scholarly journals Characterization of Properties, In Vitro and In Vivo Evaluation of Calcium Phosphate/Amino Acid Cements for Treatment of Osteochondral Defects

Materials ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 436
Author(s):  
Lubomir Medvecky ◽  
Maria Giretova ◽  
Radoslava Stulajterova ◽  
Jan Danko ◽  
Katarina Vdoviakova ◽  
...  
Keyword(s):  
Amino Acids ◽  
Calcium Phosphate ◽  
Subchondral Bone ◽  
Hyaline Cartilage ◽  
Healing Process ◽  
Complex Mixture ◽  
Surrounding Tissue ◽  
Osteochondral Defects ◽  
Post Surgery ◽  
Defect Sites

Novel calcium phosphate cements containing a mixture of four amino acids, glycine, proline, hydroxyproline and either lysine or arginine (CAL, CAK) were characterized and used for treatment of artificial osteochondral defects in knee. It was hypothesized that an enhanced concentration of extracellular collagen amino acids (in complex mixture), in connection with bone cement in defect sites, would support the healing of osteochondral defects with successful formation of hyaline cartilage and subchondral bone. Calcium phosphate cement mixtures were prepared by in situ reaction in a planetary ball mill at aseptic conditions and characterized. It was verified that about 30–60% of amino acids remained adsorbed on hydroxyapatite particles in cements and the addition of amino acids caused around 60% reduction in compressive strength and refinement of hydroxyapatite particles in their microstructure. The significant over-expression of osteogenic genes after the culture of osteoblasts was demonstrated in the cement extracts containing lysine and compared with other cements. The cement pastes were inserted into artificial osteochondral defects in the medial femoral condyle of pigs and, after 3 months post-surgery, tissues were analyzed macroscopically, histologically, immunohistochemically using MRI and X-ray methods. Analysis clearly showed the excellent healing process of artificial osteochondral defects in pigs after treatment with CAL and CAK cements without any inflammation, as well as formation of subchondral bone and hyaline cartilage morphologically and structurally identical to the original tissues. Good integration of the hyaline neocartilage with the surrounding tissue, as well as perfect interconnection between the neocartilage and new subchondral bone tissue, was demonstrated. Tissues were stable after 12 months’ healing.

scholarly journals The Morphological, Clinical and Radiological Outputs of the Preclinical Study After Treatment of the Osteochondral Lesions in the Porcine Knee Model Using Implantation of Scaffold Based on the of Calcium Phosphate Biocement

2021 ◽  
Vol 8 ◽  
Author(s):  
Katarína Vdoviaková ◽  
Ján Danko ◽  
Lenka Krešáková ◽  
Veronika Šimaiová ◽  
Eva Petrovová ◽  
...  
Keyword(s):  
Amino Acids ◽  
Calcium Phosphate ◽  
Subchondral Bone ◽  
Osteochondral Defect ◽  
Knee Joints ◽  
Cartilage Tissue ◽  
Osteochondral Defects ◽  
Animal Group ◽  
Native Cartilage ◽  
Stifle Joint

The symptomatic full-thickness cartilage lesions or cartilage degeneration leads to the destruction of the normal chondral architecture and bone structure in affected area, causes the osteoarthritis, and general damage to the health. Knee joints are most frequently affected by this condition. The permanent damage of the articular cartilage and subchondral bone has motivated many scientists and clinicians to explore new methods of regeneration of osteochondral defects, such as novel materials. We studied the potential of the biocement based on calcium phosphate consisting of a mixture of four amino acids (glycine, proline, hydroxyproline and lysine) in the regenerating process of the artificially created osteochondral defect on the porcine medial femoral condyle in the stifle joint. The mass ratio of the amino acids in biocement CAL was 4:2:2:1. The Ca/P ratio in cement was 1.67 which correspond with ratio in hydroxyapatite. We compared the results with spontaneous healing of an artificially created cyst with that of the healthy tissue. The animal group treated with biocement paste CAL presented completely filled osteochondral defects. The results were confirmed by histological and radiological assessments, which have shown regenerated chondral and bone tissue in the examined knee joints. Macroscopic evaluation showed that neocartilage was well integrated with the adjacent native cartilage in animal group with biocement CAL, compared with healing of the artificial cyst, where treated cartilage surfaces were visibly lower than the surrounding native cartilage surface and a border between native and restored tissue was apparent. The qualitative assessment of the implant histology specimens showed full regeneration of the hyaline cartilage and subchondral bone in animals with biocement CAL. The artificial cyst group showed remarkable fibrillation. The detailed MRI analysis of cross-section of osteochondral defect confirmed the complete cartilage and subchondral bone healing where the thickness of the regenerated cartilage was 1.5 mm. The MRI imaging of defects in the artificial cyst group showed incomplete healing, neo cartilage tissue reduced up to 50%.

scholarly journals In Vivo Study of Osteochondral Defect Regeneration Using Innovative Composite Calcium Phosphate Biocement in a Sheep Model

Materials ◽  
2021 ◽  
Vol 14 (16) ◽  
pp. 4471
Author(s):  
Lenka Kresakova ◽  
Jan Danko ◽  
Katarina Vdoviakova ◽  
Lubomir Medvecky ◽  
Zdenek Zert ◽  
...  
Keyword(s):  
Amino Acids ◽  
Calcium Phosphate ◽  
Osteochondral Defect ◽  
Articular Surface ◽  
Fibrous Tissue ◽  
Treated Group ◽  
Negative Control ◽  
Osteochondral Defects ◽  
Sheep Model

This study aimed to clarify the therapeutic effect and regenerative potential of the novel, amino acids-enriched acellular biocement (CAL) based on calcium phosphate on osteochondral defects in sheep. Eighteen sheep were divided into three groups, the treated group (osteochondral defects filled with a CAL biomaterial), the treated group with a biocement without amino acids (C cement), and the untreated group (spontaneous healing). Cartilages of all three groups were compared with natural cartilage (negative control). After six months, sheep were evaluated by gross appearance, histological staining, immunohistochemical staining, histological scores, X-ray, micro-CT, and MRI. Treatment of osteochondral defects by CAL resulted in efficient articular cartilage regeneration, with a predominant structural and histological characteristic of hyaline cartilage, contrary to fibrocartilage, fibrous tissue or disordered mixed tissue on untreated defect (p < 0.001, modified O’Driscoll score). MRI results of treated defects showed well-integrated and regenerated cartilage with similar signal intensity, regularity of the articular surface, and cartilage thickness with respect to adjacent native cartilage. We have demonstrated that the use of new biocement represents an effective solution for the successful treatment of osteochondral defects in a sheep animal model, can induce an endogenous regeneration of cartilage in situ, and provides several benefits for the design of future therapies supporting osteochondral defect healing.

scholarly journals Rat perichondrium transplanted to articular cartilage defects forms articular-like, hyaline cartilage

2020 ◽  
Author(s):  
Zelong Dou ◽  
Daniel Muder ◽  
Marta Baroncelli ◽  
Ameya Bendre ◽  
Alexandra Gkourogianni ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Articular Cartilage ◽  
Subchondral Bone ◽  
Fluorescent Protein ◽  
Bone Marrow Cells ◽  
Hyaline Cartilage ◽  
Cartilage Defects ◽  
Trochlear Groove ◽  
Post Surgery ◽  
Articular Cartilage Defects

AbstractReconstruction of articular surfaces destroyed by infection or trauma is hampered by the lack of suitable graft tissues. Perichondrium autotransplants have been used for this purpose. However, the role of the transplanted perichondrium in the healing of resurfaced joints have not been investigated. Perichondrial and periosteal tissues were harvested from rats hemizygous for a ubiquitously expressed enhanced green fluorescent protein (EGFP) transgene and transplanted into full-thickness articular cartilage defects at the trochlear groove of distal femur in wild-type littermates. As an additional control, cartilage defects were left without a transplant (no transplant control). Distal femurs were collected 3, 14, 56, 112 days after surgery. Transplanted cells and their progenies were readily detected in the defects of perichondrium and periosteum transplanted animals but not in defects left without a transplant. Perichondrium transplants expressed SOX9 and with time differentiated into a hyaline cartilage that expanded and filled out the defects with Col2a1-positive chondrocytes and a matrix rich in proteoglycans. Interestingly, at later timepoints the cartilaginous perichondrium transplants were actively remodeled into bone at the transplant-bone interface and at post-surgery day 112 EGFP-positive perichondrium cells at the articular surface were positive for Prg4. In addition, both perichondrium and periosteum transplants contributed cells to the subchondral bone and bone marrow, suggesting differentiation into osteoblast/osteocytes as well as bone marrow cells. In summary, we found that perichondrium transplanted to articular cartilage defects develops into an articular-like, hyaline cartilage that integrates with the subchondral bone, and is maintained for an extended time. The findings indicate that perichondrium is a suitable tissue for repair and engineering of articular cartilage.

scholarly journals Educational Intervention on Self Efficacy among Postoperative Fracture: A Literature Review

2021 ◽  
Vol 4 (2) ◽  
pp. 231-242
Author(s):  
Sri Wirayuni Ni Luh Putu ◽  
Sri Yona
Keyword(s):  
Literature Review ◽  
Self Efficacy ◽  
Healing Process ◽  
Rehabilitation Program ◽  
Surrounding Tissue ◽  
Nursing Interventions ◽  
Post Surgery ◽  
Long Time ◽  
Postoperative Fracture ◽  
Rehabilitation Exercises

Fracture is a disruption of the normal discontinuity of bone and causes the surrounding tissue to be disrupted. Management of fractures is generally divided into recognition, reduction, retention, and rehabilitation. Exercises in the postoperative fracture patient rehabilitation program require patience and take a long time to achieve maximum cure. Nurses' therapeutic action in helping patients do rehabilitation exercises is by increasing the patient's self-efficacy to be independent in carrying out activities. Efforts to increase self-efficacy can be made through nursing interventions. This literature review aimed to explore the appropriate interventions on improving self-efficacy among postoperative fracture patients. Methods: This study was obtained from 4 databases, namely EBSCO, Key clinical, Willey, and Proquest, using inclusion and exclusion criteria. Results obtained. Decreased self-efficacy can occur in cases that require long action both for the healing process and chronic disease and when taking actions to maintain health, including post-surgery fractures. In conclusion, educational media will make it easier to provide interventions in increasing self-efficacy by paying attention to the factors that affect self-efficacy, namely master experience, vicarious experience, verbal persuasion, and emotional Arousal. The recommendation is that patients need support for adjusting the use of tools in providing education, providing logistics from samples in the application of education through technology media and to parents

scholarly journals Micro-Computed Tomography Analysis of Subchondral Bone Regeneration Using Osteochondral Scaffolds in an Ovine Condyle Model

2021 ◽  
Vol 11 (3) ◽  
pp. 891
Author(s):  
Taylor Flaherty ◽  
Maryam Tamaddon ◽  
Chaozong Liu
Keyword(s):  
Computed Tomography ◽  
Bone Regeneration ◽  
Subchondral Bone ◽  
Volume Ratio ◽  
Bone Volume ◽  
Osteochondral Defects ◽  
Micro Ct ◽  
Micro Computed Tomography ◽  
Trabecular Thickness ◽  
Osteochondral Scaffold

Osteochondral scaffold technology has emerged as a promising therapy for repairing osteochondral defects. Recent research suggests that seeding osteochondral scaffolds with bone marrow concentrate (BMC) may enhance tissue regeneration. To examine this hypothesis, this study examined subchondral bone regeneration in scaffolds with and without BMC. Ovine stifle condyle models were used for the in vivo study. Two scaffold systems (8 mm diameter and 10 mm thick) with and without BMC were implanted into the femoral condyle, and the tissues were retrieved after six months. The retrieved femoral condyles (with scaffold in) were examined using micro-computed tomography scans (micro-CT), and the micro-CT data were further analysed by ImageJ with respect to trabecular thickness, bone volume to total volume ratio (BV/TV) ratio, and degree of anisotropy of bone. Statistical analysis compared bone regeneration between scaffold groups and sub-set regions. These results were mostly insignificant (p < 0.05), with the exception of bone volume to total volume ratio when comparing scaffold composition and sub-set region. Additional trends in the data were observed. These results suggest that the scaffold composition and addition of BMC did not significantly affect bone regeneration in osteochondral defects after six months. However, this research provides data which may guide the development of future treatments.

scholarly journals The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series

2021 ◽  
Author(s):  
Klaus Pastl ◽  
Wolfgang Schimetta
Keyword(s):  
Healing Process ◽  
Case Series ◽  
Clinical Importance ◽  
Fusion Rate ◽  
Surrounding Tissue ◽  
Allogeneic Bone ◽  
Foot Surgery ◽  
Bone Screw ◽  
Transplant Failure

Abstract Introduction The allogeneic bone screw transplant is a new osteosynthesis device making the use of foreign fixation material obsolete for various kinds of indications. Moreover, it is integrated into the recipient bone by natural bone remodeling without harming the surrounding tissue. The aim of this study was to determine the efficacy and safety of the transplant for osteotomy and arthrodesis in hand and foot surgery and to evaluate the clinical importance of the device. Materials and methods A single-surgeon case series of 32 patients who had undergone hand or foot surgery with the application of an allogeneic bone screw with an average follow-up time of 1 year is reported. Clinical data were reviewed to evaluate the pain levels and satisfaction of the patients and the frequency and type of complications occurring during the healing process. Routine radiography and computed tomography were reviewed to determine the fusion rate, the ingrowth behavior of the transplant and the possible occurrence of transplant failure. Results High patient satisfaction was paired with low postoperative pain levels and a low complication rate. 97% of the patients were free of pain at the timepoint of the second follow-up examination, the mean time of recovery of full mobility was 50.1 ± 26.1 days after surgery. Wound healing disturbance occurred only in two cases. Bony consolidation of the osteotomy or arthrodesis gap as well as osseointegration of the transplant was seen in all cases. No transplant failure or transplant loosening occurred. Conclusions The application of the allogeneic bone screw resulted in a 100% fusion rate while the patient burden was low. The transplant is safe and suited for various kinds of osteosynthesis in hand and foot surgery.

Ultrapurified Alginate Gel Containing Bone Marrow Aspirate Concentrate Enhances Cartilage and Bone Regeneration on Osteochondral Defects in a Rabbit Model

2021 ◽  
pp. 036354652110141
Author(s):  
Liang Xu ◽  
Atsushi Urita ◽  
Tomohiro Onodera ◽  
Ryosuke Hishimura ◽  
Takayuki Nonoyama ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Bone Marrow ◽  
Cell Transplantation ◽  
Cartilage Repair ◽  
Subchondral Bone ◽  
Bone Repair ◽  
Bone Marrow Aspirate ◽  
Defect Group ◽  
The Other ◽  
Osteochondral Defects

Background: Ultrapurified alginate (UPAL) gel implantation has been demonstrated as effective in cartilage repair for osteochondral defects; however, cell transplantation within UPAL gels would be required to treat larger defects. Hypothesis: The combination of UPAL gel and bone marrow aspirate concentrate (BMAC) would enhance cartilage repair and subchondral bone repair for large osteochondral defects. Study Design: Controlled laboratory study. Methods: A total of 104 osteochondral defects (1 defect per knee) of 52 rabbits were randomly divided into 4 groups (26 defects per group): defects without any treatment (Defect group), defects treated using UPAL gel alone (UPAL group), defects treated using UPAL gel containing allogenic bone marrow mesenchymal stromal cells (UPAL-MSC group), and defects treated using UPAL gel containing BMAC (UPAL-BMAC group). At 4 and 16 weeks postoperatively, macroscopic and histologic evaluations and measurements of repaired subchondral bone volumes of reparative tissues were performed. Collagen orientation and mechanical properties of the reparative tissue were assessed at 16 weeks. Results: The defects in the UPAL-BMAC group were repaired with hyaline-like cartilage with well-organized collagen structures. The histologic scores at 4 weeks were significantly higher in the UPAL-BMAC group (16.9 ± 2.0) than in the Defect group (4.7 ± 1.9; P < .05), the UPAL group (10.0 ± 3.3; P < .05), and the UPAL-MSC group (12.2 ± 2.9; P < .05). At 16 weeks, the score in the UPAL-BMAC group (24.4 ± 1.7) was significantly higher than those in the Defect group (9.0 ± 3.7; P < .05), the UPAL group (14.2 ± 3.9; P < .05), and the UPAL-MSC group (16.3 ± 3.6; P < .05). At 4 and 16 weeks, the macroscopic evaluations were significantly superior in the UPAL-BMAC group compared with the other groups, and the values of repaired subchondral bone volumes in the UPAL-BMAC group were significantly higher than those in the Defect and UPAL groups. The mechanical properties of the reparative tissues were significantly better in the UPAL-BMAC group than in the other groups. Conclusion: The implantation of UPAL gel containing BMAC-enhanced hyaline-like cartilage repair and subchondral bone repair of osteochondral defects in a rabbit knee model. Clinical Relevance: These data support the potential clinical application of 1-step treatment for large osteochondral defects using biomaterial implantation with cell transplantation.

The dog as a preclinical model to evaluate interface morphology and micro-motion in cemented total knee replacement

2012 ◽  
Vol 25 (01) ◽  
pp. 01-10 ◽  
Author(s):  
M. A. Miller ◽  
M. Khorasani ◽  
K. L. Townsend ◽  
M. J. Allen ◽  
K. A. Mann
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Subchondral Bone ◽  
Tibial Component ◽  
Preclinical Model ◽  
Interface Morphology ◽  
Material Interfaces ◽  
Post Surgery ◽  
Total Knee ◽  
Micro Motion

SummaryObjectives: This study investigated cemented fixation of the tibial component from a canine total knee replacement preclinical model. The objective was to determine the local morphology at the material interfaces (implant, cement, bone) and the local relative micro-motion due to functional loading following in vivo service.Methods: Five skeletally mature research dogs underwent unilateral total knee replacement using a cemented implant system with a polyethylene (PE) monobloc tibial component. Use of the implanted limb was assessed by pressure-sensitive walkway analysis. At 60 weeks post-surgery, the animals were euthanatized and the tibia sectioned en bloc in the sagittal plane to create medial and lateral specimens. High resolution imaging was used to quantify the morphology under the tray and along the keel. Specimens were loaded to 50% body weight and micro-motions at the PE-cement and cement-bone interfaces were quantified.Results: There was significantly (p = 0.002) more cement-bone apposition and interdigitation along the central keel compared to the regions under the tray. Cavitary defects were associated with the perimeters of the implant (60 ± 25%). Interdigitation fraction was negatively correlated with cavitary defect fraction, cement crack fraction, and total micro-motion.Clinical significance: Achieving good inter-digitation of cement into subchondral bone beneath the tibial tray is associated with improved interface morphology and reduced micro-motion; features that could result in a reduced incidence of aseptic loosening. Multiple drill holes distributed over the cut tibial surface and adequate pressurization of the cement into the subchondral bone should improve fixation and reduce interface micro-motion and cavitary defects.

scholarly journals The fat anchor orchiopexy technique: results and outcomes from 150 cases surgical experience

2021 ◽  
Author(s):  
Claudio Spinelli ◽  
Alessia Bertocchini ◽  
Gianmartin Cito ◽  
Marco Ghionzoli ◽  
Silvia Strambi
Keyword(s):  
Undescended Testis ◽  
Healing Process ◽  
Day Surgery ◽  
Post Surgery ◽  
Post Operative Pain ◽  
Surgical Wounds ◽  
Bilateral Cryptorchidism ◽  
Long Time ◽  
History Of

Abstract Purpose The purpose of the study is to evaluate results and outcomes in a long-time follow-up period, by performing a novel testicular fixation procedure, known as “fat anchor orchidopexy” (FAO), for the treatment of palpable low inguinal undescended testis. Materials and methods We retrospectively reviewed all patients who underwent scrotal orchiopexy technique, from May 2013 to May 2019, at the Pediatric Surgery Division of Department of Surgical Pathology, University of Pisa (Italy). FAO (Spinelli’s technique) consists in anchoring the testicles to sub-scrotal fat with a single trans-scrotal incision. All the patients enrolled had history of unilateral or bilateral undescended testis. Data collected included patient’s age, operative times and complications. Results A total of 150 children with cryptorchidism were treated using a single trans-scrotal orchiopexy. Of them, 130 patients (86.7%) had unilateral undescended testis and 20 (13.3%) bilateral cryptorchidism. Mean patient’s age was 21 months (range: 14–28 months). All the procedures were planned in a day-surgery setting. Trans-scrotal orchiopexy was successful in all cases and no patients required an additional groin incision. No intraoperatively and postoperatively major complications were observed. Patients’ post-operative pain was mild (mean pediatric visual analog scale = 2). In all cases, the healing process was rapid and no surgical wounds infections were reported during the post-operative period, referring excellent cosmesis results. During a mean 48-month follow-up period, no testicular retraction, recurrence or testis atrophy was reported. Conclusion The original Spinelli’s technique (FAO) proves to be a safe and effective method for the treatment of palpable or distal-to-external-inguinal-ring testes. No immediate and delayed post-surgery complications were reported. In all cases, the anchored testicle remained in the scrotal position with normal vascularization. This novel surgical technique could give better options for scrotal fixation in case of low-lying cryptorchid testes.

Artificial Osteochondral Interface of Bioactive Fibrous Membranes Mediating Calcified Cartilage Reconstruction

2021 ◽  
Author(s):  
Mengtao Liu ◽  
Xiurong Ke ◽  
Yuejun Yao ◽  
Fanghui Wu ◽  
Shuo Ye ◽  
...  
Keyword(s):  
Subchondral Bone ◽  
Hyaline Cartilage ◽  
Interface Region ◽  
Calcified Cartilage ◽  
Cartilage Reconstruction ◽  
Fibrous Membranes

Calcified cartilage is a mineralized osteochondral interface region between the hyaline cartilage and subchondral bone, whereas there were few reported artificial biomaterials that could offer bioactivities for substantial reconstruction of...

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