scholarly journals The Accordion Maneuver: A Noninvasive Strategy for Absent or Delayed Callus Formation in Cases of Limb Lengthening

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Asim M. Makhdom ◽  
Adrian Sever Cartaleanu ◽  
Juan Sebastian Rendon ◽  
Isabelle Villemure ◽  
Reggie C. Hamdy
Keyword(s):  
Bone Formation ◽  
Bone Regeneration ◽  
Distraction Osteogenesis ◽  
Surgical Procedures ◽  
Bone Healing ◽  
Callus Formation ◽  
Limb Lengthening ◽  
Successful Outcome ◽  
Review Of The Literature ◽  
Successful Approach

The distraction osteogenesis (DO) technique has been used worldwide to treat many orthopaedic conditions. Although successful, absent or delayed callus formation in the distraction gap can lead to significant morbidities. An alternate cycle of distraction-compression (accordion maneuver) is one approach to accelerate bone regeneration. The primary aim of our study is to report our experience with the accordion maneuver during DO and to provide a detailed description of this technique, as performed in our center. The secondary aim is to present a review of the literature regarding the use of accordion maneuver. We reviewed the database of all patients undergoing limb lengthening from the year of 1997 to 2012. Four patients (6.15%) out of 65 showed poor bone regenerate in their tibiae and therefore accordion maneuver was applied for a mean of 6.75 weeks. Of these, three patients have had successful outcome with this technique. The literature showed that this technique is successful approach to trigger bone healing. However, details of how and when to apply this combination of distraction-compression forces were lacking. In conclusion, the accordion technique is safe noninvasive approach to promote bone formation, thus avoiding more invasive surgical procedures in cases of poor callus formation in limb lengthening.

scholarly journals Lipoteichoic Acid Accelerates Bone Healing by Enhancing Osteoblast Differentiation and Inhibiting Osteoclast Activation in a Mouse Model of Femoral Defects

2020 ◽  
Vol 21 (15) ◽  
pp. 5550
Author(s):  
Chih-Chien Hu ◽  
Chih-Hsiang Chang ◽  
Yi-min Hsiao ◽  
Yuhan Chang ◽  
Ying-Yu Wu ◽  
...  
Keyword(s):  
Mouse Model ◽  
Bone Formation ◽  
Bone Regeneration ◽  
Bone Healing ◽  
Lipoteichoic Acid ◽  
Calcium Deposition ◽  
Micro Computed Tomography ◽  
Osteoclast Activation

Lipoteichoic acid (LTA) is a cell wall component of Gram-positive bacteria. Limited data suggest that LTA is beneficial for bone regeneration in vitro. Thus, we used a mouse model of femoral defects to explore the effects of LTA on bone healing in vivo. Micro-computed tomography analysis and double-fluorochrome labeling were utilized to examine whether LTA can accelerate dynamic bone formation in vivo. The effects of LTA on osteoblastogenesis and osteoclastogenesis were also studied in vitro. LTA treatment induced prompt bone bridge formation, rapid endochondral ossification, and accelerated healing of fractures in mice with femoral bone defects. In vitro, LTA directly enhanced indicators of osteogenic factor-induced MC3T3-E1 cell differentiation, including alkaline phosphatase activity, calcium deposition and osteopontin expression. LTA also inhibited osteoclast activation induced by receptor activator of nuclear factor-kappa B ligand. We identified six molecules that may be associated with LTA-accelerated bone healing: monocyte chemoattractant protein 1, chemokine (C-X-C motif) ligand 1, cystatin C, growth/differentiation factor 15, endostatin and neutrophil gelatinase-associated lipocalin. Finally, double-fluorochrome, dynamic-labeling data indicated that LTA significantly enhanced bone-formation rates in vivo. In conclusion, our findings suggest that LTA has promising bone-regeneration properties.

scholarly journals Effects of Polylactide Copolymer Implants and Platelet-Rich Plasma on Bone Regeneration within a Large Calvarial Defect in Sheep

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Bartłomiej Błaszczyk ◽  
Wojciech Kaspera ◽  
Krzysztof Ficek ◽  
Maciej Kajor ◽  
Marcin Binkowski ◽  
...  
Keyword(s):  
Bone Formation ◽  
Bone Regeneration ◽  
Bone Healing ◽  
Platelet Rich Plasma ◽  
Calvarial Defect ◽  
Proof Of Concept ◽  
Adult Sheep ◽  
The Future ◽  
Calvarial Defects

The aim of this study was to verify whether L-lactide/DL-lactide copolymer 80/20 (PLDLLA) and platelet-rich plasma (PRP) trigger bone formation within critical-sized calvarial defects in adult sheep (n=6). Two craniectomies, each ca. 3 cm in diameter, were created in each animal. The first craniectomy was protected with an inner polylactide membrane, filled with PRP-polylactide granules, and covered with outer polylactide membrane. The second control craniectomy was left untreated. The animals were euthanized at 6, 7, 17, 19, 33, and 34 weeks after surgery, and the quality and the rate of reossification were assessed histomorphometrically and microtomographically. The study demonstrated that application of implants made of PLDLLA 80/20 combined with an osteopromotive substance (e.g., PRP) may promote bone healing in large calvarial defect in sheep. These promising proof-of-concept studies need to be verified in the future on a larger cohort of animals and over a longer period of time in order to draw definitive conclusions.

scholarly journals Observer Strategy and Radiographic Classification of Healing after Grafting of Cystic Defects in Maxilla: A Radiological Appraisal

2013 ◽  
Vol 14 (2) ◽  
pp. 227-232 ◽  
Author(s):  
Nivedita V Bajantai ◽  
Sanjay Krishna Sriram ◽  
Roopa Rani Sriram ◽  
VK Prabhakar Rao ◽  
Priti D Desai
Keyword(s):  
Bone Density ◽  
Bone Formation ◽  
Bone Regeneration ◽  
Bone Healing ◽  
New Bone Formation ◽  
Follow Up Studies ◽  
Operating Surgeon ◽  
Radiographic Classification

ABSTRACT Aim The aim is to radiographically quantify the bone density and relate the same with observer strategy in the bone healing. Objectives To assess pattern of bone regeneration following grafting of defects with hydroxyapatite after apicoectomy/cystic enucleation. Materials and methods An observer strategy involving trained and experienced examiners used in large series of cases, evaluated radiographically over a period of 1 year with intervals. The cases were grouped into different categories depending on (1) surgical site outline merging with material margin, (2) internal portion of surgical site (i.e. bone formation characteristics) and (3) density of surgical site. The radiographs examined by blind process and the findings were tabulated. Operating surgeon (oral surgeon) has done the interpretation of data to create observer strategy of grafting cases. Observations and results The outline of the defect was changed, partly reduced and completely absent along with remodeling, which showed ground glass, specular or trabecular pattern of bone over a time with increasing density correlating bone regeneration within a short duration. The applied strategy and classification are recommended for follow-up studies. In this study the characteristics of the new bone formation were also delineated. This strategy is helpful for follow-up studies; implant procedures and so; to know quality and condition of bone after treatment. How to cite this article Kattimani VS, Bajantai NV, Sriram SK, Sriram RR, Rao VKP, Desai PD. Observer Strategy and Radiographic Classification of Healing after Grafting of Cystic Defects in Maxilla: A Radiological Appraisal. J Contemp Dent Pract 2013;14(2):227-232.

scholarly journals The Experimental Study on Promoting the Ilizarov Distraction Osteogenesis by the Injection of Liquid Alg/nHAC Biocomposites

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Xinhui Liu ◽  
Di Yu ◽  
Jieyan Xu ◽  
Chao Zhu ◽  
Qingling Feng ◽  
...  
Keyword(s):  
Distraction Osteogenesis ◽  
Bone Healing ◽  
Tumor Resection ◽  
Limb Lengthening ◽  
Limb Length ◽  
Biomechanical Test ◽  
Bone Trabecula ◽  
General Observation ◽  
Percentage Area ◽  
Limb Length Inequality

Limb lengthening is frequently utilized in treating limb length inequalities, angulation deformities, nonunions, complex fractures, and deficiencies after tumor resection in more recent year. The procedure of limb lengthening pioneered by Ilizarov is now a widely accepted method for correcting limb length inequality and short stature as well as for bridging large defects in long bones. In order to promote bone healing during distraction osteogenesis and reduce the complications caused by limb lengthening pioneered, an alginate/nanohydroxyapatite/collagen (Alg/nHAC) composite was fabricated. General observation, histologically morphological observations, X-ray examination, biomechanical test, bone density, and the percentage area of bone trabecula were used to assay the ability of Alg/nHAC composite to promote bone healing. The present study demonstrates that the injection of liquid Alg/nHAC composites can significantly promote distraction osteogenesis. Alg/nHAC composite is promising for clinical application, solving the healing problem of backbone osteotomy and the fixing problem of metaphyseal backbone.

Guided Bone Regeneration (GBR) on Healing Bone Defects: A Histological Study in Rabbits

2004 ◽  
Vol 5 (2) ◽  
pp. 114-123 ◽  
Author(s):  
Muzaffer Asian ◽  
Göksel Şimşek ◽  
Ertunҫ Dayi
Keyword(s):  
Bone Formation ◽  
Bone Regeneration ◽  
Optical Microscopy ◽  
Bone Healing ◽  
Histological Study ◽  
Bone Defects ◽  
Guided Bone Regeneration ◽  
Control Group ◽  
Healing Bone ◽  
The Right

Abstract In this study, the effects of guided bone regeneration (GBR) on the healing of bone defects were evaluated. Resorbable membranes were placed in experimentally formed cavities in the right posterior tibia of 30 rabbits. Decalcified histological sections were evaluated using optical microscopy at 10, 20, and 30 days after GBR. Osteocondrial bone union, active bone formation and spongiosal bone formation values of the GBR group are higher than the control group. It was found that GBR technique had a positive and accelerating influence in all phases of bone healing. Citation Aslan M, Şimşek G, Dayi E. Guided Bone Regeneration (GBR) on Healing Bone Defects: A Histological Study in Rabbits. J Contemp Dent Pract 2004 May;(5)2:114-123.

Experimental and Clinical Experience with Distraction Osteogenesis

1994 ◽  
Vol 31 (6) ◽  
pp. 473-482 ◽  
Author(s):  
James Aronson
Keyword(s):  
Bone Formation ◽  
Distraction Osteogenesis ◽  
Average Rate ◽  
Latency Period ◽  
Limb Lengthening ◽  
New Bone Formation ◽  
History Of ◽  
Local Host ◽  
Definition Of ◽  
Bone Transportation

G. A. Ilizarov's clinical insights and experimental biology have developed into what is known today as distraction osteogenesis. Initially used for the treatment of fractures and nonunions, his methods have proven successful for limb lengthening and bone transportation. A brief history of the development of distraction osteogenesis, definition of terms, methods, and monitoring techniques are described. The primary mechanism, intramembranous ossification, is direct bone formation in uniform gradients of mineralization from a central fibrous interzone. New bone is produced from the local host surfaces and quickly remodels to the equivalent macro and microstructure. Blood supply at the focus of distraction, dependency on a latency period, different rates, and rhythms of distraction are all tested and discussed. Data from experimental tibial lengthening in more than 125 animals (dogs, rabbits, and rats) show that distraction osteogenesis provides unlimited new bone formation that remodels at daily rates ranging from 200 to 400 μm. In over 100 clinical cases, patients ranging in age from 18 months to 49 years have regenerated bone at an average rate of 213 μm in adults and 385 μm in children. Approximately 10% of these cases required supplemental bone grafts. The article proposes that distraction osteogenesis might be successfully applied in craniofacial surgery.

scholarly journals Connective Tissue Growth Factor From Periosteal Tartrate Acid Phosphatase-Positive Monocytes Direct Skeletal Stem Cell Renewal and Fate During Bone Healing

2021 ◽  
Vol 9 ◽  
Author(s):  
Yun Bai ◽  
Tao Yu ◽  
Jiezhong Deng ◽  
Yusheng Yang ◽  
Jiulin Tan ◽  
...  
Keyword(s):  
Acid Phosphatase ◽  
Bone Regeneration ◽  
Bone Healing ◽  
Callus Formation ◽  
Tissue Growth ◽  
Cell Renewal ◽  
Differentiation Potential ◽  
Non Union ◽  
Stem Cell Renewal ◽  
Fracture Models

The periosteum is critical for bone healing. Studies have shown that the periosteum contains periosteal stem cells (PSCs) with multidirectional differentiation potential and self-renewal ability. PSCs are activated in early fracture healing and are committed to the chondrocyte lineage, which is the basis of callus formation. However, the mechanism by which PSCs are activated and committed to chondrocytes in bone regeneration remains unclear. Here, we show that tartrate acid phosphatase (TRAP)-positive monocytes secrete CTGF to activate PSCs during bone regeneration. The loss function of TRAP-positive monocytes identifies their specific role during bone healing. Then, the secreted CTGF promotes endochondral ossification and activates PSCs in mouse bone fracture models. The secreted CTGF enhances PSC renewal by upregulating the expression of multiple pluripotent genes. CTGF upregulates c-Jun expression through αVβ5 integrin. Then, c-Jun transcription activates the transcription of the pluripotent genes Sox2, Oct4, and Nanog. Simultaneously, CTGF also activates the transcription and phosphorylation of Smad3 through αVβ5 integrin, which is the central gene in chondrogenesis. Our study indicates that TRAP-positive monocyte-derived CTGF promotes bone healing by activating PSCs and directing lineage commitment and that targeting PSCs may be an effective strategy for preventing bone non-union.

scholarly journals Supercritical Carbon Dioxide Decellularized Bone Matrix Seeded with Adipose-Derived Mesenchymal Stem Cells Accelerated Bone Regeneration

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1825
Author(s):  
Keng-Fan Liu ◽  
Rong-Fu Chen ◽  
Yun-Ting Li ◽  
Yun-Nan Lin ◽  
Dar-Jen Hsieh ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Supercritical Carbon Dioxide ◽  
Bone Formation ◽  
Bone Regeneration ◽  
Callus Formation ◽  
Bone Matrix ◽  
New Bone Formation ◽  
Ki 67

Large bone fractures with segmental defects are a vital phase to accelerate bone integration. The present study examined the role of supercritical carbon dioxide (scCO2) decellularized bone matrix (scDBM) seeded with allogeneic adipose-derived mesenchymal stem cells (ADSC) as bio-scaffold for bone regeneration. Bio-scaffold produced by seeding ADSC to scDBM was evaluated by scanning electron microscopy (SEM). Rat segmental femoral defect model was used as a non-union model to investigate the callus formation in vivo. Histological analysis and osteotomy gap closure in the defect area were analyzed at 12 and 24 weeks post-surgery. Immunohistochemical expression of Ki-67, BMP-2 and osteocalcin was evaluated to assess the ability of new bone formation scDBM. ADSC was found to attach firmly to scDBM bioscaffold as evidenced from SEM images in a dose-dependent manner. Callus formation was observed using X-ray bone imaging in the group with scDBM seeded with 2 × 106 and 5 × 106 ASCs group at the same time-periods. H&E staining revealed ASCs accelerated bone formation. IHC staining depicted the expression of Ki-67, BMP-2, and osteocalcin was elevated in scDBM seeded with 5 × 106 ASCs group at 12 weeks after surgery, relative to other experimental groups. To conclude, scDBM is an excellent scaffold that enhanced the attachment and recruitment of mesenchymal stem cells. scDBM seeded with ASCs accelerated new bone formation.

scholarly journals Ibudilast Mitigates Delayed Bone Healing Caused by Lipopolysaccharide by Altering Osteoblast and Osteoclast Activity

2021 ◽  
Vol 22 (3) ◽  
pp. 1169
Author(s):  
Yuhan Chang ◽  
Chih-Chien Hu ◽  
Ying-Yu Wu ◽  
Steve W. N. Ueng ◽  
Chih-Hsiang Chang ◽  
...  
Keyword(s):  
Cell Wall ◽  
Bone Formation ◽  
Cancellous Bone ◽  
Bone Healing ◽  
Bone Bridge ◽  
Cell Wall Components ◽  
Osteoclast Activity ◽  
Wall Components

Bacterial infection in orthopedic surgery is challenging because cell wall components released after bactericidal treatment can alter osteoblast and osteoclast activity and impair fracture stability. However, the precise effects and mechanisms whereby cell wall components impair bone healing are unclear. In this study, we characterized the effects of lipopolysaccharide (LPS) on bone healing and osteoclast and osteoblast activity in vitro and in vivo and evaluated the effects of ibudilast, an antagonist of toll-like receptor 4 (TLR4), on LPS-induced changes. In particular, micro-computed tomography was used to reconstruct femoral morphology and analyze callus bone content in a femoral defect mouse model. In the sham-treated group, significant bone bridge and cancellous bone formation were observed after surgery, however, LPS treatment delayed bone bridge and cancellous bone formation. LPS inhibited osteogenic factor-induced MC3T3-E1 cell differentiation, alkaline phosphatase (ALP) levels, calcium deposition, and osteopontin secretion and increased the activity of osteoclast-associated molecules, including cathepsin K and tartrate-resistant acid phosphatase in vitro. Finally, ibudilast blocked the LPS-induced inhibition of osteoblast activation and activation of osteoclast in vitro and attenuated LPS-induced delayed callus bone formation in vivo. Our results provide a basis for the development of a novel strategy for the treatment of bone infection.

scholarly journals Systemic Administration of G-CSF Accelerates Bone Regeneration and Modulates Mobilization of Progenitor Cells in a Rat Model of Distraction Osteogenesis

2021 ◽  
Vol 22 (7) ◽  
pp. 3505
Author(s):  
Flavy Roseren ◽  
Martine Pithioux ◽  
Stéphane Robert ◽  
Laure Balasse ◽  
Benjamin Guillet ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Progenitor Cells ◽  
Distraction Osteogenesis ◽  
Rat Model ◽  
Late Phase ◽  
Control Group ◽  
Bone Lengthening ◽  
Hematopoietic Stem ◽  
Osteoblast Activity ◽  
Positron Emission

Granulocyte colony-stimulating factor (G-CSF) was shown to promote bone regeneration and mobilization of vascular and osteogenic progenitor cells. In this study, we investigated the effects of a systemic low dose of G-CSF on both bone consolidation and mobilization of hematopoietic stem/progenitor cells (HSPCs), endothelial progenitor cells (EPCs) and mesenchymal stromal cells (MSCs) in a rat model of distraction osteogenesis (DO). Neovascularization and mineralization were longitudinally monitored using positron emission tomography and planar scintigraphy. Histological analysis was performed and the number of circulating HSPCs, EPCs and MSCs was studied by flow cytometry. Contrary to control group, in the early phase of consolidation, a bony bridge with lower osteoclast activity and a trend of an increase in osteoblast activity were observed in the distracted callus in the G-CSF group, whereas, at the late phase of consolidation, a significantly lower neovascularization was observed. While no difference was observed in the number of circulating EPCs between control and G-CSF groups, the number of MSCs was significantly lower at the end of the latency phase and that of HSPCs was significantly higher 4 days after the bone lengthening. Our results indicate that G-CSF accelerates bone regeneration and modulates mobilization of progenitor cells during DO.

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