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Role of the Ilizarov non-free bone plasty in the management of long bone defects and nonunion: Problems solved and unsolved

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World Journal of Orthopedics 2020年第6期11卷 304-318页

作者： Dmitry Y Borzunov Sergei N Kolchin Tatiana A Malkova Department of traumatology and Orthopedics Ural State Medical UniversityEkaterinburg 620109Russia orthopaedic Department 4 Ilizarov National Medical Research Centre for Traumatology and OrthopaedicsKurgan 640014Russia Department for Medical Information and Analysis Ilizarov National Medical Research Centre for Traumatology and OrthopaedicsKurgan 640014Russia

BACKGROUND Ilizarov non-free bone plasty is a method of distraction osteogenesis using the Ilizarov apparatus for external fixation which originated in Russia and was disseminated across the world. It has been used in long bone defect and nonunion management along with free vascularized grafting and induced membrane technique. However, the shortcomings and problems of these methods still remain the issues which restrict their overall *** To study the recent available literature on the role of Ilizarov non-free bone plasty in long bone defect and nonunion management, its problems and the solutions to these problems in order to achieve better treatment *** Three databases(Pub Med, Scopus, and Web of Science) were searched for literature sources on distraction osteogenesis, free vascularized grafting and induced membrane technique used in long bone defect and nonunion treatment within a five-year period(2015-2019). Full-text clinical articles in the English language were selected for analysis only if they contained treatment results,complications and described large patient samples(not less than ten cases for congenital, post-tumor resection cases or rare conditions, and more than 20 cases for the rest). Case reports were *** Fifty full-text articles and reviews on distraction osteogenesis were ***-five clinical studies containing large series of patients treated with this method and problems with its outcome were analyzed. It was found that distraction osteogenesis techniques provide treatment for segmental bone defects and nonunion of the lower extremity in many clinical situations, especially in complex problems. The Ilizarov techniques treat the triad of problems simultaneously(bone loss, soft-tissue loss and infection). Management of tibial defects mostly utilizes the Ilizarov circular fixator. Monolateral fixators are preferable in the femur. The use of a ring fixator is recommended in patients with an infected tibial bone

关键词： Bone defect Ilizarov method Distraction osteogenesis Bone transport Bone nonunion Free vascularized grafts Induced membrane technique complication

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Osteoarthritis:toward a comprehensive understanding of pathological mechanism

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Bone Research 2017年第1期5卷 1-13页

作者： Di Chen Jie Shen Weiwei Zhao Tingyu Wang Lin Han John L Hamilton Hee-Jeong Im Department of Biochemistry Rush University Medical Center Department of orthopaedic surgery Washington University Department of orthopaedics & traumatology Li Ka Shing Faculty of MedicineThe University of Hong Kong Department of Pharmacy Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of Medicine School of Biomedical Engineering Scienceand Health SystemsDrexel University

Osteoarthritis （OA） is the most common degenerative joint disease and a major cause of pain and disability in adult individuals. The etiology of OA includes joint injury, obesity, aging, and heredity. However, the detailed molecular mechanisms of OA initiation and progression remain poorly understood and, currently, there are no interventions available to restore degraded cartilage or decelerate disease progression. The diathrodial joint is a complicated organ and its function is to bear weight, perform physical activity and exhibit a joint-specific range of motion during movement. During OA development, the entire joint organ is affected, including articular cartilage, subchondral bone, synovial tissue and meniscus. A full understanding of the pathological mechanism of OA development relies on the discovery of the interplaying mechanisms among different OA symptoms, including articular cartilage degradation, osteophyte formation, subchondral sclerosis and synovial hyperplasia, and the signaling pathway（s） controlling these pathological processes.

关键词： OA Osteoarthritis:toward a comprehensive understanding of pathological mechanism ADAMTS NGF

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The clinical rehabilitation of spine and spinal cord disorders: detection and evaluation using SPECT/CT

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Neural Regeneration Research 2014年第8期9卷 795-797页

作者： Max J. Scheyerer Clément M.L.Werner Patrick Veit-Haibach Centre for orthopaedic and Trauma surgery University Medical CenterJosef-Stelzmann-Str.9CologneGermany Department of surgery Division of TraumaSurgeryUniversity Hospital ZurichZurichSwitzerland Department of Medical Radiology Division of Nuclear MedicineUniversity Hospital ZurichZurichSwitzerland Department of Medical Radiology Diagnostic and Inverventional Radiolo-gyUniversity Hospital ZurichZurichSwitzerland

Spine-related disorders are caused by several factors including （1） spinal nerve/visceral nerve stimulation by perivertebral aseptic inflammation, （2） spinal nerve/visceral nerve compression by injured periverterbal soft tissue, dislocated perivertebral small joint, and proliferative/degenerative tissue and, （3） secondary damage to the spinal cord, peripheral nerve, vessels and autonomic nerve, which further stimulate nerve root sheath and surround- ing pain-carrying nerve fibers. In many cases, the source of pain cannot be detected by standard image modalities. Particularly in anatomically complex regions like the spine, SPECT/CT can be helpful for some aspects by intro- ducing a metabolical dimension to the classical way of morphology-based diagnostic. The aim of the present review was to give an overview of the adoption of SPECT/CT in a clinical spine-focused setting.

关键词： SPECT The clinical rehabilitation of spine and spinal cord disorders detection and evaluation using SPECT/CT

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Bone marrow-derived mesenchymal stem cells versus adipose-derived mesenchymal stem cells for peripheral nerve regeneration

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Neural Regeneration Research 2018年第1期13卷 100-104页

作者： Marcela Fernandes Sandra Gomes Valente Rodrigo Guerra Sabongi Joao Baptista Gomes dos Santos Vilnei Mattioli Leite Henning Ulrich Arthur Andrade Nery Maria José da Silva Fernandes division of Hand and Upper Limb surgery Department of Orthopedics and Traumatology Universidade Federal de Sao Paulo Sao Paulo Brazil Department of Biochemistry Institute of Chemistry Universidade de Sao Paulo Sao Paulo Brazil division of Neurosciences Department of Neurology and Neurosurgery Universidade Federal de Sao Paulo Sao Paulo Brazil

Studies have confirmed that bone marrow-derived mesenchymal stem cells （MSCs） can be used for treatment of several nervous system diseases. However, isolation of bone marrow-derived MSCs （BMSCs） is an invasive and painful process and the yield is very low. Therefore, there is a need to search for other alterative stem cell sources. Adipose-derived MSCs （ADSCs） have phenotypic and gene expression profiles similar to those of BMSCs. The production of ADSCs is greater than that of BMSCs, and ADSCs proliferate faster than BMSCs. To compare the effects of venous grafts containing BMSCs or ADSCs on sciatic nerve injury, in this study, rats were randomly divided into four groups： sham （only sciatic nerve exposed）, Matrigel （MG; sciatic nerve injury ＋ intravenous transplantation of MG vehicle）, ADSCs （sciatic nerve injury ＋ intravenous MG containing ADSCs）, and BMSCs （sciatic nerve injury ＋ intravenous MG containing BMSCs） groups. Sciatic functional index was calculated to evaluate the function of injured sciatic nerve. Morphologic characteristics of nerves distal to the lesion were observed by toluidine blue staining. Spinal motor neurons labeled with Fluoro-Gold were quantitatively assessed. Compared with sham-operated rats, sciatic functional index was lower, the density of small-diameter fibers was significantly increased, and the number of motor neurons significantly decreased in rats with sciatic nerve injury. Neither ADSCs nor BMSCs significantly improved the sciatic nerve function of rats with sciatic nerve injury,increased fiber density, fiber diameters, axonal diameters, myelin sheath thickness, and G ratios （axonal diameter/fiber diameter ratios） in the sciatic nerve distal to the lesion site. There was no significant difference in the number of spinal motor neurons among ADSCs, BMSCs and MG groups. These results suggest that neither BMSCs nor ADSCs provide satisfactory results for peripheral nerve repair when using MG as the conductor for engraftment.

关键词： nerve regeneration mesenchymal stem cells adipose-derived mesenchmal stem cells sciatic nerve Matrigel sciatic functional index neural regeneration

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Long-term results of an anatomically implanted hip arthroplasty with a short stem prosthesis (MiniHip^(TM))

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World Journal of Orthopedics 2018年第10期9卷 210-219页

作者： Lars V von Engelhardt Andreas Breil-Wirth Christian Kothny Jorn Bengt Seeger Christian Grasselli Joerg Jerosch Faculty of Health University of Witten/Herdecke Department of Trauma surgery Orthopedics and Sports Medicine Katholisches Karl-Leisner Klinikum Department of Orthopedics Trauma Surgery and Sports MedicineJohanna Etienne Hospital Munich Ortho Center Department of orthopaedics and orthopaedic surgery University Hospital Giessen and Marburg Department of orthopaedics and traumatology Waldburg-Zeil Clinic Tettnang

AIM To evaluate the clinical and radiological outcome nineand ten years after short-stemmed, bone preserving and anatomical hip arthroplasty with the MiniHip^(TM) system. METHODS In a prospective study, 186 patients underwent hip arthroplasty with a partial neck preserving short stem(MiniHip^(TM), Corin). Elderly patients were not excluded from this study, thus the mean age at the time of surgery was 59.3 years(range 32 to 82 years). surgery and the follow-up assessments were performed at two Centers. Up until now, the mean follow-up was 112.5 ± 8.2 mo. The Oxford Hip Score(OHS) and the Hip Dysfunction Osteoarthritis and Outcome Score(HOOS) was assessed pre-and each year after surgery. The clinical follow-up was accompanied by standardized a.p. and axial radiological examinations. Periprosthetic lucencies, hypertrophies within the Gruen zones one to fourteen were assessed. A subsidence of the stem was investigated according to Morray and heterotopic ossifications were assessed according to *** The OHS and HOOS improved from 18 ± 3.3 to 46 ± 2.0 and from 30 ± 8.3 to 95 ± 4.6 points, P 0.05). Two stems were revised due to a symptomatic subsidence four and twelve months postoperatively. Thus, the survivorship for aseptic loosening at nine to ten years was 98.66%. Including one stem revision due to a symptomatic exostosis, bursitis and thigh pain as well as one revision because of a septic stem loosening, the overall survival for the stem with revision for any reason was 97.32%. Besides one asymptomatic patient, radiological signs of a proximal stress-shielding, such as bone resorptions within the proximal Gruen zones, were not noticed. Findings suggesting a distal loading, e.g., bony hypertrophies or bone appositions of more than 2 mm, were also not detected. CONCLUSION Regarding these first long-term results on the MiniHip^(TM), the implant performed excee

关键词： Primary hip arthroplasty Long-term results Short stem endoprothesis Prospective follow-up study Stress-shielding

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Spiral CT arthrography of multiplanar reconstruction and virtual arthroscopy technique in diagnosis of knee with internal derangements

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Chinese Journal of traumatology 2004年第2期7卷 108-112页

作者：熊传芝郝敬明 Department of orthopaedic surgery Xuzhou Hospital Affiliated to Dongnan University

Objective:To evaluate the values of spiral CT arthrography with multiplanar reconstruction and virtual arthroscopy technique i n diagnosis of internal derangements of the knee. Methods:Ten bovine knees were used for experiment. The menisci , anterior and posterior cruciate ligaments and cartilage of these 10 bovine kne es were injured with a hook. Each of the joints was injected with 100 ml air, th en soon scanned with a PQ6000 spiral computed tomography scanner. The data obtai ned was input into the work station, and multiplanar reconstruction technique wa s used to illustrate lesions in the knees. The results of CT diagnosis were comp ared to those found by gross inspection of the specimens. Clinically, 10 knees o f 9 patients diagnosed as internal derangement were evaluated with the same meth od after 50-70 ml air was injected into each of the joints. Nine months later, the data of 2 patients were used for CT endoscopy reconstruction. The results we re compared with intraoperative findings. Results:Experimentally, the sensitivity and specificity were 88.9 % and 93.9 % by detection of meniscal abnormalities, 85.7 % and 10 0% by detection of cruciate ligament lesions, and 72.7 % and 100% by detectio n of cartilage damage, respectively. Clinically, the sensitivity and specificity were 90.0 % and 95.0 % by detection of meniscal lesion. As to ligament, t he figures were 85.7 % and 100% respectively. Images of virtual arthroscopy s imulated the images of real arthroscopy. Conclusions:Spiral CT arthrography of multiplanar reconstructi on technique offers fine images of internal structures of the knee, with clear b order and internal structure. It is an accurate method for detecting meniscal, cruciate and collateral ligament and cartilaginous lesions that cause internal d erangement of the knee. Virtual arthroscopy technique is a hopeful method for de tecting reasons of derangement of the knee.

关键词： Knee injuries Arthrography Tomography scanners, X -ray computed

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CONSTRUCTING AAV-TGFβ_1 AND COMPARISING ITS BIOLOGICAL EFFECTS ON PROTEOGLYCAN SYNTHESIS OF NUCLEUS PULPOUS CELLS WITH AV-TGFβ_1

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Journal of Shanghai Second Medical University(Foreign Language Edition) 2007年第2期19卷 90-94页

作者：赛佳明胡有谷王德春 Department of orthopaedic surgery Affiliated Hospital of Medical College Qingdao University orthopaedic Laboratory Orthopaedics and Traumatology Hospital Qingdao266003 China.

Objective To construct adeno-associated virus express system for TGFβ1 (AAV-TGFβ1) and compare its biological effects on proteoglycan synthesis of the rabbit lumbar disc nucleus pulpous (NP) cells with adenovirus (Ad) express system for TGFβ1 (AV-TGFβ1). Methods TGFβ1 gene was obtained by polymerase chain reactions (PCR). The upstream of TGFβ1 contained restriction enzyme site of EcoR Ⅰ, and the restriction enzyme site of Sal Ⅰ was at the downstream of TGFβ1. Using the multiple cloning sites (MCS) in plasmid AAV and the corresponding contained restriction enzyme site in PCR product of TGFβ1, TGFβ1 gene was subcloned into AAV. The recombinant plasmid AAV-TGFβ1 was detected by restriction enzyme digestion and DNA sequencing. Then, AAV-TGFβ1 virus was packaged and TGFβ1 expression mediated by AAV was detected by immunofluence analysis in H293 cells. AAV transfection rate to NP cells was evaluated with AAV-PEGF. After NP cells were respectively transfected by AAV-TGFβ1 virus and AV-TGFβ1 virus, proteoglycan synthesis was detected and compared by using Antonopulos methods. Results DNA sequencing revealed that the PCR-amplified TGFβ1 gene was consistent with NCBI Gene Bank. The recombinant plasmid was proved to be constructed successfully by restriction enzyme digestion. AAV could be transfected into NP cells and mediate an efficient expression of TGFβ1 protein. AV-TGFβ1 virus could quickly enhance the proteoglycan synthesis of the NP cells, but its biological effect was transient. AAV-TGFβ1 virus could enhance stably proteoglycan synthesis. Conclusion AAV-TGFβ1 virus was successful constructed and enhanced stably proteoglycan synthesis of NP cells.

关键词： adeno-associated virus adenovirus transforming growth factor β1 nucleus pulpous proteoglycan

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Case report： A 10 years follow-up of periprosthetic femoral fracture after total hip arthroplasty in osteopetrosis

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Chinese Journal of traumatology 2017年第3期20卷 173-176页

作者： Zhan-Feng Zhang Dan Wang Li-Dong Wu Xue-Song Dai Department of orthopaedic surgery The First People's Hospital of Huzhou Huzhou Zhejiang 313000 China Department of orthopaedic surgery The Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310009 China

Osteopetrosis is an inherited disorder characterized by increased bone density and brittle bone quality. Degenerative changes often occur after the age of 40 in patients with osteopetrosis. Operative inter- vention is the primary treatment option if the clinical manifestation of secondary osteoarthritis is severe. A 44-year-old male suffering autosomal dominant osteopetrosis and progressive unilateral hip osteo- arthritis required a total hip arthroplasty. However, there were several technical challenges associated with this procedure including creating a femoral medullary canal and developing a Vancouver type B2 periprosthetic femoral fracture postoperatively. To afford some experience for the management of similar cases, we here present our technical solutions to these problems.

关键词： Osteopetrosis Arthroplasty, replacement, hip Periprosthetic femoral fractures

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Advanced Hydrogel systems for mandibular reconstruction

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Bioactive Materials 2023年第3期21卷 175-193页

作者： Jiaxin Guo Hao Yao Xu Li Liang Chang Zixuan Wang Wangyong Zhu Yuxiong Su Ling Qin Jiankun Xu Musculoskeletal Research Laboratory Department of Orthopaedics&TraumatologyThe Chinese University of Hong KongHong Kong SARChina Innovative orthopaedic Biomaterial and Drug Translational Research Laboratory Li Ka Shing Institute of Health SciencesThe Chinese University of Hong KongHong Kong SARChina Department of Mechanical Engineering Tsinghua UniversityBeijingChina division of Oral and Maxillofacial surgery Faculty of DentistryThe University of Hong KongHong Kong SARChina

Mandibular defect becomes a prevalent maxillofacial disease resulting in mandibular dysfunctions and huge psychological burdens to the *** the routine presence of oral contaminations and aesthetic restoration of facial structures,the current clinical treatments are however limited,incapable to reconstruct the structural integrity and regeneration,spurring the need for cost-effective mandibular tissue *** systems possess great merit for mandibular reconstruction with precise involvement of cells and bioactive *** this review,current clinical treatments and distinct mode(s)of mandible formation and pathological resorption are summarized,followed by a review of hydrogel-related mandibular tissue engineering,and an update on the advanced fabrication of hydrogels with improved mechanical property,antibacterial ability,injectable form,and 3D bioprinted hydrogel *** exploration of advanced hydrogel systems will lay down a solid foundation for a bright future with more biocompatible,effective,and personalized treatment in mandibular reconstruction.

关键词： Hydrogel Mandibular defect Tissue engineering Injectable materials Bone regeneration

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Growth of TiO2 Nanotube on Titanium Substrate to Enhance its Biotribological Performance and Biocorrosion Resistance

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Journal of Bionic Engineering 2019年第6期16卷 1039-1051页

作者： Jiajun Luo Bianhong Li Sara Ajami Shuanhong Ma Feng Zhou Chaozong Liu Institute of orthopaedic&Musculoskeletal Science Division of Surgery&Interventional ScienceUniversity College LondonRoyal National Orthopaedic HospitalStanmoreHA14LPUnited Kingdom School of Mechatronical Engineering Beijing Institute of TechnologyBeijing 100081China State Key Laboratory of Solid L ubrication Lanzhou Institute of Chemical PhysicsChinese Academy of SciencesLanzhou 730000China

TiO2 nanotubes(NTs)have a great potential in improving the osetointegration of titanium(Ti)-based *** efforts have been made to evaluate the biological performance of the TiO2 nanotube in regulating protein adsorption and cells *** often used in orthopaedic applications,although biotribological performance and biocorrosion are important issues in these applications,few researches have been reported on the biotribological perfonnance of NT *** paper reports the preparation of a structure-optimised TiO2 NT(SO-NT)material via a multi-step oxidation strategy,as well as its biotribological and biocorrosion *** this procedure,an interfacial bonding layer of approximately 120 nm=150 nm was first formed on the titanium substrate,which was then joined to the NT *** mechanical testing with respect to impact,bending,and biotribological perfbnnance have demonstrated the resultant SO-NT layer possess improved mechanical stability compared to conventional *** uniform hyperfine interfacial bonding layer with nano-sized grains exhibited a strong bonding to NT layer and Ti *** was observed that the layer not only effectively dissipates external impacts and shear stress but also acts as a good corrosion resistance barrier to prevent the Ti substrate from *** models were proposed to analyze and predict the shear performance and corrosion-resistance mechanisms of the resultant *** obtained results demonstrated that the SO-NT material has great potential in orthopaedic applications.

关键词： TiO2 nanotubes tribology titanium implant surface modification biomaterials

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