Management of Distal Tibial Metaphyseal Bone Defects With an Intramedullary Nitinol Scaffold: A Novel Technique

2016 ◽  
Vol 10 (4) ◽  
pp. 368-371 ◽  
Author(s):  
Samuel E. Ford ◽  
J. Kent Ellington
Keyword(s):  
Mechanical Stability ◽  
Demineralized Bone Matrix ◽  
Articular Surface ◽  
Plate Fixation ◽  
Bone Matrix ◽  
Bone Allograft ◽  
Nitinol Alloy ◽  
Metaphyseal Bone ◽  
Bone Autograft ◽  
Demineralized Bone

Difficult problems that are faced when reconstructing severe pilon fractures include filling metaphyseal defects and supporting an impacted, multifragmented articular surface. Supplements to plate fixation currently available in a surgeon’s armamentarium include cancellous bone autograft, structural bone allograft, demineralized bone matrix, and calcium-based cements. Cancellous autograft possesses limited inherent mechanical stability and is associated with graft site morbidity. Structural allografts incorporate inconsistently and are plagued by late resorption. Demineralized bone matrix also lacks inherent structural stability. Calcium phosphate cements are not rigidly fixed to bone unless fixation is applied from cortical bone or through a plate, which must be taken into consideration when planning fixation. The Conventus DRS (Conventus Orthopaedics, Maple Grove, MN) implant is an expandable nitinol scaffold that takes advantage of the elasticity and shape memory of nitinol alloy. Once deployed and locked, it serves as a stable intramedullary base for fragment-specific periarticular fracture fixation, even in the face of metaphyseal bone loss. Two cases of successful implant use are presented. In both cases, the implant is used to fill a metaphyseal void and provide stable articular support to the distal tibial plafond. Levels of Evidence: Therapeutic Level V: Case Report, Expert Opinion

scholarly journals Fabrication of Demineralized Bone Matrix/Polycaprolactone Composites Using Large Area Projection Sintering (LAPS)

2019 ◽  
Vol 3 (2) ◽  
pp. 30 ◽  
Author(s):  
Mohsen Ziaee ◽  
Rebecca Hershman ◽  
Ayesha Mahmood ◽  
Nathan B. Crane
Keyword(s):  
Additive Manufacturing ◽  
Cancellous Bone ◽  
Demineralized Bone Matrix ◽  
Bone Matrix ◽  
Bone Allograft ◽  
Layer By Layer ◽  
Large Area ◽  
Manufacturing Method ◽  
Synthetic Scaffolds ◽  
Demineralized Bone

Cadaveric decellularized bone tissue is utilized as an allograft in many musculoskeletal surgical procedures. Typically, the allograft acts as a scaffold to guide tissue regeneration with superior biocompatibility relative to synthetic scaffolds. Traditionally these scaffolds are machined into the required dimensions and shapes. However, the geometrical simplicity and, in some cases, limited dimensions of the donated tissue restrict the use of allograft scaffolds. This could be overcome by additive manufacturing using granulated bone that is both decellularized and demineralized. In this study, the large area projection sintering (LAPS) method is evaluated as a fabrication method to build porous structures composed of granulated cortical bone bound by polycaprolactone (PCL). This additive manufacturing method utilizes visible light to selectively cure the deposited material layer-by-layer to create 3D geometry. First, the spreading behavior of the composite mixtures is evaluated and the conditions to attain improved powder bed density to fabricate the test specimens are determined. The tensile strength of the LAPS fabricated samples in both dry and hydrated states are determined and compared to the demineralized cancellous bone allograft and the heat treated demineralized-bone/PCL mixture in mold. The results indicated that the projection sintered composites of 45–55 wt %. Demineralized bone matrix (DBM) particulates produced strength comparable to processed and demineralized cancellous bone.

scholarly journals First Human Leucocyte Antigen (HLA) Response and Safety Evaluation of Fibrous Demineralized Bone Matrix in a Critical Size Femoral Defect Model of the Sprague-Dawley Rat

Materials ◽  
2020 ◽  
Vol 13 (14) ◽  
pp. 3120
Author(s):  
Nicolas Söhling ◽  
Maximilian Leiblein ◽  
Alexander Schaible ◽  
Maren Janko ◽  
Joachim Schwäble ◽  
...  
Keyword(s):  
Bone Healing ◽  
Critical Size ◽  
Demineralized Bone Matrix ◽  
High Surface ◽  
Bone Matrix ◽  
Volume Ratio ◽  
Bone Allograft ◽  
Control Group ◽  
Sprague Dawley ◽  
Demineralized Bone

Treatment of large bone defects is one of the great challenges in contemporary orthopedic and traumatic surgery. Grafts are necessary to support bone healing. A well-established allograft is demineralized bone matrix (DBM) prepared from donated human bone tissue. In this study, a fibrous demineralized bone matrix (f-DBM) with a high surface-to-volume ratio has been analyzed for toxicity and immunogenicity. f-DBM was transplanted to a 5-mm, plate-stabilized, femoral critical-size-bone-defect in Sprague-Dawley (SD)-rats. Healthy animals were used as controls. After two months histology, hematological analyses, immunogenicity as well as serum biochemistry were performed. Evaluation of free radical release and hematological and biochemical analyses showed no significant differences between the control group and recipients of f-DBM. Histologically, there was no evidence of damage to liver and kidney and good bone healing was observed in the f-DBM group. Reactivity against human HLA class I and class II antigens was detected with mostly low fluorescence values both in the serum of untreated and treated animals, reflecting rather a background reaction. Taken together, these results provide evidence for no systemic toxicity and the first proof of no basic immunogenic reaction to bone allograft and no sensitization of the recipient.

Treatment of Humeral Nonunions With Cancellous Allograft, Demineralized Bone Matrix, and Plate Fixation

2004 ◽  
Author(s):  
Nathan L. Taylor ◽  
Frank J. Raia ◽  
Benton E. Heyworth ◽  
Melvin P. Rosenwasser
Keyword(s):  
Demineralized Bone Matrix ◽  
Plate Fixation ◽  
Bone Matrix ◽  
Cancellous Allograft ◽  
Demineralized Bone

Treatment of Humeral Nonunions with Allograft, Demineralized Bone Matrix, and Plate Fixation

2005 ◽  
Vol 13 (2) ◽  
pp. 105-112 ◽  
Author(s):  
N. L. Taylor ◽  
F. J. Raia ◽  
S. A. Crow ◽  
B. E. Heyworth ◽  
M. P. Rosenwasser
Keyword(s):  
Demineralized Bone Matrix ◽  
Plate Fixation ◽  
Bone Matrix ◽  
Demineralized Bone

scholarly journals Osteoformation potential of an allogenic partially demineralized bone matrix in critical-size defects in the rat calvarium

2021 ◽  
pp. 112207
Author(s):  
Ahmad Moustapha Diallo ◽  
Solène Rota ◽  
Michel Boissière ◽  
Raphaël Bardonnet ◽  
Emmanuel Pauthe ◽  
...  
Keyword(s):  
Critical Size ◽  
Demineralized Bone Matrix ◽  
Bone Matrix ◽  
Critical Size Defects ◽  
Demineralized Bone

Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate

2021 ◽  
pp. 105566562110251
Author(s):  
Vijay Kumar ◽  
Vidya Rattan ◽  
Sachin Rai ◽  
Satinder Pal Singh ◽  
Jai Kumar Mahajan
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Demineralized Bone Matrix ◽  
Bone Matrix ◽  
Volumetric Analysis ◽  
Group I ◽  
Alveolar Bone Grafting ◽  
Group Ii ◽  
Demineralized Bone

Objective: Comparison between bovine-derived demineralized bone matrix (DMBM) and iliac crest graft over long term for secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and palate (UCLP) in terms of radiological and clinical outcomes. Design: Prospective, randomized, parallel groups, double-blind, controlled trial. Setting: Unit of Oral and Maxillofacial Surgery, Oral Health Science Centre, Postgraduate Institute of Medical Education & Research, Chandigarh. Participants: Twenty patients with UCLP. Interventions: Patients were allocated into group I (Iliac crest bone graft) and group II (DMBM) for SABG. Outcomes were assessed at 2 weeks, 6 months, and then after mean follow-up period of 63 months. Outcomes Measures: Volumetric analysis of the grafted bone in the alveolar cleft site was done through cone beam computed tomography using Cavalieri principle and modified assessment tool. Clinical assessment was performed in terms of pain, swelling, duration of hospital stay, cost of surgery, alar base symmetry, and donor site morbidity associated with iliac crest harvesting. Results: Volumetric analysis through Cavalieri principle revealed comparable bone uptake at follow-up of 6 months between group I (70%) and group II (69%). Modified assessment tool showed no significant difference between horizontal and vertical bone scores over short- and long-term follow-up. In group II, there was higher cost of surgery, but no donor site morbidity unlike group I. Conclusions: Demineralized bone matrix proved analogous to iliac crest bone graft as per volumetric analysis over shorter period. However, although statistically insignificant, net bone volume achieved was lower than the iliac crest graft at longer follow-up.

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