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2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Taweechok Wisanuyotin ◽  
Permsak Paholpak ◽  
Winai Sirichativapee ◽  
Weerachai Kosuwon

AbstractBiological reconstruction is widely used to reconstruct bone defects after resection of bone tumors in the extremities. This study aimed to identify risk factors for failure and to compare outcomes of the allograft, nonvascularized autograft, and recycled frozen autograft reconstruction after resection of primary malignant bone tumors in the extremities. A retrospective study was performed at a single center between January 1994 and December 2017. Ninety patients with primary malignant bone tumors of the extremities were treated with tumor resection and reconstruction using one of three bone graft methods: nonvascularized autograft (n = 27), allograft (n = 34), and recycled frozen autograft (n = 29). The median time for follow-up was 59.2 months (range 24–240.6 months). Overall failure of biological reconstruction occurred in 53 of 90 patients (58.9%). The allograft group had the highest complication rates (n = 21, 61.8%), followed by the recycled frozen autograft (n = 17, 58.6%) and nonvascularized autograft (n = 15, 55. 6%) groups. There was no statistically significant difference among these three groups (p = 0.89). The mean MSTS score was 22.6 ± 3.4 in the nonvascularized autograft group, 23.4 ± 2.6 in the allograft group, and 24.1 ± 3.3 in the recycled frozen autograft group. There was no significant difference among the groups (p = 0.24). After bivariate and multivariable analyses, patient age, sex, tumor location, graft length, methods, and type of reconstruction had no effects on the failure of biological reconstruction. Biological reconstruction using allograft, nonvascularized autograft, and recycled frozen autograft provide favorable functional outcomes despite high complication rates. This comparative study found no significant difference in functional outcomes or complication rates among the different types of reconstruction.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shahnaz Razavi ◽  
Maliheh Jahromi ◽  
Elham Vatankhah ◽  
Reihaneh Seyedebrahimi

Abstract Background Fibrin as an extracellular matrix feature like biocompatibility, creates a favorable environment for proliferation and migration of cells and it can act as a reservoir for storage and release of growth factors in tissue engineering. Methods In this study, the inner surface of electrospun poly (lactic-co-glycolic acid) (PLGA) nanofibrous conduit was biofunctionalized with laminin containing brain derived neurotrophic factor (BDNF) and gold nanoparticles in chitosan nanoparticle. The rats were randomly divided into five groups, including autograft group as the positive control, PLGA conduit coated by laminin and filled with DMEM/F12, PLGA conduit coated by laminin and filled with rat-adipose derived stem cells (r-ADSCs), PLGA conduit coated by laminin containing gold-chitosan nanoparticles (AuNPs-CNPs), BDNF-chitosan nanoparticles (BDNF-CNPs) and filled with r-ADSCs or filled with r-ADSCs suspended in fibrin matrix, and they were implanted into a 10 mm rat sciatic nerve gap. Eventually, axonal regeneration and functional recovery were assessed after 12 weeks. Results After 3 months post-surgery period, the results showed that in the PLGA conduit filled with r-ADSCs without fibrin matrix group, positive effects were obtained as compared to other implanted groups by increasing the sciatic functional index significantly (p < 0.05). In addition, the diameter nerve fibers had a significant difference mean in the PLGA conduit coated by laminin and conduit filled with r-ADSCs in fibrin matrix groups relative to the autograft group (p < 0.001). However, G-ratio and amplitude (AMP) results showed that fibrin matrix might have beneficial effects on nerve regeneration but, immunohistochemistry and real-time RT-PCR outcomes indicated that the implanted conduit which filled with r-ADSCs, with or without BDNF-CNPs and AuNPs-CNPs had significantly higher expression of S100 and MBP markers than other conduit implanted groups (p < 0.05). Conclusions It seems, in this study differential effects of fibrin matrix, could be interfered it with other factors thereby and further studies are required to determine the distinctive effects of fibrin matrix combination with other exogenous factors in peripheral nerve regeneration.


Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 733
Author(s):  
Milan Krticka ◽  
Ladislav Planka ◽  
Lucy Vojtova ◽  
Vladimir Nekuda ◽  
Premysl Stastny ◽  
...  

Many growth factors have been studied as additives accelerating lumbar fusion rates in different animal models. However, their low hydrolytic and thermal stability both in vitro and in vivo limits their workability and use. In the proposed work, a stabilized vasculogenic and prohealing fibroblast growth factor-2 (FGF2-STAB®) exhibiting a functional half-life in vitro at 37 °C more than 20 days was applied for lumbar fusion in combination with a bioresorbable scaffold on porcine models. An experimental animal study was designed to investigate the intervertebral fusion efficiency and safety of a bioresorbable ceramic/biopolymer hybrid implant enriched with FGF2-STAB® in comparison with a tricortical bone autograft used as a gold standard. Twenty-four experimental pigs underwent L2/3 discectomy with implantation of either the tricortical iliac crest bone autograft or the bioresorbable hybrid implant (BHI) followed by lateral intervertebral fixation. The quality of spinal fusion was assessed by micro-computed tomography (micro-CT), biomechanical testing, and histological examination at both 8 and 16 weeks after the surgery. While 8 weeks after implantation, micro-CT analysis demonstrated similar fusion quality in both groups, in contrast, spines with BHI involving inorganic hydroxyapatite and tricalcium phosphate along with organic collagen, oxidized cellulose, and FGF2- STAB® showed a significant increase in a fusion quality in comparison to the autograft group 16 weeks post-surgery (p = 0.023). Biomechanical testing revealed significantly higher stiffness of spines treated with the bioresorbable hybrid implant group compared to the autograft group (p < 0.05). Whilst histomorphological evaluation showed significant progression of new bone formation in the BHI group besides non-union and fibrocartilage tissue formed in the autograft group. Significant osteoinductive effects of BHI based on bioceramics, collagen, oxidized cellulose, and FGF2-STAB® could improve outcomes in spinal fusion surgery and bone tissue regeneration.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenwei Li ◽  
Yaoyong Lou ◽  
Bin Wang

AbstractBackgroundConjunctival autograft transplantation from superior conjunctiva is often chosen to lower the postoperative recurrence rate for pterygium treatment. However, inferior conjunctival autograft (ICA) might be taken as an alternative surgery method, especially under certain conditions. Consequently, we designed this research to estimate and contrast the result of inferior conjunctival autograft and superior conjunctival autograft (SCA) on the postoperative recurrence rate.MethodsWe searched through network database (PubMed, Embase and Cochrane Central Register of Controlled Trials) to choose suitable randomized controlled trials (RCTs). Based on Cochrane review methods, we evaluated eligibility and risk of bias of included studies. The primary measures included postoperative recurrence rate. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were assessed. RevMan 5.3 software was utilized to conduct statistical analysis.ResultsFour RCTs composed of a total of 438 eyes were included in this meta-analysis, with 234 eyes in the inferior conjunctival autograft group and 204 eyes in the superior conjunctival autograft group. Statistical meta-analysis revealed that the postoperative recurrence rate was similar between the two groups (RR = 0.77, 95% CI: 0.36 to 1.62,P = 0.49). Only two RCTs applied the postoperative pain scale and one of them did not provided adequate numbers.ConclusionsOur meta-analysis indicated that inferior autograft transplantation and superior autograft transplantation had a similar effect on postoperative recurrence rate. The inferior autograft group might have a less postoperative pain. Subsequent RCTs which have more patients participated and more outcomes are needed to confirm our conclusions in years to come.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ema Onode ◽  
Takuya Uemura ◽  
Kiyohito Takamatsu ◽  
Takuya Yokoi ◽  
Kosuke Shintani ◽  
...  

AbstractPeripheral nerve regeneration using nerve conduits has been less effective than autogenous nerve grafts. To overcome this hurdle, we developed a tissue-engineered nerve conduit coated with mouse induced pluripotent stem cell (iPSC)-derived neurospheres, for the first time, which accelerated nerve regeneration in mice. We previously demonstrated the long-term efficacy and safety outcomes of this hybrid nerve conduit for mouse peripheral nerve regeneration. In this study, we investigated the therapeutic potential of nerve conduits coated with human iPSC (hiPSC)-derived neurospheres in rat sciatic nerve defects, as a translational preclinical study. The hiPSC-derived quaternary neurospheres containing neural stem/progenitor cells were three-dimensionally cultured within the nerve conduit (poly l-lactide and polycaprolactone copolymer) for 14 days. Complete 5-mm defects were created as a small size peripheral nerve defect in sciatic nerves of athymic nude rats and reconstructed with nerve conduit alone (control group), nerve conduits coated with hiPSC-derived neurospheres (iPS group), and autogenous nerve grafts (autograft group) (n = 8 per group). The survival of the iPSC-derived neurospheres was continuously tracked using in vivo imaging. At 12 weeks postoperatively, motor and sensory function and histological nerve regeneration were evaluated. Before implantation, the hiPSC-derived quaternary neurospheres that three-dimensional coated the nerve conduit were differentiated into Schwann-like cells. The transplanted hiPSC-derived neurospheres survived for at least 56 days after implantation. The iPS group showed non-significance higher sensory regeneration than the autograft group. Although there was no actual motor functional nerve regeneration in the three groups: control, iPS, and autograft groups, the motor function in the iPS group recovered significantly better than that in the control group, but it did not recover to the same level as that in the autograft group. Histologically, the iPS group demonstrated significantly higher axon numbers and areas, and lower G-ratio values than the control group, whereas the autograft group demonstrated the highest axon numbers and areas and the lowest G-ratio values. Nerve conduit three-dimensionally coated with hiPSC-derived neurospheres promoted axonal regeneration and functional recovery in repairing rat sciatic nerve small size defects. Transplantation of hiPSC-derived neurospheres with nerve conduits is a promising clinical iPSC-based cell therapy for the treatment of peripheral nerve defects.


Author(s):  
Claudio Legnani ◽  
Enrico Borgo ◽  
Vittorio Macchi ◽  
Alberto Ventura

Aim: To compare the outcomes of patients who underwent autograft tenodesis with those who underwent allograft tenodesis for the treatment of chronic mechanical ankle instability. Patients & methods: Ten patients who underwent allograft lateral tenodesis were compared with 15 patients who underwent lateral tenodesis using a split peroneus brevis tendon. Patients were followed up after an average time of 10.5 years. Results: No statistically significant differences concerning American Orthopaedic Foot and Ankle Society and Karlsson–Peterson scores were reported (p = n.s.). A reduced average radiographic anterior talar translation was observed in the autograft group compared with the allograft group (1.4 and 4.0 mm respectively, p < 0.001). Conclusion: Both surgical techniques significantly improved subjective and objective outcomes in patients suffering from chronic ankle instability compared with pre-operatory status. Autograft stabilization provided reduced post-operative anterior talar translation compared with allograft tenodesis.


2020 ◽  
Author(s):  
mengjia FEI ◽  
dong XU ◽  
yi LAI ◽  
yanan XU ◽  
jingwen ZHANG ◽  
...  

Abstract Objective To evaluate the feasibility and efficacy of total parathyroidectomy followed by modified needle-quantified injection of parathyroid autograft compared with classic incision and transplantation.Methods We conducted a retrospective study of 171 patients with secondary hyperparathyroidism treated by hemodialysis or peritoneal dialysis. These patients were included in our study from April 2006 to December 2016,who had undergone total parathyroidectomies with autotransplantation . Patients were divided into classic incision for transplantation of parathyroid autograft group and modified needle-quantified injection group. Clinical and biochemical characteristics, including preoperative and postoperative intact parathyroid hormone levels were recorded and compared between two group patients. Results To compare the techniques of modified needle-quantified injection and classic incision and transplantation, pre- and postoperative biochemistry and length of operation was recorded and analyzed. Preoperative biochemistry was similarly in both groups. However, autograft function achieved was significantly faster in the group with modified needle-quantified injection compared with classic incision and transplantation (P = 0.03). Median time to parathyroid function regain was 3 months for injection compared with 7 months for classic incision. There was no remarkable difference in the recurrence rates between the two groups.Conclusion The modified needle-quantified injection of parathyroid tissue is a feasible and simple alternative to the more commonly used method of classic incision and transplantation.


2020 ◽  
Author(s):  
Shahnaz Razavi ◽  
Maliheh Jahromi ◽  
Elham Vatankhah ◽  
Reihaneh Seyedebrahimi

Abstract Background: Fibrin as an extracellular matrix feature like biocompatibility, creates a favorable environment for proliferation and migration of cells and acts as a reservoir for storage and release of growth factors in tissue engineering. Methods: In this study, the inner surface electrospun poly (lactic-co-glycolic acid) (PLGA) nanofibrous conduit was biofunctionalized with laminin containing brain derived neurotrophic factor (BDNF) and gold nanoparticles in chitosan nanoparticle. The rats were randomly divided into five groups, including autograft group as the positive control, PLGA conduit coated by laminin and filled with DMEM/F12, PLGA conduit coated by laminin and filled with adipose-derived stem cells (rADSCs) , PLGA conduit coated by laminin containing gold-chitosan nanoparticles (AuNPs-CNPs), BDNF-chitosan nanoparticles (BDNF-CNPs) and filled with rADSCs or filled with rADSCs suspended in fibrin matrix, and they were implanted to bridge a 10 mm rat sciatic nerve gap. Eventually, axonal regeneration and functional recovery were assessed after 12 weeks.Results: After 3months post-surgery period, the results showed that in the PLGA conduit filled with rADSCs without fibrin matrix group, positive effects were obtained as compared to other implanted groups by increasing the sciatic functional index significantly (p < 0.05). In addition, the diameter nerve fibers had a significant difference mean in the PLGA conduit coated by laminin and conduit filled with rADSCs in fibrin matrix groups relative to the autograft group (p< 0.001). However, G-ratio and amplitude (AMP) results showed that fibrin matrix might have beneficial effects on nerve regeneration but, immunohistochemistry and real-time PCR outcomes indicated that the implanted conduit which filled with rADSCs with or without BDNF-CNPs and AuNPs-CNPs had significantly higher expression of S100, MBP and NF200 markers than other conduit implanted groups (p< 0.05).Conclusions: It seems, in this study differential effects of fibrin matrix, could be interfered it with other factors thereby and further studies are required to determine the distinctive effects of fibrin matrix combination with other exogenous factors in peripheral nerve regeneration.


Author(s):  
Siavash Sharifi ◽  
Amin Bigham-Sadegh ◽  
Ahmad Oryan ◽  
Yasmin Alavi

Abstract Nowadays, bone grafting is used in both human and veterinary orthopedics to stimulate fracture healing, accelerate arthrodesis, and to restore bone defects. In such procedures, orthopedic surgeons are searching to favorable substitute for autograft bone. The present study seeks to investigate the use of Theranekron in bone defect healing process. 20 native rabbits (male rabbits weighing approximately 2 kg and aged 1.5-2 years) were divided into 4 groups of five, and bone fragments were removed from their radius bones. In the first group, Theranekron 1mg/kg was injected into bone defect. Normal saline was injected into the same site of the five rabbits in the second group (saline treated controls). As for the third group (the untreated controls), nothing was injected. In the fourth group (autograft group), the removed bone was put in place and muscle and skin were sutured. Post op lateral x-rays were prepared on days 14, 28, 42, and 56. Bone biopsy for histopathological study was performed after 8 weeks. Radiographs and samples were analyzed statistically in terms of union, osteogenesis activity, and bone Remodeling. Results: Radiological evaluation showed that autograft group was significantly superior to both untreated and saline treated controls (p=0.02, p=0.04, respectively). Also, Theranekron group proved better than untreated controls (p=0.04). Histopathological evaluation showed terabecular bone and bone marrow formations in Theranekron and also autograft groups. In the untreated and saline treated controls, most part of defect was filled with fibrous tissue. Conclusion: Theranekron treated group showed almost similarly to autograft counterpart, but better than normal saline and untreated controls. Keywords: Thranekron, Bone repair, Autograft, Rabbits


2019 ◽  
Author(s):  
Siavash Sharifi ◽  
Amin Bigham-Sadegh ◽  
Ahmad Oryan ◽  
Yasmin Alavi

Abstract Background Nowadays, bone grafting is used in both human and veterinary orthopedics to stimulate fracture healing, accelerate joint union, and to restore bone defects. In such procedures, orthopedic surgeons are searching to favorable substitute for autograft bone. The present study seeks to investigate the use of this extract in bone defect healing process. 20 native rabbits were divided into 4 groups of five, and bone fragments were removed from their radius bones. In the first group, Theranekron 1mg/kg was injected into bone defect. Normal saline was injected into the same site of the five rabbits in the second group (saline treated controls). As for the third group (the untreated controls), nothing was injected. In the fourth group (autograft group), the removed bone was put in place and muscle and skin were sutured. Post op lateral x-rays were prepared on days 14, 28, 42, and 56. Bone biopsy for histopathological study was performed after 8 weeks. Radiographs and samples were analyzed statistically in terms of union, osteogenesis activity, and bone Remodeling.Results Radiological evaluation showed that autograft group was significantly superior to both untreated and saline treated controls (p=0.02, p=0.04, respectively). Also, Theranekron group proved better than untreated controls (p=0.04). Histopathological evaluation showed terabecular bone and bone marrow formations in Theranekron and also autograft groups. In the untreated and saline treated controls, most part of defect was filled with fibrous tissue.Conclusion Theranekron treated group showed almost similarly to autograft counterpart, but better than normal saline and untreated controls.


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