From bench to clinic and back: skeletal stem cells and impaction bone grafting for regeneration of bone defects

2012 ◽  
Vol 8 (10) ◽  
pp. 779-786 ◽  
Author(s):  
A. Aarvold ◽  
J. O. Smith ◽  
E. R. Tayton ◽  
A. M. H. Jones ◽  
J. I. Dawson ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Grafting ◽  
Bone Defects ◽  
Impaction Bone Grafting ◽  
Regeneration Of Bone

scholarly journals Effect of Systemic Zoledronic Acid Dosing Regimens on Bone Regeneration in Osteoporotic Rats

2021 ◽  
Vol 11 (4) ◽  
pp. 1906
Author(s):  
Marwa Y. Shaheen ◽  
Amani M. Basudan ◽  
Abdurahman A. Niazy ◽  
Jeroen J. J. P. van den Beucken ◽  
John A. Jansen ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Femoral Condyle ◽  
Bone Defects ◽  
Histological Evaluation ◽  
Favorable Effect ◽  
Osteoporotic Bone ◽  
Bovine Bone ◽  
Graft Placement ◽  
Regeneration Of Bone

The aim of this study was to evaluate the regeneration of bone defects created in the femoral condyle of osteoporotic rats, following intravenous (IV) zoledronate (ZA) treatment in three settings: pre-bone grafting (ZA-Pre), post-bone grafting (ZA-Post), and pre- plus post-bone grafting (ZA-Pre+Post). Twenty-four female Wistar rats were ovariectomized (OVX). After 12 weeks, bone defects were created in the left femoral condyle. All defects were grafted with a particulate inorganic cancellous bovine bone substitute. ZA (0.04 mg/kg, weekly) was administered to six rats 4 weeks pre-bone graft placement. To another six rats, ZA was given post-bone graft placement creation and continued for 6 weeks. Additional six rats received ZA treatment pre- and post-bone graft placement. Control animals received weekly saline intravenous injections. At 6 weeks post-bone graft placement, samples were retrieved for histological evaluation of the bone area percentage (BA%) and remaining bone graft percentage (RBG%). BA% for ZA-Pre (50.1 ± 3.5%) and ZA-Post (49.2 ± 8.2%) rats was significantly increased compared to that of the controls (35.4 ± 5.4%, p-value 0.031 and 0.043, respectively). In contrast, ZA-Pre+Post rats (40.7 ± 16.0%) showed similar BA% compared to saline controls (p = 0.663). For RBG%, all experimental groups showed similar results ranging from 36.3 to 47.1%. Our data indicate that pre- or post-surgical systemic IV administration of ZA improves the regeneration of bone defects grafted with inorganic cancellous bovine-bone particles in osteoporotic bone conditions. However, no favorable effect on bone repair was seen for continued pre- plus post-surgical ZA treatment.

scholarly journals Enhanced regeneration of bone defects using sintered porous Ti6Al4V scaffolds incorporated with mesenchymal stem cells and platelet-rich plasma

RSC Advances ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 5128-5138
Author(s):  
Ji Li ◽  
Ketao Wang ◽  
Xiaowei Bai ◽  
Qi Wang ◽  
Ningyu Lv ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Bone Regeneration ◽  
Platelet Rich Plasma ◽  
Bone Defects ◽  
Regeneration Of Bone

Porous Ti6AI4V scaffolds incorporated with MSC and PRP are more effective in enhancing the bone regeneration.

Impaction bone grafting in hip re-revision surgery

2021 ◽  
Vol 103-B (3) ◽  
pp. 492-499
Author(s):  
Eduardo Garcia-Rey ◽  
Laura Saldaña ◽  
Eduardo Garcia-Cimbrelo
Keyword(s):  
Aseptic Loosening ◽  
Acetabular Component ◽  
Revision Surgery ◽  
Bone Grafting ◽  
Bone Defects ◽  
Bone Stock ◽  
Impaction Bone Grafting ◽  
Acetabular Bone ◽  
Acetabular Bone Defects

Aims Bone stock restoration of acetabular bone defects using impaction bone grafting (IBG) in total hip arthroplasty may facilitate future re-revision in the event of failure of the reconstruction. We hypothesized that the acetabular bone defect during re-revision surgery after IBG was smaller than during the previous revision surgery. The clinical and radiological results of re-revisions with repeated use of IBG were also analyzed. Methods In a series of 382 acetabular revisions using IBG and a cemented component, 45 hips (45 patients) that had failed due to aseptic loosening were re-revised between 1992 and 2016. Acetabular bone defects graded according to Paprosky during the first and the re-revision surgery were compared. Clinical and radiological findings were analyzed over time. Survival analysis was performed using a competing risk analysis. Results Intraoperative bone defect during the initial revision included 19 Paprosky type IIIA and 29 Paprosky type IIIB hips; at re-revision, seven hips were Paprosky type II, 27 type IIIA and 11 were type IIIB (p = 0.020). The mean preoperative Harris Hip Score was 45.4 (SD 6.4), becoming 80.7 (SD 12.7) at the final follow-up. In all, 12 hips showed radiological migration of the acetabular component, and three required further revision surgery. The nine-year cumulative failure incidence (nine patients at risk) of the acetabular component for further revision surgery was 9.6% (95% confidence interval (CI) 2.9 to 21.0) for any cause, and 7.5% (95% CI 1.9 to 18.5) for aseptic loosening. Hips with a greater hip height had a higher risk for radiological migration (odds ratio 1.09, 95% CI 1.02 to 1.17; p = 0.008). Conclusion Bone stock restoration can be obtained using IBG in revision hip surgery. This technique is also useful in re-revision surgery; however, a better surgical technique including a closer distance to hip rotation centre could decrease the risk of radiological migration of the acetabular component. A longer follow-up is required to assess potential fixation deterioration. Cite this article: Bone Joint J 2021;103-B(3):492–499.

scholarly journals Mid-term results of impaction bone grafting in tibial bone defects in complex primary knee arthroplasty for severe varus deformity

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 2
Author(s):  
Yashwant Singh Tanwar ◽  
Yatinder Kharbanda ◽  
Harsh Bhargava ◽  
Kulbhushan Attri ◽  
Anoop Bandil
Keyword(s):  
Knee Arthroplasty ◽  
Bone Grafting ◽  
Primary Total Knee Arthroplasty ◽  
Varus Deformity ◽  
Womac Score ◽  
Bone Defects ◽  
Impaction Bone Grafting ◽  
Tibial Condyle ◽  
Primary Knee Arthroplasty ◽  
The Many

Introduction: Bone defects are a challenging problem encountered occasionally during primary knee arthroplasty. These defects should be meticulously addressed so as to avoid malalignment and premature loosening and failure. Out of the many options available to deal with these defects, impaction bone grafting provides a more biological solution, which is especially important in case of primary knees. Materials and methods: A retrospective analysis was done and patients with severe varus deformity of more than 20 degrees who had undergone primary knee arthroplasty with impaction bone grafting of the tibial condyle defect were followed up. Results: Between 2008 and 2014, out of the 1124 patients who underwent primary total knee arthroplasty, only 26 knees in 23 patients met the inclusion criteria. The amount of varus deformity ranged from 20 to 35 degrees. Follow-up ranged from 3 to 8 years with an average of 6 years. The average pre-operative Knee Society Score (KSS) and Western Ontario McMaster Universities (WOMAC) score were 24.2 and 78, respectively. There were significant improvements in the post-op scores, with the average KSS being 90.2 and the WOMAC being 38. Conclusion: Impaction bone grafting provides an invaluable option to the orthopedic surgeon for managing bone defects, especially in case of primary knee arthroplasty as it reconstitutes the bone stock.

scholarly journals Pharmacological Approaches and Regeneration of Bone Defects with Dental Pulp Stem Cells

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
M. Adamička ◽  
A. Adamičková ◽  
L. Danišovič ◽  
A. Gažová ◽  
J. Kyselovič
Keyword(s):  
Stem Cells ◽  
Bone Defects ◽  
Autogenous Bone ◽  
Marker Genes ◽  
Pharmacological Agents ◽  
Undifferentiated State ◽  
Chondrogenic Marker ◽  
Inflammatory Drugs ◽  
Chemical Stimuli ◽  
Regeneration Of Bone

Bone defects in the craniomaxillofacial skeleton vary from small periodontal defects to extensive bone loss, which are difficult to restore and can lead to extensive damage of the surrounding structures, deformities, and limited functions. Plenty of surgical regenerative procedures have been developed to reconstruct or prevent alveolar defects, based on guided bone regeneration involving the use of autogenous bone grafts or bone substituents. However, these techniques have limitations in the restoration of morphological and functional reconstruction, thus stopping disease progression but not regenerating lost tissue. Most promising candidates for regenerative therapy of maxillofacial bone defects represent postnatal stem cells, because of their replication potential in the undifferentiated state and their ability to differentiate as well. There is an increased need for using various orofacial sources of stem cells with comparable properties to mesenchymal stem cells because they are more easily available with minimally invasive procedures. In addition to the source of MSCs, another aspect affects the regeneration outcomes. Thermal, mechanical, and chemical stimuli after surgical procedures have the ability to generate pain, usually managed with pharmacological agents, mostly nonsteroidal anti-inflammatory drugs (NSAIDs). Some studies revealed that NSAIDs have no significant cytotoxic effect on bone marrow stem cells from mice, while other studies showed regulation of osteogenic and chondrogenic marker genes in MSC cells by NSAIDs and paracetamol, but no effect was observed in connection with diclofenac use. Therefore, there is a need to focus on such pharmacotherapy, capable of affecting the characteristics and properties of implanted MSCs.

Impaction bone grafting for the reconstruction of large bone defects in revision knee arthroplasty

2015 ◽  
Vol 27 (1) ◽  
pp. 35-46 ◽  
Author(s):  
M. Rudert ◽  
B.M. Holzapfel ◽  
E. von Rottkay ◽  
D.E. Holzapfel ◽  
U. Noeth
Keyword(s):  
Knee Arthroplasty ◽  
Bone Grafting ◽  
Bone Defects ◽  
Impaction Bone Grafting ◽  
Revision Knee Arthroplasty ◽  
Large Bone ◽  
Large Bone Defects

scholarly journals Effectiveness of mesenchymal stem cell-conditioned medium in bone regeneration in animal and human models: a systematic review and meta-analysis

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Maria Paula Benavides-Castellanos ◽  
Nathaly Garzón-Orjuela ◽  
Itali Linero
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Animal Models ◽  
Conditioned Medium ◽  
Meta Analysis ◽  
Bone Defects ◽  
Favorable Effect ◽  
Human Models ◽  
Regeneration Of Bone

Abstract Background Given the limitations of current therapies for the reconstruction of bone defects, regenerative medicine has arisen as a new therapeutic strategy along with mesenchymal stem cells (MSCs), which, because of their osteogenic potential and immunomodulatory properties, have emerged as a promising alternative for the treatment of bone injuries. In vivo studies have demonstrated that MSCs have a positive effect on regeneration due to their secretion of cytokines and growth factors that, when collected in conditioned medium (MSC-CM) and applied to an injured tissue, can modulate and promote the formation of new tissue. Objective To evaluate the effectiveness of application of conditioned medium derived from mesenchymal stem cells in bone regeneration in animal and human models. Methods We conducted a systematic review with a comprehensive search through February of 2018 using several electronic databases (MEDLINE, EMBASE, SCOPUS, CENTRAL (Ovid), and LILACS), and we also used the “snowballing technique”. Articles that met the inclusion criteria were selected through abstract review and subsequent assessment of the full text. We assessed the risk of bias with the SYRCLE and Cochrane tools, and three meta-analyses were performed. Results We included 21 articles, 19 of which used animal models and 2 of which used human models. In animal models, the application of MSC-CM significantly increased the regeneration of bone defects in comparison with control groups. Human studies reported early mineralization in regenerated bones, and no bone resorption, inflammation, nor local or systemic alterations were observed in any case. The meta-analysis showed an overall favorable effect of the application of MSC-CM. Conclusions The application of MSC-CM to bone defects has a positive and favorable effect on the repair and regeneration of bone tissue, particularly in animal models. It is necessary to perform additional studies to support the application of MSC-CM in clinical practice.

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