scholarly journals Surgical treatment of congenital kyphosis caused by multiple vertebral malformations

2018 ◽  
Vol 9 (1) ◽  
pp. 112-117
Author(s):  
Artem V. Kosulin ◽  
Dmitriy V. Elyakin ◽  
Ekaterina I. Okhlopkova ◽  
Olesya G. Pridatko ◽  
Yuliya V. Klybanskaya ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Graft ◽  
Bone Grafting ◽  
Bone Growth ◽  
Bone Matrix ◽  
Anterior Fusion ◽  
Fusion Procedure ◽  
Lumbar Vertebral Body ◽  
Congenital Kyphosis

Clinical case of successful operative treatment of congenital kyphosis is reported. Deformation was caused by multiple lower thoracic and lumbar vertebral body abnormalities. Associated spinal abnormalities were outspread absence of laminae, hydromyelia, and diastematomyelia. Preoperative computed tomography analysis revealed absence of instrumentable bony structures within malformed lower thoracic and lumbar spine. As instrumented fusion procedure was technically impossible anterior fusion without internal fixation was performed. Autogenous rib was used as a bone graft. Bone graft was extended with calcium sulphas (osteoconductive media), demineralized allograft bone matrix (osteoinductive media), and patient’s bone marrow aspirate (osteogenic media). Resulting combined bone grafting material possessed osteoconductivity, osteoinductivity, ostegenicity, and mechanical strength. At 18 months post operation follow-up computed tomography revealed solid bony fusion formation. Some neurologic improvement also was noticed. Congenital kyphosis caused by multiple outspread vertebral malformations remains insufficiently studied clinical problem. Affected children need individual multidisciplinary surgical approach, meticulous surgical planning, and regular neurological, imaging, and orthopedic follow-up until the end of bone growth. Absence of instrumentable bony structures in desired spinal arthrodesis does not preclude successful fusion. Combination of several heterogenous bone grafting materials with different properties provides fusion in difficult clinical setting.

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.

RADIOLUNATE FUSION WITH DISTRACTION USING CORTICOCANCELLOUS BONE GRAFT FOR MINIMIZING DECREASE OF WRIST MOTION IN RHEUMATOID WRISTS

Hand Surgery ◽  
2009 ◽  
Vol 14 (01) ◽  
pp. 15-21 ◽  
Author(s):  
Tatsuya Masuko ◽  
Norimasa Iwasaki ◽  
Jun-ichi Ishikawa ◽  
Hiroyuki Kato ◽  
Akio Minami
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Graft ◽  
Range Of Motion ◽  
Clinical Evaluation ◽  
Radiological Assessment ◽  
Wrist Flexion ◽  
Wrist Motion ◽  
Fusion Procedure ◽  
Radiocarpal Joint

Radiolunate fusion is a limited carpal fusion procedure used for patients with rheumatoid arthritis. However, this procedure inevitably causes decreases in range of motion, especially wrist flexion. Linscheid and Dobyns described the possibility of minimizing the decrease in motion at the radiocarpal joint by slight distraction of the joint. We hypothesized for our modified procedure that a corticocancellous bone graft was inserted between the radius and the lunate with a small amount of over-correction could provide slight distraction of radioscaphoid joint and protect the joint from decreased range of motion after arthrodesis. Twelve wrists in ten patients with rheumatoid arthritis underwent radiolunate fusion. Mean age at operation was 53 years old and mean follow-up period was 5.7 years. Clinical evaluation and radiological assessment showed that decrease in range of motion was minimized compared with other procedures. Because our modified procedure can minimize decrease in motion, it is recommended.

scholarly journals The Fate of Bone Graft for Periprosthetic Osteolysis in Total Ankle Arthroplasty

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000 ◽  
Author(s):  
Yoo Jung Park ◽  
Dong-Woo Shim ◽  
Yeokgu Hwang ◽  
Jin Woo Lee
Keyword(s):  
Clinical Outcome ◽  
Bone Graft ◽  
Bone Grafting ◽  
Distal Tibia ◽  
Total Ankle Arthroplasty ◽  
Implant Failure ◽  
Periprosthetic Osteolysis ◽  
Aofas Score ◽  
Ankle Arthroplasty

Category: Ankle Arthritis Introduction/Purpose: Periprosthetic osteolysis in total ankle arthroplasty (TAA) is a substantial problem. It may cause implant failure and has potential to affect long-term implant survival. To prevent major revisional arthroplasty, it is important to make an early diagnosis of osteolysis and decide an appropriate timing of surgical intervention such as bone graft. We report our experience of bone graft for osteolysis after TAA associated with clinical and radiologic outcome. Methods: Between May 2004 and Oct. 2013, 238 primary TAA were performed on 219 patients. We excluded 37 ankles with follow-up less than 24 months; thus, 201 ankles in 185 patients with mean follow-up of 61.9 (range, 24-130) months were included in the study. Nineteen patients were treated with a total of 21 bone graft procedures for periprosthetic osteolysis after TAA. Of these patients, 12 (57.1%) were males with mean follow-up length after bone graft 35.0 months. Location of osteolysis, bone grafting method and clinical outcome parameters using visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score were recorded. Results: Radiographs revealed total of 62 osteolysis lesions in 19 patients; 35 (56.5%) distal tibial lesions, 23 (37.0%) talar lesions. Autogenous iliac bone graft was used in 18 procedures (85.7%). The mean scores (and standard deviation) improved for the VAS from 4.8 ± 1.23 points before bone graft to 3.0 ± 0.94 points at the last follow-up (p<0.05); and for the AOFAS score from 76.8 ± 5.9 before bone graft to 84.3 ± 4.5 at the last follow-up (p<0.05). After 21 bone graft procedures, 6 demonstrated detection of newly developed osteolysis. One patient needed a repeat bone graft procedure with cementation after the primary bone grafting due to large cyst on distal tibia. There was no implant failure or major revisions after the bone graft. Conclusion: Bone graft for periprosthetic osteolysis may improve patient’s clinical outcome and give support to the structures surrounding the implant. Bone grafting in optimal timing may also improve implant survivorship. However, further study is needed for the etiology of newly developed painless osteolysis even after the bone graft.

The Biomechanical Effect of Bone Grafting and Bone Graft Remodeling in Patients With Anterior Shoulder Instability

2020 ◽  
Vol 48 (8) ◽  
pp. 1857-1864 ◽  
Author(s):  
Bastian Sigrist ◽  
Stephen Ferguson ◽  
Elisabeth Boehm ◽  
Christian Jung ◽  
Markus Scheibel ◽  
...  
Keyword(s):  
Bone Graft ◽  
Shoulder Instability ◽  
Bone Grafting ◽  
Patient Specific ◽  
Anterior Shoulder Instability ◽  
Cavity Depth ◽  
Long Term Follow Up ◽  
Biomechanical Effect

Background: Individual constitutional differences in glenoid shape and bone remodeling require a patient-specific and longitudinal approach to evaluate the biomechanical effects of glenoid bone grafting in patients with anterior shoulder instability. Purpose: To quantify the longitudinal, in vivo, biomechanical effects of bone grafting, bone graft remodeling, and glenoid shape in patients with anterior shoulder instability by means of patient-specific finite element models. Study Design: Descriptive laboratory study. Methods: In total, 25 shoulders of 24 patients with anterior shoulder instability and anterior glenoid bone loss underwent an arthroscopic iliac crest bone graft transfer (ICBGT) procedure with either autologous or allogenic bone. Patient-specific finite element simulations based on preoperative, postoperative, and follow-up computed tomography scans were used to quantify the bone-mediated stability ratio (SR) and the distance to dislocation. Additionally, the relationship between glenoid morphological parameters and the SR was assessed. Results: The ICBGT procedure significantly increased the SR and distance to dislocation in the 2-, 3-, and 4-o’clock directions immediately after the surgical intervention ( P < .01) in both the autograft and the allograft groups. Although the SR and distance to dislocation decreased subsequently, autografts showed long-term effects on SR and dislocation distance in the 3-o’clock direction ( P < .01) and on SR in the 4-o’clock direction ( P < .01). Allografts showed no significant effect on SR and dislocation distance in long-term follow-up ( P > .05). Overall, glenoid retroversion as well as cavity depth predicted stability in all 4 dislocation directions, with glenoid cavity depth showing the highest correlation coefficients ( R = 0.71, 0.8, 0.73, and 0.7 for 2-, 3-, 4-, and 5-o’clock, respectively). Conclusion: The autologous ICBGT procedure biomechanically improved anterior shoulder stability in long-term follow-up, whereas the use of allografts did not show any bone-mediated biomechanical effect at follow-up due to resorption. Furthermore, in addition to measurements of defect extent, the glenoid depth and version seem to be useful parameters to determine the biomechanical effect and need for glenoid bone grafting in patients with shoulder instability. Clinical Relevance: This study proposes the use of autologous bone grafts for a successful long-term stabilization effect. Additionally, this study proposes additional glenoid morphological measures to predict shoulder stability.

Current Updates on Bone Grafting Biomaterials and Recombinant Human Growth Factors Implanted Biotherapy for Spinal Fusion: A Review of Human Clinical Studies

2018 ◽  
Vol 16 (2) ◽  
pp. 94-110 ◽  
Author(s):  
Guanbao Li ◽  
Pinquan Li ◽  
Qiuan Chen ◽  
Hnin Ei Thu ◽  
Zahid Hussain
Keyword(s):  
Bone Graft ◽  
Spinal Fusion ◽  
Bone Grafting ◽  
Demineralized Bone Matrix ◽  
Donor Site ◽  
Bone Matrix ◽  
Great Promise ◽  
Level Of Evidence ◽  
Bone Fusion ◽  
Bone Graft Substitutes

Background:Owing to their great promise in the spinal surgeries, bone graft substitutes have been widely investigated for their safety and clinical potential. By the current advances in the spinal surgery, an understanding of the precise biological mechanism of each bone graft substitute is mandatory for upholding the induction of solid spinal fusion.Objective:The aim of the present review is to critically discuss various surgical implications and level of evidence of most commonly employed bone graft substitutes for spinal fusion.Method:Data was collected via electronic search using “PubMed”, “SciFinder”, “ScienceDirect”, “Google Scholar”, “Web of Science” and a library search for articles published in peer-reviewed journals, conferences, and e-books.Results:Despite having exceptional inherent osteogenic, osteoinductive, and osteoconductive features, clinical acceptability of autografts (patient’s own bone) is limited due to several perioperative and postoperative complications i.e., donor-site morbidities and limited graft supply. Alternatively, allografts (bone harvested from cadaver) have shown great promise in achieving acceptable bone fusion rate while alleviating the donor-site morbidities associated with implantation of autografts. As an adjuvant to allograft, demineralized bone matrix (DBM) has shown remarkable efficacy of bone fusion, when employed as graft extender or graft enhancer. Recent advances in recombinant technologies have made it possible to implant growth and differentiation factors (bone morphogenetic proteins) for spinal fusion.Selection of a particular bone grafting biotherapy can be rationalized based on the level of spine fusion, clinical experience and preference of orthopaedic surgeon, and prevalence of donor-site morbidities.

Scaphoid Nonunion: Treatment with a Pedicled Vascularized Bone Graft Based on the 1,2 Intercompartmental Supraretinacular Branch of the Radial Artery

2002 ◽  
Vol 27 (5) ◽  
pp. 413-416 ◽  
Author(s):  
R. G. STRAW ◽  
T. R. C. DAVIS ◽  
J. J. DIAS
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Scaphoid Fracture ◽  
Vascularized Bone Graft ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Union Rate ◽  
Fracture Nonunions ◽  
Vascularized Bone

Pedicled vascularized bone grafts (Zaidemberg’s technique) were used to treat 22 established scaphoid fracture nonunions, 16 of which were found to have avascular proximal poles at surgery. After a follow-up of 1–3 years, only six (27%) of the 22 fracture nonunions had united. Only two of the 16 nonunions with avascular proximal poles united, compared with four of the six nonunions with vascular proximal poles. We conclude that this technique of pedicled vascularized bone grafting may not improve the union rate for scaphoid fracture nonunions with avascular proximal pole fragments.

scholarly journals Role of bone marrow infiltration in management of delayed union of long bones fracture

2020 ◽  
Vol 6 (5) ◽  
pp. 968
Author(s):  
Sanjay Kumar Meena ◽  
Naveen Goyal ◽  
Devendra Tetarwal ◽  
Bharat Sharma
Keyword(s):  
Bone Marrow ◽  
Minimally Invasive ◽  
Bone Graft ◽  
Bone Grafting ◽  
Delayed Union ◽  
Fracture Site ◽  
Bone Marrow Infiltration ◽  
Long Bones ◽  
Safe Procedure

<p class="abstract"><strong>Background:</strong> Usually delayed union of fracture long bones are managed by putting a bone graft at fracture site , but bone grafting have donor site complication like scar, infection ,hernia ,gait disturbance , cosmetic problem, as well as recipient site complication like soft tissue trauma , de-vascularisation of fracture fragment. Bone marrow infiltration is a minimally invasive method done percutaneously. It is easy, safe procedure with no associated complications that may occur in bone grafting.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in the Department of orthopedics, Government Medical College, Kota from June 2011 to November 2013 to evaluate the efficacy of percutaneous bone marrow infiltration in cases of delayed union of long bones. 27 patients included in study with 28 bones, as one patient has given bone marrow injection in two bones (tibia &amp; femur), so the cases included in study counted as 28 cases. The mean age of this study was 38.28 years, ranging from 18 years to 75 years.  All cases were follow up after 4 to 6 weeks and thereafter one month interval. Final follow up was taken when fracture site shows clinical and radiological sign of union.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 23 united cases 19 had excellent results and 04 cases had good results. The five cases which fail to unite were taken as poor results.</p><p class="abstract"><strong>Conclusions:</strong> Bone marrow infiltration is a minimally invasive, safe bone graft substitute for delayed union of long bones and have less complications.</p>

scholarly journals Tomographic evaluation of atrophic maxilla rehabilitated with autogenous and xenogeneic block grafts

2017 ◽  
Vol 4 (4) ◽  
pp. 112
Author(s):  
Julio Cesar Lara Sawada ◽  
Luis Eduardo Marques Padovan ◽  
Bernardo Mattos Da Silveira ◽  
Fernando Gianzanti Peres ◽  
Marcela Claudino
Keyword(s):  
Computed Tomography ◽  
Bone Graft ◽  
Dimensional Stability ◽  
Experimental Studies ◽  
Cone Beam ◽  
Autogenous Bone ◽  
Linear Measurements ◽  
Atrophic Maxilla ◽  
The Mean

Aim: The aim of this study was to evaluate the dimensional stability of autogenous and xenogenous bone blocks after grafting procedures using cone beam computed tomography Material and Methods: Autogenous (n=6) and xenogeneic (n=7) bone graft blocks were evaluated after 8 (T1) and 16 (T2) months. A dimensional analysis was carried using linear measurements of the height and thickness of the blocks in the tomographic exam.Results: For the autogenous bone blocks, there was a reduction in height of 1.42mm (10.06%) and a reduction in mean thickness of 1.24mm (29.60%). For the xenogeneic bone blocks, the mean height reduction was 1.38mm (10.02%) and the mean thickness reduction was 0.97mm (18.81%) with remodeling (26.62%). However, there were no significant differences between the xenogeneic and autogenous bone blocks (p=0.366).Conclusions: The results showed no differences in the dimensional stability of autogenous or xenogenous bone graft blocks. However, clinical and experimental studies with longer follow up periods are needed to elucidate the mechanisms involved in the remodeling process of bone grafts.

Clinical outcomes and fusion rates following anterior lumbar interbody fusion with bone graft substitute i-FACTOR, an anorganic bone matrix/P-15 composite

2014 ◽  
Vol 21 (6) ◽  
pp. 867-876 ◽  
Author(s):  
Ralph J. Mobbs ◽  
Monish Maharaj ◽  
Prashanth J. Rao
Keyword(s):  
Bone Graft ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Short Form ◽  
Bone Matrix ◽  
Bone Graft Substitute ◽  
Short Form Health Survey ◽  
I Factor ◽  
Short Form Health

Object Despite limited availability and the morbidity associated with autologous iliac crest bone graft (ICBG), its use in anterior lumbar interbody fusion (ALIF) procedures remains the gold standard to achieve arthrodesis. The search for alternative grafts yielding comparable or superior fusion outcomes with fewer complications continues. In particular, i-FACTOR, a novel bone graft substitute composed of anorganic bone matrix (ABM) with P-15 small peptide, is one example currently used widely in the dental community. Although preclinical studies have documented its usefulness, the role of i-FACTOR in ALIF procedures remains unknown. The authors' goal was to determine the safety and efficacy of i-FACTOR bone graft composite used in patients who underwent ALIF by evaluating fusion rates and clinical outcomes. Methods A nonblinded cohort of patients who were all referred to a single surgeon's practice was prospectively studied. One hundred ten patients with degenerative spinal disease underwent single or multilevel ALIF using the ABM/P-15 bone graft composite with a mean of 24 months (minimum 15 months) of follow-up were enrolled in the study. Patient's clinical outcomes were assessed using the Oswestry Disability Index for low-back pain, the 12-Item Short Form Health Survey, Odom's criteria, and a visual analog scale for pain. Fine-cut CT scans were used to evaluate the progression to fusion. Results All patients who received i-FACTOR demonstrated radiographic evidence of bony induction and early incorporation of bone graft. At a mean of 24 months of follow-up (range 15–43 months), 97.5%, 81%, and 100% of patients, respectively, who had undergone single-, double-, and triple-level surgery exhibited fusion at all treated levels. The clinical outcomes demonstrated a statistically significant (p < 0.05) difference between preoperative and postoperative Oswestry Disability Index, 12-Item Short Form Health Survey, and visual analog scores. Conclusions The use of i-FACTOR bone graft substitute demonstrates promising results for facilitating successful fusion and improving clinical outcomes in patients who undergo ALIF surgery for degenerative spinal pathologies.

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