scholarly journals Management of Hepple Stage V Osteochondral Lesion of Talus with Platelet-Rich Plasma (PRP) Scaffold

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Zhongmin Shi
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Platelet Rich Plasma ◽  
Short Form ◽  
Osteochondral Lesion ◽  
Surgical Techniques ◽  
Cancellous Bone Graft ◽  
Sf 36 ◽  
Osteochondral Lesion Of Talus

Category: Ankle Introduction/Purpose: There is no consensus on treatment or prognosis for Hepple stage V Osteochondral lesion of talus (OLTs), especially for lesion more than 1.5 cm2. This research was to investigate surgical techniques and clinical outcomes of platelet-rich plasma (PRP) scaffold for Hepple stage V OLTs. Methods: 14 patients were treated by cancellous bone graft with PRP gel scaffold between 2013 and 2015 with average age of 38.9 years old and mean set of 23.5 months. Ankle X-ray and MRI were obtained at the final follow-up for evaluation. Functional outcomes were scored by the Visual Analog Scale (VAS) score, American Orthopaedics Foot and Ankle Society (AOFAS) ankle- hindfoot score and Short Form (36) Survey score (SF-36). Range of motion (ROM) of ankle joint and complications were also recorded. Results: 13 patients got the final follow-up with a mean duration of 18 months. MRI showed complete regeneration of subchondral bone and cartilage in all patients. The post-operative VAS, AOFAS ankle-hindfoot score and SF-36 score improved significantly (P<0.0001) without obvious complications. Conclusion: We suggest that for the patients of Hepple stage V OLTs, cancellous bone graft with PRP scaffold may be a safe and effective treatment.

scholarly journals Management of Hepple Stage V Osteochondral Lesion of the Talus with a Platelet-Rich Plasma Scaffold

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Wenqi Gu ◽  
Tanzhu Li ◽  
Zhongmin Shi ◽  
Guohua Mei ◽  
Jianfeng Xue ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Platelet Rich Plasma ◽  
Short Form ◽  
Osteochondral Lesion ◽  
Osteochondral Lesions ◽  
Cancellous Bone Graft ◽  
Sf 36 ◽  
American Orthopaedic

There has been no consensus on the treatment or prognosis of Hepple stage V osteochondral lesions of the talus (OLTs), especially for lesions greater than 1.5 cm2in size. The objective of this study was to investigate the clinical outcomes achieved upon application of a platelet-rich plasma (PRP) scaffold with a cancellous bone autograft for Hepple stage V OLTs. Fourteen patients (mean age, 39 years) were treated with a cancellous bone graft and a PRP scaffold between 2013 and 2015. The mean time to surgical treatment was 23.5 months. Ankle X-ray and magnetic resonance imaging were performed at the final follow-up. Functional outcomes were evaluated according to the Visual Analog Scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Short Form 36 (SF-36) score. The range of motion (ROM) of the ankle joint and complications also were recorded. Thirteen patients completed the full follow-up, with a mean follow-up duration of 18 months. MRI demonstrated the complete regeneration of subchondral bone and cartilage in all patients. The postoperative VAS, AOFAS ankle and hindfoot, and SF-36 scores were improved significantly (allP<0.001) without obvious complications. We suggest that, for the Hepple stage V OLTs, management with cancellous bone graft and PRP scaffold may be a safe and effective treatment.

scholarly journals Management of Hepple Stage V Osteochondral Lesion of the Talus with a Platelet-Rich Plasma Scaffold

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0043
Author(s):  
Zhongmin Shi
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Platelet Rich Plasma ◽  
Osteochondral Lesion ◽  
Osteochondral Lesions ◽  
Cancellous Bone Graft ◽  
Sf 36 ◽  
American Orthopaedic ◽  
Bone Autograft

Category: Ankle Introduction/Purpose: There has been no consensus on the treatment or prognosis of Hepple stage V osteochondral lesions of the talus (OLTs), especially for lesions greater than 1.5 cm2 in size. The objective of this study was to investigate the clinical outcomes achieved upon application of a platelet-rich plasma (PRP) scaffold with a cancellous bone autograft for Hepple stage V OLTs. Methods: Fourteen patients (mean age, 39 years) were treated with a cancellous bone graft and a PRP scaffold between 2013 and 2015. The mean time to surgical treatment was 23.5 months. Ankle X-ray and magnetic resonance imaging were performed at the final follow-up. Functional outcomes were evaluated according to the Visual Analog Scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Short Form36 (SF-36) score.The range of motion (ROM) of the ankle joint and complications also were recorded. Results: Thirteen patients completed the full follow-up, with a mean follow-up duration of 18 months. MRI demonstrated the complete regeneration of subchondral bone and cartilage in all patients.The postoperative VAS, AOFAS ankle and hindfoot, and SF-36 scores were improved significantly (all 𝑃 < 0.001) without obvious complications. Conclusion: We suggest that, for the Hepple stage V OLTs, management with cancellous bone graft and PRP scaffold may be a safe and effective treatment.

scholarly journals The treatment of the atrophic clavicular nonunion by double-plate fixation with autogenous cancellous bone graft: a prospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jun Zhang ◽  
Peng Yin ◽  
Bo Han ◽  
Jianmin Zhao ◽  
Bo Yin
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Short Form ◽  
Plate Fixation ◽  
Statistical Significance ◽  
Bodily Pain ◽  
Clinical Results ◽  
Outcome Questionnaire ◽  
Cancellous Bone Graft ◽  
Sf 36

Abstract Background The objective of this study is to assess prospectively the effectiveness of double-plate fixation combined with autogenous cancellous bone graft in the treatment for the atrophic clavicular nonunion. Methods Between February 2013 and November 2017, a total of 12 patients with atrophic clavicular nonunion (mean age, 40.4 ± 9.0 years, range, 27–60 years) were treated by double-plate fixation with autogenous cancellous bone graft in our institute. The Constant Score System was used to evaluate the preoperative and final outcomes. The Short Form-36 (SF-36) outcome questionnaire was used to assess the final clinical results. Results All patients were followed-up, with the average follow-up of 34.7 ± 6.7 months (range, 24–48 months). The healing rate was 100% in our study. The mean time of bony union was 9 weeks (range, 8–10 weeks). One patient had a postoperative superficial infection, and the patient was cured by oral antibiotics and wound dressing. No implant-related complications (plate-screw loosening or breakage) were observed postoperatively. No vascular injury, neural impairment, or thoracic outlet syndrome was discovered preoperatively or postoperatively. There is a statistical significance between the preoperative and the postoperative constant scores (P < 0.05). All the patients were satisfied with their final clinical results by SF-36 outcome questionnaire. Average scores of the physical function and bodily pain components of the SF-36 were 94.2 ± 7.3 and 92.5 ± 5.8, respectively. Conclusion Our results presented that double-plate fixation with autogenous cancellous bone graft is an effective treatment for atrophic clavicular nonunion, especially for those with a significant bone defect.

Addition to the Toolbox of Surgical Techniques for Palatal Fistula Repair

2021 ◽  
pp. 105566562110037
Author(s):  
Catherine de Blacam ◽  
David Orr
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Hard Palate ◽  
Surgical Techniques ◽  
Cancellous Bone Graft ◽  
Fistula Repair ◽  
Palatal Fistula

In response to the article by Rothermel and colleagues, the authors suggest the use of cancellous bone graft for repair of fistulae of the hard palate as an addition to the proposed toolbox.

Outcomes of Evans Versus Hintermann Calcaneal Lengthening Osteotomy for Flexible Flatfoot

2019 ◽  
Vol 40 (6) ◽  
pp. 661-671 ◽  
Author(s):  
Sarah Ettinger ◽  
Tim Mattinger ◽  
Christina Stukenborg-Colsman ◽  
Daiwei Yao ◽  
Leif Claassen ◽  
...  
Keyword(s):  
Rating Scale ◽  
Short Form ◽  
Surgical Techniques ◽  
Degenerative Changes ◽  
Ucla Activity Score ◽  
Metatarsal Angle ◽  
Sf 36 ◽  
Flexible Flatfoot ◽  
Significant Correction

Background: Evans (E) and Hintermann (H) lateral lengthening calcaneal osteotomies (LLCOTs) are commonly used to correct flexible flatfoot deformities. Both methods are well accepted and produce good clinical results. The aim of this study was to compare the postoperative outcomes of both osteotomies. Methods: We retrospectively examined 53 patients with flatfoot deformities, who received surgery between October 2008 and March 2014. Seventeen E-LLCOT and 36 H-LLCOT procedures were performed during this time period, with a mean follow-up of 67.7 ± 20.6 and 40 ± 12.9 months, respectively. Data were collected using clinical and radiological examination, as well as clinical scores (Foot and Ankle Outcome Score [FAOS], University of California at Los Angeles [UCLA] activity score, numerical rating scale [NRS], and the Short-Form 36-item Health Survey [SF-36]) during regular follow-up. Results: For both groups of patients, the FAOS score, pain-NRS, and SF-36 improved significantly following surgery ( P < .05). The talus–second metatarsal angle, talonavicular coverage, and naviculocuneiform overlap showed significant correction ( P < .05). Postoperatively, radiographic degenerative changes were detected in the calcaneocuboid (CC) and subtalar joint in both groups of patients: 41% and 18% after E-LLCOT compared with 25% and 14% after H-LLCOT, although these changes did not have any clinical relevance ( P < .05). No secondary arthrodesis was necessary. There were no significant differences in the clinical or radiological outcome parameters when compared between the 2 groups. Conclusion: Both surgical techniques resulted in a significant improvement of clinical outcome scores and led to good radiological correction of flatfoot deformities. It appears that the CC joint develops less degenerative changes following the H-LLCOT procedure. Level of Evidence: Level III, comparative series.

scholarly journals Novel, vacuum-assisted method for harvesting autogenous cancellous bone graft and bone marrow from the proximal tibial metaphysis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0014
Author(s):  
Paul Bagi ◽  
Raymond Walls
Keyword(s):  
Bone Marrow ◽  
Bone Graft ◽  
Cancellous Bone ◽  
Proximal Tibia ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Cancellous Bone Graft ◽  
Incision Length ◽  
Donor Site Pain

Category: Other Introduction/Purpose: Autogenous cancellous bone graft and bone marrow aspirate are commonly used in lower extremity fusion procedures. Autologous graft is considered the gold standard as it is osteogenic, osteoinductive, and osteoconductive, and is without the potential risks of graft-associated infection and immunologic reaction. Disadvantages include graft harvest time and donor site morbidity due to the surgical incision, approach and bone corticotomy. This study evaluated the safety and efficacy of a novel vacuum-assisted bone graft harvesting device which was able to obtain both cancellous bone and bone marrow for insertion into the arthrodesis sites of patients undergoing complex primary and revision lower extremity fusion procedures. Methods: Between March and November 2017, 9 patients had a foot and/or ankle complex primary or revision arthrodesis performed, with autogenous cancellous graft and bone marrow harvested from the ipsilateral proximal tibia. All patients were 18 years or older with no prior history of knee pain, injury, or surgery at the proximal tibia. Following a circular corticotomy, cancellous bone was harvested using a novel suction-powered, hand-driven bone curettage system (Avitus Orthopaedics, Farmington, CT). The donor site was backfilled with bone graft substitute. Incision length was recorded as well as surgical time from donor site incision to completion of graft acquisition. The volume of cancellous graft and bone marrow were separately recorded. All patients were non-weight bearing on the involved extremity for a minimum of 6 weeks post-operatively and all were evaluated at 2 and 6 weeks post-operatively for donor site pain and associated complications. Results: There were five male and four female patients with an average age of 51 years and 8 months. Procedures included six complex primary fusions and three revision subtalar or tibio-talar-calcaneal fusions for nonunion. Mean incision length was 2 cm (range 1.80-2.75 cm). Mean volume of obtained graft material included 25 cm3 of cancellous bone (range 9-30 cm3) and 21 cm3 bone marrow aspirate (range 10-40 cm3). Mean procedure time was 5 mins (range 4-8 mins), and average blood loss was less than 1 mL. Two patients had mild pain at 2 week follow-up; however, no patients reported donor site pain at 6 week follow-up. There were no major or minor complications including fracture, infection, hematoma formation, sensory changes, or wound healing issues. Conclusion: The use of an innovative, vacuum-assisted bone harvesting device allows large volumes of autogenous cancellous bone graft and marrow to be rapidly and readily obtained from the ipsilateral proximal tibia with minimal donor site morbidity.

The Repair and Healing of Two Traumatic Ilial Body Fractures Adjacent to Cemented Total Hip Acetabular Components

1992 ◽  
Vol 05 (02) ◽  
pp. 85-89
Author(s):  
P. K. Shires ◽  
T. L. Dew
Keyword(s):  
Internal Fixation ◽  
Cancellous Bone ◽  
Surgical Techniques ◽  
Autogenous Bone ◽  
Cancellous Bone Graft ◽  
Standard Methods ◽  
Intravenous Antibiotics ◽  
Prophylactic Use ◽  
Acetabular Components ◽  
Autogenous Bone Grafts

SummaryThis report has documented the repair and healing of two ilial fractures in dogs which were compounded by the presence of a cemented acetabular prosthesis. While specific recommendations can not be made from such a small number of cases, the information presented herein suggests that such fractures will heal without complication if aseptic surgical techniques and standard methods of internal fixation are employed. The authors strongly recommend the prophylactic use of intravenous antibiotics and the placement of cancellous bone graft when the repair of such fractures is attempted.Two traumatic ilial fractures involving the cement/bone interface of acetabular prostheses were repaired using lag screws, cerclage wires, and autogenous bone grafts. The fractures healed and ambulatory function was regained.

Arthrodesis of the Distal Two Tarsal Joints in the Horse Using Perforated Stainless Steel Cylinders and Cancellous Bone Graft

1991 ◽  
Vol 4 (01) ◽  
pp. 21-27 ◽  
Author(s):  
R. M. Archer ◽  
R. K. Schneider
Keyword(s):  
Stainless Steel ◽  
Bone Graft ◽  
Cancellous Bone ◽  
Cancellous Bone Graft ◽  
The Third ◽  
Partial Fusion

SummaryTwo perforated stainless steel cylinders and autogenous cancellous bone were implanted into each of the distal intertarsal and tarsometatarsal joints of seven horses. In two control horses holes were drilled into each joint and autogenous cancellous bone was implanted without stainless steel cylinders. Horses which had cylinders implanted in the distal tarsal joints exhibited less lameness and were more comfortable following surgery than were the control horses. Fracture of the third tarsal, central tarsal, or third metatarsal occurred in five of the seven horses implanted with stainless steel cylinders within 45 days of surgery. Two implanted horses and two control horses were observed for five months after surgery. Partial fusion of the distal tarsal joints occurred in all four horses. Control horses were more lame than the implanted horses and developed a large bony exostosis over the medial distal tarsus.

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