Treatment of Tibial Bone Defects with Free Flap, PMM-a Spacer, and Secondary Bone Grafting

2006 ◽  
Vol 22 (04) ◽  
Author(s):  
Pedro Cavadas
Keyword(s):  
Free Flap ◽  
Bone Grafting ◽  
Bone Defects ◽  
Tibial Bone

scholarly journals Bone transport versus acute shortening for the management of infected tibial bone defects: A meta-analysis

2020 ◽  
Author(s):  
Hongjie Wen ◽  
Shouyan Zhu ◽  
Canzhang Li ◽  
Yongqing Xu
Keyword(s):  
Bone Grafting ◽  
Meta Analysis ◽  
Functional Results ◽  
Bone Defects ◽  
Bone Transport ◽  
Bone Union ◽  
Fixation Index ◽  
Cochrane Library ◽  
Tibial Bone ◽  
Acute Shortening

Abstract Background: The treatment for infected tibial bone defects can be a great challenge for the orthopaedic surgeon. This meta-analysis was conducted to compare the efficacy and safety between bone transport (BT) and the acute shortening technique (AST) in the treatment of infected tibial bone defects.Methods: A literature survey was conducted by searching the PubMed, Web of Science, Cochrane Library, and Embase databases together with the China National Knowledge Infrastructure (CNKI) and the Wanfang database for articles published up to 9 August 2019. The Newcastle-Ottawa scale (NOS) was adapted to evaluate the bias and risks in each eligible study. The data of the external fixation index (EFI), bone grafting, bone and functional results, complications, bone union time and characteristics of participants were extracted. RevMan v.5.3 was used to perform relevant statistical analyses. Relative risk (RR) was used for the binary variables and standard mean difference (SMD) for continuous variables. Each variable included its 95% confidence interval (CI).Results: Five studies, including a total of 199 patients, were included in the meta-analysis. Statistical significance was observed in the EFI (SMD = 0.63, 95% CI: 0.25, 1.01, P = 0.001) and bone grafting (RR = 0.26, 95%CI: 0.15, 0.46, P <0.00001); however, no significance was observed in bone union time (SMD = –0.02, 95% CI: –0.39, 0.35, P = 0.92), bone results (RR = 0.97, 95% CI: 0.91, 1.04, P = 0.41), functional results (RR = 0.96, 95% CI: 0.86, 1.08, P = 0.50) and complications (RR = 0.76, 95% CI: 0.41, 1.39, P = 0.37).Conclusions: AST is preferred from the aspect of minimising the treatment period, whereas BT is superior to AST for reducing bone grafting. Due to the limited number of trials, the meaning of this conclusion should be taken with caution for infected tibial bone defects.Trial registration: PROSPERO CRD42019133659

scholarly journals Bone transport versus acute shortening for the management of infected tibial bone defects: a meta-analysis

2020 ◽  
Author(s):  
Hongjie Wen ◽  
Shouyan Zhu ◽  
Canzhang Li ◽  
Yongqing Xu
Keyword(s):  
Bone Grafting ◽  
Meta Analysis ◽  
Functional Results ◽  
Bone Defects ◽  
Bone Transport ◽  
Bone Union ◽  
Fixation Index ◽  
Cochrane Library ◽  
Tibial Bone ◽  
Acute Shortening

Abstract Background: The treatment for infected tibial bone defects can be a great challenge for the orthopaedic surgeon. This meta-analysis was conducted to compare the safety and efficacy between bone transport (BT) and the acute shortening technique (AST) in the treatment of infected tibial bone defects. Methods: A literature survey was conducted by searching the PubMed, Web of Science, Cochrane Library, and Embase databases together with the China National Knowledge Infrastructure (CNKI) and the Wanfang database for articles published up to 9 August 2019. The modified Newcastle-Ottawa scale (NOS) was adapted to evaluate the bias and risks in each eligible study. The data of the external fixation index (EFI), bone grafting, bone and functional results, complications, bone union time and characteristics of participants were extracted. RevMan v.5.3 was used to perform relevant statistical analyses. Standard mean difference (SMD) was used for continuous variables and relative risk (RR) for the binary variables. All of the variables included its 95% confidence interval (CI). Results: Five studies, including a total of 199 patients, were included in the study. Statistical significance was observed in the EFI (SMD = 0.63, 95% CI: 0.25, 1.01, P = 0.001) and bone grafting (RR = 0.26, 95%CI: 0.15, 0.46, P <0.00001); however, no significance was observed in bone union time (SMD = –0.02, 95% CI: –0.39, 0.35, P = 0.92), bone results (RR = 0.97, 95% CI: 0.91, 1.04, P = 0.41), functional results (RR = 0.96, 95% CI: 0.86, 1.08, P = 0.50) and complications (RR = 0.76, 95% CI: 0.41, 1.39, P = 0.37). Conclusions: AST is preferred from the aspect of minimising the treatment period, whereas BT is superior to AST for reducing bone grafting. Due to the limited number of trials, the meaning of this conclusion should be taken with caution for infected tibial bone defects.

scholarly journals Bone transport versus acute shortening for the management of infected tibial bone defects: a meta-analysis

2019 ◽  
Author(s):  
Hongjie Wen ◽  
Shouyan Zhu ◽  
Canzhang Li ◽  
Yongqing Xu
Keyword(s):  
Bone Grafting ◽  
Meta Analysis ◽  
Functional Results ◽  
Bone Defects ◽  
Bone Transport ◽  
Bone Union ◽  
Fixation Index ◽  
Cochrane Library ◽  
Tibial Bone ◽  
Acute Shortening

Abstract Background The treatment for infected tibial bone defects can be a great challenge for the orthopaedic surgeon. This meta-analysis was conducted to compare the efficacy and safety between bone transport (BT) and acute shortening technique (AST) in the treatment of infected tibial bone defects.Materials and Methods A literature survey was conducted by searching the PubMed, Web of Science, Cochrane Library, Embase together with China National Knowledge Infrastructure (CNKI), and Wanfang database for articles published as of August 9, 2019. NOS (Newcastle-Ottawa scale) and Cochrane's risk of bias tool were adapted to evaluated the bias and risk of each eligible study. The data of external fixation index (EFI), bone grafting, bone and functional results, complications, bone union time and characteristics of participants were extracted. RevMan V.5.3 was used to perform relevant statistical analyses. Relative risk (RR) were used for the binary variables and standard mean difference (SMD) for continuous variable. Each variable included its 95% confidence interval (CI).Results 5 studies, including a total of 199 patients, were included in the meta-analysis. Statistical significance was observed in EFI (SMD = 0.63,95% CI:0.25,1.01,P=0.001) and Bone grafting (RR = 0.26,95%CI:0.15,0.46,P<0.00001), however, no significance was observed in bone union time (SMD = -0.02, 95% CI: -0.39, 0.35, P=0.92), bone results (RR = 0.97,95%CI:0.91,1.04,P=0.41),functional results (RR = 0.96,95%CI:0.86,1.08,P=0.50) and complication (RR = 0.76,95%CI:0.41,1.39,P=0.37).Conclusions AST is preferred on the aspect of minimizing treatment period, while BT is superior to AST for reducing bone grafting. Due to the limited number of trials, The meaning of this conclusion should be taken with caution for infected tibial bone defects.

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.

Ilizarov bone transport using an intramedullary cable transportation system in the treatment of tibial bone defects

Injury ◽  
2020 ◽  
Author(s):  
Thomas Rosteius ◽  
Simon Pätzholz ◽  
Valentin Rausch ◽  
Sebastian Lotzien ◽  
Björn Behr ◽  
...  
Keyword(s):  
Bone Defects ◽  
Transportation System ◽  
Bone Transport ◽  
Tibial Bone ◽  
Ilizarov Bone Transport

scholarly journals COMBINED USE OF HYALURONIC ACID WITH NANO-BIOACTIVE GLASS ENHANCED BIOCEMENT BASED SILICATE STIMULATED BONE REGENERATIVE CAPACITY IN TIBIAL BONE DEFECTS OF RABBITS: IN-VIVO STUDY

2021 ◽  
Vol 9 (5) ◽  
pp. 630-638
Author(s):  
Fatema Aziz Al-Sayed ◽  
◽  
Radwa Hamed Hegazy ◽  
Zeinab Amin Salem ◽  
Hanan Hassan El-Beheiry ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Bioactive Glass ◽  
Bone Regeneration ◽  
Bone Defects ◽  
Bone Area ◽  
Regenerative Capacity ◽  
Tibial Bone ◽  
Group 3 ◽  
Area Percentage ◽  
Group 1

An ideal biomaterial for bone regeneration is a longstanding quest nowadays. This study aimed to evaluate the osteogenic potentiality of nano-bioactive glass enhanced biocement based silicate with or without hyaluronic acid seeded in rabbits’ tibial bone defects. For this, 24 male rabbits with two 5 mm defects (1 defect per tibia) were divided into three equal groups. Among the predefined three groups, for the rabbits of group 1(control) bone defects were left untreated while for the members of group 2 defects received nano-bioactive glass enhanced biocement based silicate cement, and group 3 defects received nano-bioactive glass cement mixed with hyaluronic acid. Animals of each group were divided equally for euthanization after 3 and 6 weeks. Bone specimens were processed and examined histologically with histomorphometrically analysis of new bone area percentage. The bone defects in group 3 showed significantly improved osseous healing histologically as compared to the group 1&2. The morphometric analysis also revealed a significant increase in the new bone area percentage in group 3 as compared to the group 1 and 2 (P < 0.05). The results of the present study can be concluded that bone defects could be treated with nano-bioactive glass and hyaluronic acid cement. Although, nano-bioactive glass alone was capable of bone regeneration the combination of both had significant regenerative capacity.

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.

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