Ko, Frank C.; van der Meulen, Marjolein C.H.; Bostrom, Mathias P.G.

    2014-01-01

    Enhancing the quantity and quality of cancellous bone with anabolic pharmacologic agents may lead to more successful outcomes of non-cemented joint replacements. Using a novel rabbit model of cancellous bone loading, we examined two specific questions regarding bone formation at the bone-implant interface: (1) does the administration of intermittent PTH, a potent anabolic agent, and mechanical loading individually and combined enhance the peri-implant cancellous bone volume fraction; and, (2) does surgical trauma enhance the anabolic effect of PTH on peri-implant bone volume fraction. In this model, PTH enhanced peri-implant bone volume fraction by 30% in loaded bone, while mechanical loading alone increased bone volume fraction modestly (+10%). Combined mechanical loading and PTH treatment had no synergistic effect on any cancellous parameters. However, a strong combined effect was found in bone volume fraction with combined surgery and PTH treatment (+34%) compared to intact control limbs. Adaptive changes in the cancellous bone tissue included increased ultimate stress and enhanced remodeling activity. The number of proliferative osteoblasts increased as did their expression of pro-collagen 1 and PTH receptor 1, and the number of TRAP positive osteoclasts also increased. In summary, both loading and intermittent PTH treatment enhanced peri-implant bone volume, and surgery and PTH treatment had a strong combined effect. This finding is of clinical importance since enhancing early osseointegration in the post-surgical period has numerous potential benefits. PMID:22613252

  19. Decreased cortical and increased cancellous bone in two children with primary hyperparathyroidism.

    PubMed

    Boechat, M I; Westra, S J; Van Dop, C; Kaufman, F; Gilsanz, V; Roe, T F

    1996-01-01

    The basis for this study is two children with primary hyperparathyroidism (PHPT) who radiographically manifested both marked subperiosteal resorption and prominent osteosclerosis. We hypothesize that the parathyroid hormone (PTH) elevation not only increased osteoclastic resorption of cortical bone but also simultaneously enhanced cancellous bone formation, giving rise to osteosclerosis. In this report, we describe the changes in trabecular and cortical bone density, as measured by quantitative computed tomography (QCT), in these two young patients with severe PHPT, before and after removal of a parathyroid adenoma. Before surgery, the radiographic findings of subperiosteal resorption and osteosclerosis were associated with low cortical and high cancellous bone density values in both children. Within 1 week of surgery, both cortical and cancellous bone density values increased and serum concentrations of calcium and, to a lesser degree, phosphorus decreased due to the "hungry bone syndrome." Twelve weeks after parathyroidectomy, QCT bone density values and skeletal radiographs were normal in both patients. The findings suggest that in patients with severe PHPT, the catabolic effect of PTH on cortical bone may be associated with a simultaneous anabolic effect on cancellous bone, and PTH may cause a significant redistribution of bone mineral from cortical to cancellous bone. PMID:8544781

  20. Revision hip arthroplasty using impacted cancellous bone and cement: a long-term follow-up study.

    PubMed

    Arumugam, Gowthaman; Nanjayan, Shashi Kumar; Quah, Conal; Wraighte, Philip; Howard, Peter

    2015-12-01

    Acetabular bone deficiency is one of the many challenging problems encountered in revision hip arthroplasty. A variety of surgical options and techniques are available including impaction bone grafting. We present our long-term experience of 68 consecutive cups in 64 patients, using impacted cancellous bone grafting with bone cement. With a mean follow-up of 10.5 year (IQR 7.5-12.9) after revision surgery, three implants had undergone further revision. Three patients had subsequent femoral peri-prosthetic fractures, and none of these three required further acetabular revision. Survival of the acetabular components was 95.5 % for all causes and 100 % for aseptic loosening as the end point, with a further four patients showing radiographic, but asymptomatic loosening. A significant correlation was found between previous revision and re-revision (early failure) (p = 0.01) as well as progression of lytic lesion and re-revision (p = 0.01). The median Harris hip score at final follow-up was 79.5 (IQR 67.9-80.4). The use of impacted morcellised allograft bone with a cemented cup is an effective technique to achieve longevity and restoration of bone stock in acetabular revision arthroplasty. Our series has shown good clinical and radiological outcome with survivorship of the prosthesis exceeding 95 % at 10 years.

  1. The effect of screw pullout rate on screw purchase in synthetic cancellous bone.

    PubMed

    Zdero, Rad; Schemitsch, Emil H

    2009-02-01

    Clinically, orthopaedic fracture fixation constructs are mounted using screws inserted into cancellous bone, while biomechanical studies are increasingly using commercially available synthetic bones. The goal of this study was to examine the effect of screw pullout rate on cancellous bone screw purchase strength in synthetic cancellous bone. Sixty synthetic cancellous bone cubes (40x40x40 mm(3)) each had one orthopaedic cancellous bone screw (major diameter=6.5 mm) inserted to a depth of 30 mm. Screws were extracted to obtain outcome measures of failure force, failure shear stress, failure energy, failure displacement, resistance force, and removal energy. The ten test groups (n=6 cubes per group) had screws extracted at pullout rates of 1 mmmin, 2.5 mmmin, 5 mmmin, 7.5 mmmin, 10 mmmin, 20 mmmin, 30 mmmin, 40 mmmin, 50 mmmin, and 60 mmmin. The aggregate average results for failure force, failure stress, failure energy, failure displacement, resistance force, and postfailure removal energy for combined pullout rates were, respectively, 984.8+/-63.9 N, 3.5+/-0.2 MPa, 298.3+/-41.7 J, 0.53+/-0.08 mm, 453.8+/-19.6 N, and 5420.1+/-489.7 J. Most statistical differences (40 of 47) involved either the 5 mmmin or the 60 mmmin rates being compared to other rates. Failure force, failure stress, and resistance force increased and were highly linearly correlated with pullout rate (R(2)=0.78, 0.76, and 0.74, respectively). Failure energy, failure displacement, and removal energy were relatively unchanged over the pullout range tested, yielding low correlation coefficients (R(2)<0.05). Failure force, failure stress, and resistance force were affected by bone screw pullout rate in synthetic cancellous bone, while failure energy, failure displacement, and removal energy remained unchanged. This is the first study to perform an extensive investigation of cancellous bone screw pullout rate in synthetic cancellous bone.

  2. Substitutes of structural and non-structural autologous bone grafts in hindfoot arthrodeses and osteotomies: a systematic review

    PubMed Central

    2013-01-01

    Background Structural and non-structural substitutes of autologous bone grafts are frequently used in hindfoot arthrodeses and osteotomies. However, their efficacy is unclear. The primary goal of this systematic review was to compare autologous bone grafts with structural and non-structural substitutes regarding the odds of union in hindfoot arthrodeses and osteotomies. Methods The Medline and EMBASE and Cochrane databases were searched for relevant randomized and non-randomized prospective studies as well as retrospective comparative chart reviews. Results 10 studies which comprised 928 hindfoot arthrodeses and osteotomies met the inclusion criteria for this systematic review. The quality of the retrieved studies was low due to small samples sizes and confounding variables. The pooled random effect odds for union were 12.8 (95% CI 12.7 to 12.9) for structural allografts, 5.7 (95% CI 5.5 to 6.0) for cortical autologous grafts, 7.3 (95% CI 6.0 to 8.6) for cancellous allografts and 6.0 (95% CI 5.7 to 6.4) for cancellous autologous grafts. In individual studies, the odds of union in hindfoot arthrodeses achieved with cancellous autologous grafts was similar to those achieved with demineralised bone matrix or platelet derived growth factor augmented ceramic granules. Conclusion Our results suggest an equivalent incorporation of structural allografts as compared to autologous grafts in hindfoot arthrodeses and osteotomies. There is a need for prospective randomized trials to further clarify the role of substitutes of autologous bone grafts in hindfoot surgery. PMID:23390993

  3. High‐Resolution Three‐Dimensional Computed Tomography Analysis of the Clinical Efficacy of Cultured Autogenous Periosteal Cells in Sinus Lift Bone Grafting

    PubMed Central

    Ogawa, Shin; Hoshina, Hideyuki; Nakata, Koh; Yamada, Kazuho; Uematsu, Kohya; Kawase, Tomoyuki; Takagi, Ritsuo

    2015-01-01

    Abstract Background and Purpose Sinus lift (SL) using cultured autogenous periosteal cells (CAPCs) combined with autogenous bone and platelet‐rich plasma (PRP) was performed to evaluate the effect of cell administration on bone regeneration, by using high‐resolution three‐dimensional computed tomography (CT). Materials and Methods SL with autogenous bone and PRP plus CAPC [CAPC(+)SL] was performed in 23 patients. A piece of periosteum taken from the mandible was cultured in M199 medium with 10% fetal bovine serum (FBS) for 6 weeks. As control, 16 patients received SL with autogenous bone and PRP [CAPC(−)SL]. Three‐dimensional CT imaging was performed before and 4 months and 1 year after SL, and stratification was performed based on CT numbers (HUs) corresponding to soft tissue and cancellous or cortical bone. Results The augmented bone in CAPC(+)SL revealed an increase in HUs corresponding to cancellous bone as well as a decrease in HUs corresponding to grafted cortical bone. In addition, HUs corresponding to cancellous bone in the graft bed were increased in CAPC(+)SL but were decreased in CAPC(−)SL. Insertion torque during implant placement was significantly higher in CAPC(+)SL. Conclusion By promoting bone anabolic activity both in augmented bone and graft bed, CAPCs are expected to aid primary fixation and osseointegration of implants in clinical applications. PMID:26017402

  4. Supercritical carbon dioxide-processed resorbable polymer nanocomposites for bone graft substitute applications

    NASA Astrophysics Data System (ADS)

    Baker, Kevin C.

    Numerous clinical situations necessitate the use of bone graft materials to enhance bone formation. While autologous and allogenic materials are considered the gold standards in the setting of fracture healing and spine fusion, their disadvantages, which include donor site morbidity and finite supply have stimulated research and development of novel bone graft substitute materials. Among the most promising candidate materials are resorbable polymers, composed of lactic and/or glycolic acid. While the characteristics of these materials, such as predictable degradation kinetics and biocompatibility, make them an excellent choice for bone graft substitute applications, they lack mechanical strength when synthesized with the requisite porous morphology. As such, porous resorbable polymers are often reinforced with filler materials. In the presented work, we describe the use of supercritical carbon dioxide (scCO2) processing to create porous resorbable polymeric constructs reinforced by nanostructured, organically modified Montmorillonite clay (nanoclay). scCO2 processing simultaneously disperses the nanoclay throughout the polymeric matrix, while imparting a porous morphology to the construct conducive to facilitating cellular infiltration and neoangiogenesis, which are necessary components of bone growth. With the addition of as little as 2.5wt% of nanoclay, the compressive strength of the constructs nearly doubles putting them on par with human cortico-cancellous bone. Rheological measurements indicate that the dominant mode of reinforcement of the nanocomposite constructs is the restriction of polymer chain mobility. This restriction is a function of the positive interaction between polymer chains and the nanoclay. In vivo inflammation studies indicate biocompatibility of the constructs. Ectopic osteogenesis assays have determined that the scCO2-processed nanocomposites are capable of supporting growth-factor induced bone formation. scCO 2-processed resorbable

  5. Spatial relationships between bone formation and mechanical stress within cancellous bone.

    PubMed

    Cresswell, E N; Goff, M G; Nguyen, T M; Lee, W X; Hernandez, C J

    2016-01-25

    Bone adapts to mechanical stimuli. While in vivo mechanical loading has been shown to increase the density of cancellous bone, theory suggests that the relationship between tissue stress/strain and subsequent bone formation occurs at the scale of individual trabeculae. Here we examine bone formation one week following mechanical stimulus. Three bouts of cyclic loading (300 cycles/day on 3 consecutive days) were applied to caudal vertebrae of female rats (n=7). Bone formation was determined using three-dimensional images of fluorescent markers of bone formation (0.7×0.7×5.0μm(3)) and local tissue stress/strain was determined using high-resolution finite element models. Three days of mechanical stimuli resulted in an increase in mineralizing surface (loaded: 17.68±2.17%; control: 9.05±3.20%; mean±SD) and an increase in the volume of bone formed (loaded: 7.09±1.97%; control: 1.44±0.50%). The number of bone formation sites was greater in loaded animals (650.71±118.54) than pinned not loaded controls (310.71±91.55), a difference that was explained by the number of formation sites at regions with large local tissue strain energy density (SED). In addition, the probability of observing bone formation was greater at locations of the microstructure experiencing greater SED, but did not exceed 32%, consistent with prior work. Our findings demonstrate that bone formation in the week following a short term mechanical stimulus occurs near regions of bone tissue experiencing high tissue SED, although the ability of finite element models to predict the locations of bone formation remains modest and further improvements may require accounting for additional factors such as osteocyte distribution or fluid flow.

  6. Quantitative measures of osteoinductivity of a porous poly(propylene fumarate) bone graft extender.

    PubMed

    Lewandrowski, Kai-Uwe; Hile, David D; Thompson, Benjamin M J; Wise, Donald L; Tomford, William W; Trantolo, Debra J

    2003-02-01

    Bioresorbable bone graft substitutes could alleviate disadvantages associated with the use of autografts, allografts, and other synthetic materials. However, little is known about the minimum autograft/extender ratio for a given material at which a sufficient osteoinductive effect is still seen. Therefore, we investigated a bioresorbable bone graft substitute made from the unsaturated polyester poly(propylene fumarate), PPF, at various mixing ratios with autograft. The bone graft extender is cross-linked in the presence of a hydroxylapatite filler and effervescent foaming agents citric acid and sodium bicarbonate. The porous bone graft extender material develops porosity in vivo by generating carbon dioxide during the effervescent reaction, resulting in foam formation and expansion with respective pore sizes of 50 to 1000 microm. In an attempt to determine how much cancellous autograft bone could be extended with the poly(propylene fumarate) material and at which ratio the autograft/extender combination remained supportive of the overall structural integrity of the repairing defect site, we studied the amount of new bone formation on implantation of the materials in 3-mm holes made in the anteromedial tibial metaphysis of Sprague-Dawley rats. The extender formulation was analyzed at high autograft/extender (75% autograft/25% extender) and low autograft/extender (25% autograft/75% extender) mixing ratios and compared with negative (extender alone) and positive (autograft alone) controls. Animals from each of the formulations were killed in groups of eight at 6 weeks postoperatively. Hence, a total of 32 animals were included in this study. Histologic analysis of the healing process revealed enhanced in vivo osteoinduction with the bone graft extender regardless of the autograft loading. Histomorphometry did not show any statistically significant difference between the high and low autograft/extender ratios. All formulations maintained implant integrity and did not

  7. Bone graft substitutes for spine fusion: A brief review

    PubMed Central

    Gupta, Ashim; Kukkar, Nitin; Sharif, Kevin; Main, Benjamin J; Albers, Christine E; El-Amin III, Saadiq F

    2015-01-01

    Bone graft substitutes are widely used in the field of orthopedics and are extensively used to promote vertebral fusion. Fusion is the most common technique in spine surgery and is used to treat morbidities and relieve discomfort. Allograft and autograft bone substitutes are currently the most commonly used bone grafts to promote fusion. These approaches pose limitations and present complications to the patient. Numerous alternative bone graft substitutes are on the market or have been developed and proposed for application. These options have attempted to promote spine fusion by enhancing osteogenic properties. In this review, we reviewed biology of spine fusion and the current advances in biomedical materials and biological strategies for application in surgical spine fusion. Our findings illustrate that, while many bone graft substitutes perform well as bone graft extenders, only osteoinductive proteins (recombinant bone morphogenetic proteins-2 and osteogenic protein-1) provide evidence for use as both bone enhancers and bone substitutes for specific types of spinal fusion. Tissue engineered hydrogels, synthetic polymer composites and viral based gene therapy also holds the potential to be used for spine fusion in future, though warrants further investigation to be used in clinical practice. PMID:26191491

  8. Iliac Bone Grafting of the Intact Glenoid Improves Shoulder Stability with Optimal Graft Positioning

    PubMed Central

    Willemot, Laurent B.; Eby, Sarah F.; Thoreson, Andrew R.; Debeer, Phillipe; Victor, Jan; An, Kai-Nan; Verborgt, Olivier

    2014-01-01

    Background Bone grafting procedures are increasingly popular for the treatment of anterior shoulder instability. In cases with high risk of recurrence, open coracoid transplantation is preferred but can be technically demanding. Free bone graft glenoid augmentation may be an alternative strategy for high-risk patients without significant glenoid bone loss. This biomechanical cadaver study aims to assess the stabilizing effect of free iliac crest bone grafting of the intact glenoid and the importance of sagittal graft position. Methods Eight fresh frozen cadaver shoulders were tested. The bone graft was fixed on the glenoid neck at three sagittal positions (50%, 75% and 100% below the glenoid equator). Displacement and reaction force were monitored with a custom device while translating the humeral head over the glenoid surface in both anterior and antero-inferior direction. Results Peak force (PF) increased significantly from the standard labral repair to the grafted conditions in both anterior (14.7 (±5.5 N) vs. 27.3 (±6.9 N)) and antero-inferior translation (22.0 (±5.3 N) vs. 29.3 (±6.9 N)). PF was significantly higher for the grafts at the 50% and 75% positions, compared to the grafts 100% below the equator with anterior translation. Antero-inferior translation resulted in significantly higher values for the 100% and 75% positions compared to the 50% position. Conclusions This biomechanical study confirms improved anterior glenohumeral stability after iliac crest bone graft augmentation of the anterior glenoid. The results also demonstrate the importance of bone graft position in the sagittal plane, with the ideal position determined by the direction of dislocation. PMID:25457786

  9. Bioreactor cultivation of anatomically shaped human bone grafts.

    PubMed

    Temple, Joshua P; Yeager, Keith; Bhumiratana, Sarindr; Vunjak-Novakovic, Gordana; Grayson, Warren L

    2014-01-01

    In this chapter, we describe a method for engineering bone grafts in vitro with the specific geometry of the temporomandibular joint (TMJ) condyle. The anatomical geometry of the bone grafts was segmented from computed tomography (CT) scans, converted to G-code, and used to machine decellularized trabecular bone scaffolds into the identical shape of the condyle. These scaffolds were seeded with human bone marrow-derived mesenchymal stem cells (MSCs) using spinner flasks and cultivated for up to 5 weeks in vitro using a custom-designed perfusion bioreactor system. The flow patterns through the complex geometry were modeled using the FloWorks module of SolidWorks to optimize bioreactor design. The perfused scaffolds exhibited significantly higher cellular content, better matrix production, and increased bone mineral deposition relative to non-perfused (static) controls after 5 weeks of in vitro cultivation. This technology is broadly applicable for creating patient-specific bone grafts of varying shapes and sizes.

  10. Bioreactor Cultivation of Anatomically Shaped Human Bone Grafts

    PubMed Central

    Temple, Joshua P.; Yeager, Keith; Bhumiratana, Sarindr; Vunjak-Novakovic, Gordana; Grayson, Warren L.

    2015-01-01

    In this chapter, we describe a method for engineering bone grafts in vitro with the specific geometry of the temporomandibular joint (TMJ) condyle. The anatomical geometry of the bone grafts was segmented from computed tomography (CT) scans, converted to G-code, and used to machine decellularized trabecular bone scaffolds into the identical shape of the condyle. These scaffolds were seeded with human bone marrow-derived mesenchymal stem cells (MSCs) using spinner flasks and cultivated for up to 5 weeks in vitro using a custom-designed perfusion bioreactor system. The flow patterns through the complex geometry were modeled using the FloWorks module of SolidWorks to optimize bioreactor design. The perfused scaffolds exhibited significantly higher cellular content, better matrix production, and increased bone mineral deposition relative to non-perfused (static) controls after 5 weeks of in vitro cultivation. This technology is broadly applicable for creating patient-specific bone grafts of varying shapes and sizes. PMID:24014312

  11. Autogenous bone grafts contamination after exposure to the oral cavity.

    PubMed

    Nary Filho, Hugo; Pinto, Tábata Fernandes; de Freitas, Caio Peixoto; Ribeiro-Junior, Paulo Domingos; dos Santos, Pâmela Letícia; Matsumoto, Mariza Akemi

    2014-03-01

    The purpose of this paper was to analyze specimens of autogenous bone block grafts exposed to the oral cavity after ridge reconstructions. Specimens of chronic suppurative osteomyelitis (CSO) of the jaws were used as comparison for bacterial colonization pattern. For this, 5 specimens of infected autogenous bone grafts were used and 10 specimens of CSO embedded in paraffin were stained with Brown and Brenn technique and analyzed under light microscopy. The results showed a similar colonization pattern in both situations, with the establishment of bacterial biofilm and the predominance of Gram-positive bacteria. The conclusion was that the similarity in bacterial distribution and colonization between autogenous bone grafts and CSO stresses the necessity of more invasive procedures for the treatment of the autogenous bone grafts early exposed to the oral cavity.

  12. Autogenous bone grafts contamination after exposure to the oral cavity.

    PubMed

    Nary Filho, Hugo; Pinto, Tábata Fernandes; de Freitas, Caio Peixoto; Ribeiro-Junior, Paulo Domingos; dos Santos, Pâmela Letícia; Matsumoto, Mariza Akemi

    2014-03-01

    The purpose of this paper was to analyze specimens of autogenous bone block grafts exposed to the oral cavity after ridge reconstructions. Specimens of chronic suppurative osteomyelitis (CSO) of the jaws were used as comparison for bacterial colonization pattern. For this, 5 specimens of infected autogenous bone grafts were used and 10 specimens of CSO embedded in paraffin were stained with Brown and Brenn technique and analyzed under light microscopy. The results showed a similar colonization pattern in both situations, with the establishment of bacterial biofilm and the predominance of Gram-positive bacteria. The conclusion was that the similarity in bacterial distribution and colonization between autogenous bone grafts and CSO stresses the necessity of more invasive procedures for the treatment of the autogenous bone grafts early exposed to the oral cavity. PMID:24621694

  13. Penetration of piperacillin-tazobactam into cancellous and cortical bone tissues.

    PubMed Central

    Incavo, S J; Ronchetti, P J; Choi, J H; Wu, H; Kinzig, M; Sörgel, F

    1994-01-01

    The penetration characteristics of piperacillin-tazobactam into cortical and cancellous bone tissues were investigated in 10 patients undergoing total hip replacement. The concentration ratios of piperacillin/tazobactam were 9.4 +/- 1.8 in cancellous bone tissue and 8.0 +/- 2.2 in cortical bone tissue, which were close to the 8:1 ratio of drugs administered. The mean ratios of drug concentrations in bone and plasma for cancellous and cortical tissue were 23 and 18%, respectively, for piperacillin and 26 and 22%, respectively, for tazobactam. The concentrations of tazobactam achieved are sufficient to exert anti-beta-lactamase activity and supportive of clinical trials involving bone and joint infections, including those caused by beta-lactamase-producing pathogens. PMID:8031071

  14. Effect of medullary cavity in cancellous bone on two-wave phenomenon

    NASA Astrophysics Data System (ADS)

    Hachiken, Takuma; Nakanishi, Shoko; Matsukawa, Mami

    2016-07-01

    Osteoporotic patients have a larger medullary cavity in their cancellous bone than healthy people. In this study, the effect of the medullary cavity on the two-wave phenomenon was experimentally investigated using a cancellous bone model and a radius bone model. In the cancellous bone model, with the increase in hole (medullary cavity) diameter, the amplitudes of the fast waves became smaller, whereas the amplitudes of the slow waves became larger. In the radius bone model, the fast wave overlapped with the circumferential wave. The slow wave became larger with increasing hole diameter. The analysis of the slow wave thus seems to be useful for the in vivo diagnosis of the degree of osteoporosis.

  15. Oxidative stress and gamma radiation-induced cancellous bone loss with musculoskeletal disuse

    PubMed Central

    Kondo, Hisataka; Yumoto, Kenji; Alwood, Joshua S.; Mojarrab, Rose; Wang, Angela; Almeida, Eduardo A. C.; Searby, Nancy D.; Limoli, Charles L.

    2010-01-01

    Exposure of astronauts in space to radiation during weightlessness may contribute to subsequent bone loss. Gamma irradiation of postpubertal mice rapidly increases the number of bone-resorbing osteoclasts and causes bone loss in cancellous tissue; similar changes occur in skeletal diseases associated with oxidative stress. Therefore, we hypothesized that increased oxidative stress mediates radiation-induced bone loss and that musculoskeletal disuse changes the sensitivity of cancellous tissue to radiation exposure. Musculoskeletal disuse by hindlimb unloading (1 or 2 wk) or total body gamma irradiation (1 or 2 Gy of 137Cs) of 4-mo-old, male C57BL/6 mice each decreased cancellous bone volume fraction in the proximal tibiae and lumbar vertebrae. The extent of radiation-induced acute cancellous bone loss in tibiae and lumbar vertebrae was similar in normally loaded and hindlimb-unloaded mice. Similarly, osteoclast surface in the tibiae increased 46% as a result of irradiation, 47% as a result of hindlimb unloading, and 64% as a result of irradiation + hindlimb unloading compared with normally loaded mice. Irradiation, but not hindlimb unloading, reduced viability and increased apoptosis of marrow cells and caused oxidative damage to lipids within mineralized tissue. Irradiation also stimulated generation of reactive oxygen species in marrow cells. Furthermore, injection of α-lipoic acid, an antioxidant, mitigated the acute bone loss caused by irradiation. Together, these results showed that disuse and gamma irradiation, alone or in combination, caused a similar degree of acute cancellous bone loss and shared a common cellular mechanism of increased bone resorption. Furthermore, irradiation, but not disuse, may increase the number of osteoclasts and the extent of acute bone loss via increased reactive oxygen species production and ensuing oxidative damage, implying different molecular mechanisms. The finding that α-lipoic acid protected cancellous tissue from the

  16. The Use of Bone Graft Substitute in Hand Surgery

    PubMed Central

    Liodaki, Eirini; Kraemer, Robert; Mailaender, Peter; Stang, Felix

    2016-01-01

    Abstract Bone defects are a very common problem in hand surgery, occurring in bone tumor surgery, in complicated fractures, and in wrist surgery. Bone substitutes may be used instead of autologous bone graft to avoid donor site morbidity. In this article, we will review our experience with the use of Cerament bone void filler (Bonesupport, Lund, Sweden) in elective and trauma hand surgery. A prospective clinical study was conducted with 16 patients treated with this bone graft substitute in our department over a period of 3.5 years. Twelve patients (2 female, 10 male; with an average age of 42.42 years) with monostoic enchondroma of the phalanges were treated and 4 patients (1 female, 3 male; with an average age of 55.25 years) with complicated metacarpal fractures with bone defect. Data such as postoperative course with rating of pain, postoperative complications, functional outcome assessment at 1, 2, 3, 6 months, time to complete remodeling were registered. Postoperative redness and swelling after bone graft substitute use was noticed in 7 patients with enchondroma surgery due to the thin soft-tissue envelope of the fingers. Excellent total active motion of the involved digit was noticed in 10 of 12 enchondroma patients and in all 4 fracture patients at 2-month follow-up. In summary, satisfying results are described, making the use of injectable bone graft substitute in the surgical treatment of enchondromas, as well as in trauma hand surgery a good choice. PMID:27310946

  17. Hydroxyapatite crystals as a bone graft substitute in benign lytic lesions of bone

    PubMed Central

    Gupta, Anil Kumar; Kumar, Praganesh; Keshav, Kumar; Singh, Anant

    2015-01-01

    Background: Bone grafts are required to fill a cavity created after curettage of benign lytic lesions of the bone. To avoid the problems associated at donor site with autologous bone graft, we require allograft or bone graft substitutes. We evaluated the healing of lytic lesions after hydroxyapatite (HA) grafting by serial radiographs. Materials and Methods: Forty cases of benign lytic lesions of bone were managed by simple curettage and grafting using HA blocks. Commercially available HA of bovine origin (Surgiwear Ltd., Shahjahanpur, India) was used for this purpose. Mean duration of followup was 34.8 months (range 12–84 months). Mean patient age was 19.05 years (range 3–55 years). Radiological staging of graft incorporation was done as per criteria of Irwin et al. 2001. Results: In our series, two cases were in stage I. A total of 11 cases were in stage II and 27 were in stage III. Graft incorporation was radiologically complete by 15 months. Clinical recovery was observed before radiological healing. The average time taken to return to preoperative function was 3 months. Recurrence was observed in giant cell tumor (n = 3) and chondromyxoid fibroma (n = 1). There was no incidence of graft rejection, collapse, growth plate disturbances or antigenic response. Conclusions: We conclude that calcium HA is biologically acceptable bone graft substitute in the management of benign lytic lesions of bone. PMID:26806973

  18. Chevron bone graft procedure for the correction of brachymetatarsia.

    PubMed

    Alter, S A; Feinman, B; Rosen, R G

    1995-01-01

    Brachymetatarsia is a relatively rare condition, although there are many surgical procedures to correct the condition. The authors present a case study with a 2-year follow-up period demonstrating the successful surgical treatment of a 4th metatarsal brachymetatarsia of the left foot of a 14-year-old female. The operative technique and literature review are discussed. This technique combines the idea of bone grafting with a specific graft shape and donor site to facilitate graft stability and graft healing. PMID:7599619

  19. Effect of Vacuum-Assisted Closure Combined with Open Bone Grafting to Promote Rabbit Bone Graft Vascularization

    PubMed Central

    Hu, Chao; Zhang, Taogen; Ren, Bin; Deng, Zhouming; Cai, Lin; Lei, Jun; Ping, Ansong

    2015-01-01

    Background Patients with composite bone non-union and soft tissue defects are difficult to treat. Vacuum-assisted closure (VAC) combined with open bone grafting is one of the most effective treatments at present. The aim of the present study was to preliminarily investigate the effect and mechanism of VAC combined with open bone grafting to promote rabbit bone graft vascularization, and to propose a theoretical basis for clinical work. Material/Methods Twenty-four New Zealand white rabbits were randomly divided into an experimental and a control group. Allogeneic bones were grafted and banded with the proximal femur with a suture. The experimental group had VAC whereas the control group had normal wound closure. The bone vascularization rate was compared based on X-ray imaging, fluorescent bone labeling (labeled tetracycline hydrochloride and calcein), calcium content in the callus, and expression of fibroblast growth factor-2 (FGF-2) in bone allografts by Western blot analysis at the 4th, 8th, and 12th week after surgery. Results At the 4th, 8th, and 12th week after surgery, the results of the tests demonstrated that the callus was larger, contained more calcium (p<0.05), and expressed FGF-2 at higher levels (p<0.05) in the experimental group than in the control group. Fluorescent bone labeling showed the distance between the two fluorescent ribbons was significantly shorter in the control group than in the experimental group at the 8th and 12th week after surgery. Conclusions VAC combined with open bone grafting promoted rabbit bone graft vascularization. PMID:25913359

  20. The Palatal Bone Block Graft for Onlay Grafting Combined with Maxillary Implant Placement: A Case Series.

    PubMed

    Gluckman, Howard; Du Toit, Jonathan; Salama, Maurice

    2016-01-01

    The aim of this study was to introduce an intraoral bone block harvesting technique--the palatal bone block graft (PBBG)--as an alternative harvest site for autogenous bone blocks. The PBBG technique was used to onlay graft esthetic zone defects simultaneous to implant placement in five patients. Measurable objectives were used to evaluate outcomes, and treatment was reassessed at up to 6 years. Defects of the maxilla were successfully grafted with PBBG in all five cases, and tissues remained stable at 1- and 6-year follow-ups. Harvesting an autogenous bone block from the palate is an advantageous, predictable, and reproducible method for augmenting buccofacial defects at implant placement, and may be considered as an alternative to conventional intraoral bone block donor sites when treating the maxilla.

  1. Reproducibility of techniques using Archimedes' principle in measuring cancellous bone volume.

    PubMed

    Zou, L; Bloebaum, R D; Bachus, K N

    1997-01-01

    Researchers have been interested in developing techniques to accurately and reproducibly measure the volume fraction of cancellous bone. Historically bone researchers have used Archimedes' principle with water to measure the volume fraction of cancellous bone. Preliminary results in our lab suggested that the calibrated water technique did not provide reproducible results. Because of this difficulty, it was decided to compare the conventional water method to a water with surfactant and a helium method using a micropycnometer. The water/surfactant and the helium methods were attempts to improve the fluid penetration into the small voids present in the cancellous bone structure. In order to compare the reproducibility of the new methods with the conventional water method, 16 cancellous bone specimens were obtained from femoral condyles of human and greyhound dog femora. The volume fraction measurements on each specimen were repeated three times with all three techniques. The results showed that the helium displacement method was more than an order of magnitudes more reproducible than the two other water methods (p < 0.05). Statistical analysis also showed that the conventional water method produced the lowest reproducibility (p < 0.05). The data from this study indicate that the helium displacement technique is a very useful, rapid and reproducible tool for quantitatively characterizing anisotropic porous tissue structures such as cancellous bone.

  2. Reproducibility of techniques using Archimedes' principle in measuring cancellous bone volume.

    PubMed

    Zou, L; Bloebaum, R D; Bachus, K N

    1997-01-01

    Researchers have been interested in developing techniques to accurately and reproducibly measure the volume fraction of cancellous bone. Historically bone researchers have used Archimedes' principle with water to measure the volume fraction of cancellous bone. Preliminary results in our lab suggested that the calibrated water technique did not provide reproducible results. Because of this difficulty, it was decided to compare the conventional water method to a water with surfactant and a helium method using a micropycnometer. The water/surfactant and the helium methods were attempts to improve the fluid penetration into the small voids present in the cancellous bone structure. In order to compare the reproducibility of the new methods with the conventional water method, 16 cancellous bone specimens were obtained from femoral condyles of human and greyhound dog femora. The volume fraction measurements on each specimen were repeated three times with all three techniques. The results showed that the helium displacement method was more than an order of magnitudes more reproducible than the two other water methods (p < 0.05). Statistical analysis also showed that the conventional water method produced the lowest reproducibility (p < 0.05). The data from this study indicate that the helium displacement technique is a very useful, rapid and reproducible tool for quantitatively characterizing anisotropic porous tissue structures such as cancellous bone. PMID:9140874

  3. Design of functionally graded dental implant in the presence of cancellous bone.

    PubMed

    Hedia, H S

    2005-10-01

    In a previous work by the author [Hedia HS, Mahmoud NA. Biomed Mater Eng 2004;14(2):133--143], a functionally graded material (FGM) dental implant was designed without cancellous bone in the model. In this investigation, the effect of the presence of cancellous bone as a thin layer around the dental implant was investigated. It is well known that the main inorganic component of natural bone is hydroxyapatite (HAP) and that the main organic component is collagen (Col). HAP implants are not bioabsorbable, and because induction of bone into and around the artificially made HAP is not always satisfactory, loosening or breakage of HAP implants might occur after implantation in the clinical application. The development of a new material that is bioabsorbable and that has osteo-conductive activity is needed. Therefore, the aim of the current investigation was to design an implant, in the presence of cancellous bone as a thin layer around it, from FGM. In this study, a novel biomaterial, Col/HAP, as a FGM, was developed using the finite element and optimization techniques that are available in the ANSYS package. These materials have a self-organized character similar to that of natural bone. The investigations have shown that the maximum stress in the cortical bone and cancellous bone for the Col/HAP functionally graded implant has been reduced by about 40% and 19%, respectively, compared with currently used titanium dental implants.

  4. Pharmacokinetics of cefuroxime in porcine cortical and cancellous bone determined by microdialysis.

    PubMed

    Tøttrup, Mikkel; Hardlei, Tore Forsingdal; Bendtsen, Michael; Bue, Mats; Brock, Birgitte; Fuursted, Kurt; Søballe, Kjeld; Birke-Sørensen, Hanne

    2014-06-01

    Traditionally, the pharmacokinetics of antimicrobials in bone have been investigated using bone biopsy specimens, but this approach suffers from considerable methodological limitations. Consequently, new methods are needed. The objectives of this study were to assess the feasibility of microdialysis (MD) for measuring cefuroxime in bone and to obtain pharmacokinetic profiles for the same drug in porcine cortical and cancellous bone. The measurements were conducted in bone wax sealed and unsealed drill holes in cortical bone and in drill holes in cancellous bone and in subcutaneous tissue. As a reference, the free and total plasma concentrations were also measured. The animals received a bolus of 1,500 mg cefuroxime over 30 min. No significant differences were found between the key pharmacokinetic parameters for sealed and unsealed drill holes in cortical bone. The mean ± standard error of the mean area under the concentration-time curve (AUC) values from 0 to 5 h were 6,013 ± 1,339, 3,222 ± 1086, 2,232 ± 635, and 952 ± 290 min · μg/ml for free plasma, subcutaneous tissue, cancellous bone, and cortical bone, respectively (P < 0.01, analysis of variance). The AUC for cortical bone was also significantly different from that for cancellous bone (P = 0.04). This heterogeneous tissue distribution was also reflected in other key pharmacokinetic parameters. This study validates MD as a suitable method for measuring cefuroxime in bone. Cefuroxime penetration was impaired for all tissues, and bone may not be considered one distinct compartment.

  5. Bone grafting for reconstructive osteotomies of the foot.

    PubMed

    Alter, S A; Licovski, L

    1996-01-01

    This article presents a literature review of the use of bone grafts in reconstructive osteotomies of the foot. Applications of this techniques, specifically for the calcaneus, cuneiforms, and metatarsal bones, are discussed. Surgical treatment of various conditions such as pes valgus, metatarsus adductus, hallux abducto valgus, and brachymetatarsia are highlighted. PMID:8915865

  6. Greater Bone Formation Induction Occurred in Aged than Young Cancellous Bone Sites

    NASA Technical Reports Server (NTRS)

    Ke, H. Z.; Jee, W. S. S.; Ito, H.; Setterberg, R. B.; Li, M.; Lin, B. Y.; Liang, X. G.; Ma, Y. F.

    1993-01-01

    We have determined the differences in the effects of continual prostaglandin E(sub 2) (PGE(sub 2) treatment in aged (non-growing) and young (growing) cancellous bone sites in 7-month-old Sprague-Dawley rats. The sites involved are the aged distal tibial metaphysis (DTM) with a closed epiphysis and the young proximal tibial metaphysis (PTM) with a slow growing, open epiphysis. The study involved rats treated with 0, 1, 3 or 6 mg PGE(sub 2)/kg/d for 60, 120 and 180 days. Static and dynamic histomorphometry of percent trabecular area, and tissue-referent bone formation rate (BFR/TV) were determined in both DTM and PTM. In pretreatment controls, the secondary spongiosa of the two metaphyses contain the same amount of cancellous bone (11% in DTM vs. 13% in PTM), but markedly less bone formation in DTM (0.6%/y in DTM vs. 41.5%/y in PTM). After 60 days of 6 mg PGE(sub 2)/kg/d treatment, %Tb.Ar was increased 607% in DTM and 199% in PTM, BFR/TV was increased to nearly 14 fold in DTM and only 5 fold in PTM. These results indicated the aged metaphysis of the DTM was much more responsive to PGE(sub 2) treatment than young, growing metaphysis of the PTM. The results of 120 and 180 days treatment did not significantly differ from 60 days treatment in both sites, indicating that the effect of continuous daily PGE2 treatment were in equilibrium after 60 days. We concluded that aged metaphysis was much more responsive to PGE(sub 2) treatment than young growing metaphysis.

  7. Greater Bone Fomation Induction Occurred in Aged Than Young Cancellous Bone Sites

    NASA Technical Reports Server (NTRS)

    Ke, H. Z.; Jee, Webster S. S.; Ito, H.; Setterberg, R. B.; Li, M.; Lin, B. Y.; Liang, X. G.; Ma, Y.F.

    1993-01-01

    We have determined the differences in the effects of continual prostaglandin E2 (PGE2) treatment in aged (non-growing) and young (growing) cancellous bone sites in 7 month-old Sprague-Dawley rats. The sites involved are the aged Distal Tibial Metaphysis (DTM) with a closed epiphysis and the young Proximal Tibial Metaphysis (PTM) with a slow growing, open epiphysis. The study involved rats treated with 0, 1, 3 or 6 mg PGE2/kg/d for 60, 120 and 180 days. Static and dynamic histomorphometty of percent trabecular area, and tissue-referent bone formation rate (BFR/TV) were determined in both DTM and PTM. In pretreatment controls, the secondary spongiosa of the two metaphyses contain the same amount of cancellous bone (11% in DTM vs. 13% in PTM), but markedly less bone formation in DTM (0.6%/y in DTM vs. 41.5%/y in PTM). After 60 days of 6 mg PGE2/kg/d treatment, %Tb.Ar was increased 607% in DTM and 199% in PTM, BFR/TV was increased to nearly 14 fold in DTM and only 5 fold in PTM. These results indicated the aged metaphysis of the DTM was much more responsive to PGE2 treatment than young, growing metaphysis of the PTM. The results of 120 and 180 days treatment did not significantly differ from 60 days treatment in both sites, indicating that the effect of continuous daily PGE2 treatment were in equilibrium after 60 days. We concluded that aged metaphysis was much more responsive to PGE2 treatment than young growing metaphysis.

  8. Tissue-engineered autologous grafts for facial bone reconstruction.

    PubMed

    Bhumiratana, Sarindr; Bernhard, Jonathan C; Alfi, David M; Yeager, Keith; Eton, Ryan E; Bova, Jonathan; Shah, Forum; Gimble, Jeffrey M; Lopez, Mandi J; Eisig, Sidney B; Vunjak-Novakovic, Gordana

    2016-06-15

    Facial deformities require precise reconstruction of the appearance and function of the original tissue. The current standard of care-the use of bone harvested from another region in the body-has major limitations, including pain and comorbidities associated with surgery. We have engineered one of the most geometrically complex facial bones by using autologous stromal/stem cells, native bovine bone matrix, and a perfusion bioreactor for the growth and transport of living grafts, without bone morphogenetic proteins. The ramus-condyle unit, the most eminent load-bearing bone in the skull, was reconstructed using an image-guided personalized approach in skeletally mature Yucatán minipigs (human-scale preclinical model). We used clinically approved decellularized bovine trabecular bone as a scaffolding material and crafted it into an anatomically correct shape using image-guided micromilling to fit the defect. Autologous adipose-derived stromal/stem cells were seeded into the scaffold and cultured in perfusion for 3 weeks in a specialized bioreactor to form immature bone tissue. Six months after implantation, the engineered grafts maintained their anatomical structure, integrated with native tissues, and generated greater volume of new bone and greater vascular infiltration than either nonseeded anatomical scaffolds or untreated defects. This translational study demonstrates feasibility of facial bone reconstruction using autologous, anatomically shaped, living grafts formed in vitro, and presents a platform for personalized bone tissue engineering.

  9. Tissue-Engineered Autologous Grafts for Facial Bone Reconstruction

    PubMed Central

    Bhumiratana, Sarindr; Bernhard, Jonathan C.; Alfi, David M.; Yeager, Keith; Eton, Ryan E.; Bova, Jonathan; Shah, Forum; Gimble, Jeffrey M.; Lopez, Mandi J.; Eisig, Sidney B.; Vunjak-Novakovic, Gordana

    2016-01-01

    Facial deformities require precise reconstruction of the appearance and function of the original tissue. The current standard of care—the use of bone harvested from another region in the body—has major limitations, including pain and comorbidities associated with surgery. We have engineered one of the most geometrically complex facial bones by using autologous stromal/stem cells, without bone morphogenic proteins, using native bovine bone matrix and a perfusion bioreactor for the growth and transport of living grafts. The ramus-condyle unit (RCU), the most eminent load-bearing bone in the skull, was reconstructed using an image-guided personalized approach in skeletally mature Yucatan minipigs (human-scale preclinical model). We used clinically approved decellularized bovine trabecular bone as a scaffolding material, and crafted it into an anatomically correct shape using image-guided micromilling, to fit the defect. Autologous adipose-derived stromal/stem cells were seeded into the scaffold and cultured in perfusion for 3 weeks in a specialized bioreactor to form immature bone tissue. Six months after implantation, the engineered grafts maintained their anatomical structure, integrated with native tissues, and generated greater volume of new bone and greater vascular infiltration than either non-seeded anatomical scaffolds or untreated defects. This translational study demonstrates feasibility of facial bone reconstruction using autologous, anatomically shaped, living grafts formed in vitro, and presents a platform for personalized bone tissue engineering. PMID:27306665

  10. Rib Bone Graft Adjusted to Fit the Facial Asymmetry: A Frame Structure Graft.

    PubMed

    Lee, Yoon Ho; Choi, Jong Hwan; Hwang, Kun; Choi, Jun Ho

    2015-10-01

    The authors introduce the concept of a "frame structure graft" in which a harvested rib bone was adjusted to fit facial asymmetry. On the costochondral junction of the sixth or seventh rib, a 5 cm incision was made. Through a subperiosteal dissection, the rib bone was harvested. Using a reciprocating saw, the harvested rib was scored on its anterior surface as well as its posterior surface with a partial depth at different intervals. The harvested rib bone was placed on the skin surface of the unaffected side of the face and a curvature was created exactly matching that of the unaffected side by bending the bone using a greenstick fracture. Thereafter, the graft was adjusted to conceal the asymmetry of the deficient side. The adjusted "frame structure" was transferred to the defect through the incisions on the affected side, and the "frame structure" graft was placed on the mandible or zygoma. The graft fixation was done externally with at least 2 Kirschner wires (K-wires). From January 2005 to August 2013, a total of 30 patients (13 men, 17 women, mean age 25.6 years) received a frame structure graft. All 30 patients achieved good healing at the operation site without complications. Donor-site morbidity as pneumothorax from the rib bone harvest was not found. Merits of this frame structure graft, the authors think, are that this method could allow a similar curvature to the normal side. In addition, the procedure itself is easy. PMID:26468802

  11. Specimen size effect in the volumetric shrinkage of cancellous bone measured at two levels of dehydration.

    PubMed

    Lievers, W Brent; Lee, Victoria; Arsenault, Simon M; Waldman, Stephen D; Pilkey, A Keith

    2007-01-01

    Water is commonly removed from bone to study its effect on mechanical behaviour; however, dehydration also alters the bone structure. To make matters worse, measuring structural changes in cancellous bone is complicated by a number of factors. Therefore, the goals of this study were to address these issues by (1) comparing Archimedes' method and a helium pycnometer as methods for measuring cancellous bone volume; (2) measuring the apparent dimensional and volumetric tissue shrinkage of cancellous bone at two levels of dehydration; and, (3) identifying whether a size effect exists in cancellous bone shrinkage. Cylindrical specimens (3, 5 and 8.3 mm diameters) of cancellous bone were taken from the distal bovine femur. The apparent dimensions of each cylindrical specimen were measured in a fully hydrated state (HYD), after drying at room temperature (AIR), and after oven drying at 105 degrees C (OVEN). Tissue volume measurements for those three hydration states were obtained using both a helium pycnometer and Archimedes' method. Aluminium foams, which mimic the cancellous structure, were used as controls. The results suggest that the helium pycnometer and Archimedes' method yield identical results in the HYD and AIR states, but that Archimedes' method under-predicts the nominal OVEN volume by incorporating the collagen-apatite porosity. A distinct size effect on volumetric shrinkage is observed (p<0.025) using the pycnometer in both AIR and OVEN states. Apparent dimensional shrinkage (2% and 7%) at the two dehydration levels is much smaller than the measured volumetric tissue shrinkage (16% and 29%), which results in a reduced dehydrated bone volume fraction.

  12. Bone grafting: history, rationale, and selection of materials and techniques.

    PubMed

    Horowitz, Robert A; Leventis, Minas D; Rohrer, Michael D; Prasad, Hari S

    2014-01-01

    In the 100-year history of bone replacement in the human body for different purposes, a wide variety of surgical approaches and materials have been used. The techniques and materials selected significantly affect the outcome of bone replacement procedures in terms of bone formation volume and the quality and amount of vital bone. The choices facing the dental surgeon at the time of extraction, ridge augmentation, or sinus graft are wide-ranging. When choosing a bone graft material the surgeon should consider its ultimate effect on healing patterns in and around the alveolar bone at the endpoint of the procedure. As this article concludes, a better understanding of the materials and the results that can be predictably achieved with them can be valuable to the appropriately trained surgeon when preparing for these procedures. PMID:25455148

  13. Zirconia toughened alumina ceramic foams for potential bone graft applications: fabrication, bioactivation, and cellular responses.

    PubMed

    He, X; Zhang, Y Z; Mansell, J P; Su, B

    2008-07-01

    Zirconia toughened alumina (ZTA) has been regarded as the next generation orthopedic graft material due to its excellent mechanical properties and biocompatibility. Porous ZTA ceramics with good interconnectivity can potentially be used as bone grafts for load-bearing applications. In this work, three-dimensional (3D) interconnected porous ZTA ceramics were fabricated using a direct foaming method with egg white protein as binder and foaming agent. The results showed that the porous ZTA ceramics possessed a bimodal pore size distribution. Their mechanical properties were comparable to those of cancellous bone. Due to the bio-inertness of alumina and zirconia ceramics, surface bioactivation of the ZTA foams was carried out in order to improve their bioactivity. A simple NaOH soaking method was employed to change the surface chemistry of ZTA through hydroxylation. Treated samples were tested by conducting osteoblast-like cell culture in vitro. Improvement on cells response was observed and the strength of porous ZTA has not been deteriorated after the NaOH treatment. The porous 'bioactivated' ZTA ceramics produced here could be potentially used as non-degradable bone grafts for load-bearing applications. PMID:18305904

  14. Estrogen modulates the mRNA levels for cancellous bone protein of ovariectomized rats.

    PubMed

    Salih, M A; Liu, C C; Arjmandi, B H; Kalu, D N

    1993-12-01

    This study was undertaken to examine the effects of ovariectomy and 17 beta-estradiol (E2) on the gene expression of type 1 collagen, osteocalcin and the protooncogen, c-myc, in cancellous bone. Female Sprague-Dawley rats, aged 95 days, were divided into 4 groups. Group 1 was sham operated and Groups 2-4 were ovariectomized. Groups 3 and 4 received daily injections of 160 ng and 1600 ng E2/kg body weight, respectively. Groups 1 and 2 received the solvent vehicle. All animals were sacrificed after 14 days. The femurs were dissected out and cancellous bone scraped from the distal metaphysis. RNA was isolated from the cancellous bone, immobilized on filters or size-fractionated by agarose gel electrophoresis and adsorbed on filters which were then hybridized with specific cDNA probes. Ovariectomy resulted in a significant increase in the mRNAs of type 1 collagen, osteocalcin and c-myc. The increase was suppressed in animals that received 17 beta-estradiol injections. In addition, ovariectomy caused the expected decrease in cancellous bone in the proximal tibia and increased osteoclast and osteoblast numbers. The ovariectomy-induced changes were prevented by 17 beta-estradiol administration. These findings suggest that the lack of ovarian hormones shortly after ovariectomy up-regulates and estrogen administration down-regulates the expression of important cancellous bone matrix proteins as well as the protooncogen, c-myc.

  15. Prostaglandin E2 Adds Bone to a Cancellous Bone Site with a Closed Growth Plate and Low Bone Turnover in Ovariectomized Rats

    NASA Technical Reports Server (NTRS)

    Ma, Y. F.; Ke, H. Z.; Jee, W. S. S.

    1994-01-01

    The objects of this study were to determine the responses of a cancellous bone site with a closed growth plate (the distal tibial metaphysis, DTM) to ovariectomy (OVX) and OVX plus a prostaglandin E2 (PGE2) treatment, and compare the site's response to previous findings reported for another site (the proximal tibial metaphysis, PTM). Thirty-five 3-month old female Sprague-Dawley rats were divided into five groups: basal, sham-OVX, and OVX+0, +1, or +6 mg PGE2/kg/d injected subcutaneously for 3 months and given double fluorescent labels before sacrifice. Cancellous bone histomorphometric analyses were performed on 20-micron-thick undecalcified DTM sections. Similar to the PTM, the DTM showed age-related decreases in bone formation and increases in bone resorption, but it differed in that at 3 months post-OVX; there was neither bone loss nor changes in formation endpoints. Giving 1 mg PGE2/kg/d to OVX rats prevented most age-related changes and maintained the bone formation histomorphometry near basal levels. Treating OVX rats with 6 mg PGE2/kg/d prevented age-related bone changes, added extra bone, and improved microanatomical structure by stimulating bone formation without altering bone resorption. Furthermore, after PGE2 administration, the DTM, a cancellous bone site with a closed growth plate, inereased bone formation more than did the cancellous bone in the PTM.

  16. Prostaglandin E2 Adds Bone to a Cancellous Bone Site with a Closed Growth Plate and Low Bone Turnover in Ovariectomized Rats

    NASA Technical Reports Server (NTRS)

    Ma, Y. F.; Ke, H. Z.; Jee, W. S. S.

    1994-01-01

    The objects of this study were to determine the responses of a cancellous bone site with a closed growth plate, (the distal tibial metaphysis (DTM), to ovariectomy (OVX) and OVX plus a prostaglandin E(2) treatment, and compare the site's response to previous findings reported for another site, the proximal tibial metaphysis (PTM). Thirty five 3-month old female Sprague-Dawley rats were divided into five groups; basal, sham OVX, and OVX+0, +1, or +6 mg PGE(2)/kg/d injected subcutaneously for 3 months and given double fluorescent labels before sacrifice. Cancellous bone histomorphometric analyses were performed on 20 micrometer thick undecalcified DTM sections. Similar to the PTM, the DTM showed age-related decreases in bone formation and increases in bone resorption, but it differed in that at 3 months POST OVX there was neither bone loss nor changes in formation endpoints. Giving 1 mg PGE(2)/kg/d to OVX rats prevented most age-related changes and maintained the bone formation histomorphometry near basal levels. Treating OVX rats with 6 mg PGE(2)/kd/d prevented age-related bone changes, added extra bone, and improved microanatomical structure by stimulating bone formation, without altering bone resportion. Futhermore, After PGE(2) admimnistration, the DTM, a cancellous bone site with a closed growth plate, increased bone formation more than did the cancellous bone in the PTM.

  17. Anabolic Responses of an Adult Cancellous Bone Site to Prostaglandin E2 in the Rat

    NASA Technical Reports Server (NTRS)

    Ito, Hiroshi; Ke, Hua Zhu; Jee, Webster S. S.; Sakou, Takashi

    1993-01-01

    The objects of this study were to determine: (1) the response of a non-growing cancellous bone site to daily prostaglandin E2 (PGE2) administration; and (2) the differences in the effects of daily PGE2, administration in growing (proximal tibial metaphysis, PTM) and non-growing cancellous bone sites (distal tibial metaphysis, DTM). Seven-month-old male Sprague-Dawley rats were given daily subcutaneous injections of 0, 1, 3 and 6 mg PGE2/kg per day for 60, 120 and 180 days. The static and dynamic histomorphometric analyses were performed on double-fluorescent labeled undecalcified distal tibial metaphyses (DTM). No age-related changes were found in static and dynamic histomorphometry of DTM cancellous bone between 7 and 13 months of age. The DTM of 7-month-old (basal controls) rats consisted of a 24.5 +/- 7.61%-metaphyseal cancellous bone mass, and a thick trabeculae (92 +/- 12 micro-m). It also had a very low tissue-base bone formation rate (3.0 +/- 7.31%/year). Exogenous PGE2 administration produced the following transient changes in a dose-response manner between zero and 60 days: (1) increased trabecular bone mass and improved architecture (increased trabecular bone area, width and number, and decreased trabecular separation); (2) increased trabecular interconnections: (3) increased bone formation parameters; and (4) decreased eroded perimeter. A new steady state with more cancellous bone mass and higher bone turnover was observed from day 60 onward, The elevated bone mass induced by the first 60 days of PGE2 treatment was maintained by another 60 and 120 days with continuous daily PGE2 treatment. When these findings were compared to those previously reported for the PTM, we found that the DTM was much more responsive to PGE2 treatment than the PTM. Percent trabecular bone area and tissue based bone formation rate increased significantly more in DTM as compared to PTM after the 60 days of 6 mg PGE2 treatment. These observations indicate that a non

  18. Carbon nanotube-based bioceramic grafts for electrotherapy of bone.

    PubMed

    Mata, D; Horovistiz, A L; Branco, I; Ferro, M; Ferreira, N M; Belmonte, M; Lopes, M A; Silva, R F; Oliveira, F J

    2014-01-01

    Bone complexity demands the engineering of new scaffolding solutions for its reconstructive surgery. Emerging bone grafts should offer not only mechanical support but also functional properties to explore innovative bone therapies. Following this, ceramic bone grafts of Glass/hydroxyapatite (HA) reinforced with conductive carbon nanotubes (CNTs) - CNT/Glass/HA - were prepared for bone electrotherapy purposes. Computer-aided 3D microstructural reconstructions and TEM analysis of CNT/Glass/HA composites provided details on the CNT 3D network and further correlation to their functional properties. CNTs are arranged as sub-micrometric sized ropes bridging homogenously distributed ellipsoid-shaped agglomerates. This arrangement yielded composites with a percolation threshold of pc=1.5vol.%. At 4.4vol.% of CNTs, thermal and electrical conductivities of 1.5W·m(-1)·K(-1) and 55S·m(-1), respectively, were obtained, matching relevant requisites in electrical stimulation protocols. While the former avoids bone damaging from Joule's heat generation, the latter might allow the confinement of external electrical fields through the conductive material if used for in vivo electrical stimulation. Moreover, the electrically conductive bone grafts have better mechanical properties than those of the natural cortical bone. Overall, these highly conductive materials with controlled size CNT agglomerates might accelerate bone bonding and maximize the delivery of electrical stimulation during electrotherapy practices.

  19. Cortical and cancellous bone in the human femoral neck: evaluation of an interactive image analysis system.

    PubMed

    Bell, K L; Garrahan, N; Kneissel, M; Loveridge, N; Grau, E; Stanton, M; Reeve, J

    1996-11-01

    An interactive image analysis package was developed to examine whole cross-sections from the femoral neck. The package quantifies cortical width (Ct.Wi), cortical porosity (Ct.Po), and proportions of cortical, cancellous bone as a percentage of bone plus marrow area. Segmental analysis was used to quantify circumferential variations in bone distribution within the femoral cross-section. To evaluate reproducibility of data four independent operators analyzed previously prepared femoral neck sections from a 2000 BC population. Differences in total and circumferential distributions of cortical and cancellous bone with respect to gender and age of samples were demonstrated. Reproducibility was assessed using coefficients of variation (CV). Analysis of sections using a variable magnification, giving largest possible image size, rather than a set magnification reduced variation between operators for all measurements. Use of a calculated threshold significantly decreased variation between operators for the proportions of cortical and cancellous bone (p < or = 0.026). Dividing the image into 8 rather than 16 segments also improved reproducibility. There was little agreement between operators in the determination of cortical porosity. The mean CV for the other quantitative indices such as cortical width and proportions of cortical and cancellous bone ranged from 4.87% to 13.52%. The genders showed similar patterns in circumferential distribution of bone. Cortical width was significantly greater in the inferior region compared to the other areas, whereas percent cortical bone was lowest at the superior region. The center of mass (COM) for the younger age group was located anteriorly, whereas in the older samples the COM was located posteriorly of the center of area (p = 0.041). Basic data relating to cortical and cancellous bone of acceptable reproducibility in comparison with current standards in iliac histomorphometry can now be provided at modest cost in operator time and

  20. Bone graft complications: what can we do to prevent them?

    NASA Astrophysics Data System (ADS)

    Tandon, Rahul; Herford, Alan S.

    2014-03-01

    Introduction: Bone grafts are commonly used in oral and maxillofacial surgery, helping to restore missing bone structure and provide osseous support. In spite of their reported success, complications can and do arise. Examples include loosening and resorption of the graft, infection, and complete loss of the graft. These complications can potentially lead to larger defects, necessitating additional procedures to correct the problem. This not only causes great discomfort to the patient, but also drains considerable time and resources away from the clinician. Thus, improvements on identifying ways to identify and prevent these complications are constantly being sought. We have performed a literature review and identified several areas in the field of optics that could potentially help solve our problem. Optical Techniques: Raman spectroscopy has been shown to provide a transcutaneous measurement of bone mineral and matrix Raman bands. This could potentially provide surgeons with the ability to more accurately assess bone graft osseointegration. In-vivo near-infrared optical imaging could potentially provide accurate diagnosis of pathologic lesions such as osteosarcoma. Contrast-enhanced ultrasound could be used to detect vascular disturbances and other information related to the transplantation of osseous components. Conclusion: Bone graft complications can be one of the most devastating consequences of osseous surgery. As surgeons, we are constantly searching for ways to identify them earlier and prevent them. We hope that by presenting areas that could be used, we can gain a better insight to ways in which both fields can benefit.

  1. Arthroscopic Bone Graft Procedure for Anterior Inferior Glenohumeral Instability

    PubMed Central

    Taverna, Ettore; D'Ambrosi, Riccardo; Perfetti, Carlo; Garavaglia, Guido

    2014-01-01

    There are many described surgical techniques for the treatment of recurrent anterior shoulder instability. Numerous authors have performed anterior bone block procedures with good results for the treatment of anterior shoulder instability with glenoid bone loss. The benefits of using arthroscopic procedures for surgical stabilization of the shoulder include smaller incisions with less soft-tissue dissection, better visualization of the joint, better repair accessibility, and the best possible outcome for external rotation. We describe an arthroscopic anteroinferior shoulder stabilization technique with an iliac crest tricortical bone graft and capsulolabral reconstruction. It is an all-arthroscopic technique with the advantage of not using fixation devices, such as screws, but instead using special buttons to fix the bone graft. The steps of the operation are as follows: precise placement of a specific posterior glenoid guide that allows the accurate positioning of the bone graft on the anterior glenoid neck; fixation of the graft flush with the anterior glenoid rim using specific buttons under arthroscopic control; and finally, subsequent capsular, labral, and ligament reconstruction on the glenoid rim using suture anchors and leaving the graft as an extra-articular structure. PMID:25685669

  2. Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting

    PubMed Central

    Baksi, D D; Pal, A K; Baksi, D P

    2016-01-01

    Background: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8–30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN) of femoral head. Moreover, in presence of AVN of femoral head neither free fibular graft nor cancellous bone graft is satisfactory. The vascularied bone grafting by deep circumflex iliac artery based on iliac crest bone grafting, free vascularied fibular grafting and muscle pedicle periosteal grafting showed high incidence of success rate. Osteosynthesis is the preferred treatment of choice in ununited femoral neck fracture in younger individuals. Materials and Methods: Of the 293 patients operated during the period from June 1977 to June 2009, 42 were lost to followup. Seven patients with gluteus medius muscle pedicle bone grafting (MPBG) were excluded. Thus, out of 244 patients, 208 (85.3%) untreated nonunion and 36 (14.7%) following failure of primary internal fixation were available for studies. Time interval between the date of injury and operation in untreated nonunion cases was mean 6.5 months and in failed internal fixation cases was mean 11.2 months. Ages of the patients varied from 16 to 55 years. Seventy patients had partial and 174 had subtotal absorption of the femoral neck. Evidence of avascular necrosis (AVN) femoral head was found histologically in 135 (54.3%) and radiologically in 48 (19.7%) patients. The patients were operated by open reduction of fracture, cannulated hip

  3. Ultrasonic characterization of human cancellous bone using the Biot theory: inverse problem.

    PubMed

    Sebaa, N; Fellah, Z E A; Fellah, M; Ogam, E; Wirgin, A; Mitri, F G; Depollier, C; Lauriks, W

    2006-10-01

    This paper concerns the ultrasonic characterization of human cancellous bone samples by solving the inverse problem using experimental transmitted signals. The ultrasonic propagation in cancellous bone is modeled using the Biot theory modified by the Johnson et al. model for viscous exchange between fluid and structure. The sensitivity of the Young modulus and the Poisson ratio of the skeletal frame is studied showing their effect on the fast and slow wave forms. The inverse problem is solved numerically by the least squares method. Five parameters are inverted: the porosity, tortuosity, viscous characteristic length, Young modulus, and Poisson ratio of the skeletal frame. The minimization of the discrepancy between experiment and theory is made in the time domain. The inverse problem is shown to be well posed, and its solution to be unique. Experimental results for slow and fast waves transmitted through human cancellous bone samples are given and compared with theoretical predictions.

  4. The non-linear relationship between BUA and porosity in cancellous bone

    NASA Astrophysics Data System (ADS)

    Hodgskinson, R.; Njeh, C. F.; Whitehead, M. A.; Langton, C. M.

    1996-11-01

    There is growing interest in assessing the clinical value of ultrasound in the prediction and management of osteoporosis. However, the mechanism of ultrasound propagation in cancellous bone is not well understood. The Biot theory is one approach to modelling the interaction of sound waves with cancellous structure, and porosity is one of its input parameters. In this paper we report the relationship between broadband ultrasonic attenuation (BUA) corrected for specimen thickness (nBUA) and porosity in a porous Perspex cancellous bone mimic, a stereolithography cancellous bone mimic and in natural human and bovine tissue. nBUA and porosity have a non-linear parabolic relationship. The maximum nBUA value occurs at approximately 30% porosity in the Perspex mimic, approximately 70% in the stereolithography mimic and approximately 75% in natural cancellous bone. We discuss the effect of structure on the form of the nBUA - porosity relationship.

  5. Empirical angle-dependent Biot and MBA models for acoustic anisotropy in cancellous bone.

    PubMed

    Lee, Kang Il; Hughes, E R; Humphrey, V F; Leighton, T G; Choi, Min Joo

    2007-01-01

    The Biot and the modified Biot-Attenborough (MBA) models have been found useful to understand ultrasonic wave propagation in cancellous bone. However, neither of the models, as previously applied to cancellous bone, allows for the angular dependence of acoustic properties with direction. The present study aims to account for the acoustic anisotropy in cancellous bone, by introducing empirical angle-dependent input parameters, as defined for a highly oriented structure, into the Biot and the MBA models. The anisotropy of the angle-dependent Biot model is attributed to the variation in the elastic moduli of the skeletal frame with respect to the trabecular alignment. The angle-dependent MBA model employs a simple empirical way of using the parametric fit for the fast and the slow wave speeds. The angle-dependent models were used to predict both the fast and slow wave velocities as a function of propagation angle with respect to the trabecular alignment of cancellous bone. The predictions were compared with those of the Schoenberg model for anisotropy in cancellous bone and in vitro experimental measurements from the literature. The angle-dependent models successfully predicted the angular dependence of phase velocity of the fast wave with direction. The root-mean-square errors of the measured versus predicted fast wave velocities were 79.2 m s(-1) (angle-dependent Biot model) and 36.1 m s(-1) (angle-dependent MBA model). They also predicted the fact that the slow wave is nearly independent of propagation angle for angles about 50 degrees , but consistently underestimated the slow wave velocity with the root-mean-square errors of 187.2 m s(-1) (angle-dependent Biot model) and 240.8 m s(-1) (angle-dependent MBA model). The study indicates that the angle-dependent models reasonably replicate the acoustic anisotropy in cancellous bone.

  6. Bone grafting in the surgical management of osseous neoplasms.

    PubMed

    Leonheart, E E; Mendicino, R W

    1996-01-01

    The diagnosis and treatment of osseous neoplasms are challenges for the foot and ankle surgeon. Osseous neoplasms are potentially debilitating, thus appropriate diagnosis and management are critical to success. Resection of these lesions can result in large osseous deficits, requiring bone grafting for replacement. The graft may provide osteogenesis, structural support, or both. This article presents possible surgical therapeutic alternatives in management of benign and low-grade malignant osseous neoplasms in the foot and ankle. PMID:8915860

  7. Changed morphology and mechanical properties of cancellous bone in the mandibular condyles of edentate people.

    PubMed

    Giesen, E B W; Ding, M; Dalstra, M; van Eijden, T M G J

    2004-03-01

    Since edentate subjects have a reduced masticatory function, it can be expected that the morphology of the cancellous bone of their mandibular condyles has changed according to the altered mechanical environment. In the present study, the morphology of cylindrical cancellous bone specimens of the mandibular condyles of edentate subjects (n = 25) was compared with that of dentate subjects (n = 24) by means of micro-computed tomography and by the application of Archimedes' principle. Stiffness and strength were determined by destructive mechanical testing. Compared with dentate subjects, it appeared that, in edentate subjects, the bone was less dense and the trabecular structure was less plate-like. The regression models of stiffness and strength built from bone volume fraction and the trabecular orientation relative to the axis of the specimen were similar for both dentate and edentate subjects. This indicates that, under reduced mechanical load, the fundamental relationship between bone morphology and mechanical properties does not change. PMID:14981130

  8. Bone augmentation for cancellous bone- development of a new animal model

    PubMed Central

    2013-01-01

    Background Reproducible and suitable animal models are required for in vivo experiments to investigate new biodegradable and osteoinductive biomaterials for augmentation of bones at risk for osteoporotic fractures. Sheep have especially been used as a model for the human spine due to their size and similar bone metabolism. However, although sheep and human vertebral bodies have similar biomechanical characteristics, the shape of the vertebral bodies, the size of the transverse processes, and the different orientation of the facet joints of sheep are quite different from those of humans making the surgical approach complicated and unpredictable. Therefore, an adequate and safe animal model for bone augmentation was developed using a standardized femoral and tibia augmentation site in sheep. Methods The cancellous bone of the distal femur and proximal tibia were chosen as injection sites with the surgical approach via the medial aspects of the femoral condyle and proximal tibia metaphysis (n = 4 injection sites). For reproducible drilling and injection in a given direction and length, a custom-made c-shaped aiming device was designed. Exact positioning of the aiming device and needle positioning within the intertrabecular space of the intact bone could be validated in a predictable and standardized fashion using fluoroscopy. After sacrifice, bone cylinders (∅ 32 mm) were harvested throughout the tibia and femur by means of a diamond-coated core drill, which was especially developed to harvest the injected bone area exactly. Thereafter, the extracted bone cylinders were processed as non-decalcified specimens for μCT analysis, histomorphometry, histology, and fluorescence evaluation. Results The aiming device could be easily placed in 63 sheep and assured a reproducible, standardized injection area. In four sheep, cardiovascular complications occurred during surgery and pulmonary embolism was detected by computed tomography post surgery in all of these animals

  9. Osteostimulatory effect of bone grafts on fibroblast cultures

    PubMed Central

    Fathima, Hameed; Harish

    2015-01-01

    Objective: We analyzed the morphological changes and alkaline phosphatase (ALP) level in fibroblast, which is indicative of their functional ability when cultured in three different commercially available graft materials with osseoconductive property. Materials and Methods: Fibroblasts obtained from fifth passage were seeded within three different bone substitutes (bovine hydroxyapatite [HA] [Osseo-graft®], β-tricalciumphosphate [RTR®], bovine HA [Bio-oss®]) and incubated under standard cell culture conditions. 10 samples in each group were evaluated for cell morphology and alkaline phosphates activity using scanning electron microscopy and spectrophotometric analysis on the 7th day of culture. Results: Fibroblast cultured with RTR® showed changes in morphology and increase in ALP activity when compared to fibroblast cultured with Osseo-graft® and Bio-oss®. Conclusion: Alkaline phosphatase activity was observed in fibroblasts when cultured with three types of commercially available bone grafts. ALP activity was highest when cultured with β-tricalcium phosphate graft material indicating its better bone regenerating capacity of this graft material. PMID:26283815

  10. Hindlimb unloading has a greater effect on cortical compared with cancellous bone in mature female rats

    NASA Technical Reports Server (NTRS)

    Allen, Matthew R.; Bloomfield, Susan A.

    2003-01-01

    This study was designed to determine the effects of 28 days of hindlimb unloading (HU) on the mature female rat skeleton. In vivo proximal tibia bone mineral density and geometry of HU and cage control (CC) rats were measured with peripheral quantitative computed tomography (pQCT) on days 0 and 28. Postmortem pQCT, histomorphometry, and mechanical testing were performed on tibiae and femora. After 28 days, HU animals had significantly higher daily food consumption (+39%) and lower serum estradiol levels (-49%, P = 0.079) compared with CC. Proximal tibia bone mineral content and cortical bone area significantly declined over 28 days in HU animals (-4.0 and 4.8%, respectively), whereas total and cancellous bone mineral densities were unchanged. HU animals had lower cortical bone formation rates and mineralizing surface at tibial midshaft, whereas differences in similar properties were not detected in cancellous bone of the distal femur. These results suggest that cortical bone, rather than cancellous bone, is more prominently affected by unloading in skeletally mature retired breeder female rats.

  11. Nasal bone grafts from the removed hump used as overlay grafts to camouflage concave lateral crura.

    PubMed

    Kubilay, Utku; Erdogdu, Suleyman; Sezen, Ozan Seymen

    2014-01-01

    Alar cartilage consists of a medial crus, middle crus and lateral crus. The lateral crus is an important aesthetic and functional structure of the nose. A 32-year-old male patient with concave lateral crura was operated by the authors. An open rhinoplasty with a dorsal approach to the septum is preferred. The nasal bones harvested from the hump, which is an autogenous graft trimmed and sutured on both concave lateral crura as an overlay camouflage grafts. Satisfactory result was achieved.

  12. In vitro cartilage tissue engineering using cancellous bone matrix gelatin as a biodegradable scaffold.

    PubMed

    Yang, Bo; Yin, Zhanhai; Cao, Junling; Shi, Zhongli; Zhang, Zengtie; Song, Hongxing; Liu, Fuqiang; Caterson, Bruce

    2010-08-01

    In this study, we constructed tissue-engineered cartilage using allogeneic cancellous bone matrix gelatin (BMG) as a scaffold. Allogeneic BMG was prepared by sequential defatting, demineralization and denaturation. Isolated rabbit chondrocytes were seeded onto allogeneic cancellous BMG, and cell-BMG constructs were harvested after 1, 3 and 6 weeks for evaluation by hematoxylin and eosin staining for overall morphology, toluidine blue for extracellular matrix (ECM) proteoglycans, immunohistochemical staining for collagen type II and a transmission electron microscope for examining cellular microstructure on BMG. The prepared BMG was highly porous with mechanical strength adjustable by duration of demineralization and was easily trimmed for tissue repair. Cancellous BMG showed favorable porosity for cell habitation and metabolism material exchange with larger pore sizes (100-500 microm) than in cortical BMG (5-15 microm), allowing cell penetration. Cancellous BMG also showed good biocompatibility, which supported chondrocyte proliferation and sustained their differentiated phenotype in culture for up to 6 weeks. Rich and evenly distributed cartilage ECM proteoglycans and collagen type II were observed around chondrocytes on the surface and inside the pores throughout the cancellous BMG. Considering the large supply of banked bone allografts and relatively convenient preparation, our study suggests that allogeneic cancellous BMG is a promising scaffold for cartilage tissue engineering.

  13. Predictable synthetic bone grafting procedures for implant reconstruction: part two.

    PubMed

    Ganz, Scott D; Valen, Maurice

    2002-01-01

    When teeth are missing, the surrounding bone and soft tissue is challenged as a result of the natural resorptive process or from traumatic destruction subsequent to extraction. The diminished structural foundation for prosthetic reconstruction with or without implants can therefore be compromised. Recent technological innovations in computer hardware and software have given clinicians the tools to determine 3-dimensional anatomy, quality, and density of bone, which can aid in the diagnosis and treatment planning for reparative or augmentative grafting procedures. Advanced synthetic bioactive resorbable bone graft (SBRG) materials and innovative surgical techniques have made it possible to predictably alter the defective site to create favorable osseous conditions for implant placement. The synthetically derived, resorbable, cluster-like, hydrophilic, particulate, bone-grafting material, having similar mechanical and chemical properties as the host bone, can provide the means to modify existing bone topography by aggressively overpacking the material for ridge preservation, ridge augmentation, or to enhance the bony site and subsequent prosthetic rehabilitation. Since bone does not bridge in empty spaces, the aggressive overfill, commonly referred to as force mineralization, controls excessive bleeding and eliminates voids. Part 1 of this 2-part series presented evidence of safety and effectiveness of the SBRG materials, crystal morphology, chemical properties, and characterization through animal and clinical studies. The osteoconductive cluster particulate assists in the bridging of lost bone anatomy by chemotactic response and resorption concurrent with regeneration of new bone formations. Part 2 demonstrates specific clinical handling characteristics and use of this material to facilitate implant placement and/or prosthetic reconstruction through clinical case applications. Additionally, in a unique clinical presentation, a composite graft mixture consisting of

  14. Toll-Like Receptor 4 Mediates the Regenerative Effects of Bone Grafts for Calvarial Bone Repair

    PubMed Central

    Wang, Dan; Gilbert, James R.; Shaw, Melissa A.; Shakir, Sameer; Losee, Joseph E.; Billiar, Timothy R.

    2015-01-01

    Craniofacial trauma is difficult to repair and presents a significant burden to the healthcare system. The inflammatory response following bone trauma is critical to initiate healing, serving to recruit inflammatory and progenitor cells and to promote angiogenesis. A role for inflammation in graft-induced bone regeneration has been suggested, but is still not well understood. The current study assessed the impact of Toll-like receptor (TLR4) signaling on calvarial repair in the presence of morselized bone components. Calvarial defects in wild-type and global TLR4−/− knockout mouse strains were treated with fractionated bone components in the presence or absence of a TLR4 neutralizing peptide. Defect healing was subsequently evaluated over 28 days by microcomputed tomography and histology. The matrix-enriched fraction of morselized bone stimulated calvarial bone repair comparably with intact bone graft, although the capacity for grafts to induce calvarial bone repair was significantly diminished by inhibition or genetic ablation of TLR4. Overall, our findings suggest that the matrix component of bone graft stimulates calvarial bone repair in a TLR4-dependent manner. These results support the need to better understand the role of inflammation in the design and implementation of strategies to improve bone healing. PMID:25603990

  15. Toll-like receptor 4 mediates the regenerative effects of bone grafts for calvarial bone repair.

    PubMed

    Wang, Dan; Gilbert, James R; Shaw, Melissa A; Shakir, Sameer; Losee, Joseph E; Billiar, Timothy R; Cooper, Gregory M

    2015-04-01

    Craniofacial trauma is difficult to repair and presents a significant burden to the healthcare system. The inflammatory response following bone trauma is critical to initiate healing, serving to recruit inflammatory and progenitor cells and to promote angiogenesis. A role for inflammation in graft-induced bone regeneration has been suggested, but is still not well understood. The current study assessed the impact of Toll-like receptor (TLR4) signaling on calvarial repair in the presence of morselized bone components. Calvarial defects in wild-type and global TLR4(-/-) knockout mouse strains were treated with fractionated bone components in the presence or absence of a TLR4 neutralizing peptide. Defect healing was subsequently evaluated over 28 days by microcomputed tomography and histology. The matrix-enriched fraction of morselized bone stimulated calvarial bone repair comparably with intact bone graft, although the capacity for grafts to induce calvarial bone repair was significantly diminished by inhibition or genetic ablation of TLR4. Overall, our findings suggest that the matrix component of bone graft stimulates calvarial bone repair in a TLR4-dependent manner. These results support the need to better understand the role of inflammation in the design and implementation of strategies to improve bone healing.

  16. Changes in canine cortical and cancellous bone mechanical properties following immobilization and remobilization with exercise.

    PubMed

    Kaneps, A J; Stover, S M; Lane, N E

    1997-11-01

    The purpose of this study was to assess cortical and cancellous bone responses to unilateral limb immobilization and, subsequently, to remobilization with exercise, in a young adult canine model. Right forelimbs of 14 1-2-year old mongrel dogs were immobilized in a non-weight-bearing position by a bandage for 16 weeks. Six control dogs were untreated. At 16 weeks, seven immobilized and three control dogs were euthanized. The remaining seven immobilized dogs began a recovery protocol consisting of 16 weeks of kennel confinement (without the right forelimb bandaged) followed by 16 weeks of treadmill exercise conducted three times per week. These seven dogs and three control dogs were euthanized at 48 weeks. Bone mineral density of the proximal radii was determined with dual-energy X-ray absorptiometry and humeral middiaphyseal cross-sectional areas were determined with computed tomography. Humeri were tested in cranio-caudal three-point bending to failure. Cancellous bone cores from the lateral humeral condyles had wet apparent density determined and were tested to failure in compression. Mechanical properties, bone density, and cross-sectional areas were compared between immobilized (right forelimb), contralateral weight bearing (left forelimb), and control forelimbs with Kruskal-Wallis and post hoc tests. At 16 weeks, bone mineral density, cortical load, yield, and stiffness as well as cancellous bone failure stress, yield stress, and modulus were significantly lower (p < 0.02) for immobilized limbs than control limbs. Immobilized limb cancellous bone mechanical properties were 28%-74% of control values, and cortical bone mechanical properties were 71%-98% of control values. After 32 weeks of remobilization, cortical and cancellous bone mechanical properties were not different from control values except that cortical bone failure stress and modulus were significantly higher (p < 0.01) between remobilized and control limbs. In summary, 16 weeks of forelimb

  17. Adaptation of Cancellous Bone to Aging and Immobilization in Growing Rats

    NASA Technical Reports Server (NTRS)

    Chen, Meng Meng; Jee, Webster S. S.; Ke, Hua Zhu; Lin, Bia Yun; Li, Qing Nan; Li, Xiao Jian

    1992-01-01

    Two-and-a half month-old female rats were subjected to right hindlimb immobilization or served as controls for 0, 1, 2, 8, 14, and 20 weeks. The right hindlimb was immobilized by bandaging it against the abdomen, thus unloading it. Cancellous bone histomorphometry was performed on microradiographs and double-fluorescent labeled 20 micron sections of the distal femoral metaphyses. Primary spongiosa bone loss occurred rapidly by 2 weeks, and secondary spongiosa bone loss occurred rapidly by 8 weeks of immobilization, and then equilibrated at 60% less bone mass than age-related controls. The negative bone balance induced by immobilization was caused by transient increase in bone resorption, decrease in bone formation, and longitudinal bone growth. The dynamic data of secondary spongiosa cancellous bone showed that percent eroded perimeter was transiently elevated by 55% to 82% between 1 and 8 weeks, percent labeled perimeter was transiently depressed by 32% to 50% between 1 and 14 weeks, mineral apposition rate was depressed by 23% and 19% at 1 and 2 weeks, and bone formation rate-bone area referent was transiently depressed by 35% and 59%c at 1 and 2 weeks. All the above parameters were at age-related control levels by 20 weeks of immobilization. However, bone formation rate-tissue area referent was depressed (-65%) throughout the study. Immobilization depressed completely longitudinal bone growth by 2 weeks and remained so. Only 0.65 mm of new metaphysis was generated in the immobilized versus 2.1 mm in controls during the study period. The immobilization induced an early cancellous bone loss which equilibrated at a new steady state with less bone and a normal (age-related control) bone turnover rate. When these findings were compared to an earlier study of 9 month-old virgin females subjected to right hindlimb immobilization up to 26 weeks, we found the adaptive responses of the cancellous bone were identical except that they occurred earlier and equilibrated

  18. Adaptation of Cancellous Bone to Aging and Immobilization in Growing Rats

    NASA Technical Reports Server (NTRS)

    Chen, Meng-Meng; Jee, Webster S. S.; Ke, Hua-Zhu; Lin, Bai-Yun; Li, Qing-Nan; Li, Xiao-Jian

    1992-01-01

    Two-and-half-month-old female rats were subjected to right hindlimb immobilization or served as controls for 0, 1, 2, 8, 14, and 20 weeks. The right hindlimb was immobilized by bandaging it against the abdomen, thus unloading it. Cancellous bone histomorphometry was performed on microradiographs and double-fluorescent labeled 20 tLm sections of the distal femoral metaphyses. Primary spongiosa bone loss occurred rapidly by 2 weeks, and secondary spongiosa bone loss occurred rapidly by 8 weeks of immobilization, and then equilibrated at 60% less bone mass than age-related controls. The negative bone balance induced by immobilization was caused by transient increase in bone resorption, decrease in bone formation, and longitudinal bone growth. The dynamic data of secondary spongiosa cancellous bone showed that percent eroded perimeter was transiently elevated by 55 to 82% between 1 and 8 weeks, percent labeled perimeter was transiently depressed by 32% to 50% between 1 and 14 weeks, mineral apposition rate was depressed by 23% and 19% at I and 2 weeks, and bone formation rate-bone area referent was transiently depressed by 35% and 59% at 1 and 2 weeks. All the above parameters were at age-related control levels by 20 weeks of immobiliza- tion. However, bone formation rate-tissue area referent was depressed (-65%) throughout the study. Immobilization depressed completely longitudinal bone growth by 2 weeks and remained so. Only 0.65 mm of new metaphysis was generated in the immobilized versus 2.1 mm in controls during the study period. The immobilization induced an early cancellous bone loss which equilibrated at a new steady state with less bone and a normal (age-related control) bone turnover rate. When these findings were compared to an earlier study of 9-month-old virgin females subjected to right hindlimb immobilization up to 26 weeks, we found the adaptive responses of the cancellous bone were identical except that they occurred earlier and equilibrated sooner in

  19. Vascularized iliac bone graft in cases of ankle tuberculosis.

    PubMed

    Yoshida, Tatsuya; Sakamoto, Akio; Iwamoto, Yukihide

    2009-02-01

    Ankle tuberculosis is a very rare occurrence. Because the ankle is a weightbearing joint, the affected ankle tends to become damaged. Consequently, the surgical procedure of arthrodesis is necessary, which usually proves effective. We report two cases of ankle tuberculosis, in patients 53 and 71 years of age. The former case had been diagnosed initially as osteoarthritis and then later as pyogenic osteomyelitis; the latter case had been diagnosed as pigmented villonodular synovitis, a benign but aggressive lesion that involves the joints. In addition to antitubercular medicine, these cases were treated with debridement for necrotic tissue and arthrodesis. In the former case, an iliac osteocutaneous flap was performed, and arthrodesis between the tibia, talus, and calcaneus was obtained. In the other case, a vascularized iliac bone graft was performed that resulted in arthrodesis between the tarsal bones, talus, and calcaneus but with pseudoarthrosis between the tibia and the talus. Settlement of the joint tuberculosis and gait ability without resorption or corruption of the grafted bone was obtained in both cases. Vascularized bone graft offers the benefits of achieving bone defect reconstruction with promotion of bone union, and the infection can be expected to resolve through medication delivered via the circulation.

  20. Directional tortuosity as a predictor of modulus damage for vertebral cancellous bone.

    PubMed

    Fyhrie, David P; Zauel, Roger

    2015-01-01

    There are many methods used to estimate the undamaged effective (apparent) moduli of cancellous bone as a function of bone volume fraction (BV/TV), mean intercept length(MIL), and other image based average microstructural measures. The MIL and BV/TV are both only functions of the cancellous microstructure and, therefore, cannot directly account for damage induced changes in the intrinsic trabecular hard tissue mechanical properties. Using a nonlinear finite element (FE) approximation for the degradation of effective modulus as a function of applied effective compressive strain, we demonstrate that a measurement of the directional tortuosity of undamaged trabecular hard tissue strongly predicts directional effective modulus (r2>0.90) and directional effective modulus degradation (r2>0.65). This novel measure of cancellous bone directional tortuosity has the potential for development into an anisotropic approach for calculating effective mechanical properties as a function of trabecular level material damage applicable to understanding how tissue microstructure and intrinsic hard tissue moduli interact to determine cancellous bone quality.

  1. Optimized demineralization of human cancellous bone by application of a vacuum.

    PubMed

    Eagle, Mark J; Rooney, Paul; Kearney, John N

    2015-07-01

    Human demineralized bone matrix derived from cortical bone is used by surgeons due to its ability to promote bone formation. There is also a need for shaped demineralized bone matrices made from cancellous bone, where the properties of the material allow its insertion into defects, therefore acting as a void filler and scaffold onto which new bone can form. In this study, we report that demineralized bone sponges were prepared by dissecting and cutting knee bone into cancellous bone cubes of 1 cm(3) . These cubes were then taken through a series of warm water washes, some with sonication, centrifugation, and two decontamination chemical washes. The cubes were optimally demineralized into sponges with 0.5N hydrochloric acid under vacuum with constant pH measurement. Demineralization was confirmed by quantitative measurement of calcium and qualitatively by compression. The sponges were freeze dried before terminal sterilisation with a target dose of 25 kGy gamma radiation whilst frozen. Samples of the sponges were histologically examined for calcium and collagen and also tested for osteoinductivity. Data showed well defined collagen staining in the sponges, with little residual calcium. Sponges from two out of three donors demonstrated osteoinductivity when implanted into the muscle of an athymic mouse.

  2. Association of microstructural and mechanical properties of cancellous bone and their fracture risk assessment tool scores.

    PubMed

    Wu, Dengke; Li, Xin; Tao, Cheng; Dai, Ruchun; Ni, Jiangdong; Liao, Eryuan

    2015-01-01

    This study is to investigate the association between fracture probabilities determined by using the fracture risk assessment tool (FRAX) and the microstructure and mechanical properties of femoral bone trabecula in osteoporosis (OP) and osteoarthritis (OA) patients with hip replacements. By using FRAX, we evaluated fracture risks of the 102 patients with bone replacements. Using micro CT scanning, we obtained the analysis parameters of microstructural properties of cancellous bone. Through morphometric observations, fatigue tests and compression tests, we obtained parameters of mechanical properties of cancellous bones. Relevant Pearson analysis was performed to investigate the association between the fracture probability and the microstructure and mechanical properties of femoral bone trabecula in patients. Fifteen risk factors in FRAX were compared between OP and OA patients. FRAX hip fracture risk score and major osteoporotic in OP and OA patients were significantly different. FRAX was associated with tissue bone mineral density and volumetric bone mineral density. Our study suggests that the probabilities of major osteoporotic and hip fracture using FRAX is associated with bone mass but not with micro bone quality. PMID:26064297

  3. Fast characterization of two ultrasound longitudinal waves in cancellous bone using an adaptive beamforming technique.

    PubMed

    Taki, Hirofumi; Nagatani, Yoshiki; Matsukawa, Mami; Mizuno, Katsunori; Sato, Toru

    2015-04-01

    The received signal in through-transmission ultrasound measurements of cancellous bone consists of two longitudinal waves, called the fast and slow waves. Analysis of these fast and slow waves may reveal characteristics of the cancellous bone that would be good indicators of osteoporosis. Because the two waves often overlap, decomposition of the received signal is an important problem in the characterization of bone quality. This study proposes a fast and accurate decomposition method based on the frequency domain interferometry imaging method with a modified wave transfer function that uses a phase rotation parameter. The proposed method accurately characterized the fast and slow waves in the experimental study, and the residual intensity, which was normalized with respect to the received signal intensity, was less than -20 dB over the bone specimen thickness range from 6 to 15 mm. In the simulation study, the residual intensity was less than -20 dB over the specimen thickness range from 3 to 8 mm. Decomposition of a single received signal takes only 5 s using a laptop personal computer with a single central processing unit. The proposed method has great potential to provide accurate and rapid measurements of indicators of osteoporosis in cancellous bone.

  4. Development and validation of a multiecho computer simulation of ultrasound propagation through cancellous bone

    NASA Astrophysics Data System (ADS)

    Langton, Christian; Church, Luke

    2002-05-01

    Cancellous bone consists of a porous open-celled framework of trabeculae interspersed with marrow. Although the measurement of broadband ultrasound attenuation (BUA) has been shown to be sensitive to osteoporotic changes, the exact dependence on material and structural parameters has not been elucidated. A 3-D computer simulation of ultrasound propagation through cancellous bone has been developed, based upon simple reflective behavior at the multitude of trabecular/marrow interfaces. A cancellous bone framework is initially described by an array of bone and marrow elements. An ultrasound pulse is launched along each row of the model with partial reflection occurring at each bone/marrow interface. If a reverse direction wave hits an interface, a further forward (echo) wave is created, with phase inversion implemented if appropriate. This process is monitored for each wave within each row. The effective received signal is created by summing the time domain data, thus simulating detection by a phase-sensitive ultrasound transducer, as incorporated in clinical systems. The simulation has been validated on a hexagonal honeycomb design of variable mesh size, first against a commercial computer simulation solution (Wave 2000 Pro), and second, via experimental measurement of physical replicas produced by stereolithography.

  5. Material heterogeneity in cancellous bone promotes deformation recovery after mechanical failure

    PubMed Central

    Torres, Ashley M.; Matheny, Jonathan B.; Keaveny, Tony M.; Taylor, David; Rimnac, Clare M.; Hernandez, Christopher J.

    2016-01-01

    Many natural structures use a foam core and solid outer shell to achieve high strength and stiffness with relatively small amounts of mass. Biological foams, however, must also resist crack growth. The process of crack propagation within the struts of a foam is not well understood and is complicated by the foam microstructure. We demonstrate that in cancellous bone, the foam-like component of whole bones, damage propagation during cyclic loading is dictated not by local tissue stresses but by heterogeneity of material properties associated with increased ductility of strut surfaces. The increase in surface ductility is unexpected because it is the opposite pattern generated by surface treatments to increase fatigue life in man-made materials, which often result in reduced surface ductility. We show that the more ductile surfaces of cancellous bone are a result of reduced accumulation of advanced glycation end products compared with the strut interior. Damage is therefore likely to accumulate in strut centers making cancellous bone more tolerant of stress concentrations at strut surfaces. Hence, the structure is able to recover more deformation after failure and return to a closer approximation of its original shape. Increased recovery of deformation is a passive mechanism seen in biology for setting a broken bone that allows for a better approximation of initial shape during healing processes and is likely the most important mechanical function. Our findings suggest a previously unidentified biomimetic design strategy in which tissue level material heterogeneity in foams can be used to improve deformation recovery after failure. PMID:26929343

  6. Phase velocity and attenuation predictions of waves in cancellous bone using an iterative effective medium approximation.

    PubMed

    Potsika, Vassiliki T; Protopappas, Vasilios C; Vavva, Maria G; Polyzos, Demosthenes; Fotiadis, Dimitrios I

    2013-01-01

    The quantitative determination of wave dispersion and attenuation in bone is an open research area as the factors responsible for ultrasound absorption and scattering in composite biological tissues have not been completely explained. In this study, we use the iterative effective medium approximation (IEMA) proposed in [1] so as to calculate phase velocity and attenuation in media with properties similar to those of cancellous bones. Calculations are performed for a frequency range of 0.4-0.8 MHz and for different inclusions' volume concentrations and sizes. Our numerical results are compared with previous experimental findings so as to assess the effectiveness of IEMA. It was made clear that attenuation and phase velocity estimations could provide supplementary information for cancellous bone characterization. PMID:24111396

  7. Progressive femoral cortical and cancellous bone density loss after uncemented tapered-design stem fixation

    PubMed Central

    Nowak, Tobias E; Haeberle, Lothar; Mueller, Lars P; Kress, Alexander; Voelk, Michael; Pfander, David; Forst, Raimund; Schmidt, Rainer

    2010-01-01

    Background Aseptic implant loosening and periprosthetic bone loss are major problems after total hip arthroplasty (THA). We present an in vivo method of computed tomography (CT) assisted osteodensitometry after THA that differentiates between cortical and cancellous bone density (BD) and area around the femoral component. Method Cortical and cancellous periprosthetic femoral BD (mg CaHA/mL), area (mm2) and contact area between the prothesis and cortical bone were determined prospectively in 31 patients 10 days, 1 year, and 6 years after uncemented THA (mean age at implantation: 55 years) using CT-osteodensitometry. Results 6 years postoperatively, cancellous BD had decreased by as much as 41% and cortical BD by up to 27% at the metaphyseal portion of the femur; this decrease was progressive between the 1-year and 6-year examinations. Mild cortical hypertrophy was observed along the entire length of the diaphysis. No statistically significant changes in cortical BD were observed along the diaphysis of the stem. Interpretation Periprosthetic CT-assisted osteodensitometry has the technical ability to discriminate between cortical and cancellous bone structures with respect to strain-adapted remodeling. Continuous loss of cortical and cancellous BD at the femoral metaphysis, a homeostatic cortical strain configuration, and mild cortical hypertrophy along the diaphysis suggest a diaphyseal fixation of the implanted stem. CT-assisted osteodensitometry has the potential to become an effective instrument for quality control in THA by means of in vivo determination of periprosthetic BD, which may be a causal factor in implant loosening after THA. PMID:20180716

  8. Increased presence of capillaries next to remodeling sites in adult human cancellous bone.

    PubMed

    Kristensen, Helene Bjoerg; Andersen, Thomas Levin; Marcussen, Niels; Rolighed, Lars; Delaisse, Jean-Marie

    2013-03-01

    Vascularization is a prerequisite for osteogenesis in a number of situations, including bone development, fracture healing, and cortical bone remodeling. It is unknown whether a similar link exists between cancellous bone remodeling and vascularization. Here, we show an association between remodeling sites, capillaries, proliferative cells, and putative osteoblast progenitors. Iliac crest biopsies from normal human individuals were subjected to histomorphometry and immunohistochemistry to identify the respective positions of bone remodeling sites, CD34-positive capillaries, smooth muscle actin (SMA)-positive putative osteoblast progenitors, including pericytes, Ki67-positive proliferative cells, and bone remodeling compartment (BRC) canopies. The BRC canopy is a recently described structure separating remodeling sites from the bone marrow, consisting of CD56-positive osteoblasts at an early differentiation stage. We found that bone remodeling sites were associated with a significantly increased presence of capillaries, putative osteoblast progenitors, and proliferative cells in a region within 50 µm of the bone or the canopy surface. The increases were the highest above eroded surfaces and at the level of the light-microscopically assessed contact of these three entities with the bone or canopy surfaces. Between 51 and 100 µm, their densities leveled to that found above quiescent surfaces. Electron microscopy asserted the close proximity between BRC canopies and capillaries lined by pericytes. Furthermore, the BRC canopy cells were found to express SMA. These ordered distributions support the existence of an osteogenic-vascular interface in adult human cancellous bone. The organization of this interface fits the current knowledge on the mode of action of vasculature on osteogenesis, and points to the BRC canopy as a central player in this mechanism. We propose a model where initiation of bone remodeling coincides with the induction of proximity of the

  9. Three dimensional stereolithography models of cancellous bone structures from muCT data: testing and validation of finite element results.

    PubMed

    Dobson, C A; Sisias, G; Phillips, R; Fagan, M J; Langton, C M

    2006-04-01

    Stereolithography (STL) models of complex cancellous bone structures have been produced from three-dimensional micro-computed tomography data sets of human cancellous bone histological samples from four skeletal sites. The STL models have been mechanically tested and the derived stiffness compared with that predicted by finite element analysis. The results show a strong correlation (R2 = 0.941) between the predicted and calculated stiffnesses of the structures and show promise for the use of STL as an additional technique to complement the use of finite element models, for the assessment of the mechanical properties of complex cancellous bone structures.

  10. Effect of cancellous bone on the functionally graded dental implant concept.

    PubMed

    Hedia, H S

    2005-01-01

    In a previous work by the author [H.S. Hedia and M. Nemat-Alla, Design optimization of functionally graded dental implant, submitted to be published in the J. Bio-Medical Materials and Engineering], a functionally graded material dental implant was designed without cansellous bone in the model. In this investigation the effect of presence cancellous bone as a thin layer around the dental implant was investigated. It is well known that the main inorganic component of natural bone is hydroxyapatite (HAP) and that the main organic component is collagen (Col). Hydroxyapatite HAP implants are not bioabsorbable, and because induction of bone into and around the artificially made HAP is not always satisfactory, loosening or breakage of HAP implants may occur after implantation in the clinical application. The development of a new material which is bioabsorbable and which has osteoconductive activity is needed. Therefore, the aim of the current investigation is to design an implant, in the presence of cancellous bone as a thin layer around it, from functionally graded material. In this study, a novel biomaterial, collagen/hydroxyapatite (Col/HAP) as a functionally graded material (FGM), was developed using the finite element and optimization techniques which are available in the ANSYS package. These materials have a self-organized character similar to that of natural bone. The investigations have shown that the maximum stress in the cortical bone and cancellous bone for the Col/HAP functionally graded implant has been reduced by about 40% and 19% respectively compared to currently used titanium dental implants.

  11. Intermittent PTH administration and mechanical loading are anabolic for periprosthetic cancellous bone.

    PubMed

    Grosso, Matthew J; Courtland, Hayden-William; Yang, Xu; Sutherland, James P; Stoner, Kirsten; Nguyen, Joseph; Fahlgren, Anna; Ross, F Patrick; van der Meulen, Marjolein C H; Bostrom, Mathias P

    2015-02-01

    The purpose of this study was to determine the individual and combined effects on periprosthetic cancellous bone of intermittent parathyroid hormone administration (iPTH) and mechanical loading at the cellular, molecular, and tissue levels. Porous titanium implants were inserted bilaterally on the cancellous bone of adult rabbits beneath a loading device attached to the distal lateral femur. The left femur received a sham loading device. The right femur was loaded daily, and half of the rabbits received daily PTH. Periprosthetic bone was evaluated up to 28 days for gene expression, histology, and µCT analysis. Loading and iPTH increased bone mass by a combination of two mechanisms: (1) Altering cell populations in a pro-osteoblastic/anti-adipocytic direction, and (2) controlling bone turnover by modulating the RANKL-OPG ratio. At the tissue level, BV/TV increased with both loading (+53%, p < 0.05) and iPTH (+54%, p < 0.05). Combined treatment showed only small additional effects at the cellular and molecular levels that corresponded to a small additive effect on bone volume (+13% compared to iPTH alone, p > 0.05). This study suggests that iPTH and loading are potential therapies for enhancing periprosthetic bone formation. The elucidation of the cellular and molecular response may help further enhance the combined therapy and related targeted treatment strategies. PMID:25408434

  12. Numerical investigation of ultrasound reflection and backscatter measurements in cancellous bone on various receiving areas.

    PubMed

    Hosokawa, Atsushi

    2014-07-01

    In this study, new ultrasound reflection and backscatter measurements in cancellous bone using a membrane-type hydrophone are proposed. A membrane hydrophone made of a piezoelectric polymer film mounted on an annular frame allows an incident ultrasound wave to pass through its aperture because it has no backing material. Therefore, in measurements using the membrane hydrophone, the receiving area could be located independently from the transmitting area. In addition, the size and shape of the receiving area, which corresponded to those of the electrode deposited on the piezoelectric film, could be arranged in various ways. To investigate the validity of the proposed measurements, before bench-top experiments, the reflected and backscattered waves from cancellous bone were numerically simulated using a finite-difference time-domain method. The reflection and backscatter parameters were measured on various receiving areas, and their correlation coefficients with the structural parameters in the cancellous bone were derived. The simulated results suggested that appropriate receiving areas for the reflection and backscatter measurements could exist and that the proposed measurements could be more effective for evaluating bone properties than conventional measurements.

  13. Signal of Interest Selection Standard for Ultrasonic Backscatter in Cancellous Bone Evaluation.

    PubMed

    Liu, Chengcheng; Tang, Tao; Xu, Feng; Ta, Dean; Matsukawa, Mami; Hu, Bo; Wang, Weiqi

    2015-10-01

    The aim of this study was to examine the effect of the backscattered signal of interest (SOI) on ultrasonic cancellous bone evaluation. In vitro backscatter measurements were performed using 16 bovine cancellous bone specimens and six different transducers with central frequencies of 0.5, 1, 2.25, 3.5, 5 and 10 MHz. The SOI for signal analysis was selected by a rectangular window. The delay (T1) and duration (T2) of the time window were varied, and the apparent integrated backscatter (AIB) and its correlation to bone volume fraction (BV/TV) were calculated. The results indicate that in addition to affecting the measured value of AIB, the SOI influences the observed correlation between AIB and BV/TV. Strong positive correlations were observed for short T1 (0.5 MHz: ≤6 μs, 1 MHz: ≤3 μs, 2.25 and 3.5 MHz: ≤2 μs, 5 and 10 MHz: ≤1 μs). However, strong negative correlations were observed when T1 was long (0.5 MHz: >9 μs, 1 MHz: >7 μs, 2.25 and 3.5 MHz: >3 μs, 5 and 10 MHz: >2 μs). The T2 value, especially low values (≤3 μs), also influenced the correlation coefficients. Positive correlations were more commonly observed at lower frequencies (i.e., 0.5-1 MHz), whereas negative correlations were more common at higher frequencies (i.e., 2.25-10 MHz). An explicit standard for in vitro SOI selection and cancellous bone assessment was proposed for a broad frequency range (0.5-10 MHz). Current conflicting findings are explained, and constructive suggestions for ultrasonic backscatter cancellous bone evaluation are provided. PMID:26210784

  14. Prostaglandin E2 Prevents Ovariectomy-Induced Cancellous Bone Loss in Rats

    NASA Technical Reports Server (NTRS)

    Ke, Hua Zhu; Li, Mei; Jee, Webster S. S.

    1992-01-01

    The object of this study was to determine whether prostaglandin E2, (PGE2) can prevent ovariectomy induced cancellous bone loss. Thirty-five 3-month-old female Sprague-Dawley rats were divided into two groups. The rats in the first group were ovariectomized (OVX) while the others received sham operation (sham-OVX). The OVX group was further divided into three treatment groups. The daily doses for the three groups were 0,1 and 6 mg PGE2/kg for 90 days. Bone histomorphometric analyses were performed on double-fluorescent-labeled undecalcified proximal tibial metaphysis (PTM). We confirmed that OVX induces massive cancellous bone loss (-80%) and a higher bone turnover (+143%). The new findings from the present study demonstrate that bone loss due to ovarian hormone deficiency can be prevented by a low-dose (1 mg) daily administration of PGE2. Furthermore, a higher-dose (6 mg) daily administration of PGE2 not only prevents bone loss but also adds extra bone to the proximal tibial metaphyses. PGE, at the 1-mg dose level significantly increased trabecular bone area, trabecular width, trabecular node density, density of node to node, ratio of node to free end, and thus significantly decreased trabecular separation from OVX controls. At this dose level, these same parameters did not differ significantly from sham-OVX controls. However, at the 6-mg dose level PGE2, there were significant increases in trabecular bone area, trabecular width, trabecular node density, density of node to node, and ratio of node to free end, while there was significant decrease in trabecular separation from both OVX and sham-operated controls. The changes in indices of trabecular bone microanatomical structure indicated that PGE2 prevented bone loss as well as the disconnection of existing trabeculae. In summary, PGE2, administration to OVX rats decreased bone turnover and increased bone formation parameters resulting in a positive bone balance that prevented bone loss (in both lower and higher

  15. Effects of pre- and postoperative irradiation on the healing of bone grafts in the rabbit

    SciTech Connect

    Morales, M.J.; Marx, R.E.; Gottlieb, C.F.

    1987-01-01

    Healing of cellular bone grafts irradiated at various times in the postsurgical course was compared to the healing characteristics of bone grafts placed into already irradiated tissue and to controls of irradiated host mandible in a rabbit model. Physical graft consolidation was assessed by load stress characteristics and serial histologic examination. Results indicated that grafts placed into already irradiated tissues failed to form bone in both phases of expected regeneration resulting in structurally weakened and histologically deficient ossicles. Bone grafts irradiated after placement were tolerant of irradiation. Bone grafts irradiated after four weeks were found to be less affected by irradiation than those irradiated within the first four weeks, forming an ossicle structurally and histologically superior to that of bone ossicles developed from grafts placed into irradiated tissues.

  16. Bupivacaine for pain reduction after iliac crest bone graft harvest.

    PubMed

    O'Neill, Kevin R; Lockney, Dennis T; Bible, Jesse E; Crosby, Colin G; Devin, Clinton J

    2014-05-01

    Iliac crest bone graft remains the gold standard in achieving spinal arthrodesis, but chronic pain from graft harvest occurs in up to 39% of patients. Studies have shown that a single administration of local anesthetic reduces short-term pain, but they have not adequately investigated possible longer-term benefits. The goal of this study was to determine whether local administration of bupivacaine after iliac crest bone graft harvesting reduces pain and improves patient-reported outcomes. In this prospective, randomized, controlled, and blinded clinical study, 40 patients were identified who underwent posterior spine fusion with iliac crest bone graft and were randomized to receive either bupivacaine (treatment group, n=20) or saline (control group, n=20) at the iliac crest bone graft site. Pain at the harvest site was determined by a series of 12 visual and numeric pain scale assessments. Short Form-12 mental and physical component scores, EuroQol-5D, and Oswestry Disability Index assessments were made, along with determination of patient satisfaction and self-reported outcome of surgery. Baseline pain and outcome assessments were statistically similar (P>.05). Average pain scores were lower for all 12 assessments in the treatment group at mean follow-up of 5 weeks (significant differences in 6 assessments) and 20 weeks (significant differences in 2 assessments). No significant differences were found in Short Form-12 and EuroQol-5D scores. For patients who underwent lumbar fusion, the treatment group had significantly improved Oswestry Disability Index scores (mean±SD=10.8±7.1 vs 18.7±5.9, P=.012). Significantly more patients in the treatment group reported that surgery met all expectations (90% vs 50%, P=.016). This study is the 1st to show that a single administration of bupivacaine at the iliac crest bone graft harvest site during posterior spine fusion surgery can result in improved outcomes and reduced pain far beyond the anesthetic duration of activity

  17. Fabrication and development of artificial osteochondral constructs based on cancellous bone/hydrogel hybrid scaffold.

    PubMed

    Song, Kedong; Li, Liying; Yan, Xinyu; Zhang, Yu; Li, Ruipeng; Wang, Yiwei; Wang, Ling; Wang, Hong; Liu, Tianqing

    2016-06-01

    Using tissue engineering techniques, an artificial osteochondral construct was successfully fabricated to treat large osteochondral defects. In this study, porcine cancellous bones and chitosan/gelatin hydrogel scaffolds were used as substitutes to mimic bone and cartilage, respectively. The porosity and distribution of pore size in porcine bone was measured and the degradation ratio and swelling ratio for chitosan/gelatin hydrogel scaffolds was also determined in vitro. Surface morphology was analyzed with the scanning electron microscope (SEM). The physicochemical properties and the composition were tested by using an infrared instrument. A double layer composite scaffold was constructed via seeding adipose-derived stem cells (ADSCs) induced to chondrocytes and osteoblasts, followed by inoculation in cancellous bones and hydrogel scaffolds. Cell proliferation was assessed through Dead/Live staining and cellular activity was analyzed with IpWin5 software. Cell growth, adhesion and formation of extracellular matrix in composite scaffolds blank cancellous bones or hydrogel scaffolds were also analyzed. SEM analysis revealed a super porous internal structure of cancellous bone scaffolds and pore size was measured at an average of 410 ± 59 μm while porosity was recorded at 70.6 ± 1.7 %. In the hydrogel scaffold, the average pore size was measured at 117 ± 21 μm and the porosity and swelling rate were recorded at 83.4 ± 0.8 % and 362.0 ± 2.4 %, respectively. Furthermore, the remaining hydrogel weighed 80.76 ± 1.6 % of the original dry weight after hydration in PBS for 6 weeks. In summary, the cancellous bone and hydrogel composite scaffold is a promising biomaterial which shows an essential physical performance and strength with excellent osteochondral tissue interaction in situ. ADSCs are a suitable cell source for osteochondral composite reconstruction. Moreover, the bi-layered scaffold significantly enhanced cell proliferation compared to the cells seeded on

  18. Fabrication and development of artificial osteochondral constructs based on cancellous bone/hydrogel hybrid scaffold.

    PubMed

    Song, Kedong; Li, Liying; Yan, Xinyu; Zhang, Yu; Li, Ruipeng; Wang, Yiwei; Wang, Ling; Wang, Hong; Liu, Tianqing

    2016-06-01

    Using tissue engineering techniques, an artificial osteochondral construct was successfully fabricated to treat large osteochondral defects. In this study, porcine cancellous bones and chitosan/gelatin hydrogel scaffolds were used as substitutes to mimic bone and cartilage, respectively. The porosity and distribution of pore size in porcine bone was measured and the degradation ratio and swelling ratio for chitosan/gelatin hydrogel scaffolds was also determined in vitro. Surface morphology was analyzed with the scanning electron microscope (SEM). The physicochemical properties and the composition were tested by using an infrared instrument. A double layer composite scaffold was constructed via seeding adipose-derived stem cells (ADSCs) induced to chondrocytes and osteoblasts, followed by inoculation in cancellous bones and hydrogel scaffolds. Cell proliferation was assessed through Dead/Live staining and cellular activity was analyzed with IpWin5 software. Cell growth, adhesion and formation of extracellular matrix in composite scaffolds blank cancellous bones or hydrogel scaffolds were also analyzed. SEM analysis revealed a super porous internal structure of cancellous bone scaffolds and pore size was measured at an average of 410 ± 59 μm while porosity was recorded at 70.6 ± 1.7 %. In the hydrogel scaffold, the average pore size was measured at 117 ± 21 μm and the porosity and swelling rate were recorded at 83.4 ± 0.8 % and 362.0 ± 2.4 %, respectively. Furthermore, the remaining hydrogel weighed 80.76 ± 1.6 % of the original dry weight after hydration in PBS for 6 weeks. In summary, the cancellous bone and hydrogel composite scaffold is a promising biomaterial which shows an essential physical performance and strength with excellent osteochondral tissue interaction in situ. ADSCs are a suitable cell source for osteochondral composite reconstruction. Moreover, the bi-layered scaffold significantly enhanced cell proliferation compared to the cells seeded on

  19. Architectural measures of the cancellous bone of the mandibular condyle identified by principal components analysis.

    PubMed

    Giesen, E B W; Ding, M; Dalstra, M; van Eijden, T M G J

    2003-09-01

    As several morphological parameters of cancellous bone express more or less the same architectural measure, we applied principal components analysis to group these measures and correlated these to the mechanical properties. Cylindrical specimens (n = 24) were obtained in different orientations from embalmed mandibular condyles; the angle of the first principal direction and the axis of the specimen, expressing the orientation of the trabeculae, ranged from 10 degrees to 87 degrees. Morphological parameters were determined by a method based on Archimedes' principle and by micro-CT scanning, and the mechanical properties were obtained by mechanical testing. The principal components analysis was used to obtain a set of independent components to describe the morphology. This set was entered into linear regression analyses for explaining the variance in mechanical properties. The principal components analysis revealed four components: amount of bone, number of trabeculae, trabecular orientation, and miscellaneous. They accounted for about 90% of the variance in the morphological variables. The component loadings indicated that a higher amount of bone was primarily associated with more plate-like trabeculae, and not with more or thicker trabeculae. The trabecular orientation was most determinative (about 50%) in explaining stiffness, strength, and failure energy. The amount of bone was second most determinative and increased the explained variance to about 72%. These results suggest that trabecular orientation and amount of bone are important in explaining the anisotropic mechanical properties of the cancellous bone of the mandibular condyle. PMID:14667134

  20. Advancements in Orthopedic Intervention: Retrograde Drilling and Bone Grafting of Osteochondral Lesions of the Knee Using Magnetic Resonance Imaging Guidance

    SciTech Connect

    Seebauer, Christian J.; Bail, Hermann J.; Rump, Jens C. Walter, Thula Teichgraeber, Ulf K. M.

    2010-12-15

    Computer-assisted surgery is currently a novel challenge for surgeons and interventional radiologists. Magnetic resonance imaging (MRI)-guided procedures are still evolving. In this experimental study, we describe and assess an innovative passive-navigation method for MRI-guided treatment of osteochondritis dissecans of the knee. A navigation principle using a passive-navigation device was evaluated in six cadaveric knee joint specimens for potential applicability in retrograde drilling and bone grafting of osteochondral lesions using MRI guidance. Feasibility and accuracy were evaluated in an open MRI scanner (1.0 T Philips Panorama HFO MRI System). Interactive MRI navigation allowed precise drilling and bone grafting of osteochondral lesions of the knee. All lesions were hit with an accuracy of 1.86 mm in the coronal plane and 1.4 mm the sagittal plane. Targeting of all lesions was possible with a single drilling. MRI allowed excellent assessment of correct positioning of the cancellous bone cylinder during bone grafting. The navigation device and anatomic structures could be clearly identified and distinguished throughout the entire drilling procedure. MRI-assisted navigation method using a passive navigation device is feasible for the treatment of osteochondral lesions of the knee under MRI guidance and allows precise and safe drilling without exposure to ionizing radiation. This method may be a viable alternative to other navigation principles, especially for pediatric and adolescent patients. This MRI-navigated method is also potentially applicable in many other MRI-guided interventions.

  1. Injectable polyHIPEs as high-porosity bone grafts.

    PubMed

    Moglia, Robert S; Holm, Jennifer L; Sears, Nicholas A; Wilson, Caitlin J; Harrison, Dawn M; Cosgriff-Hernandez, Elizabeth

    2011-10-10

    Polymerization of high internal phase emulsions (polyHIPEs) is a relatively new method for the production of high-porosity scaffolds. The tunable architecture of these polyHIPE foams makes them attractive candidates for tissue engineered bone grafts. Previously studied polyHIPE systems require either toxic diluents or high cure temperatures which prohibit their use as an injectable bone graft. In contrast, we have developed an injectable polyHIPE that cures at physiological temperatures to a rigid, high-porosity foam. First, a biodegradable macromer, propylene fumarate dimethacrylate (PFDMA), was synthesized that has appropriate viscosity and hydrophobicity for emulsification. The process of surfactant selection is detailed with particular focus on the key structural features of both polymer (logP values, hydrogen bond acceptor sites) and surfactant (HLB values, hydrogen bond donor sites) that enable stable HIPE formation. Incubation of HIPEs at 37 °C was used to initiate radical cross-linking of the unsaturated double bond of the methacrylate groups to polymerize the continuous phase and lock in the emulsion geometry. The resulting polyHIPEs exhibited ~75% porosity, pore sizes ranging from 4 to 29 μm, and an average compressive modulus and strength of 33 and 5 MPa, respectively. These findings highlight the great potential of these scaffolds as injectable, tissue engineered bone grafts.

  2. Scaffold-free Three-dimensional Graft From Autologous Adipose-derived Stem Cells for Large Bone Defect Reconstruction

    PubMed Central

    Dufrane, Denis; Docquier, Pierre-Louis; Delloye, Christian; Poirel, Hélène A.; André, Wivine; Aouassar, Najima

    2015-01-01

    Abstract Long bone nonunion in the context of congenital pseudarthrosis or carcinologic resection (with intercalary bone allograft implantation) is one of the most challenging pathologies in pediatric orthopedics. Autologous cancellous bone remains the gold standard in this context of long bone nonunion reconstruction, but with several clinical limitations. We then assessed the feasibility and safety of human autologous scaffold-free osteogenic 3-dimensional (3D) graft (derived from autologous adipose-derived stem cells [ASCs]) to cure a bone nonunion in extreme clinical and pathophysiological conditions. Human ASCs (obtained from subcutaneous adipose tissue of 6 patients and expanded up to passage 4) were incubated in osteogenic media and supplemented with demineralized bone matrix to obtain the scaffold-free 3D osteogenic structure as confirmed in vitro by histomorphometry for osteogenesis and mineralization. The 3D “bone-like” structure was finally transplanted for 3 patients with bone tumor and 3 patients with bone pseudarthrosis (2 congenital, 1 acquired) to assess the clinical feasibility, safety, and efficacy. Although minor clones with structural aberrations (aneuploidies, such as tri or tetraploidies or clonal trisomy 7 in 6%–20% of cells) were detected in the undifferentiated ASCs at passage 4, the osteogenic differentiation significantly reduced these clonal anomalies. The final osteogenic product was stable, did not rupture with forceps manipulation, did not induce donor site morbidity, and was easily implanted directly into the bone defect. No acute (<3 mo) side effects, such as impaired wound healing, pain, inflammatory reaction, and infection, or long-term side effects, such as tumor development, were associated with the graft up to 4 years after transplantation. We report for the first time that autologous ASC can be fully differentiated into a 3D osteogenic-like implant without any scaffold. We demonstrated that this engineered tissue can

  3. Pharmacokinetics of gentamicin eluted from a regenerating bone graft substitute

    PubMed Central

    Stravinskas, M.; Horstmann, P.; Ferguson, J.; Hettwer, W.; Tarasevicius, S.; Petersen, M. M.; McNally, M. A.; Lidgren, L.

    2016-01-01

    bone graft substitute: In vitro and clinical release studies. Bone Joint Res 2016;5:427–435. DOI: 10.1302/2046-3758.59.BJR-2016-0108.R1. PMID:27678329

  4. Circulation, bone scans, and tetracycline labeling in microvascularized and vascular bundle implanted rib grafts

    SciTech Connect

    Lalonde, D.H.; Williams, H.B.; Rosenthall, L.; Viloria, J.B.

    1984-11-01

    The circulation in microvascularized rib grafts has been compared with that in conventional rib grafts and in those augmented by a direct vascular bundle implantation into the bone grafts. A new experimental model has been designed to correlate vascular perfusion, bone scan patterns, tetracycline labeling, and histological findings in these bone grafts. Posterior microvascularized rib grafts were found to have a circulatory pattern identical to that of the normal rib. Failed microvascularized rib grafts were revascularized more slowly than conventional rib grafts. Vascular bundles implanted into rib grafts remained patent and increased the rate of revascularization. The stripping or preservation of periosteum had no observable effects on the rate or pattern of conventional rib graft revascularization. The circulation in rib grafts was accurately reflected in technetium 99 bone scans, as was the patency of the anastomoses of microvascularized rib grafts and of implanted vascular bundles. In contrast, tetracycline labeling was repeatedly observed in avascular areas of bone grafts and, therefore, is not a reliable indicator of bone graft circulation.

  5. Early postoperative bone scintigraphy in the evaluation of microvascular bone grafts in head and neck reconstruction

    PubMed Central

    Schuepbach, Jonas; Dassonville, Olivier; Poissonnet, Gilles; Demard, Francois

    2007-01-01

    Background Bone scintigraphy was performed to monitor anastomotic patency and bone viability. Methods In this retrospective study, bone scans were carried out during the first three postoperative days in a series of 60 patients who underwent microvascular bone grafting for reconstruction of the mandible or maxilla. Results In our series, early bone scans detected a compromised vascular supply to the bone with high accuracy (p < 10-6) and a sensitivity that was superior to the sensitivity of clinical monitoring (92% and 75% respectively). Conclusion When performing bone scintigraphy during the first three postoperative days, it not only helps to detect complications with high accuracy, as described in earlier studies, but it is also an additional reliable monitoring tool to decide whether or not microvascular revision surgery should be performed. Bone scans were especially useful in buried free flaps where early postoperative monitoring depended exclusively on scans. According to our experience, we recommend bone scans as soon as possible after surgery and immediately in cases suspicious of vascularized bone graft failure. PMID:17448223

  6. Osteogenetic activity in composite grafts of demineralized compact bone and marrow

    SciTech Connect

    Wittbjer, J.; Palmer, B.; Rohlin, M.; Thorngren, K.G.

    1983-03-01

    The effects of a composite graft of autologous marrow and demineralized autologous compact bone on the healing of a surgically created bone defect were observed in adult rabbits. A segment of the radius was bilaterally resected, demineralized, and replaced. On one side the bone graft was supplemented with autologous marrow. The new bone formation was measured 14 and 28 days after operation by roentgenography, including planimetry with scintigraphy and autoradiography using /sup 99m/Tc-labelled MDP. The composite graft, i.e., demineralized compact bone and marrow, had a significantly higher (p less than 0.01) bone formation rate 14 days after operation compared with the graft with demineralized compact bone in the opposite radius. At 28 days, however, there were no differences between the sides. Viable autologous marrow cells and demineralized autologous compact bone graft accelerate the rate of osteogenesis, but only at the beginning of the healing process.

  7. Transcriptional profiling of cortical versus cancellous bone from mechanically-loaded murine tibiae reveals differential gene expression.

    PubMed

    Kelly, Natalie H; Schimenti, John C; Ross, F Patrick; van der Meulen, Marjolein C H

    2016-05-01

    Mechanical loading is an anabolic stimulus that increases bone mass, and thus a promising method to counteract osteoporosis-related bone loss. The mechanism of this anabolism remains unclear, and needs to be established for both cortical and cancellous envelopes individually. We hypothesized that cortical and cancellous bone display different gene expression profiles at baseline and in response to mechanical loading. To test this hypothesis, the left tibiae of 10-week-old female C57Bl/6 mice were subjected to one session of axial tibial compression (9N, 1200cycles, 4Hz triangle waveform) and euthanized 3 and 24h following loading. The right limb served as the contralateral control. We performed RNA-seq on marrow-free metaphyseal samples from the cortical shell and the cancellous core to determine differential gene expression at baseline (control limb) and in response to load. Differential expression was verified with qPCR. Cortical and cancellous bone exhibited distinctly different transcriptional profiles basally and in response to mechanical loading. More genes were differentially expressed with loading at 24h with more genes downregulated at 24h than at 3h in both tissues. Enhanced Wnt signaling dominated the response in cortical bone at 3 and 24h, but in cancellous bone only at 3h. In cancellous bone at 24h many muscle-related genes were downregulated. These findings reveal key differences between cortical and cancellous genetic regulation in response to mechanical loading. Future studies at different time points and multiple loading sessions will add to our knowledge of cortical and cancellous mechanotransduction with the potential to identify new targets for mouse genetic knockout studies and drugs to treat osteoporosis. PMID:26876048

  8. Improvement of cancellous bone microstructure in patients on teriparatide following alendronate pretreatment.

    PubMed

    Fahrleitner-Pammer, Astrid; Burr, David; Dobnig, Harald; Stepan, Jan J; Petto, Helmut; Li, Jiliang; Krege, John H; Pavo, Imre

    2016-08-01

    An increase in procollagen type I amino-terminal propeptide (PINP) early after teriparatide initiation was shown to correlate with increased lumbar spine areal BMD and is a good predictor of the anabolic response to teriparatide. Few data exist correlating PINP and bone microstructure, and no data exist in patients on teriparatide following prior potent antiresorptive treatment. This exploratory analysis aimed to investigate the effects of teriparatide on cancellous bone microstructure and correlations of bone markers with microstructure in alendronate-pretreated patients. This was a post hoc analysis of changes in bone markers and three-dimensional indices of bone microstructure in paired iliac crest biopsies from a prospective teriparatide treatment study in postmenopausal women with osteoporosis who were either treatment-naïve (TN, n=16) or alendronate-pretreated (ALN, n=29) at teriparatide initiation. Teriparatide (20μg/day) was given for 24months; biopsies were taken at baseline and endpoint, and serum concentrations of PINP and type 1 collagen cross-linked C-telopeptide (βCTX) were measured at intervals up to 24months. In the TN and ALN groups, respectively, mean (SD) increases in three-dimensional bone volume/tissue volume were 105 (356)% (P=0.039) and 55 (139)% (P<0.005) and trabecular thickness 30.4 (30)% (P<0.001) and 30.8 (53)% (P<0.001). No significant changes were observed in trabecular number or separation. In the ALN patients, 3-month change of neither PINP nor βCTX correlated with indices of cancellous bone microstructure. However, 12-month changes in biochemical bone markers correlated significantly with improvements in bone volume/tissue volume, r=0.502 (P<0.01) and r=0.378 (P<0.05), trabecular number, r=0.559 (P<0.01) and r=0.515 (P<0.01), and reduction of trabecular separation, r=-0.432 (P<0.05) and r=-0.530 (P<0.01), for PINP and βCTX, respectively. We conclude that cancellous bone microstructure improved with teriparatide therapy

  9. Improvement of cancellous bone microstructure in patients on teriparatide following alendronate pretreatment.

    PubMed

    Fahrleitner-Pammer, Astrid; Burr, David; Dobnig, Harald; Stepan, Jan J; Petto, Helmut; Li, Jiliang; Krege, John H; Pavo, Imre

    2016-08-01

    An increase in procollagen type I amino-terminal propeptide (PINP) early after teriparatide initiation was shown to correlate with increased lumbar spine areal BMD and is a good predictor of the anabolic response to teriparatide. Few data exist correlating PINP and bone microstructure, and no data exist in patients on teriparatide following prior potent antiresorptive treatment. This exploratory analysis aimed to investigate the effects of teriparatide on cancellous bone microstructure and correlations of bone markers with microstructure in alendronate-pretreated patients. This was a post hoc analysis of changes in bone markers and three-dimensional indices of bone microstructure in paired iliac crest biopsies from a prospective teriparatide treatment study in postmenopausal women with osteoporosis who were either treatment-naïve (TN, n=16) or alendronate-pretreated (ALN, n=29) at teriparatide initiation. Teriparatide (20μg/day) was given for 24months; biopsies were taken at baseline and endpoint, and serum concentrations of PINP and type 1 collagen cross-linked C-telopeptide (βCTX) were measured at intervals up to 24months. In the TN and ALN groups, respectively, mean (SD) increases in three-dimensional bone volume/tissue volume were 105 (356)% (P=0.039) and 55 (139)% (P<0.005) and trabecular thickness 30.4 (30)% (P<0.001) and 30.8 (53)% (P<0.001). No significant changes were observed in trabecular number or separation. In the ALN patients, 3-month change of neither PINP nor βCTX correlated with indices of cancellous bone microstructure. However, 12-month changes in biochemical bone markers correlated significantly with improvements in bone volume/tissue volume, r=0.502 (P<0.01) and r=0.378 (P<0.05), trabecular number, r=0.559 (P<0.01) and r=0.515 (P<0.01), and reduction of trabecular separation, r=-0.432 (P<0.05) and r=-0.530 (P<0.01), for PINP and βCTX, respectively. We conclude that cancellous bone microstructure improved with teriparatide therapy

  10. Determining the modulus of intact bovine vertebral cancellous bone tissue: Development and validation of a protocol

    NASA Astrophysics Data System (ADS)

    Engbretson, Andrew Craig

    Cancellous, or spongy, bone accounts for nearly 80% of the human skeleton's internal surface area, despite comprising only 20% of its mass. It is made up of a network of struts and plates that provide lightweight internal support to mammalian bones. In addition, it often serves as the main interface between the skeletal system and implanted devices such as artificial hips, knees, and fracture fixation devices. However, hip arthroplasties can succumb to loosening of the implant due to bone resorption, which is thought to be caused by a mismatch in both apparent and real stiffness between the device and the surrounding bone. Many studies have attempted to determine the Young's modulus of cancellous bone tissue, but the results are far from being in agreement. Reported values range from less than 1 to nearly 20 GPa. In addition, the small size of trabeculae has made dissection and testing a challenge. In this thesis, whole individual trabeculae from a bovine lumbar spine were tested in three-point bending to determine their Young's modulus using custom-made equipment to fit a miniature single-axis testing device. The device itself was validated by testing materials with moduli ranging from 1 to 200 GPa. The structure of the cancellous bone and the morphology of the individual struts were determined using micro x-ray computed tomography (muXCT). Individual struts were manually isolated from slices made using a low-speed saw under constant lubrication and measured under a stereomicroscope. Samples exhibiting no machined surfaces (and thus deemed to be whole, or "uncut" were compared to struts that had been cut by the saw during sectioning. Validation showed that the system was capable of determining the modulus of materials that were approximately five times stiffer than the expected cancellous modulus (copper, at 115 GPa) to within 10% of published values. This gave confidence in the results for bone. The modulus of the "uncut" specimens was found to be 15.28 2.26 GPa

  11. Radionuclide evaluation of free vascularized bone graft viability. [/sup 99m/Tc-methylene diphosphonate

    SciTech Connect

    Lisbona, R.; Rennie, W.R.J.; Daniel, R.K.

    1980-02-01

    Free vascularized bone grafting is a new technique applied to the reconstructive surgery of long bones affected by aggressive benign or malignant processes, as well as traumatic deficiencies. These bone lesions may be treated by en bloc excision and replacement with fibular segments or osteocutaneous flaps from the groin isolated on their vascular pedicle. Microvascular anastomosis of the pedicle at the recipient site is necessary. Radionuclide bone imaging is unique in the assessment of the free vascularized bone graft because postoperative graft uptake of radiopharmaceutical reflects patent anastomoses and segmental bone viability.

  12. Experimental and clinical analysis of a posterolateral lumbar appendicular bone graft fusion

    PubMed Central

    Wang, Jian-Wen; Xiao, Dong-Min; Wu, Hong; Ye, Ming; Li, Xiong

    2015-01-01

    Objective: This study aimed to investigate the animal experimental and clinical results of the bone graft fusion of a posterolateral lumbar appendicular bone. Methods: 1. Sixty rabbits were randomly divided into experimental and control groups. Posterolateral lumbar bone graft with the appendicular bone and iliac bones, respectively, was then performed on these two groups. A lumbar spine X-ray was performed on the postoperative 4th, 8th and 16th weeks, and the gray value changes of the bone graft fusion area were measured to calculate fusion rates. Histology analysis was also performed to observe and count osteoblasts. 2. The appendicular bones of 106 patients who suffered from lumbar disorders were cut during lumbar surgery, and a posterolateral lumbar bone graft was performed. The postoperative follow-up used the Steffee criteria to evaluate clinical efficacy and the White criteria to evaluate fusion conditions. Results: No significant difference was observed in the relative gray values of X-ray bone density, bone graft fusion rates, and osteoblast counts in the bone graft regions between the two groups (P > 0.05). The follow-up duration of the 106 patients were 4-8 years (6.12 years), the clinical efficacy rate was 85.85%, and the fusion rate was 83.02%. Conclusions: The animal experimental and clinical results of posterolateral lumbar bone graft fusion with autologous iliac and appendicular bones were similar. PMID:26885221

  13. Specific Biomimetic Hydroxyapatite Nanotopographies Enhance Osteoblastic Differentiation and Bone Graft Osteointegration

    PubMed Central

    Loiselle, Alayna E.; Wei, Lai; Faryad, Muhammad; Paul, Emmanuel M.; Lewis, Gregory S.; Gao, Jun; Lakhtakia, Akhlesh

    2013-01-01

    Impaired healing of cortical bone grafts represents a significant clinical problem. Cadaveric bone grafts undergo extensive chemical processing to decrease the risk of disease transmission; however, these processing techniques alter the bone surface and decrease the osteogenic potential of cells at the healing site. Extensive work has been done to optimize the surface of bone grafts, and hydroxyapatite (HAP) and nanotopography both increase osteoblastic differentiation. HAP is the main mineral component of bone and can enhance osteoblastic differentiation and bone implant healing in vivo, while nanotopography can enhance osteoblastic differentiation, adhesion, and proliferation. This is the first study to test the combined effects of HAP and nanotopographies on bone graft healing. With the goal of identifying the optimized surface features to improve bone graft healing, we tested the hypothesis that HAP-based nanotopographic resurfacing of bone grafts improves integration of cortical bone grafts by enhancing osteoblastic differentiation. Here we show that osteoblastic cells cultured on processed bones coated with specific-scale (50–60 nm) HAP nanotopographies display increased osteoblastic differentiation compared to cells on uncoated bone, bones coated with poly-l-lactic acid nanotopographies, or other HAP nanotopographies. Further, bone grafts coated with 50–60-nm HAP exhibited increased formation of new bone and improved healing, with mechanical properties equivalent to live autografts. These data indicate the potential for specific HAP nanotopographies to not only increase osteoblastic differentiation but also improve bone graft incorporation, which could significantly increase patient quality of life after traumatic bone injuries or resection of an osteosarcoma. PMID:23510012

  14. Spontaneous Bone Healing after Cysts Enucleation without Bone Grafting Materials: A Randomized Clinical Study

    PubMed Central

    Rubio, Eduardo Daniel; Mombrú, Carlos Mariano

    2014-01-01

    The aim of this study was to evaluate spontaneous bone regeneration after cysts enucleation of the jaws without the use of bone grafting materials. We included 18 patients at random (11 men and 7 women) with a mean age of 31.8 years, with jaw cysts treated by enucleation, without the use of grafting materials. A method of measurements to assess the percentage of reduction of the bone cavities was used to objectify the results. The patients were evaluated before and at least 6 months after surgery, with radiographic scans based on linear measures with a computerized method using Nemoceph program (Nemotec, NemoCeph Software, Madrid, España). The analysis of the sample shows an average of 85.59% decrease in horizontal measures, 89.53% in the vertical, and 88.98 and 89.81% in the diagonal left and right, respectively. The total average reduction was 88.47%. It showed a greater decrease in vertical and diagonal measurements with respect to horizontal. Regeneration in 12 patients was 100% and in 6 patients was higher at 50.4%. Bone density increased in the postoperative radiographs. The results suggest that in some cases, spontaneous bone regeneration can be achieved by cysts enucleation without bone grafting materials. PMID:25709749

  15. Mechanical properties of cancellous bone in the human mandibular condyle are anisotropic.

    PubMed

    Giesen, E B; Ding, M; Dalstra, M; van Eijden, T M

    2001-06-01

    The objective of the present study was (1) to test the hypothesis that the elastic and failure properties of the cancellous bone of the mandibular condyle depend on the loading direction, and (2) to relate these properties to bone density parameters. Uniaxial compression tests were performed on cylindrical specimens (n=47) obtained from the condyles of 24 embalmed cadavers. Two loading directions were examined, i.e., a direction coinciding with the predominant orientation of the plate-like trabeculae (axial loading) and a direction perpendicular to the plate-like trabeculae (transverse loading). Archimedes' principle was applied to determine bone density parameters. The cancellous bone was in axial loading 3.4 times stiffer and 2.8 times stronger upon failure than in transverse loading. High coefficients of correlation were found among the various mechanical properties and between them and the apparent density and volume fraction. The anisotropic mechanical properties can possibly be considered as a mechanical adaptation to the loading of the condyle in vivo. PMID:11470118

  16. Solitary haemangioma of the shaft of long bones: resection and reconstruction with autologous bone graft.

    PubMed

    Li, Zhaoxu; Tang, Jicun; Ye, Zhaoming

    2013-04-01

    Bone haemangiomas are uncommon lesions, occurring in the skull or spine. A solitary haemangioma in the diaphysis of a long bone is rare. We retrospectively investigated six patients who presented with a solitary haemangioma in a long bone diaphysis. After segmental bone resection, the bone defect was replaced by a bone autograft. Patients were reviewed clinically and with radiographs. The mean follow-up was 6 years (range : 1-20 years). At the time of latest follow-up, no patient had a recurrence. Postoperative complications were one wound necrosis and one superficial wound infection. Union of the gap filling graft with the host bone was achieved in all patients at an average of 4 months (range: 3-8 months). The average Musculoskeletal Tumor Society functional score was 77% (range: 53%-90%) of normal at 6 months postoperatively, and 97% (range: 95%-99%) at the last follow-up evaluation. Segmental resection for solitary haemangioma and reconstruction with autologous bone graft can be considered as a suitable treatment option.

  17. Aneurysmal bone cyst involving the metacarpal bone in a child.

    PubMed

    Song, Kwang Soon; Lee, Si Wook; Bae, Ki Cheor; Sohn, Eun Seok

    2015-03-01

    Aneurysmal bone cysts associated with tubular bones of the hand occur rarely and require particular diagnostic and therapeutic management techniques. While optimal treatment has not been established, accepted treatments range from aggressive radical treatment, including en bloc resection and excision diaphysectomy with strut bone grafting, to relatively simple techniques, such as thorough curettage followed by bone graft. Aggressive treatment approaches may be optimal for the cases with articular surface involvement, full-bone invasion of the phalanx or metacarpal, or more than 1 recurrence. We report a monocentric case of aneurysmal bone cysts involving metacarpal bone in a child who achieved favorable outcome with curettage and morselized cancellous bone grafts. PMID:25750953

  18. Compressive properties of commercially available polyurethane foams as mechanical models for osteoporotic human cancellous bone

    PubMed Central

    Patel, Purvi SD; Shepherd, Duncan ET; Hukins, David WL

    2008-01-01

    Background Polyurethane (PU) foam is widely used as a model for cancellous bone. The higher density foams are used as standard biomechanical test materials, but none of the low density PU foams are universally accepted as models for osteoporotic (OP) bone. The aim of this study was to determine whether low density PU foam might be suitable for mimicking human OP cancellous bone. Methods Quasi-static compression tests were performed on PU foam cylinders of different lengths (3.9 and 7.7 mm) and of different densities (0.09, 0.16 and 0.32 g.cm-3), to determine the Young's modulus, yield strength and energy absorbed to yield. Results Young's modulus values were 0.08–0.93 MPa for the 0.09 g.cm-3 foam and from 15.1–151.4 MPa for the 0.16 and 0.32 g.cm-3 foam. Yield strength values were 0.01–0.07 MPa for the 0.09 g.cm-3 foam and from 0.9–4.5 MPa for the 0.16 and 0.32 g.cm-3 foam. The energy absorbed to yield was found to be negligible for all foam cylinders. Conclusion Based on these results, it is concluded that 0.16 g.cm-3 PU foam may prove to be suitable as an OP cancellous bone model when fracture stress, but not energy dissipation, is of concern. PMID:18844988

  19. Porous poly(propylene fumarate) foam coating of orthotopic cortical bone grafts for improved osteoconduction.

    PubMed

    Lewandrowski, Kai-Uwe; Bondre, Shrikar; Hile, David D; Thompson, Benjamin M J; Wise, Donald L; Tomford, William W; Trantolo, Debra J

    2002-12-01

    A porous biodegradable scaffold coating for perforated and demineralized cortical bone allografts could maintain immediate structural recovery and subsequently allow normal healing and remodeling by promoting bony ingrowth and avoiding accelerated graft resorption. This new type of osteoconductive surface modification should improve allograft incorporation by promoting new bone growth throughout the biodegradable scaffold, hence encasing the graft with the recipient's own bone. We investigated the feasibility of augmenting orthotopically transplanted cortical bone grafts with osteoconductive biodegradable polymeric scaffold coatings. Five types of bone grafts were prepared: type I, untreated fresh-frozen cortical bone grafts (negative control); type II, perforated and partially demineralized cortical bone grafts without additional coating (positive control); type III, perforated and partially demineralized cortical bone coated with a low-porosity poly(propylene fumarate) (PPF) foam; type IV, perforated and partially demineralized cortical bone coated with a medium-porosity PPF foam; and type V, perforated and partially demineralized cortical bone coated with a high-porosity PPF foam. Grafts were implanted into the rat tibial diaphysis. Fixation was achieved with an intramedullary threaded K-wire. Two sets of animals were operated on. Animals were killed in groups of eight with one set being killed 12 weeks, and the other 16 weeks, postoperatively. Radiographic, histologic, and histomorphometric analyses of grafts showed that the amount of new bone forming around the foam-coated grafts was significantly higher than that in the type I control group (uncoated) or that in type II group (perforated and partially demineralized cortical bone grafts). Although all foam formulations appeared initially equally osteoconductive, histologic evaluation of medium-porosity PPF foam-based coatings appeared to result in a sustained response 16 weeks postoperatively. Significant

  20. Tissue-level remodeling simulations of cancellous bone capture effects of in vivo loading in a rabbit model.

    PubMed

    Morgan, Timothy G; Bostrom, Mathias P G; van der Meulen, Marjolein C H

    2015-03-18

    The adaptation of cancellous bone to mechanical stimuli occurs throughout normal skeletal growth and aging, as well as in response to surgery, disease and device implantation. Previously we developed an in vivo cancellous loading model in the distal lateral femur of the rabbit. In response to daily in vivo loading for four weeks, bone mass increased, trabeculae thickened and the apparent modulus of the underlying cancellous bone increased. Here, we simulated our prior in vivo rabbit loading experiment using a cell-based tissue remodeling algorithm (Mullender et al., 1994) and compared the results to the in vivo experimental data published previously. Cancellous bone tissue was added or removed from the surface of trabeculae in regions of high and low mechanical stimulus, respectively. To examine the effect of material properties on mechanically regulated adaptation, we implemented both a homogeneous material model and a model where the relative density of tissue was lower for new and surface bone tissue compared to interior tissue. The simulations captured the changes in histomorphometric parameters and mechanical properties measured in the in vivo experiment illustrating the ability of computational simulations to predict the effect of mechanically regulated adaptation on cancellous bone histomorphometry and apparent modulus. PMID:25579991

  1. Does PRP enhance bone integration with grafts, graft substitutes, or implants? A systematic review

    PubMed Central

    2013-01-01

    Background Several bone implants are applied in clinical practice, but none meets the requirements of an ideal implant. Platelet-rich plasma (PRP) is an easy and inexpensive way to obtain growth factors in physiologic proportions that might favour the regenerative process. The aim of this review is to analyse clinical studies in order to investigate the role of PRP in favouring bone integration of graft, graft substitutes, or implants, and to identify the materials for which the additional use of PRP might be associated with superior osseo- and soft tissues integration. Methods A search on PubMed database was performed considering the literature from 2000 to 2012, using the following string: ("Bone Substitutes"[Mesh] OR "Bone Transplantation"[Mesh] OR "Bone Regeneration"[Mesh] OR "Osseointegration"[Mesh]) AND ("Blood Platelets"[Mesh] OR "Platelet-Rich Plasma"[Mesh]). After abstracts screening, the full-texts of selected papers were analyzed and the papers found from the reference lists were also considered. The search focused on clinical applications documented in studies in the English language: levels of evidence included in the literature analysis were I, II and III. Results Literature analysis showed 83 papers that fulfilled the inclusion criteria: 26 randomized controlled trials (RCT), 14 comparative studies, 29 case series, and 14 case reports. Several implant materials were identified: 24 papers on autologous bone, 6 on freeze-dried bone allograft (FDBA), 16 on bovine porous bone mineral (BPBM), 9 on β-tricalcium phosphate (β-TCP), 4 on hydroxyapatite (HA), 2 on titanium (Ti), 1 on natural coral, 1 on collagen sponge, 1 on medical-grade calcium sulphate hemihydrate (MGCSH), 1 on bioactive glass (BG) and 18 on a combination of biomaterials. Only 4 papers were related to the orthopaedic field, whereas the majority belonged to clinical applications in oral/maxillofacial surgery. Conclusions The systematic research showed a growing interest in this approach

  2. Recurrent Stenotrophomonas maltophilia bacteremia after iliac crest bone graft harvest.

    PubMed

    Hagiya, Hideharu; Ogawa, Hiroko; Ishida, Tomoharu; Terasaka, Tomohiro; Kimura, Kosuke; Waseda, Koichi; Hanayama, Yoshihisa; Horita, Masahiro; Shimamura, Yasunori; Kondo, Eisei; Otsuka, Fumio

    2014-01-01

    We describe a rare case of recurrent Stenotrophomonas maltophilia bacteremia in a previously healthy 45-year-old man. The infection was caused by osteomyelitis at the site of an iliac crest bone graft harvest. A genetic analysis using enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) revealed that the blood isolates and pathogens obtained from the surgical wound were identical. Initial treatment with levofloxacin and cefozopran was ineffective, but the patient's infection was successfully treated by long-term administration of latamoxef and trimethoprim-sulfamethoxazole. The present case suggests that attention should be given to the possibility of S. maltophilia infection in any situations. PMID:25088888

  3. Combination of negative pressure wound therapy with open bone grafting for bone and soft tissue defects.

    PubMed

    Deng, Kai; Yu, Ai-Xi; Xia, Cheng-Yan; Li, Zong-Huan; Wang, Wei-Yang

    2013-08-01

    The aim of this study was to investigate the efficiency of negative pressure wound therapy (NPWT) combined with open bone graft (OBG; NPWT-OBG) for the treatment of bone and soft tissue defects with polluted wounds in an animal model. All rabbits with bone and soft tissue defects and polluted wounds were randomly divided into two groups, the experimental group (NPWT with bone graft) and the control group (OBG). The efficacy of the treatment was assessed by the wound conditions and healing time. Bacterial bioburdens and bony calluses were evaluated by bacteria counting and X-rays, respectively. Furthermore, granulation tissue samples from the wounds on days 0, 3, 7 and 14 of healing were evaluated for blood vessels and vascular endothelial growth factor (VEGF) levels. Wounds in the experimental group tended to have a shorter healing time, healthier wound conditions, lower bacterial bioburden, improvement of the bony calluses and an increased blood supply compared with those in the control group. With NPWT, wound infection was effectively controlled. For wounds with osseous and soft tissue defects, NPWT combined with bone grafting was demonstrated to be more effective than an OBG.

  4. Alveolar Bone Grafting in Cleft Patients from Bone Defect to Dental Implants

    PubMed Central

    Vuletić, Marko; Jokić, Dražen; Rebić, Jerko; Žabarović, Domagoj; Macan, Darko

    2014-01-01

    Cleft lip and palate is the most common congenital deformity affecting craniofacial structures. Orofacial clefts have great impact on the quality of life which includes aesthetics, function, psychological impact, dental development and facial growth. Incomplete fusion of facial prominences during the fourth to tenth week of gestation is the main cause. Cleft gaps are closed with alveolar bone grafts in surgical procedure called osteoplasty. Autogenic bone is taken from the iliac crest as the gold standard. The time of grafting can be divided into two stages: primary and secondary. The alveolar defect is usually reconstructured between 7 and 11 years and is often related to the development of the maxillary canine root. After successful osteoplasty, cleft defect is closed but there is still a lack of tooth. The space closure with orthodontic treatment has 50-75% success. If the orthodontic treatment is not possible, in order to replace the missing tooth there are three possibilities: adhesive bridgework, tooth transplantation and implants. Dental implant has the role of holding dental prosthesis, prevents pronounced bone atrophy and loads the augmentation material in the cleft area. Despite the fact that autologous bone from iliac crest is the gold standard, it is not a perfect source for reconstruction of the alveolar cleft. Bone morphogenic protein (BMP) is appropriate as an alternative graft material. The purpose of this review is to explain morphology of cleft defects, historical perspective, surgical techniques and possibilities of implant and prosthodontic rehabilitation.

  5. Treatment of chondroblastoma of the calcaneus with a secondary aneurysmal bone cyst using endoscopic curettage without bone grafting.

    PubMed

    Otsuka, Takanobu; Kobayashi, Masaaki; Yonezawa, Masato; Kamiyama, Fumiaki; Matsushita, Yasusi; Matsui, Nobuo

    2002-04-01

    Chondroblastoma is a relatively rare benign bone tumor. Approximately 7% of chondroblastomas occur in the calcaneus, and 17% of chondroblastoma associated with cystic lesions. We report a case of a chondroblastoma in the calcaneus with a secondary aneurysmal bone cyst treated successfully by endoscopic curettage without bone grafting. New bone formation is facilitated by minimal damage to the bone and soft tissue. The cosmetic results of this procedure are good. Two years later, the patient is asymptomatic with no radiographic evidence of recurrence. Endoscopic curettage without bone grafting is a promising new treatment for chondroblastoma.

  6. Reconstruction of the anterior cruciate ligament: a comparison between bone-patellar tendon-bone grafts and fourstrand hamstring grafts

    PubMed Central

    Razi, Mohammad; Sarzaeem, Mohammad Mahdi; Kazemian, Gholam Hossein; Najafi, Farideh; Najafi, Mohammad Amin

    2014-01-01

    Background: Disruption of anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. The choice of graft for (ACL) reconstruction remains controversial. This prospective, randomized clinical trial aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis (ST) grafts for ACL reconstruction over a 3-year follow-up interval. Methods: Seventy-one patients with an average age of 29± 4.5yearswere treated for torn ACL between 2008 and 2009. Forty-sixpatients underwent reconstruction with BPTB autograft, and 41 were treated with ST autograft. At the time of final follow-up, 37 patients in patella group and 34 patients in hamstring group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC (International Knee Documentation Committee) score and complications. Results: At 36thmonth of follow-up, 34 (92%) and 28 (82%) patients in BPTB and ST group, respectively had good-to-excellent IKDC score (p > 0.05). The activity levels were higher in BPTB group (p> 0.05). At 3rd yearof follow up, the Lachman test was graded normal, for 23 (62%) and 11 (32%) patients in BPTB and ST group, respectively (p=0.019). Regarding the pivot-shift test, 29 (79%) and 15 (44%) patients in patella and hamstring group, respectively had normal test at the latest follow-up (p=0.021).There were no significant differences in terms of thigh circumference difference, effusion, knee range of motion, pain and complications. Conclusion: The results indicate a trend toward increased graft laxity and pivot-shift grades in patients undergoing reconstruction with hamstring autograft compared with patella tendon. However, the two groups had comparable results in terms of activity level and knee function. PMID:25694992

  7. Microstructures and properties of cancellous bone of avascular necrosis of femoral heads

    NASA Astrophysics Data System (ADS)

    Yao, Xuefeng; Wang, Peng; Dai, Ruchun; Yeh, Hsien Yang

    2010-03-01

    The aim of this study is to investigate microscopic structure and characterize cancellous bone of avascular necrosis of the femoral head (ANFH). The rabbit model of the ANFH is established. The histopathologic features are studied successfully. The differences between the steroid-injection group (S.G.) and the controlled group (C.G.) are examined, including the weight of rabbits, the hematological examination and the three-dimensional structures. It is found that the plasma levels of cholesterol (CHO), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) in S.G. are lower than those in C.G. when the triglyceride (TG) increased in the S.G.; but the bone mineral content (BMC) and the structural model index (SMI) of the organ and tissue decreased significantly in S.G. Three-dimensional structures of the femoral head are obtained using micro-computed tomography (CT) scanning and the mechanical model is established to analyze the influences of these structural changes on the mechanical properties of the cancellous bone.

  8. Radially and Axially Graded Multizonal Bone Graft Substitutes Targeting Critical-Sized Bone Defects from Polycaprolactone/Hydroxyapatite/Tricalcium Phosphate

    PubMed Central

    Ergun, Asli; Yu, Xiaojun; Valdevit, Antonio; Ritter, Arthur

    2012-01-01

    Repair and regeneration of critical sized defects via the utilization of polymeric bone graft substitutes are challenges. Here, we introduce radially and axially graded multizonal bone graft substitutes fabricated from polycaprolactone (PCL), and PCL biocomposites with osteoconductive particles, that is, hydroxyapatite (HA), and β-tricalcium phosphate (TCP). The novel bone graft substitutes should provide a greater degree of freedom to the orthopedic surgeon especially for repair of critically sized bone defects. The modulus of the graft substitute could be tailored in the axial direction upon the systematic variation of the HA/TCP concentration, while in the radial direction the bone graft substitute consisted of an outer layer with high stiffness, encapsulating a softer core with greater porosity. The biocompatibility of the bone graft substitutes was investigated using in vitro culturing of human bone marrow-derived stromal cells followed by the analysis of cell proliferation and differentiation rates. The characterization of the tissue constructs included the enzymatic alkaline phosphates (ALP) activity, microcomputed tomography imaging, and polymerase chain reaction analysis involving the expressions of bone markers, that is, Runx2, ALP, collagen type I, osteopontin, and osteocalcin, overall demonstrating the differentiation of bone marrow derived stem cells (BMSCs) via osteogenic lineage and formation of mineralized bone tissue. PMID:22764839

  9. Morbidity of harvesting of retromolar bone grafts: a prospective study.

    PubMed

    Nkenke, Emeka; Radespiel-Tröger, Martin; Wiltfang, Jörg; Schultze-Mosgau, Stefan; Winkler, Gerhard; Neukam, Friedrich Wilhelm

    2002-10-01

    20 retromolar bone grafts were harvested in outpatients for augmentation of the implant site from January to June 2000 (10 female, 10 male, 40.9 +/- 12.8 years, minimum 17 years, maximum 66 years). The aim of the study was to assess typical complications of this procedure in a prospective manner. For the determination of the superficial sensory function of the inferior alveolar and the lingual nerve, an objective method was used. The bone grafts were harvested for single tooth reconstruction. In 14 cases a ridge augmentation and in 6 cases an endoscopically controlled crestal sinus floor elevation was performed. Preoperatively, the height of bone above the cranial aspect of the inferior alveolar nerve in the retromolar region was assessed radiologically with known markers. The maximum mouth opening was determined. The superficial sensory function of the inferior alveolar and the lingual nerve was assessed with the Pointed-Blunt Test, the Two-Point-Discrimination Test and the objective method of the 'Pain and Thermal Sensitivity' Test (PATH Test). Moreover, the pulp sensitivity of the teeth of the donor site was determined by cold vitality testing. All tests were repeated 1 week postoperatively. Intraoperatively, the width of the retromolar region was measured with a caliper. The patients rated the operative strain on a visual analogue scale. The height of bone above the inferior alveolar nerve in the retromolar region was 11.0 +/- 2.2 mm. The width of the retromolar area was 14.2 +/- 1.9 mm. Postoperatively, the maximal mouth opening changed significantly (40.8 +/- 3.5 mm preoperatively, 38.9 +/- 3.7 mm postoperatively, P = 0.006). However, the reduction was not relevant clinically. A direct injury of the inferior alveolar or lingual nerve did not occur. A sensitivity impairment could not be detected for either of the nerves by the different test methods 1 week postoperatively. The operative strain related to the donor site was significantly less than the strain

  10. Fully Threaded Versus Partially Threaded Screws: Determining Shear in Cancellous Bone Fixation.

    PubMed

    Downey, Michael W; Kosmopoulos, Victor; Carpenter, Brian B

    2015-01-01

    Many researchers have studied and compared various forms of intraosseous fixation. No studies have examined the effects of shear through stiffness and failure strength of a fully threaded versus a partially threaded screw. Our hypothesis was that the fully threaded lag screw technique would provide greater shear strength and resistance. Thirty-six synthetic sawbone blocks were used to test screw fixation. In group 1 (n = 9), 2 blocks were fixed together using a fully threaded 4.0-mm stainless steel cancellous bone screw and the lag technique. In group 2 (n = 8), 2 blocks were fixed together using the standard manufacturer-recommended method for inserting 4.0-mm partially threaded stainless steel cancellous bone screws. The constructs were then mechanically tested. Shear was applied by compressing each construct at an axial displacement rate of 0.5 mm/s until failure. The fully threaded screw had a significantly greater (p = .026) initial stiffness (106.4 ± 15.8 N/mm) than the partially threaded screw (80.1 ± 27.5 N/mm). The yield load and displacement for the fully threaded group (429.4 ± 11.7 N and 7.2 ± 0.35 mm) were 64% and 67% greater than those for the partially threaded screw group (261.4 ± 26.1 N and 4.3 ± 1.03 mm), respectively. The results of the present study have demonstrated the importance of a full-thread construct to prevent shear and to decrease strain at the fracture. The confirmation of our hypothesis questions the future need and use of partially threaded screws for cancellous bone fixation. PMID:26210079

  11. Guided Bone Regeneration in Long-Bone Defects with a Structural Hydroxyapatite Graft and Collagen Membrane

    PubMed Central

    Walker, John A.; Singleton, Brian M.; Hernandez, Jesus W.; Son, Jun-Sik; Kim, Su-Gwan; Oh, Daniel S.; Appleford, Mark R.; Ong, Joo L.; Wenke, Joseph C.

    2013-01-01

    There are few synthetic graft alternatives to treat large long-bone defects resulting from trauma or disease that do not incorporate osteogenic or osteoinductive factors. The aim of this study was to test the additional benefit of including a permeable collagen membrane guide in conjunction with a preformed porous hydroxyapatite bone graft to serve as an improved osteoconductive scaffold for bone regeneration. A 10-mm-segmental long-bone defect model in the rabbit radius was used. The hydroxyapatite scaffolds alone or with a collagen wrap were compared as experimental treatment groups to an empty untreated defect as a negative control or a defect filled with autologous bone grafts as a positive control. All groups were evaluated after 4 and 8 weeks of in vivo implantation using microcomputed tomography, mechanical testing in flexure, and histomorphometry. It was observed that the use of the wrap resulted in an increased bone volume regenerated when compared to the scaffold-only group (59% greater at 4 weeks and 27% greater after 8 weeks). Additionally, the increase in density of the regenerated bone from 4 to 8 weeks in the wrap group was threefold than that in the scaffold group. The use of the collagen wrap showed significant benefits of increased interfacial bone in-growth (149% greater) and periosteal remodeling (49%) after 4 weeks compared to the scaffold-alone with the two groups being comparable after 8 weeks, by when the collagen membrane showed close-to-complete resorption. While the autograft and wrap groups showed significantly greater flexural strength than the defect group after 8 weeks, the scaffold-alone group was not significantly different from the other three groups. It is most likely that the wrap shows improvement of function by acting like a scaffold for periosteal callus ossification, maintaining the local bone-healing environment while reducing fibrous infiltration (15% less than scaffold only at 4 weeks). This study indicates that the use of

  12. Radiographic evaluation of the symphysis menti as a donor site for an autologous bone graft in pre-implant surgery

    PubMed Central

    Di Bari, Roberto; Coronelli, Roberto

    2013-01-01

    Purpose This study was performed to obtain a quantitative evaluation of the cortical and cancellous bone graft harvestable from the mental and canine regions, and to evaluate the cortical vestibular thickness. Materials and Methods This study collected cone-beam computed tomographic (CBCT) images of 100 Italian patients. The limits of the mental region were established: 5 mm in front of the medial margin of each mental foramen, 5 mm under the apex of each tooth present, and above the inferior mandibular cortex. Cortical and cancellous bone volumes were evaluated using SimPlant software (SimPlant 3-D Pro, Materialize, Leuven, Belgium) tools. In addition, the cortical vestibular thickness (minimal and maximal values) was evaluated in 3 cross-sections corresponding to the right canine tooth (3R), the median section (M), and the left canine tooth (3L). Results The cortical volume was 0.71±0.23 mL (0.27-1.96 mL) and the cancellous volume was 2.16±0.76 mL (0.86-6.28 mL). The minimal cortical vestibular thickness was 1.54±0.41 mm (0.61-3.25 mm), and the maximal cortical vestibular thickness was 3.14±0.75mm(1.01-5.83 mm). Conclusion The use of the imaging software allowed a patient-specific assessment of mental and canine region bone availability. The proposed evaluation method might help the surgeon in the selection of the donor site by the comparison between bone availability in the donor site and the reconstructive exigency of the recipient site. PMID:24083206

  13. Layered socket Grafting using an anorganic bovine bone mineral-collagen composite.

    PubMed

    Schmitz, John P

    2013-01-01

    Following tooth extraction, socket grafts are commonly used to prevent incomplete healing and to optimize the bony site for implant placement (1). Many particulate, composite, and putty-like bone grafting materials either with or without a membrane have been used as socket grafts. This article introduces the layered socket grafting technique for socket grafting without the use of a membrane or primary closure. This technique uses a particulate anorganic bone mineral to graft the apices of sockets and then a composite material consisting of anorganic bovine bone mineral and collagen for the superior or crestal one-third of a socket or defect. When grafting sockets, the technique is fast and does not require the use of releasing flaps or primary closure and can also be used to manage large periapical defects. PMID:23488427

  14. Short- and long-term effects of vertebroplastic bone cement on cancellous bone.

    PubMed

    Quan, Renfu; Ni, Yueming; Zhang, Liang; Xu, Jinwei; Zheng, Xuan; Yang, Disheng

    2014-07-01

    Vertebroplasty using poly(methyl methacrylate) (PMMA) bone cement is the most common method to treat osteoporotic vertebral fractures. However, several questions of interest remain to be clarified, including how does PMMA affect the cement-bone interface area and surrounding bone tissue, can damaged bone tissues be repaired, how will PMMA change the bone interface over the long-term, and what happens to PMMA itself? The purpose of this study is to investigate these concerns and provide a basis for clinical evaluation. We made bone defects in the lumbar vertebrae of New Zealand rabbits as a model of osteoporosis and injected them with bone cement. A mechanical testing machine was used to perform axial compression, three-point bending, and twisting resistance tests to observe and investigate the short- and long-term biomechanical properties of PMMA after implantation. Optical, fluorescence, scanning electron microscopy, and nanoindentation were used to observe the changes in the interface microstructure. PMMA can rapidly establish the strong support with stable function in the near future. Biomechanical experiments showed that biomechanical property of bone cement group was significantly higher than those in the other two groups (P<0.05) biomechanical property of bone cement group may decline with the time, but it's still better than that of OP in the control group (P<0.05). Histomorphological observation result shows that under osteoporosis state the bone grows slower, also bone's rebuilding time extended. And in the later period, main bone's continuous osteoporosis has some impact on the interface. Nano-indentation testing shows that the young modulus and stiffness of the interface among bone, material and interface were significantly differences (P<0.05). Bone cement had gave the best nano indentation hardness, then was interface and bone tissue. PMMA bone cement was able to quickly support and stabilize the defect in the short term, and bone growth restarted at

  15. Eggshell Derived Hydroxyapatite as Bone Graft Substitute in the Healing of Maxillary Cystic Bone Defects: A Preliminary Report

    PubMed Central

    Kattimani, Vivekanand S; Chakravarthi, P Srinivas; Kanumuru, Narasimha Reddy; Subbarao, Vummidisetti V; Sidharthan, A; Kumar, T S Sampath; Prasad, L Krishna

    2014-01-01

    Background: Since ancient times, use of graft materials to promote healing of defects of bone is wellknown. Traditionally, missing bone is replaced with material from either patient or donor. Multiple sources of bone grafts have been used to graft bone defects to stimulate bone healing. Hydroxyapatite is naturally occurring mineral component of bone, which is osteoconductive. This versatile biomaterial is derived from many sources. The aim of this study is to evaluate the efficacy of eggshell derived hydroxyapatite (EHA) in the bone regeneration of human maxillary cystic bone defects secondary to cystic removal/apicoectomy and compare the material properties of EHA in vitro. Materials and Methods: A total of eight maxillary bone defects were grafted after cystic enucleation and/or apicoectomy in the year 2008 and completed the study at 1 year. The patients were followed-up 2 weeks after surgery for signs and symptoms of infection or any other complications that may have been related to surgical procedure. Follow-up radiographs were obtained immediately after surgery followed by 1, 2, and 3 months to assess the efficacy of EHA in bone healing. Physicochemical characterization of the EHA was carried out in comparison with synthetic hydroxyapatite (SHA), also compared the biocompatibility of EHA using in vitro cytotoxicity test. Results: By the end of the 8th week, the defects grafted with EHA showed complete bone formation. However, bone formation in non-grafted sites was insignificant. The values of density measurements were equal or more than that of surrounding normal bone. These results indicate that the osseous regeneration of the bone defect filled with EHA is significant. EHA showed the superior material properties in comparison with SHA. Conclusion: EHA is a versatile novel bone graft substitute that yielded promising results. Because of its biocompatibility, lack of disease transfer risks, ease of use and unlimited availability, EHA remains a viable choice

  16. Comparative study between cortical bone graft versus bone dust for reconstruction of cranial burr holes

    PubMed Central

    Worm, Paulo V.; Ferreira, Nelson P.; Faria, Mario B.; Ferreira, Marcelo P.; Kraemer, Jorge L.; Collares, Marcus V. M.

    2010-01-01

    Background: As a consequence of the progressive evolution of neurosurgical techniques, there has been increasing concern with the esthetic aspects of burr holes. Therefore, the objective of this study was to compare the use of cortical bone graft and bone dust for correcting cranial deformities caused by neurosurgical trephines. Methods: Twenty-three patients were enrolled for cranial burr hole reconstruction with a 1-year follow-up. A total of 108 burr holes were treated; 36 burr holes were reconstructed with autogenous cortical bone discs (33.3%), and the remaining 72 with autogenous wet bone powder (66.6%). A trephine was specifically designed to produce this coin-shaped bone plug of 14 mm in diameter, which fit perfectly over the burr holes. The reconstructions were studied 12 months after the surgical procedure, using three-dimensional quantitative computed tomography. Additionally, general and plastic surgeons blinded for the study evaluated the cosmetic results of those areas, attributing scores from 0 to 10. Results: The mean bone densities were 987.95 ± 186.83 Hounsfield units (HU) for bone fragment and 473.55 ± 220.34 HU for bone dust (P < 0.001); the mean cosmetic scores were 9.5 for bone fragment and 5.7 for bone dust (P < 0.001). Conclusions: The use of autologous bone discs showed better results than bone dust for the reconstruction of cranial burr holes because of their lower degree of bone resorption and, consequently, better cosmetic results. The lack of donor site morbidity associated with procedural low cost qualifies the cortical autograft as the first choice for correcting cranial defects created by neurosurgical trephines. PMID:21206899

  17. Distribution of Young's modulus in the cancellous bone of the proximal canine tibia.

    PubMed

    Sumner, D R; Willke, T L; Berzins, A; Turner, T M

    1994-08-01

    Canine cancellous bone is used as a model for human bone in experimental orthopedic research, including models of total knee arthroplasty. Depth-force measurements produced by small-diameter indentation testing were used to derive the variation of Young's modulus over the transverse cross-sectional surface at three levels within the proximal canine tibia. At the most proximal section the presence of lateral and medial peaks of equal modulus (approximately 1100 MPa) was found. Modulus averages for the three resection levels revealed a trend of distally decreasing values, from 692 MPa proximally to 417 MPa distally. Average regional modulus values for the canine tibia were 50-75% higher than previously reported for the tibia of healthy young adult humans, although the local maxima were only 5-20% greater in canines.

  18. Determining attenuation properties of interfering fast and slow ultrasonic waves in cancellous bone

    PubMed Central

    Nelson, Amber M.; Hoffman, Joseph J.; Anderson, Christian C.; Holland, Mark R.; Nagatani, Yoshiki; Mizuno, Katsunori; Matsukawa, Mami; Miller, James G.

    2011-01-01

    Previous studies have shown that interference between fast waves and slow waves can lead to observed negative dispersion in cancellous bone. In this study, the effects of overlapping fast and slow waves on measurements of the apparent attenuation as a function of propagation distance are investigated along with methods of analysis used to determine the attenuation properties. Two methods are applied to simulated data that were generated based on experimentally acquired signals taken from a bovine specimen. The first method uses a time-domain approach that was dictated by constraints imposed by the partial overlap of fast and slow waves. The second method uses a frequency-domain log-spectral subtraction technique on the separated fast and slow waves. Applying the time-domain analysis to the broadband data yields apparent attenuation behavior that is larger in the early stages of propagation and decreases as the wave travels deeper. In contrast, performing frequency-domain analysis on the separated fast waves and slow waves results in attenuation coefficients that are independent of propagation distance. Results suggest that features arising from the analysis of overlapping two-mode data may represent an alternate explanation for the previously reported apparent dependence on propagation distance of the attenuation coefficient of cancellous bone. PMID:21973378

  19. Fractal dimension predicts broadband ultrasound attenuation in stereolithography models of cancellous bone

    NASA Astrophysics Data System (ADS)

    Langton, C. M.; Whitehead, M. A.; Haire, T. J.; Hodgskinson, R.

    1998-02-01

    There has been considerable debate on the relative dependence of broadband ultrasound attenuation (nBUA, ) upon the density and structure of cancellous bone. A nonlinear relationship between nBUA and porosity has recently been demonstrated using stereolithography models, indicating a high structural dependence for nBUA. We report here on the measurement of trabecular perimeter and fractal dimension on the two-dimensional images used to create the stereolithography models. Adjusted coefficients of determination with nBUA were 94.4% and 98.4% for trabecular perimeter and fractal dimension respectively. The feature of fractal dimension representing both the porosity and connectivity of a given structure is most exciting. Further work is required to determine the relationship between broadband ultrasound attenuation and fractal dimension in complex three-dimensional cancellous bone structures.

  20. Determining attenuation properties of interfering fast and slow ultrasonic waves in cancellous bone.

    PubMed

    Nelson, Amber M; Hoffman, Joseph J; Anderson, Christian C; Holland, Mark R; Nagatani, Yoshiki; Mizuno, Katsunori; Matsukawa, Mami; Miller, James G

    2011-10-01

    Previous studies have shown that interference between fast waves and slow waves can lead to observed negative dispersion in cancellous bone. In this study, the effects of overlapping fast and slow waves on measurements of the apparent attenuation as a function of propagation distance are investigated along with methods of analysis used to determine the attenuation properties. Two methods are applied to simulated data that were generated based on experimentally acquired signals taken from a bovine specimen. The first method uses a time-domain approach that was dictated by constraints imposed by the partial overlap of fast and slow waves. The second method uses a frequency-domain log-spectral subtraction technique on the separated fast and slow waves. Applying the time-domain analysis to the broadband data yields apparent attenuation behavior that is larger in the early stages of propagation and decreases as the wave travels deeper. In contrast, performing frequency-domain analysis on the separated fast waves and slow waves results in attenuation coefficients that are independent of propagation distance. Results suggest that features arising from the analysis of overlapping two-mode data may represent an alternate explanation for the previously reported apparent dependence on propagation distance of the attenuation coefficient of cancellous bone.

  1. Can we achieve bone healing using the diamond concept without bone grafting for recalcitrant tibial nonunions?

    PubMed

    Ollivier, M; Gay, A M; Cerlier, A; Lunebourg, A; Argenson, J N; Parratte, S

    2015-07-01

    The purpose of this study was to evaluate the efficacy and safety of a combination of recombinant human bone morphogenetic protein 7 (rhBMP-7) and resorbable calcium phosphate bone substitute (rCPBS) as a salvage solution for recalcitrant tibial fracture nonunions. Twenty consecutive patients, 16 male and four female, with a mean age of 46.8±15.7 years (21-78) and a mean body mass index (BMI) of 24.2±5.3kgm(-2) (21.5-28.5), suffering from 20 recalcitrant tibial fracture nonunions were included. The mean number of operations performed prior to the procedure was 3.3, with homolateral iliac crest bone grafts being used for all of the patients. All patients were treated with a procedure including debridement and decortications of the bone ends, nonunion fixation with a locking plate, and filling of the bony defect with a combined graft of rhBMP-7 (as osteoinductor) with an rCPBS (as scaffold). The mean follow-up was 14±2.7 months. Both clinical and radiological union occurred in 18 cases, within a mean time of 4.7±3.2 months. A recurrence of deep infection was diagnosed for one of the non-consolidated patients. No specific complication of rCPBS or rhBMP-7 was encountered. This study supports the view that the application of rCPBS combined with rhBMP-7, without any bone grafting, is safe and efficient in the treatment of recalcitrant bone union. PMID:25933808

  2. Transcutaneous Raman spectroscopy for assessing progress of bone-graft incorporation in bone reconstruction and repair

    NASA Astrophysics Data System (ADS)

    Okagbare, Paul I.; Esmonde-White, Francis W. L.; Goldstein, Steven A.; Morris, Michael D.

    2011-03-01

    Allografts and other bone-grafts are frequently used for a variety of reconstructive approaches in orthopaedic surgery. However, successful allograft incorporation remains uncertain. Consequently, there is significant need for methods to monitor the fate of these constructs. Only few noninvasive methods can fully assess the progress of graft incorporation and to provide information on the metabolic status of the graft, such as the mineral and matrix composition of the regenerated-tissue that may provide early indications of graft success or failure. For example, Computed-tomography and MRI provide information on the morphology of the graft/host interface. Limited information is also available from DXA. To address this challenge, we present here the implementation of a noninvasive Raman spectroscopy technique for in-vivo assessment of allograft incorporation in animal-model. In an animal use committee approved osseointegration experiment, a 3mm defect is created in rat's tibia. The defect is reconstructed using auto or allograft and Raman spectra are collected at several time-points during healing using an array of optical-fibers in contact with the skin of the rat over the tibia while the rat is anaesthetized. The array allows excitation and collection of Raman spectra through the skin at various positions around the tibia. Raman parameters such as mineral/matrix, carbonate/phosphate and cross-linking are recovered and monitored. The system is calibrated against locally-constructed phantoms that mimic the morphology, optics and spectroscopy of the rat. This new technology provides a non-invasive method for in-vivo assessment of bone-graft incorporation in animal-models and can be adapted for similar study in human subjects.

  3. Tumour Transfer to Bone Graft Donor Site: A Case Report and Review of the Literature of the Mechanism of Seeding

    PubMed Central

    Dias, Richard G.; Carter, Simon R.; Grimer, Robert J.; Tillman, Roger M.

    2000-01-01

    Purpose. Transmission of malignant tumour cells to a bone graft donor site is a rare complication of bone grafting.We report a case of seeding of malignant fibrous histiocytoma from the femur to a pelvic bone graft donor site. Discussion. We review the literature, discuss the possible mechanism of tumour transfer and offer advice aimed at avoiding this complication. PMID:18521435

  4. Histological evaluation of the influence of magnetic field application in autogenous bone grafts in rats

    PubMed Central

    Puricelli, Edela; Dutra, Nardier B; Ponzoni, Deise

    2009-01-01

    Background Bone grafts are widely used in oral and maxillofacial reconstruction. The influence of electromagnetic fields and magnets on the endogenous stimulation of target tissues has been investigated. This work aimed to assess the quality of bone healing in surgical cavities filled with autogenous bone grafts, under the influence of a permanent magnetic field produced by in vivo buried devices. Methods Metal devices consisting of commercially pure martensitic stainless steel washers and titanium screws were employed. Thirty male Wistar rats were divided into 3 experimental and 3 control groups. A surgical bone cavity was produced on the right femur, and a bone graft was collected and placed in each hole. Two metallic washers, magnetized in the experimental group but not in the control group, were attached on the borders of the cavity. Results The animals were sacrificed on postoperative days 15, 45 and 60. The histological analysis of control and experimental samples showed adequate integration of the bone grafts, with intense bone neoformation. On days 45 and 60, a continued influence of the magnetic field on the surgical cavity and on the bone graft was observed in samples from the experimental group. Conclusion The results showed intense bone neoformation in the experimental group as compared to control animals. The intense extra-cortical bone neoformation observed suggests that the osteoconductor condition of the graft may be more susceptible to stimulation, when submitted to a magnetic field. PMID:19134221

  5. Decellularization and Delipidation Protocols of Bovine Bone and Pericardium for Bone Grafting and Guided Bone Regeneration Procedures

    PubMed Central

    Ferroni, Letizia; Guazzo, Riccardo; Sbricoli, Luca; De Benedictis, Giulia; Finotti, Luca; Isola, Maurizio; Bressan, Eriberto; Zavan, Barbara

    2015-01-01

    The combination of bone grafting materials with guided bone regeneration (GBR) membranes seems to provide promising results to restore bone defects in dental clinical practice. In the first part of this work, a novel protocol for decellularization and delipidation of bovine bone, based on multiple steps of thermal shock, washes with detergent and dehydration with alcohol, is described. This protocol is more effective in removal of cellular materials, and shows superior biocompatibility compared to other three methods tested in this study. Furthermore, histological and morphological analyses confirm the maintenance of an intact bone extracellular matrix (ECM). In vitro and in vivo experiments evidence osteoinductive and osteoconductive properties of the produced scaffold, respectively. In the second part of this study, two methods of bovine pericardium decellularization are compared. The osmotic shock-based protocol gives better results in terms of removal of cell components, biocompatibility, maintenance of native ECM structure, and host tissue reaction, in respect to the freeze/thaw method. Overall, the results of this study demonstrate the characterization of a novel protocol for the decellularization of bovine bone to be used as bone graft, and the acquisition of a method to produce a pericardium membrane suitable for GBR applications. PMID:26191793

  6. Glycation of human cortical and cancellous bone captures differences in the formation of Maillard reaction products between glucose and ribose.

    PubMed

    Sroga, Grażyna E; Siddula, Alankrita; Vashishth, Deepak

    2015-01-01

    To better understand some aspects of bone matrix glycation, we used an in vitro glycation approach. Within two weeks, our glycation procedures led to the formation of advanced glycation end products (AGEs) at the levels that corresponded to approx. 25-30 years of the natural in vivo glycation. Cortical and cancellous bones from human tibias were glycated in vitro using either glucose (glucosylation) or ribose (ribosylation). Both glucosylation and ribosylation led to the formation of higher levels of AGEs and pentosidine (PEN) in cancellous than cortical bone dissected from all tested donors (young, middle-age and elderly men and women). More efficient glycation of bone matrix proteins in cancellous bone most likely depended on the higher porosity of this tissue, which facilitated better accessibility of the sugars to the matrix proteins. Notably, glycation of cortical bone from older donors led to much higher AGEs levels as compared to young donors. Such efficient in vitro glycation of older cortical bone could result from aging-related increase in porosity caused by the loss of mineral content. In addition, more pronounced glycation in vivo would be driven by elevated oxidation processes. Interestingly, the levels of PEN formation differed pronouncedly between glucosylation and ribosylation. Ribosylation generated very high levels of PEN (approx. 6- vs. 2.5-fold higher PEN level than in glucosylated samples). Kinetic studies of AGEs and PEN formation in human cortical and cancellous bone matrix confirmed higher accumulation of fluorescent crosslinks for ribosylation. Our results suggest that in vitro glycation of bone using glucose leads to the formation of lower levels of AGEs including PEN, whereas ribosylation appears to support a pathway toward PEN formation. Our studies may help to understand differences in the progression of bone pathologies related to protein glycation by different sugars, and raise awareness for excessive sugar supplementation in food and

  7. Current status of bone graft options for anterior interbody fusion of the cervical and lumbar spine.

    PubMed

    Chau, Anthony Minh Tien; Xu, Lileane Liang; Wong, Johnny Ho-Yin; Mobbs, Ralph Jasper

    2014-01-01

    Anterior cervical discectomy and fusion (ACDF) and anterior lumbar interbody fusion (ALIF) are common surgical procedures for degenerative disc disease of the cervical and lumbar spine. Over the years, many bone graft options have been developed and investigated aimed at complimenting or substituting autograft bone, the traditional fusion substrate. Here, we summarise the historical context, biological basis and current best evidence for these bone graft options in ACDF and ALIF. PMID:23743981

  8. Novel methodology for assessing biomaterial-biofluid interaction in cancellous bone.

    PubMed

    Bou-Francis, Antony; Widmer Soyka, René P; Ferguson, Stephen J; Hall, Richard M; Kapur, Nikil

    2015-06-01

    Understanding the cement flow behaviour and accurately predicting the cement placement within the vertebral body is extremely challenging. Vertebral cancellous bone displays highly complex geometrical structures and architectural inhomogeneities over a range of length scales, thus making the scientific understanding of the cement injection behaviour difficult in clinical or cadaveric studies. Previous experimental studies on cement flow have used open-porous aluminum foam to represent osteoporotic bone. Although the porosity was well controlled, the geometrical structure of each of the foams was inherently unique. This paper presents novel methodology using customized, reproducible and pathologically representative three-dimensional bone surrogates to help study biomaterial--biofluid interaction. The aim was to provide a robust tool for comprehensive assessment of biomaterial injection behaviour through controlling the bone surrogate morphology and the injection parameters (i.e. needle gauge, needle placement, flow rate and injected volume), measuring the injection pressure, and allowing the visualization and quantitative analysis of the spreading distribution. This methodology provides a clinically relevant representation of cement flow patterns and a tool for validating computational simulations.

  9. Comparison of alendronate and sodium fluoride effects on cancellous and cortical bone in minipigs. A one-year study.

    PubMed Central

    Lafage, M H; Balena, R; Battle, M A; Shea, M; Seedor, J G; Klein, H; Hayes, W C; Rodan, G A

    1995-01-01

    Fluoride stimulates trabecular bone formation, whereas bisphosphonates reduce bone resorption and turnover. Fracture prevention has not been convincingly demonstrated for either treatment so far. We compared the effects of 1-yr treatment of 9-mo-old minipigs with sodium fluoride (NaF, 2 mg/kg/d p.o.) or alendronate (ALN, 4 amino-1-hydroxybutylidene bisphosphonate monosodium, 1 mg/kg/d p.o.) on the biomechanical and histomorphometric properties of pig bones. As expected, NaF increased and ALN decreased bone turnover, but in these normal animals neither changed mean bone volume. NaF reduced the strength of cancellous bone from the L4 vertebra, relative to control animals, and the stiffness (resistance to deformation) of the femora, relative to the ALN group. In the ALN-treated animals, there was a strong positive correlation between bone strength and L5 cancellous bone volume, but no such correlation was observed in the NaF group. Furthermore, the modulus (resistance to deformation of the tissue) was inversely related to NaF content and there was a relative decrease in bone strength above 0.25 mg NaF/g bone. Moreover, within the range of changes measured in this study, there was an inverse correlation between bone turnover, estimated as the percentage of osteoid surface, and modulus. These findings have relevant implications regarding the use of these agents for osteoporosis therapy. PMID:7738180

  10. Beta-1 adrenergic agonist treatment mitigates negative changes in cancellous bone microarchitecture and inhibits osteocyte apoptosis during disuse.

    PubMed

    Swift, Joshua M; Swift, Sibyl N; Allen, Matthew R; Bloomfield, Susan A

    2014-01-01

    The sympathetic nervous system (SNS) plays an important role in mediating bone remodeling. However, the exact role that beta-1 adrenergic receptors (beta1AR) have in this process has not been elucidated. We have previously demonstrated the ability of dobutamine (DOB), primarily a beta1AR agonist, to inhibit reductions in cancellous bone formation and mitigate disuse-induced loss of bone mass. The purpose of this study was to characterize the independent and combined effects of DOB and hindlimb unloading (HU) on cancellous bone microarchitecture, tissue-level bone cell activity, and osteocyte apoptosis. Male Sprague-Dawley rats, aged 6-mos, were assigned to either normal cage activity (CC) or HU (n = 18/group) for 28 days. Animals were administered either daily DOB (4 mg/kg BW/d) or an equal volume of saline (VEH) (n = 9/gp). Unloading resulted in significantly lower distal femur cancellous BV/TV (-33%), Tb.Th (-11%), and Tb.N (-25%) compared to ambulatory controls (CC-VEH). DOB treatment during HU attenuated these changes in cancellous bone microarchitecture, resulting in greater BV/TV (+29%), Tb.Th (+7%), and Tb.N (+21%) vs. HU-VEH. Distal femur cancellous vBMD (+11%) and total BMC (+8%) were significantly greater in DOB- vs. VEH-treated unloaded rats. Administration of DOB during HU resulted in significantly greater osteoid surface (+158%) and osteoblast surface (+110%) vs. HU-VEH group. Furthermore, Oc.S/BS was significantly greater in HU-DOB (+55%) vs. CC-DOB group. DOB treatment during unloading fully restored bone formation, resulting in significantly greater bone formation rate (+200%) than in HU-VEH rats. HU resulted in an increased percentage of apoptotic cancellous osteocytes (+85%), reduced osteocyte number (-16%), lower percentage of occupied osteocytic lacunae (-30%) as compared to CC-VEH, these parameters were all normalized with DOB treatment. Altogether, these data indicate that beta1AR agonist treatment during disuse mitigates negative

  11. Anterior Palatal Island Advancement Flap for Bone Graft Coverage: Technical Note

    PubMed Central

    Rahpeyma, Amin; Khajehahmadi, Saeedeh

    2015-01-01

    Background: The most important step in bone graft management is soft tissue coverage. Dehiscence of the wound leads to graft exposure and subsequent problems. Purpose: This study introduces an axial pattern flap for bone graft coverage in anterior maxilla. Patients and Methods: Use of Anterior Palatal Island Advancement Flap is presented by the authors. It is a mucoperiosteal flap with axial pattern blood supply, based on nasopalatine artery. It is easy to raise and predictable. Results: Anterior Palatal Island Advancement Flap was effective in bone graft coverage in premaxillary edentulous area. Conclusion: It can be used as an aid for bone graft coverage of premaxillary edentulous ridge, where the need for mucosa is small in width but long in length. PMID:27512552

  12. Development of hydroxyapatite scaffolds for artificial bone grafts

    NASA Astrophysics Data System (ADS)

    Ajaal, Tawfik Taher

    The Taguchi method of experimental design is very well suited to improving the production process of the synthetic bone grafts for several reasons. First, it is very efficient and easy to apply, so that it does not require large amounts of time or resources to conduct a given set of experiments. This makes it possible to conduct a series of experiments that result in continuous process improvement. Second, the effect of many different process variables can be examined simultaneously, which ensures that beneficial factor combinations are not overlooked. Finally, using a Taguchi signal-to-noise ratio leads to concurrent optimization of the process and reduction of process variability. The application of Taguchi method was successful in optimizing the production process of the synthetic bone grafts. The compressive strength was doubled while maintaining the appropriate porosity level and microstructure for the bioactivity process. The mean value of the compression strength obtained was 5.8 MPa with density of 0.515 gm/cm3 for samples prepared from 45 pores per inch (PPI) foam reticulate, and 3.2 MPa with 0.422 gm/cm 3 for samples prepared from 30 PPI foam reticulate. Three levels of porosity were identified namely, macro, meso, and micro-porosity. The pore sizes were (350--400) mum, (100--120) mum and (2--6) mum respectively based on the used substrate. Using the Taguchi method in conjunction with a statistical experimental design, the various steps of the scaffold production process such as slurry preparation, coating process, drying, calcining and sintering processes were optimized. The final optimized process gave highly reproducible results.

  13. Vascularized Fibula Grafts for Reconstruction of Bone Defects after Resection of Bone Sarcomas

    PubMed Central

    Petersen, Michael Mørk; Hovgaard, Dorrit; Elberg, Jens Jørgen; Rechnitzer, Catherine; Daugaard, Søren; Muhic, Aida

    2010-01-01

    We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1–24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4/3/1) operated on form 2000 to 2006. The bone defects reconstructed were proximal femoral diaphysis and epiphysis (n = 2), humeral diaphysis (n = 2), humeral proximal diaphysis and epiphysis (n = 1), femoral diaphysis (n = 1), ulnar diaphysis (n = 1), and tibial diaphysis (n = 1). One patient with Ewing's sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26–75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis (n = 2), and hip dislocation (n = 1). Limb-sparing surgery with reconstruction of bone defects using vascularized fibular grafts in BS cases is feasible with acceptable clinical results, but fractures should be expected in many patients. PMID:20490263

  14. Prospective Analysis of Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients

    PubMed Central

    Reddy, M Gokul Chandra; Babu, V Ramesh; Rao, V Eswar; Chaitanya, J Jaya; Allareddy, S; Reddy, C Charan Kumar

    2015-01-01

    Background: To assess the success of the uptake of bone graft in cleft alveolus of the cleft lip and palate patients, quantitatively through computed tomography (CT) scan 6 months postoperative. To assess the successful eruption of permanent lateral incisor or canine in the bone grafted area. Materials and Methods: The children age group of 9-21 years with unilateral cleft lip and palate came to the hospital, needing secondary alveolar bone grafting. A detailed history and clinical examination of the patient was taken. A 3D CT scan was taken and the volume of the cleft was measured pre-operatively. After ambulatory period, 3D CT scan of the alveolar cleft region was taken and volume of the bone grafted was measured and patient was discharged from the hospital. After 6 months, patient was recalled and again 3D CT scan was taken and the volume of remaining bone was measured. Results: The mean volume of the defect pre-operatively is 0.80 cm3 with a standard deviation of 0.36 cm3 with minimum volume of the defect 0.44 cm3 and maximum volume of the defect 1.60 cm3. The mean volume of the bone post-operative immediately after grafting is 1.01 cm3 with a standard deviation of 0.52 cm3 with minimum of bone volume is 0.48 cm3 and maximum of 2.06 cm3. The mean volume of the bone after 6 months after bone grafting is 0.54 cm3 with a standard deviation of 0.33 cm3, minimum bone volume of 0.22 cm3 and maximum bone volume of 1.42 cm3. Conclusion: The CT scan is a valuable radiographic imaging modality to assess and follow the clinical outcome of secondary alveolar bone grafting. PMID:25954076

  15. Is Bone Grafting Necessary in the Treatment of Malunited Distal Radius Fractures?

    PubMed Central

    Disseldorp, Dominique J. G.; Poeze, Martijn; Hannemann, Pascal F. W.; Brink, Peter R. G.

    2015-01-01

    Background Open wedge osteotomy with bone grafting and plate fixation is the standard procedure for the correction of malunited distal radius fractures. Bone grafts are used to increase structural stability and to enhance new bone formation. However, bone grafts are also associated with donor site morbidity, delayed union at bone–graft interfaces, size mismatch between graft and osteotomy defect, and additional operation time. Purpose The goal of this study was to assess bone healing and secondary fracture displacement in the treatment of malunited distal radius fractures without the use of bone grafting. Methods Between January 1993 and December 2013, 132 corrective osteotomies and plate fixations without bone grafting were performed for malunited distal radius fractures. The minimum follow-up time was 12 months. Primary study outcomes were time to complete bone healing and secondary fracture displacement. Preoperative and postoperative radiographs during follow-up were compared with each other, as well as with radiographs of the uninjured side. Results All 132 osteotomies healed. In two cases (1.5%), healing took more than 4 months, but reinterventions were not necessary. No cases of secondary fracture displacement or hardware failure were observed. Significant improvements in all radiographic parameters were shown after corrective osteotomy and plate fixation. Conclusion This study shows that bone grafts are not required for bone healing and prevention of secondary fracture displacement after corrective osteotomy and plate fixation of malunited distal radius fractures. Level of evidence Therapeutic, level IV, case series with no comparison group PMID:26261748

  16. Periodontal bone regeneration in intrabony defects using osteoconductive bone graft versus combination of osteoconductive and osteostimulative bone graft: A comparative study

    PubMed Central

    Mahajan, Anushi; Kedige, Suresh

    2015-01-01

    Background: Bone loss is one of the hallmarks of periodontitis. Hence, a major focus of research into periodontal regeneration has concentrated on the initiation of Osteogenesis. Osteoinduction requires the differentiation of mesenchymal cells into osteoblasts with subsequent formation of new bone. The present study has been carried out to evaluate periodontal bone regeneration in intrabony defects using osteostimulative oleaginous calcium hydroxide suspension Osteora® (Metacura, Germany) in combination with osteoconductive bone graft Ossifi™ (Equinox Medical Technologies, Holland). Materials and Methods: A total of 22 sites in patients within the age range of 25-50 years, with intrabony defects were selected and divided into two groups (Group A and Group B) by using the split-mouth design technique. All the selected sites were assessed with the clinical parameters such as - Plaque Index, Gingival Index, Sulcus Bleeding Index, Periodontal Probing Depth, Clinical Attachment Level, Gingival Recession and radiographic parameter to assess the amount of Defect Fill. Mann-Whitey U-test and Wilcoxon Signed Rank Test has been used to find the significance of study parameters on continuous scale for the comparison between the mesial and distal bone levels. P < 0.05 was considered to be statistically significant. Results: Osteora® in combination with osteoconductive Ossifi™ showed better regenerative potential and more significant amount of bone fill in periodontal intrabony defects than when Ossifi™ was used alone (P = 0.039). Conclusion: Osteora® can be used as an adjunct to osteoconductive bone grafts, as an osteo-stimulating agent in the treatment of periodontal intrabony defects. PMID:25709671

  17. Alveolar bone grafting in association with polyostotic fibrous dysplasia and bisphosphonate-induced abnormal bone turnover in a bilateral cleft lip and palate patient: a case report.

    PubMed

    Kodama, Yasumitsu; Ogose, Akira; Oguri, Yoshimitsu; Ubaidus, Sobhan; Iizuka, Tateyuki; Takagi, Ritsuo

    2012-09-01

    A case is presented of extensive alveolar bone grafting in a patient with bilateral cleft lip and palate and polyostotic fibrous dysplasia. The patient previously underwent bisphosphonate therapy. Because of an abnormal and often decreased bone turnover caused by the fibrous dysplasia and the bisphosphonate therapy, bone grafting in such a patient poses several potential difficulties. In addition, the histomorphometric analysis of the bone grafts showed markedly decreased bone turnover. However, alveolar bone grafting using the iliac crest was performed successfully. Sufficient occlusion was achieved by postoperative low-loading orthodontic treatment.

  18. Evidence for reduced cancellous bone mass in the spontaneously hypertensive rat

    NASA Technical Reports Server (NTRS)

    Wang, T. M.; Hsu, J. F.; Jee, W. S.; Matthews, J. L.

    1993-01-01

    The histomorphometric changes in the proximal tibial metaphysis and epiphyseal growth plate and midtibial shaft of 26-week-old spontaneously hypertensive rats (SHR) compared with those of the corresponding normotensive Wistar-Kyoto (WKY) rats were studied. A decrease in body weight, growth plate thickness, and longitudinal growth rate of the proximal tibial epiphysis, trabecular bone volume, trabecular thickness and number, the number of osteoblasts and osteoprogenitor cells per millimeter square surface of the proximal tibial metaphysis, periosteal and endocortical apposition rate and bone formation rate of the tibial diaphysis were observed in the SHR. Additionally, systolic blood pressure, the number of osteoclasts per millimeter square surface and average number of nuclei per osteoclast of the proximal tibial metaphysis were significantly increased. Thus, osteoclastic activity is dominant over osteoblastic and chondroblastic activity in the SHR that results in a cancellous bone deficit in the skeleton. It will require additional work to ascertain the underlying cause for this condition as several factors in the SHR with a potential for causing this change are present, including elevated parathyroid hormone (PTH), depressed 1,25-(OH)2D3, low calcium absorption, reduced body weight (reduced loading) elevated blood pressure and possibly other direct cell differences in the mutant strain. At present elevated PTH and adaptation to underloading from reduced weight are postulated to be a likely cause, but additional studies are required to test this interpretation.

  19. Bioactive Ti metal analogous to human cancellous bone: Fabrication by selective laser melting and chemical treatments.

    PubMed

    Pattanayak, Deepak K; Fukuda, A; Matsushita, T; Takemoto, M; Fujibayashi, S; Sasaki, K; Nishida, N; Nakamura, T; Kokubo, T

    2011-03-01

    Selective laser melting (SLM) is a useful technique for preparing three-dimensional porous bodies with complicated internal structures directly from titanium (Ti) powders without any intermediate processing steps, with the products being expected to be useful as a bone substitute. In this study the necessary SLM processing conditions to obtain a dense product, such as the laser power, scanning speed, and hatching pattern, were investigated using a Ti powder of less than 45 μm particle size. The results show that a fully dense plate thinner than 1.8 mm was obtained when the laser power to scanning speed ratio was greater than 0.5 and the hatch spacing was less than the laser diameter, with a 30 μm thick powder layer. Porous Ti metals with structures analogous to human cancellous bone were fabricated and the compressive strength measured. The compressive strength was in the range 35-120 MPa when the porosity was in the range 75-55%. Porous Ti metals fabricated by SLM were heat-treated at 1300 °C for 1h in an argon gas atmosphere to smooth the surface. Such prepared specimens were subjected to NaOH, HCl, and heat treatment to provide bioactivity. Field emission scanning electron micrographs showed that fine networks of titanium oxide were formed over the whole surface of the porous body. These treated porous bodies formed bone-like apatite on their surfaces in a simulated body fluid within 3 days. In vivo studies showed that new bone penetrated into the pores and directly bonded to the walls within 12 weeks after implantation into the femur of Japanese white rabbits. The percentage bone affinity indices of the chemical- and heat-treated porous bodies were significantly higher than that of untreated implants.

  20. Bioactive Ti metal analogous to human cancellous bone: Fabrication by selective laser melting and chemical treatments.

    PubMed

    Pattanayak, Deepak K; Fukuda, A; Matsushita, T; Takemoto, M; Fujibayashi, S; Sasaki, K; Nishida, N; Nakamura, T; Kokubo, T

    2011-03-01

    Selective laser melting (SLM) is a useful technique for preparing three-dimensional porous bodies with complicated internal structures directly from titanium (Ti) powders without any intermediate processing steps, with the products being expected to be useful as a bone substitute. In this study the necessary SLM processing conditions to obtain a dense product, such as the laser power, scanning speed, and hatching pattern, were investigated using a Ti powder of less than 45 μm particle size. The results show that a fully dense plate thinner than 1.8 mm was obtained when the laser power to scanning speed ratio was greater than 0.5 and the hatch spacing was less than the laser diameter, with a 30 μm thick powder layer. Porous Ti metals with structures analogous to human cancellous bone were fabricated and the compressive strength measured. The compressive strength was in the range 35-120 MPa when the porosity was in the range 75-55%. Porous Ti metals fabricated by SLM were heat-treated at 1300 °C for 1h in an argon gas atmosphere to smooth the surface. Such prepared specimens were subjected to NaOH, HCl, and heat treatment to provide bioactivity. Field emission scanning electron micrographs showed that fine networks of titanium oxide were formed over the whole surface of the porous body. These treated porous bodies formed bone-like apatite on their surfaces in a simulated body fluid within 3 days. In vivo studies showed that new bone penetrated into the pores and directly bonded to the walls within 12 weeks after implantation into the femur of Japanese white rabbits. The percentage bone affinity indices of the chemical- and heat-treated porous bodies were significantly higher than that of untreated implants. PMID:20883832

  1. Experimental study of cancellous bone under large strains and a constitutive probabilistic model.

    PubMed

    Kefalas, V; Eftaxiopoulos, D A

    2012-02-01

    Experimental study of bovine cancellous bone up to compaction under uniaxial compression and up to fracture under tension, has been pursued in this article. Compression experiments have revealed the known three stages of the constitutive response, namely the initial increasing and softening branches at moderate strains, the plateau region at large strains and the hardening part at very large strains under compaction. Tension tests have quantified the increasing and softening branches of the stress-strain curve up to fracture. Subsequently, a constitutive mechanical model, for the simulation of the experimental findings up to very large strains (75% engineering strain under compression), is proposed. The model is based on the statistical description of (a) the failure process of the trabecular structure at small and moderate strains and (b) the compaction process of the trabecular mass at very large strains under compression. Several fitting cases indicated that the presented constitutive law can capture the evolution of the experimental results. PMID:22301172

  2. Effects of sodium hydroxide, sodium hypochlorite, and gaseous hydrogen peroxide on the natural properties of cancellous bone.

    PubMed

    Bi, Long; Li, De-Cheng; Huang, Zhao-Song; Yuan, Zhi

    2013-07-01

    Processed xenegeneic cancellous bone represents an alternative to bone autograft. In order to observe the effects of present prion inactivation treatments on the natural properties of xenogeneic cancellous bones, we treated bovine bone granules with sodium hydroxide (NaOH), sodium hypochlorite (NaOCl), and gaseous hydrogen peroxide (gH2 O2 ) respectively in this study. The microstructure, composition, and mineral content of the granules were evaluated by scanning electron micrograph, energy dispersive X-ray spectroscopy, ash analysis, and micro-computed tomography. The biomechanical property was analyzed by a materials testing machine. The cytocompatibility was evaluated by using a mouse fibroblast cell line (3T3). The microstructure, organic content, and mechanical strength were dramatically altered at the surface of bone in both NaOH- and NaOCl-treated groups, but not in the gH2 O2 -treated group. Compared with the gH2 O2 -treated group, attachment and proliferation of 3T3 were reduced in either NaOH- or NaOCl-treated groups. As the consequence, gH2 O2 treatment may be a useful approach of disinfection for the preparation of natural cancellous bone with well-preserved structural, mechanical, and biological properties.

  3. Donor Site Evaluation: Anterior Iliac Crest Following Secondary Alveolar Bone Grafting

    PubMed Central

    Vura, Nandagopal; Reddy K., Rajiv; R., Sudhir; G., Rajasekhar; Kaluvala, Varun Raja

    2013-01-01

    Introduction: The use of autogenous bone graft for Secondary alveolar bone grafting is well established in the treatment of cleft lip and palate patients. Aims and Objectives: To evaluate post-operative morbidity of anterior iliac crest graft after secondary alveolar bone grafting in cleft patients. Material and Methods: Forty patients during the period from July 2008 to March 2013, who underwent secondary alveolar bone grafting by harvesting graft from anterior iliac crest in Mamata Dental Hospital, Khammam, Andhra Pradesh, India are included in the present study. Unilateral and bilateral cleft patients who had undergone secondary alveolar bone grafting (SABG) with anterior iliac crest as their donor site have been selected and post- operative complications from the surgery were evaluated with the help of a questionnaire which included pain, gait disturbances, numbness and scar problems (infection, irritation). Results: Patients who were operated gave maximum score for pain as 8 on visual analogue scale. No pain was observed in any of the cases after 8 days, gait disturbances were seen in all patients (limping) for 2-6 days, there was no post-operative numbness with all the patients returning to their routine in 6- 15 days and 90% of the patients gave a satisfied response towards scar. Conclusion: From the results in our study the morbidity after harvesting bone from iliac crest was found to be moderate to low, which had minimal complications and were well tolerated and greater acceptance from the patient. PMID:24392424

  4. Impaction grafted bone chip size effect on initial stability in an acetabular model: Mechanical evaluation

    PubMed Central

    Holton, Colin; Bobak, Peter; Wilcox, Ruth; Jin, Zhongmin

    2013-01-01

    Introduction Acetabular bone defect reconstruction is an increasing problem for surgeons with patients undergoing complex primary or revision total hip replacement surgery. Impaction bone grafting is one technique that has favourable long-term clinical outcome results for patients who undergo this reconstruction method for acetabular bone defects. Creating initial mechanical stability of the impaction bone graft in this technique is known to be the key factor in achieving a favourable implant survival rate. Different sizes of bone chips were used in this technique to investigate if the size of bone chips used affected initial mechanical stability of a reconstructed acetabulum. Methodology Twenty acetabular models were created in total. Five control models were created with a cemented cup in a normal acetabulum. Then five models in three different groups of bone chip size were constructed. The three groups had an acetabular protrusion defect reconstructed using either; 2–4 mm3, 10 mm3 or 20 mm3 bone chip size for impaction grafting reconstruction. The models underwent compression loading up to 9500 N and displacement within the acetabular model was measured indicating the initial mechanical stability. Results This study reveals that, although not statistically significant, the largest (20 mm3) bone chip size grafted models have an inferior maximum stiffness compared to the medium (10 mm3) bone chip size. Interpretations Our study suggests that 10 mm3 size of bone chips provide better initial mechanical stability compared to smaller or larger bone chips. We dismissed the previously held opinion that the biggest practically possible graft is best for acetabular bone graft impaction. PMID:24396238

  5. Allograft tolerance in pigs after fractionated lymphoid irradiation. I. Skin grafts after partial lateral irradiation and bone marrow cell grafting

    SciTech Connect

    Vaiman, M.; Daburon, F.; Remy, J.; Villiers, P.A.; de Riberolles, C.; Lecompte, Y.; Mahouy, G.; Fradelizi, D.

    1981-05-01

    Experiments with pigs have been performed to establish bone marrow chimerism and skin graft tolerance between SLA genotyped animals. Recipients were conditioned by means of fractionated partial irradiation from lateral cobalt sources (partial lateral irradiation (PLI)). The head, neck, and lungs were protected with lead, the rest of the body being irradiated including the thymus, the majority of lymphoid organs with spleen, and most of the bone marrow sites.

  6. Does peripheral quantitative computed tomography ignore tissue density of cancellous bone?

    PubMed

    Banse, X; Devogelaer, J P

    2002-01-01

    The purpose of this work was to determine the capacity of peripheral quantitative computed tomography (pQCT) to accurately measure the true physical properties of vertebral cancellous bone samples and to predict their stiffness. pQCT bone mineral density (BMD) was first measured in ideal conditions. Ten cubic specimens of vertebral cancellous bone (10 x 10 x 10 mm) were washed with a water jet, defatted, and scanned in saline after elimination of air bubbles; thirteen slices were obtained. Seventy-one unprepared cylindrical samples were scanned in more realistic conditions, which allow further biomechanical testing. After extraction from the vertebral body, the samples were pushed into a plastic tube (no effort was made to remove the marrow or air bubbles), and only four slices were obtained to reduce the duration of scan. For the 81 samples, the true bone volume fraction (BV/TV, %), true apparent density (rho(app), g/cm(3)), and tissue density (rho(tiss), g/cm(3)) (an indicator of the degree of mineralization of the matrix) were then measured using Archimedes principle. rho(app) was closely correlated to BV/TV (r(2) = 0.97). rho(tiss) (1.58 +/- 0.08 g/cm(2)) was almost constant but had some influence on rho(app) (r(2) = 0.03, p < 0.001). The pQCT BMD predicted accurately rho(app) (r(2) = 0.96) and BV/TV (r(2) = 0.93) for the cylinders. For the cubes, in ideal conditions, the same correlations were even better (r(2) > 0.99, both). Analysis of covariance indicated no difference (p > 0.05) in the regressions due to preparation of the samples. The stiffness was better predicted by the true rho(app) (r(2) = 0.87) than by BV/TV (r(2) = 0.83), indicating that stiffness was influenced by small differences in the tissue density. Consequently, the correlation between pQCT BMD and stiffness was excellent (r(2) = 0.84). The fact that pQCT did not ignore this tissue density information compensated for the inaccuracies linked to realistic scanning conditions of the cylinder

  7. Histologic Evaluation of Critical Size Defect Healing With Natural and Synthetic Bone Grafts in the Pigeon ( Columba livia ) Ulna.

    PubMed

    Tunio, Ahmed; Jalila, Abu; Goh, Yong Meng; Shameha-Intan; Shanthi, Ganabadi

    2015-06-01

    Fracture and bone segment loss are major clinical problems in birds. Achieving bone formation and clinical union in a fracture case is important for the survival of the bird. To evaluate the efficacy of bone grafts for defect healing in birds, 2 different bone grafts were investigated in the healing of a bone defect in 24 healthy pigeons ( Columba livia ). In each bird, a 1-cm critical size defect (CSD) was created in the left ulna, and the fracture was stabilized with external skeletal fixation (ESF). A graft of hydroxyapatite (HA) alone (n = 12 birds) or demineralized bone matrix (DBM) combined with HA (n = 12 birds) was implanted in the CSD. The CSD healing was evaluated at 3 endpoints: 3, 6, and 12 weeks after surgery. Four birds were euthanatized at each endpoint from each treatment group, and bone graft healing in the ulna CSD was evaluated by histologic examination. The CSD and graft implants were evaluated for quality of union, cortex development, and bone graft incorporation. Results showed no graft rejection in any bird, and all birds had connective tissue formation in the defect because of the bone graft application. These results suggest that bone defect healing can be achieved by a combination of osteoinductive and osteoconductive bone graft materials for clinical union and new bone regeneration in birds. The combination of DBM and HA resulted in a better quality bone graft (P < .05) than did HA alone, but there was no significant differences in cortex development or bone graft incorporation at 3, 6, or 12 weeks. From the results of this study, we conclude that HA bone grafts, alone or in combination with DBM, with external skeletal fixation is suitable and safe for bone defect and fracture treatment in pigeons.

  8. Correction of mandibular deficiency by inverted-L osteotomy of ramus and iliac crest bone grafting

    PubMed Central

    Zhu, Song-Song; Feng, Ge; Li, Ji-Hua; Luo, En; Hu, Jing

    2012-01-01

    This study was to describe the use of inverted-L osteotomy of ramus and iliac bone graft for the management of mandibular deficiency in adult patients. From 2008 to 2010, 11 patients (aged 19 to 29 years) with mandibular deficiency underwent intraoral or extraoral inverted-L osteotomy of ramus and iliac crest bone grafting. Data were collected from the patients' records, photographs and radiographs. The height and width of the ramus were successfully expanded by inverted-L osteotomy and iliac crest bone grafting with minimal complications in all patients, resulting in significant improvement in occlusion and facial appearance. Our early results showed that the inverted-L osteotomy of ramus and iliac crest bone grafting is safe and effective, and should be considered as a good alternative for the patients with mandibular deficiency. PMID:23258379

  9. In vitro assessment of biomaterial-induced remodeling of subchondral and cancellous bone for the early intervention of joint degeneration with focus on the spinal disc

    NASA Astrophysics Data System (ADS)

    McCanless, Jonathan D.

    Osteoarthritis-associated pain of the spinal disc, knee, and hip derives from degeneration of cartilagenous tissues in these joints. Traditional therapies have focused on these cartilage (and disc specific nucleus pulposus) changes as a means of treatment through tissue grafting, regenerative synthetic implants, non-regenerative space filling implants, arthroplasty, and arthrodesis. Although such approaches may seem apparent upon initial consideration of joint degeneration, tissue pathology has shown changes in the underlying bone and vascular bed precede the onset of cartilaginous changes. It is hypothesized that these changes precedent joint degeneration and as such may provide a route for early prevention. The current work proposes an injectable biomaterial-based therapy within these subchondral and cancellous bone regions as a means of preventing or reversing osteoarthritis. Two human concentrated platelet releasate-containing alginate hydrogel/beta-tricalcium phosphate composites have been developed for this potential biomaterial application. The undertaking of assessing these materials through bench-, in vitro, and ex vivo work is described herein. These studies showed the capability of the biomaterials to initiate a wound healing response in monocytes, angiogenic and differentiation behavior in immature endothelial cells, and early osteochondral differentiation in mesenchymal stem cells. These cellular activities are associated with fracture healing and endochondral bone formation, demonstrating the potential of the biomaterials to induce osseous and vascular tissue remodeling underlying osteoarthritic joints as a novel therapy for a disease with rapidly growing healthcare costs.

  10. Functional regeneration of ligament-bone interface using a triphasic silk-based graft.

    PubMed

    Li, Hongguo; Fan, Jiabing; Sun, Liguo; Liu, Xincheng; Cheng, Pengzhen; Fan, Hongbin

    2016-11-01

    The biodegradable silk-based scaffold with unique mechanical property and biocompatibility represents a favorable ligamentous graft for tissue-engineering anterior cruciate ligament (ACL) reconstruction. However, the low efficiency of ligament-bone interface restoration barriers the isotropic silk graft to common ACL therapeutics. To enhance the regeneration of the silk-mediated interface, we developed a specialized stratification approach implementing a sequential modification on isotropic silk to constitute a triphasic silk-based graft in which three regions respectively referring to ligament, cartilage and bone layers of interface were divided, followed by respective biomaterial coating. Furthermore, three types of cells including bone marrow mesenchymal stem cells (BMSCs), chondrocytes and osteoblasts were respectively seeded on the ligament, cartilage and bone region of the triphasic silk graft, and the cell/scaffold complex was rolled up as a multilayered graft mimicking the stratified structure of native ligament-bone interface. In vitro, the trilineage cells loaded on the triphasic silk scaffold revealed a high proliferative capacity as well as enhanced differentiation ability into their corresponding cell lineage. 24 weeks postoperatively after the construct was implanted to repair the ACL defect in rabbit model, the silk-based ligamentous graft exhibited the enhancement of osseointegration detected by a robust pullout force and formation of three-layered structure along with conspicuously corresponding matrix deposition via micro-CT and histological analysis. These findings potentially broaden the application of silk-based ligamentous graft for ACL reconstruction and further large animal study. PMID:27566867

  11. Kuhlmann vascularized bone grafting for treatment of Kienböck's disease: a case report.

    PubMed

    Sbai, Mohamed Ali; Msek, Hichem; Benzarti, Sofien; Boussen, Monia; Maalla, Riadh

    2016-01-01

    Treatment of Kienböck's disease has historically been determined by staging, ulnar variance, and presence or absence of arthritic changes. With the advent of newer techniques of vascularized bone grafting, the status of the cartilage shell of the lunate has become another factor that can influence the procedure performed. The purpose of this article is to describe the technique of Kuhlmann vascularized bone graft for Kienböck's disease. In addition, the indications, contraindications, and outcomes are described. PMID:27583101

  12. Bone graft and mesenchimal stem cells: clinical observations and histological analysis

    PubMed Central

    Bertolai, Roberto; Catelani, Carlo; Aversa, Alessandro; Rossi, Alessandro; Giannini, Domenico; Bani, Daniele

    2015-01-01

    Summary Autologous bone, for its osteoconductive, osteoinductive and osteogenetic properties, has been considered to be the gold standard for maxillary sinus augmentation procedures. Autograft procedures bring also some disadvantages: sometimes the limited amount of available intraoral bone makes necessary to obtain bone from an extraoral site, and this carries an associated morbidity. To overcome this problem we started using homologous freeze-dried bone in maxillary sinus augmentation procedures. This bone is industrially processed with γ-irradiation to eliminate its disease transmission potential and it’s considered safe, but this treatment also eliminates the osteoinductive and osteogenetic properties, making it just an inert scaffold for regeneration. Mesenchymal stem cells are successfully used in and orthopedic surgery for their amplification potential of healing mechanisms. We assumed that mesenchymal stem cells can restore the osteogenetic and osteoinductive properties in homologous bone grafts. The aim of this study was an histological evaluation of bone regeneration in maxillary sinus elevation using: 1) mesenchymal stem cells engineered freeze-dried bone allografts; 2) freeze-dried bone allografts. Twenty patients (10M, 10F) with a mean age of 55.2 years affected by severe maxillary atrophy were treated with bilateral maxillary sinus floor elevation. For each patient were randomly assigned a “test” side and a “control” side, different from each other exclusively in the composition of the graft material. The “control” sides were composed by corticocancellous freeze-dried bone chips and the “test” sides were composed by corticocancellous freeze-dried bone chips engineered in a bone marrow mesenchymal stem cells concentrate. After three months bone biopsies were performed on the grafts and histological specimens were made in order to evaluate the healed bone from an histological point of view. Histologically all the specimens showed

  13. Mandibular Nonvascularized Bone Grafts of Critical Sizes and Complex Warfare Defects With Interrami Intraoral Fixation.

    PubMed

    Shuker, Sabri T

    2015-06-01

    The reconstruction of mandibular bone grafts of critical size complex defects and posterior segments malpositioned due to modern warfare injuries is a difficult, challenging task. The condition becomes even more complex if primary reconstruction is carried out inexpertly, which leads to severe disfigurement, rami mesial superior shift, tongue prolapsed, loss of speech, etc.A new interrami intraoral Kirschner wire fixation (IRIF) technique is presented for the reconstruction of large mandibular defects by nonvascularized iliac bone grafts. Twelve symphysis, parasymphysis, and lateral mandibular avulsed or chopped off with bone loss ranging from 5 cm to "ear-to-ear" rami defects underwent nonvascularized iliac bone block graft. A direct stainless steel wire fixation was carried out between bone blocks and original bone. Indirect rigid fixations were applied using a 2-mm horseshoe-shaped K-wire IRIF technique. Two complications were reported: one due to infection and the other due to the mucosa dehiscing where 2 cm of sequestrated bone was removed. The biomechanics (stress/strain distribution and strength) along the K-wire substitute the tension on the alveolar part of the mandible, creating a zone of resistance in the rami zone. This successful bone healing between the mandibular bone and the graft may have resulted from prolonged periods of sufficient stabilization during function of the mandible and bone graft function as one mandible unit during the healing period by IRIF. This new technique is quick, cheap, easy, and well tolerated by the patient for many months without complications and has been successful in modern warfare reconstructions of mandibular bone graft large defects.

  14. Effects of phase cancellation and receiver aperture size on broadband ultrasonic attenuation for trabecular bone in vitro.

    PubMed

    Cheng, Jiqi; Serra-Hsu, Frederick; Tian, Yuan; Lin, Wei; Qin, Yi-Xian

    2011-12-01

    Phase cancellation in ultrasound due to large receiver size has been proposed as a contributing factor to the inaccuracy of estimating broadband ultrasound attenuation (BUA), which is used to characterize bone quality. Transducers with aperture size ranging from 2 to 5 mm have been used in previous attempts to study the effect of phase cancellation. However, these receivers themselves are susceptible to phase cancellation because aperture size is close to one center wavelength (about 3 mm at 500 KHz in water). This study uses an ultra small receiver (aperture size: 0.2 mm) in conjunction with a newly developed two-dimensional (2-D) synthetic array system to investigate the effects of phase cancellation and receiver aperture size on BUA estimations of bone tissue. In vitro ultrasound measurements were conducted on 54 trabecular bone samples (harvested from sheep femurs) in a confocal configuration with a focused transmitter and synthesized focused receivers of different aperture sizes. Phase sensitive (PS) and phase insensitive (PI) detections were performed. The results show that phase cancellation does have a significant effect on BUA. The normalized BUA (nBUA) with PS is 8.1% higher than PI nBUA while PI BUA is well correlated with PS BUA. Receiver aperture size also influences the BUA reading for both PI and PS detection and smaller receiver aperture tends to result in higher BUA readings. The results also indicate that the receiver aperture size used in the confocal configuration with PI detection should at least equal the aperture of the transmitter to capture most of the energy redistributed by the interference and diffraction from the trabecular bone.

  15. Osseous and dental outcomes of primary gingivoperiosteoplasty with iliac bone graft: A radiological evaluation.

    PubMed

    Touzet-Roumazeille, Sandrine; Vi-Fane, Brigitte; Kadlub, Natacha; Genin, Michaël; Dissaux, Caroline; Raoul, Gwenaël; Ferri, Joël; Vazquez, Marie-Paule; Picard, Arnaud

    2015-07-01

    Primary alveolar cleft repair has two main purposes: to restore normal morphology and normal function. Gingivoperiosteoplasty with bone grafting in mixed dentition has been a well-established procedure. We hypothesized that 1) performance of this surgery in deciduous dentition would provide favorable bone graft osseointegration, and 2) would improve the support of incisor teeth eruption, thereby avoiding maxillary growth disturbances. We conducted a retrospective study of clinical and tridimensional radiological data for 73 patients with alveolar clefts (with or without lip and palate clefts) who underwent gingivoperiosteoplasty with iliac bone graft in deciduous dentition. Pre- and post-operative Cone Beam Computed Tomography (CBCT) comparison allowed evaluation of the ratio between bone graft volume and initial cleft volume (BGV/ICV ratio), and measurement of central incisor teeth movements. This series of 73 patients included 44 males and 29 females, with a mean age of 5.5 years. Few complications were observed. Post-operative CBCT was performed at 7.4 months. The mean BGV/ICV ratio was 0.62. Axial rotation was significantly improved post-operatively (p = 0.004). Gingivoperiosteoplasty with iliac bone graft is safe when performed in deciduous dentition and results in a sufficient bone graft volume to support lateral incisor eruption and upper central incisor tooth position improvement.

  16. Autogenous calvarium bone grafting as a treatment for severe bone resorption in the upper maxilla: a case report.

    PubMed

    Díaz-Romeral-Bautista, Migugel; Manchón-Miralles, Angel; Asenjo-Cabezón, Jorge; Cebrián-Carretero, José-Luis; Torres-García-Denche, Jesús; Linares-García-Valdecasas, Rafael

    2010-03-01

    Atrophic maxilla rehabilitation has been the subject of several studies for decades; despite this, there are still many different therapeutic choices for the best way to treat maxillary resorption in order to enable implant placement and integration. These possibilities include the optimal use of remaining bone structures, such as the pterygoid processes or zygomatic arch, which involves using zygomaticus and pterygoid implants in combination with standard implants placed in the residual bone; alternatively, regenerative techniques, alveolar bone expansion/distraction or bone grafting techniques may be used. Severe maxillary atrophy has a multifactorial aetiology; the most important factors being long evolution edentulism, hyperpneumatization of the maxillary sinus, post-traumatic deficit, bone loss after surgery (tumours, cysts) and periodontal problems or infection. In this report, we present a clinical case of onlay block reconstruction in an atrophic maxilla with harvested cranial calvarium bone grafts for successful future implant-supported oral rehabilitation.

  17. Late Effects of Heavy Ion Irradiation on Ex Vivo Osteoblastogenesis and Cancellous Bone Microarchitecture

    NASA Technical Reports Server (NTRS)

    Tran, Luan Hoang; Alwood, Joshua; Kumar, Akhilesh; Limoli, C. L.; Globus, Ruth

    2012-01-01

    . Thus, both low and high doses of heavy ion irradiation cause time dependent, adaptive changes in redox state within marrow cells but only high doses (50, 200cGy) inhibit osteoblastogenesis and cause cancellous bone loss. We conclude space radiation has the potential to cause persistent damage to bone marrow derived stem and progenitor cells for osteoblasts despite adaptive changes in cellular redox state.

  18. Bone graft substitutes and bone morphogenetic proteins for osteoporotic fractures: what is the evidence?

    PubMed

    Van Lieshout, Esther M M; Alt, Volker

    2016-01-01

    Despite improvements in implants and surgical techniques, osteoporotic fractures remain challenging to treat. Among other major risk factors, decreased expression of morphogenetic proteins has been identified for impaired fracture healing in osteoporosis. Bone grafts or bone graft substitutes are often used for stabilizing the implant and for providing a scaffold for ingrowth of new bone. Both synthetic and naturally occurring biomaterials are available. Products generally contain hydroxyapatite, tricalcium phosphate, dicalcium phosphate, calcium phosphate cement, calcium sulfate (plaster of Paris), or combinations of the above. Products have been used for the treatment of osteoporotic fractures of the proximal humerus, distal radius, vertebra, hip, and tibia plateau. Although there is generally consensus that screw augmentation increased the biomechanical properties and implant stability, the results of using these products for void filling are not unequivocal. In osteoporotic patients, Bone Morphogenetic Proteins (BMPs) have the potential impact to improve fracture healing by augmenting the impaired molecular and cellular mechanisms. However, the clinical evidence on the use of BMPs in patients with osteoporotic fractures is poor as there are no published clinical trials, case series or case studies. Even pre-clinical literature on in vitro and in vivo data is weak as most articles focus on the beneficial role for BMPs for restoration of the underlying pathophysiological factors of osteoporosis but do not look at the specific effects on osteoporotic fracture healing. Limited data on animal experiments suggest stimulation of fracture healing in ovariectomized rats by the use of BMPs. In conclusion, there is only limited data on the clinical relevance and optimal indications for the use of bone graft substitute materials and BMPs on the treatment of osteoporotic fractures despite the clinical benefits of these materials in other clinical indications. Given the

  19. Scaffold-free Three-dimensional Graft From Autologous Adipose-derived Stem Cells for Large Bone Defect Reconstruction: Clinical Proof of Concept.

    PubMed

    Dufrane, Denis; Docquier, Pierre-Louis; Delloye, Christian; Poirel, Hélène A; André, Wivine; Aouassar, Najima

    2015-12-01

    Long bone nonunion in the context of congenital pseudarthrosis or carcinologic resection (with intercalary bone allograft implantation) is one of the most challenging pathologies in pediatric orthopedics. Autologous cancellous bone remains the gold standard in this context of long bone nonunion reconstruction, but with several clinical limitations. We then assessed the feasibility and safety of human autologous scaffold-free osteogenic 3-dimensional (3D) graft (derived from autologous adipose-derived stem cells [ASCs]) to cure a bone nonunion in extreme clinical and pathophysiological conditions. Human ASCs (obtained from subcutaneous adipose tissue of 6 patients and expanded up to passage 4) were incubated in osteogenic media and supplemented with demineralized bone matrix to obtain the scaffold-free 3D osteogenic structure as confirmed in vitro by histomorphometry for osteogenesis and mineralization. The 3D "bone-like" structure was finally transplanted for 3 patients with bone tumor and 3 patients with bone pseudarthrosis (2 congenital, 1 acquired) to assess the clinical feasibility, safety, and efficacy. Although minor clones with structural aberrations (aneuploidies, such as tri or tetraploidies or clonal trisomy 7 in 6%-20% of cells) were detected in the undifferentiated ASCs at passage 4, the osteogenic differentiation significantly reduced these clonal anomalies. The final osteogenic product was stable, did not rupture with forceps manipulation, did not induce donor site morbidity, and was easily implanted directly into the bone defect. No acute (<3 mo) side effects, such as impaired wound healing, pain, inflammatory reaction, and infection, or long-term side effects, such as tumor development, were associated with the graft up to 4 years after transplantation. We report for the first time that autologous ASC can be fully differentiated into a 3D osteogenic-like implant without any scaffold. We demonstrated that this engineered tissue can safely promote

  20. Complications associated with negative pressure reaming for harvesting autologous bone graft: a case series.

    PubMed

    Lowe, Jason A; Della Rocca, Gregory J; Murtha, Yvonne; Liporace, Frank A; Stover, Michael D; Nork, Sean E; Crist, Brett D

    2010-01-01

    A technical benefit of the reamer-irrigator-aspirator (RIA) system (Synthes, Paoli, PA) is the ability to harvest large volumes (40-90 cm3) of autogenous bone graft. Early evaluations of this technique have reported few problems, all of which were attributed to technical error. This case series reviews 6 RIA-associated complications including 4 fractures and their contributing risk factors. Cases were collected from 4 independent orthopaedic centers, and all patients underwent RIA bone graft harvesting in a lower extremity long bone injuries. In this population, 2 patients experienced acute RIA-associated events, necessitating an additional procedure or altered postoperative rehabilitation, whereas 4 patients fractured through their donor site in the early postoperative period. This series suggests that surgeons should (1) preoperatively assess cortical diameters at long bone harvest sites, (2) carefully monitor intraoperative reaming, and (3) avoid RIA bone graft harvesting in patients with a history of osteoporosis or osteopenia unless postharvest intramedullary stabilization is considered.

  1. Long-term outcome of dental implants after maxillary augmentation with and without bone grafting

    PubMed Central

    Machuca-Ariza, Jesús; Ruiz-Martos, Alberto; Ramos-Robles, Mª-Carmen; Martínez-Lara, Ildefonso

    2016-01-01

    Background This study aims to evaluate the technique of sinus bone reformation, which consists of elevating the sinus membrane and placement the implant without bone graft, compared with the widely-used technique involving raising the maxillary sinus and grafting, using animal hydroxyapatite as the filler, while simultaneously fixing the implants. Material and Methods This is a retrospective study on two groups of patients who underwent elevation of the sinus membrane and simultaneous placement of the implant. The grafting technique was applied to one group, while the other had no graft. An alveolar ridge height of 4 to 7 mm was necessary. Radiological control was undertaken at 6 months and one year post-prosthetic loading. In each group 38 implants were placed. Results No significant behavioural differences were observed in the implants according to the Albrektsson success criteria. Implant failure was observed in 2 implants from the bone grafting group (success rate 93%) and in 1 implant from the reformation group (success rate 97%). In this group, bone formation was observed on both sides of each implant, the bone gain was measured using image management software (2.7±0.9mm mesial and 2.6±0.9mm distal). There was no correlation between mesial and distal bone gain and implant´s length. Conclusions The results indicate that bone reformation is a valid technique in cases involving atrophy of the posterior maxilla. Primary stability, maintenance of space by the implant, and the formation of a blood clot are crucial in this technique in order to achieve bone formation around the implant. It is an alternative to the conventional technique of sinus lift with filling material, and has several advantages over this procedure, including a lower infection risk, as it does not involve a biomaterial, reduced cost, a simpler technique, and better acceptance by the patient. Key words:Bone formation, sinus membrane elevation, maxillary sinus, bone grafting. PMID:26827071

  2. Anisotropic post-yield response of cancellous bone simulated by stress-strain curves of bulk equivalent structures.

    PubMed

    Tsouknidas, Alexander; Maliaris, Georgios; Savvakis, Savvas; Michailidis, Nikolaos

    2015-01-01

    During the last decade, finite element (FE) modelling has become ubiquitous in understanding complex mechanobiological phenomena, e.g. bone-implant interactions. The extensive computational effort required to achieve biorealistic results when modelling the post-yield behaviour of microstructures like cancellous bone is a major limitation of these techniques. This study describes the anisotropic biomechanical response of cancellous bone through stress-strain curves of equivalent bulk geometries. A cancellous bone segment, reverse engineered by micro computed tomography, was subjected to uniaxial compression. The material's constitutive law, obtained by nano-indentations, was considered during the simulation of the experimental process. A homodimensionally bulk geometry was employed to determine equivalent properties, resulting in a similar anisotropic response to the trabecular structure. The experimental verification of our model sustained that the obtained stress-strain curves can adequately reflect the post-yield behaviour of the sample. The introduced approach facilitates the consideration of nonlinearity and anisotropy of the tissue, while reducing the geometrical complexity of the model to a minimum. PMID:24156688

  3. Anisotropic post-yield response of cancellous bone simulated by stress-strain curves of bulk equivalent structures.

    PubMed

    Tsouknidas, Alexander; Maliaris, Georgios; Savvakis, Savvas; Michailidis, Nikolaos

    2015-01-01

    During the last decade, finite element (FE) modelling has become ubiquitous in understanding complex mechanobiological phenomena, e.g. bone-implant interactions. The extensive computational effort required to achieve biorealistic results when modelling the post-yield behaviour of microstructures like cancellous bone is a major limitation of these techniques. This study describes the anisotropic biomechanical response of cancellous bone through stress-strain curves of equivalent bulk geometries. A cancellous bone segment, reverse engineered by micro computed tomography, was subjected to uniaxial compression. The material's constitutive law, obtained by nano-indentations, was considered during the simulation of the experimental process. A homodimensionally bulk geometry was employed to determine equivalent properties, resulting in a similar anisotropic response to the trabecular structure. The experimental verification of our model sustained that the obtained stress-strain curves can adequately reflect the post-yield behaviour of the sample. The introduced approach facilitates the consideration of nonlinearity and anisotropy of the tissue, while reducing the geometrical complexity of the model to a minimum.

  4. Experience of using vascularized bone grafts in reconstructive surgery of the upper limbs

    NASA Astrophysics Data System (ADS)

    Atamanov, E. A.; Keosyan, V. T.; Bryukhanov, A. V.; Tsaregorodtseva, E. M.; Danilov, A. V.

    2015-11-01

    The article describes the results of treatment patients with defects and diseases of bone tissue using bone grafting with vascularized bone grafts from different areas of the body. The results of treatment of 27 patients with bone tissue defects of the upper extremities are demonstrated. 16 of patients had scaphoid nonunion. 2 cases of nonunion were reported: one scaphoid nonunion due to unstable osteosynthesis and one lunate fragmentation nonunion in patient with late stage Kienbock`s disease. Vascularized bone graft from distal radius was used in both cases. We had two cases of delayed union at 18 months in surgical treatment of scaphoid. 2 patients had metacarpal bone defect, 1 patient with radius bone defect, 2 patients with SLAC (scapholunate advanced collapse), 2 patients with bone defect of the humerus, 1 patient with bone defect of the ulna. In all cases we used vascularized bone crafts from various anatomical areas. We achieved union in all other cases. The study shows high efficiency of upper extremity bone defect replacement methods.

  5. A Population-Based 16-Year Study on the Risk Factors of Surgical Site Infection in Patients after Bone Grafting

    PubMed Central

    Lee, Fang-Hsin; Shen, Po-Chuan; Jou, I-Ming; Li, Chung-Yi; Hsieh, Jeng-Long

    2015-01-01

    Abstract Bone grafting is a commonly used orthopedic surgical procedure that will provide bone formation in bone defects or regions of defective bone healing. A major complication following bone grafting is a postoperative recipient graft site infection that is associated with substantial mortality and increased use of medical resources. The purpose of the study was to identify the risk factors associated with infection after bone-grafting surgery. Data from 1,303,347 patients listed in the Taiwan National Health Insurance Research Database (NHIRD) and admitted to hospitals from 1997 through 2012 who underwent primary bone grafting (mean age: 46.57 years old; mean length of hospital stay: 8.04 days) were analyzed. The incidence of infection by age, hospital stay, gender, income, chronic disease (tuberculosis [TB]; diabetes mellitus [DM]; acquired immunodeficiency syndrome [AIDS]), fracture complications (nonunion; delayed union fracture), types of graft and hospital was evaluated. Three percent of the patients developed a postoperative recipient graft site infection. Multivariable analysis revealed that patients were more likely to develop a post bone-grafting surgery infection if they were older, had a longer hospital stay, were male, had a lower income, or had comorbid TB, DM, or AIDS. Patients were more likely to develop an infection if they had a nonunion, an alloplast graft, or treated in a local clinic. Our findings should provide a clinically relevant reference for surgeons who perform bone grafting. Patients should be informed of the potential risks. PMID:26632703

  6. Secondary bone grafting for unilateral alveolar clefts: a review of surgical techniques.

    PubMed

    Shafer, D M

    1995-03-01

    For the past 5 years we have been performing the closure of the oronasal fistula with alveolar bone grafting in the early-to-late secondary time period. The final decision as to whether early or late grafting should be done is based on if a grafting is needed to support the eruption of a functional lateral incisor. Generally the Moczair type buccal flap, with a "Z" release for wide clefts, is used for the buccal flap. This is combined with lateral releasing incisions on the palate for palatal closure. Separate nasal and oral closures are performed in all cases, with bone placed between the two layers in the alveolar defect. It is believed that this treatment sequence best fulfills the criteria for successful alveolar bone grafting outlined at the beginning of this chapter. Figure 8 demonstrates an alveolar bone grafting procedure in a 10-year-old girl just before eruption of the canine tooth treated with a buccal Moczair flap, lateral releasing incisions on the palate, two-layered closure, and the placement of an iliac bone graft.

  7. Alternative method to treat oroantral communication and fistula with autogenous bone graft and platelet rich firbin

    PubMed Central

    Niedzielska, Iwona; Borgiel-Marek, Halina; Różanowski, Bartosz

    2016-01-01

    Background Removing a tooth from the jaw results in the occurrence of oroantral communication in beneficial anatomic conditions or in the case of a iatrogenic effect. Popularized treatments of the oroantral communication have numerous faults. Large bone defect eliminates the chance to introduce an implant. Purpose of this work was assessment of the usefulness of autogenous bone graft and PRF in normal bone regeneration in the site of oroantral communication. Material and Methods Bone regeneration in the site of oroantral communication was assessed in 20 patients. Bone defects were supplemented autogenous bone graft from mental protuberance in 14 cases and from oblique line in 6 cases. The graft was covered with a PRF membrane. Results In the study group in all cases closure of the oroantral communication was observed. The average width of the alveolar was 13 mm and the average height was 12.5 mm. In 3 patients an average increase of alveolar height of 1.5 mm was observed. Conclusions This method may be the best option to prepare alveolar for new implant and prosthetic solutions. Key words:Oroantral communication, oroantral fistula, autogenous bone graft, bone regeneration, platelet rich fibrin. PMID:27475687

  8. Clinical application of autogenous mandibular bone grafts. Analysis of 166 cases.

    PubMed

    Hong, M; Chen, Z H; Sun, H; Bu, R F; Chen, M J; Xie, G C; Wang, Y M; Wang, X S

    1989-10-01

    Of the 166 patients receiving autogenous mandibular bone grafts during 1972-1987, 55 were used for repair of mandibular bone defect, 67 for correction of maxillofacial malformation and 44 for reconstruction of temporo-mandibular joint. Follow-up showed that 155 patients had satisfactory results after operation.

  9. Composite coating of 58S bioglass and hydroxyapatite on a poly (ethylene terepthalate) artificial ligament graft for the graft osseointegration in a bone tunnel

    NASA Astrophysics Data System (ADS)

    Li, Hong; Wu, Yang; Ge, Yunsheng; Jiang, Jia; Gao, Kai; Zhang, Pengyun; Wu, Lingxiang; Chen, Shiyi

    2011-09-01

    The purpose of this study was to determine the effect of the combination of hydroxyapatite (HA) and bioglass (BG) on polyethylene terephthalate (PET) artificial ligament graft osseointegration within the bone tunnel. The results of in vitro culturing of MC3T3-E1 mouse osteoblastic cells proved that this HA/BG composite coating can promote the cell compatibility of grafts. A rabbit extraarticular tendon-to-bone healing model was used to evaluate the effect of this composite coating on PET artificial ligaments in vivo. The final results demonstrated that HA/BG coating improved new bone formation at the graft-bone interface and increased the load-to-failure property of graft in bone tunnel compared to the control group at early time. The study has shown that HA/BG composite coating on the PET artificial ligament surface has a positive effect in the induction of artificial ligament osseointegration within the bone tunnel.

  10. Histomorphometric Assessment of Cancellous and Cortical Bone Material Distribution in the Proximal Humerus of Normal and Osteoporotic Individuals

    PubMed Central

    Sprecher, Christoph M.; Schmidutz, Florian; Helfen, Tobias; Richards, R. Geoff; Blauth, Michael; Milz, Stefan

    2015-01-01

    Abstract Osteoporosis is a systemic disorder predominantly affecting postmenopausal women but also men at an advanced age. Both genders may suffer from low-energy fractures of, for example, the proximal humerus when reduction of the bone stock or/and quality has occurred. The aim of the current study was to compare the amount of bone in typical fracture zones of the proximal humerus in osteoporotic and non-osteoporotic individuals. The amount of bone in the proximal humerus was determined histomorphometrically in frontal plane sections. The donor bones were allocated to normal and osteoporotic groups using the T-score from distal radius DXA measurements of the same extremities. The T-score evaluation was done according to WHO criteria. Regional thickness of the subchondral plate and the metaphyseal cortical bone were measured using interactive image analysis. At all measured locations the amount of cancellous bone was significantly lower in individuals from the osteoporotic group compared to the non-osteoporotic one. The osteoporotic group showed more significant differences between regions of the same bone than the non-osteoporotic group. In both groups the subchondral cancellous bone and the subchondral plate were least affected by bone loss. In contrast, the medial metaphyseal region in the osteoporotic group exhibited higher bone loss in comparison to the lateral side. This observation may explain prevailing fracture patterns, which frequently involve compression fractures and certainly has an influence on the stability of implants placed in this medial region. It should be considered when planning the anchoring of osteosynthesis materials in osteoporotic patients with fractures of the proximal humerus. PMID:26705200

  11. The Biological Response following Autogenous Bone Grafting for Large-Volume Defects of the Knee

    PubMed Central

    DeLano, Mark C.; Spector, Myron; Jeng, Lily; Pittsley, Andrew; Gottschalk, Alexander

    2012-01-01

    Objective: This report focuses on the biological events occurring at various intervals following autogenous bone grafting of large-volume defects of the knee joint’s femoral condyle secondary to osteochondritis dissecans (OCD) or osteonecrosis (ON). It was hypothesized that the autogenous bone graft would integrate and the portion exposed to the articular surface would form fibrocartilage, which would endure for years. Methods: Between September 29, 1987 and August 8, 1994, there were 51 patients treated with autogenous bone grafting for large-volume osteochondral defects. Twenty-five of the 51 patients were available for long-term follow-up up to 21 years. Patient follow-up was accomplished by clinical opportunity and intentional research. Videotapes were available on all index surgeries for review and comparison. All had preoperative and postoperative plain film radiographs. Long-term follow-up included MRI up to 21 years. Second-look arthroscopy and biopsy were obtained on 14 patients between 8 weeks and 20 years. Results: Radiological assessment showed the autogenous bone grafts integrated with the host bone. The grafts retained the physical geometry of the original placement. MRI showed soft tissue covering the grafts in all cases at long-term follow-up. Interval biopsy showed the surface covered with fibrous tissue at 8 weeks and subsequently converted to fibrocartilage with hyaline cartilage at 20 years. Conclusion: Autogenous bone grafting provides a matrix for large osteochondral defects that integrates with the host bone and results in a surface repair of fibrocartilage and hyaline cartilage that can endure for up to 20 years. PMID:26069622

  12. Adenovirus-mediated bone morphogenetic protein-2 gene transfection of bone marrow mesenchymal stem cells combined with nano-hydroxyapatite to construct bone graft material in vitro.

    PubMed

    Li, W C; Wang, D P; Li, L J; Zhu, W M; Zeng, Y J

    2013-04-01

    To study the adhesion, proliferation and expression of bone marrow mesenchymal stem cells (BMSCs) on nano-hydroxyapatite (Nano-HA) bone graft material after transfection of adenovirus-mediated human bone morphogenetic protein-2 expression vector (Ad-BMP-2). BMSCs were transfected using Ad-BMP-2. Immunohistochemistry and Western blot were used to detect BMP-2 expression in transfected cells. After transfection, BMP-2 protein was highly expressed in BMSCs; MTT test assay showed that the Nano-HA bone graft material could not inhibit in vitro proliferation of BMSCs. Ad-BMP-2-transfected BMSCs are well biocompatible with Nano-HA bone graft material, the transfected cells in material can secrete BMP-2 stably for a long time.

  13. Ordinary and Activated Bone Grafts: Applied Classification and the Main Features

    PubMed Central

    Deev, R. V.; Drobyshev, A. Y.; Bozo, I. Y.; Isaev, A. A.

    2015-01-01

    Bone grafts are medical devices that are in high demand in clinical practice for substitution of bone defects and recovery of atrophic bone regions. Based on the analysis of the modern groups of bone grafts, the particularities of their composition, the mechanisms of their biological effects, and their therapeutic indications, applicable classification was proposed that separates the bone substitutes into “ordinary” and “activated.” The main differential criterion is the presence of biologically active components in the material that are standardized by qualitative and quantitative parameters: growth factors, cells, or gene constructions encoding growth factors. The pronounced osteoinductive and (or) osteogenic properties of activated osteoplastic materials allow drawing upon their efficacy in the substitution of large bone defects. PMID:26649300

  14. Age-related differences in microstructure, density and biomechanics of vertebral cancellous bone of Chinese males.

    PubMed

    Liu, Guo-Min; Xu, Chuan-Jie; Kong, Ning; Zhu, Xiao-Min; Zhang, Xing-Yi; Yao, Yan

    2012-12-01

    The conventional lumbar separation was performed by removing soft tissue, subsidiary structures and leaving only the vertebral body. The vertebral body was cut into two halves along the median sagittal plane, keeping the upper and lower end plates of each half, which were subsequently used for biomechanical, morphological and density experiments. From the age of 20-29 to 30-39 years, both the horizontal trabecular thickness (Tb.Th) and vertical Tb.Th decreased; the horizontal and vertical Tb.Sp increased; the plate-like trabecular Tb.Th decreased; the apparent density and volume ratio decreased; and the elastic modulus and the ultimate stress decreased; with all changes being statistically significant (p < 0.01). Similar trends were obtained from ages 40-49 to 50-59, although the changes were not significant (p > 0.05), except for the reduction in ultimate stress (p < 0.05). With aging, the collagen cross-linking capacity declined; the thicknesses of the collagen fibrils were variable, ranging from almost the same to loose, sparse or disordered thickness; and the finer collagen fibrils between the thick filaments were disorganized. In males aged from 20 to 59 years old, the horizontal and vertical Tb.Th and the plate-like Tb.Th of the vertebral body decreased, while the horizontal and vertical Tb.Sp increased. Additionally, the density, elastic modulus and the ultimate stress of the cancellous bone decreased with age. Thus, the associated changes of bone microstructure, density and biomechanics with age may lead to an increased risk of osteoporosis and fracture.

  15. Compressive behaviour of gyroid lattice structures for human cancellous bone implant applications.

    PubMed

    Yánez, A; Herrera, A; Martel, O; Monopoli, D; Afonso, H

    2016-11-01

    Electron beam melting (EBM) was used to fabricate porous titanium alloy structures. The elastic modulus of these porous structures was similar to the elastic modulus of the cancellous human bone. Two types of cellular lattice structures were manufactured and tested: gyroids and diamonds. The design of the gyroid structures was determined by the main angle of the struts with respect to the axial direction. Thus, structures with angles of between 19 and 68.5° were manufactured. The aim of the design was to reduce the amount of material needed to fabricate a structure with the desired angles to increase the range of stiffness of the scaffolds. Compression tests were conducted to obtain the elastic modulus and the strength. Both parameters increased as the angle decreased. Finally, the specific strength of the gyroid structures was compared with that of the diamond structures and other types of structures. It is shown that, for angles lower than 35°, the gyroid structures had a high strength to weight ratios. PMID:27524040

  16. Conventional, Bayesian, and Modified Prony's methods for characterizing fast and slow waves in equine cancellous bone

    PubMed Central

    Groopman, Amber M.; Katz, Jonathan I.; Holland, Mark R.; Fujita, Fuminori; Matsukawa, Mami; Mizuno, Katsunori; Wear, Keith A.; Miller, James G.

    2015-01-01

    Conventional, Bayesian, and the modified least-squares Prony's plus curve-fitting (MLSP + CF) methods were applied to data acquired using 1 MHz center frequency, broadband transducers on a single equine cancellous bone specimen that was systematically shortened from 11.8 mm down to 0.5 mm for a total of 24 sample thicknesses. Due to overlapping fast and slow waves, conventional analysis methods were restricted to data from sample thicknesses ranging from 11.8 mm to 6.0 mm. In contrast, Bayesian and MLSP + CF methods successfully separated fast and slow waves and provided reliable estimates of the ultrasonic properties of fast and slow waves for sample thicknesses ranging from 11.8 mm down to 3.5 mm. Comparisons of the three methods were carried out for phase velocity at the center frequency and the slope of the attenuation coefficient for the fast and slow waves. Good agreement among the three methods was also observed for average signal loss at the center frequency. The Bayesian and MLSP + CF approaches were able to separate the fast and slow waves and provide good estimates of the fast and slow wave properties even when the two wave modes overlapped in both time and frequency domains making conventional analysis methods unreliable. PMID:26328678

  17. Conventional, Bayesian, and Modified Prony's methods for characterizing fast and slow waves in equine cancellous bone.

    PubMed

    Groopman, Amber M; Katz, Jonathan I; Holland, Mark R; Fujita, Fuminori; Matsukawa, Mami; Mizuno, Katsunori; Wear, Keith A; Miller, James G

    2015-08-01

    Conventional, Bayesian, and the modified least-squares Prony's plus curve-fitting (MLSP + CF) methods were applied to data acquired using 1 MHz center frequency, broadband transducers on a single equine cancellous bone specimen that was systematically shortened from 11.8 mm down to 0.5 mm for a total of 24 sample thicknesses. Due to overlapping fast and slow waves, conventional analysis methods were restricted to data from sample thicknesses ranging from 11.8 mm to 6.0 mm. In contrast, Bayesian and MLSP + CF methods successfully separated fast and slow waves and provided reliable estimates of the ultrasonic properties of fast and slow waves for sample thicknesses ranging from 11.8 mm down to 3.5 mm. Comparisons of the three methods were carried out for phase velocity at the center frequency and the slope of the attenuation coefficient for the fast and slow waves. Good agreement among the three methods was also observed for average signal loss at the center frequency. The Bayesian and MLSP + CF approaches were able to separate the fast and slow waves and provide good estimates of the fast and slow wave properties even when the two wave modes overlapped in both time and frequency domains making conventional analysis methods unreliable.

  18. Compressive behaviour of gyroid lattice structures for human cancellous bone implant applications.

    PubMed

    Yánez, A; Herrera, A; Martel, O; Monopoli, D; Afonso, H

    2016-11-01

    Electron beam melting (EBM) was used to fabricate porous titanium alloy structures. The elastic modulus of these porous structures was similar to the elastic modulus of the cancellous human bone. Two types of cellular lattice structures were manufactured and tested: gyroids and diamonds. The design of the gyroid structures was determined by the main angle of the struts with respect to the axial direction. Thus, structures with angles of between 19 and 68.5° were manufactured. The aim of the design was to reduce the amount of material needed to fabricate a structure with the desired angles to increase the range of stiffness of the scaffolds. Compression tests were conducted to obtain the elastic modulus and the strength. Both parameters increased as the angle decreased. Finally, the specific strength of the gyroid structures was compared with that of the diamond structures and other types of structures. It is shown that, for angles lower than 35°, the gyroid structures had a high strength to weight ratios.

  19. Osteoblast-specific overexpression of amphiregulin leads to transient increase in femoral cancellous bone mass in mice.

    PubMed

    Vaidya, Mithila; Lehner, Diana; Handschuh, Stephan; Jay, Freya F; Erben, Reinhold G; Schneider, Marlon R

    2015-12-01

    The epidermal growth factor receptor ligand amphiregulin (AREG) has been implicated in bone physiology and in bone anabolism mediated by intermittent parathyroid hormone treatment. However, the functions of AREG in bone have been only incipiently evaluated in vivo. Here, we generated transgenic mice overexpressing AREG specifically in osteoblasts (Col1-Areg). pQCT analysis of the femoral metaphysis revealed increased trabecular bone mass at 4, 8, and 10weeks of age in Col1-Areg mice compared to control littermates. However, the high bone mass phenotype was transient and disappeared in older animals. Micro-CT analysis of the secondary spongiosa confirmed increased trabecular bone volume and trabecular number in the distal femur of 4-week-old AREG-tg mice compared to control littermates. Furthermore, μ-CT analysis of the primary spongiosa revealed unaltered production of new bone trabeculae in distal femora of Col1-Areg mice. Histomorphometric analysis revealed a reduced number of osteoclasts in 4-week-old Col1-Areg mice, but not at later time points. Cancellous bone formation rate remained unchanged in Col1-Areg mice at all time points. In addition, bone mass and bone turnover in lumbar vertebral bodies were similar in Col1-Areg and control mice at all ages examined. Proliferation and differentiation of osteoblasts isolated from neonatal calvariae did not differ between Col1-Areg and control mice. Taken together, these data suggest that AREG overexpression in osteoblasts induces a transient high bone mass phenotype in the trabecular compartment of the appendicular skeleton by a growth-related, non-cell autonomous mechanism, leading to a positive bone balance with unchanged bone formation and lowered bone resorption.

  20. Human parathyroid hormone-(1-38) restores cancellous bone to the immobilized, osteopenic proximal tibial metaphysis in rats

    NASA Technical Reports Server (NTRS)

    Ma, Y. F.; Jee, W. S.; Ke, H. Z.; Lin, B. Y.; Liang, X. G.; Li, M.; Yamamoto, N.

    1995-01-01

    The purpose of this study was to determine if human parathyroid hormone-(1-38) (hPTH(1-38)) can restore cancellous bone mass to the established osteopenic, immobilized proximal tibial metaphyses of female rats. The right hindlimbs of 6-month-old female Sprague-Dawley rats were immobilized by bandaging the right hindlimbs to the abdomen. After 30 days of right hindlimb immobilization, the rats were subcutaneously injected with 200 micrograms hPTH(1-38)/kg/day for 15 days (short-term treatment) or 75 days (longer-term treatment). Static bone histomorphometry was performed on the primary spongiosa, and both static and dynamic histomorphometry were performed on the secondary spongiosa of the right proximal tibial metaphyses. Immobilization for 30 days without treatment decreased trabecular bone area, number, and thickness in both primary and secondary spongiosa, and induced an increase in eroded perimeter and a decrease in tissue referent-bone formation rate in the secondary spongiosa. These changes reached a new steady state thereafter. Treatment with 200 micrograms hPTH(1-38)/kg/day for 15 days, beginning 30 days after immobilization, significantly increased trabecular bone area, thickness, and number in both primary and secondary spongiosa despite continuous immobilization when compared with controls. The short-term PTH treatment (15 days) significantly increased labeling perimeter, mineral apposition rate, and tissue referent-bone formation rate in the secondary spongiosa and stimulated longitudinal bone growth as compared with the controls. Longer PTH treatment (75 days) further increased trabecular bone area, thickness, and number as compared with controls and groups given short-term PTH treatment (15 days). The bone formation indices in the secondary spongiosa of the longer-term treated rats were lower than those of the short-term treated group, but they were still higher than those of controls. Our findings indicate that PTH treatment stimulates cancellous bone

  1. Posterolateral spinal fusion in a rabbit model using a collagen–mineral composite bone graft substitute

    PubMed Central

    Vizesi, F.; Cornwall, G. B.; Bell, D.; Oliver, R.; Yu, Y.

    2009-01-01

    Choosing the appropriate graft material to participate in the healing process in posterolateral spinal fusion continues to be a challenge. Combining synthetic graft materials with bone marrow aspirate (BMA) and autograft is a reasonable treatment option for surgeons to potentially reduce or replace the need for autograft. FormaGraft, a bone graft material comprising 12% bovine-derived collagen and 88% ceramic in the form of hydroxyapatite (HAp) and beta tricalcium phosphate (β-TCP) was evaluated in three possible treatment modalities for posterior spinal fusion in a standard rabbit model. These three treatment groups were FormaGraft alone, FormaGraft soaked in autogenous BMA, and FormaGraft with BMA and iliac crest autograft. No statistically demonstrable benefits or adverse effects of the addition of BMA were found in the current study based on macroscopic, radiology or mechanical data. This may reflect, in part, the good to excellent results of the collagen HA/TCP composite material alone in a well healing bony bed. Histology did, however, reveal a benefit with the use of BMA. Combining FormaGraft with autograft and BMA achieved results equivalent to autograft alone. The mineral and organic nature of the material provided a material that facilitated fusion between the transverse processes in a standard preclinical posterolateral fusion model. PMID:19475437

  2. Cyclooxygenase-2 inhibition does not impair block bone grafts healing in rabbit model.

    PubMed

    Moreschi, Eduardo; Biguetti, Claudia Cristina; Comparim, Eliston; De Andrade Holgado, Leandro; Ribeiro-Junior, Paulo Domingos; Nary-Filho, Hugo; Matsumoto, Mariza Akemi

    2013-12-01

    Success of alveolar reconstructions using onlay autogenous block bone grafts depends on their adequate integration to the recipient bed influenced by a number of local molecules. Considering the fundamental role of cyclooxygenase (COX-2) in bone repair, the aim of this study was to analyze the effect of its inhibition in the integration of endochondral (EC) iliac crest, and intramembranous (IM) calvaria bone grafts. Thirty-two rabbits were divided into 4 groups: Calvaria Control (CC) and Iliac Control--treated with oral 0.9 % saline solution, and Calvarial-NSAID (C-NSAID) and Iliac-NSAID (I-NSAID) groups--treated with oral 6 mg/Kg non-steroidal anti-inflammatory drug etoricoxib. After 7, 14, 30 and 60 days the animals were euthanized and the specimens removed for histological, histomorphometric and immunohistochemistry analysis. At day 60, a tight integration of IM blocks could be seen with the presence of remodeling bone, whereas integration of EC grafts was mainly observed at the edges of the grafts. A significant higher percentage of bone matrix in the interface region of the CC grafts in comparison to C-NSAID only at day 14, whereas no differences were detected comparing the EC grafts. No differences were observed in Runx-2 and vascular endothelial growth factor (VEGF) immunolabeling when comparing CC and C-NSAID groups, while a significant weaker Runx-2 and VEGF labeling was detected in I-NSAID group at day 60. Although some influence was detected in osteogenesis, it is concluded that drug induced inhibition of COX-2 does not impair onlay bone grafts' healing of both embryologic origins in rabbits. PMID:23783533

  3. Synchrotron X-ray bio-imaging of natural and synthetic bone-graft materials in an aqueous environment

    NASA Astrophysics Data System (ADS)

    Kim, Yong-Gun; Bark, Chung Wung

    2014-11-01

    Bone-graft materials in dentistry have osteoinductive and osteoconductive abilities, which depend on their microstructural characteristics, such as their porosity, particle size, micro channels, and absorption. These characteristics have been observed using various imaging techniques, such as optical microscopy and scanning electron microscopy (SEM). However, most techniques cannot provide images in water, even though graft materials in vivo are invariably in contact with different water-based fluids. Synchrotron X-ray imaging allows sample microenvironments to be controlled as X-ray beams easily penetrate air and water. In this report, we used the synchrotron X-ray imaging technique to provide in-situ images of various bone-graft materials in aqueous environments. We observed internal microstructural images of bone-graft materials in real-time in 0.9% saline solution and interactions between bone-graft materials and saline, that is, hydration patterns and bone-graft expansion.

  4. Two-Stage Revision Anterior Cruciate Ligament Reconstruction: Bone Grafting Technique Using an Allograft Bone Matrix.

    PubMed

    Chahla, Jorge; Dean, Chase S; Cram, Tyler R; Civitarese, David; O'Brien, Luke; Moulton, Samuel G; LaPrade, Robert F

    2016-02-01

    Outcomes of primary anterior cruciate ligament (ACL) reconstruction have been reported to be far superior to those of revision reconstruction. However, as the incidence of ACL reconstruction is rapidly increasing, so is the number of failures. The subsequent need for revision ACL reconstruction is estimated to occur in up to 13,000 patients each year in the United States. Revision ACL reconstruction can be performed in one or two stages. A two-stage approach is recommended in cases of improper placement of the original tunnels or in cases of unacceptable tunnel enlargement. The aim of this study was to describe the technique for allograft ACL tunnel bone grafting in patients requiring a two-stage revision ACL reconstruction. PMID:27274452

  5. Two-Stage Revision Anterior Cruciate Ligament Reconstruction: Bone Grafting Technique Using an Allograft Bone Matrix.

    PubMed

    Chahla, Jorge; Dean, Chase S; Cram, Tyler R; Civitarese, David; O'Brien, Luke; Moulton, Samuel G; LaPrade, Robert F

    2016-02-01

    Outcomes of primary anterior cruciate ligament (ACL) reconstruction have been reported to be far superior to those of revision reconstruction. However, as the incidence of ACL reconstruction is rapidly increasing, so is the number of failures. The subsequent need for revision ACL reconstruction is estimated to occur in up to 13,000 patients each year in the United States. Revision ACL reconstruction can be performed in one or two stages. A two-stage approach is recommended in cases of improper placement of the original tunnels or in cases of unacceptable tunnel enlargement. The aim of this study was to describe the technique for allograft ACL tunnel bone grafting in patients requiring a two-stage revision ACL reconstruction.

  6. Short-term Results of Muscle-Pedicle Bone Grafting with Tensor Fascia Lata for Delayed Femoral Neck Fractures; Case Series and Literature Review

    PubMed Central

    Salgotra, Kuldip; Kohli, Sarabjeet; Vishwakarma, Nilesh

    2016-01-01

    Neglected, untreated and delayed femur neck fractures are commonly encountered and the treatment dilemma arises especially when the patient is physiologically young and osteosynthesis is the preferred option. Controversy exists in the current literature as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularized fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata and Quadratus femoris graft) and vascularized bone grafting do not have clear lines of indications. The current study is a case series of 7 patients with femur neck fractures with delayed presentation beyond the vascular emergency period who were treated with osteosynthesis with muscle pedicle bone graft (MPBG) using tensor fascia lata muscle pedicle graft. Patients were followed clinical and radiologically at 6 weeks, 3 and 6 months, 1 year and 3 years and patients were regularly followed. The mean age of the patients was 47 ± 1.1 ranging from 38 to 55 years. There were 6 (85.7%) men and 1 (14.3%) women among the patients. Overall 5 (71.5%) patients had transcervical and 2 (28.5%) had subcapital fractures. At the end of 6 months, 6 (85.7%) patients were pain free and on plain radiographs fracture union was noted. One (14.3%) patient developed collapse and persistent nonunion. Younger group less than 50 years presenting with neglected fracture neck femur should always be give an option of head salvage surgery in selected cases. Muscle pedicle bone grafting has been proven although inconsistently as a valid option for fracture neck femur. We encourage osteosynthesis with the use of tensor fascia lata muscle pedicle grafting along with cancellous cannulated screws as a first option in selected cases of neglected femur neck fractures. PMID:27331067

  7. Immobilization of a bone and cartilage stimulating peptide to a synthetic bone graft.

    PubMed

    Wang, Vivian; Misra, Gauri; Amsden, Brian

    2008-05-01

    A synthetic peptide fragment of human collagen type I (BCSP-1) was linked to the surface of a commercially available ceramic in an effort to improve the properties of the bone graft substitute to accelerate local healing. BCSP-1 was covalently immobilized on the surface of the ceramic via the linkers 3-aminopropyl-triethoxysilane (APTES) and suberic acid bis-N-hydroxysuccinimide ester (DSS). The chosen chemistry was non-cytotoxic. A rat calvaria cell assay using alkaline phosphatase (ALP) as an osteoblast differentiation marker, showed that modifying the surface of the ceramic was enough to enhance ALP activity, although the total cell population on the surface decreased. A significant increase in ALP activity/cell was noted with serum albumin bound to the surface, however, the BCSP-1 bound surface exhibited an even greater ALP activity that showed a surface concentration dependent trend. An optimal BCSP-1 surface density in the range of 0.87-2.24 nmol/cm2 elicited the maximum ALP activity/cell at day 6 of culture. The peptide bound ceramic generated an ALP activity/cell that was roughly 3-fold higher than the non-modified ceramic and 2-fold higher than the APTES-grafted ceramic. PMID:18030432

  8. Systemic and local zoledronic acid treatment with hydroxyapatite bone graft: A histological and histomorphometric experimental study

    PubMed Central

    Günes, Nedim; Dundar, Serkan; Saybak, Arif; Artas, Gökhan; Acikan, Izzet; Ozercan, I. Hanifi; Atilgan, Serhat; Yaman, Ferhan

    2016-01-01

    In this study, the aim was to compare the relative efficacy of systemic and local zoledronic acid (ZA) on a hydroxyapatite (HA) bone graft in a rat critical-size calvarial bone defect. In total, 84 female rats were divided into four groups: Empty control (EC) group with no treatment applied; HA group, in which only HA bone graft material was used in the calvarium; and HA plus local ZA (HA+LZA) and HA plus systemic ZA (HA+SZA) groups, in which animals received ZA locally or systemically, respectively, with HA bone graft material in the calvarium. A 5-mm standardised critical-size calvarial bone defect was created with a standard trephine drill and the respective treatment was applied. Rats were sacrificed 7, 14 and 28 days later. The numbers of osteoclasts and osteoblasts, and degree of bone formation were evaluated histopathologically and histomorphometrically. Statistically significant differences were detected between the HA, HA+LZA and HA+SZA groups and the EC group for new bone formation (P<0.05). Osteoblast numbers in the HA+LZA and HA+SZA groups were significantly higher compared with those in the EC and HA groups (P<0.05). No statistically significant difference was detected between the HA+LZA and HA+SZA groups in new bone formation or osteoblast number (P>0.05). Bone formation was significantly higher in the HA group than in the EC group (P<0.05). The numbers of osteoclasts in the HA+LZA and HA+SZA groups were significantly higher than those in the groups EC and HA (P<0.05); however, there was no significant difference between groups HA+LZA and HA+SZA (P>0.05). Within the limitations of this study, systemic or local administration of ZA enhanced new bone formation with a HA bone graft in a rat critical-size calvarial defect model. PMID:27698743

  9. Systemic and local zoledronic acid treatment with hydroxyapatite bone graft: A histological and histomorphometric experimental study

    PubMed Central

    Günes, Nedim; Dundar, Serkan; Saybak, Arif; Artas, Gökhan; Acikan, Izzet; Ozercan, I. Hanifi; Atilgan, Serhat; Yaman, Ferhan

    2016-01-01

    In this study, the aim was to compare the relative efficacy of systemic and local zoledronic acid (ZA) on a hydroxyapatite (HA) bone graft in a rat critical-size calvarial bone defect. In total, 84 female rats were divided into four groups: Empty control (EC) group with no treatment applied; HA group, in which only HA bone graft material was used in the calvarium; and HA plus local ZA (HA+LZA) and HA plus systemic ZA (HA+SZA) groups, in which animals received ZA locally or systemically, respectively, with HA bone graft material in the calvarium. A 5-mm standardised critical-size calvarial bone defect was created with a standard trephine drill and the respective treatment was applied. Rats were sacrificed 7, 14 and 28 days later. The numbers of osteoclasts and osteoblasts, and degree of bone formation were evaluated histopathologically and histomorphometrically. Statistically significant differences were detected between the HA, HA+LZA and HA+SZA groups and the EC group for new bone formation (P<0.05). Osteoblast numbers in the HA+LZA and HA+SZA groups were significantly higher compared with those in the EC and HA groups (P<0.05). No statistically significant difference was detected between the HA+LZA and HA+SZA groups in new bone formation or osteoblast number (P>0.05). Bone formation was significantly higher in the HA group than in the EC group (P<0.05). The numbers of osteoclasts in the HA+LZA and HA+SZA groups were significantly higher than those in the groups EC and HA (P<0.05); however, there was no significant difference between groups HA+LZA and HA+SZA (P>0.05). Within the limitations of this study, systemic or local administration of ZA enhanced new bone formation with a HA bone graft in a rat critical-size calvarial defect model.

  10. Results of triple muscle (sartorius, tensor fascia latae and part of gluteus medius) pedicle bone grafting in neglected femoral neck fracture in physiologically active patients

    PubMed Central

    Mishra, Pankaj Kumar; Gupta, Anuj; Gaur, Suresh Chandra

    2014-01-01

    Background: Femoral neck fractures are notorious for complications like avascular necrosis and nonunion. In developing countries, various factors such as illiteracy, low socioeconomic status, ignorance are responsible for the delay in surgery. Neglected fracture neck femur always poses a formidable challenge. The purpose of this study was to evaluate the results of triple muscle pedicle bone grafting using sartorius, tensor fasciae latae and part of gluteus medius in neglected femoral neck fracture. Materials and Methods: This is a retrospective study with medical record of 50 patients, who were operated by open reduction, internal fixation along with muscle pedicle bone grafting by the anterior approach. After open reduction, two to three cancellous screws (6.5 mm) were used for internal fixation in all cases. A bony chunk of the whole anterior superior iliac spine of 1 cm thickness, 1 cm width and 4.5 cm length, taken from the iliac crest comprised of muscle pedicle of sartorius, tensor fascia latae and part of gluteus medius. Then the graft with all three muscles mobilized and put in the trough made over the anterior or anterosuperior aspect of the femoral head. The graft was fixed with one or two 4.5 mm self-tapping cortical screw in anterior to posterior direction. Results: 14 patients were lost to followup. The results were based on 36 patients. We observed that in our series, there was union in 34, out of 36 (94.4%) patients. All patients were within the age group of 15-51 years (average 38 years) with displaced neglected femoral neck fracture of ≥30 days. Mean time taken for full clinicoradiological union was 14 weeks (range-10-24 weeks). Conclusion: Triple muscle pedicle bone grafting gives satisfactory results for neglected femoral neck fracture in physiologically active patients. PMID:25298553

  11. Human parathyroid hormone-(1-38) restores cancellous bone to the immobilized, osteopenic proximal tibial metaphysis in rats

    NASA Technical Reports Server (NTRS)

    Ma, Y. F.; Jee, W. S. S.; Ke, H. Z.; Lin, B. Y.; Liang, X. G.; Li, M.; Yamamoto, N.

    1994-01-01

    The purpose of this study was to determine if human parathyroid hormone-(1-38) (PTH) can restore cancellous bone mass to the established osteopenic, immobilized proximal tibial metaphyses (PTM) of female rats. The right hindlimbs of six-month-old female Sprague-Dawley rats were immobilized by bandaging the right hindlimbs to the abdomen. After 30 days of right hindlimb immobilization (RHLI), the rats were subcutaneously injected with 200 microgram hPTH(1-38)/kg/day for 15 (short-term) or 75 (longer-term) days. Static bone histomorphometry was performed on the primary spongiosa, while both static and dynamic histomorphometry were performed on the secondary spongiosa of the right PTM. Immobilization for 30 days without treatment decreased trabecular bone area, number and thickness in both primary and secondary spongiosa, and induced an increase in eroded perimeter and a decrease in tissue referent-bone formation rate (BFR/TV) in the secondary spongios. These changes reached a new steady state thereafter. Treatment with 200 microgram hPTH(1-38)/kg/day for 15 days, beginning at 30 days post immobilization (IM), significantly increased trabecular bone area, thickness and number in both primary and secondary spongiosa despite continuous IM when compared to the age-related and IM controls. The short-term (15 days) PTH treatment significantly increased labeling perimeter, mineral apposition rate and BFR/TV in the secondary spongiosa and stimulated longitudinal bone growth as compared to the age-related and IM controls. PTH treatment for longer-term (75 days) further increased trabecular bone area, thickness and number as compared to aging and IM controls and short-term (15 days) PTH treated groups. The bone formation indices in the secondary spongiosa of these longer-term treated rats were lower than that of short-term (15 days) PTH treated group, but they were still higher than those of IM and age-related controls. Our findings indicate that PTH treatment stimulates

  12. Evaluation of bone response to synthetic bone grafting material treated with argon-based atmospheric pressure plasma.

    PubMed

    Beutel, Bryan G; Danna, Natalie R; Gangolli, Riddhi; Granato, Rodrigo; Manne, Lakshmiprada; Tovar, Nick; Coelho, Paulo G

    2014-12-01

    Bone graft materials are utilized to stimulate healing of bone defects or enhance osseointegration of implants. In order to augment these capabilities, various surface modification techniques, including atmospheric pressure plasma (APP) surface treatment, have been developed. This in vivo study sought to assess the effect of APP surface treatment on degradation and osseointegration of Synthograft™, a beta-tricalcium phosphate (β-TCP) synthetic bone graft. The experimental (APP-treated) grafts were subjected to APP treatment with argon for a period of 60s. Physicochemical characterization was performed by environmental scanning electron microscopy, surface energy (SE), and x-ray photoelectron spectroscopy analyses both before and after APP treatment. Two APP-treated and two untreated grafts were surgically implanted into four critical-size calvarial defects in each of ten New Zealand white rabbits. The defect samples were explanted after four weeks, underwent histological analysis, and the percentages of bone, soft tissue, and remaining graft material were quantified by image thresholding. Material characterization showed no differences in particle surface morphology and that the APP-treated group presented significantly higher SE along with higher amounts of the base material chemical elements on it surface. Review of defect composition showed that APP treatment did not increase bone formation or reduce the amount of soft tissue filling the defect when compared to untreated material. Histologic cross-sections demonstrated osteoblastic cell lines, osteoid deposition, and neovascularization in both groups. Ultimately, argon-based APP treatment did not enhance the osseointegration or degradation of the β-TCP graft. Future investigations should evaluate the utility of gases other than argon to enhance osseointegration through APP treatment.

  13. Results of Wagner SL revision stem with impaction bone grafting in revision total hip arthroplasty

    PubMed Central

    Singh, Somesh P; Bhalodiya, Haresh P

    2013-01-01

    Background: As the number of total hip arthroplasties (THAs) performed increases, so do the number of required revisions. Impaction bone grafting with Wagner SL Revision stem is a good option for managing bone deficiencies arising from aseptic osteolysis. We studied the results of cementless diaphyseal fixation in femoral revision after total hip arthroplasty and whether there was spontaneous regeneration of bone stock in the proximal femur after the use of Wagner SL Revision stem (Zimmer, Warsaw, IN, USA) with impaction bone grafting. Materials and Methods: We performed 53 hip revisions using impaction bone grafting and Wagner SL Revision stems in 48 patients; (5 cases were bilateral) for variety of indications ranging from aseptic osteolysis to preiprosthetic fractures. The average age was 59 years (range 44-68 years). There were 42 male and 6 female patients. Four patients died after surgery for reasons unrelated to surgery. 44 patients were available for complete analysis. Results: The mean Harris Hip Score was 42 before surgery and improved to 86 by the final followup evaluation at a mean point of 5.5 years. Of the 44 patients, 87% (n=39) had excellent results and 10% (n=5) had good results. The stem survival rate was 98% (n=43). Conclusion: Short term results for revision THA with impaction bone grafting and Wagner SL revision stems are encouraging. However, it is necessary to obtain long term results through periodic followup evaluation, as rate of complications may increase in future. PMID:23960279

  14. Clinical and Radiographic Assessment of Secondary Bone Graft Outcomes in Cleft Lip and Palate Patients

    PubMed Central

    Khalil, W.; de Musis, C. R.; Volpato, L. E. R.; Veiga, K. A.; Vieira, E. M. M.; Aranha, A. M.

    2014-01-01

    Purpose. To compare the results of secondary alveolar bone grafts in patients with complete cleft lip and cleft lip and palate using 2 radiographic scales and according to the rate of canine eruption through the newly formed bone. Materials and Methods. We analyzed pre- and postoperative radiographs of 36 patients for the amount of bone in the cleft site according to the Bergland and Chelsea scales. The associations between the variables and the correlation between the scales were measured. Results. A total of 54.2% and 20.8% of cases were classified as type I and type II, respectively, using the Bergland scale, whereas 50% and 22.5% were classified as types A and C, respectively, using the Chelsea scale. A positive correlation between the 2 scales was observed. In 33.3% of males, 58.3% of females, 54.5% of unilateral cleft cases, and 12.5% of bilateral cleft cases, the permanent canines had erupted. Bone grafts performed prior to canine eruption achieved more satisfactory results. Conclusions. Our results suggest that both radiographic scales are important tools for the evaluation of bone grafts. Additionally, longer time periods of evaluation were associated with improved results for patients with secondary alveolar bone grafts. PMID:27351004

  15. Ceramic and non-ceramic hydroxyapatite as a bone graft material: a brief review.

    PubMed

    Dutta, S R; Passi, D; Singh, P; Bhuibhar, A

    2015-03-01

    Treatment of dental, craniofacial and orthopedic defects with bone graft substitutes has shown promising result achieving almost complete bone regeneration depending on product resorption similar to human bone's physicochemical and crystallographic characteristics. Among these, non-ceramic and ceramic hydroxyapatite being the main inorganic salt of bone is the most studied calcium phosphate material in clinical practices ever since 1970s and non-ceramic since 1985. Its "chemical similarity" with the mineralized phase of biologic bone makes it unique. Hydroxyapatite as an excellent carrier of osteoinductive growth factors and osteogenic cell populations is also useful as drug delivery vehicle regardless of its density. Porous ceramic and non-ceramic hydroxyapatite is osteoconductive, biocompatible and very inert. The need for bone graft material keeps on increasing with increased age of the population and the increased conditions of trauma. Recent advances in genetic engineering and doping techniques have made it possible to use non-ceramic hydroxyapatite in larger non-ceramic crystals and cluster forms as a successful bone graft substitute to treat various types of bone defects. In this paper we have mentioned some recently studied properties of hydroxyapatite and its various uses through a brief review of the literatures available to date. PMID:25428698

  16. Traumatic Periprosthetic Acetabular Fracture Treated with One-Stage Exchange and Bone Reconstruction Using a Synthetic Bone Graft Substitute

    PubMed Central

    2016-01-01

    A case of a traumatic periprosthetic acetabular fracture in an elderly patient, which was treated by one-stage hip exchange with implantation of an antiprotrusio cage and reconstruction of the acetabular bone loss with an injectable calcium sulphate/hydroxyapatite bone graft substitute, is reported. The paste-like bone graft substitute was injected through the holes of the antiprotrusio cage. After a setting time of 15 minutes, a low-profile cup was cemented onto the cage using polymethylmethacrylate and a new stem was inserted. The patient was encouraged to ambulate three days postoperatively weight-bearing as tolerated. At the one-year follow-up visit the patient was ambulatory and full weight-bearing without any walking aids. The follow-up radiographs demonstrated stable position and articulation of the revision hip arthroplasty with no signs of loosening of the antiprotrusio cage. However, the most interesting finding was that the bone graft substitute had remodelled to a great extent into bone. This calcium sulphate/hydroxyapatite composite shows high osteoconductive potential and can be used to regenerate bone stock in revision arthroplasty. PMID:27446621

  17. Posterolateral Arthrodesis in Lumbar Spine Surgery Using Autologous Platelet-Rich Plasma and Cancellous Bone Substitute: An Osteoinductive and Osteoconductive Effect

    PubMed Central

    Tarantino, Roberto; Donnarumma, Pasquale; Mancarella, Cristina; Rullo, Marika; Ferrazza, Giancarlo; Barrella, Gianna; Martini, Sergio; Delfini, Roberto

    2014-01-01

    Study Design Prospective cohort study. Objectives To analyze the effectiveness and practicality of using cancellous bone substitute with platelet-rich plasma (PRP) in posterolateral arthrodesis. Methods Twenty consecutive patients underwent posterolateral arthrodesis with implantation of cancellous bone substitute soaked with PRP obtained directly in the operating theater on the right hemifield and cancellous bone substitute soaked with saline solution on the right. Results Computed tomography scans at 6 and 12 months after surgery were performed in all patients. Bone density was investigated by comparative analysis of region of interest. The data were analyzed with repeated-measures variance analyses with value of density after 6 months and value of density after 12 months, using age, levels of arthrodesis, and platelet count as covariates. The data demonstrated increased bone density using PRP and heterologous cancellous block resulting in an enhanced fusion rate during the first 6 months after surgery. Conclusions PRP used with cancellous bone substitute increases the rate of fusion and bone density joining osteoinductive and osteoconductive effect. PMID:25083353

  18. Posterolateral arthrodesis in lumbar spine surgery using autologous platelet-rich plasma and cancellous bone substitute: an osteoinductive and osteoconductive effect.

    PubMed

    Tarantino, Roberto; Donnarumma, Pasquale; Mancarella, Cristina; Rullo, Marika; Ferrazza, Giancarlo; Barrella, Gianna; Martini, Sergio; Delfini, Roberto

    2014-08-01

    Study Design Prospective cohort study. Objectives To analyze the effectiveness and practicality of using cancellous bone substitute with platelet-rich plasma (PRP) in posterolateral arthrodesis. Methods Twenty consecutive patients underwent posterolateral arthrodesis with implantation of cancellous bone substitute soaked with PRP obtained directly in the operating theater on the right hemifield and cancellous bone substitute soaked with saline solution on the right. Results Computed tomography scans at 6 and 12 months after surgery were performed in all patients. Bone density was investigated by comparative analysis of region of interest. The data were analyzed with repeated-measures variance analyses with value of density after 6 months and value of density after 12 months, using age, levels of arthrodesis, and platelet count as covariates. The data demonstrated increased bone density using PRP and heterologous cancellous block resulting in an enhanced fusion rate during the first 6 months after surgery. Conclusions PRP used with cancellous bone substitute increases the rate of fusion and bone density joining osteoinductive and osteoconductive effect.

  19. Application of bioabsorbable screw fixation for anterior cervical decompression and bone grafting

    PubMed Central

    Zhao, Bo; Qiu, Xiaowen; Wang, Dong; Li, Haopeng; He, Xijing

    2016-01-01

    OBJECTIVES: To examine the application of bioabsorbable screws for anterior cervical decompression and bone grafting fixation and to study their clinical effects in the treatment of cervical spondylosis. METHODS: From March 2007 to September 2012, 56 patients, 36 males and 20 females (38-79 years old, average 58.3±9.47 years), underwent a novel operation. Grafts were fixed by bioabsorbable screws (PLLA, 2.7 mm in diameter) after anterior decompression. The bioabsorbable screws were inserted from the midline of the graft bone to the bone surface of the upper and lower vertebrae at 45 degree angles. Patients were evaluated post-operatively to observe the improvement of symptoms and evaluate the fusion of the bone. The Japanese Orthopaedic Association (JOA) score was used to evaluate the recovery of neurological functions. RESULTS: All screws were successfully inserted, with no broken screws. The rate of symptom improvement was 87.5%. All of the grafts fused well with no extrusion. The average time for graft fusion was 3.8±0.55 months (range 3-5 months). Three-dimensional reconstruction of CT scans demonstrated that the grafts fused with adjacent vertebrae well and that the screws were absorbed as predicted. The MRI findings showed that the cerebrospinal fluid was unobstructed. No obvious complications appeared in any of the follow-up evaluations. CONCLUSIONS: Cervical spondylosis with one- or two-level involvement can be effectively treated by anterior decompression and bone grafting with bioabsorbable screw fixation. This operative method is safe and can avoid the complications induced by metal implants. PMID:27438565

  20. Extraction site preservation using an in-situ hardening alloplastic bone graft substitute.

    PubMed

    Leventis, Minas D; Fairbairn, Peter; Horowitz, Robert A

    2014-01-01

    This case report highlights the use of an in-situ hardening alloplastic bone grafting material composed of beta-tricalcium phosphate (β-TCP) granules coated with poly(lactic-co-glycolic acid) (PLGA) to preserve the dimensions and architecture of the alveolar ridge after atraumatic extraction. This material provided a stable scaffold that, although left uncovered, deterred the ingrowth of unwanted soft tissue, allowing newly formed keratinized soft tissue to proliferate over the healing grafted socket and gradually cover the site. At re-entry after 4 months adequate newly formed bone was observed, allowing for the correct positional placement of an implant. The results of this case suggest that an in-situ hardening alloplastic grafting material can be successfully utilized with minimally invasive procedures to preserve the bone and the soft-tissue profile of the alveolar ridge for future implant rehabilitation.

  1. Histomorphometric analysis of the repair process of autogenous bone grafts fixed at rat calvaria with cyanoacrylate

    PubMed Central

    ESTEVES, Jônatas Caldeira; BORRASCA, Albanir Gabriel; ARANEGA, Alessandra Marcondes; GARCIA JUNIOR, Idelmo Rangel; MAGRO FILHO, Osvaldo

    2011-01-01

    Objective The purpose of this study was to perform histological and histometric analyses of the repair process of autogenous bone grafts fixed at rat calvaria with ethyl-cyanoacrylate adhesive. Material and Methods Thirty-two rats were divided into two groups (n=16), Group I - Control and Group II - Adhesive. Osteotomies were made at the right parietal bone for graft obtainment using a 4-mm-diameter trephine drill. Then, the bone segments were fixed with the adhesive in the parietal region of the opposite side to the donor site. After 10 and 30 days, 8 animals of each group were euthanized and the calvarias were laboratorially processed for obtaining hematoxylin and eosin-stained slides for histological and histometric analyses. Results An intense inflammatory reaction was observed at the 10-day period. At 30 days, this reaction was less intense, despite the presence of adhesive at the recipient-site/graft interface. Graft incorporation to the recipient site was observed only at the control group, which maintained the highest graft size at 10 and 30 days. Conclusions Although the fragment was stable, the presence of adhesive in Group II did not allow graft incorporation to the recipient site, determining a localized, discrete and persistent inflammatory reaction. PMID:21986659

  2. Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography.

    PubMed

    Xiao, W-L; Zhang, D-Z; Chen, X-J; Yuan, C; Xue, L-F

    2016-06-01

    Cone beam computed tomography (CBCT) allows for a significantly lower radiation dose than conventional computed tomography (CT) scans and provides accurate images of the alveolar cleft area. The osteogenic effect of guided bone regeneration (GBR) vs. conventional alveolar bone grafting alone for alveolar cleft defects was evaluated in this study. Sixty alveolar cleft patients were divided randomly into two groups. One group underwent GBR using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting only (non-GBR group). CBCT images were obtained at 1 week and at 3 months following the procedure. Using Simplant 11.04 software, the bone resorption rate was calculated and compared between the two groups. The bone resorption rate from 1 week to 3 months following bone grafting without the GBR technique was 36.50±5.04%, whereas the bone resorption rate using the GBR technique was 31.69±5.50% (P=0.017). The application of autogenous iliac bone combined with the GBR technique for alveolar bone grafting of alveolar cleft patients can reduce bone resorption and result in better osteogenesis.

  3. Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography.

    PubMed

    Xiao, W-L; Zhang, D-Z; Chen, X-J; Yuan, C; Xue, L-F

    2016-06-01

    Cone beam computed tomography (CBCT) allows for a significantly lower radiation dose than conventional computed tomography (CT) scans and provides accurate images of the alveolar cleft area. The osteogenic effect of guided bone regeneration (GBR) vs. conventional alveolar bone grafting alone for alveolar cleft defects was evaluated in this study. Sixty alveolar cleft patients were divided randomly into two groups. One group underwent GBR using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting only (non-GBR group). CBCT images were obtained at 1 week and at 3 months following the procedure. Using Simplant 11.04 software, the bone resorption rate was calculated and compared between the two groups. The bone resorption rate from 1 week to 3 months following bone grafting without the GBR technique was 36.50±5.04%, whereas the bone resorption rate using the GBR technique was 31.69±5.50% (P=0.017). The application of autogenous iliac bone combined with the GBR technique for alveolar bone grafting of alveolar cleft patients can reduce bone resorption and result in better osteogenesis. PMID:26876144

  4. The mechanically stable steam sterilization of bone grafts.

    PubMed

    Draenert, G F; Delius, M

    2007-03-01

    Bone allografts are the standard material used in augmentative bone surgery. However, steam-sterilized bone has a low mechanical stability and limited ossification based on low strain-adapted bone remodelling. Here we describe a new technique which allows the bone to be autoclaved without losing its mechanical stability and osteoconductivity. The compression strength of the new material was compared with steam-sterilized and fresh bone based on mechanical testing using bone cylinders (n=30/group). Allogeneic new material and fresh bone were press-fit implanted into rabbit patellar grooves and examined under fluorescent light and conventional microscopy. Initial healing was assessed after 30 d (n=5/group). Osseous integration and remodelling was studied after 100 d (n=12/group). Steam-sterilized bone showed no mechanical stability, whereas the new material was stiff and had compression curves similar to fresh bone; both groups showed equal degrees of direct ossification after 30 d, advanced bony ingrowth and remodelling after 100 d, and similar ingrowth depths on histomorphometric analysis. The new method preserved the stiffness and osteoconductivity of bone after steam sterilization, and microstructure, mineralization, and composition were conserved. This technique could be useful for bone banking in Third World countries.

  5. Human periodontal ligament stem cells cultured onto cortico-cancellous scaffold drive bone regenerative process.

    PubMed

    Diomede, F; Zini, N; Gatta, V; Fulle, S; Merciaro, I; D'Aurora, M; La Rovere, R M; Traini, T; Pizzicannella, J; Ballerini, P; Caputi, S; Piattelli, A; Trubiani, O

    2016-01-01

    The purpose of this work was to test, in vitro and in vivo, a new tissue-engineered construct constituted by porcine cortico-cancellous scaffold (Osteobiol Dual Block) (DB) and xeno-free ex vivo culture of human Periodontal Ligament Stem Cells (hPDLSCs). hPDLSCs cultured in xeno-free media formulation preserved the stem cells' morphological features, the expression of stemness and pluripotency markers, and their ability to differentiate into mesenchymal lineage. Transmission electron microscopy analysis suggested that after one week of culture, both noninduced and osteogenic differentiation induced cells joined and grew on DB secreting extracellular matrix (ECM) that in osteogenic induced samples was hierarchically assembled in fibrils. Quantitative RT-PCR (qRT-PCR) showed the upregulation of key genes involved in the bone differentiation pathway in both differentiated and undifferentiated hPDLSCs cultured with DB (hPDLSCs/DB). Functional studies revealed a significant increased response of calcium transients in the presence of DB, both in undifferentiated and differentiated cells stimulated with calcitonin and parathormone, suggesting that the biomaterial could drive the osteogenic differentiation process of hPDLSCs. These data were confirmed by the increase of gene expression of L-type voltage-dependent Ca2+ (VDCCL), subunits α1C and α2D1 in undifferentiated cells in the presence of DB. In vivo implantation of the hPDLSCs/DB living construct in the mouse calvaria evidenced a precocious osteointegration and vascularisation process. Our results suggest consideration of DB as a biocompatible, osteoinductive and osteoconductive biomaterial, making it a promising tool to regulate cell activities in biological environments and for a potential use in the development of new custom-made tissue engineering. PMID:27633707

  6. Accuracy of cancellous bone volume fraction measured by micro-CT scanning.

    PubMed

    Ding, M; Odgaard, A; Hvid, I

    1999-03-01

    Volume fraction, the single most important parameter in describing trabecular microstructure, can easily be calculated from three-dimensional reconstructions of micro-CT images. This study sought to quantify the accuracy of this measurement. One hundred and sixty human cancellous bone specimens which covered a large range of volume fraction (9.8-39.8%) were produced. The specimens were micro-CT scanned, and the volume fraction based on Archimedes' principle was determined as a reference. After scanning, all micro-CT data were segmented using individual thresholds determined by the scanner supplied algorithm (method I). A significant deviation of volume fraction from method I was found: both the y-intercept and the slope of the regression line were significantly different from those of the Archimedes-based volume fraction (p < 0.001). New individual thresholds were determined based on a calibration of volume fraction to the Archimedes-based volume fractions (method II). The mean thresholds of the two methods were applied to segment 20 randomly selected specimens. The results showed that volume fraction using the mean threshold of method I was underestimated by 4% (p = 0.001), whereas the mean threshold of method II yielded accurate values. The precision of the measurement was excellent. Our data show that care must be taken when applying thresholds in generating 3-D data, and that a fixed threshold may be used to obtain reliable volume fraction data. This fixed threshold may be determined from the Archimedes-based volume fraction of a subgroup of specimens. The threshold may vary between different materials, and so it should be determined whenever a study series is performed. PMID:10093033

  7. Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis

    PubMed Central

    Lee, Hyeong-Geun

    2015-01-01

    Objectives The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated. Materials and Methods Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images. Results No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was 74.6%±8.4%. Conclusion Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone. PMID:26568924

  8. Huge Subchondral Cyst Communicating with Medulary Canal of Femur in OA Knee-Treated by Extension Stem and Bone Grafting

    PubMed Central

    Rajani, Amyn M; Kumar, Ritesh; Shyam, Ashok

    2014-01-01

    Introduction: We report an osteoarthritic patient with huge sub-chondral cyst-like lesions in the Anterior part of distal femur. Deep and large bone defects and severe lateral laxity due to Advanced osteoarthritis was successfully treated with semi-constrained type total knee arthroplasty with long stem. Case Report: A 70yrs old Female was admitted in our institution diagnosed with severe bilateral Osteoarthritis. The x-rays showed bone on bone Tricompartment OA Knee with Varus Malalignment. She was posted for Single Stage Bilateral Total Knee Replacement and as planned the Left Knee Was Operated first. After exposure, Proximal Tibial, Distal Femoral Cuts and measurement of extension gaps the synovium from the anterior Femur was removed and sizing was done. The AP cut was then proceeded with. We spotted a small Osteochondral Cyst in the Anterior Femur which was curretted to remove the cystic material, which is when we realised that the cyst was large and communicating with the medulary canal. The remaining Femoral preparations was done keeping in mind the risk of iatrogenic fracture and extension Stem was used in the femur. The defect was then packed cancellous bone graft. Conclusion: If suspected a Preoperative MRI should be done to exclude any sub-chondral cysts osteochondral defects and any surprise during surgery. Usually one should keep extension stems ready for difficult cases. Operating surgeon should know his implants very well, as in many standard implants extension stems can only be used when distal femur cuts are taken accordingly as 5° Valgus. Mini incision should be avoided because it may fail to reveal such surprises and may land into periprosthetic fractures. PMID:27298967

  9. Evaluation of laser photobiomodulation on healing of bone defects grafted with bovine bone in diabetic rats

    NASA Astrophysics Data System (ADS)

    Paraguassú, Gardênia Matos; da Costa Lino, Maíra Doria Martinez; de Carvalho, Fabíola Bastos; Cangussu, Maria Cristina; Pinheiro, Antônio Luiz Barbosa; Ramalho, Luciana Maria Pedreira

    2012-09-01

    Previous studies have shown positive effects of Low Level Laser Therapy (LLLT) on the repair of bone defects, but there is a few that associates bone healing in the presence of a metabolic disorder such as Diabetes Mellitus, a systemic disorder associated to impair of the repair of different tissues. The aim of this study was to assess, histologically, the repair of surgical defects created in the femur of diabetic and non-diabetic rats treated or not with LLLT (λ780nm, 70mW, CW, o/˜0.4mm, 16J/cm2 per session) associated or not to the use of a biomaterial. Surgical tibial bone defects were created in 60 animals that were divided into 4 groups: Group B (non-diabetic + biomaterial); Group BL (non-diabetic + biomaterial + LLLT); Group BD (diabetic + biomaterial); Group BDL (diabetic + biomaterial + LLLT). The irradiated group received 16 J/cm2 per session divided into 4 points around the defect, being the first irradiation carried out immediately after surgery and repeated every 48h for 14 days. The animals were killed 15, 21 and 30 days after surgery. The specimens underwent a semi-quantitative analysis. The results showed inflammation more intense in the BD and BDL groups than in the B and BL groups in the period of 15 days (p = 0.02), however the cortical repair in the BDL group was below 25% in more than half of the specimens, while in the BD group, the repair was more than to 25% in all specimens. At 30 days, both osteoblastic activity and collagen deposition were significantly higher in the B group when compared to the BD group (p=0.04). Bone deposition was significantly higher in the BL group (p=0.023) than in BDL group. It is concluded that LLLT has a positive biomodulative effect in the early stages of the healing process of bone defects grafted with biomaterial in diabetic and non-diabetic rats.

  10. Impaction bone grafting in revision hip surgery: past, present and future.

    PubMed

    McNamara, Iain R

    2010-02-01

    Joint replacement surgery can have excellent clinical results. However, as the number of patients undergoing surgery increases, the number of failed joint replacements is set to rise. One of the greatest challenges for the revision surgeon is the restoration of bone stock. This article focuses upon revision hip surgery, with particular reference to the scope of the problem; historical and current solutions to bone loss in the femur and acetabulum; the clinical results following revision surgery; and the basic science behind impaction bone grafting, before ending with possible future directions for improving the restoration of bone stock.

  11. Effects of Chronic Heavy Alcohol Consumption and Endurance Exercise on Cancellous and Cortical Bone Microarchitecture in Adult Male Rats

    PubMed Central

    Johnson, Teresa L.; Gaddini, Gino; Branscum, Adam J.; Olson, Dawn A.; Caroline-Westerlind, Kim; Turner, Russell T.; Iwaniec, Urszula T.

    2014-01-01

    Background Bone health is influenced by numerous lifestyle factors, including diet and exercise. Alcohol is a major non-essential constituent of diet and has dose and context-dependent effects on bone. Endurance exercise is associated with increased risk for stress fractures. The purpose of this study was to determine the long-term independent and combined effects of chronic heavy alcohol consumption and endurance exercise (treadmill running) on bone mass and microarchitecture in young adult male Sprague-Dawley rats. Methods Six-month-old male rats were randomized into 4 groups (9–13 rats/group): sedentary+control diet, sedentary+ethanol diet, exercise+control diet, or exercise+ethanol diet. Ethanol-fed rats consumed a liquid diet (ethanol comprised 35% of caloric intake) ad libitum. Control rats were pair-fed the same diet with isocaloric substitution of ethanol with maltose-dextran. Exercise was conducted on a motorized treadmill (15% grade for 30 min) 5 days/week for 16 weeks. Femur and 12th thoracic vertebra were analyzed for bone mineral content (BMC) and density (BMD) using densitometry and cortical and cancellous bone architecture using microcomputed tomography. Results Ethanol consumption resulted in lower femur length, BMC, and BMD, and lower midshaft femur cortical volume, cortical thickness, and polar moment of inertia. In addition, trabecular thickness was lower in vertebra of ethanol-fed rats. Endurance exercise had no independent effect on any endpoints evaluated. A significant interaction between endurance exercise and ethanol was detected for several cancellous endpoints in the distal femur metaphysis. Ethanol-consuming rats that exercised had lower distal femur metaphysis bone volume/tissue volume, trabecular connectivity density, and trabecular thickness compared to exercising rats that consumed control diet. Conclusions The results obtained in this model suggest that chronic heavy alcohol consumption may reduce skeletal integrity by reducing

  12. Autogenous cortical bone and bioactive glass grafting for treatment of intraosseous periodontal defects

    PubMed Central

    Sumer, Mahmut; Keles, Gonca Cayir; Cetinkaya, Burcu Ozkan; Balli, Umut; Pamuk, Ferda; Uckan, Sina

    2013-01-01

    Objective: The aim of this 6-month prospective randomized clinical study was to compare the effectiveness of autogenous cortical bone (ACB) and bioactive glass (BG) grafting for the regenerative treatment of intraosseous periodontal defects. Methods: Via a split-mouth design, 15 chronic periodontitis patients (7 men, 8 women; mean age, 43.47 ± 1.45 years) who had probing pocket depths (PPDs) of ⩾6 mm following initial periodontal therapy were randomly assigned to receive 2 treatments in contralateral areas of the dentition: ACB grafting and BG grafting. The parameters compared in the patients were preoperative and 6-month postoperative PPDs, clinical attachment levels (CALs), and radiographic alveolar bone heights. Results: Both treatment modalities resulted in significant changes in postoperative measurements when compared to preoperative values (p < 0.01). PPDs were decreased, CALs were increased, and radiographic alveolar bone heights were increased by 5.00 ± 0.28, 4.60 ± 0.21, and 5.80 ± 0.43 mm in patients treated with ACB grafting and 5.13 ± 0.32, 4.67 ± 0.27, and 5.33 ± 0.36 mm in patients treated with BG grafting, respectively. Differences between the treatments were not statistically significant (P>.05). Conclusions: Within the limitations of this study, both ACB and BG grafting led to significant improvements in clinical and radiographic parameters 6 months postoperatively. These results suggest that either an ACB graft, which is completely safe with no associated concerns about disease transmission and immunogenic reactions, or a BG graft, which has an unlimited supply, can be selected for regenerative periodontal treatment. PMID:23408239

  13. Comparative study of the osteoinductive properties of bioceramic, coral and processed bone graft substitutes.

    PubMed

    Begley, C T; Doherty, M J; Mollan, R A; Wilson, D J

    1995-10-01

    This study compared the osteoinductive properties of six different bone graft substitutes: Pyrost, natural coral, Callopat, Surgibone, demineralized Surgibone and demineralized rat bone. The materials were implanted heterotopically, in the abdominal musculature of rats, and the results evaluated histologically at 3 and 6 wk post-implantation. Surprisingly, the results showed that both the demineralized rat bone and demineralized Surgibone were less osteoinductive than might be believed from the literature. Mineralized grafts showed no sign of new bone formation and exhibited variable resorption patterns. A layer of what appeared as dense calcification was seen around the coral implant. The most intense inflammatory reactions were exhibited with the xenografts Surgibone and demineralized Surgibone, indicating persistent immune responses. Coral and Pyrost elicited no marked inflammatory response, and this was attributed to the negligible amounts of protein present in these materials.

  14. Effective Bone Regeneration Using Thermosensitive Poly(N-Isopropylacrylamide) Grafted Gelatin as Injectable Carrier for Bone Mesenchymal Stem Cells.

    PubMed

    Ren, Zhiwei; Wang, Yang; Ma, Shiqing; Duan, Shun; Yang, Xiaoping; Gao, Ping; Zhang, Xu; Cai, Qing

    2015-09-01

    In this study, thermosensitive poly(N-isopropylacrylamide) (PNIPAAm) was grafted onto gelatin via atom transfer radical polymerization (ATRP). The chemical structure of PNIPAAm-grafted gelatin (Gel-PNIPAAm) was confirmed by XPS, ATR-IR, and (1)H NMR characterizations. Gel-PNIPAAm aqueous solution exhibited sol-to-gel transformation at physiological temperature, and was studied as injectable hydrogel for bone defect regeneration in a cranial model. The hydrogel was biocompatible and demonstrated the ability to enhance bone regeneration in comparison with the untreated group (control). With the incorporation of rat bone mesenchymal stem cells (BMSCs) into the hydrogel, the bone regeneration rate was further significantly enhanced. As indicated by micro-CT, histological (H&E and Masson) and immunohistochemical (osteocalcin and osteopontin) staining, newly formed woven bone tissue was clearly detected at 12 weeks postimplantation in the hydrogel/BMSCs treated group, showing indistinguishable boundary with surrounding host bone tissues. The results suggested that the thermosensitive Gel-PNIPAAm hydrogel was an excellent injectable delivery vehicle of BMSCs for in vivo bone defect regeneration. PMID:26266480

  15. Vascularized Bone Grafts from the Dorsal Wrist for the Treatment of Kienböck Disease.

    PubMed

    Nakagawa, Makoto; Omokawa, Shohei; Kira, Tsutomu; Kawamura, Kenji; Tanaka, Yasuhito

    2016-05-01

    Purpose The objective of this article is to evaluate functional and radiological outcomes of vascularized bone grafts for stage 2 and 3 Kienböck disease. The outcomes of three different donor sites via dorsal approach of the wrist were compared. Pearls and pitfalls in surgical technique were discussed. Methods There were 28 patients who underwent vascularized bone grafts, including the extensor fourth and fifth compartmental artery graft of distal radius in 8 patients, the first and second supraretinacular intercompartmental artery graft of distal radius in 12 patients, and the second dorsal metacarpal neck graft in 8 patients. Average age was 32 years, and radiological grading according to Lichtman classification was stage 2 in 8 patients, stage 3A in 10 patients, and stage 3B in 10 patients. Temporary pinning fixing the midcarpal joint was conducted for 10 weeks postoperatively. Results Follow-up periods averaged 70 months. Pain reduced in 27 patients, and visual analog scale for pain of pre- and postoperative level averaged 59 and 18. Range of wrist flexion and extension motion improved from 87 to 117 degrees, and average grip strength improved from 21 kg preoperatively to 33 kg postoperatively. Carpal height ratio had almost no change from 0.52 to 0.53. Fragmentation of necrotic bone healed in 7 of the 14 cases. Comparative analyses of functional and radiological outcomes between three donor sites found no significant difference. Conclusion Three different vascularized bone grafts from the dorsal wrist and hand area demonstrated favorable and comparable functional outcomes. It was technically important to elevate vascular bundle with surrounding retinaculum or fascia, to include sufficient periosteum, and to insert the vascularized bone as the cortex aligned longitudinally. PMID:27104073

  16. “Over-inlay” block graft and differential morphometry: a novel block graft model to study bone regeneration and host-to-graft interfaces in rats

    PubMed Central

    2016-01-01

    Purpose The aim of this study was to present new a model that allows the study of the bone healing process, with an emphasis on the biological behavior of different graft-to-host interfaces. A standardized “over-inlay” surgical technique combined with a differential histomorphometric analysis is presented in order to optimize the use of critical-size calvarial defects in pre-clinical testing. Methods Critical-size defects were created into the parietal bone of 8 male Wistar rats. Deproteinized bovine bone (DBBM) blocks were inserted into the defects, so that part of the block was included within the calvarial thickness and part exceeded the calvarial height (an “over-inlay” graft). All animals were sacrificed at 1 or 3 months. Histomorphometric and immunohistochemical evaluation was carried out within distinct regions of interest (ROIs): the areas adjacent to the native bone (BA), the periosteal area (PA) and the central area (CA). Results The animals healed without complications. Differential morphometry allowed the examination of the tissue composition within distinct regions: the BA presented consistent amounts of new bone formation (NB), which increased over time (24.53%±1.26% at 1 month; 37.73%±0.39% at 3 months), thus suggesting that this area makes a substantial contribution toward NB. The PA was mainly composed of fibrous tissue (71.16%±8.06% and 78.30%±2.67%, respectively), while the CA showed high amounts of DBBM at both time points (78.30%±2.67% and 74.68%±1.07%, respectively), demonstrating a slow remodeling process. Blood vessels revealed a progressive migration from the interface with native bone toward the central area of the graft. Osterix-positive cells observed at 1 month within the PA suggested that the periosteum was a source of osteoprogenitor elements. Alkaline phosphatase data on matrix deposition confirmed this observation. Conclusions The present model allowed for a standardized investigation of distinct graft

  17. Reengineering autologous bone grafts with the stem cell activator WNT3A.

    PubMed

    Jing, Wei; Smith, Andrew A; Liu, Bo; Li, Jingtao; Hunter, Daniel J; Dhamdhere, Girija; Salmon, Benjamin; Jiang, Jie; Cheng, Du; Johnson, Chelsey A; Chen, Serafine; Lee, Katherine; Singh, Gurpreet; Helms, Jill A

    2015-04-01

    Autologous bone grafting represents the standard of care for treating bone defects but this biomaterial is unreliable in older patients. The efficacy of an autograft can be traced back to multipotent stem cells residing within the bone graft. Aging attenuates the viability and function of these stem cells, leading to inconsistent rates of bony union. We show that age-related changes in autograft efficacy are caused by a loss in endogenous Wnt signaling. Blocking this endogenous Wnt signal using Dkk1 abrogates autograft efficacy whereas providing a Wnt signal in the form of liposome-reconstituted WNT3A protein (L-WNT3A) restores bone forming potential to autografts from aged animals. The bioengineered autograft exhibits significantly better survival in the hosting site. Mesenchymal and skeletal stem cell populations in the autograft are activated by L-WNT3A and mitotic activity and osteogenic differentiation are significantly enhanced. In a spinal fusion model, aged autografts treated with L-WNT3A demonstrate superior bone forming capacity compared to the standard of care. Thus, a brief incubation in L-WNT3A reliably improves autologous bone grafting efficacy, which has the potential to significantly improve patient care in the elderly.

  18. A medical device for prefabrication of large bone grafts in modern medicine.

    PubMed

    Laflamme, Claude; Rouabhia, Mahmoud

    2011-04-01

    Translating advances in the laboratory into sound clinical practice presents a series of formidable conceptual and technical challenges. One of them is our inability to maintain large grafts of living cells upon transfer from in vitro conditions into the host in vivo. This is due mainly to diffusion limitations within the grafting material. We embrace the well-known hypothesis of the "Diamond Concept" in bone tissue regeneration, which includes four key factors. Based on the understanding of basic elements of tissue engineering constructs, prefabrication and conditioning techniques and the nano-vascularisation of the scaffold, we furthermore hypothesize that combinations of cells, solid multipolymeric scaffold as the "core element" working as the extracellular matrix (ECM), growth factors and nano-vascularisation setting may eventually generate a large "ready-to-use"in vitro/in vivo graft. We are confident and think that growth factors will help in the construction of a step-by-step organisation of the bone tissue engineering construct (BTEC). A medical device, named in vitro/in vivo Bone Bioreactor Tissue Engineering Construct (IV2B2TEC), is proposed to fulfil the hypothesis. Soon, we hope to test the above hypothesis on a non-union bone defect in an animal model. This novel strategy will likely open new options for reconstructing extended bone defects and facilitate clinical translation of bone tissue engineering. As compared with conventional reconstructive methods, the strategy has four key advantages and might prove to be a novel armamentarium for clinicians in regenerative medicine.

  19. Reengineering autologous bone grafts with the stem cell activator WNT3A.

    PubMed

    Jing, Wei; Smith, Andrew A; Liu, Bo; Li, Jingtao; Hunter, Daniel J; Dhamdhere, Girija; Salmon, Benjamin; Jiang, Jie; Cheng, Du; Johnson, Chelsey A; Chen, Serafine; Lee, Katherine; Singh, Gurpreet; Helms, Jill A

    2015-04-01

    Autologous bone grafting represents the standard of care for treating bone defects but this biomaterial is unreliable in older patients. The efficacy of an autograft can be traced back to multipotent stem cells residing within the bone graft. Aging attenuates the viability and function of these stem cells, leading to inconsistent rates of bony union. We show that age-related changes in autograft efficacy are caused by a loss in endogenous Wnt signaling. Blocking this endogenous Wnt signal using Dkk1 abrogates autograft efficacy whereas providing a Wnt signal in the form of liposome-reconstituted WNT3A protein (L-WNT3A) restores bone forming potential to autografts from aged animals. The bioengineered autograft exhibits significantly better survival in the hosting site. Mesenchymal and skeletal stem cell populations in the autograft are activated by L-WNT3A and mitotic activity and osteogenic differentiation are significantly enhanced. In a spinal fusion model, aged autografts treated with L-WNT3A demonstrate superior bone forming capacity compared to the standard of care. Thus, a brief incubation in L-WNT3A reliably improves autologous bone grafting efficacy, which has the potential to significantly improve patient care in the elderly. PMID:25682158

  20. Brachymetatarsia of the Fourth Metatarsal, Lengthening Scarf Osteotomy with Bone Graft

    PubMed Central

    Desai, Ankit; Lidder, Surjit; R. Armitage, Andrew; S. Rajaratnam, Samuel; D. Skyrme, Andrew

    2013-01-01

    A 16-year-old girl presented with left fourth metatarsal shortening causing significant psychological distress. She underwent lengthening scarf osteotomy held with an Omnitech® screw (Biotech International, France) with the addition of two 1 cm cancellous cubes (RTI Biologics, United States). A lengthening zplasty of the extensor tendons and skin were also performed. At 6 weeks the patient was fully weight bearing and at one-year follow up, the patient was satisfied and discharged. A modified technique of lengthening scarf osteotomy is described for congenital brachymatatarsia. This technique allows one stage lengthening through a single incision with graft incorporation by 6 weeks. PMID:24191181

  1. Brachymetatarsia of the fourth metatarsal, lengthening scarf osteotomy with bone graft.

    PubMed

    Desai, Ankit; Lidder, Surjit; R Armitage, Andrew; S Rajaratnam, Samuel; D Skyrme, Andrew

    2013-01-01

    A 16-year-old girl presented with left fourth metatarsal shortening causing significant psychological distress. She underwent lengthening scarf osteotomy held with an Omnitech(®) screw (Biotech International, France) with the addition of two 1 cm cancellous cubes (RTI Biologics, United States). A lengthening zplasty of the extensor tendons and skin were also performed. At 6 weeks the patient was fully weight bearing and at one-year follow up, the patient was satisfied and discharged. A modified technique of lengthening scarf osteotomy is described for congenital brachymatatarsia. This technique allows one stage lengthening through a single incision with graft incorporation by 6 weeks. PMID:24191181

  2. Comparison of Two Synthetic Bone Graft Products in a Rabbit Posterolateral Fusion Model

    PubMed Central

    Fredericks, Douglas; Petersen, Emily B.; Watson, Nicole; Grosland, Nicole; Gibson-Corley, Katherine; Smucker, Joseph

    2016-01-01

    Background The drawbacks of iliac crest autograft as graft material for spine fusion are well reported. Despite continued modifications to improve bone healing capacity, the efficacy of synthetic graft materials as stand-alone replacements remains uncertain. The rabbit posterolateral fusion model is an established environment for testing of fusion concepts. It offers the opportunity to obtain radiographic, biomechanical and histological data on novel fusion materials. The objective of this study was to compare the spine fusion capability of two synthetic bone graft products in an established rabbit posterolateral spine fusion (PLF) model: Signafuse® Bioactive Bone Graft Putty and Actifuse® ABX. Methods Bilateral intertransverse spine fusion was performed at the L5-L6 transverse processes (TPs) of New Zealand White rabbits using either Signafuse or Actifuse ABX as the bone graft material. Bone remodeling and spine fusion were assessed at 6 and 12 weeks using radiographic, biomechanical and histological endpoints. Results Fusion rate by manual palpation at 6 weeks was greater for Signafuse (33%) compared to Actifuse ABX (0%), and equivalent in both groups at 12 weeks (50%). Biomechanical fusion rate based on flexion-extension data was 80% in Signafuse group and 44% for Actifuse ABX. Histology revealed a normal healing response in both groups. MicroCT and histomorphometric data at 6 weeks showed greater new bone formation in the Signafuse group compared to Actifuse ABX (p <0.05), with no differences detected at 12 weeks. Histological fusion scores were greater in the Signafuse group at 6 and 12 weeks, indicated by higher degree structural remodeling and tendency towards complete bridging of the fusion bed compared to the Actifuse ABX group. Conclusion Confirmed by several metrics, Signafuse outperformed Actifuse ABX as a standalone synthetic bone graft in an established PLF model, demonstrating greater rates of bone remodeling and spine fusion. The combination of 45

  3. Comparison of platelet rich plasma and synthetic graft material for bone regeneration after third molar extraction

    PubMed Central

    Nathani, Dipesh B.; Sequeira, Joyce; Rao, B. H. Sripathi

    2015-01-01

    Aims: To compare the efficacy of Platelet rich plasma and synthetic graft material for bone regeneration after bilateral third molar extraction. Material and Methods: This study was conducted in 10 patients visiting the outpatient department of Oral & Maxillofacial Surgery, Yenepoya Dental College & Hospital. Patients requiring extraction of bilateral mandibular third molars were taken for the study. Following extraction, PRP (Platelet Rich Plasma) was placed in one extraction socket and synthetic graft material in form granules [combination of Hydroxyapatite (HA) and Bioactive glass (BG)] in another extraction socket. The patients were assessed for postoperative pain and soft tissue healing. Radiological assessment of the extraction site was done at 8, 12 and 16 weeks interval to compare the change in bone density in both the sockets. Results: Pain was less on PRP site when compared to HA site. Soft tissue evaluation done using gingival healing index given by Landry et al showed better healing on PRP site when compared to HA site. The evaluation of bone density by radiological assessment showed the grey level values calculated at 4 months at the PRP site were comparatively higher than HA site. Conclusion: The study showed that the platelet rich plasma is a better graft material than synthetic graft material in terms of soft tissue and bone healing. However a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of both the materials. PMID:26981473

  4. Frontal sinus obliteration with autologous calvarial bone graft: indications and results.

    PubMed

    Vironneau, Pierre; Coste, André; Prulière-Escabasse, Virginie

    2014-11-01

    Despite increasing advances in endonasal frontal sinus surgery, frontal sinus obliteration (FSO) is sometimes necessary after failure of other surgical techniques. This procedure has been reported with autologous tissue or synthetic material, but few studies have reported results with autologous calvarial bone graft. The aim of this study was to report our experience with osteoplastic FSO calvarial bone graft. A retrospective review was performed on 11 patients operated upon for FSO with autologous calvarial bone graft from 2005 to 2011. Obliteration was indicated for chronic symptomatic frontal sinusitis with nasofrontal duct stenosis in five cases of nasal polyposis with a history of endoscopic sinus surgery, two cases of frontal trauma, two of surgery for frontal inverted papilloma and two of chronic frontal purulent sinusitis. Ten patients had a history of one or two previous functional endoscopic sinus surgery (FESS) procedures. On outcome assessment, eight patients had no residual complaints after FSO and all patients showed improvement in symptoms. Frontal sinus obliteration with autologous calvarial bone graft showed low donor site morbidity and good aesthetic results. This procedure should be considered in severe frontal sinusitis after repeated FESS procedures have failed.

  5. Spine Fusion Using Cell Matrix Composites Enriched in Bone Marrow-Derived Cells

    PubMed Central

    Nitto, Hironori; Matsukura, Yoichi; Boehm, Cynthia; Valdevit, Antonio; Kambic, Helen; Davros, William; Powell, Kimerly; Easley, Kirk

    2005-01-01

    Bone marrow-derived cells including osteoblastic progenitors can be concentrated rapidly from bone marrow aspirates using the surface of selected implantable matrices for selective cell attachment. Concentration of cells in this way to produce an enriched cellular composite graft improves graft efficacy. The current study was designed to test the hypothesis that the biologic milieu of a bone marrow clot will significantly improve the efficacy of such a graft. An established posterior spinal fusion model and cancellous bone matrix was used to compare an enriched cellular composite bone graft alone, bone matrix plus bone marrow clot, and an enriched bone matrix composite graft plus bone marrow clot. Union score, quantitative computed tomography, and mechanical testing were used to define outcome. The union score for the enriched bone matrix plus bone marrow clot composite was superior to the enriched bone matrix alone and the bone matrix plus bone marrow clot. The enriched bone matrix plus bone marrow clot composite also was superior to the enriched bone matrix alone in fusion volume and in fusion area. These data confirm that the addition of a bone marrow clot to an enriched cell-matrix composite graft results in significant improvement in graft performance. Enriched composite grafts prepared using this strategy provide a rapid, simple, safe, and inexpensive method for intraoperative concentration and delivery of bone marrow-derived cells and connective tissue progenitors that may improve the outcome of bone grafting. PMID:12567137

  6. The variation of cancellous bones at lumbar vertebra, femoral neck, mandibular angle and rib in ovariectomized sheep.

    PubMed

    Zhang, Yongqiang; Li, Yongfeng; Gao, Qi; Shao, Bo; Xiao, Jianrui; Zhou, Hong; Niu, Qiang; Shen, Mingming; Liu, Baolin; Hu, Kaijin; Kong, Liang

    2014-07-01

    This study aimed to compare the variation of cancellous bones at four skeletal sites: lumbar vertebra, femoral neck, mandibular angle and rib in ovariectomized sheep. Sixteen adult sheep were randomly divided into two groups: eight sheep were ovariectomized served as experimental group; the other eight untreated sheep were served as control group. Bone mineral density was assessed by dual-energy X-ray absorptiometry on lumbar vertebrae at baseline and twelve months after ovariectomy. After 12 months, lumbar vertebrae L3 and L4, femoral necks, mandibular angles and the fourth ribs were harvested for micro-CT scanning, histological analysis and biomechanical test. The results showed that bone mineral density of lumbar vertebra decreased significantly in twelfth month (p<0.05). The results of micro-CT showed that the bone volume/total volume decreased by 45.6%, 36.1% 21.3% and 18.7% in lumbar vertebrae, femoral necks, mandibular angles and ribs in experimental group (p<0.05) respectively. The trabecular number showed the same downtrend (p<0.05). Histological analysis showed trabecular area/tissue area decreased by 32.1%, 23.2% and 20.7% in lumbar vertebrae, femoral necks and mandibular angles respectively (p<0.05), but no significant difference in ribs. Specimens elastic modulus from lumbar vertebra, femoral neck and mandibular angle were 952±76MPa (628±70MPa), 961±173MPa (610±72MPa) and 595±60MPa (444±31MPa) in control group (experimental group) respectively. These datum indicated that the sensibility of cancellous bones to oestrogen deficiency in ovariectomized sheep was site-specific on a pattern as follows: lumbar vertebra, femoral neck, mandibular angle and rib.

  7. Heterotopic implantation of autologous bone marrow in rock pigeons (Columba livia): possible applications in avian bone grafting.

    PubMed

    Sanaei, M Reza; Abu, Jalila; Nazari, Mojgan; Faiz, Nik Mohd; Bakar, Mohd Zuki Abu; Allaudin, Zeenathul N

    2011-12-01

    Autologous bone marrow, alone or as a composite marrow graft, has received much attention in various species. To assess the potential osteogenicity of autologous, extramedullary bone marrow implants in an avian model, 24 adult pigeons (Columba livia) were given intramuscular implantations of autologous marrow aspirated from the medial tibiotarsus. Birds were euthanatized at 1, 4, 6, 8, 10, and 12 weeks after surgery to evaluate whether ectopic bone had formed at the implant sites. Primary evaluations by in situ radiography and postmortem histologic examinations showed no evidence of bone formation. Further evaluation with histologic scores and histomorphometry revealed a significantly increased rate of angiogenesis at the implant sites by the sixth and tenth week postimplantation (P < .05). No significant differences between the treatment and control sites were present at any other endpoints. Results of this study show that, although autologous bone marrow lacks heterotopic osteogenic potentials in this avian model, it could still function as a useful adjunct to routine bone grafting techniques because of its unique capabilities to promote early angiogenesis. PMID:22458179

  8. Evaluation of bone healing with eggshell-derived bone graft substitutes in rat calvaria: a pilot study.

    PubMed

    Park, Jin-Woo; Bae, Sang-Ryul; Suh, Jo-Young; Lee, Dong-Hee; Kim, Sang-Hyun; Kim, Hyungjun; Lee, Chong-Soo

    2008-10-01

    The purpose of this study was to investigate the potential effectiveness of a surface-modified natural calcium carbonate, hen eggshell (ES) as a bone graft substitute. The surface characteristics, cell viability on, and osteoconductivity of, particulated ES with and without hydrothermal treatment in phosphate solutions were evaluated. Hydrothermal treatment partially converted ES to calcium-deficient hydroxyapatite (HA) with surface microstructure. MTT assay indicated higher osteoblast viability on surface-modified ES compared with a commercially available bone substitute, anorganic bovine bone (Bio-Oss, BO) (p < 0.001). Histological and histomorphometric analysis showed significantly greater new bone formation and mineralized bone-to-graft contact of surface-modified ES, especially with hydrothermally treated ES, compared with BO in 5-mm diameter calvarial defects in rats at 4 and 8 weeks of healing (p < 0.01). Complete bony bridging was more frequently found with hydrothermally treated ES. The results of this pilot study indicate the potential efficacy of surface-modified particulated hen eggshell as an osteoconductive bone substitute in a rat calvarial defect model. PMID:18085653

  9. Design and optimization of a tissue-engineered bone graft substitute

    NASA Astrophysics Data System (ADS)

    Shimko, Daniel Andrew

    2004-12-01

    In 2000, 3.1 million surgical procedures on the musculoskeletal system were reported in the United States. For many of these cases, bone grafting was essential for successful fracture stabilization. Current techniques use intact bone obtained either from the patient (autograft) or a cadaver (allograft) to repair large defects, however, neither source is optimal. Allografts suffer integration problems, and for autografts, the tissue supply is limited. Because of these shortcomings, and the high demand for graft tissues, alternatives are being explored. To successfully engineer a bone graft replacement, one must employ a three pronged research approach, addressing (1) the cells that will inhabit the new tissue, (2) the culture environment that these cells will be exposed to, and (3) the scaffold in which these cells will reside. The work herein examines each of these three aspects in great detail. Both adult and embryonic stem cells (ESCs) were considered for the tissue-engineered bone graft. Both exhibited desirable qualities, however, neither were optimal in all categories examined. In the end, the possibility of teratoma formation and ethical issues surrounding ESCs, made the use of adult marrow-derived stem cells in the remaining experiments obligatory. In subsequent experiments, the adult stem cells' ability to form bone was optimized. Basic fibroblast growth factor, fetal bovine serum, and extracellular calcium supplementation studies were all performed. Ultimately, adult stem cells cultured in alpha-MEM supplemented with 10% fetal bovine serum, 10mM beta-glycerophosphate, 10nM dexamethasone, 50mug/ml ascorbic acid, 1%(v/v) antibiotic/antimycotic, and 10.4mM CaCl2 performed the best, producing nearly four times more mineral than any other medium formulation. Several scaffolds were then investigated including those fabricated from poly(alpha-hydroxy esters), tantalum, and poly-methylmethacrylate. In the final study, the most appealing cell type, medium

  10. Bone Repair on Fractures Treated with Osteosynthesis, ir Laser, Bone Graft and Guided Bone Regeneration: Histomorfometric Study

    NASA Astrophysics Data System (ADS)

    dos Santos Aciole, Jouber Mateus; dos Santos Aciole, Gilberth Tadeu; Soares, Luiz Guilherme Pinheiro; Barbosa, Artur Felipe Santos; Santos, Jean Nunes; Pinheiro, Antonio Luiz Barbosa

    2011-08-01

    The aim of this study was to evaluate, through the analysis of histomorfometric, the repair of complete tibial fracture in rabbits fixed with osteosynthesis, treated or not with infrared laser light (λ780 nm, 50 mW, CW) associated or not to the use of hydroxyapatite and guided bone regeneration (GBR). Surgical fractures were created, under general anesthesia (Ketamina 0,4 ml/Kg IP and Xilazina 0,2 ml/Kg IP), on the dorsum of 15 Oryctolagus rabbits that were divided into 5 groups and maintained on individual cages, at day/night cycle, fed with solid laboratory pelted diet and had water ad libidum. On groups II, III, IV and V the fracture was fixed with wire osteosynthesis. Animals of groups III and V were grafted with hydroxyapatite and GBR technique used. Animals of groups IV and V were irradiated at every other day during two weeks (16 J/cm2, 4×4 J/cm2). Observation time was that of 30 days. After animal death (overdose of general anesthetics) the specimes were routinely processed to wax and underwent histological analysis by light microscopy. The histomorfometric analysis showed an increased bone neoformation, increased collagen deposition, less reabsorption and inflammation when laser was associated to the HATCP. It is concluded that IR laser light was able to accelerate fracture healing and the association with HATCP and GBR resulted on increased deposition of CHA.

  11. Ortho- and heterotopic bone grafts in bifocal transport osteogenesis for craniofacial reconstruction--an experimental study in sheep.

    PubMed

    Kramer, F-J; Mueller, M; Rahmstorf, M; Swennen, G R J; Dempf, R; Schierle, H

    2004-09-01

    Bifocal transport osteogenesis (BTO) is a promising technique for the reconstruction of extended osseous craniofacial defects. Aim of this study was to determine the potential of this technique related to various donor sites of the transport segment. In 10 adult sheep critical size defects of the calvaria were treated by gradual movement of a transport segment consisting either of autogenous regional free calvarial bone grafts (n=5) or autogenous illiac free bone grafts (n=5). Latency period was 5 days; the rate of distraction was 1mm per day and extended approximately 40 days. The consolidation period was 28 days. After harvesting, specimens were investigated by conventional radiography, CT-scans, histologically and by fluorescence. In both groups transport osteogenesis resulted in a complete closure of the critical size defect. Membranous bone formation and remodeling occurred during the entire period of distraction and consolidation. The volumes and thickness of newly formed bone at the defect site were increased significantly when calvarial bone grafts were used (P<0.05). Iliac bone grafts became progrediently smaller during distraction, while the volume of calvarial grafts remained relatively constant (P<0.05). In conclusion, transport segments consisting of calvarial and iliac bone resulted in a reliable closure of craniofacial critical size defects in adult organisms; the application of calvarial bone grafts resulted in an increased extend of bone formation.

  12. Histomorphometric and 3D Cone-Beam Computerized Tomographic Evaluation of Socket Preservation in Molar Extraction Sites Using Human Particulate Mineralized Cancellous Allograft Bone With a Porcine Collagen Xenograft Barrier: A Case Series.

    PubMed

    Wallace, Stephen

    2015-06-01

    The purpose of this study was to evaluate the results of socket preservation after extraction using human particulate mineralized cancellous allograft bone (MCAB) and type I porcine collagen membranes (PCM) as a guided bone regeneration barrier. Fourteen patients, 12 women and 2 men, were selected who had a diagnosis of one or more unsalvageable teeth with a treatment plan to replace them with implant-supported single crown restorations. Extractions were preformed atraumatically by sectioning teeth for removal to avoid damaging the socket walls and by immediately placing MCAB graft to fill the sockets. The sockets were occluded with a new PCM. The membranes were cut to overlap the facial and lingual (or palatal) socket rim by at least 5 mm (or more if necessary) to cover bony wall fenestration or dehiscence defects. Implants were then placed 16 weeks after the extractions and augmentation. The results were evaluated clinically, histomorphometrically, and with cone-beam computerized tomographic scanning. The formation of new bone in the treated sites averaged 11.2%, with a range of 1.8% to 43%, in bone biopsies trephined from the center of the grafted socket sites. Density, calculated with proprietary software and measured in Hounsfield units (HUs), was 543 HU with a range of 420 to 822 HU. The resulting new bone regeneration varied widely, but the barrier membranes showed potential for promoting significant bone regeneration. A larger sample of treated cases is needed. Wall defects did not appear to influence the histologic results, but the number of sites was too small to determine their significance.

  13. Percutaneous vertebral augmentation and reconstruction with an intravertebral mesh and morcelized bone graft.

    PubMed

    Chiu, John C; Stechison, Michael T

    2005-01-01

    Percutaneous vertebral augmentation (VA) and reconstruction with intravertebral polyethylene mesh sac (OptiMesh) and morcelized bone graft provided a minimally invasive efficacious and controlled delivery mechanism to stabilize and treat painful osteoporotic, traumatic and neoplastic vertebral compression fractures (VCFs), as well as avoided serious complications from Polymethylmethacrylate (PMMA) of Vertebroplasty and Kyphoplasty. Osteoconductive and osteoinductive and can be used to create biologic vertebral reconstruction. The adjacent vertebra integrity should be more protected by the construct with a similar elasticity and physical characteristics of the morcelized bone, more matched to that of adjacent bone than PMMA. The indications and surgical techniques are described herein.

  14. A new Fe-Mn-Si alloplastic biomaterial as bone grafting material: In vivo study

    NASA Astrophysics Data System (ADS)

    Fântânariu, Mircea; Trincă, Lucia Carmen; Solcan, Carmen; Trofin, Alina; Strungaru, Ştefan; Şindilar, Eusebiu Viorel; Plăvan, Gabriel; Stanciu, Sergiu

    2015-10-01

    Designing substrates having suitable mechanical properties and targeted degradation behavior is the key's development of bio-materials for medical application. In orthopedics, graft material may be used to fill bony defects or to promote bone formation in osseous defects created by trauma or surgical intervention. Incorporation of Si may increase the bioactivity of implant locally, both by enhancing interactions at the graft-host interface and by having a potential endocrine like effect on osteoblasts. A Fe-Mn-Si alloy was obtained as alloplastic graft materials for bone implants that need long recovery time period. The surface morphology of the resulted specimens was investigated using scanning electrons microscopy (VegaTescan LMH II, SE detector, 30 kV), X-ray diffractions (X'Pert equipment) or X-ray dispersive energy analyze (Bruker EDS equipment). This study objective was to evaluate in vivo the mechanisms of degradation and the effects of its implantation over the main metabolic organs. Biochemical, histological, plain X radiography and computed tomography investigations showed good compatibility of the subcutaneous implants in the rat organism. The implantation of the Fe-Mn-Si alloy, in critical size bone (tibiae) defect rat model, did not induced adverse biological reactions and provided temporary mechanical support to the affected bone area. The biodegradation products were hydroxides layers which adhered to the substrate surface. Fe-Mn-Si alloy assured the mechanical integrity in rat tibiae defects during bone regeneration.

  15. Complications associated with negative pressure reaming for harvesting autologous bone graft: a case series.

    PubMed

    Lowe, Jason A; Della Rocca, Gregory J; Murtha, Yvonne; Liporace, Frank A; Stover, Michael D; Nork, Sean E; Crist, Brett D

    2010-01-01

    A technical benefit of the reamer-irrigator-aspirator (RIA) system (Synthes, Paoli, PA) is the ability to harvest large volumes (40-90 cm3) of autogenous bone graft. Early evaluations of this technique have reported few problems, all of which were attributed to technical error. This case series reviews 6 RIA-associated complications including 4 fractures and their contributing risk factors. Cases were collected from 4 independent orthopaedic centers, and all patients underwent RIA bone graft harvesting in a lower extremity long bone injuries. In this population, 2 patients experienced acute RIA-associated events, necessitating an additional procedure or altered postoperative rehabilitation, whereas 4 patients fractured through their donor site in the early postoperative period. This series suggests that surgeons should (1) preoperatively assess cortical diameters at long bone harvest sites, (2) carefully monitor intraoperative reaming, and (3) avoid RIA bone graft harvesting in patients with a history of osteoporosis or osteopenia unless postharvest intramedullary stabilization is considered. PMID:20035178

  16. Evaluation of OSSIFI® as Alloplastic Bone Graft Material in Treatment of Periodontal Infrabony Defects

    PubMed Central

    Kaushal, Sumit; Kapoor, Anoop; Singh, Preetinder; Kochhar, Gulsheen; Khuller, Nitin

    2014-01-01

    Introduction: The shift in therapeutic concepts from resection to regeneration has significantly impacted the practice of periodontology. Human studies have revealed that hydroxyapatite bone cement holds great promise as a grafting alloplastic material. Aims and Objectives: To evaluate the efficacy of OSSIFI® (combined beta tricalcium phosphate plus hydroxyapatite) in the treatment of periodontal infrabony defects. Materials and Methods: Ten study subjects were selected and divided into two groups. Group I (PD>7mm) and Group II (PD≤ 7mm). Both Groups I and II were treated by regenerative periodontal surgery using OSSIFI® as graft material. Plaque index, gingival index, pocket depth, clinical attachment levels were recorded clinically and bone fill, radiographically, at baseline, three months and six months. Results and Conclusion: Statistically significant reduction in pocket depth, plaque index, gingival index was seen after six months. There was significant bone fill seen from 3-6months with significant gain in clinical attachment levels. PMID:25478450

  17. Anatomic ACL reconstruction: rectangular tunnel/bone-patellar tendon-bone or triple-bundle/semitendinosus tendon grafting.

    PubMed

    Shino, Konsei; Mae, Tatsuo; Tachibana, Yuta

    2015-05-01

    Anatomic ACL reconstruction is the reasonable approach to restore stability without loss of motion after ACL tear. To mimic the normal ACL like a ribbon, our preferred procedures is the anatomic rectangular tunnel (ART) technique with a bone-patellar tendon-bone (BTB) graft or the anatomic triple bundle (ATB) procedure with a hamstring (HS) tendon graft. It is important to create tunnel apertures inside the attachment areas to lessen the tunnel widening. To identify the crescent-shaped ACL femoral attachment area, the upper cartilage margin, the posterior cartilage margin and the resident's ridge are used as landmarks. To delineate the C-shaped tibial insertion, medial intercondylar ridge, Parson's knob and anterior horn of the lateral meniscus are helpful. In ART-BTB procedure which is suitable for male patients engaged in contact sports, the parallelepiped tunnels with rectangular apertures are made within the femoral and tibial attachment areas. In ATB-HS technique which is mainly applied to female athletes engaged in non-contact sports including skiing or basketball, 2 femoral and 3 tibial round tunnels are created inside the attachment areas. These techniques make it possible for the grafts to run as the native ACL without impingement to the notch or PCL. After femoral fixation with an interference screw or cortical fixation devices including Endobutton, the graft is pretensioned in situ by repetitive manual pulls at 15-20° of flexion, monitoring the graft tension with tensioners on a tensioning boot installed on the calf. Tibial fixation with pullout sutures is achieved using Double Spike Plate and a screw at the pre-determined amount of tension of 10-20N. While better outcomes with less failure rate are being obtained compared to those in the past, higher graft tear rate remains a problem. Improved preventive training may be required to avoid secondary ACL injuries.

  18. Anatomic ACL reconstruction: rectangular tunnel/bone-patellar tendon-bone or triple-bundle/semitendinosus tendon grafting.

    PubMed

    Shino, Konsei; Mae, Tatsuo; Tachibana, Yuta

    2015-05-01

    Anatomic ACL reconstruction is the reasonable approach to restore stability without loss of motion after ACL tear. To mimic the normal ACL like a ribbon, our preferred procedures is the anatomic rectangular tunnel (ART) technique with a bone-patellar tendon-bone (BTB) graft or the anatomic triple bundle (ATB) procedure with a hamstring (HS) tendon graft. It is important to create tunnel apertures inside the attachment areas to lessen the tunnel widening. To identify the crescent-shaped ACL femoral attachment area, the upper cartilage margin, the posterior cartilage margin and the resident's ridge are used as landmarks. To delineate the C-shaped tibial insertion, medial intercondylar ridge, Parson's knob and anterior horn of the lateral meniscus are helpful. In ART-BTB procedure which is suitable for male patients engaged in contact sports, the parallelepiped tunnels with rectangular apertures are made within the femoral and tibial attachment areas. In ATB-HS technique which is mainly applied to female athletes engaged in non-contact sports including skiing or basketball, 2 femoral and 3 tibial round tunnels are created inside the attachment areas. These techniques make it possible for the grafts to run as the native ACL without impingement to the notch or PCL. After femoral fixation with an interference screw or cortical fixation devices including Endobutton, the graft is pretensioned in situ by repetitive manual pulls at 15-20° of flexion, monitoring the graft tension with tensioners on a tensioning boot installed on the calf. Tibial fixation with pullout sutures is achieved using Double Spike Plate and a screw at the pre-determined amount of tension of 10-20N. While better outcomes with less failure rate are being obtained compared to those in the past, higher graft tear rate remains a problem. Improved preventive training may be required to avoid secondary ACL injuries. PMID:25753837

  19. Impact of radiation therapy on healing and stability of vascularized bone grafts in a dog model.

    PubMed

    Eisenschenk, Andreas; Witzel, Christiane; Lautenbach, Martin; Ekkernkamp, Axel; Weber, Ulrich; Küntscher, Markus V

    2006-01-01

    The purpose of the study was to observe the impact of radiation therapy on healing and biomechanical properties of vascularized bone grafts, and thus to establish an appropriate large animal model. Ten male beagles were divided into two experimental groups: radiation (R) and control (C). The left 5th to 7th ribs of the animals of group R were irradiated 3 and 2 weeks preoperatively, using a dose of 8 Gy each time. Each animal of both groups underwent the following operative procedures. The 5th and 7th ribs were removed, and the 5th rib was replaced by a vascularized pedicle transfer of the 4th rib. The 7th rib was reconstructed using a pedicle transplant of the 8th rib. The 5th and 7th ribs were used as nonvascularized bone grafts to replace the donor sites of the 4th and 8th ribs, respectively. Group R received two further irradiation cycles 2 and 3 weeks postoperatively. The vascularized rib grafts of group R demonstrated a higher number of delayed unions in plain x-rays and avascular bone segments in microangiography than the control group. The presence of vital osteocytes in histology was not significantly different between groups. Biomechanical tests focusing on the durability of vascularized ribs against bending and torsion forces demonstrated a reduction of average maximum bending moments by 56.6% after radiation compared to controls (P < 0.05). Twisting moments were reduced by 47.6% (P < 0.05). The data demonstrate a significant worsening in bone healing and stability after pre- and postoperative radiation therapy to the wound bed and bone grafts. Thus, a large animal model is established for further determination of different strategies of radiotherapy in combination with vascularized bone transfers.

  20. Successful treatment of a humeral capitulum osteonecrosis with bone morphogenetic protein-7 combined with autologous bone grafting.

    PubMed

    Marsell, Richard; Hailer, Nils P

    2014-08-01

    We present the case of a 27-year-old female with subcortical osteonecrosis of the humeral capitulum. Percutaneous retrograde drilling of the lesion and application of recombinant human bone morphogenetic protein (BMP)-7 were combined with autologous bone grafting. At follow-up the patient was almost pain-free, had normalized her range of motion, and radiography showed consolidation of the lesion without any heterotopic bone formation. By timing surgery prior to subchondral collapse, biomechanical stability of the subchondral bone was maintained. To our knowledge, this is the first report on the treatment of an osteonecrosis in this location with a BMP, and this strategy could potentially be applied in other locations with juxta-articular osteonecrosis. PMID:25017508

  1. Retrospective analysis of secondary alveolar cleft grafts using iliac of chin bone.

    PubMed

    Nwoku, Alagumba L; Al Atel, Abdullah; Al Shlash, Saud; Oluyadi, Bashir A; Ismail, Salwa

    2005-09-01

    The osseous closure of alveolar clefts is an integral component of a comprehensive rehabilitation of patients with cleft lip and palate and has assumed an essential position in the reconstruction of cleft deformity. Our study consists of 35 patients aged between 7 and 11 years who received secondary bone grafting of their cleft alveolus over a 30 month period from July 1999 to December 2003. There were 22 (62.9%) males and 13 (37.1%) females. In 25 cases, bone graft was harvested from the iliac crest and in 10 others, from the mandibular symphysis. A total number of 41 osteoplasties was performed in the 35 patients. Twenty osteoplasties maintained an alveolar height up to 75% and approximately that number showed resorption varying between 50% and 75%. There was no case of complete resorption of graft. There were no serious periodontal pockets found. In all cases, the wound healed well, and there was no complication. Our experience demonstrates that secondary alveolar bone grafting is an efficacious method of rehabilitating patients with alveolar clefts.

  2. Multiple congenital brachymetatarsia. A one-stage combined shortening and lengthening procedure without iliac bone graft.

    PubMed

    Kim, J S; Baek, G H; Chung, M S; Yoon, P W

    2004-09-01

    We performed nine metatarsal and three proximal phalangeal lengthenings in five patients with congenital brachymetatarsia of the first and one or two other metatarsal bones, by a one-stage combined shortening and lengthening procedure using intercalcary autogenous bone grafts from adjacent shortened metatarsal bones. Instead of the isolated lengthening of the first and the other metatarsal bones, we shortened the adjacent normal metatarsal and used the excised bone to lengthen the short toes, except for the great toe, to restore the normal parabola. One skin incision was used. All the operations were performed bilaterally and the patients were followed up for a mean period of 69.5 months (29 to 107). They all regained a nearly normal parabola and were satisfied with the cosmetic results. Our technique is straightforward and produces good cosmetic results. Satisfactory, bony union is achieved, morbidity is low, and no additional surgery is required for the removal of metal implants. PMID:15446529

  3. From natural bone grafts to tissue engineering therapeutics: Brainstorming on pharmaceutical formulative requirements and challenges.

    PubMed

    Baroli, Biancamaria

    2009-04-01

    Tissue engineering is an emerging multidisciplinary field of investigation focused on the regeneration of diseased or injured tissues through the delivery of appropriate molecular and mechanical signals. Therefore, bone tissue engineering covers all the attempts to reestablish a normal physiology or to speed up healing of bone in all musculoskeletal disorders and injuries that are lashing modern societies. This article attempts to give a pharmaceutical perspective on the production of engineered man-made bone grafts that are described as implantable tissue engineering therapeutics, and to highlight the importance of understanding bone composition and structure, as well as osteogenesis and bone healing processes, to improve the design and development of such implants. In addition, special emphasis is given to pharmaceutical aspects that are frequently minimized, but that, instead, may be useful for formulation developments and in vitro/in vivo correlations.

  4. Effects of alendronate and strontium ranelate on cancellous and cortical bone mass in glucocorticoid-treated adult rats.

    PubMed

    Sun, P; Cai, D H; Li, Q N; Chen, H; Deng, W M; He, L; Yang, L

    2010-06-01

    We studied the effects of alendronate (Aln) and strontium ranelate (SrR) administration on cancellous and cortical bone in glucocorticoid (GC)-treated rats. Thirty-two 3.5-month male Sprague-Dawley rats were randomized into four groups: age-matched normal control (Nrm), methylprednisolone (Met; 5.0 mg/kg/day, sc, for 5 days/week), Met plus Aln orally (1.0 mg/kg/day), and Met plus SrR orally (900 mg/kg/day). The study period was 9 weeks. DXA was used to evaluate the femoral diaphysis and fifth lumbar vertebra (L5). Histomorphometry was performed in the proximal tibial metaphysis and tibial diaphysis. Met significantly decreased body weight and bone mineral density (BMD) compared with Nrm. Aln and SrR significantly increased body weight and BMD compared with Met. SrR resulted in significantly higher BMD than Aln. Met markedly decreased BV/TV, Tb.Th, and Tb.N and increased Tb.Sp compared with Nrm. Aln and SrR showed significantly increased of BV/TV, Tb.Th, and Tb.N and improved bone architecture. Moreover, Met reduced %Ct.Ar, enlarged %Ma.Ar, and decreased bone formation indices in the periosteum as well as increased ES/BS in the endosteum compared with Nrm. Aln significantly decreased endosteal ES/BS compared with Met. SrR significantly increased %Ct.Ar and bone formation indices in the periosteum as well as the endosteum and decreased endosteal ES/BS compared with Met. Furthermore, SrR led to a significantly higher cancellous and endocortical MS/BS and endocortical bone formation compared with Aln. Our findings suggest SrR at a dose of 900 mg/kg has a greater effect than Aln at 1.0 mg/kg, according to BMD and histomorphometric analysis, in preventing GC-induced osteopenia. Therefore, SrR might be applicable as a bone therapeutic agent to treat secondary osteoporosis in the clinic. PMID:20390406

  5. Quantifying trabecular orientation in the pelvic cancellous bone of modern humans, chimpanzees, and the Kebara 2 Neanderthal.

    PubMed

    Martinón-Torres, María

    2003-01-01

    The adaptive nature of bone lies in its ability to respond to the environment by conforming and reshaping itself constantly to accommodate life-time stresses experienced throughout daily activities. In order to keep strains within the bone as uniform and isotropic as possible, the trabecular orientation is determined by forces acting on the bone through adaptive remodeling. Hence, the preserved structure of bones may contain direct information about the forces they may have undergone. Some authors (Correnti [1952], Atti Acc Naz Lincei 12:518-523, [1955] Riv Antrop 42:289-336; Macchiarelli et al. [1999] J Hum Evol 36:211-232, [2001] Cambridge, UK: Cambridge University Press) have described in detail the trabecular systems of the hip bone in different primate species and have identified a gait-related system above the acetabulum with substantial differences across species (Macchiarelli et al. [1999]; Rook et al. [1999] Proc Natl Acad Sci USA 96:8875-8879). The aim of this study was to quantify trabecular orientation above the acetabulum to test the hypothesis that hominoid biomechanical behavior is recorded in the cancellous bone. The pelvic bones of 23 archaeological adult modern humans (12 females, 11 males), 20 adult Pan troglodytes (10 females, 10 males), and one adult male Neanderthal were radiographed and digitized. Fast Fourier transforms (FFTs) of the regions of interest in the corpus of the ilium were performed, with the angular distribution of the trabeculae quantified. All species displayed a constant and periodic orthogonal arrangement in the trabeculae with differences in the pattern of dominance between the arcades oriented along the 0 degrees or the 90 degrees axes. The variation in the FFT spectrum between species is discussed in the light of distinctive biomechanical features. PMID:12953177

  6. Technical tricks when using the reamer irrigator aspirator technique for autologous bone graft harvesting.

    PubMed

    Quintero, Andres J; Tarkin, Ivan S; Pape, Hans-Christoph

    2010-01-01

    This report describes technical tricks for using the reamer irrigator aspirator to harvest autologous bone graft from the femur. This device is a focus of interest in orthopaedics because it can be used to harvest bone graft from the femoral canal and medial condyle in voluminous quantities. Moreover, according to some authors, the osteogenic potential of this graft is at least as effective as that of autogenous bone obtained from the iliac crest. The reamer irrigator aspirator device has substantially different design characteristics and technicalities compared with those of a standard reamer. First, a guidewire must be redirected into multiple areas, including the center of the distal femur and into both condyles, to harvest ample bone graft. This is accomplished by prebending the guidewire in a stronger fashion than required for regular reaming in the case of femoral nailing procedures. This bend can increase the risk for eccentric reaming as well as lodging of the suctioning device within the femoral canal. Second, the front and lateral drilling surfaces of this device are very sharp and further cleaned and maintained sharp by the irrigation process to permit the surgeon to obtain significant volumes of graft with a single passage of this device. At the same time, however, this sharp front-end cutting design can increase the risk of iatrogenic fracture if reaming is performed without caution. Third, a powerful suctioning device is connected to the reamer such that the blood loss that can occur during continuous reaming, irrigation, and aspiration must be considered with this technique. We hereby discuss these potential dangers and describe the correct use of this device with technical tricks to minimize the risk of unexpected intraoperative events. PMID:20035177

  7. Fragmented Adipose Tissue Graft for Bone Healing: Histological and Histometric Study in Rabbits’ Calvaria

    PubMed Central

    Oliveira, Lidiane C.; Giovanini, Allan F.; Abuabara, Allan; Klug, Luiz G.; Gonzaga, Carla C.; Zielak, João C.; Urban, Cícero A.

    2013-01-01

    Objective The adipose tissue represents an important reservoir of stem cells. There are few studies in the literature with which to histologically evaluate whether or not the adipose tissue graft is really a safe option to achieve bone repair. This study histologically analyzed the effect of fragmented autogenous adipose tissue grafts on bone healing in surgically created, critical-size defects (CSD) in a rabbit’s calvaria. Study design Forty-two New Zealand rabbits were used in this study. CSD that were 15 mm in diameter were created in the calvarium of each animal. The defects were randomly divided into two groups: in Group C (control), the defect was filled only by a blood clot and, in Group FAT (i.e., fragmented adipose tissue), the defect was filled with fragmented autogenous adipose tissue grafts. The groups were divided into subgroups (n = 7) for euthanasia at 7, 15, and 40 days after the procedure had been conducted. Histologic and histometric analyses were performed. Data were statistically analysed with ANOVA and Tukey’s tests (p < 0.05). Results The amount of bone formation did not show statistically significant differences seven days after the operation, which indicates that the groups had similar amounts of mineral deposition in the earlier period of the repair. Conversely, a significant of amount of bone matrix deposition was identified in the FAT group at 15 and 40 days following the operation, both on the border and in the body of the defect. Such an outcome was not found in the control group. Conclusion In this study, an autologous adipose tissue graft may be considered as likely biomaterial for bone regeneration, since it positively affected the amount of bone formation in surgically created CSD in the rabbits’ calvaria 40 days after the procedure had been performed. Further investigations with a longer time evaluation are warranted to determine the effectiveness of autologous adipose tissue graft in the bone healing. Key words

  8. Secondary alveolar bone grafting in cleft of the lip and palate patients

    PubMed Central

    Walia, Abhilashaa

    2011-01-01

    Aim: The aim was to restore the function and form of both arches with a proper occlusal relationship and eruption of tooth in the cleft area. Materials and Methods: Eleven patients were selected irrespective of sex and socio-economic status and whose age was within the mixed dentition period. Iliac crest is grafted in cleft area and subsequently evaluated for graft success using study models, and periapical and occlusal radiographs. Results: At the time of evaluation teeth were erupted in the area and good alveolar bone levels were present. Premaxilla becomes immobile with a good arch form and arch continuity. There are no major complications in terms of pain, infection, paraesthesia, hematoma formation at donor site without difficulty in walking. There is no complication in terms of pain, infection, exposure of graft, rejection of graft, and wound dehiscence at the recipient site. Discussion: It is evident that secondary alveolar grafting during the mixed dentition period is more beneficial for patients at the donor site as well as the recipient site. Conclusion: Long-term follow-up is required to achieve maximum advantage of secondary alveolar grafting; the age of the patient should be within the mixed dentition period, irrespective of sex, socio-economic status. It may be unilateral or bilateral. PMID:22090755

  9. Silver nanoparticle based antibacterial methacrylate hydrogels potential for bone graft applications.

    PubMed

    González-Sánchez, M Isabel; Perni, Stefano; Tommasi, Giacomo; Morris, Nathanael Glyn; Hawkins, Karl; López-Cabarcos, Enrique; Prokopovich, Polina

    2015-05-01

    Infections are frequent and very undesired occurrences after orthopedic procedures; furthermore, the growing concern caused by the rise in antibiotic resistance is progressively dwindling the efficacy of such drugs. Artificial bone graft materials could solve some of the problems associated with the gold standard use of natural bone graft such as limited bone material, pain at the donor site and rejections if donor tissue is used. We have previously described new acrylate base nanocomposite hydrogels as bone graft materials. In the present paper, we describe the integration of silver nanoparticles in the polymeric mineralized biomaterial to provide non-antibiotic antibacterial activity against Staphylococcus epidermidis and Methicillin-resistant Staphylococcus aureus. Two different crosslinking degrees were tested and the silver nanoparticles were integrated into the composite matrix by means of three different methods: entrapment in the polymeric hydrogel before the mineralization; diffusion during the process of calcium phosphate crystallization and adsorption post-mineralization. The latter being generally the most effective method of encapsulation; however, the adsorption of silver nanoparticles inside the pores of the biomaterial led to a decreasing antibacterial activity for adsorption time longer than 2 days.

  10. Silver nanoparticle based antibacterial methacrylate hydrogels potential for bone graft applications

    PubMed Central

    González-Sánchez, M. Isabel; Perni, Stefano; Tommasi, Giacomo; Morris, Nathanael Glyn; Hawkins, Karl; López-Cabarcos, Enrique; Prokopovich, Polina

    2015-01-01

    Infections are frequent and very undesired occurrences after orthopedic procedures; furthermore, the growing concern caused by the rise in antibiotic resistance is progressively dwindling the efficacy of such drugs. Artificial bone graft materials could solve some of the problems associated with the gold standard use of natural bone graft such as limited bone material, pain at the donor site and rejections if donor tissue is used. We have previously described new acrylate base nanocomposite hydrogels as bone graft materials. In the present paper, we describe the integration of silver nanoparticles in the polymeric mineralized biomaterial to provide non-antibiotic antibacterial activity against Staphylococcus epidermidis and Methicillin-resistant Staphylococcus aureus. Two different crosslinking degrees were tested and the silver nanoparticles were integrated into the composite matrix by means of three different methods: entrapment in the polymeric hydrogel before the mineralization; diffusion during the process of calcium phosphate crystallization and adsorption post-mineralization. The latter being generally the most effective method of encapsulation; however, the adsorption of silver nanoparticles inside the pores of the biomaterial led to a decreasing antibacterial activity for adsorption time longer than 2 days. PMID:25746278

  11. Treatment of scaphoid nonunion with vascularised and nonvascularised dorsal bone grafting from the distal radius

    PubMed Central

    Medina, Carlos Eduardo Gonzalez; Mattar, Rames; Ulson, Heitor Jose Rizzardo; de Resende, Marcelo Rosa; Etchebehere, Mauricio

    2009-01-01

    We conducted a prospective randomised study comparing the clinical, functional and radiographic results of 46 patients treated for scaphoid nonunion using a vascularised bone graft from the dorsal and distal aspect of the radius (group I), relative to 40 patients treated by means of a conventional non-vascularised bone graft from the distal radius (group II). Surgical findings included 30 sclerotic, poorly-vascularised scaphoids in group I versus 20 in group II. Bone fusion was achieved in 89.1% of group I and 72.5% of group II patients (p = 0.024). Functional results were good to excellent in 72.0% of the patients in group I and 57.5% in group II. Considering only patients with sclerotic, poorly-vascularised scaphoids, the mean final outcome scores obtained were 7.5 and 6.0 for groups I and group II, respectively. We conclude that vascularised bone grafting yields superior results and is more efficient when there is a sclerotic, poorly-vascularised proximal pole in patients in scaphoid nonunion. PMID:19730861

  12. Bone grafts engineered from human adipose-derived stem cells in dynamic 3D-environments.

    PubMed

    Declercq, Heidi A; De Caluwé, Tamara; Krysko, Olga; Bachert, Claus; Cornelissen, Maria J

    2013-01-01

    Modular tissue engineering (TE) is a promising alternative to overcome the limits in traditional TE. In the present study, adipose tissue derived stem cells (ADSC)-laden microcarriers are used as building blocks (microtissues) that self-assemble into macrotissues in a bottom-up approach. These bone grafts were compared with a classical top-down approach (scaffolds). This concept was compared with bone marrow derived stem cells (BMSC) as cell source. Cells were immunophenotypically analyzed, followed by 2D/3D osteogenic differentiation in static/dynamic conditions. The bone graft quality was evaluated by (immuno)histochemistry and gene expression. After 6 weeks of dynamic culturing, scaffolds were highly colonized although not in the center and the osteogenic gene expression was higher in contrast to static cultures. A cell-to-microcarrier ratio of 5 × 10(6) cells-0.09 g microcarriers leaded to aggregate formation resulting in microtissues with subsequent macrotissue formation. ADSC/BMSC on scaffolds showed a downregulation of Runx2 and collagen I, demonstrating the end-stage, in contrary to microcarriers, where an upregulation of Runx2, collagen I together with BSP and osteocalcin was observed. This paper showed that high quality bone grafts (2 cm³) can be engineered in a bottom-up approach with cell-laden microcarriers.

  13. Silver nanoparticle based antibacterial methacrylate hydrogels potential for bone graft applications.

    PubMed

    González-Sánchez, M Isabel; Perni, Stefano; Tommasi, Giacomo; Morris, Nathanael Glyn; Hawkins, Karl; López-Cabarcos, Enrique; Prokopovich, Polina

    2015-05-01

    Infections are frequent and very undesired occurrences after orthopedic procedures; furthermore, the growing concern caused by the rise in antibiotic resistance is progressively dwindling the efficacy of such drugs. Artificial bone graft materials could solve some of the problems associated with the gold standard use of natural bone graft such as limited bone material, pain at the donor site and rejections if donor tissue is used. We have previously described new acrylate base nanocomposite hydrogels as bone graft materials. In the present paper, we describe the integration of silver nanoparticles in the polymeric mineralized biomaterial to provide non-antibiotic antibacterial activity against Staphylococcus epidermidis and Methicillin-resistant Staphylococcus aureus. Two different crosslinking degrees were tested and the silver nanoparticles were integrated into the composite matrix by means of three different methods: entrapment in the polymeric hydrogel before the mineralization; diffusion during the process of calcium phosphate crystallization and adsorption post-mineralization. The latter being generally the most effective method of encapsulation; however, the adsorption of silver nanoparticles inside the pores of the biomaterial led to a decreasing antibacterial activity for adsorption time longer than 2 days. PMID:25746278

  14. Man as a Living Bioreactor: Prefabrication of a Custom Vascularized Bone Graft in the Gastrocolic Omentum.

    PubMed

    Wiltfang, Jörg; Rohnen, Michael; Egberts, Jan-Hendrik; Lützen, Ulf; Wieker, Henning; Açil, Yahya; Naujokat, Hendrik

    2016-08-01

    Reconstruction of critical-size jaw defects still remains challenging. The standard treatment today is transplantation of autologous bone grafts, which is associated with high donor-site morbidity and unsatisfactory outcomes. We aimed to reconstruct a mandibular discontinuity defect after ablative surgery using the gastrocolic omentum as a bioreactor for heterotopic ossification. Three-dimensional computed tomography data were used to produce an ideal virtual replacement for the mandibular defect. A titanium mesh cage was filled with bone mineral blocks, infiltrated with 12 mg of recombinant human bone morphogenetic protein 2, and enriched with bone marrow aspirate. The scaffold was implanted into the gastrocolic omentum, and 3 months later, a free flap was harvested to reconstruct the mandibular defect. In vivo single photon emission computed tomography/computed tomography revealed bone remodeling and mineralization inside the mandibular transplant during prefabrication and after transplantation. Reconstruction was possible without any further modifications of the graft. A histological evaluation revealed that large sections of the Bio-Oss material were covered with osteoid matrix 3 months after transplantation. The quality of life of the patient significantly increased with acquisition of the ability to masticate and the improvement in pronunciation and aesthetics. Heterotopic bone induction to form a mandibular replacement inside the gastrocolic omentum is possible in human subjects. Heterotopic prefabrication is associated with many advantages, like allowing a reduced operative burden compared with conventional techniques and good three-dimensional outcomes. PMID:27317022

  15. Structural mechanical properties of radiation-sterilized human Bone-Tendon-Bone grafts preserved by different methods.

    PubMed

    Gut, Grzegorz; Marowska, Joanna; Jastrzebska, Anna; Olender, Ewa; Kamiński, Artur

    2016-06-01

    To avoid the risk of infectious disease transmission from donor to recipient, allografts should be terminally sterilized. In the previous paper (Kaminski et al. in Cell Tissue Bank 10:215-219, 2009) we presented the effect of various methods of preservation (deep fresh freezing, glycerolization, lyophilization), followed by irradiation with different doses of electron beam (EB), on material (intrinsic) mechanical properties of human patellar tendons cut out as for anterior cruciate ligament reconstruction, obtained in failure tensile test. As structural mechanical properties are equally important to predict the behaviour of the graft as a whole functional unit, the purpose of the present paper was to show the results for failure load and elongation, obtained in the same experiment. Paired Bone-Tendon-Bone grafts (BTB) were prepared from cadaveric human patella tendons with both patellar and tibial attachments. They were preserved by deep freezing, glycerolization or lyophilization and subsequently EB-irradiated with the doses of 25, 35, 50 or 100 kGy (fresh-frozen grafts) or a single dose of 35 kGy (glycerolized and lyophilized grafts). Each experimental (irradiated) group was provided with control (non-irradiated), donor-matched group. The specimens from all groups were subjected to mechanical failure tensile test with the use of Instron system in order to measure their structural properties (failure load and elongation). All lyophilized grafts were rehydrated before mechanical testing. In our study we did not observe significant deterioration of structural mechanical properties of BTB grafts processed by fresh-freezing and then terminal sterilized with growing doses of EB up to 100 kGy. In contrast, BTB grafts processed by glycerolization or lyophilization and irradiated with 35 kGy showed significant decrease of failure load. Obtained results suggest that deep-frozen irradiated grafts retain their initial mechanical properties to an extent which does not

  16. Structural mechanical properties of radiation-sterilized human Bone-Tendon-Bone grafts preserved by different methods.

    PubMed

    Gut, Grzegorz; Marowska, Joanna; Jastrzebska, Anna; Olender, Ewa; Kamiński, Artur

    2016-06-01

    To avoid the risk of infectious disease transmission from donor to recipient, allografts should be terminally sterilized. In the previous paper (Kaminski et al. in Cell Tissue Bank 10:215-219, 2009) we presented the effect of various methods of preservation (deep fresh freezing, glycerolization, lyophilization), followed by irradiation with different doses of electron beam (EB), on material (intrinsic) mechanical properties of human patellar tendons cut out as for anterior cruciate ligament reconstruction, obtained in failure tensile test. As structural mechanical properties are equally important to predict the behaviour of the graft as a whole functional unit, the purpose of the present paper was to show the results for failure load and elongation, obtained in the same experiment. Paired Bone-Tendon-Bone grafts (BTB) were prepared from cadaveric human patella tendons with both patellar and tibial attachments. They were preserved by deep freezing, glycerolization or lyophilization and subsequently EB-irradiated with the doses of 25, 35, 50 or 100 kGy (fresh-frozen grafts) or a single dose of 35 kGy (glycerolized and lyophilized grafts). Each experimental (irradiated) group was provided with control (non-irradiated), donor-matched group. The specimens from all groups were subjected to mechanical failure tensile test with the use of Instron system in order to measure their structural properties (failure load and elongation). All lyophilized grafts were rehydrated before mechanical testing. In our study we did not observe significant deterioration of structural mechanical properties of BTB grafts processed by fresh-freezing and then terminal sterilized with growing doses of EB up to 100 kGy. In contrast, BTB grafts processed by glycerolization or lyophilization and irradiated with 35 kGy showed significant decrease of failure load. Obtained results suggest that deep-frozen irradiated grafts retain their initial mechanical properties to an extent which does not

  17. Is nonstructural bone graft useful in surgical treatment of lumbar spinal tuberculosis?

    PubMed Central

    Liu, Jia-Ming; Chen, Xuan-Yin; Zhou, Yang; Long, Xin-Hua; Chen, Wen-Zhao; Liu, Zhi-Li; Huang, Shan-Hu; Yao, Hao-Qun

    2016-01-01

    Abstract Surgical intervention is an important option for treating spinal tuberculosis. Previous studies have reported different surgical procedures and bone grafts for it. To our knowledge, few studies demonstrated the clinical results of using nonstructural autogenous bone graft in surgical treatment of spinal tuberculosis. The purpose of this study is to compare the clinical outcomes of surgical management lumbar spinal tuberculosis by one-stage posterior debridement with nonstructural autogenous bone grafting and instrumentation versus anterior debridement, strut bone grafting combined with posterior instrumentation. A total of 58 consecutive patients who underwent surgical treatment due to lumbar spinal tuberculosis from January 2011 to December 2013 were included. A total of 22 patients underwent one-stage posterior debridement, nonstructural autogenous bone grafting, and instrumentation (group A), and 36 patients received anterior debridement, strut bone grafting combined with posterior instrumentation (group B). The operative duration, total blood loss, perioperative transfusion, length of hospital stay, hospitalization cost, and complications were recorded. The bony fusion of the graft was assessed by computed tomography scans. American Spinal Injury Association (ASIA) Impairment Scale was used to evaluate the neurological function of patients in the 2 groups. All the patients were followed up, with a mean follow-up duration of 21.6 ± 5.7 months in group A and 22.3 ± 6.2 months in group B (P = 0.47). The average operative duration was 257.5 ± 91.1 minutes in group A and 335.7 ± 91.0 minutes in group B (P = 0.002). The mean total blood loss was 769.6 ± 150.9 mL in group A and 1048.6 ± 556.9 mL in group B (P = 0.007). Also, significant differences were found between the 2 groups in perioperative transfusion volumes, length of hospital stay, and hospitalization cost (P < 0.05), which were less in group A

  18. Decomposition of two-component ultrasound pulses in cancellous bone using modified least squares prony method--phantom experiment and simulation.

    PubMed

    Wear, Keith A

    2010-02-01

    Porous media such as cancellous bone often support the simultaneous propagation of two compressional waves. When small bone samples are interrogated in through-transmission with broadband sources, these two waves often overlap in time. The modified least-squares Prony's (MLSP) method was tested for decomposing a 500 kHz-center-frequency signal containing two overlapping components: one passing through a polycarbonate plate (to produce the "fast" wave) and another passing through a cancellous-bone-mimicking phantom (to produce the "slow" wave). The MLSP method yielded estimates of attenuation slopes accurate to within 7% (polycarbonate plate) and 2% (cancellous bone phantom). The MLSP method yielded estimates of phase velocities accurate to within 1.5% (both media). The MLSP method was also tested on simulated data generated using attenuation slopes and phase velocities corresponding to bovine cancellous bone. Throughout broad ranges of signal-to-noise ratio (SNR), the MLSP method yielded estimates of attenuation slope that were accurate to within 1.0% and estimates of phase velocity that were accurate to within 4.3% (fast wave) and 1.3% (slow wave).

  19. THE EFFECT OF 2-BUTYL-CYANOACRYLATE ADHESIVE IN OSTEOTOMIES AND BONE GRAFTS IN RABBITS: MACROSCOPIC AND RADIOGRAPHIC CHARACTERISTICS

    PubMed Central

    Xavier, Mário Sérgio Viana; Leite, Vilnei Mattioli

    2015-01-01

    Objective: To evaluate the effect of butyl-2-cyanoacrylate tissue adhesive in osteotomies and bone grafts, with regard to macroscopic and radiographic characteristics. Methods: Forty-eight rabbits were used, randomly divided into four groups of 12 animals, with observation periods of two, four, eight and 16 weeks. Both thoracic limbs were operated in each animal and two osteotomies were performed in each of the radii, withdrawing a bone fragment (bone graft) of 1 cm in length. On one side, the bone graft was then replaced and a drop of adhesive was applied to each of the osteotomies. On the other side, the same procedure was performed without applying the adhesive. The rejection level for the nullity hypothesis was set at 0.05% or 5%. Results: Blue marks were present in all the surgical specimens in which adhesive was applied. From the fourth week onwards, there was absence of movement of the bone grafts with adhesive and control. In group A, in the proximal osteotomies with adhesive, there was less deviation of the bone graft (p = 0.02). In group C, the union (p = 0.03) and the integration of the bone graft (p = 0.02) were better in the proximal osteotomies with adhesive. Conclusions: The adhesive was not completely metabolized within 16 weeks. There was clinical consolidation of the osteotomies within four weeks. The adhesive stabilized the bone graft within the first weeks and did not interfere with the consolidation of the osteotomies, or the integration of the bone graft in radiographic observations. PMID:27047878

  20. The effect of supplementation of a glutamine precursor on the growth plate, articular cartilage and cancellous bone in fundectomy-induced osteopenic bone

    PubMed Central

    TOMASZEWSKA, Ewa; DOBROWOLSKI, Piotr; PROST, Łukasz; HUŁAS-STASIAK, Monika; MUSZYŃSKI, Siemowit; BLICHARSKI, Tomasz

    2015-01-01

    The aim of the study was to investigate the effect of 2-oxoglutaric acid (2-Ox) supplementation (a precursor of glutamine and hydroxyproline, the most abundant amino acid of collagen) on cartilage and bone in pigs after fundectomy. Pigs at the age of forty days were subjected to fundectomy and divided into two groups depending on 2-Ox supplementation (at the daily dosage of 0.4 g/kg of body weight). Other pigs were sham operated. Pigs were euthanized at the age of eight months. An analysis of the morphometry of trabeculae, growth plate and articular cartilage in fundectomy-induced osteopenic bone was performed. Moreover, the levels of expression of osteocalcin, osteopontin and osteoprotegerin in trabecular bone and osteocalcin in articular cartilage were evaluated. Articular cartilage was thinnest in fundectomized pigs and thickest in 2-Ox-supplemented animals after fundectomy. Moreover, 2-Ox supplementation after fundectomy enhanced the total thickness of the growth plate and trabeculae in fundectomized pigs. The most evident signal for osteocalcin and osteoprotegerin in trabecular bone was in sham-operated and 2-Ox-supplemented pigs; a low reaction was observed in the fundectomized group. Additionally, as a long-term postoperative consequence, a change was observed in the expression of osteocalcin in articular cartilage. It seems that 2-Ox is suitable for use in preventing the negative effects of fundectomy on cancellous bone and cartilage. PMID:26725871

  1. Connective tissue-bone onlay graft with enamel matrix derivative for treatment of gingival recession: a case report.

    PubMed

    Nozawa, Takeshi; Sugiyama, Takahiko; Satoh, Tohru; Tanaka, Koji; Enomoto, Hiroaki; Ito, Koichi

    2002-12-01

    We describe a case of gingival recession in which root coverage and coronal bone regrowth were achieved after treatment with a connective tissue-bone graft and enamel matrix derivative. The connective tissue-bone graft was harvested from a maxillary edentulous area and then curved to fit the root surfaces of the maxillary left central and lateral incisors. Enamel matrix derivative was applied to the root surfaces, and the connective tissue-bone graft was fixed to the interdental bone by a titanium screw. Six months later, the exposed roots were covered with thick gingiva, and coronal regrowth of thick bone was evident at reentry surgery. This technique is useful for esthetic restoration placement with an intracrevicular margin on teeth with a thin, receding gingiva.

  2. Simulation of the in vivo resorption rate of β-tricalcium phosphate bone graft substitutes implanted in a sheep model.

    PubMed

    Bashoor-Zadeh, Mahdieh; Baroud, Gamal; Bohner, Marc

    2011-09-01

    A few years ago, a model was proposed to predict the effect of the pore architecture of a bone graft substitute on its cell-mediated resorption rate. The aim of the present study was to compare the predictions of the model with the in vivo resorption rate of four β-tricalcium phosphate bone graft substitutes implanted in a sheep model. The simulation algorithm contained two main steps: (1) detection of the pores that could be accessed by blood vessels of 50 μm in diameter, and (2) removal of one solid layer at the surface of these pores. This process was repeated until full resorption occurred. Since the pore architecture was complex, μCT data and fuzzy imaging techniques were combined to reconstruct the precise bone graft substitute geometry and then image processing algorithms were developed to perform the resorption simulation steps. The proposed algorithm was verified by comparing its results with the analytical results of a simple geometry and experimental in-vivo data of β-TCP bone substitutes with more complex geometry. An excellent correlation (r(2)>0.9 for all 4 bone graft substitutes) was found between simulation results and in-vivo data, suggesting that this resorption model could be used to (i) better understand the in vivo behavior of bone graft substitutes resorbed by cell-mediation, and (ii) optimize the pore architecture of a bone graft substitute, for example to maximize its resorption rate.

  3. An in vivo swine study for xeno-grafts of calcium sulfate-based bone grafts with human dental pulp stem cells (hDPSCs).

    PubMed

    Kuo, Tzong-fu; Lee, Sheng-Yang; Wu, Hong-Da; Poma, Malosi; Wu, Yu-Wei; Yang, Jen-Chang

    2015-05-01

    The purpose of this in vivo study was to evaluate the effect of human dental pulp stem cells (hDPSCs) on various resorbable calcium sulfate/calcium phosphate bone grafts in bone regeneration. Granular particles of calcium sulfate dehydrate (CSD), α-calcium sulfate hemihydrate/amorphous calcium phosphate (α-CSH/ACP), and CSD/β-tricalcium phosphates (β-TCP) were prepared for in vitro dissolution and implantation test. The chemical compositions of specimen residues after dissolution test were characterized by XRD. The ratios of new bone formation for implanted grafts/hDPSCs were evaluated using mandible bony defect model of Lanyu pig. All the graft systems exhibited a similar two-stage dissolution behavior and phase transformation of poor crystalline HAp. Eight weeks post-operation, the addition of hDPSCs to various graft systems showed statistically significant increasing in the ratio of new bone formation (p<0.05). Null hypothesis of hDPSCs showing no scaffold dependence in bone regeneration was rejected. The results suggest that the addition of hDPSCs to calcium sulfate based xenografts could enhance the bone regeneration in the bony defect. PMID:25746240

  4. Calcium phosphate-hybridized tendon graft to enhance tendon-bone healing two years after ACL reconstruction in goats

    PubMed Central

    2011-01-01

    Background We developed a novel technique to improve tendon-bone attachment by hybridizing calcium phosphate (CaP) with a tendon graft using an alternate soaking process. However, the long-term result with regard to the interface between the tendon graft and the bone is unclear. Methods We analyzed bone tunnel enlargement by computed tomography and histological observation of the interface and the tendon graft with and without the CaP hybridization 2 years after anterior cruciate ligament (ACL) reconstruction in goats using EndoButton and the postscrew technique (CaP, n = 4; control, n = 4). Results The tibial bone tunnel enlargement rates in the CaP group were lower than those in the control group (p < 0.05). In the CaP group, in the femoral and tibial bone tunnels at the anterior and posterior of the joint aperture site, direct insertion-like formation that contained a cartilage layer without tidemarks was more observed at the tendon-bone interface than in the control group (p < 0.05). Moreover, the gap area between the tendon graft and the bone was more observed at the femoral bone tunnel of the joint aperture site in the control group than in the CaP group (p < 0.05). The maturation of the tendon grafts determined using the ligament tissue maturation index was similar in both groups. Conclusions The CaP-hybridized tendon graft enhanced the tendon-bone healing 2 years after ACL reconstruction in goats. The use of CaP-hybridized tendon grafts can reduce the bone tunnel enlargement and gap area associated with the direct insertion-like formation in the interface near the joint. PMID:22166674

  5. Determination of mechanical properties of impacted human morsellized cancellous allografts for revision joint arthroplasty.

    PubMed

    Tanabe, Y; Wakui, T; Kobayashi, A; Ohashi, H; Kadoya, Y; Yamano, Y

    1999-12-01

    This paper deals with the characterization of mechanical properties of impacted morsellized cancellous allograft (IMCA) produced by dynamic compaction of allograft femoral heads ground by commercially available bone mills, i.e. rotating rasp and reciprocating type bone mills. Various ranges and profiles of particle size in the graft aggregates were obtained using these bone mills, and the effect of number of compaction as well as the distribution of particle sizes on the mechanical properties of IMCA under quasistatic compression and shear loading conditions was discussed. The morsellized cancellous allograft prepared by the reciprocating type bone mill showed a broad distribution of particle sizes, and gave IMCA superior mechanical properties to the graft with a more uniform size distribution, or prepared by the rotating rasp type bone mills. The increase of number of compaction also improved the mechanical properties of IMCA in compression.

  6. μCT-Based Measurement of Cortical Bone Graft-to-Host Union

    PubMed Central

    Reynolds, David G.; Shaikh, Saad; Papuga, Mark Owen; Lerner, Amy L.; O'Keefe, Regis J.; Schwarz, Edward M.; Awad, Hani A.

    2009-01-01

    Evaluation of structural bone grafts risk of failure requires noninvasive quantitative predictors of functional strength. We hypothesized that a quantitative graft-to-host union biometric would correlate significantly with biomechanical properties as a surrogate for the risk of fracture. To test this, we developed a novel algorithm to compute the union between host callus and graft, which was termed the union ratio. We compared the union ratio of live autografts to devitalized allografts implanted into the mid-diaphysis of mouse femurs for 6 and 9 wk. Surprisingly, the autograft union ratio decreased from 0.228 ± 0.029 at 6 wk to 0.15 ± 0.011 at 9 wk (p < 0.05) and did not correlate with the torsional properties of the autografts . The allograft union ratio was 0.105 ± 0.023 at 6 wk but increased to 0.224 ± 0.029 at 9 wk (p < 0.05). As a single variable, the union ratio correlated significantly with ultimate torque (R 2 = 0.58) and torsional rigidity (R 2 = 0.51) of the allografts. Multivariable regression analyses of allografts that included the union ratio, the graft bone volume, the maximum and minimum polar moment of inertia, and their first-order interaction terms with the union ratio as independent variables resulted in significant correlations with the ultimate torque and torsional rigidity (adjusted R 2 = 0.80 and 0.89, respectively). These results suggest that, unlike live autografts, the union between the devitalized allograft and host contributes significantly to the strength of grafted bone. The union ratio has important clinical implications as a novel biometric for noninvasive assessment of functional strength and failure risk. PMID:19063685

  7. Endoscopic bone grafting for management of nonunion of the tuberosity avulsion fracture of the fifth metatarsal.

    PubMed

    Lui, Tun Hing

    2008-11-01

    The most common fracture of the proximal fifth metatarsal is the tuberosity avulsion fracture. Most of the time, the fracture is relatively undisplaced and it can be treated conservatively with a hard-soled shoe or walking cast. For painful intra-articular nonunion, internal fixation with or without bone graft is the treatment of choice. We describe an endoscopic approach to treat nonunions of the tuberosity avulsion fracture. Under endoscopic guidance, the nonunion site can be debrided thoroughly and bone grafted without the need of extensive soft tissue dissection. Moreover, the condition of the fifth metatarsal cuboid articulation can be assessed and intra-articular pathology can be dealed with arthroscopically. Finally, the desired position of the screw can be guided by the arthroscopic aiming device.

  8. Fragment fixation with a bone graft and dynamic staples for osteochondritis dissecans of the humeral capitellum.

    PubMed

    Harada, Mikio; Ogino, Toshihiko; Takahara, Masatoshi; Ishigaki, Daisuke; Kashiwa, Hideo; Kanauchi, Yumiko

    2002-01-01

    To attain bony union of the fragment in osteochondritis dissecans of the humeral capitellum, fragment fixation was performed with a bone graft and dynamic staples in 4 patients. The staples were inserted not from the articular surface but from the lateral aspect of the capitellum. All patients achieved bony union without complication, and 3 of them returned to playing competitive baseball. At final follow-up after surgery (mean, 7.5 years [range, 2.1-11 years]), 3 patients were able to throw a ball without pain and the remaining patient felt elbow dullness after he played recreational-level baseball as a pitcher. These results suggest that the procedure of fragment fixation with a bone graft and dynamic staples can provide satisfactory results for osteochondritis dissecans of the humeral capitellum with a large osteochondral fragment.

  9. 8-10 year follow-up survival of dental implants in maxillae with or without autogenous bone graft reconstruction

    PubMed Central

    de Moraes, Paulo H; Olate, Sergio; Lauria, Andrezza; Asprino, Luciana; de Moraes, Márcio; de Albergaria-Barbosa, José Ricardo

    2015-01-01

    The aim of this research was to ascertain the survival of implants installed in the atrophic maxillae of patients treated with or without autogenous bone graft at 8 to 10 years of follow-up. A retrospective study was conducted using clinical and imaging analysis. 42 adult patients were selected, treated with osseointegrated implants in a fixed maxillary prosthesis model with suprastructure using 6 to 8 implants; of these, 22 underwent reconstruction with a bone graft taken from the anterior iliac crest and 20 were treated without any type of bone graft. The sequence of removal, installation and management of the grafts followed routine patterns, and the implant installation and prosthesis preparation also followed parameters established in previous publications. Variables of implant survival, stage of loss and bone stability of the implants were analyzed with the Wilcoxon signed-rank test, considering a value of P<0.05 to obtain statistical significance. After 8 to 10 years of follow-up the 306 implants installed in the 42 patients were evaluated. 162 implants were in the bone graft group, where 8.0% of implants were lost in the pre-loading stage, 3.7% in the post-loading stage and 88.7% had complete survival. In the group without bone graft, 6.17% were lost in the pre-loading stage, 1.85% in the post-loading stage and 90.97% had complete survival. There was no significant difference in the survival of the implants between the two groups (P=0.082). Cervical bone loss between the groups showed no significant differences either (P=0.241). The implants in grafted maxillae with cases of severe maxillary atrophy are just as efficient as implants installed in maxillae without bone graft. PMID:26770565

  10. An Injectable Hydrogel as Bone Graft Material with Added Antimicrobial Properties

    PubMed Central

    Tommasi, Giacomo; Perni, Stefano

    2016-01-01

    Currently, the technique which provides the best chances for a successful bone graft, is the use of bone tissue from the same patient receiving it (autograft); the main limitations are the limited availability and the risks involved in removing living bone tissue, for example, explant site pain and morbidity. Allografts and xenografts may overcome these limitations; however, they increase the risk of rejection. For all these reasons the development of an artificial bone graft material is particularly important and hydrogels are a promising alternative for bone regeneration. Gels were prepared using 1,4-butanediol diacrylate as crosslinker and alpha tricalciumphosphate; ZnCl2 and SrCl2 were added to the aqueous phase. MTT results demonstrated that the addition of strontium had a beneficial effect on the osteoblast cells density on hydrogels, and zinc instead did not increase osteoblast proliferation. The amount of calcium produced by the osteoblast cells quantified through the Alizarin Red protocol revealed that both strontium and zinc positively influenced the formation of calcium; furthermore, their effect was synergistic. Rheology properties were used to mechanically characterize the hydrogels and especially the influence of crosslinker's concentration on them, showing the hydrogels presented had extremely good mechanical properties. Furthermore, the antimicrobial activity of strontium and zinc in the hydrogels against methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis was determined. PMID:27174392

  11. Hybrid Matrix Grafts to Favor Tissue Regeneration in Rabbit Femur Bone Lesions

    PubMed Central

    Goy, Dante Pascual; Gorosito, Emmanuel; Costa, Hermes S; Mortarino, Pablo; Pedemonte, Noelia Acosta; Toledo, Javier; Mansur, Herman S; Pereira, Marivalda M; Battaglino, Ricardo; Feldman, Sara

    2012-01-01

    At present, typical approaches employed to repair fractures and other bone lesions tend to use matrix grafts to promote tissue regeneration. These grafts act as templates, which promote cellular adhesion, growth and proliferation, osteoconduction, and even osteoinduction, which commonly results in de novo osteogenesis. The present work aimed to study the bone-repairing ability of hybrid matrixes (HM) prepared with polyvinyl alcohol (PVA) and bioactive glass in an experimental rabbit model. The HM were prepared by combining 30% bioactive glass (nominal composition of 58% SiO2 -33 % CaO - 9% P2O5) and 70% PVA. New Zealand rabbits were randomly divided into the control group (C group) and two groups with bone lesions, in which one received a matrix implant HM (Implant group), while the other did not (no Implant group). Clinical monitoring showed no altered parameters from either the Implant or the no Implant groups as compared to the control group, for the variables of diet grades, day and night temperatures and hemograms. In the Implant group, radiologic and tomographic studies showed implanted areas with clean edges in femoral non-articular direction, and radio-dense images that suggest incipient integration. Minimum signs of phlogosis could be observed, whereas no signs of rejection at this imaging level could be identified. Histological analysis showed evidence of osteo-integration, with the formation of a trabecular bone within the implant. Together, these results show that implants of hybrid matrixes of bioactive glass are capable of promoting bone regeneration. PMID:22848334

  12. An Injectable Hydrogel as Bone Graft Material with Added Antimicrobial Properties.

    PubMed

    Tommasi, Giacomo; Perni, Stefano; Prokopovich, Polina

    2016-06-01

    Currently, the technique which provides the best chances for a successful bone graft, is the use of bone tissue from the same patient receiving it (autograft); the main limitations are the limited availability and the risks involved in removing living bone tissue, for example, explant site pain and morbidity. Allografts and xenografts may overcome these limitations; however, they increase the risk of rejection. For all these reasons the development of an artificial bone graft material is particularly important and hydrogels are a promising alternative for bone regeneration. Gels were prepared using 1,4-butanediol diacrylate as crosslinker and alpha tricalciumphosphate; ZnCl2 and SrCl2 were added to the aqueous phase. MTT results demonstrated that the addition of strontium had a beneficial effect on the osteoblast cells density on hydrogels, and zinc instead did not increase osteoblast proliferation. The amount of calcium produced by the osteoblast cells quantified through the Alizarin Red protocol revealed that both strontium and zinc positively influenced the formation of calcium; furthermore, their effect was synergistic. Rheology properties were used to mechanically characterize the hydrogels and especially the influence of crosslinker's concentration on them, showing the hydrogels presented had extremely good mechanical properties. Furthermore, the antimicrobial activity of strontium and zinc in the hydrogels against methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis was determined. PMID:27174392

  13. Improving the clinical evidence of bone graft substitute technology in lumbar spine surgery.

    PubMed

    Hsu, Wellington K; Nickoli, M S; Wang, J C; Lieberman, J R; An, H S; Yoon, S T; Youssef, J A; Brodke, D S; McCullough, C M

    2012-12-01

    Bone graft substitutes have been used routinely for spine fusion for decades, yet clinical evidence establishing comparative data remains sparse. With recent scrutiny paid to the outcomes, complications, and costs associated with osteobiologics, a need to improve available data guiding efficacious use exists. We review the currently available clinical literature, studying the outcomes of various biologics in posterolateral lumbar spine fusion, and establish the need for a multicenter, independent osteobiologics registry. PMID:24353975

  14. Collagen-grafted porous HDPE/PEAA scaffolds for bone reconstruction.

    PubMed

    Kim, Chang-Shik; Jung, Kyung-Hye; Kim, Hun; Kim, Chan-Bong; Kang, Inn-Kyu

    2016-01-01

    After tumor resection, bone reconstruction such as skull base reconstruction using interconnected porous structure is absolutely necessary. In this study, porous scaffolds for bone reconstruction were prepared using heat-pressing and salt-leaching methods. High-density polyethylene (HDPE) and poly(ethylene-co-acrylic acid) (PEAA) were chosen as the polymer composites for producing a porous scaffold of high mechanical strength and having high reactivity with biomaterials such as collagen, respectively. The porous structure was observed through surface images, and its intrusion volume and porosity were measured. Owing to the carboxylic acids on PEAA, collagen was successfully grafted onto the porous HDPE/PEAA scaffold, which was confirmed by FT-IR spectroscopy and electron spectroscopy for chemical analysis. Osteoblasts were cultured on the collagen-grafted porous scaffold, and their adhesion, proliferation, and differentiation were investigated. The high viability and growth of the osteoblasts suggest that the collagen-grafted porous HDPE/PEAA is a promising scaffold material for bone generation. PMID:27468356

  15. Anterior debridement and bone grafting of spinal tuberculosis with one-stage instrumentation anteriorly or posteriorly.

    PubMed

    Zhao, Jie; Lian, Xiao Feng; Hou, Tie Sheng; Ma, Hui; Chen, Zhi Ming

    2007-12-01

    Between 2000 and 2004, 40 cases (average age 38, range 16-65 years) of spinal tuberculosis were treated with anterior debridement and iliac bone graft with one-stage anterior or posterior instrumentation in our unit. All patients received at least 2 weeks of regular antituberculous chemotherapy before surgery. We followed up all patients for 12-48 months (mean 22 months). Local symptoms of all patients were relieved significantly 1-3 weeks postoperatively; 23 of 25 cases (92%) with neurogical deficit had excellent or good clinical results. Erythrocyte sedimentation rates (ESR) returned from 51 mm/h to 32 mm/h (average) two weeks postoperatively. Kyphosis degrees were corrected by a mean of 16 degrees . Fusion rate of the grafting bone was 72.5% one year postoperatively and 90% two years postoperatively. Severe complications did not occur. We therefore believe that patients undergoing anterior debridement and iliac bone grafting with one-stage anterior or posterior instrumentation achieve satisfactory clinical and radiographic outcomes.

  16. Collagen-grafted porous HDPE/PEAA scaffolds for bone reconstruction.

    PubMed

    Kim, Chang-Shik; Jung, Kyung-Hye; Kim, Hun; Kim, Chan-Bong; Kang, Inn-Kyu

    2016-01-01

    After tumor resection, bone reconstruction such as skull base reconstruction using interconnected porous structure is absolutely necessary. In this study, porous scaffolds for bone reconstruction were prepared using heat-pressing and salt-leaching methods. High-density polyethylene (HDPE) and poly(ethylene-co-acrylic acid) (PEAA) were chosen as the polymer composites for producing a porous scaffold of high mechanical strength and having high reactivity with biomaterials such as collagen, respectively. The porous structure was observed through surface images, and its intrusion volume and porosity were measured. Owing to the carboxylic acids on PEAA, collagen was successfully grafted onto the porous HDPE/PEAA scaffold, which was confirmed by FT-IR spectroscopy and electron spectroscopy for chemical analysis. Osteoblasts were cultured on the collagen-grafted porous scaffold, and their adhesion, proliferation, and differentiation were investigated. The high viability and growth of the osteoblasts suggest that the collagen-grafted porous HDPE/PEAA is a promising scaffold material for bone generation.

  17. Insulin-like growth factor-1 suspended in hyaluronan improves cartilage and subchondral cancellous bone repair in osteoarthritis of temporomandibular joint.

    PubMed

    Liu, X-W; Hu, J; Man, C; Zhang, B; Ma, Y-Q; Zhu, S-S

    2011-02-01

    This study sought to evaluate the effects of intra-articular injection of insulin-like growth factor-1 (IGF-1) suspended in hyaluronan (HA) on the cartilage and subchondral cancellous bone repair in osteoarthritis (OA) of the temporomandibular joint (TMJ). Disc perforation was performed bilaterally in rabbit TMJs to induce OA. Four groups of animals (n=12) received OA induction only, and either intra-articular HA injection alone, intra-articular IGF-1 injection alone, or a combination of HA and IGF-1 injection. All therapy was begun 4 weeks after OA induction. The animals were killed 12 or 24 weeks after the first injection, for histology and micro-CT examinations. Two additional animals were used as normal controls. Typical cartilage and subchondral cancellous bone lesions were observed in the OA group. No protective effect on cartilage and subchondral cancellous bone was found in the HA or IGF-1 alone groups. Better histological repair and nearly normal micro-architectural properties of the subchondral cancellous bone were observed in the HA+IGF-1 group compared with the HA or IGF-1 alone groups. HA may be used as an effective carrier for intra-articular injection of IGF-1 and the combination of HA/IGF-1 shows promise as a new rational approach to therapy of TMJ OA. PMID:21055904

  18. Fabrication of cancellous biomimetic chitosan-based nanocomposite scaffolds applying a combinational method for bone tissue engineering.

    PubMed

    Jamalpoor, Zahra; Mirzadeh, Hamid; Joghataei, Mohammad Taghi; Zeini, Darya; Bagheri-Khoulenjani, Shadab; Nourani, Mohammad Reza

    2015-05-01

    The aim of this study was to mimic the specific structure of bone and fabricate a biomimetic nano-hydroxyapatite (HA)/chitosan (Cs)/gelatin scaffolds using combination of particle leaching and freeze drying methods eliminating mold effects. To achieve an optimum structure, scaffolds with different gelatin/Cs weight ratio were fabricated. Morphological characterization of scaffolds by scanning electron microscopy method showed highly interconnected porous structures similar to cancellous bone with mean pore size ranging from 140 to 190 μm. Nano-HA crystals were dispersed homogeneously in the polymer matrix according to the energy-dispersive X-ray spectroscopy and transmission electron microscopy images. Fourier transform infrared and X-ray diffraction results disclosed that chemical interactions were formed between nano-HA, Cs, gelatin and crystallinity of each material decreased with blending. It was found that increasing the gelatin content significantly improved water uptake, degradation rate as well as attachment, infiltration and proliferation of Saos2 cells to the scaffolds. The presented results confirm that the designed biomimetic nano-HA /Cs/gelatin scaffolds can be used as promising substitutes for bone tissue engineering.

  19. The Content of the 14 Metals in Cancellous and Cortical Bone of the Hip Joint Affected by Osteoarthritis

    PubMed Central

    Zioła-Frankowska, Anetta; Kubaszewski, Łukasz; Dąbrowski, Mikołaj; Kowalski, Artur; Rogala, Piotr; Strzyżewski, Wojciech; Łabędź, Wojciech; Uklejewski, Ryszard; Novotny, Karel; Kanicky, Viktor; Frankowski, Marcin

    2015-01-01

    The aim of the study was to determine the content of particular elements Ca, Mg, P, Na, K, Zn, Cu, Fe, Mo, Cr, Ni, Ba, Sr, and Pb in the proximal femur bone tissue (cancellous and cortical bone) of 96 patients undergoing total hip replacement for osteoarthritis using ICP-AES and FAAS analytical techniques. The interdependencies among these elements and their correlations depended on factors including age, gender, place of residence, tobacco consumption, alcohol consumption, exposure to environmental pollution, physical activity, and type of degenerative change which were examined by statistical and chemometric methods. The factors that exerted the greatest influence on the elements in the femoral head and neck were tobacco smoking (higher Cr and Ni content in smokers), alcohol consumption (higher concentrations of Ni, Cu in people who consume alcohol), and gender (higher Cu, Zn, and Ni concentrations in men). The factors influencing Pb accumulation in bone tissue were tobacco, alcohol, gender, and age. In primary and secondary osteoarthritis of the hip, the content and interactions of elements are different (mainly those of Fe and Pb). There were no significant differences in the concentrations of elements in the femoral head and neck that could be attributed to residence or physical activity. PMID:26357659

  20. The Content of the 14 Metals in Cancellous and Cortical Bone of the Hip Joint Affected by Osteoarthritis.

    PubMed

    Zioła-Frankowska, Anetta; Kubaszewski, Łukasz; Dąbrowski, Mikołaj; Kowalski, Artur; Rogala, Piotr; Strzyżewski, Wojciech; Łabędź, Wojciech; Uklejewski, Ryszard; Novotny, Karel; Kanicky, Viktor; Frankowski, Marcin

    2015-01-01

    The aim of the study was to determine the content of particular elements Ca, Mg, P, Na, K, Zn, Cu, Fe, Mo, Cr, Ni, Ba, Sr, and Pb in the proximal femur bone tissue (cancellous and cortical bone) of 96 patients undergoing total hip replacement for osteoarthritis using ICP-AES and FAAS analytical techniques. The interdependencies among these elements and their correlations depended on factors including age, gender, place of residence, tobacco consumption, alcohol consumption, exposure to environmental pollution, physical activity, and type of degenerative change which were examined by statistical and chemometric methods. The factors that exerted the greatest influence on the elements in the femoral head and neck were tobacco smoking (higher Cr and Ni content in smokers), alcohol consumption (higher concentrations of Ni, Cu in people who consume alcohol), and gender (higher Cu, Zn, and Ni concentrations in men). The factors influencing Pb accumulation in bone tissue were tobacco, alcohol, gender, and age. In primary and secondary osteoarthritis of the hip, the content and interactions of elements are different (mainly those of Fe and Pb). There were no significant differences in the concentrations of elements in the femoral head and neck that could be attributed to residence or physical activity. PMID:26357659

  1. Effects of low-level laser therapy on autogenous bone graft stabilized with a new heterologous fibrin sealant.

    PubMed

    de Oliveira Gonçalves, Jéssica Barbosa; Buchaim, Daniela Vieira; de Souza Bueno, Cleuber Rodrigo; Pomini, Karina Torres; Barraviera, Benedito; Júnior, Rui Seabra Ferreira; Andreo, Jesus Carlos; de Castro Rodrigues, Antonio; Cestari, Tania Mary; Buchaim, Rogério Leone

    2016-09-01

    Autogenous bone grafts are used to repair bone defects, and the stabilization is needed for bone regeneration. Laser photobiomodulation is a modality of treatment in clinical practice for tissue regeneration, and it has therapeutic effects as an anti-inflammatory, analgesic and modulating cellular activity. The aim of the present study was to evaluate the effects of low-level laser therapy (LLLT) on an autogenous bone graft integration process stabilized with a new heterologous fibrin sealant. Forty rats were divided into two groups: Autogenous Fibrin Graft (AFG, n=20), in which a 5mm dome osteotomy was conducted in the right parietal bone and the graft was adhered to the left side using fibrin sealant; and Autogenous Fibrin Graft Laser (AFGL, n=20), which was subjected to the same procedures as AFG with the addition of LLLT. The treatment was performed immediately following surgery and then three times a week until euthanasia, using an 830nm laser (30mW, 6J/cm(2), 0.116cm(2), 258.6mW/cm(2), 2.9J). Five animals from each group were euthanized at 10, 20, 30 and 40days postoperative, and the samples were submitted to histomorphological and histomorphometric analysis. Partial bone regeneration occurred, with new bone tissue integrating the graft to the recipient bed and small areas of connective tissue. Comparative analysis of the groups at the same intervals revealed minor interfaces in group AFGL, with statistically significant differences (p<0.05) at all of the analyzed intervals (10days p=0.0087, 20days p=0.0012, 30days p<0.0001, 40days p=0.0142). In conclusion, low-level laser therapy stimulated bone regeneration and accelerated the process of integration of autogenous bone grafts. PMID:27497370

  2. Effect of ovariectomy on BMD, micro-architecture and biomechanics of cortical and cancellous bones in a sheep model.

    PubMed

    Wu, Zi-xiang; Lei, Wei; Hu, Yun-yu; Wang, Hai-qiang; Wan, Shi-yong; Ma, Zhen-sheng; Sang, Hong-xun; Fu, Suo-chao; Han, Yi-sheng

    2008-11-01

    Osteoporotic/osteopenia fractures occur most frequently in trabeculae-rich skeletal sites. The purpose of this study was to use a high-resolution micro-computed tomography (micro-CT) and dual energy X-ray absorptionmeter (DEXA) to investigate the changes in micro-architecture and bone mineral density (BMD) in a sheep model resulted from ovariectomy (OVX). Biomechanical tests were performed to evaluate the strength of the trabecular bone. Twenty adult sheeps were randomly divided into three groups: sham group (n=8), group 1 (n=4) and group 2 (n=8). In groups 1 and 2, all sheep were ovariectomized (OVX); in the sham group, the ovaries were located and the oviducts were ligated. In all animals, BMD for lumbar spine was obtained during the surgical procedure. BMD at the spine, femoral neck and femoral condyle was determined 6 months (group 1) and 12 months (group 2) post-OVX. Lumbar spines and femora were obtained and underwent BMD scan, micro-CT analysis. Compressive mechanical properties were determined from biopsies of vertebral bodies and femoral condyles. BMD, micro-architectural parameters and mechanical properties of cancellous bone did not decrease significantly at 6 months post-OVX. Twelve months after OVX, BMD, micro-architectural parameters and mechanical properties decreased significantly. The results of linear regression analyses showed that trabecular thickness (Tb.Th) (r=0.945, R2=0.886) and bone volume fraction (BV/TV) (r=0.783, R2=0.586) had strong (R2>0.5) correlation to compression stress. In OVX sheep, changes in the structural parameters of trabecular bone are comparable to the human situation during osteoporosis was induced. The sheep model presented seems to meet the criteria for an osteopenia model for fracture treatment with respect to morphometric and mechanical properties. But the duration of OVX must be longer than 12 months to ensure the animal model can be established successfully.

  3. Potential of centrifugal seeding method in improving cells distribution and proliferation on demineralized cancellous bone scaffolds for tissue-engineered meniscus.

    PubMed

    Zhang, Zheng-Zheng; Jiang, Dong; Wang, Shao-Jie; Qi, Yan-Song; Zhang, Ji-Ying; Yu, Jia-Kuo

    2015-07-22

    Tissue-engineered meniscus offers a possible solution to the regeneration and replacement problem of meniscectomy. However, the nonuniform distribution and declined proliferation of seeded cells on scaffolds hinder the application of tissue-engineered meniscus as a new generation of meniscus graft. This study systematically investigated the performances of different seeding techniques by using the demineralized cancellous bone (DCB) as the scaffold. Static seeding, injection seeding, centrifugal seeding, and vacuum seeding methods were used to seed the meniscal fibrochondrocytes (MFCs) and mesenchymal stem cells (MSCs) to scaffolds. Cell-binding efficiency, survival rate, distribution ability, and long-term proliferation effects on scaffolds were quantitatively evaluated. Cell adhesion was compared via cell-binding kinetics. Cell viability and morphology were assessed by using fluorescence staining. Combined with the reconstructed three-dimensional image, the distribution of seeded cells was investigated. The Cell Counting Kit-8 assay and DNA assay were employed to assess cell proliferation. Cell-binding kinetics and cell survival of the MFCs were improved via centrifugal seeding compared to injection or vacuum seeding methods. Seeded MFCs by centrifugation showed a more homogeneous distribution throughout the scaffold than cells seeded by other methods. Moreover, the penetration depth in the scaffold of seeded MFCs by centrifugation was 300-500 μm, much higher than the value of 100-300 μm by the surface static and injection seeding. The long-term proliferation of the MFCs in the centrifugal group was also significantly higher than that in the other groups. The results of the MSCs were similar to those of the MFCs. The centrifugal seeding method could significantly improve MFCs or MSCs distribution and proliferation on the DCB scaffolds, thus providing a simple, cost-effective, and effective cell-seeding protocol for tissue-engineered meniscus.

  4. Osseointegration of titanium fixtures in onlay grafting procedures with autogenous bone and hydroxylapatite. An experimental histometric study.

    PubMed

    Schliephake, H; van den Berghe, P; Neukam, F W

    1991-01-01

    The aim of the present study was to determine the degree of osseointegration of fixtures in different onlay grafting materials. Hydroxylapatite blocks of 2 different pore sizes and free monocortical bone grafts from the iliac crest were inserted in Göttingen minipigs and fixed with 2 titanium fixtures. The extent of the bone/implant interface area on the fixture surface was determined from histological specimens by morphometric measurements and related to the total thread surface of the fixtures. Fixtures inserted into bone grafts showed the most complete degree of osseointegration, whereas the smallest bone/implant interface area was found with fixtures inserted into those HA blocks with the smaller pore size. There was a significant decrease in the degree of osseointegration between the host bone site and the augmentation material only with the fixtures inserted into the HA blocks of smaller pore size.

  5. Effects of Long-Term Daily Administration of Prostaglandin-E2 on Maintaining Elevated Proximal Tibial Metaphyseal Cancellous Bone Mass in Male Rats

    NASA Technical Reports Server (NTRS)

    Ke, Hua Zhu; Jee, Webster S. S.; Mori, Satoshi; Li, Xiao Jian; Kimmel, Donald B.

    1992-01-01

    The effects of long-term prostaglandin E(sub 2) (PGE(sub 2)) on cancellous bone in proximal tibial metaphysis were studied in 7 month old male Sprague-Dawley rats given daily subcutaneous injections of 0, 1, 3, and 6 mg PGE(sub 2)/kg/day and sacrificed after 60, 120, and 180 days. Histomorphometric analyses were performed on double fluorescent-labeled undecalcified bone specimens. After 60 days of treatment, PGE(sub 2) produced diffusely labeled trabecular bone area, increased trabecular bone area, eroded and labeled trabecular perimeter, mineral apposition rate, and bone formation rate at all dose levels when compared with age-matched controls. In rats given PGE(sub 2) for longer time periods (120 and 180 days), trabecular bone area, diffusely labeled trabecular bone area, labeled perimeter, mineral apposition, and bone formation rates were sustained at the elevated levels achieved earlier at 60-day treatment. The eroded perimeter continued to increase until 120 days, then plateau. The observation that continuous systemic PGE(sub 2) administration to adult male rats elevated metaphyseal cancellous bone mass to 3.5-fold of the control level within 60 days and maintained it for another 120 days indicates that the powerful skeletal anabolic effects of PGE2 can be sustained with continuous administration .

  6. Stem cells in bone grafting: Trinity allograft with stem cells and collagen/beta-tricalcium phosphate with concentrated bone marrow aspirate.

    PubMed

    Guyton, Gregory P; Miller, Stuart D

    2010-12-01

    The orthopedic foot and ankle surgeon needs bone grafts in the clinical situation of fracture healing and in bone-fusion procedures. This article briefly outlines thought processes and techniques for 2 recent options for the surgeon. The Trinity product is a unique combination of allograft bone and allograft stem cells. The beta-tricalcium phosphate and collagen materials provide an excellent scaffold for bone growth; when combined with concentrated bone marrow aspirate, they also offer osteoconductive and osteoinductive as well as osteogenerative sources for new bone formation.

  7. Does chemotherapy impair the bone healing and biomechanical stability of vascularized rib and fibula grafts?

    PubMed

    Eisenschenk, Andreas; Witzel, Christiane; Lautenbach, Martin; Ekkernkamp, Axel; Weber, Ulrich; Küntscher, Markus V

    2007-01-01

    The purpose of this study was to observe the impact of chemotherapy on the healing and biomechanical properties of vascularized bone grafts. Ten male beagle dogs were divided into two experimental groups: a chemotherapy group (CH) and control group (C). Group CH received adjuvant and neo-adjuvant chemotherapy. Each animal of both groups underwent the following operative procedures. The 5th and 7th rib were removed and replaced by vascularized pedicle transfers of the adjacent 4th and 8th rib. Additionally, a free fibular flap was elevated and retransferred to the same anatomic position. The rate of bony union on plain x-ray was 100 percent in group C, 30 percent in the vascularized rib, and 80 percent in the fibula grafts of group CH. Microangiography demonstrated no avascular bone segments in group C and in the fibula flaps of group CH. The vascularized ribs of group CH presented with 20 percent avascular bone segments. Biomechanical tests focusing on the durability of the vascularized grafts against bending and torsion forces demonstrated a reduction of the average maximum bending times by 17 percent and 23.9 percent compared to the controls ( P < 0.05). The twisting times were reduced by 13.8 percent (n.s.) and 32.5 percent ( P < 0.05). The data demonstrated a clear worsening in bone healing and stability after simulated adjuvant and neo-adjuvant chemotherapy. Thus, a large animal model was established for the further determination of the effects of chemotherapy on different vascularized bone transfers.

  8. Increased serum IgE concentrations during infection and graft versus host disease after bone marrow transplantation.

    PubMed Central

    Walker, S A; Rogers, T R; Perry, D; Hobbs, J R; Riches, P G

    1984-01-01

    Serum IgE concentrations estimated in 25 bone marrow transplant recipients during episodes of infection or graft versus host disease, or both, were raised not only in some patients with acute graft versus host disease but also in many patients with infection. Raised values were not seen in chronic graft versus host disease. The routine estimation of serum IgE in bone marrow transplant recipients had minimal value because of the lack of specificity of the IgE response. PMID:6368605

  9. Non-invasive diffuse correlation tomography reveals spatial and temporal blood flow differences in murine bone grafting approaches

    PubMed Central

    Han, Songfeng; Proctor, Ashley R.; Vella, Joseph B.; Benoit, Danielle S. W.; Choe, Regine

    2016-01-01

    Longitudinal blood flow during murine bone graft healing was monitored non-invasively using diffuse correlation tomography. The system utilized spatially dense data from a scanning set-up, non-linear reconstruction, and micro-CT anatomical information. Weekly in vivo measurements were performed. Blood flow changes in autografts, which heal successfully, were localized to graft regions and consistent across mice. Poor healing allografts showed heterogeneous blood flow elevation and high inter-subject variabilities. Allografts with tissue-engineered periosteum showed responses intermediate to both autografts and allografts, consistent with healing observed. These findings suggest that spatiotemporal blood flow changes can be utilized to differentiate the degree of bone graft healing.

  10. Treatment of the benign bone tumors including femoral neck lesion using compression hip screw and synthetic bone graft

    PubMed Central

    Nakamura, Tomoki; Matsumine, Akihiko; Asanuma, Kunihiro; Matsubara, Takao; Sudo, Akihiro

    2015-01-01

    Purpose: The proximal femur is one of the most common locations for benign bone tumors and tumor like conditions. We describe the clinical outcomes of the surgical treatment of benign lesions of the proximal femur including femoral neck using compression hip screw and synthetic bone graft. Methods: Thirteen patients with benign bone tumors or tumor like conditions of the proximal femur including femoral neck were surgically treated. Their average age at the time of presentation was 35 years and the average follow-up time was 76 months. Results: The average intraoperative blood loss was 1088 mL and intraoperative blood transfusion was required in eight patients. The average operative time was 167 minutes. All patients required one week and 12 weeks after surgery before full weight-bearing was allowed. All patients had regained full physical function without pain by the final follow-up. No patient sustained a pathological fracture of the femur following the procedure. All patients achieved partial or complete radiographic consolidation of the lesion within one year except one patient who developed a local tumor recurrence in 11 months. Post-operative superficial wound infection was observed in one patient, which resolved with intravenous antibiotics. Chronic hip pain was observed in one patient due to the irritation of tensor fascia lata muscle by the tube plate. Conclusion: We suggest that the treatment of benign bone lesion of the proximal femur using compression hip screw and synthetic bone graft is a safe and effective method. PMID:27163071

  11. Design, synthesis, and initial evaluation of D-glyceraldehyde crosslinked gelatin-hydroxyapatite as a potential bone graft substitute material

    NASA Astrophysics Data System (ADS)

    Florschutz, Anthony Vatroslav

    Utilization of bone grafts for the treatment of skeletal pathology is a common practice in orthopaedic, craniomaxillofacial, dental, and plastic surgery. Autogenous bone graft is the established archetype but has disadvantages including donor site morbidity, limited supply, and prolonging operative time. In order to avoid these and other issues, bone graft substitute materials are becoming increasingly prevalent among surgeons for reconstructing skeletal defects and arthrodesis applications. Bone graft substitutes are biomaterials, biologics, and guided tissue/bone regenerative devices that can be used alone or in combinations as supplements or alternatives to autogenous bone graft. There is a growing interest and trend to specialize graft substitutes for specific indications and although there is good rationale for this indication-specific approach, the development and utility of a more universal bone graft substitute may provide a better answer for patients and surgeons. The aim of the present research focuses on the design, synthesis, and initial evaluation of D-glyceraldehyde crosslinked gelatin-hydroxyapatite composites for potential use as a bone graft substitutes. After initial establishment of rational material design, gelatinhydroxyapatite scaffolds were fabricated with different gelatin:hydroxyapatite ratios and crosslinking concentrations. The synthesized scaffolds were subsequently evaluated on the basis of their swelling behavior, porosity, density, percent composition, mechanical properties, and morphology and further assessed with respect to cell-biomaterial interaction and biomineralization in vitro. Although none of the materials achieved mechanical properties suitable for structural graft applications, a reproducible material design and synthesis was achieved with properties recognized to facilitate bone formation. Select scaffold formulations as well as a subset of scaffolds loaded with recombinant human bone morphogenetic protein-2 were

  12. Facial growth after primary periosteoplasty versus primary bone grafting in unilateral cleft lip and palate.

    PubMed

    Sameshima, G T; Banh, D S; Smahel, Z; Melnick, M

    1996-07-01

    A cephalometric evaluation of long-term changes resulting from two different surgical techniques for the correction of unilateral cleft lip and palate (UCLP) was undertaken on a sample of 19 males with primary bone grafting, and 42 males with primary periosteoplasty from the Science Academy of the Czech Republic, Prague. Lateral cephalometric radiographs collected at approximately 10 and 15 years of age were traced, digitized, and analyzed using the finite-element method. Facial growth and development between the two groups were compared. Significant differences between the two groups were found in the upper face, the posterior part of the maxilla, the anterior bony chin, and nasal bone areas. The periosteoplasty group demonstrated significantly greater vertical development between anterior cranial base and the maxilla. The bony chin was larger and a greater inferior displacement of the posterior palate were found in the periosteoplasty group. An increased proclination in the nasal bone was observed in the bone graft group. This investigation both confirms the findings of a previous study of these sample populations, and provides additional important details regarding the differences between the groups.

  13. Arthroscopically assisted medial meniscal allograft transplantation using a modified bone plug to facilitate passage: surgical technique.

    PubMed

    Kim, Jin Goo; Lee, Yong Seuk; Lee, Soo Won; Kim, Young Jae; Kong, Doo Hwan; Ko, Min Soo

    2009-07-01

    This article describes a novel medial meniscal allograft transplantation method that permits easy passage of posterior bone plugs and facilitates bone-to-bone healing. With this method, an anterior bone plug with a long cylindrical shape is prepared, and the posterior bone plug is prepared using only a 2-mm deep, flat bone shell containing cancellous material with 6 baseball Ethibond stitches placed around it. The graft is divided into 3 portions, and boundaries of each are marked. Using a posteromedial portal, the posterior bony bed is prepared directly, and the exact anatomic location is visualized. This modified method facilitates graft passage as well as bone-to-bone healing.

  14. Secure fixation of femoral bone plug with a suspensory button in anatomical anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft

    PubMed Central

    TAKETOMI, SHUJI; INUI, HIROSHI; NAKAMURA, KENSUKE; YAMAGAMI, RYOTA; TAHARA, KEITARO; SANADA, TAKAKI; MASUDA, HIRONARI; TANAKA, SAKAE; NAKAGAWA, TAKUMI

    2015-01-01

    Purpose the efficacy and safety of using a suspensory button for femoral fixation in anatomical anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BPTB) graft have not been established. The purpose of the current study was to evaluate bone plug integration onto the femoral socket and migration of the bone plug and the EndoButton (EB) (Smith & Nephew, Andover, MA, USA) after rectangular tunnel ACL reconstruction with BPTB autograft. Methods thirty-four patients who underwent anatomical rectangular ACL reconstruction with BPTB graft using EB for femoral fixation and in whom three-dimensional (3D) computed tomography (CT) was performed one week and one year after surgery were included in this study. Bone plug integration onto the femoral socket, bone plug migration, soft tissue interposition, EB migration and EB rotation were evaluated on 3D CT. The clinical outcome was also assessed and correlated with the imaging outcomes. Results the bone plug was integrated onto the femoral socket in all cases. The incidence of bone plug migration, soft tissue interposition, EB migration and EB rotation was 15, 15, 9 and 56%, respectively. No significant association was observed between the imaging outcomes. The postoperative mean Lysholm score was 97.1 ± 5.0 points. The postoperative side-to-side difference, evaluated using a KT-2000 arthrometer, averaged 0.5 ± 1.3 mm. There were no complications associated with EB use. Imaging outcomes did not affect the postoperative KT side-to-side difference. Conclusions the EB is considered a reliable device for femoral fixation in anatomical rectangular tunnel ACL reconstruction with BPTB autograft. Level of evidence Level IV, therapeutic case series. PMID:26889465

  15. Guided tissue regeneration and bone grafts in the treatment of furcation defects.

    PubMed

    Caffesse, R G; Nasjleti, C E; Plotzke, A E; Anderson, G B; Morrison, E C

    1993-11-01

    The present study evaluated the effects of guided tissue regeneration (GTR), with and without demineralized freeze-dried cortical bone grafts, in the treatment of furcation defects in 4 female beagle dogs with naturally occurring periodontal disease. The root surfaces were thoroughly debrided. Four weeks later, full thickness facial and lingual mucoperiosteal flaps were reflected using inverse bevel incisions on both sides of the mandible involving the 2nd, 3rd, and 4th premolar, and the 1st molar teeth. Following debridement, notches were placed on the roots at the level of supporting bone. Test quadrants were randomly selected and furcations were filled with reconstituted, demineralized, freeze-dried human cortical bone grafts. Following bone grafting, all defects were covered with an expanded polytetrafluoroethylene (ePTFE) membrane, which was sutured with 4-0 sutures. Afterward, interproximal sutures were placed through the flaps, assuring the flaps covered the membranes completely. The contralateral side, serving as control, was treated by debridement only and application of ePTFE membrane. All membranes were removed 6 weeks after surgery. Dogs were sacrificed at 4 months after surgery. Both mesio-distal and bucco-lingual histologic sections were evaluated by descriptive histology. Linear measurements and surface area determination of the furcal tissues were carried out using the microscope attached to a digitizer. Twelve to 20 nonserial sections were made of the mid-buccal aspects of each root of each treated tooth. Half of these sections were stained with Harris' hematoxylin and eosin (H&E) and the other half stained with Mallory's trichrome stain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8295103

  16. Development and validation of technique for in-vivo 3D analysis of cranial bone graft survival

    NASA Astrophysics Data System (ADS)

    Bernstein, Mark P.; Caldwell, Curtis B.; Antonyshyn, Oleh M.; Ma, Karen; Cooper, Perry W.; Ehrlich, Lisa E.

    1997-05-01

    Bone autografts are routinely employed in the reconstruction of facial deformities resulting from trauma, tumor ablation or congenital malformations. The combined use of post- operative 3D CT and SPECT imaging provides a means for quantitative in vivo evaluation of bone graft volume and osteoblastic activity. The specific objectives of this study were: (1) Determine the reliability and accuracy of interactive computer-assisted analysis of bone graft volumes based on 3D CT scans; (2) Determine the error in CT/SPECT multimodality image registration; (3) Determine the error in SPECT/SPECT image registration; and (4) Determine the reliability and accuracy of CT-guided SPECT uptake measurements in cranial bone grafts. Five human cadaver heads served as anthropomorphic models for all experiments. Four cranial defects were created in each specimen with inlay and onlay split skull bone grafts and reconstructed to skull and malar recipient sites. To acquire all images, each specimen was CT scanned and coated with Technetium doped paint. For purposes of validation, skulls were landmarked with 1/16-inch ball-bearings and Indium. This study provides a new technique relating anatomy and physiology for the analysis of cranial bone graft survival.

  17. Engineering anatomically shaped vascularized bone grafts with hASCs and 3D-printed PCL scaffolds.

    PubMed

    Temple, Joshua P; Hutton, Daphne L; Hung, Ben P; Huri, Pinar Yilgor; Cook, Colin A; Kondragunta, Renu; Jia, Xiaofeng; Grayson, Warren L

    2014-12-01

    The treatment of large craniomaxillofacial bone defects is clinically challenging due to the limited availability of transplantable autologous bone grafts and the complex geometry of the bones. The ability to regenerate new bone tissues that faithfully replicate the anatomy would revolutionize treatment options. Advances in the field of bone tissue engineering over the past few decades offer promising new treatment alternatives using biocompatible scaffold materials and autologous cells. This approach combined with recent advances in three-dimensional (3D) printing technologies may soon allow the generation of large, bioartificial bone grafts with custom, patient-specific architecture. In this study, we use a custom-built 3D printer to develop anatomically shaped polycaprolactone (PCL) scaffolds with varying internal porosities. These scaffolds are assessed for their ability to support induction of human adipose-derived stem cells (hASCs) to form vasculature and bone, two essential components of functional bone tissue. The development of functional tissues is assessed in vitro and in vivo. Finally, we demonstrate the ability to print large mandibular and maxillary bone scaffolds that replicate fine details extracted from patient's computed tomography scans. The findings of this study illustrate the capabilities and potential of 3D printed scaffolds to be used for engineering autologous, anatomically shaped, vascularized bone grafts.

  18. Biomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery

    PubMed Central

    Bashti, Kaveh; Tahmasebi, Mohammad N; Kaseb, Hasan; Farahmand, Farzam; Akbar, Mohammad; Mobini, Amir

    2015-01-01

    Background: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. Purposes: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL) reconstruction and to compare its biomechanical features with conventional absorbable interference screw technique in a bovine model. Methods: Twenty pairs of bovine knees were harvested after death. Soft tissue was removed and the Achilles tendon was harvested to be used as an ACL graft. It was secured into the bone tunnel on the tibial side via two different methods: Bashti Bone Plug technique and conventional screw method. Biomechanical strength was measured using 200 N and 300 N cyclic loading on the graft. Pull out strength was also tested until the graft fails. Results: No graft failure was observed after 200 N and 300 N cyclic loading in either fixation methods. When testing for pull out failure, 21 tendons (53%) were torn and 19 tendons (48%) slipped out. No fixation failure occurred, which did not reveal a significant difference between the bone plug or interference screw group (P=0.11). The mean pull out force until failure of the graft was 496±66 N in the screw group and 503±67 N in the bone plug group (P=0.76). Conclusions: Our suggested fixation technique of Bashti bone plug is a native, cheap, and feasible method that provides comparable biomechanical strength with interference screw when soft tissue fixation was attempted in bovine model. PMID:25692166

  19. Quantitation and localisation of aluminum in human cancellous bone in renal osteodystrophy

    SciTech Connect

    Boyce, B.F.; Eider, H.Y.; Fell, S.G.; Nicholson, W.A.; Smith, G.D.; Dempster, D.W.; Gray, C.C.; Boyle, I.T.

    1981-01-01

    There is increasing evidence that aluminium toxicity may be responsible for a type of vitamin D-resistant osteomalacia and an unusually severe form of dementia (''dialysis dementia'') occurring in some patients with chronic renal failure on regular haemodialysis. High concentrations of Al have been found in blood, bone and brain tissue from these patients. The A1 comes either from the water used during dialysis (added in some public water supplies during purification to precipitate contaminants) or from aluminium salts taken orally to bind phosphates and so restrict their dietary adsorption. Recent X-ray microanalytical studies have demonstrated Al in lysosomes of cerebral cells and at the calcification front in bone of patients dying of dialysis dementia but its concentration at this site in bone has not been measured using this technique. We have examined transiliac bone biopsies from 3 patients with dialysis dementia and 6 non-demented patients on regular haemodialysis, Atomic absorption spectrometry (AAS) reveals high Al content in bone from the 3 demented and 2 of the non-demented patients. All had vitamin D-resistant osteomalacia. Using X-ray microanalysis Al was located in the bone of these five patients only. The Al had a highly focal distribution and was measured at up to 40 times higher concentration than by AAS but only in mineralisation nuclei of the calcification front or less than 2 micrometer into the mineralized bone. The study was done retrospectively on biopsies fixed in 10% buffered formalin, which almost certainly eluted some of the Al. In life, Al levels may have been higher than those we have detected.

  20. Inverse problems in cancellous bone: Estimation of the ultrasonic properties of fast and slow waves using Bayesian probability theory

    PubMed Central

    Anderson, Christian C.; Bauer, Adam Q.; Holland, Mark R.; Pakula, Michal; Laugier, Pascal; Bretthorst, G. Larry; Miller, James G.

    2010-01-01

    Quantitative ultrasonic characterization of cancellous bone can be complicated by artifacts introduced by analyzing acquired data consisting of two propagating waves (a fast wave and a slow wave) as if only one wave were present. Recovering the ultrasonic properties of overlapping fast and slow waves could therefore lead to enhancement of bone quality assessment. The current study uses Bayesian probability theory to estimate phase velocity and normalized broadband ultrasonic attenuation (nBUA) parameters in a model of fast and slow wave propagation. Calculations are carried out using Markov chain Monte Carlo with simulated annealing to approximate the marginal posterior probability densities for parameters in the model. The technique is applied to simulated data, to data acquired on two phantoms capable of generating two waves in acquired signals, and to data acquired on a human femur condyle specimen. The models are in good agreement with both the simulated and experimental data, and the values of the estimated ultrasonic parameters fall within expected ranges. PMID:21110589

  1. Maxillary reconstruction with particulate bone graft and titanium mesh: a treatment option for large complex odontoma of the maxilla.

    PubMed

    Utumi, Estevam Rubens; Cremonini, Caio Cesar; Pedron, Irineu Gregnanin; Zambon, Camila Eduarda; Cavalcanti, Marcelo Gusmão Paraíso; Ceccheti, Marcelo Minharro

    2011-07-01

    Odontomas are the most common type of odontogenic tumor and are generally asymptomatic. The purpose of this paper was to describe the case of a complex odontoma in a patient who had asymptomatic swelling in the central maxillary region, along with unerupted central and lateral incisors. In this case, surgical excision of the lesion was performed and an iliac bone graft was introduced into the defect area with a titanium mesh covering up the grafted harvesting bone. After 2 years of followup, no recurrence was identified. Patient followup is still in progress to evaluate bone graft resorption, and the patient awaits complete bone development. Oral rehabilitation with an osseointegrated titanium implant is expected in the future. An option of the large complex odontoma treatment is discussed.

  2. Ultrasonic scanner for in vivo measurement of cancellous bone properties from backscattered data.

    PubMed

    Litniewski, Jerzy; Cieslik, Lucyna; Lewandowski, Marcin; Tymkiewicz, Ryszard; Zienkiewicz, Boguslaw; Nowicki, Andrzej

    2012-07-01

    A dedicated ultrasonic scanner for acquiring RF echoes backscattered from the trabecular bone was developed. The design of device is based on the goal of minimizing of custom electronics and computations executed solely on the main computer processor and the graphics card. The electronic encoder-digitizer module executing all of the transmission and reception functions is based on a single low-cost field programmable gate array (FPGA). The scanner is equipped with a mechanical sector-scan probe with a concave transducer with 50 mm focal length, center frequency of 1.5 MHz and 60% bandwidth at -6 dB. The example of femoral neck bone examination shows that the scanner can provide ultrasonic data from deeply located bones with the ultrasound penetrating the trabecular bone up to a depth of 20 mm. It is also shown that the RF echo data acquired with the scanner allow for the estimation of attenuation coefficient and frequency dependence of backscattering coefficient of trabecular bone. The values of the calculated parameters are in the range of corresponding in vitro data from the literature but their variation is relatively high.

  3. Cancellous bone healing around strontium-doped hydroxyapatite in osteoporotic rats previously treated with zoledronic acid.

    PubMed

    Li, Yunfeng; Shui, Xueping; Zhang, Li; Hu, Jing

    2016-04-01

    Bisphosphonates (BPs) are potent anti-osteoporotic agents. Strontium-doped hydroxyapatite (HA) (SrHA) has been reported to increase bone density and improve trabecular microarchitecture in osteoporotic animals. But information about the effect of SrHA on the surrounding bone tissue in osteoporotic animals previously on BPs treatment is limited. We hypothesize that SrHA will induce increased bone density in the vicinity of the material when compared to HA, even in osteoporotic animals previously treated with BPs. HA and 10%SrHA (HA with 10 mol % calcium substituted by strontium) implants were prepared and characterized by scanning electronic microscopy (SEM), X-ray photoemission spectroscopy (XPS), and X-ray diffraction (XRD). Osteoporotic animal model was established by bilateral ovariectomy. Twelve weeks later, all OVX rats accepted subcutaneous injection of zoledronic acid (ZOL) at the dose of 1.5 μg/kg weekly for another twelve weeks. Subsequently, rod-shaped HA and SrHA implants were inserted in the distal femur of the OVX animals previously treated with ZOL. Eight weeks after implantation, specimens were harvested for histological and micro-computed tomography (micro-CT) analysis. Compared to HA, 10%SrHA raised the percent bone volume by 32.7%, the mean trabecular thickness by 36.5%, the mean trabecular number by 34.3%, the mean connectivity density by 38.4%, while the mean trabecular separation showed no significant difference. 10%SrHA also increased the bone area density by 36.3% in histological analysis. Results from this study indicated that 10%SrHA increased bone density and improved trabecular microarchitecture around implants in osteoporotic animals previously treated with ZOL when compared to HA. PMID:25891947

  4. Development of a Three-Dimensional (3D) Printed Biodegradable Cage to Convert Morselized Corticocancellous Bone Chips into a Structured Cortical Bone Graft

    PubMed Central

    Chou, Ying-Chao; Lee, Demei; Chang, Tzu-Min; Hsu, Yung-Heng; Yu, Yi-Hsun; Liu, Shih-Jung; Ueng, Steve Wen-Neng

    2016-01-01

    This study aimed to develop a new biodegradable polymeric cage to convert corticocancellous bone chips into a structured strut graft for treating segmental bone defects. A total of 24 adult New Zealand white rabbits underwent a left femoral segmental bone defect creation. Twelve rabbits in group A underwent three-dimensional (3D) printed cage insertion, corticocancellous chips implantation, and Kirschner-wire (K-wire) fixation, while the other 12 rabbits in group B received bone chips implantation and K-wire fixation only. All rabbits received a one-week activity assessment and the initial image study at postoperative 1 week. The final image study was repeated at postoperative 12 or 24 weeks before the rabbit scarification procedure on schedule. After the animals were sacrificed, both femurs of all the rabbits were prepared for leg length ratios and 3-point bending tests. The rabbits in group A showed an increase of activities during the first week postoperatively and decreased anterior cortical disruptions in the postoperative image assessments. Additionally, higher leg length ratios and 3-point bending strengths demonstrated improved final bony ingrowths within the bone defects for rabbits in group A. In conclusion, through this bone graft converting technique, orthopedic surgeons can treat segmental bone defects by using bone chips but with imitate characters of structured cortical bone graft. PMID:27104525

  5. Development of a Three-Dimensional (3D) Printed Biodegradable Cage to Convert Morselized Corticocancellous Bone Chips into a Structured Cortical Bone Graft.

    PubMed

    Chou, Ying-Chao; Lee, Demei; Chang, Tzu-Min; Hsu, Yung-Heng; Yu, Yi-Hsun; Liu, Shih-Jung; Ueng, Steve Wen-Neng

    2016-04-20

    This study aimed to develop a new biodegradable polymeric cage to convert corticocancellous bone chips into a structured strut graft for treating segmental bone defects. A total of 24 adult New Zealand white rabbits underwent a left femoral segmental bone defect creation. Twelve rabbits in group A underwent three-dimensional (3D) printed cage insertion, corticocancellous chips implantation, and Kirschner-wire (K-wire) fixation, while the other 12 rabbits in group B received bone chips implantation and K-wire fixation only. All rabbits received a one-week activity assessment and the initial image study at postoperative 1 week. The final image study was repeated at postoperative 12 or 24 weeks before the rabbit scarification procedure on schedule. After the animals were sacrificed, both femurs of all the rabbits were prepared for leg length ratios and 3-point bending tests. The rabbits in group A showed an increase of activities during the first week postoperatively and decreased anterior cortical disruptions in the postoperative image assessments. Additionally, higher leg length ratios and 3-point bending strengths demonstrated improved final bony ingrowths within the bone defects for rabbits in group A. In conclusion, through this bone graft converting technique, orthopedic surgeons can treat segmental bone defects by using bone chips but with imitate characters of structured cortical bone graft.

  6. Donor site morbidity after reconstruction of alveolar bone defects with mandibular symphyseal bone grafts in cleft patients--111 consecutive patients.

    PubMed

    Andersen, K; Nørholt, S E; Knudsen, J; Küseler, A; Jensen, J

    2014-04-01

    The aim of this study was to assess the objective and subjective morbidity after reconstruction of alveolar bone defects with mandibular symphyseal bone grafts in patients with cleft lip and palate. One hundred and eleven patients born between 1995 and 1999, who had undergone chin bone harvesting for alveolar cleft reconstruction in the period from 2000 through 2011, were included. A survey of medical records was conducted. Subjective morbidity after reconstruction was assessed using a questionnaire. Medical records revealed few postoperative incidents; 5.6% reported persistent sensory disturbances in the donor area. Postoperative pain averaged 3.6 ± 2.1 (scale 0-10). The overall satisfaction with the surgical result was 8.7 ± 1.7 (scale 0-10). This study revealed that chin bone harvesting for reconstruction of alveolar defects in patients with cleft lip and palate is a safe and predictable procedure, highly appreciated by the patients, and characterized by only minor postoperative incidents. Patients must be informed of the risk of sensory disturbances in the donor area.

  7. Effects of Prostaglandin E2 and Risedronate Administration on Cancellous Bone in Older Female Rats

    NASA Technical Reports Server (NTRS)

    Lin, B. Y.; Jee, W. S. S.; Ma, Y. F.; Ke, H. Z.; Kimmel, D. B.; Li, X. J.

    1994-01-01

    The effects of Prostaglandin E2 (PGE2) and Risedronate (Ris) both separately and in combination (PGE2 + Ris) were studied on the intact aged female rat skeleton to determine whether the combination of PGE2 with an antiresorptive agent is more effective anabolically than PGE2 alone. Nine month-old Sprague-Dawley rats were injected subcutaneously either with vehicle, 6 mg PGE2/kg per day, 1 or 5 microgram Ris/kg twice a week, or 6 mg PGE2/kg per day plus 1 or 5 microgram Ris/kg twice a week (PGE2 + 1 Ris or PGE2 + 5 Ris) for 60 days. After the treatment, we determined the longitudinal bone growth rate, the qualitative appearance of the primary spongiosa (PS), and the static and dynamic bone histomorphometry of the secondary spongiosa (SS) of the proximal tibial metaphysis (PTM) by examining undecalcified longitudinal sections after double fluorescent labeling. The relative effects of these treatments on longitudinal bone growth were ranked as follows: PGE2 + 5 Ris greater than PGE2 + 1 Ris = basal greater than PGE2 greater than 1 microgram Ris = 5 microgram Ris = aging. The density of the PS was ranked as follows: PGE2 + 5 Ris greater than PGE2 + 1 Ris = PGE2 = 5 microgram Ris = 1 microgram Ris greater than basal = aging. The increase in density of the PS was the result of stimulated longitudinal growth and the action of bisphosphonate. Bone mass in the SS was ranked as follows: PGE2 + 5 Ris = PGE2 + 1 Ris = PGE2 greater than 5 microgram Ris = 1 microgram Ris = aging = basal. However, PGE2 alone and its cotreatment with Ris accumulated bone by different tissue mechanisms. PGE2 alone created new bone by increasing activation frequency 8.3-fold and the formation to resorption ratio 1.3-fold from the controls. The combination of PGE2 and Ris depressed activation frequency (-54% to -74%), and bone formation rate (tissue-based -31%, and bone-based -42%) and eroded surface (-79% to -81%), so as to increase the formation to resorption ratio (three- to four-fold) over PGE2

  8. Computer-aided osteotomy design for harvesting autologous bone grafts in reconstructive surgery

    NASA Astrophysics Data System (ADS)

    Krol, Zdzislaw; Zerfass, Peter; von Rymon-Lipinski, Bartosz; Jansen, Thomas; Hauck, Wolfgang; Zeilhofer, Hans-Florian U.; Sader, Robert; Keeve, Erwin

    2001-05-01

    Autologous grafts serve as the standard grafting material in the treatment of maxillofacial bone tumors, traumatic defects or congenital malformations. The pre-selection of a donor site depends primarily on the morphological fit of the available bone mass and the shape of the part that has to be transplanted. To achieve sufficient incorporation of the autograft into the host bone, precise planning and simulation of the surgical intervention based on 3D CT studies is required. This paper presents a method to identify an optimal donor site by performing an optimization of appropriate similarity measures between donor region and a given transplant. At the initial stage the surgeon has to delineate the osteotomy border lines in the template CT data set and to define a set of constraints for the optimization of appropriate similarity measures between donor region and a given transplant. At the initial stage the surgeon has to delineate the osteotomy border lines in the template CT data set and to define a set of constraints for the optimization task in the donor site CT data set. The following fully automatic optimization stage delivers a set of sub-optimal and optimal donor sites for a given template. All generated solutions can be explored interactively on the computer display using an efficient graphical interface. Reconstructive operations supported by our system were performed on 28 patients. We found that the operation time can be considerably shortened by this approach.

  9. The microstructure of mandibular bone grafts and three-dimensional cell clusters

    NASA Astrophysics Data System (ADS)

    Gürel, Sarper; Unold, Corinne; Deyhle, Hans; Schulz, Georg; Kühl, Sebastian; Saldamli, Belma; Tübel, Jutta; Burgkart, Rainer; Beckmann, Felix; Müller, Bert

    2010-09-01

    During the last decade, several tissues and biomaterials for medical applications in replacing bony tissues have been developed. Three-dimensional cell clusters and mandibular bone grafts are two distinct examples of these developments. The characterization of the complex three-dimensional structures, however, is still mainly restricted on the twodimensional analysis of histological slices. The present paper examines the quantitative analysis of mandibular bone grafts and three-dimensional cell clusters on the basis of synchrotron radiation-based micro computed tomography measurements. An automated search of pre-defined microstructures through component labeling is applied to the real datasets in order to identify features that reside independently from other components. The examples demonstrate three levels of complexity: rather large pieces of bone augmentation material that touch each other, individual adipocytes difficult to automatically segment in a wet cluster and osmium-stained adipocyte exhibiting higher X-ray absorption than the surrounding tissue. Although the structures of interest such as the cells can be labeled, de-clustering of the components requires the incorporation of erosion and dilation algorithms.

  10. Reconstruction of severely resorbed edentulous maxillae using osseointegrated fixtures in immediate autogenous bone grafts.

    PubMed

    Adell, R; Lekholm, U; Gröndahl, K; Brånemark, P I; Lindström, J; Jacobsson, M

    1990-01-01

    A surgical technique for rehabilitation of severely resorbed edentulous maxillae using fixed prostheses or overdentures supported by osseointegrated fixtures in immediate autogenous corticocancellous bone grafts from the ilium is described. The results of the first 23 consecutively treated patients are reviewed. The mean observation time was 4.2 years (range 1 to 10 years). A total of 124 fixtures was originally placed into the grafts, supplemented with 16 fixtures inserted later into seven of the jaws. Throughout their observation period, 17 of the patients had continuously stable prostheses. The remaining five had overdentures, and one patient had resorted to a conventional complete denture. After 4 years, 12 of 16 patients had continuously stable prostheses. Corresponding values at 5 years were 7 of 8 patients. Calculated from the date of abutment connection, 82.1% and 81.6% of the original fixtures were clinically stable and radiographically osseointegrated after 4 and 5 years in function, respectively. From the date of fixture placement, the corresponding figures were 75.3% and 73.8%, respectively. The mean marginal bone loss after the first year of prosthesis function was 1.49 mm. The annual marginal bone loss thereafter was about 0.1 mm. The results indicate that this technique is worthwhile for patients with extreme maxillary atrophy and who cannot wear conventional complete dentures.

  11. Treatment of alveolar cleft performing a pyramidal pocket and an autologous bone grafting.

    PubMed

    Morselli, Paolo Giovanni; Giuliani, Renzo; Pinto, Valentina; Oranges, Carlo Maria; Negosanti, Luca; Tavaniello, Beatrice; Morellini, Andrea

    2009-09-01

    Alveolar cleft repair is a debate topic in cleft lip and palate treatment.The aim of this article is to analyze the outcomes and the advantages of the autologous bone grafting performed during the period between 1981 and 2006. In our plastic surgery unit, 468 patients with alveolar clefts have been treated. According to our protocol, the timing for the closure of the alveolar cleft ranged from 7 to 11 years (mean, 9.4 years). Autologous bone was taken from the skull in the 45% of patients, from the iliac crest in 35% of cases, and from the chin in 20% of cases. The surgical technique of creating a pyramidal pocket to secure the bone graft was central to achieving a good result. The postoperative evaluation of the results, using clinical criteria and endoral radiography, orthopantomography, and teleradiography at 3, 6, 12 months after surgery, and more recently, in the last 82 cases by a three-dimensional computed tomography, allows us to assert that we obtained optimal results in 50% of treated cases, good results in 40%, sufficient in 4%, partial failure in 5.4%, and complete failure in 0.6%.

  12. Maxillary sinus augmentation using recombinant bone morphogenetic protein-2/acellular collagen sponge in combination with a mineralized bone replacement graft: a report of three cases.

    PubMed

    Tarnow, Dennis P; Wallace, Stephen S; Testori, Tiziano; Froum, Stuart J; Motroni, Alessandro; Prasad, Hari S

    2010-04-01

    The objective of the following case reports was to assess whether mineralized bone replacement grafts (eg, xenografts and allografts) could be added to recombinant human bone morphogenetic protein-2/acellular collagen sponge (rhBMP-2/ACS) in an effective manner that would: (1) reduce the graft shrinkage observed when using rhBMP-2/ACS alone, (2) reduce the volume and dose of rhBMP-2 required, and (3) preserve the osteoinductivity that rhBMP-2/ACS has shown when used alone. The primary outcome measures were histomorphometric analysis of vital bone production and analysis of serial computed tomographic scans to determine changes in bone graft density and stability. Over the 6-month course of this investigation, bone graft densities tended to increase (moreso with the xenograft than the allograft). The increased density in allograft cases was likely the result of both compression of the mineralized bone replacement graft and vital bone formation, seen histologically. Loss of volume was greater with the four-sponge dose than the two-sponge dose because of compression and resorption of the sponges. Vital bone formation in the allograft cases ranged from 36% to 53% but, because of the small sample size, it was not possible to determine any significant difference between the 5.6 mL (four-sponge) dose and the 2.8 mL (two-sponge) dose. Histology revealed robust new woven bone formation with only minimal traces of residual allograft, which appeared to have undergone accelerated remodeling or rhBMP-2-mediated resorption. PMID:20228973

  13. Abrogation of hybrid resistance to bone marrow engraftment by graft versus host induced immune deficiency

    SciTech Connect

    Hakim, F.T.; Shearer, G.M.

    1986-03-01

    Lethally irradiated F/sub 1/ mice, heterozygous at the hematopoietic histocompatibility (Hh) locus at H-2D/sup b/, reject bone marrow grafts from homozygous H-2/sup b/ parents. This hybrid resistance (HR) is reduced by prior injection of H-2/sup b/ parental spleen cells. Since injection of parental spleen cells produces a profound suppression of F/sub 1/ immune functions, the authors investigated whether parental-induced abrogation of HR was due to graft-vs-host induced immune deficiency (GVHID). HR was assessed by quantifying engraftment in irradiated mice using /sup 125/I-IUdR spleen uptake; GVHID by measuring generation of cytotoxic T lymphocytes (CTL) from unirradiated mice. They observed correlation in time course, spleen dose dependence and T cell dependence between GVHID and loss of HR. The injection of B10 recombinant congenic spleens into (B10 x B10.A) F/sub 1/ mice, prior to grafting with B10 marrow, demonstrated that only those disparities in major histocompatibility antigens which generated GVHID would result in loss of HR. Spleens from (B10 x B10.A(2R))F/sub 1/ mice (Class I disparity only) did not induce GVHID or affect HR, while (B10 x B10.A(5R)F/sub 1/ spleens (Class I and II disparity) abrogated CTL generation and HR completely. GVHID produced by a Class II only disparity, as in (B10 x B10.A(5R))F/sub 1/ spleens injected into (B6/sup bm12 x B10.A(5R))F/sub 1/ mice, was also sufficient to markedly reduce HR to B10 bone marrow. Modulation of hematopoietic graft rejection by GVHID may affect marrow engraftment in man.

  14. Histological evaluation of a biomimetic material in bone regeneration after one year from graft

    PubMed Central

    Figliuzzi, Michele M.; De Fazio, Rossella; Tiano, Rosamaria; De Franceschi, Serena; Pacifico, Delfina; Mangano, Francesco; Fortunato, Leonzio

    2014-01-01

    Summary Aim The use of substitute materials is one of the solutions used in periodontology for the reconstruction of intrabony defects. Advances in scientific research gave rise to a new generation of biomaterials of synthetic origin stoichiometrically unstable and therefore really absorbable. Our research is directed precisely towards a biomaterial synthesis, Engipore® (Finceramica, Faenza, Italy) which is a bone substitute of the latest hydroxyapatite-based generation, that possesses chemical and morphological properties similar to those of natural bone in the treatment of infrabony periodontal defects. Aim of this study was to evaluate the efficacy of Engipore® in the treatment of intrabony periodontal defects. Methods The study was conducted on 100 parodontopatics patients, which had gingival pockets of at least infrabonies 8/10 mm. The histological evaluation was performed with samples after one year from the graft. Results The histological samples collected after one year showed an abundant new bone formation, with mature lamellar bone tissue surrounding the residual particles of Engipore® that appear completely osteointegrated. The surrounding connective tissue shows no signs of inflammation. Conclusions The results obtained in our research demonstrated that, after a proper selection of patients and lesions, and applying an adequate surgical technique, this type of biomaterial in the treatment of periodontal defects acts in an optimal manner as a filler inducing the formation of new bone as evidenced by histological examinations. PMID:25506415

  15. Design of ceramic-based cements and putties for bone graft substitution.

    PubMed

    Bohner, M

    2010-01-01

    In the last 15 years, a large number of commercial ceramic-based cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements), and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considered, including mixing and delivery, sterilization, and shelf-life. PMID:20574942

  16. Correlations between initial cleft size and dental anomalies in unilateral cleft lip and palate patients after alveolar bone grafting

    PubMed Central

    Jabbari, Fatima; Reiser, Erika; Thor, Andreas; Hakelius, Malin; Nowinski, Daniel

    2016-01-01

    Objective To determine in individuals with unilateral cleft lip and palate the correlation between initial cleft size and dental anomalies, and the outcome of alveolar bone grafting. Methods A total of 67 consecutive patients with non-syndromic unilateral complete cleft lip and palate (UCLP) were included from the cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. All patients were operated by the same surgeon and treated according to the Uppsala protocol entailing: lip plasty at 3 months, soft palate closure at 6 months, closure of the residual cleft in the hard palate at 2 years of age, and secondary alveolar bone grafting (SABG) prior to the eruption of the permanent canine. Cleft size was measured on dental casts obtained at the time of primary lip plasty. Dental anomalies were registered on radiographs and dental casts obtained before bone grafting. Alveolar bone height was evaluated with the Modified Bergland Index (mBI) at 1 and 10-year follow-up. Results Anterior cleft width correlated positively with enamel hypoplasia and rotation of the central incisor adjacent to the cleft. There was, however, no correlation between initial cleft width and alveolar bone height at either 1 or 10 years follow-up. Conclusions Wider clefts did not seem to have an impact on the success of secondary alveolar bone grafting but appeared to be associated with a higher degree of some dental anomalies. This finding may have implications for patient counseling and treatment planning. PMID:26923345

  17. BIOMECHANICAL STUDY OF TRANSCORTICAL OR TRANSTRABECULAR BONE FIXATION OF PATELLAR TENDON GRAFT WITH BIOABSORBABLE PINS IN ACL RECONSTRUCTION IN SHEEP

    PubMed Central

    Albano, Mauro Batista; Borges, Paulo César; Namba, Mario Massatomo; da Silva, João Luiz Vieira; de Assis Pereira Filho, Francisco; Filho, Edmar Stieven; Matias, Jorge Eduardo Fouto

    2015-01-01

    Objective: To determine the initial resistance of fixation using the Rigid Fix® system, and compare it with traditional fixation methods using metal interference screws; and to evaluate the resistance of the fixation with the rigid fix system when the rotational position of the bone block is altered in the interior of the femoral tunnel. Methods: forty ovine knee specimens (stifle joints) were submitted to anterior cruciate ligament reconstruction (ACL) using a bone-tendon-bone graft. In twenty specimens, the Rigid Fix method was used; this group was subdivided into two groups: ten knees the pins transfixed only the spongious area of the bone block, and ten for fixation passing through the layer of cortical bone. In the twenty remaining specimens, the graft was fixed with 9mm metal interference screws. Results: comparison of the RIGIDFIX® method with the metal interference screw fixation method did not show any statistically significant differences in terms of maximum load and rigidity; also, there were no statistically significant differences when the rotational position of the bone block was altered inside the femoral tunnel. For these evaluations, a level of significance of p < 0.017 was considered. Conclusion: fixation of the bone-tendon-bone graft with 2 bioabsorbable pines, regardless of the rotational position inside the femoral tunnel, gave a comparable fixation in terms of initial resistance to the metal interference screw, in this experimental model. PMID:27027081

  18. Treatment of osteonecrosis of the femoral head with vascularized bone grafting.

    PubMed

    Millikan, Patrick D; Karas, Vasili; Wellman, Samuel S

    2015-09-01

    Osteonecrosis of the femoral head (ONFH) is a challenging diagnosis for the patient and treating surgeon. Though its cause is poorly understood, several methods of surgical treatment exist and are performed with variable success. Vascularized bone grafting is one such treatment that attempts to restore viable bone, structural support, and blood supply to the avascular portion of the femoral head. This review summarizes the various approaches to this technique that have been proposed and put into practice. The cost effectiveness of these procedures, both in time and resources, has been evaluated and found to be favorable. The use of revascularization procedures, along with the introduction of other potentiating factors, may signal an exciting future for this debilitating disease process.

  19. Improved graft-versus-host disease-free, relapse-free survival associated with bone marrow as the stem cell source in adults

    PubMed Central

    Mehta, Rohtesh S.; de Latour, Regis Peffault; DeFor, Todd E; Robin, Marie; Lazaryan, Aleksandr; Xhaard, Aliénor; Bejanyan, Nelli; de Fontbrune, Flore Sicre; Arora, Mukta; Brunstein, Claudio G.; Blazar, Bruce R.; Weisdorf, Daniel J.; MacMillan, Margaret L.; Socie, Gerard; Holtan, Shernan G.

    2016-01-01

    We previously reported that bone marrow grafts from matched sibling donors resulted in best graft-versus-host disease-free, relapse-free survival at 1-year post allogeneic hematopoietic cell transplantation. However, pediatric patients comprised the majority of bone marrow graft recipients in that study. To better define this outcome in adults and pediatric patients at 1- and 2-years post- allogeneic hematopoietic cell transplantation, we pooled data from the University of Minnesota and the Hôpital Saint-Louis in Paris, France (n=1901). Graft-versus-host disease-free, relapse-free survival was defined as the absence of grade III–IV acute graft-versus-host disease, chronic graft-versus-host disease (requiring systemic therapy or extensive stage), relapse and death. In adults, bone marrow from matched sibling donors (n=123) had best graft-versus-host disease-free, relapse-free survival at 1- and 2-years, compared with peripheral blood stem cell from matched sibling donors (n=540) or other graft/donor types. In multivariate analysis, peripheral blood stem cells from matched sibling donors resulted in a 50% increased risk of events contributing to graft-versus-host disease-free, relapse-free survival at 1- and 2-years than bone marrow from matched sibling donors. With limited numbers of peripheral blood stem cell grafts in pediatric patients (n=12), graft-versus-host disease-free, relapse-free survival did not differ between bone marrow and peripheral blood stem cell graft from any donor. While not all patients have a matched sibling donor, graft-versus-host disease-free, relapse-free survival may be improved by the preferential use of bone marrow for adults with malignant diseases. Alternatively, novel graft-versus-host disease prophylaxis regimens are needed to substantially impact graft-versus-host disease-free, relapse-free survival with the use of peripheral blood stem cell. PMID:27036159

  20. Fast and slow wave detection in bovine cancellous bone in vitro using bandlimited deconvolution and Prony's method.

    PubMed

    Wear, Keith; Nagatani, Yoshiki; Mizuno, Katsunori; Matsukawa, Mami

    2014-10-01

    Fast and slow waves were detected in a bovine cancellous bone sample for thicknesses ranging from 7 to 12 mm using bandlimited deconvolution and the modified least-squares Prony's method with curve fitting (MLSP + CF). Bandlimited deconvolution consistently isolated two waves with linear-with-frequency attenuation coefficients as evidenced by high correlation coefficients between attenuation coefficient and frequency: 0.997 ± 0.002 (fast wave) and 0.986 ± 0.013 (slow wave) (mean ± standard deviation). Average root-mean-squared (RMS) differences between the two algorithms for phase velocities were 5 m/s (fast wave, 350 kHz) and 13 m/s (slow wave, 750 kHz). Average RMS differences for signal loss were 1.6 dB (fast wave, 350 kHz) and 0.4 dB (slow wave, 750 kHz). Phase velocities for thickness = 10 mm were 1726 m/s (fast wave, 350 kHz) and 1455 m/s (slow wave, 750 kHz). Results show support for the model of two waves with linear-with frequency attenuation, successful isolation of fast and slow waves, good agreement between bandlimited deconvolution and MLSP + CF as well as with a Bayesian algorithm, and potential variations of fast and/or slow wave properties with bone sample thickness.

  1. Growth promoting in vitro effect of synthetic cyclic RGD-peptides on human osteoblast-like cells attached to cancellous bone.

    PubMed

    Magdolen, Ursula; Auernheimer, Jörg; Dahmen, Claudia; Schauwecker, Johannes; Gollwitzer, Hans; Tübel, Jutta; Gradinger, Reiner; Kessler, Horst; Schmitt, Manfred; Diehl, Peter

    2006-06-01

    In tissue engineering, the application of biofunctional compounds on biomaterials such as integrin binding RGD-peptides has gained growing interest. Anchorage-dependent cells like osteoblasts bind to these peptides thus ameliorating the integration of a synthetic implant. In case sterilized bone grafts are used as substitutes for reconstruction of bone defects, the ingrowth of the implanted bone is often disturbed because of severe pretreatment such as irradiation or autoclaving, impairing the biological and mechanical properties of the bone. We report for the first time on the in vitro coating of the surface of freshly resected, cleaned bone discs with synthetic, cyclic RGD-peptides. For this approach, two different RGD-peptides were used, one containing two phosphonate anchors, the other peptide four of these binding moieties to allow efficient association of these reactive RGD-peptides to the inorganic bone matrix. Human osteoblast-like cells were cultured on RGD-coated bone discs and the adherence and growth of the cells were analyzed. Coating of bone discs with RGD-peptides did not improve the adhesion rate of osteoblast-like cells to the discs but significantly (up to 40%) accelerated growth of these cells within 8 days after attachment. This effect points to pretreatment of bone implants, especially at the critical interface area between the implanted bone and the non-resected residual bone structure, before re-implantation in order to stimulate and enhance osteointegration of a bone implant. PMID:16685410

  2. A facile magnesium-containing calcium carbonate biomaterial as potential bone graft.

    PubMed

    He, Fupo; Zhang, Jing; Tian, Xiumei; Wu, Shanghua; Chen, Xiaoming

    2015-12-01

    The calcium carbonate is the main composition of coral which has been widely used as bone graft in clinic. Herein, we readily prepared novel magnesium-containing calcium carbonate biomaterials (MCCs) under the low-temperature conditions based on the dissolution-recrystallization reaction between unstable amorphous calcium carbonate (ACC) and metastable vaterite-type calcium carbonate with water involved. The content of magnesium in MCCs was tailored by adjusting the proportion of ACC starting material that was prepared using magnesium as stabilizer. The phase composition of MCCs with various amounts of magnesium was composed of one, two or three kinds of calcium carbonates (calcite, aragonite, and/or magnesian calcite). The different MCCs differed in topography. The in vitro degradation of MCCs accelerated with increasing amount of introduced magnesium. The MCCs with a certain amount of magnesium not only acquired higher compressive strength, but also promoted in vitro cell proliferation and osteogenic differentiation. Taken together, the facile MCCs shed light on their potential as bone graft.

  3. A facile magnesium-containing calcium carbonate biomaterial as potential bone graft.

    PubMed

    He, Fupo; Zhang, Jing; Tian, Xiumei; Wu, Shanghua; Chen, Xiaoming

    2015-12-01

    The calcium carbonate is the main composition of coral which has been widely used as bone graft in clinic. Herein, we readily prepared novel magnesium-containing calcium carbonate biomaterials (MCCs) under the low-temperature conditions based on the dissolution-recrystallization reaction between unstable amorphous calcium carbonate (ACC) and metastable vaterite-type calcium carbonate with water involved. The content of magnesium in MCCs was tailored by adjusting the proportion of ACC starting material that was prepared using magnesium as stabilizer. The phase composition of MCCs with various amounts of magnesium was composed of one, two or three kinds of calcium carbonates (calcite, aragonite, and/or magnesian calcite). The different MCCs differed in topography. The in vitro degradation of MCCs accelerated with increasing amount of introduced magnesium. The MCCs with a certain amount of magnesium not only acquired higher compressive strength, but also promoted in vitro cell proliferation and osteogenic differentiation. Taken together, the facile MCCs shed light on their potential as bone graft. PMID:26539810

  4. Numerical Analysis of Ultrasound Backscattered Waves in Cancellous Bone Using a Finite-Difference Time-Domain Method: Isolation of the Backscattered Waves From Various Ranges of Bone Depths.

    PubMed

    Hosokawa, Atsushi

    2015-06-01

    Using a finite-difference time-domain method, ultrasound backscattered waves inside cancellous bone were numerically analyzed to investigate the backscatter mechanism. Two bone models with different thicknesses were modeled with artificial absorbing layers positioned at the back surfaces of the model, and an ultrasound pulse wave was transmitted toward the front surface. By calculating the difference between the simulated waveforms obtained using the two bone models, the backscattered waves from a limited range of depths in cancellous bone could be isolated. The results showed that the fast and slow longitudinal waves, which have previously been observed only in the ultrasound waveform transmitted through the bone, could be distinguished in the backscattered waveform from a deeper bone depth when transmitting the ultrasound wave parallel to the main orientation of the trabecular network. The amplitudes of the fast and slow backscattered waves were more closely correlated with the bone porosity [R2 = 0.84 and 0.66 (p < 0.001), respectively] than the amplitude of the whole (nonisolated) backscattered waves [R2 = 0.48 (p < 0.001)]. In conclusion, the nonisolated backscattered waves could be regarded as the superposition of the fast and slow waves reflected from various bone depths, returning at different times.

  5. Repair of a segmental long bone defect in human by implantation of a novel multiple disc graft.

    PubMed

    Hesse, Eric; Kluge, Gerald; Atfi, Azeddine; Correa, Diego; Haasper, Carl; Berding, Georg; Shin, Hoen-oh; Viering, Jörg; Länger, Florian; Vogt, Peter M; Krettek, Christian; Jagodzinski, Michael

    2010-05-01

    Large segmental defects of the weight bearing long bones are very difficult to reconstruct. Current treatment options are afflicted with several limitations and disadvantages. We describe a novel approach to regenerate a segmental long bone defect in a patient using a multiple disc graft. Decellularized bovine trabecular bone discs were seeded with autologous bone marrow cells and cultured in a perfusion chamber for three weeks. Multiple cell-seeded discs were implanted to close a 72 mm defect of the distal tibia in a 58-year-old woman, and fixed by an intramedullary nail. Bone formation was assessed non-invasively by plain radiographs and 18F-labeled sodium fluoride-based co-registration of positron emission- and computed tomography (PET/CT). Bone was actively formed around the grafted defect as early as six weeks after surgery. Because the tibia was sufficiently stabilized, the patient was able to freely walk with full weight bearing 6 weeks after surgery. The uneventful two-year follow-up and the satisfaction of the patient demonstrated the success of the procedure. Therefore the use of multiple cell-seeded disc grafts can be considered as a treatment alternative for patients with segmental long bone defects. PMID:20153850

  6. Long-term functional outcome and donor-site morbidity associated with autogenous iliac crest bone grafts utilizing a modified anterior approach.

    PubMed

    Singh, Jaspal Ricky; Nwosu, Uzoma; Egol, Kenneth A

    2009-01-01

    Prior studies and techniques for harvesting iliac crest bone have shown significant postoperative pain, disability, and poor cosmesis. This retrospective study was conducted to examine bone graft donor-site morbidity by evaluating functional outcomes in patients who have undergone a modified anterior harvesting approach. The medical charts and hospital records of 43 patients were retrospectively reviewed over a 6-year period. Demographic information, operative notes, laboratory results, and the American Society of Anesthesiologists (ASA) classification were recorded. All patients were evaluated retrospectively at a mean 41 months after bone-graft harvesting. Patients available for follow-up were asked to quantify their pain level at the donor-site on a visual analog pain scale (0-10). They also completed SMFA forms, as well as a survey pertaining to sensory deficits, gait disturbances, and cosmetic appearance. Forty-four patients met the inclusion criteria consisting of 25 males and 18 females, mean age 47 years (range, 22 to 80 years). A total of 32 (73%) patients were available for long-term follow-up at a mean of 41.3 months (range, 8 to 83 months). Eight (25%) of these patients reported minimal postoperative pain at time of follow-up. Three of 32 (9%) patients reported minor ambulation difficulty as a result of donor-site pain. Other minor complications included hypertrophic scar formation (7%) and hematoma/seroma (3%). There were no major complications reported, such as deformity at the crest site (0%) or infection (0%). SMFA scores demonstrated a mean dysfunction score of 48.5 (range, 41.8 to 71.1) and a bother index of mean 47.9 (range, 42.6 to 73.9). Utilizing the anterior approach in iliac crest bone harvesting provides an abundant supply of both cortical and cancellous bone, an aesthetically favorable scar, and decreased postoperative donor-site pain. There were very few complications seen in our cohort as compared to previous studies with very good long

  7. Assessing cement injection behaviour in cancellous bone: an in vitro study using flow models.

    PubMed

    Bou-Francis, Antony; López, Alejandro; Persson, Cecilia; Hall, Richard M; Kapur, Nikil

    2014-10-01

    Understanding the cement injection behaviour during vertebroplasty and accurately predicting the cement placement within the vertebral body is extremely challenging. As there is no standardized methodology, we propose a novel method using reproducible and pathologically representative flow models to study the influence of cement properties on injection behaviour. The models, confined between an upper glass window and a lower aluminium plate, were filled with bone marrow substitute and then injected (4, 6 and 8 min after cement mixing) with commercially available bone cements (SimplexP, Opacity+, OsteopalV and Parallax) at a constant flow rate (3 mL/min). A load cell was used to measure the force applied on the syringe plunger and calculate the peak pressure. A camera was used to monitor the cement flow during injection and calculate the following parameters when the cement had reached the boundary of the models: the time to reach the boundary, the filled area and the roundness. The peak pressure was comparable to that reported during clinical vertebroplasty and showed a similar increase with injection time. The study highlighted the influence of cement formulations and model structure on the injection behaviour and showed that cements with similar composition/particle size had similar flow behaviour, while the introduction of defects reduced the time to reach the boundary, the filled area and the roundness. The proposed method provides a novel tool for quick, robust differentiation between various cement formulations through the visualization and quantitative analysis of the cement spreading at various time intervals. PMID:24913614

  8. Effect of zoledronate acid treatment on osseointegration and fixation of implants in autologous iliac bone grafts in ovariectomized rabbits.

    PubMed

    Qi, Mengchun; Hu, Jing; Li, Jianping; Li, Jinyuan; Dong, Wei; Feng, Xiaojie; Yu, Jing

    2012-01-01

    One main problem associated with alveolar bone augmentation in implant dentistry is resorption of grafted bone, which may be further compromised by systemic skeletal disorders such as osteoporosis. Zoledronate acid (ZOL) is the most potent bisphosphonate to treat osteoporosis and therefore it is hypothesized to be able to invert the negative effect of osteoporosis on osseointegration and fixation of dental implants in autologous bone grafts. In this study, 56 rabbits received bilateral ovariectomy (OVX) (40 rabbits) or sham operation (16 rabbits). Three months later, 8 animals from each group were sacrificed for bone mineral density (BMD) examination. Then the remaining animals underwent bilateral autologous iliac bone grafting with simultaneous implantation of titanium implants in tibiae and were divided into 5 groups (n=8): Sham, OVX, Loc-ZOL (local treatment), Sys-ZOL (systemic treatment) and Loc+Sys-ZOL (local plus systemic) group. At 3 months after implantation, all animals were sacrificed and specimens were harvested for examinations. Both BMD and histological examinations of femurs showed osteoporotic changes after ovariectomy, while systemic treatment with ZOL restored mineralized bone. Micro-CT examination demonstrated that OVX group showed significant decrease of mineralized bone and implant-bone contact when compared with sham control, whereas both systemic and local treatments of ZOL significantly increased mineralized bone and implant-bone contact in ovariectomized animals. However, the best effects were observed in Loc+Sys-ZOL group (combined use of ZOL) and most of bone indices were similar to (IBCR, p>0.05) or higher than (BV/TV, Conn.D and Tb.N) (p<0.01) those of the sham group, except Tb.Th, which was still significantly lower (p<0.01), and Tb.Sp, which was further decreased (p<0.01). The aforementioned effects were also confirmed by histomorphometric analysis of bone indices on implant-bone contact and mineralized bone. In addition, biomechanical

  9. A New Method for Xenogeneic Bone Graft Deproteinization: Comparative Study of Radius Defects in a Rabbit Model

    PubMed Central

    Lei, Pengfei; Sun, Rongxin; Wang, Long; Zhou, Jialin; Wan, Lifei; Zhou, Tianjian; Hu, Yihe

    2015-01-01

    Background and Objectives Deproteinization is an indispensable process for the elimination of antigenicity in xenograft bones. However, the hydrogen peroxide (H2O2) deproteinized xenograft, which is commonly used to repair bone defect, exhibits limited osteoinduction activity. The present study was designed to develop a new method for deproteinization and compare the osteogenic capacities of new pepsin deproteinized xenograft bones with those of conventional H2O2 deproteinized ones. Methods Bones were deproteinized in H2O2 or pepsin for 8 hours. The morphologies were compared by HE staining. The content of protein and collagen I were measured by the Kjeldahl method and HPLC-MS, respectively. The physical properties were evaluated by SEM and mechanical tests. For in vivo study, X-ray, micro-CT and HE staining were employed to monitor the healing processes of radius defects in rabbit models transplanted with different graft materials. Results Compared with H2O2 deproteinized bones, no distinct morphological and physical changes were observed. However, pepsin deproteinized bones showed a lower protein content, and a higher collagen content were preserved. In vivo studies showed that pepsin deproteinized bones exhibited better osteogenic performance than H2O2 deproteinized bones, moreover, the quantity and quality of the newly formed bones were improved as indicated by micro-CT analysis. From the results of histological examination, the newly formed bones in the pepsin group were mature bones. Conclusions Pepsin deproteinized xenograft bones show advantages over conventional H2O2 deproteinized bones with respect to osteogenic capacity; this new method may hold potential clinical value in the development of new biomaterials for bone grafting. PMID:26719896

  10. Allogeneic Versus Autologous Derived Cell Sources for Use in Engineered Bone-Ligament-Bone Grafts in Sheep Anterior Cruciate Ligament Repair

    PubMed Central

    Mahalingam, Vasudevan D.; Behbahani-Nejad, Nilofar; Horine, Storm V.; Olsen, Tyler J.; Smietana, Michael J.; Wojtys, Edward M.; Wellik, Deneen M.; Arruda, Ellen M.

    2015-01-01

    The use of autografts versus allografts for anterior cruciate ligament (ACL) reconstruction is controversial. The current popular options for ACL reconstruction are patellar tendon or hamstring autografts, yet advances in allograft technologies have made allogeneic grafts a favorable option for repair tissue. Despite this, the mismatched biomechanical properties and risk of osteoarthritis resulting from the current graft technologies have prompted the investigation of new tissue sources for ACL reconstruction. Previous work by our lab has demonstrated that tissue-engineered bone-ligament-bone (BLB) constructs generated from an allogeneic cell source develop structural and functional properties similar to those of native ACL and vascular and neural structures that exceed those of autologous patellar tendon grafts. In this study, we investigated the effectiveness of our tissue-engineered ligament constructs fabricated from autologous versus allogeneic cell sources. Our preliminary results demonstrate that 6 months postimplantation, our tissue-engineered auto- and allogeneic BLB grafts show similar histological and mechanical outcomes indicating that the autologous grafts are a viable option for ACL reconstruction. These data indicate that our tissue-engineered autologous ligament graft could be used in clinical situations where immune rejection and disease transmission may preclude allograft use. PMID:25397361

  11. Allogeneic versus autologous derived cell sources for use in engineered bone-ligament-bone grafts in sheep anterior cruciate ligament repair.

    PubMed

    Mahalingam, Vasudevan D; Behbahani-Nejad, Nilofar; Horine, Storm V; Olsen, Tyler J; Smietana, Michael J; Wojtys, Edward M; Wellik, Deneen M; Arruda, Ellen M; Larkin, Lisa M

    2015-03-01

    The use of autografts versus allografts for anterior cruciate ligament (ACL) reconstruction is controversial. The current popular options for ACL reconstruction are patellar tendon or hamstring autografts, yet advances in allograft technologies have made allogeneic grafts a favorable option for repair tissue. Despite this, the mismatched biomechanical properties and risk of osteoarthritis resulting from the current graft technologies have prompted the investigation of new tissue sources for ACL reconstruction. Previous work by our lab has demonstrated that tissue-engineered bone-ligament-bone (BLB) constructs generated from an allogeneic cell source develop structural and functional properties similar to those of native ACL and vascular and neural structures that exceed those of autologous patellar tendon grafts. In this study, we investigated the effectiveness of our tissue-engineered ligament constructs fabricated from autologous versus allogeneic cell sources. Our preliminary results demonstrate that 6 months postimplantation, our tissue-engineered auto- and allogeneic BLB grafts show similar histological and mechanical outcomes indicating that the autologous grafts are a viable option for ACL reconstruction. These data indicate that our tissue-engineered autologous ligament graft could be used in clinical situations where immune rejection and disease transmission may preclude allograft use.

  12. No effect of dynamic loading on bone graft healing in femoral segmental defect reconstructions in the goat.

    PubMed

    Bullens, Pieter H J; Hannink, Gerjon; Verdonschot, Nico; Buma, Pieter

    2010-12-01

    We studied if a static or dynamic mode of nail fixation influenced the healing of segmental defect reconstructions in long bones. Defects in the femur of goats were reconstructed using a cage filled with firmly impacted morsellised allograft mixed with a hydroxyapatite paste (Ostim). All reconstructions were stabilised with an intramedullary nail. In one group (n=6) the intramedullary nail was statically locked, in the second group (n=6) a dynamic mode of nail fixation was applied. We hypothesised that dynamisation of the nail would load, and by that stimulate the healing of the bone graft. Mechanical torsion strength of the reconstructions of the femur with the static and dynamic mode of nail fixation appeared to be 74.8±17.5% and 73.0±13.4%, respectively as compared with the contralateral femurs after 6 months. In all reconstructions, the grafts united radiographically and histologically to the host bone, and remodelled into a new vital bone structure. No large differences were found between newly formed bone areas inside and outside the mesh of the two groups. The area of callus outside the mesh in the dynamic mode of fixation group was smaller (p=0.042), whilst the percentage of bone outside the mesh was larger (p=0.049), as compared to the static mode of fixation group. The data suggest that healing of these defects with impacted morsellised graft in a cage is not significantly influenced by the mode of fixation of the nail in this model.

  13. The biological approach in acetabular revision surgery: impaction bone grafting and a cemented cup.

    PubMed

    Colo, Ena; Rijnen, Wim H C; Schreurs, Berend Willem

    2015-01-01

    Acetabular impaction bone grafting (IBG) in combination with a cemented cup in revision total hip arthroplasty (THA) is a proven and well-recognised technique which has been used in clinical practice for more than 35 years. Nowadays, with cemented prostheses tending to lose a larger part of the THA market every year in primary and revision cases, and many young surgeons being only trained in implanting uncemented prostheses, this technique is considered by many as technically demanding and time consuming, making its use less appealing. Despite this image and many new innovative techniques using uncemented implants in acetabular revisions over the last 25 years, IBG with a cemented cup is still one of the few techniques that really can reconstitute bone and respects human biology. In this era of many biologically-based breakthroughs in medicine, it is hard to explain that the solution of most orthopaedic surgeons for the extensive bone defects as frequently seen during acetabular revision surgery, consists of implanting bigger and larger metal implants. This review aims to put the IBG method into a historical perspective, to describe the surgical technique and present the clinical results.

  14. Processing strategies for smart electroconductive carbon nanotube-based bioceramic bone grafts.

    PubMed

    Mata, D; Oliveira, F J; Ferreira, N M; Araújo, R F; Fernandes, A J S; Lopes, M A; Gomes, P S; Fernandes, M H; Silva, R F

    2014-04-11

    Electroconductive bone grafts have been designed to control bone regeneration. Contrary to polymeric matrices, the translation of the carbon nanotube (CNT) electroconductivity into oxide ceramics is challenging due to the CNT oxidation during sintering. Sintering strategies involving reactive-bed pressureless sintering (RB + P) and hot-pressing (HP) were optimized towards prevention of CNT oxidation in glass/hydroxyapatite (HA) matrices. Both showed CNT retentions up to 80%, even at 1300 °C, yielding an increase of the electroconductivity in ten orders of magnitude relative to the matrix. The RB + P CNT compacts showed higher electroconductivity by ∼170% than the HP ones due to the lower damage to CNTs of the former route. Even so, highly reproducible conductivities with statistical variation below 5% and dense compacts up to 96% were only obtained by HP. The hot-pressed CNT compacts possessed no acute toxicity in a human osteoblastic cell line. A normal cellular adhesion and a marked orientation of the cell growth were observed over the CNT composites, with a proliferation/differentiation relationship favouring osteoblastic functional activity. These sintering strategies offer new insights into the sintering of electroconductive CNT containing bioactive ceramics with unlimited geometries for electrotherapy of the bone tissue. PMID:24622290

  15. Processing strategies for smart electroconductive carbon nanotube-based bioceramic bone grafts

    NASA Astrophysics Data System (ADS)

    Mata, D.; Oliveira, F. J.; Ferreira, N. M.; Araújo, R. F.; Fernandes, A. J. S.; Lopes, M. A.; Gomes, P. S.; Fernandes, M. H.; Silva, R. F.

    2014-04-01

    Electroconductive bone grafts have been designed to control bone regeneration. Contrary to polymeric matrices, the translation of the carbon nanotube (CNT) electroconductivity into oxide ceramics is challenging due to the CNT oxidation during sintering. Sintering strategies involving reactive-bed pressureless sintering (RB + P) and hot-pressing (HP) were optimized towards prevention of CNT oxidation in glass/hydroxyapatite (HA) matrices. Both showed CNT retentions up to 80%, even at 1300 °C, yielding an increase of the electroconductivity in ten orders of magnitude relative to the matrix. The RB + P CNT compacts showed higher electroconductivity by ˜170% than the HP ones due to the lower damage to CNTs of the former route. Even so, highly reproducible conductivities with statistical variation below 5% and dense compacts up to 96% were only obtained by HP. The hot-pressed CNT compacts possessed no acute toxicity in a human osteoblastic cell line. A normal cellular adhesion and a marked orientation of the cell growth were observed over the CNT composites, with a proliferation/differentiation relationship favouring osteoblastic functional activity. These sintering strategies offer new insights into the sintering of electroconductive CNT containing bioactive ceramics with unlimited geometries for electrotherapy of the bone tissue.

  16. Self bone graft and simultaneous application of implants in upper jawbone

    PubMed Central

    VELASQUEZ, P. VITTORINI; FALISI, G.; GALLI, M.

    2010-01-01

    SUMMARY The implant supported rehabilitation of upper back sectors, sometimes, is conditioned to the pneumatization of the jawbone and so, reducing the possibility to apply the implants when the bone portion is inferior to 4 mm (important condition for the primary stability). The great rise of the jawbone and the simultaneous application of implants is, surely, the condition to have the best success guarantees compared to the only application of filling material. The surgical technologies used in the self bone grafts are various (Ilium crest, calvaria, fibula) and so also for implant applications. In this article we want to put in evidence a new technology in order to reduce at the minimum the invasive surgery of the removal and the patient morbidity. It has been executed a longitudinal study on 21 consecutive cases and illustrated by a clinical one; the success was of 94.5%. The advantages of this technique are: Functional and anatomical recovery of the jaw cavityImmediate application of implants with a thickness of remaining bone in fervor to 4 mm.Reduction of surgical timesReduced morbidity of the patientLocal an anesthesia. PMID:23285370

  17. Non-invasive diffuse correlation tomography reveals spatial and temporal blood flow differences in murine bone grafting approaches

    PubMed Central

    Han, Songfeng; Proctor, Ashley R.; Vella, Joseph B.; Benoit, Danielle S. W.; Choe, Regine

    2016-01-01

    Longitudinal blood flow during murine bone graft healing was monitored non-invasively using diffuse correlation tomography. The system utilized spatially dense data from a scanning set-up, non-linear reconstruction, and micro-CT anatomical information. Weekly in vivo measurements were performed. Blood flow changes in autografts, which heal successfully, were localized to graft regions and consistent across mice. Poor healing allografts showed heterogeneous blood flow elevation and high inter-subject variabilities. Allografts with tissue-engineered periosteum showed responses intermediate to both autografts and allografts, consistent with healing observed. These findings suggest that spatiotemporal blood flow changes can be utilized to differentiate the degree of bone graft healing. PMID:27699097

  18. Metacarpal resection with a contoured iliac bone graft and silicone rubber implant for metacarpal giant cell tumor: a case report.

    PubMed

    Carlow, S B; Khuri, S M

    1985-03-01

    A definitive surgical procedure for a giant cell tumor that combines metacarpal resection with an iliac bone graft and arthroplasty with a silicone rubber implant is proposed for the elderly patient. The results were encouraging in one patient who had a cosmetically and functionally acceptable hand and no evidence of recurrence.

  19. Alternative autogenous bone graft donor sites in brachymetatarsia reconstruction: a review of the literature with clinical presentations.

    PubMed

    Kashuk, K B; Hanft, J R; Schabler, J A; Kopelman, J

    1991-01-01

    The authors present a literature review on the surgical treatment of brachymetatarsia. They discuss the identification of donor sites for autogenous bone graft harvesting from the foot. Three case reports of brachymetatarsia, one of iatrogenic, and two of congenital origin are presented. PMID:1874999

  20. The tent pole splint: a bone-supported stereolithographic surgical splint for the soft tissue matrix expansion graft procedure.

    PubMed

    Cillo, Joseph E; Theodotou, Nicholas; Samuels, Marc; Krajekian, Joseph

    2010-06-01

    This report details the use of computer-aided planning and intraoperative stereolithographic direct-bone-contact surgical splints for the accurate extraoral placement of dental implants in the soft tissue matrix expansion (tent pole) graft of the severely resorbed mandible. PMID:20231048

  1. Non-Invasive Monitoring of Temporal and Spatial Blood Flow during Bone Graft Healing Using Diffuse Correlation Spectroscopy

    PubMed Central

    Han, Songfeng; Hoffman, Michael D.; Proctor, Ashley R.; Vella, Joseph B.; Mannoh, Emmanuel A.; Barber, Nathaniel E.; Kim, Hyun Jin; Jung, Ki Won; Benoit, Danielle S. W.; Choe, Regine

    2015-01-01

    Vascular infiltration and associated alterations in microvascular blood flow are critical for complete bone graft healing. Therefore, real-time, longitudinal measurement of blood flow has the potential to successfully predict graft healing outcomes. Herein, we non-invasively measure longitudinal blood flow changes in bone autografts and allografts using diffuse correlation spectroscopy in a murine femoral segmental defect model. Blood flow was measured at several positions proximal and distal to the graft site before implantation and every week post-implantation for a total of 9 weeks (autograft n = 7 and allograft n = 10). Measurements of the ipsilateral leg with the graft were compared with those of the intact contralateral control leg. Both autografts and allografts exhibited an initial increase in blood flow followed by a gradual return to baseline levels. Blood flow elevation lasted up to 2 weeks in autografts, but this duration varied from 2 to 6 weeks in allografts depending on the spatial location of the measurement. Intact contralateral control leg blood flow remained at baseline levels throughout the 9 weeks in the autograft group; however, in the allograft group, blood flow followed a similar trend to the graft leg. Blood flow difference between the graft and contralateral legs (ΔrBF), a parameter defined to estimate graft-specific changes, was elevated at 1–2 weeks for the autograft group, and at 2–4 weeks for the allograft group at the proximal and the central locations. However, distal to the graft, the allograft group exhibited significantly greater ΔrBF than the autograft group at 3 weeks post-surgery (p < 0.05). These spatial and temporal differences in blood flow supports established trends of delayed healing in allografts versus autografts. PMID:26625352

  2. Electrospinning of aniline pentamer-graft-gelatin/PLLA nanofibers for bone tissue engineering.

    PubMed

    Liu, Yadong; Cui, Haitao; Zhuang, Xiuli; Wei, Yen; Chen, Xuesi

    2014-12-01

    Blends of aniline pentamer-graft-gelatin (AP-g-GA) and poly(l-lactide) (PLLA) were electrospun to prepare uniform nanofibers as biomimetic scaffolds. The nanofibers exhibited good electroactivity, thermal stability and biodegradability. The biocompatibility of the nanofibers in vitro was evaluated by the adhesion and proliferation of mouse preosteoblastic MC3T3-E1 cells. The cellular elongation was significantly greater on electroactive AP-g-GA/PLLA nanofibers than on PLLA nanofibers. Moreover, the AP-g-GA/PLLA nanofibers stimulated by an electrical pulsed signal could promote the differentiation of MC3T3-E1 cells compared with pure PLLA nanofibers. Our results demonstrated that the biodegradable and electroactive AP-g-GA/PLLA nanofibers had potential application in vivo as bone repair scaffold materials in tissue engineering.

  3. Combined endodontic therapy and periapical surgery with MTA and bone graft in treating palatogingival groove

    PubMed Central

    Mittal, Mudit; Vashisth, Pallavi; Arora, Rachita; Dwivedi, Swati

    2013-01-01

    A 37-year-old male patient reported to our department with chief complaint of pain and pus discharge from the labial marginal gingiva in the maxillary right lateral incisor region since last 4 months. Clinically, the tooth was hypersensitive to percussion and palpation but failed to respond to pulp sensitivity testing. After periodontal probing, a palatal groove was observed which started at the cingulum and travelled apically and laterally, associated with a pocket depth of 8 mm. Occlusal radiograph showed circumscribed radiolucency measuring 5 mm×7 mm in diameter at the apex of the tooth. A clinical diagnosis of chronic apical abscess was established. The case was treated with a combination of mineral trioxide aggregate and bone graft. At the 6-month follow-up visit, the tooth showed progressive healing without sinus track and sulcular bleeding. PMID:23605830

  4. Autogenous bone grafting in a patient on long-term oral bisphosphonate therapy: case report.

    PubMed

    El-Halaby, Ahmed; Becker, Jeffery; Bissada, Nabil F

    2009-12-01

    A 66-year-old patient was referred to the Periodontal Clinic at Case Western Reserve University for implant placement in the mandibular left first molar area. The patient reported a history of oral bisphosphonate intake for the last 7 years for the treatment of osteoporosis. Autogenous bone block grafting was planned to augment the ridge before implant placement. The surgery was performed under local anesthesia, and the implant was successfully placed 8 months after ridge augmentation. Healing was uneventful postoperatively, and the buccolingual width of the ridge increased significantly, allowing placement of a 5-mm-diameter dental implant. The patient showed proper healing of both the donor site and the recipient site, in spite of the long-term oral bisphosphonate therapy, with no resulting osteonecrosis of the jawbone.

  5. Engineering interaction between bone marrow derived endothelial cells and electrospun surfaces for artificial vascular graft applications.

    PubMed

    Ahmed, Furqan; Dutta, Naba K; Zannettino, Andrew; Vandyke, Kate; Choudhury, Namita Roy

    2014-04-14

    The aim of this investigation was to understand and engineer the interactions between endothelial cells and the electrospun (ES) polyvinylidene fluoride-co-hexafluoropropylene (PVDF-HFP) nanofiber surfaces and evaluate their potential for endothelialization. Elastomeric PVDF-HFP samples were electrospun to evaluate their potential use as small diameter artificial vascular graft scaffold (SDAVG) and compared with solvent cast (SC) PVDF-HFP films. We examined the consequences of fibrinogen adsorption onto the ES and SC samples for endothelialisation. Bone marrow derived endothelial cells (BMEC) of human origin were incubated with the test and control samples and their attachment, proliferation, and viability were examined. The nature of interaction of fibrinogen with SC and ES samples was investigated in detail using ELISA, XPS, and FTIR techniques. The pristine SC and ES PVDF-HFP samples displayed hydrophobic and ultrahydrophobic behavior and accordingly, exhibited minimal BMEC growth. Fibrinogen adsorbed SC samples did not significantly enhance endothelial cell binding or proliferation. In contrast, the fibrinogen adsorbed electrospun surfaces showed a clear ability to modulate endothelial cell behavior. This system also represents an ideal model system that enables us to understand the natural interaction between cells and their extracellular environment. The research reported shows potential of ES surfaces for artificial vascular graft applications. PMID:24564790

  6. Alveolar bone grafting: achieving the organisational standards determined by CSAG, a baseline audit at the Birmingham Children's Hospital.

    PubMed Central

    Clarkson, J.; Paterson, P.; Thorburn, G.; El-Ali, K.; Richard, B.; Hammond, M.; Wake, M.

    2005-01-01

    INTRODUCTION: Birmingham Children's Hospital (BCH) is the centre for a regional comprehensive cleft service attempting to implement the national guidelines for minimum standards of care. A national audit of cleft management (CSAG) found that 58% of alveolar bone grafts were successful; published series suggest that success rates can be of the order of 95%. We present the results of an audit of alveolar bone grafting over a 33-month period, after implementation. PATIENTS AND METHODS: A retrospective clinical process audit was taken from the hospital notes and an analysis of radiological outcome by Bergland score was obtained by two independent assessors. RESULTS: The audit highlighted the difficulties of integrating the increased clinical workload. Other difficulties included poorly standardised pre- and postoperative occlusal radiography, inconsistent orthodontic management and a lack of prospective data collection. An 81% success rate for alveolar bone grafting compares favourably to the CSAG study. Of 82 patients, 68 had sufficient data for a retrospective review; 21 were our own patients and 47 were referred into the centralised service. The success of bone grafting as defined by CSAG (including Bergland scores) is based on only two-thirds of the patients as many have their orthodontic treatment managed in more distant units and radiographs are much harder to obtain. Bone grafting later than age 11 years, was true for 28% (6/21) of our BCH patients and 46% (22/47) for those referred to our service. CONCLUSIONS: This audit demonstrates what has been achieved in a re-organised service in the context of Real Politik in the NHS and suggests the areas that require improvement. PMID:16263019

  7. Sartorius muscle pedicle iliac bone graft for the treatment of avascular necrosis of femur head

    PubMed Central

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-01-01

    Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks. All the patients were followed clinically and radiologically at regular intervals. The operated femoral heads, were grouped according to Ficat’s staging: 24 in stage IIA (45.3%), 22 in stage IIB (41.5%) and 07 in stage III (13.2%). The average duration of surgery was 85 min (range: 55–130 min). The total duration of follow-up was average 4.2 years (range: 2.2–15 years).The Harris hip score was excellent (>90) in 18 hips (33.96%), good (80–89) in 24 hips (45.28%), fair (70–79) in 9 hips (17%) and poor (<70) in 2 hips (3.7%). AVN of the femoral head is a painful and disabling condition in young adults. Sartorius muscle pedicle bone graft technique allows adequate decompression, re vascularization and osteogenesis of the femur head in Ficat’s stage IIa, IIb and III, in young adults. This is an effective and easy technique to adopt with excellent to good results in 80% cases and is associated with only minimal complications. PMID:27583161

  8. Sartorius muscle pedicle iliac bone graft for the treatment of avascular necrosis of femur head.

    PubMed

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-08-01

    Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks. All the patients were followed clinically and radiologically at regular intervals. The operated femoral heads, were grouped according to Ficat's staging: 24 in stage IIA (45.3%), 22 in stage IIB (41.5%) and 07 in stage III (13.2%). The average duration of surgery was 85 min (range: 55-130 min). The total duration of follow-up was average 4.2 years (range: 2.2-15 years).The Harris hip score was excellent (>90) in 18 hips (33.96%), good (80-89) in 24 hips (45.28%), fair (70-79) in 9 hips (17%) and poor (<70) in 2 hips (3.7%). AVN of the femoral head is a painful and disabling condition in young adults. Sartorius muscle pedicle bone graft technique allows adequate decompression, re vascularization and osteogenesis of the femur head in Ficat's stage IIa, IIb and III, in young adults. This is an effective and easy technique to adopt with excellent to good results in 80% cases and is associated with only minimal complications. PMID:27583161

  9. Sartorius muscle pedicle iliac bone graft for the treatment of avascular necrosis of femur head.

    PubMed

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-08-01

    Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks. All the patients were followed clinically and radiologically at regular intervals. The operated femoral heads, were grouped according to Ficat's staging: 24 in stage IIA (45.3%), 22 in stage IIB (41.5%) and 07 in stage III (13.2%). The average duration of surgery was 85 min (range: 55-130 min). The total duration of follow-up was average 4.2 years (range: 2.2-15 years).The Harris hip score was excellent (>90) in 18 hips (33.96%), good (80-89) in 24 hips (45.28%), fair (70-79) in 9 hips (17%) and poor (<70) in 2 hips (3.7%). AVN of the femoral head is a painful and disabling condition in young adults. Sartorius muscle pedicle bone graft technique allows adequate decompression, re vascularization and osteogenesis of the femur head in Ficat's stage IIa, IIb and III, in young adults. This is an effective and easy technique to adopt with excellent to good results in 80% cases and is associated with only minimal complications.

  10. Histomorphometric Assessment of Cancellous and Cortical Bone Material Distribution in the Proximal Humerus of Normal and Osteoporotic Individuals: Significantly Reduced Bone Stock in the Metaphyseal and Subcapital Regions of Osteoporotic Individuals.

    PubMed

    Sprecher, Christoph M; Schmidutz, Florian; Helfen, Tobias; Richards, R Geoff; Blauth, Michael; Milz, Stefan

    2015-12-01

    Osteoporosis is a systemic disorder predominantly affecting postmenopausal women but also men at an advanced age. Both genders may suffer from low-energy fractures of, for example, the proximal humerus when reduction of the bone stock or/and quality has occurred.The aim of the current study was to compare the amount of bone in typical fracture zones of the proximal humerus in osteoporotic and non-osteoporotic individuals.The amount of bone in the proximal humerus was determined histomorphometrically in frontal plane sections. The donor bones were allocated to normal and osteoporotic groups using the T-score from distal radius DXA measurements of the same extremities. The T-score evaluation was done according to WHO criteria. Regional thickness of the subchondral plate and the metaphyseal cortical bone were measured using interactive image analysis.At all measured locations the amount of cancellous bone was significantly lower in individuals from the osteoporotic group compared to the non-osteoporotic one. The osteoporotic group showed more significant differences between regions of the same bone than the non-osteoporotic group. In both groups the subchondral cancellous bone and the subchondral plate were least affected by bone loss. In contrast, the medial metaphyseal region in the osteoporotic group exhibited higher bone loss in comparison to the lateral side.This observation may explain prevailing fracture patterns, which frequently involve compression fractures and certainly has an influence on the stability of implants placed in this medial region. It should be considered when planning the anchoring of osteosynthesis materials in osteoporotic patients with fractures of the proximal humerus.

  11. Implant prosthetic rehabilitation with a free fibula flap and interpositional bone grafting after a mandibulectomy: a clinical report.

    PubMed

    Garcia Blanco, M; Ostrosky, M A

    2013-06-01

    This clinical report describes the multidisciplinary treatment of a 16-year-old girl diagnosed with cemento-ossifying fibroma in the mandible. The resection of the lesion and reconstruction with a free osseous fibula flap with microvascular anastomosis was performed. Four months later, interpositional bone grafting of iliac spongy bone was used to gain bone height at the treated site. Twenty-four months later, 5 dental implants were placed. After a 6-month osseointegration period, a partial screw-retained fixed dental prosthesis was fabricated. Prosthodontic planning and treatment considerations are discussed. PMID:23763781

  12. Retrospective long-term analysis of bone level changes after horizontal alveolar crest reconstruction with autologous bone grafts harvested from the posterior region of the mandible

    PubMed Central

    2016-01-01

    Purpose The goal of this study was to evaluate the long-term success of horizontal alveolar crest augmentation of the retromolar region of the mandible with particulated bone, as well as factors affecting subsequent peri-implant bone loss. Methods A total of 109 patients (68 female, 41 male) suffering from alveolar ridge deficiencies of the maxilla and mandible were included in this study. All patients were treated with particulated retromolar bone grafts from the mandible prior to the insertion of endosseous dental implants. Mesial and distal peri-implant crestal bone changes were assessed at six time points. Several parameters, including implant survival and the influence of age, gender, localisation of the implant, diameter, covering procedures, and time points of implant placement, were analysed to identify associations with bone level changes using the Mann-Whitney U-test, the Kruskal-Wallis test, and Spearman's rank-order correlation coefficient. Results A total of 164 dental implants were placed in the maxilla (n=97) and in the mandible (n=67). The mean observation period was 105.26±21.58 months after implantation. The overall survival rate was 97.6% after 10 years. Overall, peri-implant bone loss was highest during the first year, but decreased over time. The mean amount of bone loss after 10 years was 2.47 mm mesially and 2.50 mm distally. Bone loss was significantly influenced by implant type and primary stability. Conclusions The use of particulated autologous retromolar bone grafts is a reliable technique for the horizontal reconstruction of local alveolar ridge deficiencies. Our results demonstrate that implants placed in augmented bone demonstrated similar bone level changes compared to implants inserted in non-augmented regions. PMID:27127688

  13. Radiographic and Histologic Evaluation of a Bone Void that Formed After Recombinant Human Bone Morphogenetic Protein-2-Mediated Sinus Graft Augmentation: A Case Report.

    PubMed

    Kang, Hyun-Joo; Jun, Choong-Man; Yun, Jeong-Ho

    2016-01-01

    In the present case report, the authors describe radiographic and histologic observations of a bone void that formed after a sinus augmentation using a graft material that contained recombinant human bone morphogenetic protein-2 (rhBMP-2) and discuss clinical and histologic implications of their findings. Sinus augmentation was performed using a graft material comprising 1 g of hydroxyapatite/β-tricalcium phosphate, which contained 1 mg of rhBMP-2. Radiographic evaluation was conducted with panoramic radiographs and computed tomography images of the augmented maxillary sinus, which were analyzed using a three-dimensional image-reconstruction program. Histologic evaluation was also performed on a biopsy specimen obtained 6 months after the sinus augmentation. The total augmented volume increased from 1,582.2 mm(3) immediately after the sinus augmentation to 3,344.9 mm3 at 6 months after the augmentation because of the formation of a bone void. Twenty-six months after the sinus augmentation, the bone void remained but had reduced in volume, with the total augmented volume reduced to 2,551.7 mm(3). Histologically, new bone was observed to be in contact with the grafted particles, and a fatty marrow-like tissue was present in the area of the bone void. This case report shows that the bone void that had formed after sinus augmentation resolved over time and seemed to be partially replaced with new bone. Furthermore, none of the implants failed, and clinical adverse events were not observed during the follow-up period. PMID:27031629

  14. Comparing Variable-Length Polyglutamate Domains to Anchor an Osteoinductive Collagen-Mimetic Peptide to Diverse Bone Grafting Materials

    PubMed Central

    Bain, Jennifer L.; Culpepper, Bonnie K.; Reddy, Michael S.; Bellis, Susan L.

    2015-01-01

    Purpose Allografts, xenografts, and alloplasts are commonly used in craniofacial medicine as alternatives to autogenous bone grafts; however, these materials lack important bone-inducing proteins. A method for enhancing the osteoinductive potential of these commercially available materials would provide a major clinical advance. In this study, a calcium-binding domain, polyglutamate, was added to an osteoinductive peptide derived from collagen type I, Asp-Gly-Glu-Ala (DGEA), to anchor the peptide onto four different materials: freeze-dried bone allograft (FDBA); anorganic bovine bone (ABB); β-tricalcium phosphate (β-TCP); and a calcium sulfate bone cement (CaSO4). The authors also examined whether peptide binding and retention could be tuned by altering the number of glutamate residues within the polyglutamate domain. Materials and Methods DGEA or DGEA modified with diglutamate (E2DGEA), tetraglutamate (E4DGEA), or heptaglutamate (E7DGEA) were evaluated for binding and release to the grafting materials. Peptides were conjugated with a fluorescein isothiocyanate (FITC) tag to allow monitoring by fluorescent microscopy or through measurements of solution fluorescence. In vivo retention was evaluated by implanting graft materials coated with FITC-peptides into rat subcutaneous pouches. Results Significantly more peptide was loaded onto the four graft materials as the number of glutamates increased, with E7DGEA exhibiting the greatest binding. There was also significantly greater retention of peptides with longer glutamate domains following a 3-day incubation with agitation. Importantly, E7DGEA peptides remained on the grafts after a 2-month implantation into skin pouches, a sufficient interval to influence bony healing. Conclusion Variable-length polyglutamate domains can be added to osteoinductive peptides to control the amount of peptide bound and rate of peptide released. The lack of methods for tunable coupling of biologics to commercial graft sources has been a

  15. The use of BMP-2 coupled - Nanosilver-PLGA composite grafts to induce bone repair in grossly infected segmental defects.

    PubMed

    Zheng, Zhong; Yin, Wei; Zara, Janette N; Li, Weiming; Kwak, Jinny; Mamidi, Rachna; Lee, Min; Siu, Ronald K; Ngo, Richard; Wang, Joyce; Carpenter, Doug; Zhang, Xinli; Wu, Benjamin; Ting, Kang; Soo, Chia

    2010-12-01

    Healing of contaminated/infected bone defects is a significant clinical challenge. Prevalence of multi-antibiotic resistant organisms has renewed interest in the use of antiseptic silver as an effective, but less toxic antimicrobial with decreased potential for bacterial resistance. In this study, we demonstrated that metallic nanosilver particles (with a size of 20-40nm)-poly(lactic-co-glycolic acid) (PLGA) composite grafts have strong antibacterial properties. In addition, nanosilver particles-PLGA composite grafts did not inhibit adherence, proliferation, alkaline phosphatase activity, or mineralization of ongrowth MC3T3-E1 pre-osteoblasts compared to PLGA controls. Furthermore, nanosilver particles did not affect the osteoinductivity of bone morphogenetic protein 2 (BMP-2). Infected femoral defects implanted with BMP-2 coupled 2.0% nanosilver particles-PLGA composite grafts healed in 12 weeks without evidence of residual bacteria. In contrast, BMP-2 coupled PLGA control grafts failed to heal in the presence of continued bacterial colonies. Our results indicate that nanosilver of defined particle size is bactericidal without discernable in vitro and in vivo cytotoxicity or negative effects on BMP-2 osteoinductivity, making it an ideal antimicrobial for bone regeneration in infected wounds.

  16. A Meta Analysis of Lumbar Spinal Fusion Surgery Using Bone Morphogenetic Proteins and Autologous Iliac Crest Bone Graft

    PubMed Central

    Zhang, Haifei; Wang, Feng; Ding, Lin; Zhang, Zhiyu; Sun, Deri; Feng, Xinmin; An, Jiuli; Zhu, Yue

    2014-01-01

    Background Bone morphogenetic protein (BMPs) as a substitute for iliac crest bone graft (ICBG) has been increasingly widely used in lumbar fusion. The purpose of this study is to systematically compare the effectiveness and safety of fusion with BMPs for the treatment of lumbar disease. Methods Cochrane review methods were used to analyze all relevant randomized controlled trials (RCTs) published up to nov 2013. Results 19 RCTs (1,852 patients) met the inclusion criteria. BMPs group significantly increased fusion rate (RR: 1.13; 95% CI 1.05–1.23, P = 0.001), while there was no statistical difference in overall success of clinical outcomes (RR: 1.04; 95% CI 0.95–1.13, P = 0.38) and complications (RR: 0.96; 95% CI 0.85–1.09, p = 0.54). A significant reduction of the reoperation rate was found in BMPs group (RR: 0.57; 95% CI 0.42–0.77, p = 0.0002). Significant difference was found in the operating time (MD−0.32; 95% CI−0.55, −0.08; P = 0.009), but no significant difference was found in the blood loss, the hospital stay, patient satisfaction, and work status. Conclusion Compared with ICBG, BMPs in lumbar fusion can increase the fusion rate, while reduce the reoperation rate and operating time. However, it doesn’t increase the complication rate, the amount of blood loss and hospital stay. No significant difference was found in the overall success of clinical outcome of the two groups. PMID:24886911

  17. Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation

    PubMed Central

    Giacomo, Giovanni Di; Costantini, Alberto; de Gasperis, Nicola; De Vita, Andrea; Lin, Bernard K. H.; Francone, Marco; Beccaglia, Mario A. Rojas; Mastantuono, Marco

    2013-01-01

    Aims: One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. Materials and Methods: A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. Results: The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P < 0.01). Discussion: To our knowledge, there are no studies in literature that show the causes of coracoid bone graft osteolysis after Latarjet procedure. Conclusion: Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level of Evidence: Level 4. Clinical Relevance: Prospective case series, Treatment study. PMID:23858288

  18. Effects of High-LET Radiation Exposure and Hindlimb Unloading on Skeletal Muscle Resistance Artery Vasomotor Properties and Cancellous Bone Microarchitecture in Mice.

    PubMed

    Ghosh, Payal; Behnke, Brad J; Stabley, John N; Kilar, Cody R; Park, Yoonjung; Narayanan, Anand; Alwood, Joshua S; Shirazi-Fard, Yasaman; Schreurs, Ann-Sofie; Globus, Ruth K; Delp, Michael D

    2016-03-01

    Weightlessness during spaceflight leads to functional changes in resistance arteries and loss of cancellous bone, which may be potentiated by radiation exposure. The purpose of this study was to assess the effects of hindlimb unloading (HU) and total-body irradiation (TBI) on the vasomotor responses of skeletal muscle arteries. Male C57BL/6 mice were assigned to control, HU (13-16 days), TBI (1 Gy (56)Fe, 600 MeV, 10 cGy/min) and HU-TBI groups. Gastrocnemius muscle feed arteries were isolated for in vitro study. Endothelium-dependent (acetylcholine) and -independent (Dea-NONOate) vasodilator and vasoconstrictor (KCl, phenylephrine and myogenic) responses were evaluated. Arterial endothelial nitric oxide synthase (eNOS), superoxide dismutase-1 (SOD-1) and xanthine oxidase (XO) protein content and tibial cancellous bone microarchitecture were quantified. Endothelium-dependent and -independent vasodilator responses were impaired in all groups relative to control, and acetylcholine-induced vasodilation was lower in the HU-TBI group relative to that in the HU and TBI groups. Reductions in endothelium-dependent vasodilation correlated with a lower cancellous bone volume fraction. Nitric oxide synthase inhibition abolished all group differences in endothelium-dependent vasodilation. HU and HU-TBI resulted in decreases in eNOS protein levels, while TBI and HU-TBI produced lower SOD-1 and higher XO protein content. Vasoconstrictor responses were not altered. Reductions in NO bioavailability (eNOS), lower anti-oxidant capacity (SOD-1) and higher pro-oxidant capacity (XO) may contribute to the deficits in NOS signaling in skeletal muscle resistance arteries. These findings suggest that the combination of insults experienced in spaceflight leads to impairment of vasodilator function in resistance arteries that is mediated through deficits in NOS signaling. PMID:26930379

  19. Impaction grafting with morsellised allograft and tricalcium phosphate-hydroxyapatite: incorporation within ovine metaphyseal bone defects.

    PubMed

    Pratt, J N J; Griffon, D J; Dunlop, D G; Smith, N; Howie, C R

    2002-08-01

    An ovine model was used to investigate the in vivo properties of impacted tricalcium phosphate-hydroxyapatite (TCP-HA) aggregates, varying in chemical composition (ratio of TCP to HA) and particle size distribution (8 versus 3 particle size ranges). All pellets were impacted to a standard compactive effort. Eight sheep underwent implantation of pellets in 4 metaphyseal defects in both rear limbs. Treatment groups consisted of: (1) allograft (clinical control). (2) 50/50 allograft/80% HA/20% TCP in 8 particle size ranges, (3) 50/50 allograft/80% TCP/20% HA in 8 sizes and (4) 50/50 allograft/80% HA/20% TCP in only 3 sizes of particles. Healing of defects was evaluated at 14 weeks with computed tomography, histology and histomorphometry. The computer tomography (CT) density measured in all defects containing synthetic agents was higher than in defects filled with allograft alone (p<0.01). Defects containing 8 sizes of 80% HA/ 20% TCP granules (group 2) achieved lower histological scores and contained less bone than the clinical control (p<0.05), whereas groups 3 and 4 did not differ from the control. Although all synthetic agents were osteoconductive, our results suggest that increasing the ratio of TCP over HA and limiting the number of particle size ranges to 3 instead of 8 improve the performance of impacted aggregates as graft expanders. Evaluation under loading conditions of morsellised allograft expanded with 80% TCP/20% HA (BoneSave) in 3 particle size ranges is warranted.

  20. Pure orbital blowout fractures reconstructed with autogenous bone grafts: functional and aesthetic outcomes.

    PubMed

    Kronig, S A J; van der Mooren, R J G; Strabbing, E M; Stam, L H M; Tan, J A S L; de Jongh, E; van der Wal, K G H; Paridaens, D; Koudstaal, M J

    2016-04-01

    The purpose of this study was to investigate the ophthalmic clinical findings following surgical reconstruction with autogenous bone grafts of pure blowout fractures. A retrospective review of 211 patients who underwent surgical repair of an orbital fracture between October 1996 and December 2013 was performed. Following data analysis, 60 patients who were followed up over a period of 1 year were included. A solitary floor fracture was present in 38 patients and a floor and a medial wall fracture in 22 patients. Comparing preoperative findings between these two groups, preoperative diplopia and enophthalmos were almost twice as frequent in the group with additional medial wall fractures: diplopia 8% and 14% and enophthalmos 18% and 55%, respectively. One year following surgery there was no diplopia present in either group. In the solitary floor fracture group, 3% still had enophthalmos. It can be concluded that at 1 year following the repair of pure orbital floor fractures using autogenous bone, good functional and aesthetic results can be obtained. In the group with both floor and medial wall fractures, no enophthalmos was found when both walls were reconstructed. When the medial wall was left unoperated, 29% of patients still suffered from enophthalmos after 1 year.