Controlled Cyclic Compression of an Open Tibial Fracture Using an External Fixator Affects Fracture Healing in Mice

Fractures resulting in impaired healing can be treated with mechanical stimulation via external fixators. To examine the effect of mechanical stimulation on fracture healing, we developed an external fixator for use in a mouse model. A 0.5 mm tibial osteotomy was stabilized with the external fixator in C57BL/6 mice. Osteotomies in the treatment group (nt = 41) were subjected to daily sessions of 150 μm of controlled displacement with the aim to create a more mineralized callus at 21 days compared with the control group (nc = 39). Qualitative assessment of the histology found no notable difference in healing patterns between groups at 7, 12, 17, and 21 days. At 21 days, micro-computed tomography (CT) analysis showed that the control group had a significantly higher bone volume (BV) fraction and trabecular number compared with treatment; however there was no significant difference in the total volume (TV) of the callus or trabecular thickness between groups. In summary, the external fixator was used with a motion application system to apply controlled displacement to a healing fracture; however, this treatment did not result in a more mineralized callus at 21 days.

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Preoperative Placement of Rigid Markers for the Treatment of Tibial Fractures Using 3D Printed External Repositioning Model Combined With External Fixator

10.21203/rs.3.rs-753353/v1 ◽

2021 ◽

Author(s):

Guoliang Li ◽

Jianyong Zhao ◽

Yadi Zhang ◽

Xuyang Wang ◽

Qilin Liu

Keyword(s):

Postoperative Complications ◽

Fracture Healing ◽

External Fixator ◽

Healing Time ◽

Tibial Fractures ◽

Control Group ◽

External Fixators ◽

Observation Group ◽

3D Printed ◽

Time Point

Abstract Purpose: To investigate the effectiveness of preoperative placement of a rigid marker 3D printed external repositioning model combined with an external fixation frame in patients with tibial fractures.Methods: Fifty-five patients with tibial fractures treated from June 2019 to August 2020 were used as study subjects. Patients were divided into a control group and an observation group according to the order of their admission to the hospital. Patients in the control group were treated with conventional surgery, and patients in the observation group were treated with preoperative placement of rigid markers 3D printed external repositioning models combined with external fixators. The treatment results of the two groups were compared.Results: Patients in the observation group had significantly shorter operative time, hospital stay and fracture healing time than patients in the control group, and intraoperative bleeding was significantly less than that in the control group (P<0.05). The pain level decreased in both groups as the time lengthened after surgery. At the same time point, the degree of pain in the observation group was significantly lower than that in the control group (P<0.05). The incidence of postoperative complications was 6.66% in the observation group and 36% in the control group, and the incidence of postoperative complications was significantly lower in the observation group than in the control group (P<0.05). The excellent rate of fracture healing was 60% in the observation group and 86.67% in the control group, and the difference in the excellent rate of fracture healing between the two groups was significant (P<0.05). Patients in both groups gradually recovered their knee and ankle functions after surgery with the extension of time. At the same time point, the HSS and Maryland scores of patients in the observation group were significantly higher than those in the control group (P<0.05).Conclusion：By using preoperative placement of rigid markers 3D printed external repositioning model combined with external fixator treatment. No further incision or fluoroscopic closed reduction is required. This reduces the patient's pain and improves the patient's fracture healing results.

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Application of Autogenous Urine-Derived Stem Cell Sheet Enhances Rotator Cuff Healing in a Canine Model

The American Journal of Sports Medicine ◽

10.1177/0363546520962774 ◽

2020 ◽

Vol 48 (14) ◽

pp. 3454-3466

Author(s):

Yang Chen ◽

Yan Xu ◽

Muzhi Li ◽

Qiang Shi ◽

Can Chen

Keyword(s):

Computed Tomography ◽

Rotator Cuff ◽

Cell Tracking ◽

Cell Sheet ◽

Canine Model ◽

The Other ◽

Control Group ◽

Micro Computed Tomography ◽

Trabecular Thickness ◽

The Right

Background: A repaired rotator cuff (RC) often heals with interposed scar tissue, making repairs prone to failure. Urine-derived stem cells (USCs), with robust proliferation ability and multilineage differentiation, can be isolated from urine, avoiding invasive and painful surgical procedures for harvesting the cells. These advantages make it a novel cell source for autologous transplantation to enhance RC healing. Hypothesis: Implantation of an autogenous USC sheet to the injury site will enhance RC healing. Study Design: Controlled laboratory study. Methods: USCs isolated from urine were cultured using ascorbic acid and transforming growth factor β3 to form a cell sheet. Sixteen male mature beagles underwent bilateral shoulder surgery. The right shoulder underwent infraspinatus tendon (IT) insertion detachment and repair only, and the other was subjected to IT insertion detachment and repair, followed by autogenous USC sheet implantation. Among the animals, 3 received a Dil (1,1′-dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine perchlorate)- labeled USC sheet implant in the right shoulder and were sacrificed at postoperative 6 weeks for cell tracking. The other animals were sacrificed at postoperative 12 weeks, and the IT-humerus complexes were harvested for gross observation, micro–computed tomography evaluation and histological analysis (n = 5), and mechanical testing (n = 8). Additionally, 13 unpaired canine cadaveric shoulders were included as native controls. Results: Micro–computed tomography analysis showed that the USC sheet group had a significant increase in bone volume/total volume and trabecular thickness at the RC healing site when compared with the control group ( P < .05 for all). Histologically, the Dil-labeled USC sheet was still visible at the RC healing site, which suggested that the implanted USCs remained viable at postoperative 6 weeks. Meanwhile, the healing interface in the USC sheet group regenerated significantly more enthesis-like tissue than did that of the control group ( P < .05). Additionally, the healing interface in the USC sheet group presented a larger fibrocartilage area, more proteoglycan deposition, and higher collagen birefringence than did that of the control group ( P < .05 for all). Biomechanically, the USC sheet group showed significantly higher failure load and stiffness versus the control group ( P < .05 for all). Conclusion: A USC sheet was able to enhance RC healing in a canine model. Clinical Relevance: The findings of the study showed that USC sheet implantation could serve as a practical application for RC healing.

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Radioprotective Effect of Sodium Selenite on Mandible of Irradiated Rats

Brazilian Dental Journal ◽

10.1590/0103-6440201902559 ◽

2019 ◽

Vol 30 (3) ◽

pp. 232-237

Author(s):

Mayra Cristina Yamasaki ◽

Rocharles CavalcanteFontenele ◽

Yuri Nejaim ◽

Deborah Queiroz Freitas

Keyword(s):

Sodium Selenite ◽

Volume Fraction ◽

Bone Microarchitecture ◽

Bone Volume ◽

Radioprotective Effect ◽

Control Group ◽

X Rays ◽

Bone Volume Fraction ◽

Trabecular Thickness ◽

Significant Difference

Abstract The purpose of this study was to test the radioprotective effect of selenium in the bone microarchitecture of irradiated rats mandibles. Forty rats were separated into 4 groups with 10 animals: control group (CG), irradiated group (IG), sodium selenite group (SSG) and sodium selenite irradiated group (SSIG). A single dose of 0.8 mg/kg sodium selenite was administered intraperitoneally in the SSG and SSIG groups. One hour later, animals of IG and SSIG groups were irradiated with 15 Gy of x-rays. Forty days after radiation a bilateral extraction of the mandibular first molars was performed. After the extraction procedure, five rats were killed after fifteen days and others five after thirty days. Micro- computed tomography was used to evaluate cortical and trabecular bone of each rat. The mean and standard deviation of each bone microarchitecture parameter were analyzed using the statistical test of two-way Analysis of Variance (ANOVA). At 15 days, the bone volume presented higher values in the CG and SSG groups (p=0.001). The same groups presented statistically significant higher values when bone volume fraction (p<0.001) and trabecular thickness (p<0.001) were analyzed. At 30 days, it was observed that in relation to the bone volume fraction, SSG group presented the highest value while SSIG group had the lowest value, with statistically significant difference (p=0.016). Sodium selenite demonstrated a median radioprotective effect in the bone microarchitecture of irradiated mandibles, which indicates the substance may be a potential radioprotective agent against chronic effects of high doses of ionizing radiation.

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Ginkgo Biloba improves bone formation during fracture healing: an experimental study in rats

Acta Ortopédica Brasileira ◽

10.1590/1413-785220172503156966 ◽

2017 ◽

Vol 25 (3) ◽

pp. 95-98 ◽

Cited By ~ 3

Author(s):

Nizamettin Guzel ◽

Emrah Sayit ◽

Osman Aynaci ◽

Servet Kerimoglu ◽

Esin Yulug ◽

...

Keyword(s):

Bone Formation ◽

Fracture Healing ◽

Ginkgo Biloba ◽

Kirschner Wire ◽

Ginkgo Biloba Extract ◽

Histological Evaluation ◽

Control Group ◽

Sprague Dawley ◽

Level Of Evidence ◽

Significant Difference

ABSTRACT OBJECTIVES: Ginkgo biloba extract (EGb 761) is a plant extract obtained from the leaves of the G. biloba tree. The aim of this study was to assess the histological and radiological effects of G. biloba extract on fracture healing in an experimental fracture model using rat femurs. METHODS: Forty-eight female Sprague-Dawley rats (weight: 195-252 g; age: 20 weeks) were used in the study. The rats were randomly divided into six groups (n=8). A transverse fracture was made in the middle of the right femur of each rat and fixed with a Kirschner wire. The G. biloba groups received 60 mg/kg oral G. biloba extract once daily. No medication was given to the control groups. On days 7, 21 and 35, both sets of femurs were evaluated radiologically and histopathologically. RESULTS: Histological evaluation revealed that the G. biloba groups had significant differences at 21 and 35 days (p<0.05). The G. biloba group showed a significant difference in terms of bone formation on day 21 when compared to the control group (p<0.05). CONCLUSIONS: This study indicated that the use of G. biloba extract accelerated fracture healing. Both radiological and histological differences were detected, but the histological differences were more remarkable. Level of Evidence I, High Quality Randomized Trial.

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THE EFFECTS OF NICOTINE ON FRACTURE HEALING: AN EXPERIMENTAL STUDY

Journal of Musculoskeletal Research ◽

10.1142/s0218957702000836 ◽

2002 ◽

Vol 06 (02) ◽

pp. 119-125

Author(s):

Mustafa Agca ◽

Ibrahim Tuncay ◽

Nihat Tosun ◽

Fuat Akpinar

Keyword(s):

Fracture Healing ◽

Healing Process ◽

Final Analysis ◽

Treated Group ◽

Control Group ◽

Significant Difference ◽

Negative Effect ◽

Treatment Research ◽

Group B ◽

Transverse Fractures

This study is aimed to evaluate treatment research the effects of nicotine on fracture healing. Thirty rats were used. Nicotine was injected subcutanously at a dosage of 2 mg/kg/day to group A and 4 mg/kg/day to group B. Control group (group C) received 0.5 ml/kg/day saline solution. Three weeks later, transverse fractures were performed on to the left ulnar and radial bones for each animal. Animals were designed to one of two follow-up groups which were euthanized either 2 or 3 weeks. On the 14th day of fracture, randomly chosen five rats from each group of A, B and C were sacrificed. At the 21st day of fracture, same procedure performed for all remaining rats. Both had surgical and histopathological evaluation were performed. Transverse fractures performed on the 21st day of study were confirmed by direct radiograms. One rat died spontaneously before completing the study was therefore excluded from the final analysis. The results indicate that healing process proceeds in each group. There was no significant difference in fracture healing between groups A and B two weeks after the fracture. However, fracture healing was significantly delayed in nicotine treated group comparing to control group. We continue to support the notion that nicotine has a negative effect on fracture healing.

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Short-term Outcomes after High Tibial Osteotomy Aimed at Neutral Alignment Combined with Arthroscopic Centralization of Medial Meniscus in Osteoarthritis Patients

10.21203/rs.3.rs-21233/v1 ◽

2020 ◽

Author(s):

Hiroki Katagiri ◽

Yusuke Nakagawa ◽

Kazumasa Miyatake ◽

Koji Otabe ◽

Toshiyuki Ohara ◽

...

Keyword(s):

Knee Osteoarthritis ◽

High Tibial Osteotomy ◽

Medial Meniscus ◽

Control Group ◽

Tibial Osteotomy ◽

Short Term ◽

Subjective Satisfaction ◽

Significant Difference ◽

Neutral Alignment

Abstract Purpose To improve long-term outcomes of open-wedge high tibial osteotomy (OWHTO), procedures combining OWHTO aimed at neutral alignment and arthroscopic centralization for meniscal extrusion have been introduced. The purpose of the present study was to compare short-term clinical and radiological outcomes of medial joint space width (JSW) after the OWHTO aimed at neutral alignment with and without arthroscopic centralization for an extruded medial meniscus. Methods A retrospective review of 50 primary OWHTO patients was conducted. Thirty-five patients included for analysis after exclusion criteria was applied. Twenty-one knee osteoarthritis patients, who underwent the OWHTO with arthroscopic meniscal centralization, were included in the centralization group. Fourteen patients, who underwent solely OWHTO, were included in the control group. Lysholm knee scale, International Knee Documentation Committee (IKDC) subjective score, Knee Osteoarthritis Outcome Score (KOOS), and patient subjective satisfaction scores were recorded at the final follow-up. Radiographic changes of JSW and joint line congruence angle (JLCA) were measured 2 years postoperatively. Patient demographic data were also reviewed. Results IKDC subjective scores, KOOS subgroup scores, patient subjective satisfaction scores, and Lysholm score did not show significant differences between the two groups at the final follow-up. Change of the JSW in the centralization group was significantly greater than that in the control group 2 years postoperatively (Control group: -0.1 mm, Centralization group: 0.8 mm P =0.03). Conclusion Change of JSW after OWHTO aimed at neutral alignment with arthroscopic centralization for extruded medial meniscus was greater than solely OWHTO, and there was no significant difference in the short-term clinical outcomes between the 2 procedures at the final follow-up.

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Locally-developed External Fixators as Definitive Treatment of Open Tibia Diaphyseal Fractures: A Clinical Prospective Study Conducted in Ivory Coast

10.21203/rs.3.rs-116154/v1 ◽

2020 ◽

Author(s):

Kouamé Jean-Eric Kouassi ◽

Jean Régis Akobé ◽

Aya Adélaïde Natacha Kouassi ◽

Loïc Founkoué ◽

Christine Detrembleur ◽

...

Keyword(s):

Fracture Healing ◽

External Fixator ◽

Ivory Coast ◽

Definitive Treatment ◽

External Fixators ◽

Negative Consequences ◽

Clinical Trial Registry ◽

Septic Complications ◽

Non Union ◽

Diaphyseal Fractures

Abstract Background: This study sought to evaluate the effectiveness of locally-developed external fixators (LDEF) as definitive treatment for open tibia diaphyseal fractures (OTDF) in Ivory Coast.Methods: Gustilo I, II and IIIA OTDFs of patients admitted within 24 hours of injury were prospectively included and treated with a locally-developed external fixator. The rates of union, mal-union, septic complications, as well as the functional results were assessed, in addition to the LDEF construct’s integrity. Predictive factors of failure or poor results were assessed.Results: Overall, 40 OTDF patients were admitted within 24 hours of injury. Gustilo I, II and IIIA fractures were observed in three, 13, and 24 patients, respectively. Uneventful fracture healing was obtained in 29 cases, with an average union time of 8.47 months. Mal-union and non-union were registered in three and four cases, respectively. Pin-track infection (PTI) was observed in 13 cases, and deep infection in seven. Infection resolved in all patients except four, who developed chronic osteomyelitis. None of the non-unions were associated with an infection. The overall functional result was satisfactory in 32 patients. PTI was the only predictive factor for chronic infection. Biplanar frames, when compared to monoplanar constructs, were associated with a significantly improved functional outcome.Conclusion: In comparison with the results obtained in the same environment without a locally-developed external fixator, the provision of such a device improved significantly the OTDF management, as it provided better stability and superior fracture healing rates. PTI remains an essential problem but with, hopefully, limited negative consequences. Trial registration: This study protocol was registered in Pan African Clinical Trial Registry under N°PACTR202009854874448. Date of registration 28 September 2020 ‘retrospectively registered’. www.pactr.org.

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Using Transgenic Mice to Explore the Effect of il-17rc Gene Knockout on Bone Metabolism

10.21203/rs.3.rs-954353/v1 ◽

2021 ◽

Author(s):

Fan Yu ◽

Bo Li ◽

Guoliang Zhang ◽

Song Zhou

Keyword(s):

Transgenic Mice ◽

Bone Metabolism ◽

Gene Knockout ◽

Control Group ◽

Signal Pathways ◽

Interleukin 17 ◽

Micro Ct ◽

Mineral Density ◽

Trabecular Thickness ◽

Significant Difference

Abstract ObjectiveTo investigate whether interleukin-17 receptor C (il-17rc) gene knockout leads to systemic osteoporosis in transgenic mice. MethodsThe immunohistochemistry and micro computed tomography (micro-CT) were used to analyze the condition of vertebral cancellous bone in 3-month healthy female wild-type C57BL/6 mice (control group) and il-17rc gene knockout C57BL/6 mice (experimental group). ResultsWild type C57BL/6 mice had higher bone density per unit volume (0.52 ± 0.12 vs. 0.47 ± 0.05, P = 0.028) (g/cm3), more trabecular connections (8.97 ± 1.46 vs. 5.59 ± 3.15, P = 0.017) (1/mm), thicker trabecular thickness (0.16 ± 0.08 vs. 0.10 ± 0.04, P = 0.029) (1/mm) and the number of trabeculae was more (5.01 ± 0.33 vs. 3.16 ± 0.37, P = 0.038) (1/mm) than mut-il-17rc mice. In addition, the results of micro-CT also showed that the osteoporosis of il-17rc gene knockout C57BL/6 mice was mainly manifested in T13 (P = 0.039), L1 (P = 0.035), L3 (P = 0.018), L5 (P = 0.021) and L6 (P = 0.036), but the mean bone mineral density between L2 (P = 0.317) and L4 (P = 0.242) was no significant difference between the two groups. ConclusionIL-17/il-17rs signal axis is widely distributed in the animal skeletal system and is one of the important signal pathways regulating bone metabolism. Knockout of il-17rc gene can lead to the occurrence of osteoporosis in model animals.

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A Comparison of the Effects of Grayanotoxin-Containing Honey (Mad Honey), Normal Honey, and Propolis on Fracture Healing

Medical Principles and Practice ◽

10.1159/000487552 ◽

2018 ◽

Vol 27 (2) ◽

pp. 99-106 ◽

Cited By ~ 2

Author(s):

Aynur Sahin ◽

Suha Turkmen ◽

Nizamettin Guzel ◽

Ahmet Mentese ◽

Suleyman Turedi ◽

...

Keyword(s):

Fracture Healing ◽

Control Group ◽

Histopathological Analysis ◽

Non Union ◽

Treatment Groups ◽

Patient Morbidity ◽

Mad Honey ◽

Significant Difference ◽

Radiological Healing ◽

Better Than

Objectives: Delayed healing and non-union of fractures have a significant effect upon patient morbidity. Studies have therefore largely concentrated on accelerating fracture healing. This study was intended to compare the effect of “mad honey” and propolis on fracture healing using radiological and histopathological analysis. Subjects and Methods: Femur fracture was surgically performed on 48 rats, followed by fixation. Animals were then divided into 8 groups: 2 control groups (15- and 30-day) and 6 treatment groups (15- and 30-day normal honey, 15- and 30-day “mad honey,” and 15- and 30-day propolis). Rats were sacrificed at the end of these periods, and radiological and histological examinations were performed. Results: Radiological healing in the propolis group after 15-day therapy was statistically better than in the control (p = 0.004) and normal honey (p = 0.006) groups. After 30-day therapy, healing in the propolis group (p = 0.005) and grayanotoxin-containing “mad honey” group (p = 0.007) were significantly better than in the control group. Histologically, there was a statistically significant difference between the 15-day propolis group and the other groups (control, honey, mad honey: p = 0.003, p = 0.003, and p = 0.002, respectively). We also found a statistically significant difference when the 30-day propolis group (p = 0.005) and “mad honey” group (p = 0.007) were compared to the control group. Conclusions: This study shows that grayanotoxin-containing “mad honey” and propolis can accelerate fracture healing.

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Acceleration of Bone Fracture Healing through the Use of Natural Bovine Hydroxyapatite Implant on Bone Defect Animal Model

Folia Medica Indonesiana ◽

10.20473/fmi.v55i3.15495 ◽

2019 ◽

Vol 55 (3) ◽

pp. 176

Author(s):

Junaidi Khotib ◽

Cantika SC Lasandara ◽

Samirah Samirah ◽

Aniek S Budiatin

Keyword(s):

Fracture Healing ◽

Bone Defect ◽

Bone Fracture ◽

Control Group ◽

Bone Fracture Healing ◽

Bone Implant ◽

Femur Bone ◽

Significant Difference ◽

Bovine Hydroxyapatite ◽

Rabbit Femur

Bone is an important organ for supports the body that stores reserve of calcium, phosphorus, and other minerals. In fracture conditions where bleeding, soft tissue edema, nerve damage, and blood vessels around the bone damage happen, they can cause the mobilization of these minerals in the surrounding tissue. One of the efforts made in the treatment of these fractures is reconnection, in which it works by filling of bone defect with a matrix and administration of anti-infection. Biomaterial filling in defective bone is thought to accelerate the healing process of bone fracture and prevent osteomyelitis. For this reason, this study evaluates the acceleration of bone fracture healing using natural hydroxyapatite (NHA) bone filler in rabbits with bone defect model. Fracture modeling was performed by surgical technique and drilling of bones with a 4.2 mm diameter to form a defect in the rabbit femur. Bone implant contained bovine hydroxyapatite-gelatin-glutaraldehyde (BHA implant) or bovine hydroxyapatite-gelatin-glutaraldehyde-gentamicin (BHA-GEN implant) that was inserted in bone defects. 27 rabbits were divided into 3 groups: the control group who had bone defect, the bone defect group was given BHA implant and the bone defect group was given BHA-GEN implant. Observation of osteoclast, osteoblast, osteocyte, BALP level, and bone morphological integrity was carried out on the 14th, 28th, and 42nd days after surgery. Histological observation of rabbit femur showed a significant difference on the number of osteoclast, osteoblast and osteocyte in all three groups. The BALP level also showed a significant difference in the group given the natural BHA bone implant compared to the control group on day 14 (p = 0.0361). Based on the result of the X-ray, there was also a better integration of rabbit femur bone in groups with the use of BHA or BHA-GEN bone implant. Thus, it can be concluded that the use of a natural BHA implant can accelerate the process of bone repair in the fracture of rabbit femur. In addition, BHA implants were compatible as a matrix for supporting the bone cell growth.

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