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Sample records for bone transport reconstruction

  1. Bone transport for limb reconstruction following severe tibial fractures

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    Julian Fürmetz

    2016-03-01

    Full Text Available A common treatment of tibial defects especially after infections is bone transport via external fixation. We compare complications and outcomes of 25 patients treated with a typical Ilizarov frame or a hybrid system for bone reconstruction of the tibia. Average follow up was 5.1 years. Particular interest was paid to the following criteria: injury type, comorbidities, development of osteitis and outcome of the different therapies. The reason for segmental resection was a second or third grade open tibia fractures in 24 cases and in one case an infection after plate osteosynthesis. Average age of the patients was 41 years (range 19 to 65 years and average defect size 6.6 cm (range 3.0 to 13.4 cm. After a mean time of 113 days 23 tibial defects were reconstructed, so we calculated an average healing index of 44.2 days/cm. Two patients with major comorbidities needed a below knee amputation. The presence of osteitis led to a more complicated course of therapy. In the follow up patients with an Ilizarov frame had better results than patients with hybrid systems. Bone transport using external fixation is suitable for larger defect reconstruction. With significant comorbidities, however, a primary amputation or other methods must be considered.

  2. Architecture and microstructure of cortical bone in reconstructed canine mandibles after bone transport distraction osteogenesis.

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    Zapata, Uriel; Halvachs, Emily K; Dechow, Paul C; Elsalanty, Mohammed E; Opperman, Lynne A

    2011-11-01

    Reconstruction of the canine mandible using bone transport distraction osteogenesis has been shown to be a suitable method for correcting segmental bone defects produced by cancer, gunshots, and trauma. Although the mechanical quality of the new regenerate cortical bone seems to be related to the mineralization process, several questions regarding the microstructural patterns of the new bony tissue remain unanswered. The purpose of this study was to quantify any microstructural differences that may exist between the regenerate and control cortical bone. Five adult American foxhound dogs underwent unilateral bone transport distraction of the mandible to repair bone defects of 30-35 mm. Animals were killed 12 weeks after the beginning of the consolidation period. Fourteen cylindrical cortical samples were extracted from the superior, medial, and inferior aspects of the lingual and buccal plates of the reconstructed aspect of the mandible, and 21 specimens were collected similarly from the contralateral aspect of the mandible. Specimens were evaluated using histomorphometric and micro-computed tomographic techniques to compare their microstructure. Except for differences in haversian canal area, histomorphometric analyses suggested no statistical differences in microstructure between regenerate and control cortical bone. Morphological evaluation suggested a consistent level of anisotropy, possibly related to the distraction vector. After 12 weeks' consolidation, bone created during bone transport distraction osteogenesis was comparable to native bone in microstructure, architecture, and mechanical properties. It is proposed that, after enough time, the properties of the regenerate bone will be identical to that of native bone.

  3. Reconstruction of large tibial bone defects following osteosarcoma resection using bone transport distraction: A report of two cases

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    Yang, Zhengming; Jin, Libin; Tao, Huimin; Yang, Disheng

    2016-01-01

    The clinical efficiency of bone transport distraction osteogenesis in the reconstruction of large tibial defects following resection of osteosarcoma remains unclear. The current study presents two cases of large tibial defects treated with bone transport distraction using an Orthofix external fixator. Case 1 was a 29-year-old man with a tibial defect 11 cm in length, while case 2 was a 16-year-old girl with a 15-cm-long defect. Bone transport distraction osteogenesis was initiated for the both cases on day 14 following resection of the tibial osteosarcoma. Bone transport distraction in case 1 and 2 was continued for 16 and 28 months, respectively, and the patients were followed up for 51 and 56 months, respectively. The two patients did not exhibit any signs of tumor recurrence or tumor metastasis during the follow-up period. The Musculoskeletal Tumor Society functional scores at final follow-up visits were 22 and 18 for case 1 and 2, respectively. Based on the experience gained in these 2 cases, a bone transport is a viable option for the reconstruction of large tibial defects following osteosarcoma resection. PMID:27446450

  4. Ortho- and heterotopic bone grafts in bifocal transport osteogenesis for craniofacial reconstruction--an experimental study in sheep.

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    Kramer, F-J; Mueller, M; Rahmstorf, M; Swennen, G R J; Dempf, R; Schierle, H

    2004-09-01

    Bifocal transport osteogenesis (BTO) is a promising technique for the reconstruction of extended osseous craniofacial defects. Aim of this study was to determine the potential of this technique related to various donor sites of the transport segment. In 10 adult sheep critical size defects of the calvaria were treated by gradual movement of a transport segment consisting either of autogenous regional free calvarial bone grafts (n=5) or autogenous illiac free bone grafts (n=5). Latency period was 5 days; the rate of distraction was 1mm per day and extended approximately 40 days. The consolidation period was 28 days. After harvesting, specimens were investigated by conventional radiography, CT-scans, histologically and by fluorescence. In both groups transport osteogenesis resulted in a complete closure of the critical size defect. Membranous bone formation and remodeling occurred during the entire period of distraction and consolidation. The volumes and thickness of newly formed bone at the defect site were increased significantly when calvarial bone grafts were used (P<0.05). Iliac bone grafts became progrediently smaller during distraction, while the volume of calvarial grafts remained relatively constant (P<0.05). In conclusion, transport segments consisting of calvarial and iliac bone resulted in a reliable closure of craniofacial critical size defects in adult organisms; the application of calvarial bone grafts resulted in an increased extend of bone formation.

  5. Reconstruction by bone transport after resection of benign tumors of tibia: A retrospective study of 38 patients

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    Borzunov, Dmitry Y; Balaev, Pavel I; Subramanyam, Koushik N

    2015-01-01

    Background: The commonly used reconstructive options after post resection defects in bone tumors like megaprosthesis, autograft, allograft, bone graft substitutes and recycled bone have their own demerits on a long term. Bone transport that regenerates patient's own bone is a less explored option of reconstruction after resection of benign bone tumors and reports on this are limited. This technique is very much relevant in tibia where Ilizarov fixator is surgeon and patient friendly. We report our experience. Materials and Methods: This is a retrospective series of resection and bone transport in 38 patients with benign tumor of tibia. There were 14 males and 24 females with mean age of 23.40 years (range 9–40 years). Lesion was located in proximal third tibia in 27, middle third in two and distal third in nine patients. The diagnosis was giant cell tumor in 32, chondroblastoma in three, chondromyxoid fibroma, enchondroma and desmoplasic fibroma in one patient each. The resection was intercalary in 28 and transarticular in 10 patients. Osteosynthesis was monofocal in three, bifocal in 31 and polyfocal in four cases. Results: Mean followup was 7.22 years (range 1.5–15 years). Mean resection length was 10.21 cm (range 3–22 cm). The mean duration of external fixator was 308.03 days (range 89–677 days) and mean external fixator index was 36.14 days/cm (range 16.84–97.43 days/cm). Twelve patients had difficulties in the form of 11 problems and five obstacles that were successfully managed. None of the patients had local recurrence of tumor or any long term complication. Mean Musculo-skeletal Tumour Society score at final followup was 27.18 (90.60%). Conclusions: Bone transport is an excellent option after resection of benign tumors of tibia with good local control and functional outcome, despite minor difficulties that need timely management. PMID:26538757

  6. Maxillary Tuberosity Reconstruction with Transport Distraction Osteogenesis

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    F. Ugurlu

    2012-01-01

    Full Text Available Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4×6×3cm cyst was discovered in the left maxillary molar region and enucleated. Three months postoperatively, the area had a severe bone defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. Three months later, a bone segment including the right upper second premolar was osteotomised and distracted horizontally. The bone segment was distracted 15 mm distally. After consolidation, implants were placed when the distractor was removed. A fixed denture was loaded over the implants after 3 months. Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis. Distalisation of the alveolar bone segment adjacent to the bony defect is an easy method for reconstructing such severe defects.

  7. Improvement of tomographic reconstruction in bone SPECT

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    Schuenemann, M.; Sahlmann, C.O.; Siefker, U.; Luig, H.; Meller, J. [Abteilungen fuer Nuklearmedizin, Georg-August-Univ. Goettingen (Germany); Heidrich, G. [Abteilungen fuer Diagnostische Radiologie, Georg-August-Univ., Goettingen (Germany); Werner, C.; Brunner, E. [Abteilungen fuer Medizinische Statistik, Georg-August-Univ., Goettingen (Germany)

    2006-07-01

    Aim: the comparison between iterative reconstruction and filtered backprojection in the reconstruction of bone SPECT in the diagnosis of skeletal metastases. Patients, methods: 47 consecutive patients (vertebral segments: n = 435), with suspected malignancy of the vertebral column, were examined by bone scintigraphy and MRI (maximal interval between the two procedures {+-} 5 weeks). The SPECT-data were reconstructed with an iterative algorithm (ISA) and with filtered backprojection. We defined semiquantitative criteria in order to assess the quality of the tomograms. Conventional reconstruction was performed both by a Wiener-filter and a low-pass-filter. Iterative reconstruction was performed by the ISA algorithm. The clinical evaluation of the different reconstruction algorithms was performed by MRI as the gold-standard. Results: sensitivity (%): 87.3 (ISA), 86.4 (low-pass), 79.7 (Wiener); specificity (%): 95.3 (ISA), 95 (low-pass), 85.4 (Wiener). The sensitivity of iterative reconstructed SPECT and low-pass reconstructed SPECT was significantly higher (p < 0.05) compared with the sensitivity of SPECT reconstructed by the Wiener-filter. The specificity of iterative reconstruction ISA and low-pass-filter reconstructed SPECT were significantly higher compared with the SPECT data reconstructed by the Wiener-filter. ISA was significantly superior to the Wiener-SPECT relating to all criteria of quality. Iterative reconstruction was significantly superior to the low-pass-SPECT relating to 2 of 3 criteria. In addition the Wiener-SPECT was significantly inferior to the low-pass-SPECT regarding to 2 of 3 criteria. Conclusion: in our series the iterative algorithm ISA was the method of choice in the reconstruction of bone SPECT data. In comparison with conventional algorithms ISA offers a significantly higher quality of the tomograms and yields a high diagnostic accuracy. (orig.)

  8. Postoperative morbidity after reconstruction of alveolar bone defects with chin bone transplants in cleft patients - 111 consecutive patients

    DEFF Research Database (Denmark)

    Andersen, Kristian; Nørholt, Sven Erik; Knudsen, Johan;

    Postoperative morbidity after reconstruction of alveolar bone defects with chin bone transplants in cleft patients - 111 consecutive patients......Postoperative morbidity after reconstruction of alveolar bone defects with chin bone transplants in cleft patients - 111 consecutive patients...

  9. FUNCTIONAL OUTCOME OF ARTHROSCOPY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE PATELLAR TENDON BONE AUTOGRAFT

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    Vinod Kumar

    2015-04-01

    Full Text Available INTRODUCTION: The anterior cruciate ligament (ACL is one of the most frequently injured ligaments in the human body. 1 The Anterior Cruciate ligament (ACL is the primary stabilizer of the knee and prevents the knee against anterior translation. 2 It is also important in counteracting rotational and valgus stress. 1 The middle third of the patellar tendon autograft for ACL reconstruction can be readily procured and firmly fixed. 3 It can tolerate the loads produced by an intensive rehabilitation programme. 3 Fixation of bone plugs using interference screws provides sufficient stability to meet the demand of a vigorous postoperative protocol. 3 It remains the gold standard for ACL reconstruction. 3 This study is to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone patellar tendon bone autograft. METHODS: This study was conducted in Kempegowda Institute of Medical Sciences Hospital from November 2012 to April 2014. During this period 20 cases of adult patients with ACL deficient patients were selected according to the inclusion criteria. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone - patellar tendon - bone autograft in terms of range of motion, postoperative knee stability, graft site morbidity and subjective knee functions. RESULTS: Results of our study showed that arthroscopy assisted anterior cruciate ligament reconstruction with bone - patellar tendon - bone autograft could effectively improve knee stability and functions after surgery without any complication. CONCLUSION : Arthroscopy assisted anterior cruciate l igament reconstruction with bone - patellar tendon - bone autograft is an excellent treatment option for anterior cruciate ligament deficient knees. It provides a stable knee and reduces postoperative morbidity and enables early rehabilitation. The functional outcome of arthroscopy assisted anterior

  10. Reconstruction of multiple metacarpal bone defect using segmentated free fibular bone flap: Case report

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    Rahmi Evinc

    2014-04-01

    Full Text Available In this report we present a case of blast injury to hand, including multiple metacarpal bone defect. Bone defects were reconstructed using fibular flap. Structural integrity of metacarpal bones was preserved with good functional results. [Hand Microsurg 2014; 3(1.000: 29-32

  11. Reconstruction of multiple metacarpal bone defect using segmentated free fibular bone flap: Case report

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    Rahmi Evinc; Can Kopal; Dogan Bek; Muzaffer Durmus

    2014-01-01

    In this report we present a case of blast injury to hand, including multiple metacarpal bone defect. Bone defects were reconstructed using fibular flap. Structural integrity of metacarpal bones was preserved with good functional results. [Hand Microsurg 2014; 3(1.000): 29-32

  12. Treatment of excessive bone loss from both crus bones with internal bone transport using an intramedullary nail. Case report.

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    Bereza, Przemysław; Wojciechowski, Piotr; Kusz, Damian

    2013-01-01

    We present a case report of a 16-year-old patient who suffered multisite and multiorgan injuries following a road accident. The most prominent musculoskeletal problem was a bilateral crush injury of the crus in combination with open fractures. The aim of this study is to present the possibilities and available methods of treatment of patients with extensive posttraumatic and postinflammatory bone loss of the lower limbs that make it possible to avoid amputation. We used intramedullary nailing and internal bone transport to reconstruct continuity and leg length of both crus bones. The treatment was complicated by poor vascularity and emerging complications. After several months and multi-stage treatment the patient was able to walk with full weight-bearing without crutches. Importantly, the patient is satisfied with the outcome of the treatment and does not consider herself disabled. The study presents our approach to the dilemma of choosing between prolonged reconstruction surgery and amputation as a final method.

  13. Early postoperative bone scintigraphy in the evaluation of microvascular bone grafts in head and neck reconstruction

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    Poissonnet Gilles

    2007-04-01

    Full Text Available Abstract Background Bone scintigraphy was performed to monitor anastomotic patency and bone viability. Methods In this retrospective study, bone scans were carried out during the first three postoperative days in a series of 60 patients who underwent microvascular bone grafting for reconstruction of the mandible or maxilla. Results In our series, early bone scans detected a compromised vascular supply to the bone with high accuracy (p Conclusion When performing bone scintigraphy during the first three postoperative days, it not only helps to detect complications with high accuracy, as described in earlier studies, but it is also an additional reliable monitoring tool to decide whether or not microvascular revision surgery should be performed. Bone scans were especially useful in buried free flaps where early postoperative monitoring depended exclusively on scans. According to our experience, we recommend bone scans as soon as possible after surgery and immediately in cases suspicious of vascularized bone graft failure.

  14. Bioactive Ca-P scaffolds used for bone reconstruction

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    RUAN Jian-ming(阮建明); ZOU Jian-peng(邹俭鹏); Goldie Elisabeth; LIU Bing(刘兵)

    2003-01-01

    Bioactive ceramic scaffolds HA*TCP, aimed to be applied in clinic, were evaluated both in vitro and in vivo models. HA*TCP was supposed as a completely biodegradable material and designed as a scaffold to be used for bone reconstruction or regeneration. Materials processing was proposed and physical properties as well as microstructure feature were characterized. Biological postulation of the relationship between seeding density and proliferation, and viability of human osteoblasts cultured on the porous HA*TCP were quantitatively measured. Bone reconstruction was investigated both in vitro and in vivo by using these biodegradable scaffolds with pore sizes ranged in 200-400 μm in diameter. The degradable scaffold supported cellular proliferation of seeded osteoblasts on the scaffold and shown normal differentiated function in vitro. Seeding density is an important factor for cell attachment and proliferation expression and has been considerably discussed. Suitable pore size of the scaffolds is required if promotion of bone reconstruction is desired. Clinical trials show that HA*TCP scaffolds are successful applied for bone reconstruction and regeneration and can be completely degraded in human body in 12 months. This approach suggests the feasibility of using porous HA*TCP scaffold materials for the transplantation of autogenous osteoblasts to regenerate bone tissue.

  15. Anterior Cruciate Ligament Reconstruction using Bone Patellar Tendon Bone autograft in ACL deficient Knee

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    Navin Kumar Karn

    2015-12-01

    Full Text Available Background & Objectives: Injury to Anterior Cruciate Ligament (ACL reconstruction has increased because of increased interest in sports. There are various grafts used for reconstruction of ACL, for example, Bone Patellar Tendon Bone, Hamstring etc. The study was conducted to evaluate the results of Bone Patellar Tendon Bone graft used for reconstruction of Anterior Cruciate Ligament.Materials & Methods: 40 patients with chronic ACL deficient knee presenting to Neuro Hospital from July 2011 to June 2013 were included in the study. The patients with intraarticular fracture of knee, severe OA knee, local active or suspected infection and systemic disease that might influence the study results were excluded from the study. Bone patellar tendon bone graft was harvested from ipsilateral knee in all the cases. The patient was followed till 2 year with specified programme of rehabilitation. The pain was assessed using VAS and the function of the knee was assessed using Modified WOMAC knee index.Results: The long term satisfactory results in terms of functional stability, symptom relief and return to preinjury level of activity was seen in 32 cases (80%. Two knees got infected out of which one required arthroscopic debridement. Mean visual analogue scale was 8 and modified WOMAC knee score was 3 at 2 year follow up.Conclusion: Bone patellar tendon bone graft is useful in high demand patients and cost effective option with high patient satisfaction rate for reconstruction of ACL.JCMS Nepal. 2015;11(3:12-15.

  16. Composites structures for bone tissue reconstruction

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    Neto, W.; Santos, João [Universidade Federal de São Carlos, Departament of Materials Engineering - Rd. Washington Luis, Km 235, 13565-905, São Carlos-SP (Brazil); Avérous, L.; Schlatter, G.; Bretas, Rosario, E-mail: bretas@ufscar.br [Université de Strasbourg, ECPM-LIPHT - 25 rue Becquerel, 67087, Strasbourg (France)

    2015-05-22

    The search for new biomaterials in the bone reconstitution field is growing continuously as humane life expectation and bone fractures increase. For this purpose, composite materials with biodegradable polymers and hydroxyapatite (HA) have been used. A composite material formed by a film, nanofibers and HA has been made. Both, the films and the non-woven mats of nanofibers were formed by nanocomposites made of butylene adipate-co-terephthalate (PBAT) and HA. The techniques used to produce the films and nanofibers were spin coating and electrospinning, respectively. The composite production and morphology were evaluated. The composite showed an adequate morphology and fibers size to be used as scaffold for cell growth.

  17. Bone and bone marrow function of reconstructed chest wall after surgical correction of pectus excavatum

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    Watanabe, Yoh; Magara, Tatsuo; Kobayashi, Hiroaki; Ichihashi, Takumi; Hikishima, Hiroshi (Kanazawa Univ. (Japan). School of Medicine)

    1984-03-01

    Bone and bone marrow functions of the reconstructed chest wall after surgical correction of the funnel chest deformities were evaluated by scanning method. In our series, three kinds of operative procedures were employed; strut method for adult cases, sternal turnover method with and without muscle pedicle for infant cases. Bone function was scanned by sup(99m)Tc-methylene-diphosphonate and bone marrow function was evaluated by sup(99m)Tc-sulfur-colloid. For the cases undergone each surgical procedure, bone and bone marrow scan were done at short term after surgery (within 30 days), at intermediate stage (one month to 12 months), and at long term stage (beyond one year). The results were as follows: By the evaluation at the long term stage of the cases undergoing strut method, bone as well as bone marrow scan visualized normal view of the reconstructed sternum. Regarding the cases undergone sternal turnover method without muscle pedicle, or free graft implantation of the plastron, the bone scan at the long term follow-up stage showed abnormal finding, i.e. hypo-, or defect-visualization of the inverted sternum, in 11.5% of the cases. Furthermore, bone marrow scan showed abnormality in 33.3% of the cases. On the other hand, the cases undergone sternal turnover method with muscle pedicle, in which blood supply to the plastron were preserved by the connection from superior epigastric artery to internal mammary artery, showed no abnormality as far as at the long term follow-up study neither in bone scan nor bone marrow scan. However, in the evaluation at short term after surgery, 50% of the cases undergoing bone scan showed abnormality. In addition, in this stage 85.7% of the bone marrow scan showed abnormal finding. These abnormality, however, normalized within 6 months for bone scan and 12 months for bone marrow scan, in contrast to the results of the cases undergone sternal turnover without pedicle.

  18. Vascularizing Bone Scaffolds for Craniofacial Reconstruction

    Science.gov (United States)

    2011-07-01

    showed superior effect on neovascularization [1]. Similarly, bone formation induced by sequential treatment with FGF2 followed by BMP2 was shown to...release of FGF2 and VEGF and delayed and sustained release of BMP2 . A variety of techniques have been described in the literature regarding the...define the microsphere fabrication conditions for FGF2, VEGF and BMP2 , we first determined the influence of molecular weight and concentration of PLGA on

  19. Anterior cruciate ligament reconstruction using the bone-posterior cruciate ligament-bone allograft

    Institute of Scientific and Technical Information of China (English)

    JIAO Chen; AO Ying-fang; LIU Ping; XIE Xing; LIU Chen; MA Yong

    2013-01-01

    Background AIIografts were widely used in anterior cruciate ligament (ACL) reconstruction for patients with ACL rupture of the knee.This study was to approve the feasibility of bone-posterior cruciate ligament-bone (BPCLB) allograft transplantation in ACL reconstruction.Methods Eight patients underwent ACL reconstructions with BPCLB allografts and were followed up for an average period of 32 months after operation.Results Subjective parameters including Intemational Knee Documentation Committee (IKDC),modified Larson knee ligament,Lysholm,and Tegner rating scales were much improved and side to side KT-2000 arthrometer difference was much less postoperatively.Pivot shift test was negative in all patients.The reconstructed ACL had satisfactory shape and tension.Conclusions BPCLB allograft is an optional choice forACL reconstruction.

  20. Frozen Autograft-Prosthesis Composite Reconstruction in Malignant Bone Tumors.

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    Subhadrabandhu, Saran; Takeuchi, Akihiko; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Miwa, Shinji; Tsuchiya, Hiroyuki

    2015-10-01

    Several methods are available using an endoprosthesis or biological reconstruction for malignant bone tumors. Methods that use allograft-prosthesis composites have shown promising results. In 1999, the authors developed a method of reconstruction that uses a tumor-bearing autograft treated with liquid nitrogen. This technique was modified to produce a pedicle frozen autograft to maintain anatomical continuity on one side. In this study, the results of bone reconstructions using frozen autograft-prosthesis composites were retrospectively evaluated. The demographic data, histological records, surgical procedures, functional scores, and complications of 22 patients who had bone sarcoma or metastasis and at least 2 years of follow-up were reviewed. There were 19 patients with primary bone sarcoma and 3 with bone metastasis. Average age was 36 years (range, 9-73 years), and mean follow-up was 63 months (range, 24-176 months). Reconstructions were performed on 10 proximal femurs, 5 distal femurs, 4 proximal tibias, 1 proximal humerus, 1 proximal radius, and 1 hemipelvis. There were 12 pedicle-freezing and 10 free-freezing procedures. Union rate was 90% (9/10), and average union time was 9.5 months. Average Musculoskeletal Tumor Society score was 89.3%. Complications included 1 fracture, 2 infections, 3 soft tissue recurrences, and 1 posterior interosseous nerve palsy. The authors concluded that the frozen autograft-prosthesis composite demonstrated excellent Musculoskeletal Tumor Society scores, a low complication rate, and a good union rate and was superior when used with the pedicle-freezing technique.

  1. Two-Stage Revision Anterior Cruciate Ligament Reconstruction: Bone Grafting Technique Using an Allograft Bone Matrix.

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    Chahla, Jorge; Dean, Chase S; Cram, Tyler R; Civitarese, David; O'Brien, Luke; Moulton, Samuel G; LaPrade, Robert F

    2016-02-01

    Outcomes of primary anterior cruciate ligament (ACL) reconstruction have been reported to be far superior to those of revision reconstruction. However, as the incidence of ACL reconstruction is rapidly increasing, so is the number of failures. The subsequent need for revision ACL reconstruction is estimated to occur in up to 13,000 patients each year in the United States. Revision ACL reconstruction can be performed in one or two stages. A two-stage approach is recommended in cases of improper placement of the original tunnels or in cases of unacceptable tunnel enlargement. The aim of this study was to describe the technique for allograft ACL tunnel bone grafting in patients requiring a two-stage revision ACL reconstruction.

  2. Comparative study between cortical bone graft versus bone dust for reconstruction of cranial burr holes

    OpenAIRE

    Worm, Paulo Valdeci; Ferreira,Nelson Pires; Faria, Mário de Barros; Ferreira, Marcelo Paglioli; Kraemer,Jorge Luiz; Collares, Marcus Vinicius Martins

    2010-01-01

    Background: As a consequence of the progressive evolution of neurosurgical techniques, there has been increasing concern with the esthetic aspects of burr holes. Therefore, the objective of this study was to compare the use of cortical bone graft and bone dust for correcting cranial deformities caused by neurosurgical trephines. Methods: Twenty-three patients were enrolled for cranial burr hole reconstruction with a 1-year follow-up. A total of 108 burr holes were treated; 36 burr holes were ...

  3. Nanostructured Biomaterials for Tissue Engineered Bone Tissue Reconstruction

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    Bressan Eriberto

    2012-01-01

    Full Text Available Bone tissue engineering strategies are emerging as attractive alternatives to autografts and allografts in bone tissue reconstruction, in particular thanks to their association with nanotechnologies. Nanostructured biomaterials, indeed, mimic the extracellular matrix (ECM of the natural bone, creating an artificial microenvironment that promotes cell adhesion, proliferation and differentiation. At the same time, the possibility to easily isolate mesenchymal stem cells (MSCs from different adult tissues together with their multi-lineage differentiation potential makes them an interesting tool in the field of bone tissue engineering. This review gives an overview of the most promising nanostructured biomaterials, used alone or in combination with MSCs, which could in future be employed as bone substitutes. Recent works indicate that composite scaffolds made of ceramics/metals or ceramics/polymers are undoubtedly more effective than the single counterparts in terms of osteoconductivity, osteogenicity and osteoinductivity. A better understanding of the interactions between MSCs and nanostructured biomaterials will surely contribute to the progress of bone tissue engineering.

  4. OSTEOARTICULAR ALLOGRAFTS IN PAEDIATRIC BONE TUMOR RECONSTRUCTION OF THE KNEE.

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    Campanacci, D A; Dursky, S; Totti, F; Frenos, F; Scoccianti, G; Beltrami, G; Capanna, R

    2015-01-01

    Osteoarticular allografts represent a reconstructive option after bone tumor resection around the knee in growing children. The major advantage is the chance to preserve the growth plate of the remaining bone, but the disadvantage is the high failure rate eventually requiring definitive prosthetic replacement at skeletal maturity. We retrospectively reviewed 22 patients who underwent osteoarticular allograft reconstructions of the distal femur (16) or proximal tibia (6). There were 12 females and 10 males with an average age at surgery of 11 years (7-15). The diagnosis was osteosarcoma in 19 cases and Ewing sarcoma in 3. All patients underwent pre- and post-operative chemotherapy. At an average follow-up of 103 months (12-167), 18 patients (82%) were alive and 4 had died (18%). We observed 10 allograft failures requiring prosthetic replacement, 6 in distal femur and 4 in proximal tibia reconstructions. At last follow-up 8 allografts (36%) were still in place. Overall allograft survival was 79.6% at five and 45.8% at ten years. In distal femur, allograft survival was 86.2% at five and 59.1% at ten years. In proximal tibia, allograft survival was 62.5% at 5 years and 31.2% at 67 months. Average limb shortening was 3 cm (0- 5) in 8 patients with the allograft still in situ and 2 cm (0-4) in 10 patients after prosthetic replacement. Average MSTS functional score of the whole series was 25 (83.7%). The MSTS score of patients after revision with prosthetic replacement was 24 (80%) while patients who still had the allograft retained had an average MSTS scores of 26.8 (89.3%). In conclusion, osteoarticular allograft reconstruction of the knee after bone tumor resection in pediatric age can be considered a temporary solution with the aim to limit limb length discrepancy before definitive prosthetic replacement after skeletal maturity.

  5. Vascularized fibula grafts for reconstruction of bone defects after resection of bone sarcomas

    DEFF Research Database (Denmark)

    Petersen, Michael Mørk; Hovgaard, Dorrit; Elberg, Jens Jørgen;

    2010-01-01

    We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1-24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4......'s sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26-75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis...... (n = 2), and hip dislocation (n = 1). Limb-sparing surgery with reconstruction of bone defects using vascularized fibular grafts in BS cases is feasible with acceptable clinical results, but fractures should be expected in many patients....

  6. Vascularized fibula grafts for reconstruction of bone defects after resection of bone sarcomas

    DEFF Research Database (Denmark)

    Petersen, Michael Mørk; Hovgaard, Dorrit; Elberg, Jens Jørgen

    2010-01-01

    We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1-24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4....../3/1) operated on form 2000 to 2006. The bone defects reconstructed were proximal femoral diaphysis and epiphysis (n = 2), humeral diaphysis (n = 2), humeral proximal diaphysis and epiphysis (n = 1), femoral diaphysis (n = 1), ulnar diaphysis (n = 1), and tibial diaphysis (n = 1). One patient with Ewing......'s sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26-75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis...

  7. Bone-patellar tendon-bone autograft versus LARS artificial ligament for anterior cruciate ligament reconstruction.

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    Pan, Xiaoyun; Wen, Hong; Wang, Lide; Ge, Tichi

    2013-10-01

    The optimized graft for use in anterior cruciate ligament (ACL) reconstruction is still in controversy. The bone-patellar tendon-bone (BPTB) autograft has been accepted as the gold standard for ACL reconstruction. However, donor site morbidities cannot be avoided after this treatment. The artificial ligament of ligament advanced reinforcement system (LARS) has been recommended for ACL reconstruction. The purpose of this study is to compare the midterm outcome of ACL reconstruction using BPTB autografts or LARS ligaments. Between July 2004 and March 2006, the ACL reconstruction using BPTB autografts in 30 patients and LARS ligaments in 32 patients was performed. All patients were followed up for at least 4 years and evaluated using the Lysholm knee score, Tegner score, International Knee Documentation Committee (IKDC) score, and KT-1000 arthrometer test. There were no significant differences between the two groups with respect to the data of Lysholm scores, Tegner scores, IKDC scores, and KT-1000 arthrometer test at the latest follow-up. Our study demonstrates that the similarly good clinical results are obtained after ACL reconstruction using BPTB autografts or LARS ligaments at midterm follow-up. In addition to BPTB autografts, the LARS ligament may be a satisfactory treatment option for ACL rupture.

  8. [Bone tissue engineering. Reconstruction of critical sized segmental bone defects in the ovine tibia].

    Science.gov (United States)

    Reichert, J C; Epari, D R; Wullschleger, M E; Berner, A; Saifzadeh, S; Nöth, U; Dickinson, I C; Schuetz, M A; Hutmacher, D W

    2012-04-01

    Well-established therapies for bone defects are restricted to bone grafts which face significant disadvantages (limited availability, donor site morbidity, insufficient integration). Therefore, the objective was to develop an alternative approach investigating the regenerative potential of medical grade polycaprolactone-tricalcium phosphate (mPCL-TCP) and silk-hydroxyapatite (silk-HA) scaffolds.Critical sized ovine tibial defects were created and stabilized. Defects were left untreated, reconstructed with autologous bone grafts (ABG) and mPCL-TCP or silk-HA scaffolds. Animals were observed for 12 weeks. X-ray analysis, torsion testing and quantitative computed tomography (CT) analyses were performed. Radiological analysis confirmed the critical nature of the defects. Full defect bridging occurred in the autograft and partial bridging in the mPCL-TCP group. Only little bone formation was observed with silk-HA scaffolds. Biomechanical testing revealed a higher torsional moment/stiffness (p CT analysis a significantly higher amount of bone formation for the ABG group when compared to the silk-HA group. No significant difference was determined between the ABG and mPCL-TCP groups. The results of this study suggest that mPCL-TCP scaffolds combined can serve as an alternative to autologous bone grafting in long bone defect regeneration. The combination of mPCL-TCP with osteogenic cells or growth factors represents an attractive means to further enhance bone formation.

  9. In Vivo Gait Analysis During Bone Transport.

    Science.gov (United States)

    Mora-Macías, J; Reina-Romo, E; Morgaz, J; Domínguez, J

    2015-09-01

    The load bearing characteristics of the intervened limb over time in vivo are important to know in distraction osteogenesis and bone healing for the characterization of the bone maturation process. Gait analyses were performed for a group of sheep in which bone transport was carried out. The ground reaction force was measured by means of a force platform, and the gait parameters (i.e., the peak, the mean vertical ground reaction force and the impulse) were calculated during the stance phase for each limb. The results showed that these gait parameters decreased in the intervened limb and interestingly increased in the other limbs due to the implantation of the fixator. Additionally, during the process, the gait parameters exponentially approached the values for healthy animals. Corresponding radiographies showed an increasing level of ossification in the callus. This study shows, as a preliminary approach to be confirmed with more experiments, that gait analysis could be used as an alternative method to control distraction osteogenesis or bone healing. For example, these analyses could determine the appropriate time to remove the fixator. Furthermore, gait analysis has advantages over other methods because it provides quantitative data and does not require instrumented fixators.

  10. Vascularized Fibula Grafts for Reconstruction of Bone Defects after Resection of Bone Sarcomas

    Science.gov (United States)

    Petersen, Michael Mørk; Hovgaard, Dorrit; Elberg, Jens Jørgen; Rechnitzer, Catherine; Daugaard, Søren; Muhic, Aida

    2010-01-01

    We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1–24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4/3/1) operated on form 2000 to 2006. The bone defects reconstructed were proximal femoral diaphysis and epiphysis (n = 2), humeral diaphysis (n = 2), humeral proximal diaphysis and epiphysis (n = 1), femoral diaphysis (n = 1), ulnar diaphysis (n = 1), and tibial diaphysis (n = 1). One patient with Ewing's sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26–75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis (n = 2), and hip dislocation (n = 1). Limb-sparing surgery with reconstruction of bone defects using vascularized fibular grafts in BS cases is feasible with acceptable clinical results, but fractures should be expected in many patients. PMID:20490263

  11. Press-fit Femoral Fixation in ACL Reconstruction using Bone-Patellar Tendon-Bone Graft

    Directory of Open Access Journals (Sweden)

    Kaseb Mohammad Hasan

    2009-05-01

    Full Text Available Bone-patellar tendon auto graft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. A prospective study was performed on 30 consecutive active people who underwent ACL reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months. Results were evaluated by an independent examiner using radiography, subjective and objective evaluation. Assessment using the IKDC knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. Lysholm's score was 63.6(40- 86 preoperatively and 91.88(73-100 at the latest follow up (P < 0.005. No patient complained of instability at latest follow up. The quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. Five Patients complained of anterior knee pain and had a positive kneeling test. We found no graft displacement on follow up radiographs. All cases showed radiological evidence of graft osteointegration at last follow up. Our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for ACL recon-struction using bone-patellar tendon-bone graft.

  12. Surface Reconstruction from Parallel Curves with Application to Parietal Bone Fracture Reconstruction.

    Directory of Open Access Journals (Sweden)

    Abdul Majeed

    Full Text Available Maxillofacial trauma are common, secondary to road traffic accident, sports injury, falls and require sophisticated radiological imaging to precisely diagnose. A direct surgical reconstruction is complex and require clinical expertise. Bio-modelling helps in reconstructing surface model from 2D contours. In this manuscript we have constructed the 3D surface using 2D Computerized Tomography (CT scan contours. The fracture part of the cranial vault are reconstructed using GC1 rational cubic Ball curve with three free parameters, later the 2D contours are flipped into 3D with equidistant z component. The constructed surface is represented by contours blending interpolant. At the end of this manuscript a case report of parietal bone fracture is also illustrated by employing this method with a Graphical User Interface (GUI illustration.

  13. Selection of allografts for impaction bone grafting for bone defect reconstruction on the acetabular side

    Institute of Scientific and Technical Information of China (English)

    XU Zheng-jian; HE Rong-xin

    2010-01-01

    Objective To review the choices of allografts for bone defect reconstruction in acetabular revision surgery using the technique of impaction bone grafting.Data sources The data cited in this review were mainly obtained from articles listed in PubMed that were published from January 1993 to July 2009. The search terms were "impaction bone grafting", "particle size", "mechanical property"and "biological behavior".Study selection Articles relevant to the choices of allografts and their results for bone defect reconstruction on the acetabular side were selected.Results Different choices of allografts, including the particle size, process of irradiation or fat reduction, composition and particle grade, are made to improve the survival rate of a prosthesis in acetabular revision surgery. This review,which compares both mechanical and biological factors, summarizes the experimental and clinical results for different techniques.Conclusions Fresh frozen cancellous allografts with particle sizes ranging from 7 to 10 mm are a favorable choice for reconstruction of bone defects of American Academy of Orthopedic Surgeons (AAOS) types Ⅱ (cavitary defect) and Ⅲ(combined cavitary and segmental defect) on the acetabular side. A fat-reducing procedure with saline or solvent/detergent is controversial. Adding autologous marrow into irradiated allografts, which provides reliable mechanical stability and biological safety, may be a substitute for fresh frozen allografts. Cortical bone can be a supplementary material in cases of insufficiency of cancellous allografts. Cartilage should be excluded from the graft material. Further research is required to demonstrate the best particle grade, and randomized controlled trials in clinical practice are required to obtain more information about the selection of allografts.

  14. Iliotibial band autograft versus bone-patella-tendon-bone autograft, a possible alternative for ACL reconstruction

    DEFF Research Database (Denmark)

    Stensbirk, Frederik; Thorborg, Kristian; Konradsen, Lars;

    2014-01-01

    PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi-ligament......PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi......-ligament reconstruction. The purpose is to assess whether the ITB autograft is a long-term reliable alternative to the bone-patella-tendon-bone (BPTB) autograft, using a prospective randomized controlled trial design. METHODS: From 1995 to 1996, sixty patients scheduled for primary ACL reconstruction were included...... compared to the BPTB graft and is recommended as a reliable alternative autograft for ACL reconstruction. LEVEL OF EVIDENCE: Therapeutic studies, Level I....

  15. Reconstruction Of Glenoid Bone Deficiency With Porous Titanium Nickelide In Recurrent Anterior Shoulder Instability

    Directory of Open Access Journals (Sweden)

    Prokhorenko Valery M.

    2015-03-01

    Full Text Available Introduction: One of the main causes of recurrent shoulder instability is a bone defect of the front edge of the glenoid. The available techniques for reconstruction of this bone defect, however, have some disadvantages.

  16. Femoral head-neck junction reconstruction, after iatrogenic bone resection.

    Science.gov (United States)

    Guevara-Alvarez, Alberto; Lash, Nicholas; Beck, Martin

    2015-07-01

    Arthroscopic over-resection of the head-neck junction during the treatment of a cam deformity can be a devastating complication and is difficult to treat. Large defects of the femoral head-neck junction (FHNJ) increase the risk of femoral neck fracture and can also affect hip biomechanics. We describe a case of an iatrogenic defect of the FHNJ due to excessive bone resection, and a previously non-described treatment using iliac crest autograft to restore femoral head-neck sphericity and hip joint stability. After protecting the femoral neck with an angled blade plate, the large anterior FHNJ defect was reconstructed using autogenous iliac crest bone graft; sphericity was restored by contouring the graft using spherical templates. Clinical and radiographic follow-up was performed up to 2 years. Results at 2 years showed no residual groin pain and normal range of motion. The Oxford Hip Score was 46/48, rated as excellent. Computed tomography (CT) scanning showed union of bone graft without resorption, and CT arthrogram indicating retained sphericity of the FHNJ without evidence of degenerative changes in the articular surface. This novel surgical technique can be used to restore the structural integrity and contour of the FHNJ that contains a significant anterior defect.

  17. Revision anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft and extra-articular iliotibial band tenodesis.

    Science.gov (United States)

    Mascarenhas, Randy; McConkey, Mark O; Forsythe, Brian; Harner, Christopher D

    2015-04-01

    Revision anterior cruciate ligament (ACL) reconstruction is a technically demanding procedure with outcomes that generally fail to reach those seen with primary ACL reconstruction. With most index procedures using autograft tissue, it is not uncommon for allograft tissue to be required for revision ACL reconstruction. Compared with autografts, allografts take longer to incorporate and lead to more episodes of instability. In this article, we describe ipsilateral iliotibial band tenodesis performed to augment use of bone-patellar tendon-bone allograft in revision ACL reconstruction. This technique adds rotational stability to protect the allograft tissue while it incorporates.

  18. The modified bone-patellar tendon-bone allograft in single-bundle anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Kang, Huijun; Wang, Fei

    2011-06-01

    Bone-patellar tendon-bone graft has been an attractive option for single-bundle anterior cruciate ligament reconstruction in clinical practice. However, the graft-tunnel mismatch in the proximal part of the tibial tunnel and the ultimate strength after postoperative ligamentization process have been potential problems for the traditional 10-mm wide graft. We modified the traditional bone-patellar tendon-bone allograft to make it double-layer, as an ideal substitute graft for single-bundle anterior cruciate ligament reconstruction with better graft-tunnel match and higher initial graft strength.

  19. Alendronate reduced peri-tunnel bone loss and enhanced tendon graft to bone tunnel healing in anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    PPY Lui

    2013-01-01

    Full Text Available Peri-tunnel bone loss after anterior cruciate ligament (ACL reconstruction is commonly observed, both clinically and experimentally. We aimed to study the effect and mechanisms of different doses of alendronate in the reduction of peri-tunnel bone loss and promotion of graft-bone tunnel healing in ACL reconstruction. Eighty-four ACL-reconstructed rats were divided into 4 groups. Alendronate at different dosages, or saline, were injected subcutaneously weekly, for 2 or 6 weeks post-reconstruction, for vivaCT (computed tomography imaging, biomechanical tests, histology and immunohistochemistry. Alendronate significantly increased bone mass and density of tissue inside bone tunnels except at the epiphyseal region of tibial tunnel. The femoral tunnel diameter decreased significantly in the mid-dose and high-dose alendronate groups compared to that in the saline group at week 6. Alendronate significantly increased the peri-tunnel bone mass and density along all tunnel regions at week 6. Better graft-bone tunnel integration and intra-tunnel graft integrity were observed in the alendronate groups. The ultimate load was significantly higher in the mid-dose and high-dose alendronate groups at week 2, but not at week 6. There was a reduction in matrix metalloprotein (MMP1, MMP13 and CD68-positive cells at the peri-tunnel region and graft-bone interface in the alendronate-treated group compared to the saline group. Alendronate reduced peri-tunnel bone resorption, increased mineralised tissue inside bone tunnel as well as histologically and biomechanically promoted graft-bone tunnel healing, probably by reducing the expression of MMP1, MMP13 and CD68-positive cells. Alendronate might be used for reducing peri-tunnel bone loss and promoting graft-bone tunnel healing at early stage post-ACL reconstruction.

  20. Morbidity of chin bone transplants used for reconstructing alveolar defects in cleft patients

    NARCIS (Netherlands)

    Booij, A; Raghoebar, GM; Jansma, J; Kalk, WWI; Vissink, A

    2005-01-01

    Objective: The aim of this study was to evaluate the objective and subjective morbidity of symphyseal chin bone harvesting used for reconstruction of alveolar defects in young cleft patients. Design: All patients who had undergone chin bone harvesting for alveolar cleft reconstruction in the period

  1. Reconstruction of the Scapholunate Ligament Using Capitohamate Bone-Ligament-Bone.

    Science.gov (United States)

    Nakamura, Toshiyasu; Abe, Koji; Iwamoto, Takuji; Ochi, Kensuke; Sato, Kazuki

    2015-11-01

    Background The biomechanical properties of the capitohamate (CH) ligament are equivalent to those of the scapholunate (SL) interosseous ligament. We reconstructed the SL ligament using the CH bone-ligament-bone substitute for chronic injury of the SL ligament. Patients and Methods Beginning in 2008, 15 wrists of 14 patients with an average age of 38 years underwent this procedure with a minimum follow-up of 2 years. Thirteen wrists had an SL joint gap more than 3 mm, and two had a complete SL ligament disruption with a severe dorsal intercalated segment instability (DISI) deformity. Kirschner wires (K-wires) were removed 8 weeks after the surgery, then active ROM exercise began. Pain (on visual analog scale [VAS]), wrist motion (angle), radiographic characteristics, such as SL gap (mm) and SL angle, and Modified Mayo Wrist Score (MMWS) were evaluated. Technique The SL joint was reduced by manipulation or with the use of joysticks, then temporary fixed with K-wires. A dorsal trough was then made between the scaphoid and the lunate. The proximal half of the CH ligament was harvested with attached bone from the capitate and hamate (CH bone-ligament-bone), inset into the SL trough, and fixed firmly with 1.2-mm diameter titanium screws in the scaphoid and lunate, respectively. Results The VAS improved from 77 preoperatively to 12 postoperatively. The average wrist extension/flexion was 74°/60°. There was no ossification of the reconstructed SL at the final follow-up. The SL gap improved from an average of 4.8 mm to an average of 2.1 mm, and the SL angle changed from 67° to 55°. The MMWS improved to 82 points postoperatively from a preoperative average of 47 with eight excellent, five good, and two fair results.

  2. Effects of a buried magnetic field on cranial bone reconstruction in rats

    Science.gov (United States)

    de ABREU, Maíra Cavallet; PONZONI, Deise; LANGIE, Renan; ARTUZI, Felipe Ernesto; PURICELLI, Edela

    2016-01-01

    ABSTRACT The understanding of bone repair phenomena is a fundamental part of dentistry and maxillofacial surgery. Objective The present study aimed to evaluate the influence of buried magnetic field stimulation on bone repair in rat calvaria after reconstruction with autogenous bone grafts, synthetic powdered hydroxyapatite, or allogeneic cartilage grafts, with or without exposure to magnetic stimulation. Material and Methods Ninety male Wistar rats were divided into 18 groups of five animals each. Critical bone defects were created in the rats’ calvaria and immediately reconstructed with autogenous bone, powdered synthetic hydroxyapatite or allogeneic cartilage. Magnetic implants were also placed in half the animals. Rats were euthanized for analysis at 15, 30, and 60 postoperative days. Histomorphometric analyses of the quantity of bone repair were performed at all times. Results These analyses showed significant group by postoperative time interactions (p=0.008). Among the rats subjected to autogenous bone reconstruction, those exposed to magnetic stimulation had higher bone fill percentages than those without magnetic implants. Results also showed that the quality of bone repair remained higher in the former group as compared to the latter at 60 postoperative days. Conclusions After 60 postoperative days, bone repair was greater in the group treated with autogenous bone grafts and exposed to a magnetic field, and bone repair was most pronounced in animals treated with autogenous bone grafts, followed by those treated with powdered synthetic hydroxyapatite and allogeneic cartilage grafts. PMID:27119765

  3. Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible?

    Directory of Open Access Journals (Sweden)

    Martin Lanzer

    2015-09-01

    Full Text Available Objectives: Free fibula flap remains the flap of choice for reconstruction of mandibular defects. If free fibula flap is not possible, the subscapular system of flaps is a valid option. In this study, we evaluated the possibility of dental implant placement in patients receiving a scapular free flap for oromandibular reconstruction. Material and Methods: We retrospectively reviewed 10 patients undergoing mandible reconstruction with a subscapular system free-tissue (lateral border of the scapula transfer at the University Hospital Zürich between January 1, 2010 and January 1, 2013. Bone density in cortical and cancellous bone was measured in Hounsfield units (HU. Changes of bone density, height and width were analysed using IBM SPSS Statistics 22. Comparisons of bone dimensions as well as bone density were performed using a chi-square test. Results: Ten patients were included. Implantation was conducted in 50%. However, all patients could have received dental implants considering bone stock. Loss of bone height and width were significant (P < 0.001. There was a statistical significant increase in bone density in cortical (P < 0.001 and cancellous (P = 0.004 bone. Conclusions: Dental implants are possible after scapular free flap reconstruction of oromandibular defects. Bone height and width were reduced, while bone density increased with time.

  4. Histological Features and Biocompatibility of Bone and Soft Tissue Substitutes in the Atrophic Alveolar Ridge Reconstruction

    Directory of Open Access Journals (Sweden)

    Carlo Maiorana

    2016-01-01

    Full Text Available The reconstruction of the atrophic alveolar ridges for implant placement is today a common procedure in dentistry daily practice. The surgical reconstruction provides for the optimization of the supporting bone for the implants and a restoration of the amount of keratinized gingiva for esthetic and functional reasons. In the past, tissue regeneration has been performed with autogenous bone and free gingival or connective tissue grafts. Nowadays, bone substitutes and specific collagen matrix allow for a complete restoration of the atrophic ridge without invasive harvesting procedures. A maxillary reconstruction of an atrophic ridge by means of tissue substitutes and its histological features are then presented.

  5. Selenoprotein P is the essential selenium transporter for bones.

    Science.gov (United States)

    Pietschmann, Nicole; Rijntjes, Eddy; Hoeg, Antonia; Stoedter, Mette; Schweizer, Ulrich; Seemann, Petra; Schomburg, Lutz

    2014-05-01

    Selenium (Se) plays an important role in bone physiology as best reflected by Kashin-Beck disease, an endemic Se-dependent osteoarthritis. Bone development is delayed in children with mutations in SECIS binding protein 2 (SBP2), a central factor for selenoprotein biosynthesis. Circulating selenoprotein P (SePP) is positively associated with bone turnover in humans, yet its function for bone homeostasis is not known. We have analysed murine models of altered Se metabolism. Most of the known selenoprotein genes and factors needed for selenoprotein biosynthesis are expressed in bones. Bone Se is not associated with the mineral but exclusively with the organic matrix. Genetic ablation of Sepp-expression causes a drastic decline in serum (25-fold) but only a mild reduction in bone (2.5-fold) Se concentrations. Cell-specific expression of a SePP transgene in hepatocytes efficiently restores bone Se levels in Sepp-knockout mice. Of the two known SePP receptors, Lrp8 was detected in bones while Lrp2 was absent. Interestingly, Lrp8 mRNA concentrations were strongly increased in bones of Sepp-knockout mice likely in order to counteract the developing Se deficiency. Our data highlight SePP as the essential Se transporter to bones, and suggest a novel feedback mechanism for preferential uptake of Se in Se-deprived bones, thereby contributing to our understanding of hepatic osteodystrophy and the consistent bone phenotype observed in subjects with inherited selenoprotein biosynthesis mutations.

  6. Free vascularized fibula grafts for salvage of failed oncologic long bone reconstruction and pathologic fractures.

    Science.gov (United States)

    Friedrich, Jeffrey B; Moran, Stephen L; Bishop, Allen T; Shin, Alexander Y

    2009-01-01

    Vascularized bone grafts, particularly the free fibula transfer, have incited revolutionary changes in the field of skeletal reconstruction. In no place has this been more evident than in oncologic reconstruction. The free vascularized fibula graft has been used to good effect for primary long-bone reconstruction, long-bone allograft complication salvage, and pathologic fracture salvage of the long bones. Although many of these procedures often entail significant complications, limb salvage has been made possible in a majority of patients using transfers of free vascularized fibula grafts. The purpose of this review is to critically evaluate the technique of onlay free vascularized fibula grafts for salvage of allograft complications and pathologic fractures of the long bones. This will be accomplished by reviewing the problem of allograft complications and pathologic fractures, the current treatment modalities available, the outcomes of these treatments, and future directions of treatment for this particular problem.

  7. Bone quality at the implant site after reconstruction of a local defect of the maxillary anterior ridge with chin bone or deproteinised cancellous bovine bone

    NARCIS (Netherlands)

    Meijndert, L.; Raghoebar, G.M.; Schüpbach, P.; Meijer, H.J.A.; Vissink, A.

    2005-01-01

    The purpose of this study was to investigate the quality of bone at grafted implant sites in the anterior maxilla. Grafting of these sites was necessary because of insufficient bone volume in a buccopalatinal direction (width at the top of the crest 1 - 3 mm). Reconstruction was performed with chin

  8. Outcome of rail fixator system in reconstructing bone gap

    Directory of Open Access Journals (Sweden)

    Amit Lakhani

    2014-01-01

    Conclusion: All patients well tolerated rail fixator with good functional results and gap reconstruction. Easy application of rail fixator and comfortable distraction procedure suggest rail fixator a good alternative for gap reconstruction of limbs.

  9. Systematic review of the use of bone cement in ossicular chain reconstruction and revision stapes surgery

    NARCIS (Netherlands)

    Wegner, Inge; van den Berg, Jelle W G; Smit, Adriana L; Grolman, Wilko

    2015-01-01

    OBJECTIVES/HYPOTHESIS: To evaluate the effectiveness of bone cement on mean postoperative air-bone gap (ABG) and the proportion of ABG closure to within 20 dB in patients undergoing ossicular chain reconstruction or revision stapes surgery. DATA SOURCES: PubMed, Embase, and Central. METHODS: A syste

  10. Combined Reconstruction of the Medial Collateral Ligament and Anterior Cruciate Ligament Using Ipsilateral Quadriceps Tendon-Bone and Bone-Patellar Tendon-Bone Autografts.

    Science.gov (United States)

    Hetsroni, Iftach; Mann, Gideon

    2016-06-01

    The exclusive autograft choice for medial collateral ligament (MCL) reconstruction that has been described until today is the semitendinosus tendon. However, this has some potential disadvantages in a knee with combined MCL-anterior cruciate ligament (ACL) injury, including weakening of the hamstring's anterior restraining action in an already ACL-injured knee and nonanatomic distal MCL graft insertion when leaving the semitendinosus insertion intact at the pes anserinus during reconstruction. Moreover, because some surgeons prefer to use the hamstring for autologous ACL reconstruction, the contralateral uninjured knee hamstring needs to be harvested as a graft source for the MCL reconstruction if autografts and not allografts are the surgeons' preference. We describe a technique for performing combined reconstruction of the MCL and ACL using ipsilateral quadriceps tendon-bone and bone-patellar tendon-bone autografts. This technique of MCL reconstruction spares the hamstring tendons and benefits from the advantage provided by bone-to-bone healing on the femur with distal and proximal MCL tibial fixation that closely reproduces the native MCL tibia insertion.

  11. Biodegradable hybrid tissue engineering scaffolds for reconstruction of large bone defects

    Science.gov (United States)

    Barati, Danial

    Complex skeletal injuries and large bone fractures are still a significant clinical problem in US. Approximately 1.5 million Americans (veterans, their families, and civilians) every year suffer from bone loss due to traumatic skeletal injuries, infection, and resection of primary tumors that require extensive grafting to bridge the gap. The US bone graft market is over $2.2 billion a year. Due to insufficient mechanical stability, lack of vascularity, and inadequate resorption of the graft, patients with traumatic large skeletal injuries undergo multiple costly operations followed by extensive recovery steps to maintain proper bone alignment and length. Current strategies for repairing damaged or diseased bones include autologous or allograft bone transplantations. However, limited availability of autografts and risk of disease transmission associated with allografts have necessitated the search for the development of new bone graft options and strategies. The overall goal of this project is to develop a much-needed bone-mimetic engineered graft as a substitute for current strategies providing required bone grafts for reconstruction of large bone defects. This project will use the structure of natural cortical bone as a guide to produce an engineered bone graft with balanced strength, osteogenesis, vascularization, and resorption. The outcome of this project will be a biodegradable hybrid scaffold system (similar to natural cortical bone) including a mechanically strong scaffold allowing for mechanical stability of the load-bearing defect site and a soft and highly porous structure such as a hydrogel phase which will allow for efficient cell and growth factor delivery into the defect implantation site, cell niche establishment and promotion of mineralization. Successful completion of this project will transform bone graft technology for regeneration of complex bone defects from a frozen or freeze-dried allograft to a safe, infection-free, mechanically

  12. Bone quality at the implant site after reconstruction of a local defect of the maxillary anterior ridge with chin bone or deproteinised cancellous bovine bone.

    Science.gov (United States)

    Meijndert, L; Raghoebar, G M; Schüpbach, P; Meijer, H J A; Vissink, A

    2005-12-01

    The purpose of this study was to investigate the quality of bone at grafted implant sites in the anterior maxilla. Grafting of these sites was necessary because of insufficient bone volume in a buccopalatinal direction (width at the top of the crest 1-3mm). Reconstruction was performed with chin bone (N=5), chin bone and a resorbable Bio-Gide GBR membrane (N=5) or Bio-Oss spongiosa granules in combination with a Bio-Gide GBR membrane (N=5). Biopsies were taken prior to implantation, i.e. 3 months after grafting with chin bone, and 6 months after grafting with Bio-Oss. Evaluation was done by assessing the histological and histomorphometric characteristics of full-length biopsies taken from the actual implant site. Both areas with non-vital bone and areas with apposition of bone and remodelling phenomena were observed in the chin bone group at the time of placement of the implants. Similar results were observed at implant sites reconstructed with a chin bone graft covered by a membrane. In the chin bone group without and with a GBR membrane, the mean total bone volume (TBV) was 55.2+/-6.8% and 57.7+/-11.5%, respectively; the marrow connective tissue volume (MCTV) was 44.8+/-6.8% and 42.3+/-11.5%, respectively. Remnants of the resorbable GBR membrane were not detected. In the Bio-Oss((R)) group, at implant placement some newly formed bone was observed in the connective tissue surrounding the Bio-Oss((R)) particles (mean TBV (newly formed bone) 17.6+/-14.5%), but most particles were surrounded by connective tissue. No convincing signs of remodelling were observed (mean remaining Bio-Oss volume 40.5+/-9.3%; mean MCTV 41.9+/-13.1%). No implants were lost during follow up (12 months). At the time of placement of the implants the grafting material (either chin bone or Bio-Oss is still not fully replaced by new vital bone. In case of Bio-Oss, most of the grafting material is even still present. Despite these differences, the 1-year clinical results were very good and

  13. Grafted bone used in acetabular reconstruction: assessment by SPECT scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fujikawa, Yosuke [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Torisu, Takehiko [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Takasita, Mitsuhiro [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan); Masumi, Shogo [Dept. of Orthopaedic Surgery, Oita Medical Univ. (Japan)

    1995-08-01

    Single photon emission computed tomography (SPECT) was carried out at the 1st, 6th, and 12th month after the operation and the uptakes on serial SPECT scintigrams were normalized. The horizontal histogram of scintigraphic activity at the level of the central grafted bone in the coronal image was designated the profile curve. Seven patients who had undergone bipolar hip arthroplasty for osteoarthritis of the hip were randomly selected. Five of seven profile curves obtained at the 1st month demonstrated a single peak at the host-graft junction. The profile curve obtained at the 6th month showed two peaks at the host-graft junction and the priphery of the grafted bone in all patients. The profile curve of the 12th month showed slightly increased activity in the center of the grafted bone. This preliminary study demonstrates that comparison of the serial profile curves on SPECT is valuable in evaluating the progress of incorporation of the grafted bone in hip arthroplasty. (orig.)

  14. Imaging of limb salvage surgery and pelvic reconstruction following resection of malignant bone tumours

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Tien Jin, E-mail: tien_jin_tan@cgh.com.sg [Department of Radiology, Vancouver General Hospital, Vancouver, BC (Canada); Aljefri, Ahmad M. [Department of Radiology, Vancouver General Hospital, Vancouver, BC (Canada); Clarkson, Paul W.; Masri, Bassam A. [Department of Orthopaedics, University of British Columbia, Vancouver, BC (Canada); Ouellette, Hugue A.; Munk, Peter L.; Mallinson, Paul I. [Department of Radiology, Vancouver General Hospital, Vancouver, BC (Canada)

    2015-09-15

    Highlights: • Advances in reconstructive orthopaedic techniques now allow for limb salvage and prosthetic reconstruction procedures to be performed on patients who would otherwise be required to undergo debilitating limb amputations for malignant bone tumours. • The resulting post-operative imaging of such cases can be daunting for the radiologist to interpret, particularly in the presence of distorted anatomy and unfamiliar hardware. • This article reviews the indications for limb salvage surgery, prosthetic reconstruction devices involved, expected post-operative imaging findings, as well as the potential hardware related complications that may be encountered in the management of such cases. • By being aware of the various types of reconstructive techniques used in limb salvage surgery as well as the potential complications, the reporting radiologist should possess greater confidence in making an accurate assessment of the expected post-operative imaging findings in the management of such cases. - Abstract: Advances in reconstructive orthopaedic techniques now allow for limb salvage and prosthetic reconstruction procedures to be performed on patients who would otherwise be required to undergo debilitating limb amputations for malignant bone tumours. The resulting post-operative imaging of such cases can be daunting for the radiologist to interpret, particularly in the presence of distorted anatomy and unfamiliar hardware. This article reviews the indications for limb salvage surgery, prosthetic reconstruction devices involved, expected post-operative imaging findings, as well as the potential hardware related complications that may be encountered in the management of such cases.

  15. Reconstruction of large limb bone defects with a double-barrel free vascularized fibular graft

    Institute of Scientific and Technical Information of China (English)

    BI Zheng-gang; HAN Xing-guang; FU Chun-jiang; CAO Yang; YANG Cheng-lin

    2008-01-01

    Background The use of a free,vascularized fibular graft is an important technique for the reconstruction of large defects in long bones.The technique has many advantages in strong,tubular bones; a more reliable vascular anatomy with a large vascular diameter and long pedicle is used,minimizing donor-site morbidity.Due to limitations in both fibular anatomy and mechanics,they cannot effectively be used to treat large limb bone defects due to their volume and strength.Methods From 1990 to 2001,16 clinical cases of large bone defects were treated using vascularized double-barrel fibular grafts.Patients were evaluated for an average of 10 months after surgery.Results All the patients achieved bony union; the average bone union took 10 months post surgery,and no stress fractures occurred.Compared with single fibular grafts,the vascularized double-barrel fibular grafts greatly facilitate bony union and are associated with fewer complications,suggesting that the vascularized double-barrel fibular graft is a valuable procedure for the correction of large bone defects in large,long bones in addition to enhancing bone intensity.Conclusions The vascularized double-barrel fibular graft is superior to the single fibular graft in stimulating osteogenous activity and biological mechanics for the correction of very large bone defects in large,long bones.Free vascularized folded double-barrel fibular grafts can not only fill up large bone defects,but also improve the intensity margin.Therefore,this study also widens its application and enlarges the treatment targets.However,in the case of bone deformability,special attention should be paid to bone fixation and protection of donor and recipient sites.

  16. Techniques of the tympanomastoidectomy with reconstruction of the posterior bone wall of the external auditory canal

    Directory of Open Access Journals (Sweden)

    Dankuc Dragan

    2015-01-01

    Full Text Available A combined tympanoplasty method, the mobile-bridge tympanoplasty, has been applied at the Clinic for Ear, Nose and Throat Diseases in Novi Sad since 1998. Mobile-bridge tympanoplasty is performed at our Clinic by applying Feldmann’s procedure utilizing a microsurgical oscillating saw. It is a combination of closed and open techniques for surgical treatment of middle ear diseases. In addition to this technique, a method for reconstruction of the posterior bone wall of the external auditory canal was introduced. This procedure is applied in cases of damage or impairment of the bony ear canal wall using mastoid cortical temporal bone graft or modeled cartilage of the concha. Maintenance of general anatomical relations in the middle ear enables good ventilation of pneumatic spaces of the middle ear and Eustachian tube permeability, thus providing good conditions for ossicular chain reconstruction. The incidence of recurrent cholesteatoma in combined mobile-bridge tympanoplasty and tympanoplasty with reconstruction of the posterior bone wall was 6% in total. The incidence values for the recurrent cholesteatoma in closed tympanoplasty and in cases of open techniques were 10%. Mobile-bridge tympanoplasty and reconstruction of the posterior bone wall of external auditory canal are methods of choice in surgical treatment of middle ear cholesteatoma that progressed to the attic space, sinus tympani and facial recess.

  17. Effect of low-dose CT and iterative reconstruction on trabecular bone microstructure assessment

    Science.gov (United States)

    Kopp, Felix K.; Baum, Thomas; Nasirudin, Radin A.; Mei, Kai; Garcia, Eduardo G.; Burgkart, Rainer; Rummeny, Ernst J.; Bauer, Jan S.; Noël, Peter B.

    2016-03-01

    The trabecular bone microstructure is an important factor in the development of osteoporosis. It is well known that its deterioration is one effect when osteoporosis occurs. Previous research showed that the analysis of trabecular bone microstructure enables more precise diagnoses of osteoporosis compared to a sole measurement of the mineral density. Microstructure parameters are assessed on volumetric images of the bone acquired either with high-resolution magnetic resonance imaging, high-resolution peripheral quantitative computed tomography or high-resolution computed tomography (CT), with only CT being applicable to the spine, which is one of clinically most relevant fracture sites. However, due to the high radiation exposure for imaging the whole spine these measurements are not applicable in current clinical routine. In this work, twelve vertebrae from three different donors were scanned with standard and low radiation dose. Trabecular bone microstructure parameters were assessed for CT images reconstructed with statistical iterative reconstruction (SIR) and analytical filtered backprojection (FBP). The resulting structure parameters were correlated to the biomechanically determined fracture load of each vertebra. Microstructure parameters assessed for low-dose data reconstructed with SIR significantly correlated with fracture loads as well as parameters assessed for standard-dose data reconstructed with FBP. Ideal results were achieved with low to zero regularization strength yielding microstructure parameters not significantly different from those assessed for standard-dose FPB data. Moreover, in comparison to other approaches, superior noise-resolution trade-offs can be found with the proposed methods.

  18. Tissue-engineered mandibular bone reconstruction for continuity defects: a systematic approach to the literature

    NARCIS (Netherlands)

    Chanchareonsook, N.; Junker, R.; Jongpaiboonkit, L.; Jansen, J.A.

    2014-01-01

    Background: Despite significant surgical advances over the last decades, segmental mandibular bone repair remains a challenge. In light of this, tissue engineering might offer a next step in the evolution of mandibular reconstruction. Purpose: The purpose of the present report was to (1) systematica

  19. Concurrent arthroscopic bicruciate ligament reconstruction using Achilles tendon-bone allografts: experience with 15 cases

    Institute of Scientific and Technical Information of China (English)

    Shi De-hai; CAI Dao-zhang; WANG Kun; RONG Li-min; XU Yi-chun

    2008-01-01

    Objective: To evaluate the clinical outcome of arthroscopically assisted combined anterior and posterior cruciate ligament (ACL/PCL) reconstructions using Achil-les tendon-bone allografts. Methods: Associated meniscus injuries were treated according to established methods prior to ligament recon-structions during arthroscopic surgery. Thirty Achilles ten-don-bone allografts were used to reconstruct torn ACL and PCL in 15 knees. At postoperative follow-up, all knees were graded using the modified IKDC and the Lysholm scoring systems just as done preoperatively. Results were analyzed compared with the contralateral healthy knees. Results: Eleven men and 4 women with a minimum of 3-year follow-up (mean 38 months) were included in the study. Preoperatively, the group ratings by the modified IKDC standards were all severely abnormal. Twelve bicruciate reconstructions were performed in subacute or chronic stage (>3-8 weeks), 3 for acute ligamentous deficien-cies (≤ 3 weeks). The noticeable early complication was transitory local fever combined with joint effusion in one case. At postoperative follow-up, 9 knees were normal, 5 nearly normal and 1 abnormal. On Lysholm score the differ-ence was statistically significant (t- test, P<0.001) before and after operation. Conclusions: Achilles tendon-bone allograft offers an alternative for simultaneous arthroscopic ACL/PCL reconstructions. However, further investigation is needed to eradicate its potential immunogenicity for better use.

  20. A Crust-based Method of Reconstructing Human Bone

    Institute of Scientific and Technical Information of China (English)

    MA Shu-chao; LIU Yi

    2014-01-01

    We present a crust-based procedure for modeling human being’s bone, which is based on voronoi diagram and its dual, Delaunay triangulation. In three-dimensional space, the crust algorithm can generate a 3D-model using a set of sample points. The purposes of this paper is to extract precise contour from CT series, then refer to these contours as sample points, and then apply the crust algorithm to these sample points to get three dimensional mesh.

  1. Massive bone loss from fungal infection after anterior cruciate ligament arthroscopic reconstruction.

    Science.gov (United States)

    Muscolo, D Luis; Carbo, Lisandro; Aponte-Tinao, Luis A; Ayerza, Miguel A; Makino, Arturo

    2009-09-01

    Although there are numerous reports of septic pyogenic arthritis after arthroscopic anterior cruciate ligament (ACL) reconstruction, there is limited information regarding the outcomes of fungal infection. We determined the outcomes of six patients with mycotic infection after regular ACL reconstruction. There were four males and two females with a mean age of 33 years. We determined the number of procedures performed, bone loss originating to control infection, and final reconstruction in these patients. An average of five arthroscopic lavage procedures had been performed at the referring centers. Fungal infection was diagnosed based on pathologic samples; five infections were the result of mucormycosis and one was Candida. After final débridement, the mean segmental bone loss was 12.8 cm. All patients were treated with intravenous antifungal coverage and cement spacers before final reconstruction. At final followup, all patients were free of clinical infection. Three had reconstruction with an allograft-prosthesis composite, two with hemicylindrical allografts, and one with an intercalary allograft arthrodesis. Despite the extremely unusual presentation of this complication, surgeons should be aware of potential and catastrophic consequences of this severe complication after ACL reconstruction.

  2. Autoclaved Tumor Bone for Skeletal Reconstruction in Paediatric Patients: A Low Cost Alternative in Developing Countries

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2013-01-01

    Full Text Available We reviewed in this series forty patients of pediatric age who underwent resection for malignant tumors of musculoskeletal system followed by biological reconstruction. Our surgical procedure for reconstruction included (1 wide en bloc resection of the tumor; (2 curettage of tumor from the resected bone; (3 autoclaving for 8 minutes (4 bone grafting from the fibula (both vascularized and nonvascularized fibular grafts used; (5 reimplantation of the autoclaved bone into the host bone defect and fixation with plates. Functional evaluation was done using MSTS scoring system. At final followup of at least 18 months (mean 29.2 months, 31 patients had recovered without any complications. Thirty-eight patients successfully achieved a solid bony union between the graft and recipient bone. Three patients had surgical site infection. They were managed with wound debridement and flap coverage of the defect. Local recurrence and nonunion occurred in two patients each. One patient underwent disarticulation at hip due to extensive local disease and one died of metastasis. For patients with non-union, revision procedure with bone graft and compression plates was successfully used. The use of autoclaved tumor grafts provides a limb salvage option that is inexpensive and independent of external resources and is a viable option for musculoskeletal tumor management in developing countries.

  3. Total reconstruction of mandible by transport distraction after complete resection for benign and malignant tumors

    Directory of Open Access Journals (Sweden)

    S M Balaji

    2016-01-01

    Conclusions: TDO potentially benefits patients with segmental bony defects following tumor ablation in mandible. It is an unswerving tool to achieve sufficient bone in mandible in patients who cannot undergo aggressive surgery or poor general health. Bone resorption remains a critical issue for this reconstruction technique, though blood supply is continuously maintained in TDO.

  4. An active contour method for bone cement reconstruction from C-arm x-ray images.

    Science.gov (United States)

    Lucas, Blake C; Otake, Yoshito; Armand, Mehran; Taylor, Russell H

    2012-04-01

    A novel algorithm is presented to segment and reconstruct injected bone cement from a sparse set of X-ray images acquired at arbitrary poses. The sparse X-ray multi-view active contour (SxMAC-pronounced "smack") can 1) reconstruct objects for which the background partially occludes the object in X-ray images, 2) use X-ray images acquired on a noncircular trajectory, and 3) incorporate prior computed tomography (CT) information. The algorithm's inputs are preprocessed X-ray images, their associated pose information, and prior CT, if available. The algorithm initiates automated reconstruction using visual hull computation from a sparse number of X-ray images. It then improves the accuracy of the reconstruction by optimizing a geodesic active contour. Experiments with mathematical phantoms demonstrate improvements over a conventional silhouette based approach, and a cadaver experiment demonstrates SxMAC's ability to reconstruct high contrast bone cement that has been injected into a femur and achieve sub-millimeter accuracy with four images.

  5. The Role of Resorbable Plate and Artificial Bone Substitute in Reconstruction of Large Orbital Floor Defect

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    Ho Kwon

    2016-01-01

    Full Text Available It is essential to reduce and reconstruct bony defects adequately in large orbital floor fracture and defect. Among many reconstructive methods, alloplastic materials have attracted attention because of their safety and ease of use. We have used resorbable plates combined with artificial bone substitutes in large orbital floor defect reconstructions and have evaluated their long-term reliability compared with porous polyethylene plate. A total of 147 patients with traumatic orbital floor fracture were included in the study. Surgical results were evaluated by clinical evaluations, exophthalmometry, and computed tomography at least 12 months postoperatively. Both orbital floor height discrepancy and orbital volume change were calculated and compared with preoperative CT findings. The average volume discrepancy and vertical height discrepancies were not different between two groups. Also, exophthalmometric measurements were not significantly different between the two groups. No significant postoperative complication including permanent diplopia, proptosis, and enophthalmos was noted. Use of a resorbable plate with an artificial bone substitute to repair orbital floor defects larger than 2.5 cm2 in size yielded long-lasting, effective reconstruction without significant complications. We therefore propose our approach as an effective alternative method for large orbital floor reconstructions.

  6. Utility of tricalcium phosphate and osteogenic matrix cellsheet constructs for bone defect reconstruction

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    AIM To determine the effects of transplanting osteogenicmatrix cell sheets and beta-tricalcium phosphate(TCP) constructs on bone formation in bone defects.METHODS: Osteogenic matrix cell sheets were preparedfrom bone marrow stromal cells (BMSCs), anda porous TCP ceramic was used as a scaffold. Threeexperimental groups were prepared, comprised of TCPscaffolds (1) seeded with BMSCs; (2) wrapped withosteogenic matrix cell sheets; or (3) both. Constructswere implanted into a femoral defect model in rats andbone growth was evaluated by radiography, histology,biochemistry, and mechanical testing after 8 wk.RESULTS: In bone defects, constructs implanted withcell sheets showed callus formation with segmental or continuous bone formation at 8 wk, in contrast toTCP seeded with BMSCs, which resulted in bone nonunion.Wrapping TCP constructs with osteogenic matrixcell sheets increased their osteogenic potential andresulting bone formation, compared with conventionalbone tissue engineering TCP scaffolds seeded withBMSCs. The compressive stiffness (mean ± SD) valueswere 225.0 ± 95.7, 30.0 ± 11.5, and 26.3 ± 10.6MPa for BMSC/TCP/Sheet constructs with continuousbone formation, BMSC/TCP/Sheet constructs withsegmental bone formation, and BMSC/TCP constructs,respectively. The compressive stiffness of BMSC/TCP/Sheet constructs with continuous bone formation wassignificantly higher than those with segmental boneformation and BMSC/TCP constructs.CONCLUSION: This technique is an improvementover current methods, such as TCP substitution, andis useful for hard tissue reconstruction and inducingearlier bone union in defects.

  7. Computer-aided planning for zygomatic bone reconstruction in maxillofacial traumatology

    CERN Document Server

    Maubleu, S; Chabanas, M; Payan, Y; Boutault, F; Maubleu, Sylvain; Marecaux, Christophe; Chabanas, Matthieu; Payan, Yohan; Boutault, Franck

    2005-01-01

    An optimal planning procedure has been proposed to define the target position of the zygomatic bone following a fracture of the mid-face skeleton. The protocol has been successfully tested on healthy subjects, and ensures the global symmetry of the face could be obtained after the reconstruction surgery. Now that the planning procedure is available, the next step of this project will be to develop an intra-operative guiding system to help the surgeon to follow the planning. This procedure will mainly rely on the intra-operative registration of the zygomatic bone fragment, and the design of specific surgical ancillaries for cranio-maxillofacial surgery.

  8. A biomechanical assessment of superior shoulder translation after reconstruction of anterior glenoid bone defects: The Latarjet procedure versus allograft reconstruction

    Directory of Open Access Journals (Sweden)

    Ryan M Degen

    2013-01-01

    Full Text Available Background : The coracoacromial ligament (CAL is an important restraint to superior shoulder translation. The effect of CAL release on superior stability following the Latarjet is unknown; therefore, our purpose was to compare the effect of two Latarjet techniques and allograft reconstruction on superior instability. Materials and Methods : Eight cadaveric specimens were tested on a simulator. Superior translation was monitored following an axial force in various glenohumeral rotations (neutral, internal, and external with and without muscle loading. Three intact CAL states were tested (intact specimen, 30% glenoid bone defect, and allograft reconstruction and two CAL deficient states (classic Latarjet (classicLAT and congruent-arc Latarjet (congruentLAT. Results : In neutral without muscle loading, a significant increase in superior translation occurred with the classicLAT as compared to 30% defect (P = 0.046 and allograft conditions (P = 0.041. With muscle loading, the classicLAT (P = 0.005, 0.002 and the congruentLAT (P = 0.018, 0.021 had significantly greater superior translation compared to intact and allograft, respectively. In internal rotation, only loaded tests produced significant results; specifically, classicLAT increased translation compared to all intact CAL states (P 0.05 and no differences (P = 1.0 were found between classicLAT and congruentLAT. Discussion: In most simulations, CAL release with the Latarjet lead to increased superior humeral translation. Conclusion: The choice of technique for glenoid bone loss reconstruction has implications on the magnitude of superior humeral translation. This previously unknown effect requires further study to determine its clinical and kinematic outcomes.

  9. Reconstruction of the anterior cruciate ligament : a clinical comparison of bone-patellar tendon-bone single bundle versus semitendinosus and gracilis double bundle technique

    NARCIS (Netherlands)

    Sadoghi, Patrick; Mueller, Peter E.; Jansson, Volkmar; van Griensven, Martin; Kroepfl, Albert; Fischmeister, Martin F.

    2011-01-01

    The study hypothesis was that the outcome of semitendinosus gracilis double bundle (STG-DB) anterior cruciate ligament (ACL) reconstruction is advantageous in terms of clinical results and restoration of anterior-posterior and rotational laxity in comparison to bone-patellar tendon-bone single-bundl

  10. The diagnostic value of the sagittal multiplanar reconstruction CT images for nasal bone fractures

    Energy Technology Data Exchange (ETDEWEB)

    Kim, B.H. [Department of Radiology, Korea University Ansan Hospital, 516 Gojan1-dong, Danwon-gu, Ansan-si, Gyunggi-do, 425-707 (Korea, Republic of); Seo, H.S., E-mail: seohs@korea.ac.k [Department of Radiology, Korea University Ansan Hospital, 516 Gojan1-dong, Danwon-gu, Ansan-si, Gyunggi-do, 425-707 (Korea, Republic of); Kim, A.-Y.; Lee, Y.S. [Department of Radiology, Dongguk University International Hospital, Gyunggi-do (Korea, Republic of); Lee, Y.H. [Department of Radiology, Korea University Ansan Hospital, 516 Gojan1-dong, Danwon-gu, Ansan-si, Gyunggi-do, 425-707 (Korea, Republic of); Suh, S.-I. [Department of Diagnostic Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of); Lee, D.H. [Department of Radiology, Seoul Medical Center, Seoul (Korea, Republic of)

    2010-04-15

    Aim: To compare the diagnostic performance of sagittal multiplanar reconstruction (MPR) images and axial images for the detection of a nasal bone fracture. Materials and methods: This prospective study included 533 consecutive patients who underwent three-dimensional images with 64-section multidetector-row CT for the evaluation of a facial bone fracture between June 2007 and May 2008 (366 males; 167 females; mean age +- standard deviation 31.1 +- 21.2 years; age range 1-92 years). Two observers independently scored the possibility of a nasal bone fracture on axial and sagittal images. Receiver operating characteristic (ROC) curve analysis was performed. Results: The Az values of the sagittal images were higher than those of the axial images for both observers (p = 0.002 and 0.010, respectively) with higher accuracy (p < 0.001 and 0.016, respectively). The sensitivities of sagittal images were superior to those of axial images, especially for type 1 simple nasal bone fractures with no or minimal displacement (observer 1, 98.6 versus 72.8%; observer 2, 84.9 versus 71%). Conclusion: Sagittal MPR facial bone CT images provided superior diagnostic performance, and their addition to axial images is useful for the evaluation of nasal bone fractures.

  11. FUNCTIONAL OUTCOME OF ACCELERATED REHABILITATION IN ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE PATELLAR TENDON BONE GRAFT A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Hiranyakumar

    2016-03-01

    Full Text Available INTRODUCTION An ideal rehabilitation program post anterior cruciate ligament reconstruction enables an individual to return to pre injury levels at a faster rate with minimal to no risk of reinjury to the graft. Rehabilitation protocols have changed considerably over time in the past. It has become “aggressive”, meaning an intensive rehabilitation which includes greater variety of exercises and sports related training. AIM OF THE STUDY The aim of our study is to assess the outcome of accelerated rehabilitation post anterior cruciate ligament (ACL reconstruction. METHODOLOGY 106 patients were operated by a single surgeon underwent arthroscopic anterior cruciate ligament reconstruction using bone patella tendon bone graft and partial meniscectomy for associated meniscal tear. Patients were put on an accelerated rehabilitation protocol designed in our institute on first post-operative day, under the guidance of a physical therapist in consultation with the operated surgeon. Patients were followed up at 3 weeks, 6 months and 9 months, post onset of rehabilitation, patients were assessed using KT1000 Arthrometer and Lysholm knee scoring system. RESULTS Out of 106 patients, who were selected, 96(91% were males and 10(9% were females. The mean pre-operative Lysholm score was 55.09. Post operatively, while on accelerated rehabilitation program the Lysholm scores were 69.73 at 3 weeks, 89.13 at 6 months and 89.19 at 9 months. In our pre-operative evaluation mean KT 1000 arthrometer score was 10.53 and post-operative at six months was 3.49. At nine months 105 patients had excellent results whereas 1 patient had good result. CONCLUSION Accelerated rehabilitation protocol enables the patient to functionally recover faster to pre injury levels. A rehabilitation protocol for 6 months is sufficient in enabling a patient to get back to pre-injury levels. Functional outcome is the same with or without associated meniscal injuries.

  12. Performance analysis of model based iterative reconstruction with dictionary learning in transportation security CT

    Science.gov (United States)

    Haneda, Eri; Luo, Jiajia; Can, Ali; Ramani, Sathish; Fu, Lin; De Man, Bruno

    2016-05-01

    In this study, we implement and compare model based iterative reconstruction (MBIR) with dictionary learning (DL) over MBIR with pairwise pixel-difference regularization, in the context of transportation security. DL is a technique of sparse signal representation using an over complete dictionary which has provided promising results in image processing applications including denoising,1 as well as medical CT reconstruction.2 It has been previously reported that DL produces promising results in terms of noise reduction and preservation of structural details, especially for low dose and few-view CT acquisitions.2 A distinguishing feature of transportation security CT is that scanned baggage may contain items with a wide range of material densities. While medical CT typically scans soft tissues, blood with and without contrast agents, and bones, luggage typically contains more high density materials (i.e. metals and glass), which can produce severe distortions such as metal streaking artifacts. Important factors of security CT are the emphasis on image quality such as resolution, contrast, noise level, and CT number accuracy for target detection. While MBIR has shown exemplary performance in the trade-off of noise reduction and resolution preservation, we demonstrate that DL may further improve this trade-off. In this study, we used the KSVD-based DL3 combined with the MBIR cost-minimization framework and compared results to Filtered Back Projection (FBP) and MBIR with pairwise pixel-difference regularization. We performed a parameter analysis to show the image quality impact of each parameter. We also investigated few-view CT acquisitions where DL can show an additional advantage relative to pairwise pixel difference regularization.

  13. Evaluation of Clinical Results and Complications of Structural Allograft Reconstruction after Bone Tumor Surgery

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    Mohammad Gharedaghi

    2016-07-01

    Full Text Available Background: Massive bone allograft is an option in cases of limb preservation and reconstruction after massive benign and malignant bone tumor resection. The purpose of this study was to analyze the outcome of these procedures at Imam Reza Hospital, Mashhad University of Medical Sciences. Methods: In this study, 113 cases have been presented. Eleven cases were excluded (patients has a traumatic defect or they passed away before the completion of the study’s two-year follow up period. Each patient completed a questionnaire, went through a physical examination and, if indicated, X-ray information was collected. The patients were divided into three groups: chemotherapy, chemotherapy plus radiation therapy, and no-adjuvant-therapy. Results: Fifty-four cases were male and the mean age was 24.5±5.39. The number of cases and indications for surgery were: 33 cases of aggressive benign tumors or low grade malignant bone tumors (large bone defects including 16 germ cell tumors, eight aneurysmal bone cysts, five low grade osteosarcomas, and four chondrosarcomas. Another 69 cases were high-grade malignant bone tumors including 42 osteosarcomas, 21 Ewing’s sarcoma, and six other high grade osteosarcomas. Patients were divided into three groups: the first group received no adjuvant therapy, the second group received chemotherapy, and the third group received chemotherapy plus radiotherapy. The location of tumors were as follows: eight cases in the pelvic bone, 12 in the proximal femur, 18 in the femoral shaft, 36 in the distal femur, 12 in the proximal tibia, and 16 in the humeral bone. The 12 cases of proximal femoral defects were reconstructed by allograft composite prosthesis, 18 diaphyseal defects with intercalary allograft, and 36 distal femoral defects were reconstructed using osteoarticular allograft. The rate of deep infection was 7:8% (eight patients and in this regard, we found a significant difference among the three groups, such that most

  14. Treatment of large bone defects with a novel biological transport disc in non-vascular transport distraction osteogenesis.

    Science.gov (United States)

    Zeng, J J; Guo, P; Zhou, N; Xie, Q T; Liao, F C

    2016-05-01

    The aim of this study was to investigate a potential novel biological transport disc that avoids secondary injury to the body and facilitates bone healing. Twenty-seven dogs were divided randomly into three groups: group A were treated with human bone morphogenetic protein 2 (BMP-2) modified bone mesenchymal stem cell (BMSC) sheets combined with freeze-dried bone allograft as biological transport disc; group B were treated with BMSC sheets combined with freeze-dried bone allograft as transport disc (control); and group C were treated with direct extension only (blank). There were nine dogs in each group. Non-vascular transport distraction osteogenesis was performed in groups A and B to repair the mandibular bone defects, and in group C only mandibular truncation surgery was performed. The regeneration of bone was evaluated through X-ray, haematoxylin and eosin assay, and immunohistochemistry. After 2, 4, and 8 weeks of distraction, new bone density values in group A were 49.00±1.16, 66.63±2.62, and 72.78±2.67, respectively, and these were significantly different to values in groups B (P=0.0005, P=0.0004, P=0.0012) and C (Ptransport disc represents an effective non-secondary injury method to enhance new bone formation in non-vascular transport distraction osteogenesis.

  15. Reconstruction of Chest Wall by Cryopreserved Sternal Allograft after Resection of Aneurysmal Bone Cyst of Sternum

    Directory of Open Access Journals (Sweden)

    Kambiz Sheikhy

    2017-01-01

    Full Text Available A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result.

  16. Reconstruction of Chest Wall by Cryopreserved Sternal Allograft after Resection of Aneurysmal Bone Cyst of Sternum

    Science.gov (United States)

    Sheikhy, Kambiz; Abbasi Dezfouli, Azizollah

    2017-01-01

    A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result. PMID:28299230

  17. Reconstruction of mandibular defects using nonvascularized autogenous bone graft in Nigerians

    Directory of Open Access Journals (Sweden)

    Kizito Chioma Ndukwe

    2014-01-01

    Full Text Available Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile-Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife constituted the study sample. Relevant information was retrieved from the patients′ records. This information include patients′ demographics (age and sex as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%. Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients and postoperative wound infection (eight patients were the most common complications recorded. Conclusion: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care

  18. Pure orbital blowout fractures reconstructed with autogenous bone grafts: functional and aesthetic outcomes.

    Science.gov (United States)

    Kronig, S A J; van der Mooren, R J G; Strabbing, E M; Stam, L H M; Tan, J A S L; de Jongh, E; van der Wal, K G H; Paridaens, D; Koudstaal, M J

    2016-04-01

    The purpose of this study was to investigate the ophthalmic clinical findings following surgical reconstruction with autogenous bone grafts of pure blowout fractures. A retrospective review of 211 patients who underwent surgical repair of an orbital fracture between October 1996 and December 2013 was performed. Following data analysis, 60 patients who were followed up over a period of 1 year were included. A solitary floor fracture was present in 38 patients and a floor and a medial wall fracture in 22 patients. Comparing preoperative findings between these two groups, preoperative diplopia and enophthalmos were almost twice as frequent in the group with additional medial wall fractures: diplopia 8% and 14% and enophthalmos 18% and 55%, respectively. One year following surgery there was no diplopia present in either group. In the solitary floor fracture group, 3% still had enophthalmos. It can be concluded that at 1 year following the repair of pure orbital floor fractures using autogenous bone, good functional and aesthetic results can be obtained. In the group with both floor and medial wall fractures, no enophthalmos was found when both walls were reconstructed. When the medial wall was left unoperated, 29% of patients still suffered from enophthalmos after 1 year.

  19. Three-dimensional visualization and characterization of bone structure using reconstructed in-vitro μCT images: A pilot study for bone microarchitecture analysis

    Energy Technology Data Exchange (ETDEWEB)

    Latief, Fourier Dzar Eljabbar, E-mail: fourier@fi.itb.ac.id [Physics of Earth and Complex Systems, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Jl. Ganesha 10, Bandung 40132 (Indonesia); Dewi, Dyah Ekashanti Octorina [2Biomedical Engineering Research Division, School of Electrical Engineering and Informatics, Institut Teknologi Bandung, Jl. Ganesha 10, Bandung 40132 (Indonesia); Shari, Mohd Aliff Bin Mohd [Faculty of Electrical Engineering, Universiti Teknologi MARA Malaysia, 40000 Shah Alam, Selangor (Malaysia)

    2014-03-24

    Micro Computed Tomography (μCT) has been largely used to perform micrometer scale imaging of specimens, bone biopsies and small animals for the study of porous or cavity-containing objects. One of its favored applications is for assessing structural properties of bone. In this research, we perform a pilot study to visualize and characterize bone structure of a chicken bone thigh, as well as to delineate its cortical and trabecular bone regions. We utilize an In-Vitro μCT scanner Skyscan 1173 to acquire a three dimensional image data of a chicken bone thigh. The thigh was scanned using X-ray voltage of 45 kV and current of 150 μA. The reconstructed images have spatial resolution of 142.50 μm/pixel. Using image processing and analysis e.i segmentation by thresholding the gray values (which represent the pseudo density) and binarizing the images, we were able to visualize each part of the bone, i.e., the cortical and trabecular regions. Total volume of the bone is 4663.63 mm{sup 3}, and the surface area of the bone is 7913.42 mm{sup 2}. The volume of the cortical is approximately 1988.62 mm{sup 3} which is nearly 42.64% of the total bone volume. This pilot study has confirmed that the μCT is capable of quantifying 3D bone structural properties and defining its regions separately. For further development, these results can be improved for understanding the pathophysiology of bone abnormality, testing the efficacy of pharmaceutical intervention, or estimating bone biomechanical properties.

  20. Characteristics of bone tunnel changes after anterior cruciate ligament reconstruction using Ligament Advanced Reinforcement System artificial ligament

    Institute of Scientific and Technical Information of China (English)

    HUANG Jian-ming; LIU Hao-yuan; CHEN Feng-rong; JIAN Guo-jian; CHEN Qi; WANG Zi-min; KANG Yi-fan

    2012-01-01

    Background There are different materials used for anterior cruciate ligament(ACL)reconstruction.It has been reported that both autologous grafts and allografts used in ACL reconstruction can cause bone tunnel enlargement.This study aimed to observe the characteristics of bone tunnel changes and possible causative factors following ACL reconstruction using Ligament Advanced Reinforcement System(LARS)artificial ligament.Methods Forty-three patients underwent ACL reconstruction using LARS artificial ligament and were followed up for 3 years.X-ray and CT examinations were performed at 1,3,6,12,24,and 36 months after surgery,to measure the width of tibial and femoral tunnels.Knee function was evaluated according to the Lysholm scoring system.The anterior and posterior stability of the knee was measured using the KT-1000 arthrometer.Results According to the Peyrache grading method,grade 1 femoral bone tunnel enlargement was observed in three cases six months after surgery.No grade 2 or grade 3 bone tunnel enlargement was found.The bone tunnel enlargement in the three cases was close to the articular surface with an average tunnel enlargement of(2.5±0.3)mm.Forty cases were evaluated as grade 0.The average tibial and femoral tunnel enlargements at the last follow-up were(0.8±0.3)and(1.1±0.3)mm,respectively.There was no statistically significant difference in bone tunnel width changes at different time points(P>0.05).X-ray and CT measurements were consistent.Conclusions There was no marked bone tunnel enlargement immediately following ACL reconstruction using LARS artificial ligament.Such enlargement may,however,result from varying grafting factors involving the LARS artificial ligament or from different fixation methods.

  1. Poly-cyclodextrin functionalized porous bioceramics for local chemotherapy and anticancer bone reconstruction.

    Science.gov (United States)

    Chai, Feng; Abdelkarim, Mohamed; Laurent, Thomas; Tabary, Nicolas; Degoutin, Stephanie; Simon, Nicolas; Peters, Fabian; Blanchemain, Nicolas; Martel, Bernard; Hildebrand, Hartmut F

    2014-08-01

    The progress in bone cancer surgery and multimodal treatment concept achieve only modest improvement in the overall survival, due to failure in clearing out residual cancer cells at the surgical margin and extreme side-effects of adjuvant postoperative treatments. Our study aims to propose a new method based on cyclodextrin polymer (polyCD) functionalized hydroxyapatite (HA) for achieving a high local drug concentration with a sustained release profile and a better control of residual malignant cells via local drug delivery and promotion of the reconstruction of bone defects. PolyCD, a versatile carrier for therapeutic molecules, can be incorporated into HA (bone regeneration scaffold) through thermal treatment. The parameters of polyCD treatment on the macroporous HA (porosity 65%) were characterized via thermogravimetric analysis. Good cytocompatibility of polyCD functionalized bioceramics was demonstrated on osteoblast cells by cell vitality assay. An antibiotic (gentamicin) and an anticancer agent (cisplatin) were respectively loaded on polyCD functionalized bioceramics for drug release test. The results show that polyCD functionalization leads to significantly improved drug loading quantity (30% more concerning gentamicin and twice more for cisplatin) and drug release duration (7 days longer concerning gentamicin and 3 days longer for cisplatin). Conclusively, this study offers a safe and reliable drug delivery system for bioceramic matrices, which can load anticancer agents (or/and antibiotics) to reduce local recurrence (or/and infection).

  2. Reconstruction of the Aceh Region following the 2004 Indian Ocean tsunami disaster: A transportation perspective

    Directory of Open Access Journals (Sweden)

    Ryo Matsumaru

    2012-07-01

    Full Text Available Aceh, located in the northernmost area of Sumatra Island, is one of the regions that suffered the most damage from the Indian Ocean tsunami in 2004. The process of reconstruction after a large-scale disaster is considered an opportunity to create a safer society, especially for developing countries, however the accumulation of knowledge about how to improve reconstruction is insufficient. The affected areas have diverse social and economic characteristics and unprecedented restoration efforts have been made. The Indian Ocean tsunami disaster, therefore, provides numerous research opportunities, and many surveys and other researches have been conducted to better understand what happened and how the reconstruction process could be improved. However, the majority of such research has focused on housing reconstruction, rebuilding livelihoods and community rehabilitation and there has been only limited research on transportation-related issues. Thus, there is significance in evaluating the reconstruction of Aceh from a transportation perspective, a dimension that has yet to be examined systematically. As a first step in the effort to evaluate various aspects of the reconstruction of Aceh from a transportation perspective, this research aims to present three transportation-related issues within the reconstruction process—1 the road network in the Banda Aceh coastal area, 2 mobility in relocation sites, and 3 reconstruction of the Banda Aceh–Meulaboh road—and to conduct a preliminary analysis of these issues by adding the viewpoint of disaster management and reconstruction, the authors' area of specialization. For conducting a preliminary analysis, existing information such as research papers, articles and reports and data collected through interviews and field reconnaissance conducted by the authors were utilized as much as possible, and such “qualitative data” was analyzed by applying the “interpretive approach”, considered an

  3. Reconstructive procedures for segmental resection of bone in giant cell tumors around the knee

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    Aggarwal Aditya

    2007-01-01

    Full Text Available Background: Segmental resection of bone in Giant Cell Tumor (GCT around the knee, in indicated cases, leaves a gap which requires a complex reconstructive procedure. The present study analyzes various reconstructive procedures in terms of morbidity and various complications encountered. Materials and Methods: Thirteen cases (M-six and F-seven; lower end femur-six and upper end tibia -seven of GCT around the knee, radiologically either Campanacci Grade II, Grade II with pathological fracture or Grade III were included. Mean age was 25.6 years (range 19-30 years. Resection arthrodesis with telescoping (shortening over intramedullary nail ( n=5, resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail ( n=3 and resection arthrodesis with intercalary fibular autograft and simultaneous limb lengthening ( n=5 were the procedure performed. Results: Shortening was the major problem following resection arthrodesis with telescoping (shortening over intramedullary nail. Only two patients agreed for subsequent limb lengthening. The rest continued to walk with shortening. Infection was the major problem in all cases of resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail and required multiple drainage procedures. Fusion was achieved after two years in two patients. In the third patient the allograft sequestrated. The patient underwent sequestrectomy, telescoping of fragments and ilizarov fixator application with subsequent limb lengthening. The patient was finally given an ischial weight relieving orthosis, 54 months after the index procedure. After resection arthrodesis with intercalary autograft and simultaneous lengthening the resultant gap (~15cm was partially bridged by intercalary nonvascularized dual fibular strut graft (6-7cm and additional corticocancellous bone graft from ipsilateral patella. Simultaneous limb lengthening with a distal tibial corticotomy was performed on an

  4. Reconstruction of the adenosine system by bone marrow-derived mesenchymal stem cell transplantation

    Institute of Scientific and Technical Information of China (English)

    Huicong Kang; Qi Hu; Xiaoyan Liu; Yinhe Liu; Feng Xu; Xiang Li; Suiqiang Zhu

    2012-01-01

    In the present study, we transplanted bone marrow-derived mesenchymal stem cells into the CA3 area of the hippocampus of chronic epilepsy rats kindled by lithium chloride-pilocarpine. Immunofluorescence and western blotting revealed an increase in adenosine A1 receptor expression and a decrease in adenosine A2a receptor expression in the brain tissues of epileptic rats 3 months after transplantation. Moreover, the imbalance in the A1 adenosine receptor/A2a adenosine receptor ratio was improved. Electroencephalograms showed that frequency and amplitude of spikes in the hippocampus and frontal lobe were reduced. These results suggested that mesenchymal stem cell transplantation can reconstruct the normal function of the adenosine system in the brain and greatly improve epileptiform discharges.

  5. Autologously generated tissue-engineered bone flaps for reconstruction of large mandibular defects in an ovine model.

    NARCIS (Netherlands)

    Tatara, A.M.; Kretlow, J.D.; Spicer, P.P.; Lu, S.; Lam, J.; Liu, W.; Cao, Y.; Liu, G.; Jackson, J.D.; Yoo, J.J.; Atala, A.; Beucken, J.J.J.P van den; Jansen, J.A.; Kasper, F.K.; Ho, T.; Demian, N.; Miller, M.J.; Wong, M.E.; Mikos, A.G.

    2015-01-01

    The reconstruction of large craniofacial defects remains a significant clinical challenge. The complex geometry of facial bone and the lack of suitable donor tissue often hinders successful repair. One strategy to address both of these difficulties is the development of an in vivo bioreactor, where

  6. A Novel Method of Orbital Floor Reconstruction Using Virtual Planning, 3-Dimensional Printing, and Autologous Bone.

    Science.gov (United States)

    Vehmeijer, Maarten; van Eijnatten, Maureen; Liberton, Niels; Wolff, Jan

    2016-08-01

    Fractures of the orbital floor are often a result of traffic accidents or interpersonal violence. To date, numerous materials and methods have been used to reconstruct the orbital floor. However, simple and cost-effective 3-dimensional (3D) printing technologies for the treatment of orbital floor fractures are still sought. This study describes a simple, precise, cost-effective method of treating orbital fractures using 3D printing technologies in combination with autologous bone. Enophthalmos and diplopia developed in a 64-year-old female patient with an orbital floor fracture. A virtual 3D model of the fracture site was generated from computed tomography images of the patient. The fracture was virtually closed using spline interpolation. Furthermore, a virtual individualized mold of the defect site was created, which was manufactured using an inkjet printer. The tangible mold was subsequently used during surgery to sculpture an individualized autologous orbital floor implant. Virtual reconstruction of the orbital floor and the resulting mold enhanced the overall accuracy and efficiency of the surgical procedure. The sculptured autologous orbital floor implant showed an excellent fit in vivo. The combination of virtual planning and 3D printing offers an accurate and cost-effective treatment method for orbital floor fractures.

  7. ACL reconstruction - discharge

    Science.gov (United States)

    Anterior cruciate ligament reconstruction - discharge; ACL reconstruction - discharge ... had surgery to reconstruct your anterior cruciate ligament (ACL). The surgeon drilled holes in the bones of ...

  8. Acetabular defect reconstruction with impacted morsellized bone grafts or TCP/HA particles. A study on the mechanical stability of cemented cups in an artificial acetabulum model.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Verdonschot, N.J.J.; Schreurs, B.W.; Buma, P.

    2002-01-01

    In revision surgery of the acetabulum bone defects can be filled with impacted human morsellized bone grafts. Because of a worldwide limited availability of human bone, alternatives are being considered. In this study we compared the initial stability of acetabular cups after reconstructing a cavita

  9. Prehospital intraosseus access with the bone injection gun by a helicopter-transported emergency medical team.

    NARCIS (Netherlands)

    Gerritse, B.M.; Scheffer, G.J.; Draaisma, J.M.T.

    2009-01-01

    BACKGROUND: To evaluate the use of the bone injection gun to obtain vascular access in the prehospital setting by an Helicopter-Transported Emergency Medical Team. METHODS: Prospective descriptive study to assess the frequency and success rate of the use of the bone injection gun in prehospital care

  10. Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases

    Directory of Open Access Journals (Sweden)

    Gurdayal Singh Kalra

    2013-01-01

    Full Text Available Introduction: The severe long bone defects usually follow high-energy trauma and are often associated with a significant soft-tissue injury. The goal of management of these open long bone defects is to provide stable fixation with maintenance of limb length and soft-tissue coverage. The purpose of this article is to present the clinic-radiological outcome, complications and treatment of post-traumatic long bone defect with vascularised fibula transfer. Materials and Methods: Retrospective records of 28 patients were analysed who presented with post-traumatic long bone defects and in whom reconstruction with vascularised free fibula was done. Demographic data were recorded and clinical and radiological assessment was done. Results: Out of 28 patients in whom vascularised free fibula transfer was carried out three flaps were lost while non-union occur in three patients. Three patients developed a stress fracture of transferred free fibula in the post-operative period. Few of the patients experienced some problems in the donor leg; however, all of them improved in subsequent follow-up. Discussion: It is clearly evident from this study that timing of surgery plays an important role in the micro-vascular reconstruction in trauma cases. All the complication like flap loss, non-union or delayed union occur in patients in whom reconstruction was delayed. Conclusion: The free vascularised fibula graft is a viable method for the reconstruction of skeletal defects of more than 6 cm, especially in cases of scarred and avascular recipient sites or in patients with combined bone and soft-tissue defects. Results are best when the reconstruction is done within 1 week of trauma.

  11. Aberrant bone density in aging mice lacking the adenosine transporter ENT1.

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    David J Hinton

    Full Text Available Adenosine is known to regulate bone production and resorption in humans and mice. Type 1 equilibrative nucleoside transporter (ENT1 is responsible for the majority of adenosine transport across the plasma membrane and is ubiquitously expressed in both humans and mice. However, the contribution of ENT1-mediated adenosine levels has not been studied in bone remodeling. With the recent identification of the importance of adenosine signaling in bone homeostasis, it is essential to understand the role of ENT1 to develop novel therapeutic compounds for bone disorders. Here we examined the effect of ENT1 deletion on bone density using X-ray, dual energy X-ray absorptiometry and micro-computerized tomography analysis. Our results show that bone density and bone mineral density is reduced in the lower thoracic and lumbar spine as well as the femur of old ENT1 null mice (>7 months compared to wild-type littermates. Furthermore, we found increased mRNA expression of tartrate-resistant acid phosphatase (TRAP, an osteoclast marker, in isolated long bones from 10 month old ENT1 null mice compared to wild-type mice. In addition, aged ENT1 null mice displayed severe deficit in motor coordination and locomotor activity, which might be attributed to dysregulated bone density. Overall, our study suggests that ENT1-regulated adenosine signaling plays an essential role in lumbar spine and femur bone density.

  12. Complex reconstruction of the dorsal hand using the induced membrane technique associated with bone substitute: A case report

    Science.gov (United States)

    Guillier, David; Rizzi, Philippe; De Taddeo, Alice; Henault, Benoit; Tchurukdichian, Alain; Zwetyenga, Narcisse

    2016-01-01

    Introduction High-energy trauma of the hand often causes tissue loss involving bone, tendon and skin and is sometimes accompanied by devascularization of digits. Bone stabilization is the first step in the management of such injuries. Materials and methods A young patient presented composite tissue loss of the dorsum of his right (dominant) hand following an accident with a surface planer. Tissue loss involved the diaphyses of the first 4 metacarpals, tendons and skin with almost complete amputation of the 3rd finger. Bone stabilization comprised osteosynthesis using pins associated with cement to fill the bone defect. Hunter tendon rods were used for tendon repair and a pedicle groin flap (McGregor) was used to achieve skin coverage. The cement was replaced with autologous cortico-cancellous bone graft combined with bone paste (Nanostim) 3 months after the cement stabilization. Results Eleven months after the accident, the patient was able to return to work as a carpenter. Pinch and Grasp strength in the injured hand were half that in the contralateral hand, but there was no loss of sensitivity. Mobility was very satisfactory with a Kapandji score of 9 and a mean TAM of 280°. The patient can write, open a bottle and does not feel limited for everyday activities. Radiographically, the bone of the 3 reconstructed metacarpals appears consolidated. Conclusion The induced membrane technique allowed the reconstruction of small bone deficits in the long bones of the hand in a two-step procedure, the first step taking place in an emergency context of composite tissue trauma. PMID:27077131

  13. Firm anchoring between a calcium phosphate-hybridized tendon and bone for anterior cruciate ligament reconstruction in a goat model

    Energy Technology Data Exchange (ETDEWEB)

    Mutsuzaki, Hirotaka [Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami Ami-machi, Inashiki-gun, Ibaraki 300-0394 (Japan); Sakane, Masataka; Ochiai, Naoyuki [Department of Orthopaedic Surgery, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 (Japan); Hattori, Shinya; Kobayashi, Hisatoshi, E-mail: sakane-m@md.tsukuba.ac.j [Biomaterial Center, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044 (Japan)

    2009-08-15

    Using an alternative soaking process improved the tendon-bone attachment for a calcium phosphate (CaP)-hybridized tendon graft. We characterized the deposited CaP on and in tendons and analyzed the histology and mechanical properties of the tendon-bone interface in anterior cruciate ligament (ACL) reconstruction in goats. The tendon grafts to be implanted were soaked ten times alternately in a Ca-containing solution and a PO{sub 4}-containing solution for 30 s each. Needlelike CaP nanocrystals including low-crystalline apatite were deposited on and between collagen fibrils from the surface to a depth of 200{mu}m inside the tendon. The structure resembles the extracellular matrix of bone. In animal experiments, the CaP-hybridized tendon directly bonded with newly formed bone at 6 weeks (n = 3), while fibrous bonding was observed in the control (n = 3). The ultimate failure load was not statistically different between the CaP (n = 7) and control (n = 7). However, in the failure mode, all the tendon-bone interfaces were intact in the CaP group, while three of seven specimens were pulled out from bone tunnels in the control. The result suggested that the strength of the tendon-bone interface in the CaP group is superior to that in the control group. Clinically, firm tendon-bone anchoring may lead to good results without the knee instability associated with the loosening of the bone-tendon junction in ACL reconstruction.

  14. The impact of morphology on light transport in cancellous bone

    NARCIS (Netherlands)

    Margallo-Balbás, E.; Taroni, D.; Pifferi, A.; Koolstra, J.H.; Van Ruyven, L.J.; French, P.J.

    2010-01-01

    In recent years, optical techniques based on diffusion approximation have demonstrated their ability to gain rich spectral information about bone. However, these methods normally assume homogeneity, while cancellous bone and marrow form a highly heterogeneous two-phase medium. This paper studies the

  15. Patient-specific reconstruction utilizing computer assisted 3D modelling for partial bone flap defect in hybrid cranioplasty

    Science.gov (United States)

    Hueh, Low Peh; Abdullah, Johari Yap; Abdullah, Abdul Manaf; Yahya, Suzana; Idris, Zamzuri; Mohamad, Dasmawati

    2016-12-01

    Autologous cranioplasty using a patient's original bone flap remain the commonest practice nowadays. However, partial bone flap defect is commonly encountered. Replacing the bone flap with pre-moulded synthetic bone flap is costly and not affordable to many patients. Hence most of the small to medium size defect was topped up with alloplastic material on a free hand basis intra-operatively which often resulted in inaccurate implant approximation with unsatisfactory cosmetic result. This study aims to evaluate implant accuracy and cosmetic outcome of cranioplasty candidates who underwent partial bone flap reconstruction utilising computer assisted 3D modelling. 3D images of the skull were obtained from post-craniectomy axial 1-mm spiral computed tomography (CT) scans and a virtual 3D model was generated using the Materialise Mimics software. The Materialise 3-Matic was then utilised to design a patient-specific implant. Prefabrication of the implant was performed by the 3D Objet printer, and a negative gypsum mold was created with the prefabricated cranial implant. Intraoperatively, a hybrid polymethyl methacrylate (PMMA)-autologous cranial implant was produced using the gypsum mold, and fit into the cranial defect. This study is still ongoing at the moment. To date, two men has underwent partial bone flap reconstruction utilising this technique and both revealed satisfactory implant alignment with favourable cosmesis. Mean implant size was 12cm2, and the mean duration of intraoperative reconstruction for the partial bone flap defect was 40 minutes. No significant complication was reported. As a conclusion, this new technique and approach resulted in satisfactory implant alignment and favourable cosmetic outcome. However, more study samples are needed to increase the validity of the study results.

  16. The Effect of Locally Administered Pamidronate on Autogenous Bone Graft in Maxillofacial Reconstruction: A Randomized Clinical Trial

    Science.gov (United States)

    Bayat, M.; Garajei, A.; Afshari Pour, E.; Hasheminasab, M.; Ghorbani, Y.; Kalantar Motamedi, M. H.; Bahrami, N.

    2017-01-01

    Background: Although bone grafts are commonly used in reconstructive surgeries, they are sensitive to local perfusion and are thus prone to severe resorption. Biphosphonates can inactivate osteoclasts and can be used to control the undesirable bone resorption. Objective: To assess the effect of administration of biphosphonates on bone resorption. Methods: 20 patients with bony defects who were candidates for free autogenous grafts were randomized into “pamidronate” and “control” groups. Bone segments were soaked in either pamidronate solution or normal saline and were inserted into the area of the surgery. Bone densities were measured post-surgery and in 6-month follow-up. Data were obtained via Digora software and analyzed. Results: The mean±SD bone density in pamidronate group changed from 93.4±14.6 to 93.6±17.5 (p<0.05); in the control group the density decreased from 89.7±13.2 to 78.9±11.4 (p<0.05). The mean difference of bone density in anterior areas of the jaws showed higher DXA in comparison to posterior regions (p=0.002). Conclusion: Locally administered pamidronate affects reduction in bone resorption.

  17. Accounting for beta-particle energy loss to cortical bone via paired-image radiation transport (PIRT).

    Science.gov (United States)

    Shah, Amish P; Rajon, Didier A; Patton, Phillip W; Jokisch, Derek W; Bolch, Wesley E

    2005-05-01

    Current methods of skeletal dose assessment in both medical physics (radionuclide therapy) and health physics (dose reconstruction and risk assessment) rely heavily on a single set of bone and marrow cavity chord-length distributions in which particle energy deposition is tracked within an infinite extent of trabecular spongiosa, with no allowance for particle escape to cortical bone. In the present study, we introduce a paired-image radiation transport (PIRT) model which provides a more realistic three-dimensional (3D) geometry for particle transport in the skeletal site at both microscopic and macroscopic levels of its histology. Ex vivo CT scans were acquired of the pelvis, cranial cap, and individual ribs excised from a 66-year male cadaver (BMI of 22.7 kg m(-2)). For the three skeletal sites, regions of trabecular spongiosa and cortical bone were identified and segmented. Physical sections of interior spongiosa were taken and subjected to microCT imaging. Voxels within the resulting microCT images were then segmented and labeled as regions of bone trabeculae, endosteum, active marrow, and inactive marrow through application of image processing algorithms. The PIRT methodology was then implemented within the EGSNRC radiation transport code whereby electrons of various initial energies are simultaneously tracked within both the ex vivo CT macroimage and the CT microimage of the skeletal site. At initial electron energies greater than 50-200 keV, a divergence in absorbed fractions to active marrow are noted between PIRT model simulations and those estimated under existing techniques of infinite spongiosa transport. Calculations of radionuclide S values under both methodologies imply that current chord-based models may overestimate the absorbed dose to active bone marrow in these skeletal sites by 0% to 27% for low-energy beta emitters (33P, 169Er, and 177Lu), by approximately 4% to 49% for intermediate-energy beta emitters (153Sm, 186Re, and 89Sr), and by

  18. Probing the electronic transport on the reconstructed Au/Ge(001 surface

    Directory of Open Access Journals (Sweden)

    Franciszek Krok

    2014-09-01

    Full Text Available By using scanning tunnelling potentiometry we characterized the lateral variation of the electrochemical potential µec on the gold-induced Ge(001-c(8 × 2-Au surface reconstruction while a lateral current flows through the sample. On the reconstruction and across domain boundaries we find that µec shows a constant gradient as a function of the position between the contacts. In addition, nanoscale Au clusters on the surface do not show an electronic coupling to the gold-induced surface reconstruction. In combination with high resolution scanning electron microscopy and transmission electron microscopy, we conclude that an additional transport channel buried about 2 nm underneath the surface represents a major transport channel for electrons.

  19. Development of a strain rate dependent material model of human cortical bone for computer-aided reconstruction of injury mechanisms.

    Science.gov (United States)

    Asgharpour, Zahra; Zioupos, Peter; Graw, Matthias; Peldschus, Steffen

    2014-03-01

    Computer-aided methods such as finite-element simulation offer a great potential in the forensic reconstruction of injury mechanisms. Numerous studies have been performed on understanding and analysing the mechanical properties of bone and the mechanism of its fracture. Determination of the mechanical properties of bones is made on the same basis used for other structural materials. The mechanical behaviour of bones is affected by the mechanical properties of the bone material, the geometry, the loading direction and mode and of course the loading rate. Strain rate dependency of mechanical properties of cortical bone has been well demonstrated in literature studies, but as many of these were performed on animal bones and at non-physiological strain rates it is questionable how these will apply in the human situations. High strain-rates dominate in a lot of forensic applications in automotive crashes and assault scenarios. There is an overwhelming need to a model which can describe the complex behaviour of bone at lower strain rates as well as higher ones. Some attempts have been made to model the viscoelastic and viscoplastic properties of the bone at high strain rates using constitutive mathematical models with little demonstrated success. The main objective of the present study is to model the rate dependent behaviour of the bones based on experimental data. An isotropic material model of human cortical bone with strain rate dependency effects is implemented using the LS-DYNA material library. We employed a human finite element model called THUMS (Total Human Model for Safety), developed by Toyota R&D Labs and the Wayne State University, USA. The finite element model of the human femur is extracted from the THUMS model. Different methods have been employed to develop a strain rate dependent material model for the femur bone. Results of one the recent experimental studies on human femur have been employed to obtain the numerical model for cortical femur. A

  20. Scaffold-free Three-dimensional Graft From Autologous Adipose-derived Stem Cells for Large Bone Defect Reconstruction

    Science.gov (United States)

    Dufrane, Denis; Docquier, Pierre-Louis; Delloye, Christian; Poirel, Hélène A.; André, Wivine; Aouassar, Najima

    2015-01-01

    Abstract Long bone nonunion in the context of congenital pseudarthrosis or carcinologic resection (with intercalary bone allograft implantation) is one of the most challenging pathologies in pediatric orthopedics. Autologous cancellous bone remains the gold standard in this context of long bone nonunion reconstruction, but with several clinical limitations. We then assessed the feasibility and safety of human autologous scaffold-free osteogenic 3-dimensional (3D) graft (derived from autologous adipose-derived stem cells [ASCs]) to cure a bone nonunion in extreme clinical and pathophysiological conditions. Human ASCs (obtained from subcutaneous adipose tissue of 6 patients and expanded up to passage 4) were incubated in osteogenic media and supplemented with demineralized bone matrix to obtain the scaffold-free 3D osteogenic structure as confirmed in vitro by histomorphometry for osteogenesis and mineralization. The 3D “bone-like” structure was finally transplanted for 3 patients with bone tumor and 3 patients with bone pseudarthrosis (2 congenital, 1 acquired) to assess the clinical feasibility, safety, and efficacy. Although minor clones with structural aberrations (aneuploidies, such as tri or tetraploidies or clonal trisomy 7 in 6%–20% of cells) were detected in the undifferentiated ASCs at passage 4, the osteogenic differentiation significantly reduced these clonal anomalies. The final osteogenic product was stable, did not rupture with forceps manipulation, did not induce donor site morbidity, and was easily implanted directly into the bone defect. No acute (development, were associated with the graft up to 4 years after transplantation. We report for the first time that autologous ASC can be fully differentiated into a 3D osteogenic-like implant without any scaffold. We demonstrated that this engineered tissue can safely promote osteogenesis in extreme conditions of bone nonunions with minor donor site morbidity and no oncological side effects. PMID

  1. Analysis of limb function after various reconstruction methods according to tumor location following resection of pediatric malignant bone tumors

    Directory of Open Access Journals (Sweden)

    Tokuhashi Yasuaki

    2010-05-01

    Full Text Available Abstract Background In the reconstruction of the affected limb in pediatric malignant bone tumors, since the loss of joint function affects limb-length discrepancy expected in the future, reconstruction methods that not only maximally preserve the joint function but also maintain good limb function are necessary. We analysis limb function of reconstruction methods by tumor location following resection of pediatric malignant bone tumors. Patients and methods We classified the tumors according to their location into 3 types by preoperative MRI, and evaluated reconstruction methods after wide resection, paying attention to whether the joint function could be preserved. The mean age of the patients was 10.6 years, Osteosarcoma was observed in 26 patients, Ewing's sarcoma in 3, and PNET(primitive neuroectodermal tumor and chondrosarcoma (grade 1 in 1 each. Results Type I were those located in the diaphysis, and reconstruction was performed using a vascularized fibular graft(vascularized fibular graft. Type 2 were those located in contact with the epiphyseal line or within 1 cm from this line, and VFG was performed in 1, and distraction osteogenesis in 1. Type III were those extending from the diaphysis to the epiphysis beyond the epiphyseal line, and a Growing Kotz was mainly used in 10 patients. The mean functional assessment score was the highest for Type I (96%: n = 4 according to the type and for VFG (99% according to the reconstruction method. Conclusion The final functional results were the most satisfactory for Types I and II according to tumor location. Biological reconstruction such as VFG and distraction osteogenesis without a prosthesis are so high score in the MSTS rating system. Therefore, considering the function of the affected limb, a limb reconstruction method allowing the maximal preservation of joint function should be selected after careful evaluation of the effects of chemotherapy and the location of the tumor.

  2. Reconstruction of transports through the Strait of Gibraltar from limited observations

    Science.gov (United States)

    Jordà, G.; Sánchez-Román, A.; Gomis, D.

    2016-04-01

    Observing the water transports through the Strait of Gibraltar is a difficult task. Here we present a methodology aimed to obtain the inflow, outflow and net transport of water from the limited set of available observations, currently consisting of an upward looking ADCP deployed at Espartel sill, two tide gauges located at each side of the Strait and radars monitoring the surface velocities. More precisely, we reconstruct the velocity field over a vertical section across the Strait using a reduced order optimal interpolation technique fed with the spatial covariance patterns deduced from high resolution numerical simulations. As a first step we carry out some sensitivity experiments with synthetic data that demonstrate the high potential of the approach. The reconstruction methodology can reproduce very satisfactorily the variability of the transports with estimated correlations for the inflow, outflow and net over 0.9 in all the cases and estimated RMS errors of 0.03, 0.08 and 0.05 Sv, respectively. However, we have also found that the reconstruction is sensible to bias problems, mostly due to the sensitivity of the method to the differences between the statistics of the actual and modeled velocity profiles. The sensitivity experiments have been used to tune the parameters of the method and a reconstruction of actual monthly transports has been performed for the period 2004-2010 along with an estimate of the associated uncertainty. This reconstruction provides for the first time a multiannual time series of the inflow and the net transports solely based on in situ observations. Therefore it can be used as an independent estimate for the validation of numerical models and surface freshwater fluxes in the Mediterranean.

  3. Application study of transport intensity equation in quantitative phase reconstruction

    Science.gov (United States)

    Song, Xiaojun; Cheng, Wei; Wei, Chunjuan; Xue, Liang; Liu, Weijing; Bai, Baodan; Chu, Fenghong

    2016-10-01

    In order to improve detection speed and accuracy of biological cells, a quantitative non-interference optical phase recovery method is proposed in commercial microscope, taking the red blood cells as the classical phase objects. Three bright field micrographs were collected in the experiment. Utilizing the transport intensity equation (TIE), the quantitative phase distributions of red blood cell are gained and agree well with the previous optical phase models. Analysis shows that the resolution of introduced system reaches sub-micron. This method not only quickly gives quantitative phase distribution of cells, but also measures a large number of cells simultaneously. So it is potential in the use of real-time observing and quantitative analyzing of cells in vivo.

  4. Long-term outcome of free fibula osteocutaneous flap and massive allograft in the reconstruction of long bone defect.

    Science.gov (United States)

    Halim, Ahmad Sukari; Chai, Siew Cheng; Wan Ismail, Wan Faisham; Wan Azman, Wan Sulaiman; Mat Saad, Arman Zaharil; Wan, Zulmi

    2015-12-01

    Reconstruction of massive bone defects in bone tumors with allografts has been shown to have significant complications including infection, delayed or nonunion of allograft, and allograft fracture. Resection compounded with soft tissue defects requires skin coverage. A composite osteocutaneous free fibula offers an optimal solution where the allografts can be augmented mechanically and achieve biological incorporation. Following resection, the cutaneous component of the free osteocutaneous fibula flaps covers the massive soft tissue defect. In this retrospective study, the long-term outcome of 12 patients, who underwent single-stage limb reconstruction with massive allograft and free fibula osteocutaneous flaps instead of free fibula osteal flaps only, was evaluated. This study included 12 consecutive patients who had primary bone tumors and had follow-up for a minimum of 24 months. The mean age at the time of surgery was 19.8 years. A total of eight patients had primary malignant bone tumors (five osteosarcomas, two chondrosarcomas and one synovial sarcoma), and four patients had benign bone tumors (two giant-cell tumors, one aneurysmal bone cyst, and one neurofibromatosis). The mean follow-up for the 12 patients was 63 months (range 24-124 months). Out of the 10 patients, nine underwent lower-limb reconstruction and ambulated with partial weight bearing and full weight bearing at an average of 4.2 months and 8.2 months, respectively. In conclusion, augmentation of a massive allograft with free fibula osteocutaneous flap is an excellent alternative for reducing the long-term complication of massive allograft and concurrently addresses the soft tissue coverage.

  5. Autologously generated tissue-engineered bone flaps for reconstruction of large mandibular defects in an ovine model.

    Science.gov (United States)

    Tatara, Alexander M; Kretlow, James D; Spicer, Patrick P; Lu, Steven; Lam, Johnny; Liu, Wei; Cao, Yilin; Liu, Guangpeng; Jackson, John D; Yoo, James J; Atala, Anthony; van den Beucken, Jeroen J J P; Jansen, John A; Kasper, F Kurtis; Ho, Tang; Demian, Nagi; Miller, Michael John; Wong, Mark E; Mikos, Antonios G

    2015-05-01

    The reconstruction of large craniofacial defects remains a significant clinical challenge. The complex geometry of facial bone and the lack of suitable donor tissue often hinders successful repair. One strategy to address both of these difficulties is the development of an in vivo bioreactor, where a tissue flap of suitable geometry can be orthotopically grown within the same patient requiring reconstruction. Our group has previously designed such an approach using tissue chambers filled with morcellized bone autograft as a scaffold to autologously generate tissue with a predefined geometry. However, this approach still required donor tissue for filling the tissue chamber. With the recent advances in biodegradable synthetic bone graft materials, it may be possible to minimize this donor tissue by replacing it with synthetic ceramic particles. In addition, these flaps have not previously been transferred to a mandibular defect. In this study, we demonstrate the feasibility of transferring an autologously generated tissue-engineered vascularized bone flap to a mandibular defect in an ovine model, using either morcellized autograft or synthetic bone graft as scaffold material.

  6. Avoiding graft-tunnel length mismatch in anterior cruciate ligament reconstruction: the single-bone plug technique.

    Science.gov (United States)

    Grawe, Brian; Smerina, Amber; Allen, Answorth

    2014-06-01

    Anterior cruciate ligament reconstruction, using autogenous bone-patellar tendon-bone (BTB) as a graft material, is commonly performed in the setting of anterior cruciate ligament insufficiency. Although bone-patellar tendon-bone autograft has an extensive track record, showing excellent clinical results, donor-site morbidity and graft-tunnel mismatch can still be problematic for a subset of patients. In the setting of a tendon graft that is too long, adequate interference screw fixation cannot be obtained, typically resulting in a tibial-sided bone plug that achieves less than 15 to 20 mm of bone in the distal tibial tunnel. We present an easy and effective technique for avoiding the graft-tunnel mismatch problems that commonly occur in patients who have an excessively long patellar tendons. This technique involves a simple preoperative planning algorithm that ultimately results in a single tibial-sided plug harvest. Bony interference fixation is then obtained on the femoral side and soft-tissue fixation on the tibial side. This technique allows for satisfactory graft fixation while avoiding the donor-site morbidity associated with patellar bone plug harvest.

  7. Reconstruction of bone fenestration on mandiblar by the guided bone regeneration methods with beta-TCP/PLGC membranes.

    Science.gov (United States)

    Koyama, Yoshihisa; Kikuchi, Masanori; Edamura, Kazuya; Nagaoka, Katsuyoshi; Tanaka, Shigeo; Tanaka, Junzo; Takakuda, Kazuo

    2007-03-01

    Guided Bone Regeneration (GBR) is a method for bone tissue regeneration. In this method, membranes are used to cover bone defects and to block the invasion of the surrounding soft tissues. It would provide sufficient time for the osteogenic cells from bone marrow to proliferate and form new bony tissues. In spite of the potential usefulness of this method, no appropriate materials for the GBR membrane have been developed. Here we design the ideal mechanical properties of the GBR membranes and created novel materials, which is the composite of beta-tricalcium phosphate (beta-TCP) and block copolymer of L-lactide, glycolide, and epsilon-caplolactone (PLGC). In the animal experiments with the use of the GBR membranes for large bone defects, we observed significant enhancement in the bone regeneration after 12 weeks implantation and proved the effectiveness of the materials.

  8. Transport of membrane-bound mineral particles in blood vessels during chicken embryonic bone development.

    Science.gov (United States)

    Kerschnitzki, Michael; Akiva, Anat; Ben Shoham, Adi; Koifman, Naama; Shimoni, Eyal; Rechav, Katya; Arraf, Alaa A; Schultheiss, Thomas M; Talmon, Yeshayahu; Zelzer, Elazar; Weiner, Stephen; Addadi, Lia

    2016-02-01

    During bone formation in embryos, large amounts of calcium and phosphate are taken up and transported to the site where solid mineral is first deposited. The initial mineral forms in vesicles inside osteoblasts and is deposited as a highly disordered calcium phosphate phase. The mineral is then translocated to the extracellular space where it penetrates the collagen matrix and crystallizes. To date little is known about the transport mechanisms of calcium and phosphate in the vascular system, especially when high transport rates are needed and the concentrations of these ions in the blood serum may exceed the solubility product of the mineral phase. Here we used a rapidly growing biological model, the chick embryo, to study the bone mineralization pathway taking advantage of the fact that large amounts of bone mineral constituents are transported. Cryo scanning electron microscopy together with cryo energy dispersive X-ray spectroscopy and focused-ion beam imaging in the serial surface view mode surprisingly reveal the presence of abundant vesicles containing small mineral particles in the lumen of the blood vessels. Morphologically similar vesicles are also found in the cells associated with bone formation. This observation directly implicates the vascular system in solid mineral distribution, as opposed to the transport of ions in solution. Mineral particle transport inside vesicles implies that far larger amounts of the bone mineral constituents can be transported through the vasculature, without the danger of ectopic precipitation. This introduces a new stage into the bone mineral formation pathway, with the first mineral being formed far from the bone itself.

  9. Efficacy of novel synthetic bone substitutes in the reconstruction of large segmental bone defects in sheep tibiae.

    Science.gov (United States)

    Li, Jiao Jiao; Roohani-Esfahani, Seyed-Iman; Dunstan, Colin R; Quach, Terrence; Steck, Roland; Saifzadeh, Siamak; Pivonka, Peter; Zreiqat, Hala

    2016-02-19

    The treatment of large bone defects, particularly those with segmental bone loss, remains a significant clinical challenge as current approaches involving surgery or bone grafting often do not yield satisfactory long-term outcomes. This study reports the evaluation of novel ceramic scaffolds applied as bone graft substitutes in a clinically relevant in vivo model. Baghdadite scaffolds, unmodified or modified with a polycaprolactone coating containing bioactive glass nanoparticles, were implanted into critical-sized segmental bone defects in sheep tibiae for 26 weeks. Radiographic, biomechanical, μ-CT and histological analyses showed that both unmodified and modified baghdadite scaffolds were able to withstand physiological loads at the defect site, and induced substantial bone formation in the absence of supplementation with cells or growth factors. Notably, all samples showed significant bridging of the critical-sized defect (average 80%) with evidence of bone infiltration and remodelling within the scaffold implant. The unmodified and modified baghdadite scaffolds achieved similar outcomes of defect repair, although the latter may have an initial mechanical advantage due to the nanocomposite coating. The baghdadite scaffolds evaluated in this study hold potential for use as purely synthetic bone graft substitutes in the treatment of large bone defects while circumventing the drawbacks of autografts and allografts.

  10. Hybrid light transport model based bioluminescence tomography reconstruction for early gastric cancer detection

    Science.gov (United States)

    Chen, Xueli; Liang, Jimin; Hu, Hao; Qu, Xiaochao; Yang, Defu; Chen, Duofang; Zhu, Shouping; Tian, Jie

    2012-03-01

    Gastric cancer is the second cause of cancer-related death in the world, and it remains difficult to cure because it has been in late-stage once that is found. Early gastric cancer detection becomes an effective approach to decrease the gastric cancer mortality. Bioluminescence tomography (BLT) has been applied to detect early liver cancer and prostate cancer metastasis. However, the gastric cancer commonly originates from the gastric mucosa and grows outwards. The bioluminescent light will pass through a non-scattering region constructed by gastric pouch when it transports in tissues. Thus, the current BLT reconstruction algorithms based on the approximation model of radiative transfer equation are not optimal to handle this problem. To address the gastric cancer specific problem, this paper presents a novel reconstruction algorithm that uses a hybrid light transport model to describe the bioluminescent light propagation in tissues. The radiosity theory integrated with the diffusion equation to form the hybrid light transport model is utilized to describe light propagation in the non-scattering region. After the finite element discretization, the hybrid light transport model is converted into a minimization problem which fuses an l1 norm based regularization term to reveal the sparsity of bioluminescent source distribution. The performance of the reconstruction algorithm is first demonstrated with a digital mouse based simulation with the reconstruction error less than 1mm. An in situ gastric cancer-bearing nude mouse based experiment is then conducted. The primary result reveals the ability of the novel BLT reconstruction algorithm in early gastric cancer detection.

  11. Reconstrucción del maxilar superior mediante transporte del proceso alveolar: Presentación de un caso Reconstruction of the maxilla by means of transport of the alveolar process: A case report

    Directory of Open Access Journals (Sweden)

    A. Bilbao

    2006-02-01

    Full Text Available La osteogénesis mediante distracción aplicada a la reconstrucción del proceso alveolar es una técnica sobradamente contrastada en la literatura, al igual que la utilización del transporte óseo en la reconstrucción de defectos segmentarios mandibulares. Presentamos en este artículo un caso de reconstrucción de un defecto segmentario del maxilar superior mediante transporte de proceso alveolar y su posterior rehabilitación protésica implantosoportada. Mostramos tanto la técnica quirúrgica como el manejo de del vector de distracción utilizando elásticos de ortodoncia y tornillos de bloqueo intermaxilar.Osteogenesis by means of distraction applied to the reconstruction of the alveolar process is a well-documented technique in the literature, as is the use of bone transport in the reconstruction of mandibular segment defects. In the present article we report on a case of reconstruction of a segment defect in the maxilla using the alveolar transport process, and on the subsequent rehabilitation by means of an implant-supported prosthesis. Both the surgical technique and the handling of the distraction vector using orthodontic bands and inter-maxillary fixation screws are shown.

  12. Regulation of placental calcium transport and offspring bone health

    Directory of Open Access Journals (Sweden)

    Laura eGoodfellow

    2011-02-01

    Full Text Available Osteoporosis causes considerable morbidity and mortality in later life, and the risk of the disease is strongly determined by peak bone mass, which is achieved in early adulthood. Poor intrauterine and early childhood growth are associated with reduced peak bone mass, and increased risk of osteoporotic fracture in older age. In this review we describe the regulatory aspects of intrauterine bone development, and then summarise the evidence relating early growth to later fracture risk. Physiological systems include vitamin D, PTH; leptin; GH/ IGF-1; finally the potential role of epigenetic processes in the underlying mechanisms will be explored. Thus factors such as maternal lifestyle, diet, body build, physical activity and vitamin D status in pregnancy all appear to influence offspring bone mineral accrual. These data demonstrate a likely interaction between environmental factors and gene expression, a phenomenon ubiquitous in the natural world (developmental plasticity, as the potential key process. Intervention studies are now required to test the hypotheses generated by these epidemiological and physiological findings, to inform potential novel public health interventions aimed at improving childhood bone health and reducing the burden of osteoporotic fracture in future generations.

  13. Reconstructing Ancient Egyptian Diet through Bone Elemental Analysis Using LIBS (Qubbet el Hawa Cemetery

    Directory of Open Access Journals (Sweden)

    Ghada Darwish Al-Khafif

    2015-01-01

    Full Text Available One of the most important advantages of LIBS that make it suitable for the analysis of archeological materials is that it is a quasi-nondestructive technique. Archeological mandibles excavated from Qubbet el Hawa Cemetery, Aswan, were subjected to elemental analysis in order to reconstruct the dietary patterns of the middle class of the Aswan population throughout three successive eras: the First Intermediate Period (FIP, the Middle Kingdom (MK, and the Second Intermediate Period (SIP. The bone Sr/Ca and Ba/Ca ratios were significantly correlated, so the Sr/Ca ratios are considered to represent the ante-mortem values. It was suggested that the significantly low FIP Sr/Ca compared to that of both the MK and the SIP was attributed to the consumption of unusual sorts of food and imported cereals during years of famine, while the MK Sr/Ca was considered to represent the amelioration of climatic, social, economic, and political conditions in this era of state socialism. The SIP Sr/Ca, which is nearly the same as that of the MK, was considered to be the reflection of the continuity of the individualism respect and state socialism and a reflection of agriculture conditions amelioration under the reign of the 17th Dynasty in Upper Egypt.

  14. Reconstructing the sequence of events surrounding body disposition based on color staining of bone*.

    Science.gov (United States)

    Huculak, Meaghan A; Rogers, Tracy L

    2009-09-01

    Literature regarding bone color is limited to determining location of primary and secondary dispositions. This research is the first to use bone color to interpret the sequence of events surrounding body disposition. Two scenarios were compared-bones buried and then exposed on the ground surface and bones exposed then buried. Forty juvenile pig humeri with minimal tissue were used in each scenario with an additional 20 controls to determine if decomposing tissue affects bone color. Munsell Color Charts were used to record bone color of surface and 2.5 cm cross-sections. Results reveal five main surface colors attributed to soil, sun, hemolysis, decomposition, and fungi. Fungi on buried bones suggests prior surface exposure. Cross-sections of strictly buried bones are identical to buried then exposed bone, stressing the importance of bone surface analysis. Cross-sectioning may help verify remains have been exposed then buried. Decomposition of excess tissue creates minimal color staining.

  15. Reconstruction of maxillary ridge atrophy caused by dentoalveolar trauma, using autogenous block bone graft harvested from chin: a case report

    Directory of Open Access Journals (Sweden)

    Francisley Ávila Souza

    2014-06-01

    Full Text Available Background: Dentoalveolar trauma, especially when involving front teeth, negatively affect the patient’s life; in particular, tooth avulsion is a complex injury that affects multiple tissues, and no treatment option offers stable long-term outcomes. The aim of this study was to report a case of reconstruction of atrophic anterior alveolar ridge after tooth loss, performed with autograft harvested from the chin, and subsequent prosthetic rehabilitation with the use of an osseointegrated implant. Case report: A 23-years-old Caucasian girl, presented an atrophic alveolar bone in the area of tooth 11, as a result of tooth resorption 10 years after a tooth reimplantation procedure. Reconstruction was performed with autogenous bone harvested from the chin. After 6-months healing period to allow autograft incorporation, a dental implant was inserted. After further 6- months, a screw-retained implant supported metal-ceramic prosthesis was fabricated. Results The prosthetic rehabilitation was successful, and after a follow-up period of 5 years, the achieved result was stable. Conclusion: It can be concluded that the autogenous bone graft harvested from the chin, is a safe and effective option for alveolar ridge defects reconstruction, allowing a subsequent placement of a dental implant supporting a prosthetic restoration.

  16. Allograft anterior cruciate ligament reconstruction in patients younger than 30 years: a matched-pair comparison of bone-patellar tendon-bone and tibialis anterior.

    Science.gov (United States)

    O'Brien, Daniel F; Kraeutler, Matthew J; Koyonos, Loukas; Flato, Russell R; Ciccotti, Michael G; Cohen, Steven B

    2014-03-01

    We conducted a study to compare patient-reported outcomes and graft-rupture rates of bone-patellar tendon-bone (BPTB) and tibialis anterior (TA) allograft primary anterior cruciate ligament (ACL) reconstruction in patients younger than 30 years. Patients were retrospectively identified as having undergone ACL reconstruction with either a BPTB (n = 20) or a TA (n = 20) allograft. Each patient in the BPTB group was matched to a patient in the TA group based on sex, age at time of surgery, height, weight, and preoperative activity level. The Lysholm Knee Scoring Scale and the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form were administered at a minimum of 1 year after surgery. Mean Lysholm scores were 92.9 (BPTB) and 93.0 (TA), and mean IKDC scores were 92.6 (BPTB) and 90.3 (TA). The differences were not statistically significant. Overall graft-rupture rates for the study period were 4.7% (BPTB) and 1.9% (TA) (P = .18). There was no statistically significant difference in patient-rated outcomes and graft-rupture rates between BPTB and TA allografts for ACL reconstruction at a minimum of 1 year after surgery. Future research efforts should focus on mid- and long-term follow-up and objective outcomes.

  17. Application of concentrated growth factors in reconstruction of bone defects after removal of large jaw cysts: The two cases report

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    Mirković Siniša

    2015-01-01

    Full Text Available Introduction. Coagulation and blood clot formation in bone defects is sometimes followed by retraction of a blood clot and serum extrusion, thus producing peripheral serum-filled spaces between bony wall and coagulum. This can result in a higher incidence of postoperative complications. Stabilization of blood coagulum, which enables successful primary healing, may be accomplished by autotransplantation, allotransplantation, xenotransplantation, or application of autologous platelet concentrate and concentrated growth factors (CGF. Case report. Two patients with large cystic lesions in the upper and lower jaw were presented. In both patients postoperative bony defects were filled with autologous fibrin rich blocks containing CGF. Postoperative course passed uneventfully. Conclusion. Application of fibrin rich blocks containing CGF is one of the possible methods for reconstruction of bone defects. CGF can be applied alone or mixed with a bone graft. The method is relatively simple, without risk of transmissible and allergic diseases and economically feasible.

  18. Clinical study of reconstructing the medial malleolus with free grafting of fibular head composite tendon bone flap

    Institute of Scientific and Technical Information of China (English)

    WU Shui-pei

    2008-01-01

    Objective: To explore new surgical procedure for repairing and reconstructing medial malleolus and soft tissue defect.Methods: According to the size of medial malleolus and composite soft tissue defect, vascular fibular head composite tendon bone flap free grafting using anterior tibial recurrent vessel as the perforating branch was designed to reconstruct the medial malleolar saddle and triangular ligament, and composite back broadest muscle flap free grafting was designed to repair the medical malleolar wound surface. From January 2000 to December 2006, the technique was used in 5 male patients who were injured by machine or in traffic accidents, causing bone and soft tissue defect. The size of wound surface ranged from 19 cm×12 cm to 24 cm×12 cm.Results: The wound surface was healed at the first stage in 4 cases, and the other case had infection and was cured in 6 months with anti infection therapy. Postoperative follow-ups from 6 months to 6 years showed that grafted bones and free cutaneous flaps were healed well, malleolar joints were stable, joint movement was normal, and the appearance was satisfactory. The overall outcome was good.Conclusion: Fibular head composite tendon bone flap free grafting is effective for repairing medical malleolar defect.

  19. Stochastic Aspect of the Tomographic Reconstruction Problems in a Transport Model

    CERN Document Server

    Kharin, Igor

    2010-01-01

    The stochastic differential and integral equations describing the system of particles weakly interacting among themselves which are absorbed and scattered by particles of a medium are considered. The time-dependent transport equation with scattering is studied taking into account stochastic nature of parameters in nuclear imaging. Using dynamic attenuated Radon transform the solution of transport equation may be derived taking into account of the scattering as perturbation. We analyze the influence of the random variables upon the image reconstruction both generally and in more details for the case of point source. It is shown by the example of the method of the filtered back projection (FBP) that unaccounted small fluctuations of attenuation coefficient can cause essential distortions of image texture and degradation of the resolution at image reconstruction in single-photon emission computerized tomography (SPECT) and less in X-ray computerized tomography (CT). The mechanism of these distortions is analyzed...

  20. Clinical observation of particulate cancellous bone impaction grafting in combination with total hip arthroplasty for acetabular reconstruction

    Institute of Scientific and Technical Information of China (English)

    LIU Xian-zhe; YANG Shu-hua; XU Wei-hua; LIU Guo-hui; YANG Cao; LI Jin; YE Zhe-wei; LIU Yong; ZHANG Yu-kun

    2008-01-01

    Objective: To investigate the effect of particulate cancellous bone impaction grafting in combination with total hip arthroplasty (THA) for acetabular reconstruction in patients with posttraumatic arthritis and bone loss afteracetabular fractures.Methods: Totally 15 consecutive cases with unilateral acetabular fracture were treated with bone impaction grafting in combination with THA in our department.There were 10 males and 5 females with mean age of 48.2 years (ranging from 36 to 73 years).Eight cases had the fracture at left hips,7 at right hips.The average age at injury was 28 years (ranging from 18 to 68 years).The mean follow-up period was 4.3 years (ranging from 2 to 7 years).Results: Compared with mean 42 points (ranging from 10 to 62) of the preoperative Harris score,the survival cases at the final follow-up had mean 84 points (ranging from 58 to 98).One patient had mild pain in the hip.No revision of the acetabular or femoral component was undertaken during the follow-up.Normal rotational centre of most hips was recovered except 2 cases in which it was 0.8 mm higher than that in opposite side.All of them had a stable radiographic appearance.Progressive radiolucent fines were observed in I,III zones in 2 cases.One patient had a nonprogressive radiolucent fine in zone III.The cup prosthesis was obviously displaced (6 mm) in one patient,but had not been revised.Conclusion: Particulate cancellous bone impaction grafting in combination with THA as a biological solution is an attractive procedure for acetabular reconstruction in patients with posttraumatic arthritis and bone loss after acetabular fracture,which can not only restore acetabular bone stock but also repair normal hip anatomy and its function.

  1. Visualization of postoperative anterior cruciate ligament reconstruction bone tunnels: Reliability of standard radiographs, CT scans, and 3D virtual reality images

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan); J.W. Potters (Jan Willem); A.H.J. Koning (Anton); C.H. Brown Jr Jr. (Charles); J.A.N. Verhaar (Jan); M. Reijman (Max)

    2011-01-01

    textabstractBackground and purpose: Non-anatomic bone tunnel placement is the most common cause of a failed ACL reconstruction. Accurate and reproducible methods to visualize and document bone tunnel placement are therefore important. We evaluated the reliability of standard radiographs, CT scans, a

  2. Orthodontically guided bone transport in the treatment of alveolar cleft: A case report

    Science.gov (United States)

    Gómez, Elena; Otero, Marta; Berraquero, Rosario; Wucherpfennig, Begona; Hernández-Godoy, Juan; Guiñales, Jorge; Vincent, Germán; Burgueño, Miguel

    2016-01-01

    Introduction Conventional treatments are sometimes not possible in certain alveolar cleft cases due to the severity of the gap which separates the fragments. Various management strategies have been proposed, including sequential surgical interventions or delaying treatment until adulthood to then carry out maxillary osteotomies. A further alternative approach has also been proposed, involving the application of bone transport techniques to mobilise the osseous fragments and thereby reduce the gap between lateral fragments and the premaxilla. Case Report We introduce the case of a 10-year-old patient who presented with a bilateral alveolar cleft and a severe gap. Stable occlusion between the premaxilla and the mandible was achieved following orthodontic treatment, making it inadvisable to perform a retrusive osteotomy of the premaxilla in order to close the alveolar clefts. Faced with this situation, it was decided we would employ a bone transport technique under orthodontic guidance using a dental splint. This would enable an osseous disc to be displaced towards the medial area and reduce the interfragmentary distance. During a second surgical intervention, closure of the soft tissues was performed and the gap was filled in using autogenous bone. Conclusions The use of bone transport techniques in selected cases allows closure of the osseous defect, whilst also preserving soft tissues and reducing the amount of bone autograft required. In our case, we were able to respect the position of the premaxilla and, at the same time, generate new tissues at both an alveolar bone and soft tissue level with results which have remained stable over the course of time. Key words:Alveolar cleft, bone transport, graft. PMID:26855699

  3. A three-dimensional reconstruction of the temporal bone by the helical scanning CT and its clinical application

    Energy Technology Data Exchange (ETDEWEB)

    Yonekawa, Hiroyuki; Ohashi, Masami; Miyashita, Souji; Gotoh, Mizuho; Nemoto, Satohiko; Kikuchi, Hideki (Azabu Triology Hospital, Sapporo (Japan)); Sakai, Noboru; Inuyama, Yukio

    1993-09-01

    The current availability of 3 dimensional (3-D) imaging from Computed Tomography (CT) has yielded new anatomical information and pre- and postoperative evaluations. However, little discussion as to the 3-D structural image of the temporal bone has been reported because conventional CT does provide sufficient data to produce such images. The helical scanning CT gathers continuous and multiple slice image data since it consists of an X-ray tube that continuously rotates around the patient while the patient moves continuously into the CT scanner. Thus, application of the helical scanning CT has made it possible to reconstruct 3-D images of the minute and complicated structure of the temporal bone. We evaluated 3-D images from 9 typical cases, examined from February to October 1992. As a result, we found that the 3-D images reconstructed with this system are useful for evaluation of the postoperative state of tympanoplasty, the diagnosis of anomalies of the bony labyrinth, and examining the extent of bone destruction induced by trauma, cholesteatoma, etc. (author).

  4. Transport approach to the reconstruction of the neutrino kinematics in current oscillation experiments

    Energy Technology Data Exchange (ETDEWEB)

    Leitner, Tina; Buss, Oliver; Mosel, Ulrich [Institut fuer Theoretische Physik, Universitaet Giessen (Germany); Alvarez-Ruso, Luis [Departamento de Fisica Teorica and IFIC, Universidad de Valencia - CSIC (Spain)

    2008-07-01

    Neutrino oscillation results depend on the neutrino energy - a quantity which can not be measured directly but has to be reconstructed from the hadronic debris coming out of the neutrino-nucleus reaction inside the detector. A reliable reconstruction of the neutrino kinematics and the initial scattering process has to account for in-medium modifications and, in particular, for final state interactions inside the target nucleus. They can, e.g. through intranuclear rescattering, change particle multiplicities and also redistribute their energy. Those effects can be simulated with our fully coupled channel GiBUU transport model where the neutrino first interacts with a bound nucleon producing secondary particles which are then transported out of the nucleus. We use a relativistic formalism that incorporates recent form factor parametrizations, and apply, besides Fermi motion, full in-medium kinematics, mean-field potentials and in-medium spectral functions. In this talk, we compare the reconstructed quantities obtained within our framework to the ones obtained by the current experiments, which, as e.g. MiniBooNE, mostly rely on simple two-body kinematics. We then discuss how these uncertainties influence not only the cross section measurements but also the oscillation results.

  5. Reconstruction

    Directory of Open Access Journals (Sweden)

    Stefano Zurrida

    2011-01-01

    Full Text Available Breast cancer is the most common cancer in women. Primary treatment is surgery, with mastectomy as the main treatment for most of the twentieth century. However, over that time, the extent of the procedure varied, and less extensive mastectomies are employed today compared to those used in the past, as excessively mutilating procedures did not improve survival. Today, many women receive breast-conserving surgery, usually with radiotherapy to the residual breast, instead of mastectomy, as it has been shown to be as effective as mastectomy in early disease. The relatively new skin-sparing mastectomy, often with immediate breast reconstruction, improves aesthetic outcomes and is oncologically safe. Nipple-sparing mastectomy is newer and used increasingly, with better acceptance by patients, and again appears to be oncologically safe. Breast reconstruction is an important adjunct to mastectomy, as it has a positive psychological impact on the patient, contributing to improved quality of life.

  6. Lattice Boltzmann prediction of transport properties in reconstructed nanostructures of organic matters in shales

    CERN Document Server

    Chen, Li; Zhang, Lei; Tao, Wenquan

    2014-01-01

    Size, morphology and distributions of pores in organic matters of shale matrix are discussed based on high resolution images from experiments in the literature. 150 nanoscale structures of the organic matters are then reconstructed by randomly placing pore spheres with different diameters and overlap tolerances. Effects of porosity, the mean diameter and the overlap tolerance on void space connectivity and pore size distribution are studied. Further, a pore-scale model based on the Lattice Boltzmann method is developed to predict the Knudsen diffusivity and permeability of the reconstructed organic matters. The simulation results show that the mean pore diameter and overlap tolerance significantly affect the transport properties. The predicted Knudsen effective diffusivity is compared with Bruggeman equation and it is found that this equation underestimate the tortuosity. A modified Bruggeman equation is proposed based on the simulation results. The predicted intrinsic permeability is in acceptable agreement ...

  7. A-mode ultrasound-based intra-femoral bone cement detection and 3D reconstruction in RTHR.

    Science.gov (United States)

    Heger, Stefan; Mumme, Thorsten; Sellei, Richard; De La Fuente, Matias; Wirtz, Dieter-C; Radermacher, Klaus

    2007-05-01

    Due to the difficulty of determining the 3D boundary of the cement-bone interface in Revision Total Hip Replacement (RTHR), the removal of the distal intra-femoral bone cement can be a time-consuming and risky operation. Within the framework of computer- and robot-assisted cement removal, the principles and first results of an automatic detection and 3D surface reconstruction of the cement-bone boundary using A-mode ultrasound are described. Sound propagation time and attenuation of cement were determined considering different techniques for the preparation of bone cement, such as the use of a vacuum system (Optivac, Biomet). A laboratory setup using a rotating, standard 5-MHz transducer was developed. The prototype enables scanning of bisected cement-prepared femur samples in a 90 degrees rotation range along their rotation axis. For system evaluation ex vivo, the distal femur of a human cadaver was prepared with bone cement and drilled (Ø 10 mm) to simulate the prosthesis cavity in a first approximation. The sample was cut in half and CT scanned (0.24 mm resolution; 0.5 mm distance; 0.5 mm thickness), and 3D voxel models of the manually segmented bone cement were reconstructed, providing the ground truth. Afterwards, 90 degrees segments of each ex-vivo sample were scanned by the A-mode ultrasound system. To obtain better ultrasound penetration, we used coded signal excitation and pulse compression filtering. A-mode ultrasound signal detection, filtering and segmentation were accomplished fully automatically. Subsequently, 3D voxel models of each sample were calculated. Accuracy evaluation of the measured ultrasound data was performed by ICP matching of each ultrasound dataset ( approximately 8000 points) to the corresponding CT dataset and calculation of the residual median distance error between the corresponding datasets. Prior to each ICP matching, an initial pre-registration was calculated using prominent landmarks in the corresponding datasets. This method

  8. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A COMPARISON BETWEEN BONE PATELLAR TENDON BONE GRAFT AND LIPSCOMB PROCEDURE - A FOLLOWUP STUDY OF 7 YEARS

    Directory of Open Access Journals (Sweden)

    Vijayamohan S

    2016-07-01

    Full Text Available BACKGROUND Anterior Cruciate Ligament injury has become more common and the demand by the patients to return to pre-injury level of activity has made reconstruction of the ligament very crucial. Though there are various techniques in reconstructing the anterior cruciate ligament, in this study, we compare two most commonly used techniques to see whether there is any significant difference in the outcome. METHODS Study included 25 patients in the age group of 19-36 years, of which 23 were males. The patients were divided randomly into 2 groups, and 15 patients underwent Anterior Cruciate Ligament reconstruction using Bone Patellar Tendon Bone Graft and 10 patients had Hamstring graft. RESULTS Patients were followed up at regular intervals monthly for the first six months and then at three monthly intervals. Patients were assessed using Knee Scoring Scale of Lysholm and Gillquist and International Knee Documentation Committee (IKDC scoring system. In addition, activity level, harvest site pain, thigh atrophy, kneeling pain and hamstring pain were assessed. All patients were followed up for a minimum period of 2 years. 20% of both groups were able to return to strenuous activity level, and 67% of Patellar tendon group and 50% of the Hamstring tendon group were able to return to moderate level of activity. 55% of patients in the patellar tendon group and 20% of patients in the hamstring tendon group had donor site pain in the first 6 months. 73% of patients in the hamstring group had at least 10 mm of thigh wasting. Pain on kneeling was seen only in the patellar tendon group (35% while hamstring pain was found only in the hamstring group (20%. CONCLUSIONS Patients in the patellar tendon group had increased anterior stability and were able to return to strenuous occupation. The difference in thigh atrophy between the two groups was not significant. The hamstring group had lower graft harvest site morbidity. Lachman test was the single most accurate

  9. Platelet Rich Fibrin (P.R.F. in Reconstructive Surgery of Atrophied Maxillary Bones: Clinical and Histological Evaluations

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    Marco Tatullo, Massimo Marrelli, Michele Cassetta, Andrea Pacifici, Luigi Vito Stefanelli, Salvatore Scacco, Gianna Dipalma, Luciano Pacifici, Francesco Inchingolo

    2012-01-01

    Full Text Available Introduction. Maxillary bone losses often require additional regenerative procedures: as a supplement to the procedures of tissue regeneration, a platelet concentrate called PRF (Platelet Rich Fibrin was tested for the first time in France by Dr. Choukroun.Aim of the present study is to investigate, clinically and histologically, the potential use of PRF, associated with deproteinized bovine bone (Bio-Oss, as grafting materials in pre-implantology sinus grafting of severe maxillary atrophy, in comparison with a control group, in which only deproteinized bovine bone (Bio-Oss was used as reconstructive material.Materials and Methods. 60 patients were recruited using the cluster-sampling method; inclusion criteria were maxillary atrophy with residual ridge < 5mm. The major atrophies in selected patients involved sinus-lift, with a second-look reopening for the implant insertion phase. The used grafting materials were: a Bio-Oss and b amorphous and membranous PRF together with Bio-Oss. We performed all operations by means of piezosurgery in order to reduce trauma and to optimize the design of the operculum on the cortical bone. The reopening of the surgical area was scheduled at 3 different times.Results. 72 sinus lifts were performed with subsequent implants insertions.We want to underline how the histological results proved that the samples collected after 106 days (Early protocol with the adding of PRF were constituted by lamellar bone tissue with an interposed stroma that appeared relaxed and richly vascularized.Conclusions. The use of PRF and piezosurgery reduced the healing time, compared to the 150 days described in literature, favoring optimal bone regeneration. At 106 days, it is already possible to achieve good primary stability of endosseous implants, though lacking of functional loading.

  10. Prevalence and influence of tibial tunnel widening after isolated anterior cruciate ligament reconstruction using patella-bone-tendon-bone-graft: long-term follow-up

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    Johannes Struewer

    2012-06-01

    Full Text Available The aim of the present study was to evaluate incidence, degree and impact of tibial tunnel widening (TW on patient-reported long-term clinical outcome, knee joint stability and prevalence of osteoarthritis (OA after isolated anterior cruciate ligament (ACL reconstruction. On average, 13.5 years after ACL reconstruction via patella-bone-tendon-bone autograft, 73 patients have been re-evaluated. Inclusion criteria consisted of an isolated anterior cruciate ligament rupture and reconstruction, a minimum of 10-year follow-up and no previous anterior cruciate ligament repair or associated intra-articular lesions. Clinical evaluation was performed via the International Knee Documentation Committee (IKDC score and the Tegner and Lysholm scores. Instrumental anterior laxity testing was carried out with the KT-1000™ arthrometer. The degree of degenerative changes and the prevalence of osteoarthritis were assessed with the Kellgren-Lawrence score. Tibial tunnel enlargement was radiographically evaluated on both antero-posterior and lateral views under establishment of 4 degrees of tibial tunnel widening by measuring the actual tunnel diameters in mm on the sclerotic margins of the inserted tunnels on 3 different points (T1-T3. Afterwards, a conversion of the absolute values in mm into a 4 staged ratio, based on the comparison to the results of the initial drill-width, should provide a better quantification and statistical analysis. Evaluation was performed postoperatively as well as on 2 year follow-up and 13 years after ACL reconstruction. Minimum follow-up was 10 years. 75% of patients were graded A or B according to IKDC score. The mean Lysholm score was 90.2 ± 4.8 (25-100. Radiological assessment on long-term follow-up showed in 45% a grade I, in 24% a grade II, in 17% a grade III and in additional 12% a grade IV enlargement of the tibial tunnel. No evident progression of TW was found in comparison to the 2 year results. Radiological evaluation

  11. Mass-conservative reconstruction of Galerkin velocity fields for transport simulations

    Science.gov (United States)

    Scudeler, C.; Putti, M.; Paniconi, C.

    2016-08-01

    Accurate calculation of mass-conservative velocity fields from numerical solutions of Richards' equation is central to reliable surface-subsurface flow and transport modeling, for example in long-term tracer simulations to determine catchment residence time distributions. In this study we assess the performance of a local Larson-Niklasson (LN) post-processing procedure for reconstructing mass-conservative velocities from a linear (P1) Galerkin finite element solution of Richards' equation. This approach, originally proposed for a-posteriori error estimation, modifies the standard finite element velocities by imposing local conservation on element patches. The resulting reconstructed flow field is characterized by continuous fluxes on element edges that can be efficiently used to drive a second order finite volume advective transport model. Through a series of tests of increasing complexity that compare results from the LN scheme to those using velocity fields derived directly from the P1 Galerkin solution, we show that a locally mass-conservative velocity field is necessary to obtain accurate transport results. We also show that the accuracy of the LN reconstruction procedure is comparable to that of the inherently conservative mixed finite element approach, taken as a reference solution, but that the LN scheme has much lower computational costs. The numerical tests examine steady and unsteady, saturated and variably saturated, and homogeneous and heterogeneous cases along with initial and boundary conditions that include dry soil infiltration, alternating solute and water injection, and seepage face outflow. Typical problems that arise with velocities derived from P1 Galerkin solutions include outgoing solute flux from no-flow boundaries, solute entrapment in zones of low hydraulic conductivity, and occurrences of anomalous sources and sinks. In addition to inducing significant mass balance errors, such manifestations often lead to oscillations in concentration

  12. Comparison of Bone Resorption Rates after Intraoral Block Bone and Guided Bone Regeneration Augmentation for the Reconstruction of Horizontally Deficient Maxillary Alveolar Ridges.

    Science.gov (United States)

    Gultekin, B Alper; Bedeloglu, Elcin; Kose, T Emre; Mijiritsky, Eitan

    2016-01-01

    Purpose. Bone atrophy after tooth loss may leave insufficient bone for implant placement. We compared volumetric changes after autogenous ramus block bone grafting (RBG) or guided bone regeneration (GBR) in horizontally deficient maxilla before implant placement. Materials and Methods. In this retrospective study, volumetric changes at RBG or GBR graft sites were evaluated using cone-beam computed tomography. The primary outcome variable was the volumetric resorption rate. Secondary outcomes were bone gain, graft success, and implant insertion torque. Results. Twenty-four patients (28 grafted sites) were included (GBR, 15; RBG, 13). One patient (RBG) suffered mucosal dehiscence at the recipient site 6 weeks after surgery, which healed spontaneously. Mean volume reduction in the GBR and RBG groups was 12.48 ± 2.67% and 7.20 ± 1.40%, respectively. GBR resulted in significantly more bone resorption than RBG (P 0.05). Conclusions. Both RBG and GBR hard-tissue augmentation techniques provide adequate bone graft volume and stability for implant insertion. However, GBR causes greater resorption at maxillary augmented sites than RBG, which clinicians should consider during treatment planning.

  13. Enhancement of Tendon–Bone Healing for Anterior Cruciate Ligament (ACL Reconstruction Using Bone Marrow-Derived Mesenchymal Stem Cells Infected with BMP-2

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    Shiyi Chen

    2012-10-01

    Full Text Available At present, due to the growing attention focused on the issue of tendon–bone healing, we carried out an animal study of the use of genetic intervention combined with cell transplantation for the promotion of this process. Here, the efficacy of bone marrow stromal cells infected with bone morphogenetic protein-2 (BMP-2 on tendon–bone healing was determined. A eukaryotic expression vector containing the BMP-2 gene was constructed and bone marrow-derived mesenchymal stem cells (bMSCs were infected with a lentivirus. Next, we examined the viability of the infected cells and the mRNA and protein levels of BMP-2-infected bMSCs. Gastrocnemius tendons, gastrocnemius tendons wrapped by bMSCs infected with the control virus (bMSCs+Lv-Control, and gastrocnemius tendons wrapped by bMSCs infected with the recombinant BMP-2 virus (bMSCs+Lv-BMP-2 were used to reconstruct the anterior cruciate ligament (ACL in New Zealand white rabbits. Specimens from each group were harvested four and eight weeks postoperatively and evaluated using biomechanical and histological methods. The bMSCs were infected with the lentivirus at an efficiency close to 100%. The BMP-2 mRNA and protein levels in bMSCs were significantly increased after lentiviral infection. The bMSCs and BMP-2-infected bMSCs on the gastrocnemius tendon improved the biomechanical properties of the graft in the bone tunnel; specifically, bMSCs infected with BMP-2 had a positive effect on tendon–bone healing. In the four-week and eight-week groups, bMSCs+Lv-BMP-2 group exhibited significantly higher maximum loads of 29.3 ± 7.4 N and 45.5 ± 11.9 N, respectively, compared with the control group (19.9 ± 6.4 N and 21.9 ± 4.9 N (P = 0.041 and P = 0.001, respectively. In the eight-week groups, the stiffness of the bMSCs+Lv-BMP-2 group (32.5 ± 7.3 was significantly higher than that of the bMSCs+Lv-Control group (22.8 ± 7.4 or control groups (12.4 ± 6.0 (p = 0.036 and 0.001, respectively. Based on the

  14. Immediate Microsurgical Bone and Nerve Reconstruction in the Irradiated Patient: A Case Report.

    Science.gov (United States)

    Tursun, Ramzey; Green, J Marshall

    2016-12-11

    Microsurgical reconstructive techniques have revolutionized the treatment of large head and neck defects. These defects were once forever life altering because of the considerable morbidity to both the form and function of the patient. As time has progressed, microsurgical technique has improved dramatically and has become institutionalized in our training programs. Free flap outcomes in head and neck reconstruction have improved dramatically, and optimization of these outcomes is now key. One overlooked area has been neurosensory reconstruction. In our practice we have focused on this detail, which has proved to be quite important to the patient. This case report details one such case in which a mandibular resection was performed to treat osteoradionecrosis. We, as the reconstructive team, elected to perform a double-barrel fibular free flap procedure with simultaneous inferior alveolar nerve reconstruction using a 70-cm processed nerve allograft. Normal neurosensory function returned in this patient. As the state of the art advances with continued successful osseous and soft tissue reconstruction in the head and neck, we propose concomitant neurosensory functional reconstruction always be considered.

  15. Adaptive growth factor delivery from a polyelectrolyte coating promotes synergistic bone tissue repair and reconstruction.

    Science.gov (United States)

    Shah, Nisarg J; Hyder, Md Nasim; Quadir, Mohiuddin A; Dorval Courchesne, Noémie-Manuelle; Seeherman, Howard J; Nevins, Myron; Spector, Myron; Hammond, Paula T

    2014-09-01

    Traumatic wounds and congenital defects that require large-scale bone tissue repair have few successful clinical therapies, particularly for craniomaxillofacial defects. Although bioactive materials have demonstrated alternative approaches to tissue repair, an optimized materials system for reproducible, safe, and targeted repair remains elusive. We hypothesized that controlled, rapid bone formation in large, critical-size defects could be induced by simultaneously delivering multiple biological growth factors to the site of the wound. Here, we report an approach for bone repair using a polyelectrolye multilayer coating carrying as little as 200 ng of bone morphogenetic protein-2 and platelet-derived growth factor-BB that were eluted over readily adapted time scales to induce rapid bone repair. Based on electrostatic interactions between the polymer multilayers and growth factors alone, we sustained mitogenic and osteogenic signals with these growth factors in an easily tunable and controlled manner to direct endogenous cell function. To prove the role of this adaptive release system, we applied the polyelectrolyte coating on a well-studied biodegradable poly(lactic-co-glycolic acid) support membrane. The released growth factors directed cellular processes to induce bone repair in a critical-size rat calvaria model. The released growth factors promoted local bone formation that bridged a critical-size defect in the calvaria as early as 2 wk after implantation. Mature, mechanically competent bone regenerated the native calvaria form. Such an approach could be clinically useful and has significant benefits as a synthetic, off-the-shelf, cell-free option for bone tissue repair and restoration.

  16. The use of brushite calcium phosphate cement for enhancement of bone-tendon integration in an anterior cruciate ligament reconstruction rabbit model.

    Science.gov (United States)

    Wen, Chun-Yi; Qin, Ling; Lee, Kwong-Man; Chan, Kai-Ming

    2009-05-01

    This study was designed to investigate the osteoconductivity and bioresorption of brushite calcium phosphate cement (CPC) in bone-tendon interface healing after anterior cruciate ligament (ACL) reconstruction. Surgical reconstruction using grafted tendon in bone tunnel was performed bilaterally in 28 skeletal mature rabbits. Brushite CPC was implanted between grafted tendon and bone tunnel of one limb with the contralateral one as the control. A batch of 14 rabbits was sacrificed at 6 and 12 weeks, respectively, after surgery. At each time point, six rabbits were used for micro-CT and subsequent histological examinations, whereas the remaining eight rabbits were used for pull-out testing. The components of brushite CPC-dicalcium phosphate dihydrate matrix degraded rapidly with beta-tricalcium phosphate granules left for guiding new bone formation. Brushite CPC augmented the peri-tendon bone volume and promoted bone growth into the healing interface. The ultimate strength and stiffness of the graft-tunnel complexes on experimental side was higher than that of the control by 117% and 102%, respectively, at 6 weeks postoperatively (p brushite CPC caused a paradigm shift in failure mode from intra-tunnel to intra-articular portion at 12 weeks postoperatively (p = 0.013). Brushite CPC significantly enhanced the bone-tendon integration after ACL reconstruction, which provided a scientific basis for clinical application.

  17. In Vivo Study of Ligament-Bone Healing after Anterior Cruciate Ligament Reconstruction Using Autologous Tendons with Mesenchymal Stem Cells Affinity Peptide Conjugated Electrospun Nanofibrous Scaffold

    Directory of Open Access Journals (Sweden)

    Jingxian Zhu

    2013-01-01

    Full Text Available Electrospinning nanofibrous scaffold was commonly used in tissue regeneration recently. Nanofibers with specific topological characteristics were reported to be able to induce osteogenic differentiation of MSCs. In this in vivo study, autologous tendon grafts with lattice-like nanofibrous scaffold wrapping at two ends of autologous tendon were used to promote early stage of ligament-bone healing after rabbit ACL reconstruction. To utilize native MSCs from bone marrow, an MSCs specific affinity peptide E7 was conjugated to nanofibrous meshes. After 3 months, H-E assessment and specific staining of collagen type I, II, and III showed direct ligament-bone insertion with typical four zones (bone, calcified fibrocartilage, fibrocartilage, and ligament in bioactive scaffold reconstruction group. Diameters of bone tunnel were smaller in nanofibrous scaffold conjugated E7 peptide group than those in control group. The failure load of substitution complex also indicated a stronger ligament-bone insertion healing using bioactive scaffold. In conclusion, lattice-like nanofibrous scaffold with specific MSCs affinity peptide has great potential in promoting early stage of ligament-bone healing after ACL reconstruction.

  18. Reconstruction of mandibular vertical defects for dental implants with autogenous bone block grafts using a tunnel approach: clinical study of 50 cases.

    Science.gov (United States)

    Restoy-Lozano, A; Dominguez-Mompell, J L; Infante-Cossio, P; Lara-Chao, J; Espin-Galvez, F; Lopez-Pizarro, V

    2015-11-01

    The objective of this study was to evaluate the outcomes of mandibular vertical defect reconstruction with autologous bone and the use of a sub-periosteal tunnel approach in preparation for dental implant insertion. Forty-three consecutive patients with an atrophic posterior mandible were reconstructed using this method. Two thin laminae of cortical bone, obtained by splitting blocks harvested from the retromolar area, were fixed in a box-like framework containing cancellous and particulate bone. The goal was to achieve an alveolar ridge width of ≥5.5mm and an effective bone height (EBH) of ≥10.5mm for dental implant insertion (≥3.4mm diameter, ≥9.5mm length). Fifty reconstruction procedures were performed. The mean EBH was 7.1±1.3mm pre-treatment and 12.3±1.1mm post-treatment (mean increase 5.2±1.4mm). Complete graft loss was recorded in two cases; the remaining complications were minor. After a mean consolidation period of 3.5 months, 96 dental implants were placed. No failure of osseointegration was observed at follow-up (mean 32.9 months). The average bone height reduction was 0.9mm (graft vertical resorption 17.4%). Reconstruction of posterior mandibular vertical defects using two autogenous cortical bone blocks with particulate bone between them, combined with a tunnelling technique, provided good healing with no wound dehiscence and minimum resorption of the grafted bone, favouring a substantial vertical bone gain.

  19. Isokinetic quadriceps and hamstring muscle strength and knee function 5 years after anterior cruciate ligament reconstruction: comparison between bone-patellar tendon-bone and hamstring tendon autografts.

    Science.gov (United States)

    Lautamies, Riitta; Harilainen, Arsi; Kettunen, Jyrki; Sandelin, Jerker; Kujala, Urho M

    2008-11-01

    Existing clinical studies have not proven which graft is to be preferred in anterior cruciate ligament (ACL) reconstruction. In recent years, bone-patellar tendon-bone and hamstring tendons have been the most frequently used graft types. Muscle strength deficit is one of the consequences after ACL reconstruction. The aim of this study was to evaluate possible differences in hamstring and quadriceps muscle strength and knee function 5 years after ACL reconstruction between the BPTB and the STG groups. The study group consisted of 288 patients (132 women, 156 men) with a unilateral ACL rupture who had received a BPTB (175 patients) or STG (113 patients) ACL reconstruction. Lower extremity concentric isokinetic peak extension and flexion torques were assessed at the angular velocities of 60 degrees /s and 180 degrees /s. The International Knee Documentation Committee (IKDC), the Tegner activity level, the Lysholm knee and the Kujala patellofemoral scores were also collected. Isokinetic quadriceps peak torque (percentage of the contralateral side) was 3.9% higher in the STG group than in the BPTB group at the velocity of 60 degrees /s and 3.2% higher at the velocity of 180 degrees /s and the isokinetic hamstring peak torque 2% higher in the BPTB group than in the STG group at the velocity of 60 degrees /s and 2.5% higher at the velocity of 180 degrees /s. In both groups the subjects had weaker quadriceps and hamstring muscle strength in the injured extremity compared with the uninjured one. In the single-leg hop test (according to the IKDC recommendations) there was a statistically significant difference (P = 0.040) between the groups. In the STG group, 68% of the patients had the single-leg hop ratio (injured vs. uninjured extremity) > or =90%, 31% of the patients 75-89% and 1% of the patients <75%, while in the BPTB group the corresponding percentages were 72, 21 and 7%. However, no statistically significant differences in clinical outcome were found between the

  20. Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data

    Science.gov (United States)

    Brandão-Filho, E. M.; Deliberador, F. R.; Giovanini, A. F.; Deliberador, T. M.

    2017-01-01

    Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery. Ten months subsequent to this procedure, provisional fixed prosthesis was installed on the implants. Four months later (postoperative month 14), the final fixed prosthesis was installed and the clinical success was observed. The insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient. PMID:28299226

  1. Intraosseous epidermoid cyst of the distal phalanx reconstructed with synthetic bone graft.

    Science.gov (United States)

    Sasaki, Hiromi; Nagano, Satoshi; Shimada, Hirofumi; Nakashima, Takayuki; Yokouchi, Masahiro; Ishidou, Yasuhiro; Setoguchi, Takao; Komiya, Setsuro

    2017-01-01

    Intraosseous epidermoid cysts are exceedingly rare. Known as pseudotumors, not true neoplasms, intraosseous epidermoid cysts usually involve the phalanges, the skull, and the toes. Intraosseous epidermoid cysts typically present as destructive osteolytic lesions on X-ray, mimicking malignant bone tumors. Here, we present two cases of an intraosseous epidermoid cyst in the distal phalanx treated with curettage and synthetic bone graft, followed by a review of the relevant literature. In both cases, the patient presented with a painful enlargement of the fingertip following a minor trauma. Magnetic resonance imaging demonstrated lesions involving the distal phalanx that had a low signal on T1-weighted imaging (WI) and a high intensity on T2-WI. In both cases, the lesions were not enhanced by gadolinium. Good remodeling and functional recoveries were obtained. For physically active patients with substantial bone defects, synthetic bone graft may be recommended.

  2. Atmospheric transport and dispersion modeling for the Hanford Environmental Dose Reconstruction Project

    Energy Technology Data Exchange (ETDEWEB)

    Ramsdell, J.V.

    1991-07-01

    Radiation doses that may have resulted from operations at the Hanford Site are being estimated in the Hanford Environmental Dose Reconstruction (HEDR) Project. One of the project subtasks, atmospheric transport, is responsible for estimating the transport, diffusion and deposition of radionuclides released to the atmosphere. This report discusses modeling transport and diffusion in the atmospheric pathway. It is divided into three major sections. The first section of the report presents the atmospheric modeling approach selected following discussion with the Technical Steering Panel that directs the HEDR Project. In addition, the section discusses the selection of the MESOI/MESORAD suite of atmospheric dispersion models that form the basis for initial calculations and future model development. The second section of the report describes alternative modeling approaches that were considered. Emphasis is placed on the family of plume and puff models that are based on Gaussian solution to the diffusion equations. The final portion of the section describes the performance of various models. The third section of the report discusses factors that bear on the selection of an atmospheric transport modeling approach for HEDR. These factors, which include the physical setting of the Hanford Site and the available meteorological data, serve as constraints on model selection. Five appendices are included in the report. 39 refs., 4 figs., 2 tabs.

  3. The Value of SPECT/CT in Monitoring Prefabricated Tissue-Engineered Bone and Orthotopic rhBMP-2 Implants for Mandibular Reconstruction.

    Directory of Open Access Journals (Sweden)

    Miao Zhou

    Full Text Available Bone tissue engineering shows good prospects for mandibular reconstruction. In recent studies, prefabricated tissue-engineered bone (PTEB by recombinant human bone morphogenetic proteins (rhBMPs applied in vivo has found to be an effective alternative for autologous bone grafts. However, the optimal time to transfer PTEB for mandibular reconstruction is still not elucidated. Thus, here in an animal experiment of rhesus monkey, the suitable transferring time for PTEB to reconstruct mandibular defects was evaluated by 99mTc-MDP SPECT/CT, and its value in monitoring orthotopic rhBMP-2 implants for mandibular reconstruction was also evaluated. The result of SPECT/CT showed higher 99mTc-MDP uptake, indicating osteoinductivity, in rhBMP-2 incorporated demineralized freeze-dried bone allograft (DFDBA and coralline hydroxyapatite (CHA implants than those without BMP stimulation. 99mTc-MDP uptake of rhBMP-2 implant peaked at 8 weeks following implantation while CT showed the density of these implants increased after 13 weeks' prefabrication. Histology confirmed that mandibular defects were repaired successfully with PTEB or orthotopically rhBMP-2 incorporated CHA implants, in accordance with SPECT/CT findings. Collectively, data shows 99mTc-MDP SPECT/CT is a sensitive and noninvasive tool to monitor osteoinductivity and bone regeneration of PTEB and orthotopic implants. The PTEB achieved peak osteoinductivity and bone density at 8 to 13 weeks following ectopic implantation, which would serve as a recommendable time frame for its transfer to mandibular reconstruction.

  4. MR imaging findings of patellar tendon after anterior cruciate ligament reconstruction with bone-tendon-bone autograft

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Kim, Hyoung Rae; Kim, Baek Hyun; Seol, Hae Young; Cha, In ho; Im, Hong Cheol [College of Medicine, Korea Univ., Seoul (Korea, Republic of); Kim, Hyoung Seuk [College of Medicine, Inje Univ., Kimhae (Korea, Republic of); Lee, Chang Hee [College of Medicine, Konkuk Univ., Seoul (Korea, Republic of)

    2002-01-01

    To evaluate the postoperative changes occurring in the patellar tendon after reconstruction of the anterior cruciate ligament (ACL) using the central one-third of the patellar tendon together with patellar and tibial bony plugs. Ten patients with ACL injury underwent sagittal and coronal T1- weighted MR imaging of both postoperative and normal knee joints. In all cases, reconstruction of the ACL was performed using the central one-third of the patellar tendon, together with patellar and tibial bony plugs. During the follow-up period of 6-27 months, patient were clinically stable. We compared the length, signal intensity and contour of both patellar tendons, as seen on MR images. No defects was found in harvested patellar tendons, and MR images showed high signal intensity within harvested tendons in six of the ten patients. In seven of ten, patellar tendons had irregular margins and were poorly delineated from adjacent tissue. The mean length of patellar tendons was 44.2 {+-}2.0 mm in normal knee and 43.9 {+-}3.1 mm in postoperative knee, while their mean thickness in postoperative knee, measured at mid-portion averaged 4.3{+-}1.2 mm. There were no statistically significant differences (p>0.05). The greatest mean thickness of patellar tendon was 6.9 {+-}1.2 mm and 4.3 {+-}0.5 mm in normal and postoperative knee, respectively. Thus, on average, postoperative patellar tendon was 161% thickner than normal tendon (p<0.05). In clinically stable patients, patellar tendons after graft harvesting had a higher signal intensity, worse-defined margins and a greater thickness than normal. We suggest that these are the normal postoperative findings.

  5. Long-term outcomes of the use of allogeneic, radiation-sterilised bone blocks in reconstruction of the atrophied alveolar ridge in the maxilla and mandible.

    Science.gov (United States)

    Krasny, Marta; Krasny, Kornel; Fiedor, Piotr; Zadurska, Małgorzata; Kamiński, Artur

    2015-12-01

    Increasingly dental surgeons face the challenge of reconstruction of the height and/or thickness of the alveolar ridge as more and more patients wish to have permanent restoration of their dental defects based on intraosseous implants. Evaluation of human allogeneic bone tissue grafts in reconstruction of atrophied alveolar ridge as a pre-implantation procedure. The material comprised 21 patients aged 19-63, treated between 2009 and 2012 by the same surgeon. Restoration of bone tissue defects was performed with allogeneic, frozen, radiation-sterilised, corticocancellous blocks. The study included 26 grafting procedures with 7 procedures consisting in reconstruction of the alveolar ridge in the mandible and 19 in the maxilla. In all the cases the atrophied alveolar ridge was successfully reconstructed, which allowed placement of intraosseous implants in compliance with the initial treatment plan. After the treatment was completed the patients reported for follow-up annually. The average time of follow-up amounted to 39 months (28-50 months). None of the implants was lost during the follow-up period. There was one case of gingival recession causing aesthetics deterioration of the prosthetic restoration. In three cases the connector became unscrewed partially, which was corrected at the same visit. Frozen, radiation-sterilised, allogeneic bone blocks constitute good and durable bone-replacement material allowing effective and long-lasting reconstruction of the atrophied alveolar ridge to support durable, implant-based, prosthetic restoration.

  6. SU-E-T-143: Effect of X-Ray and Cone Beam CT Reconstruction Parameters On Estimation of Bone Volume of Mice Used in Aging Research

    Energy Technology Data Exchange (ETDEWEB)

    Russ, M; Pang, M; Troen, B; Rudin, S; Ionita, C [University at Buffalo, Buffalo, NY (United States)

    2014-06-01

    Purpose: To investigate the variations in bone volume calculations in mice involved in aging research when changing cone beam micro-CT x-ray and reconstruction parameters. Methods: Mouse spines were placed on an indexed turn table that rotated 0.5° per projection and imaged by a self-built micro CT machine containing a CCD-based high-resolution x-ray detector. After the full 360° rotation data set of object images was obtained, a standard filtered back-projection cone beam reconstruction was performed. Four different kVp's between 40–70 kVp in 10kVp increments were selected. For each kVp two mAs settings were used. Each acquisition was reconstructed using two voxel sizes (12 and 25μm) and two step angles, 0.5° and 1°, respectively. A LabView program was written to determine the total bone volume contained in the mouse's total spine volume (bone plus gaps) as a measure of spine health. First, the user selected the desired 512×512 reconstruction to view the whole spine volume which was then used to select a gray-level threshold that allowed for viewing of the bone structure, then another threshold to include gaps. The program returned bone volume, bone × gap volume, and their ratio, BVF. Results: The calculated bone volume fractions were compared as a function of tube potential. Cases with 25μm slice thickness showed trials with lower kVp's had greater image contrast, which resulted in higher calculated bone volume fractions. Cases with 12μm reconstructed slice thickness were significantly noisier, and showed no clear maximum BVF. Conclusion: Using the projection images and reconstructions acquired from the micro CT, it can be shown that the micro-CT x-ray and reconstruction parameters significantly affect the total bone volume calculations. When comparing mice cohorts treated with different therapies researchers need to be aware of such details and use volumes which were acquired and processed in identical conditions.

  7. Monte Carlo modeling of photon transport in buried bone tissue layer for quantitative Raman spectroscopy

    Science.gov (United States)

    Wilson, Robert H.; Dooley, Kathryn A.; Morris, Michael D.; Mycek, Mary-Ann

    2009-02-01

    Light-scattering spectroscopy has the potential to provide information about bone composition via a fiber-optic probe placed on the skin. In order to design efficient probes, one must understand the effect of all tissue layers on photon transport. To quantitatively understand the effect of overlying tissue layers on the detected bone Raman signal, a layered Monte Carlo model was modified for Raman scattering. The model incorporated the absorption and scattering properties of three overlying tissue layers (dermis, subdermis, muscle), as well as the underlying bone tissue. The attenuation of the collected bone Raman signal, predominantly due to elastic light scattering in the overlying tissue layers, affected the carbonate/phosphate (C/P) ratio by increasing the standard deviation of the computational result. Furthermore, the mean C/P ratio varied when the relative thicknesses of the layers were varied and the elastic scattering coefficient at the Raman scattering wavelength of carbonate was modeled to be different from that at the Raman scattering wavelength of phosphate. These results represent the first portion of a computational study designed to predict optimal probe geometry and help to analyze detected signal for Raman scattering experiments involving bone.

  8. Effects of CT image segmentation methods on the accuracy of long bone 3D reconstructions.

    Science.gov (United States)

    Rathnayaka, Kanchana; Sahama, Tony; Schuetz, Michael A; Schmutz, Beat

    2011-03-01

    An accurate and accessible image segmentation method is in high demand for generating 3D bone models from CT scan data, as such models are required in many areas of medical research. Even though numerous sophisticated segmentation methods have been published over the years, most of them are not readily available to the general research community. Therefore, this study aimed to quantify the accuracy of three popular image segmentation methods, two implementations of intensity thresholding and Canny edge detection, for generating 3D models of long bones. In order to reduce user dependent errors associated with visually selecting a threshold value, we present a new approach of selecting an appropriate threshold value based on the Canny filter. A mechanical contact scanner in conjunction with a microCT scanner was utilised to generate the reference models for validating the 3D bone models generated from CT data of five intact ovine hind limbs. When the overall accuracy of the bone model is considered, the three investigated segmentation methods generated comparable results with mean errors in the range of 0.18-0.24 mm. However, for the bone diaphysis, Canny edge detection and Canny filter based thresholding generated 3D models with a significantly higher accuracy compared to those generated through visually selected thresholds. This study demonstrates that 3D models with sub-voxel accuracy can be generated utilising relatively simple segmentation methods that are available to the general research community.

  9. 输送盘牵张成骨重建颅颌面骨缺损的研究进展%Current status of transport distraction osteogenesis for the reconstruction of craniomaxillofacial skeletal defects

    Institute of Scientific and Technical Information of China (English)

    宋继传

    2011-01-01

    Transport distraction osteogenesis has been an extremely effective surgical technique for reconstructing critical-size skeletal defects of human long bones. It can also be applied efficiently in the reconstruction of extensive defects of craniomaxillofacial benes, which are caused by trauma, tumout resection, osteomyelitis, and bony nonunion and so on. This study reviewed its application in the craniomaxillofacial skeletal reconstruction.%输送盘牵张成骨已成为重建人类长骨大范围组织缺损极为有效的方法之一.用其也可高效地重建颅颌面骨因创伤、肿瘤术后、骨髓炎以及骨愈合不良等造成的大范围骨组织缺损.本文就输送盘牵张成骨在颅颌面骨缺损重建的应用作一综述.

  10. Bone

    Science.gov (United States)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  11. Transport simulation and image reconstruction for fast-neutron detection of explosives and narcotics

    Energy Technology Data Exchange (ETDEWEB)

    Micklich, B.J.; Fink, C.L.; Sagalovsky, L.

    1995-07-01

    Fast-neutron inspection techniques show considerable promise for explosive and narcotics detection. A key advantage of using fast neutrons is their sensitivity to low-Z elements (carbon, nitrogen, and oxygen), which are the primary constituents of these materials. We are currently investigating two interrogation methods in detail: Fast-Neutron Transmission Spectroscopy (FNTS) and Pulsed Fast-Neutron Analysis (PFNA). FNTS is being studied for explosives and narcotics detection in luggage and small containers for which the transmission ratio is greater than about 0.01. The Monte-Carlo radiation transport code MCNP is being used to simulate neutron transmission through a series of phantoms for a few (3-5) projection angles and modest (2 cm) resolution. Areal densities along projection rays are unfolded from the transmission data. Elemental abundances are obtained for individual voxels by tomographic reconstruction, and these reconstructed elemental images are combined to provide indications of the presence or absence of explosives or narcotics. PFNA techniques are being investigated for detection of narcotics in cargo containers because of the good penetration of the fast neutrons and the low attenuation of the resulting high-energy gamma-ray signatures. Analytic models and Monte-Carlo simulations are being used to explore the range of capabilities of PFNA techniques and to provide insight into systems engineering issues. Results of studies from both FNTS and PFNA techniques are presented.

  12. The mechanical and biological studies of calcium phosphate cement-fibrin glue for bone reconstruction of rabbit femoral defects

    Directory of Open Access Journals (Sweden)

    Dong J

    2013-03-01

    Full Text Available Jingjing Dong,1,* Geng Cui,2,* Long Bi,1,* Jie Li,3 Wei Lei11Institute of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, People’s Republic of China; 2Institute of Orthopedics, General Hospital of PLA, Beijing, People’s Republic of China; 3Institute of Gynecology and Obstetrics, General Hospital of PLA, Beijing, People’s Republic of China*These authors contributed equally to this workAbstract: In order to improve the mechanical and biological properties of calcium phosphate cement (CPC, nanometer-biomaterial for bone reconstruction in the rabbit femoral defect model, fibrin glue (FG, the natural product, purified from the blood was introduced at three different ratios. The CPC powder and the FG solution were mixed, respectively, at the powder/liquid (P/L ratios (g/mL of 1:1, 3:1, and 5:1 (g/mL, and pure CPC was used as a control. After being implanted into the femoral defect in rabbit, the healing process was evaluated by micro-computed tomography scan, biomechanical testing, and histological examination. By micro-computed tomography analysis, the P/L ratio of 1:1 (g/mL group indicated the largest quantity of new bone formation at 4 weeks, 8 weeks, and 12 weeks after implantation, respectively. Bone volume per trabecular volume of the 1:1 group was highest in the four groups, which was 1.45% ± 0.42%, 7.35% ± 1.45%, and 29.10% ± 1.67% at 4 weeks, 8 weeks, and 12 weeks after the operation, respectively. In the biomechanical tests, the compressive strength and the elastic modulus of the three CPC–FG groups were much higher than those of the pure CPC group at the determined time point (P < 0.05. The histological evaluation also showed the best osseointegration in the 1:1 group at 4 weeks, 8 weeks, and 12 weeks after the operation, respectively. In the 1:1 group, the bone grew into the pore of the cement in the laminar arrangement and connected with the cement tightly at the 12th week after the operation

  13. Characterization and three-dimensional reconstruction of synthetic bone model foams

    Energy Technology Data Exchange (ETDEWEB)

    Gómez, S. [Interdepartment Research Group for the Applied Scientific Collaboration (IRGASC), Division of Biomaterials and Bioengineering, Technical University of Catalonia (UPC), Avda. Diagonal 647, E-08028 Barcelona (Spain); Vlad, M.D. [Interdepartment Research Group for the Applied Scientific Collaboration (IRGASC), Division of Biomaterials and Bioengineering, Technical University of Catalonia (UPC), Avda. Diagonal 647, E-08028 Barcelona (Spain); Faculty of Medical Bioengineering, “Gr. T. Popa” University of Medicine and Pharmacy, Str. Kogalniceanu 9-13, 700454 Iasi (Romania); López, J. [Interdepartment Research Group for the Applied Scientific Collaboration (IRGASC), Division of Biomaterials and Bioengineering, Technical University of Catalonia (UPC), Avda. Diagonal 647, E-08028 Barcelona (Spain); Navarro, M. [Centre de Biotecnologia Animal i de Teràpia Gènica (CBATEG), Departament de Sanitat i d' Anatomia Animals, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Cerdanyola del Vallès (Spain); Fernández, E., E-mail: enrique.fernandez@upc.edu [Interdepartment Research Group for the Applied Scientific Collaboration (IRGASC), Division of Biomaterials and Bioengineering, Technical University of Catalonia (UPC), Avda. Diagonal 647, E-08028 Barcelona (Spain)

    2013-08-01

    Sawbones© open-cell foams with different porosity grades are being used as synthetic bone-like models for in vitro mechanical and infiltration experiments. However, a comprehensive characterization of these foams is not available and there is a lack of reliable information about them. For this reason two of these foams (Refs. 1522-505 and -507) have been characterized at the micro architectural level by scanning electron microscopy, computed tomography and image data analysis. BoneJ open software and ImageJ open software were used to obtain the characteristic histomorphometric parameters and the three dimensional virtual models of the foams. The results showed that both foams, while having different macro porosities, appeared undistinguishable at the micro scale. Moreover, the micro structural features resembled those of osteoporotic rather than healthy trabecular bone. It is concluded that Sawbones© foams behave reasonably as synthetic bone-like models. Consequently, their use is recommended for in vitro comparison purposes of both mechanical and infiltration testing performed in real vertebra. Finally, the virtual models obtained, which are available under request, can favour comparisons between future self-similar in vitro experiments and computer simulations. - Highlights: • Sawbones© model foams have been scanned by μ-CT. • Histomorphometric indices and 3D virtual models have been obtained. • The results will be of use to understand biocement vertebra infiltration studies.

  14. Effect of a combination of local flap and sequential compression-distraction osteogenesis in the reconstruction of post-traumatic tibial bone and soft tissue defects

    Institute of Scientific and Technical Information of China (English)

    HU Xiao-hua; HUANG Lei; CHEN Zhong; DU Wei-li; WANG Cheng; SHEN Yu-ming

    2013-01-01

    Background Treatment of extensive post-traumatic composite bone and soft tissue defects remains a complicated therapeutic problem and a challenge for surgeons.We investigated the application of local flaps and Ilizarov osteogenesis in the reestablishment of severe combined defects of tibial bone and soft tissue.Methods Sixteen patients with bone and soft tissue defects were included.The mean age of the patients was 31.5 years.The average time from injury to initial surgery was 14.4 weeks.The average soft tissue and bone defect sizes were 92.9cm2 and 8.7 cm,respectively.Local flaps were created to reconstruct the soft tissue defects.The Ilizarov external fixator or the Orthofix Limb Reconstruction System was used to reconstruct bony defects using delayed distraction osteogenesis.Results Two myocutaneous flaps and 14 reverse island flaps were applied.All transferred flaps survived.Fifteen patients healed with equal leg length,and one healed with a residual leg-length discrepancy of 1.5 cm.One patient with an Ilizarov external fixator developed ankle joint stiffening and a pin-track infection that was successfully treated with oral antibiotics.No patient developed pin loosening.All patients walked without assistance.Fifteen patients returned to their work,and one lost her job.The results were evaluated using the Paley bone and functional assessment scores.The bone assessment results were excellent in 14 and good in two patients.Functional assessment scores were excellent in 13,good in two,and fair in one patient.Conclusion The combination of local flaps and sequential distraction osteogenesis can be used for successful reconstruction of defects of incorporated bone and soft tissue.

  15. Mechanical Loading Improves Tendon-Bone Healing in a Rabbit Anterior Cruciate Ligament Reconstruction Model by Promoting Proliferation and Matrix Formation of Mesenchymal Stem Cells and Tendon Cells

    Directory of Open Access Journals (Sweden)

    Fanglong Song

    2017-02-01

    Full Text Available Background/Aims: This study investigated the effect of mechanical stress on tendon-bone healing in a rabbit anterior cruciate ligament (ACL reconstruction model as well as cell proliferation and matrix formation in co-culture of bone-marrow mesenchymal stem cells (BMSCs and tendon cells (TCs. Methods: The effect of continuous passive motion (CPM therapy on tendon-bone healing in a rabbit ACL reconstruction model was evaluated by histological analysis, biomechanical testing and gene expressions at the tendon-bone interface. Furthermore, the effect of mechanical stretch on cell proliferation and matrix synthesis in BMSC/TC co-culture was also examined. Results: Postoperative CPM therapy significantly enhanced tendon-bone healing, as evidenced by increased amount of fibrocartilage, elevated ultimate load to failure levels, and up-regulated gene expressions of Collagen I, alkaline phosphatase, osteopontin, Tenascin C and tenomodulin at the tendon-bone junction. In addition, BMSC/TC co-culture treated with mechanical stretch showed a higher rate of cell proliferation and enhanced expressions of Collagen I, Collagen III, alkaline phosphatase, osteopontin, Tenascin C and tenomodulin than that of controls. Conclusion: These results demonstrated that proliferation and differentiation of local precursor cells could be enhanced by mechanical stimulation, which results in enhanced regenerative potential of BMSCs and TCs in tendon-bone healing.

  16. Histomorhological and clinical evaluation of maxillary alveolar ridge reconstruction after craniofacial trauma by applying combination of allogeneic and autogenous bone graft.

    Science.gov (United States)

    De Ponte, Francesco Saverio; Falzea, Roberto; Runci, Michele; Siniscalchi, Enrico Nastro; Lauritano, Floriana; Bramanti, Ennio; Cervino, Gabriele; Cicciu, Marco

    2017-02-01

    A variety of techniques and materials for the rehabilitation and reconstruction of traumatized maxillary ridges prior to dental implants placement have been described in literature. Autogenous bone grafting is considered ideal by many researchers and it still remains the most predictable and documented method. The aim of this report is to underline the effectiveness of using allogeneic bone graft for managing maxillofacial trauma. A case of a 30-year-old male with severely atrophic maxillary ridge as a consequence of complex craniofacial injury is presented here. Augmentation procedure in two stages was performed using allogeneic and autogenous bone grafts in different areas of the osseous defect. Four months after grafting, during the implants placement surgery, samples of both sectors were withdrawn and submitted to histological evaluation. On the examination of the specimens, treated by hematoxylin and eosin staining, the morphology of integrated allogeneic bone grafts was revealed to be similar to the autologous bone. Our clinical experience shows how the allogeneic bone graft presented normal bone tissue architecture and is highly vascularized, and it can be used for reconstruction of severe trauma of the maxilla.

  17. Histomorhological and clinical evaluation of maxillary alveolar ridge reconstruction after craniofacial trauma by applying combination of allogeneic and autogenous bone graft

    Directory of Open Access Journals (Sweden)

    Francesco Saverio De Ponte

    2017-02-01

    Full Text Available A variety of techniques and materials for the rehabilitation and reconstruction of traumatized maxillary ridges prior to dental implants placement have been described in literature. Autogenous bone grafting is considered ideal by many researchers and it still remains the most predictable and documented method. The aim of this report is to underline the effectiveness of using allogeneic bone graft for managing maxillofacial trauma. A case of a 30-year-old male with severely atrophic maxillary ridge as a consequence of complex craniofacial injury is presented here. Augmentation procedure in two stages was performed using allogeneic and autogenous bone grafts in different areas of the osseous defect. Four months after grafting, during the implants placement surgery, samples of both sectors were withdrawn and submitted to histological evaluation. On the examination of the specimens, treated by hematoxylin and eosin staining, the morphology of integrated allogeneic bone grafts was revealed to be similar to the autologous bone. Our clinical experience shows how the allogeneic bone graft presented normal bone tissue architecture and is highly vascularized, and it can be used for reconstruction of severe trauma of the maxilla.

  18. Fabrication of 3D porous SF/β-TCP hybrid scaffolds for bone tissue reconstruction.

    Science.gov (United States)

    Park, Hyun Jung; Min, Kyung Dan; Lee, Min Chae; Kim, Soo Hyeon; Lee, Ok Joo; Ju, Hyung Woo; Moon, Bo Mi; Lee, Jung Min; Park, Ye Ri; Kim, Dong Wook; Jeong, Ju Yeon; Park, Chan Hum

    2016-07-01

    Bio-ceramic is a biomaterial actively studied in the field of bone tissue engineering. But, only certain ceramic materials can resolve the corrosion problem and possess the biological affinity of conventional metal biomaterials. Therefore, the recent development of composites of hybrid composites and polymers has been widely studied. In this study, we aimed to select the best scaffold of silk fibroin and β-TCP hybrid for bone tissue engineering. We fabricated three groups of scaffold such as SF (silk fibroin scaffold), GS (silk fibroin/small granule size of β-TCP scaffold) and GM (silk fibroin/medium granule size of β-TCP scaffold), and we compared the characteristics of each group. During characterization of the scaffold, we used scanning electron microscopy (SEM) and a Fourier transform infrared spectroscopy (FTIR) for structural analysis. We compared the physiological properties of the scaffold regarding the swelling ratio, water uptake and porosity. To evaluate the mechanical properties, we examined the compressive strength of the scaffold. During in vitro testing, we evaluated cell attachment and cell proliferation (CCK-8). Finally, we confirmed in vivo new bone regeneration from the implanted scaffolds using histological staining and micro-CT. From these evaluations, the fabricated scaffold demonstrated high porosity with good inter-pore connectivity, showed good biocompatibility and high compressive strength and modulus. In particular, the present study indicates that the GM scaffold using β-TCP accelerates new bone regeneration of implanted scaffolds. Accordingly, our scaffold is expected to act a useful application in the field of bone tissue engineering. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1779-1787, 2016.

  19. Complete resection and immediate reconstruction with costochondral graft for recurrent aneurysmal bone cyst of the mandibular condyle.

    Science.gov (United States)

    Ziang, Zhuo; Chi, Yang; Minjie, Chen; Yating, Qiu; Xieyi, Cai

    2013-11-01

    Aneurysmal bone cyst is a non-neoplastic expansile lesion characterized by replacement with fibro-osseous tissue and blood-filled cavernous spaces. Involvement of the condyle is rare, and only 11 cases have been reported in English-language literature to date. Its common treatment modalities are lesion excision or condylar resection, but recurrence is high in patients treated with the former. The authors reported a 19-year-old female patient with swelling of the right preauricular region, who had a surgical curettage history in another hospital. The lesion was completely resected and the jaw was immediately reconstructed with costochondral graft with the help of SurgiCase software. The patient has been symptom-free for 6 months postoperatively.

  20. Dietary reconstruction and reservoir correction of 14C dates on bones from pagan and early Christian graves in Iceland

    DEFF Research Database (Denmark)

    Sveinbjörnsdóttir, Árný E; Heinemeier, Jan; Arneborg, Jette

    2010-01-01

    in the range of AD 780?1270 (68.2% probability). Reservoir age corrections were checked by comparing 14C dates of a horse (terrestrial diet), a dog (highly marine diet), and a human (mixed diet) from the same burial. The range in measured marine protein percentage in individual diet is from about 10% up to 55...... between the excavation site and the seashore. We have radiocarbon dated 47 of these skeletons and used the carbon isotopic composition (?13C) to estimate and correct for the marine reservoir effect (the 14C difference between terrestrial and mixed marine organisms). The reservoir-corrected ages lie...... in AD 1211. Using our dietary reconstruction, his bones were about 17% marine, which is within the range of human skeletons from the same area, and the reservoir-corrected calibrated 14C age of the skeleton is in accord with the historical date....

  1. Dietary reconstruction and reservoir correction of 14C dates on bones from pagan and early Christian graves in Iceland

    DEFF Research Database (Denmark)

    Sveinbjörnsdóttir, Árný E; Heinemeier, Jan; Arneborg, Jette;

    2010-01-01

    between the excavation site and the seashore. We have radiocarbon dated 47 of these skeletons and used the carbon isotopic composition (?13C) to estimate and correct for the marine reservoir effect (the 14C difference between terrestrial and mixed marine organisms). The reservoir-corrected ages lie...... in the range of AD 780?1270 (68.2% probability). Reservoir age corrections were checked by comparing 14C dates of a horse (terrestrial diet), a dog (highly marine diet), and a human (mixed diet) from the same burial. The range in measured marine protein percentage in individual diet is from about 10% up to 55...... in AD 1211. Using our dietary reconstruction, his bones were about 17% marine, which is within the range of human skeletons from the same area, and the reservoir-corrected calibrated 14C age of the skeleton is in accord with the historical date....

  2. Segmental resection and reconstruction of bone neoplasms%骨肿瘤病段切除并骨缺损修复

    Institute of Scientific and Technical Information of China (English)

    杨安礼

    2001-01-01

    Objective To restore the function of extrimities in patients with bone neoplasms, segmental resection and reconstruction of bone neoplasms was performed. Methods The limb was conserved and bone defect repaired by artificial prosthesis vascularized bone graft, osteoarticular allograft, sliding graft, and bone cement following segmental resection of bone neoplasms. Results 26 patients were treated. No recurrence was found and a good union of bone observed locally in vascularized bone grafting and sliding grafting, in some sites osteoarticular allograft transplantation caused rejector reaction, bone cement plugging was appropriate to repair of neoplasms in special location, functions of the joint were well recovered in arthroplastey. Conclusion It is effective that a suitable bone substitutes to repair bone defect after segmental resection of bone neoplasms, in some patients with benign or low malignancy bone tumor.%目的修复切除骨肿瘤后的骨缺损肢体,恢复其功能。方法采用特制人工金属假体、带血管蒂游离骨、异体关节、自体骨、骨水泥等修复骨缺损。结果 26例中应用带血管蒂游离骨或自体骨植骨术愈合最佳并且无复发;异体骨移植有一定的排异反应;骨水泥填塞只适用于特殊部位骨缺损的修复;人工假体修复,功能恢复良好。结论对某些良性骨肿瘤及低度恶性的骨肿瘤作病段切除后,选择适当的替代物修复缺损行之有效。

  3. Mechanical tests on the reconstructed anterior cruciate ligament fixed with allogenetic cortical bone cross-pin on the femoral side

    Institute of Scientific and Technical Information of China (English)

    Liu Chang; Liu Yujie; Zhang Yingze; Qu Feng; Li Shuyuan; Wang Junliang; Qi Wei

    2014-01-01

    Background Anterior cruciate ligament reconstruction (ACLR) has developed dramatically in the last century.Now,ACLR has become a reliable and productive procedure.Patients feel satisfied in >90% cases.The aim of this study was to evaluate the feasibility of allogenetic cortical bone cross-pin (ACBCP) used as a clinical fixation method in anterior cruciate ligament reconstruction on the femoral side based on biomechanical tests in vitro.Methods The specimens were provided by the bone banks of the First Affiliated Hospital of People's Liberation Army of General Hospital from September 2011 to June 2012.Fresh deep frozen human allogenetic cortical bone was machined into cross-pins which is 4.0 mm in diameter and 75.0 mm in length.Biomechanical parameters compared with Rigidfix were collected while cross-pins were tested in double-shear test.The load-to-failure test and cycling test were carried out in a goat model to reconstruct anterior cruciate ligament with Achilles tendon autograft on the femoral side fixed by human 4.0 mm ACBCP and 3.3 mm Rigidfix served as control.Maximum failure load,yield load,and stiffness of fixation in single load-to-failure test were compared between the two groups.Cycle-specific stiffness and displacement at cycles 1,30,200,400,and 1 000 were also compared in between.Results In double-shear test both maximum failed load and yield load of 4.0 mm humanACBCP were (1 236.998±201.940) N.Maximum failed load and yield load of Rigidfix were (807.929±110.511) N and (592.483±58.821) N.The differences of maximum failed load and yield load were significant between ACBCP and Rigidfix,P <0.05.The shear strength of ACBCP and Rigidfix were (49.243±8.039) MPa and (34.637±3.439) MPa,respectively,P <0.05.In the load-to-failure test ex vivo,yield load and maximum failed load of ACBCP fixation complexity ((867.104±132.856)N,(1 032.243±196.281) N) were higher than those of Rigidfix ((640.935±42.836) N,(800.568±64.890) N,P <0.05).However

  4. Accuracy of fibular sectioning and insertion into a rapid-prototyped bone plate, for mandibular reconstruction using CAD-CAM technology.

    Science.gov (United States)

    Ciocca, Leonardo; Marchetti, Claudio; Mazzoni, Simona; Baldissara, Paolo; Gatto, Maria Rosaria Antonella; Cipriani, Riccardo; Scotti, Roberto; Tarsitano, Achille

    2015-01-01

    Modern techniques of mandibular reconstruction, such as CAD-CAM technology and rapid prototyping, offer new means by which reconstructive surgery can be planned to optimise aesthetic outcomes and prosthetic rehabilitation. The high degree of accuracy afforded by these approaches is principally attributable to high-precision fibular sectioning and insertion of the bone into a customised bone plate. CAD-CAM mandibular reconstruction procedures using vascularised bone free-flap transfers were performed on 10 patients with benign or malignant neoplasms. Five were not treated with the aid of CAD-CAM technology, and served as the control group. Five were scheduled for maxillofacial surgery using surgical cutting guides and customised bone plates. A generalised linear model for linear measures was used to compare the accuracy of reconstruction between the two groups. A difference, even though not significant, in the lateral shift of the mesial and distal positions of the fibular units was evident between groups. CAD-CAM-generated fibular surgical guides afford improved accuracy when used to restore native anatomy, especially in the context of mandibular arch restoration, and both operating room time and related costs are reduced during fibular sectioning.

  5. Reconstruction of the mandible using preshaped 2.3 mm titanium plates, autogenous particulate cortico-cancellous bone grafts and platelet rich plasma: a report on eight patients.

    NARCIS (Netherlands)

    Merkx, M.A.W.; Fennis, J.P.M.; Verhagen, C.M.; Stoelinga, P.J.W.

    2004-01-01

    The results are presented of eight patients who had partial mandibulectomies for malignant tumours and were secondarily reconstructed with pre-shaped 2.3 mm titanium plates, autogenous particulate cortico-cancellous bone grafts and platelet rich plasma. Healing was uneventful in all cases and when p

  6. Reconstruction of the mandible with a poly(D,L-lactide) scaffold, autogenous corticocancellous bone graft, and autogenous platelet-rich plasma: an animal experiment.

    NARCIS (Netherlands)

    Fennis, J.P.M.; Stoelinga, P.J.W.; Merkx, M.A.T.; Jansen, J.A.

    2005-01-01

    An animal study is presented, evaluating a method of mandibular reconstruction using a poly(D,Llactide) (PDLLA) scaffold. Six goats underwent a continuity resection of the mandibular angle. The defect was bridged with a preshaped PDLLA scaffold, filled with an autogenous particulate bone graft from

  7. Hemicortical Resection and Inlay Allograft Reconstruction for Primary Bone Tumors A Retrospective Evaluation in the Netherlands and Review of the Literature

    NARCIS (Netherlands)

    Bus, M. P. A.; Bramer, J. A. M.; Schaap, G. R.; Schreuder, H. W. B.; Jutte, P. C.; van der Geest, I. C. M.; van de Sande, M. A. J.; Dijkstra, P. D. S.

    2015-01-01

    Background: Selected primary tumors of the long bones can be adequately treated with hemicortical resection, allowing for optimal function without compromising the oncological outcome. Allografts can be used to reconstruct the defect. As there is a lack of studies of larger populations with sufficie

  8. Hemicortical resection and inlay allograft reconstruction for primary bone tumors: a retrospective evaluation in the Netherlands and review of the literature

    NARCIS (Netherlands)

    Bus, M.P.; Bramer, J.A.; Schaap, G.R.; Schreuder, H.W.B.; Jutte, P.C.; Geest, I.C.M. van der; Sande, M.A. van de; Dijkstra, P.D.

    2015-01-01

    BACKGROUND: Selected primary tumors of the long bones can be adequately treated with hemicortical resection, allowing for optimal function without compromising the oncological outcome. Allografts can be used to reconstruct the defect. As there is a lack of studies of larger populations with sufficie

  9. Imaging and quantifying solute transport across periosteum: implications for muscle-bone crosstalk.

    Science.gov (United States)

    Lai, Xiaohan; Price, Christopher; Lu, Xin Lucas; Wang, Liyun

    2014-09-01

    Muscle and bone are known to act as a functional unit and communicate biochemically during tissue development and maintenance. Muscle-derived factors (myokines) have been found to affect bone functions in vitro. However, the transport times of myokines to penetrate into bone, a critical step required for local muscle-bone crosstalk, have not been quantified in situ or in vivo. In this study, we investigated the permeability of the periosteum, a major barrier to muscle-bone crosstalk by tracking and modeling fluorescent tracers that mimic myokines under confocal microscopy. Periosteal surface boundaries and tracer penetration within the boundaries were imaged in intact murine tibiae using reflected light and time-series xz confocal imaging, respectively. Four fluorescent tracers including sodium fluorescein (376Da) and dextrans (3kDa, 10kDa and 40kDa) were chosen because they represented a wide range of molecular weights (MW) of myokines. We found that i) murine periosteum was permeable to the three smaller tracers while the 40kDa could not penetrate beyond 40% of the outer periosteum within 8h, suggesting that periosteum is semi-permeable with a cut-off MW of approximately 40kDa, and ii) the characteristic penetration time through the periosteum (~60μm thick) increased with tracer MW and fit well with a relationship tcs=-4.43×10(4)-0.57×MWDa-4×10(4)-8.65×10(8)MWDa-4×10(4), from which, the characteristic penetration times of various myokines were extrapolated. To achieve effective muscle-bone crosstalk, likely signaling candidates should have shorter penetration time than their bioactive time, which we assumed to be 5 times of the molecule's half-lifetime in the body. Myokines such as PGE2, IGF-1, IL-15 and FGF-2 were predicted to satisfy this requirement. In summary, a novel imaging approach was developed and used to investigate the transport of myokine mimicking-tracers through the periosteum, enabling further quantitative studies of muscle-bone

  10. Morphometric study of maxillary sinus by computed tomography. Assessment of sinus floor bone reconstruction

    OpenAIRE

    2012-01-01

    Rehabilitation with dental implants in posterior maxilla is difficult because of the presence of maxillary sinus with anatomical variations. The aim of this research was to evaluate the sinus volume to install one or more implants without invading the sinus membrane. Forty (40) maxillary sinuses were evaluated in 22 skulls by computed tomography measuring in the axial, coronal and sagittal slice. The sinus were classified according to the remaining alveolar bone and a dental implant in the pl...

  11. In Vitro Evaluation of Nanoscale Hydroxyapatite-Based Bone Reconstructive Materials with Antimicrobial Properties.

    Science.gov (United States)

    Ajduković, Zorica R; Mihajilov-Krstev, Tatjana M; Ignjatović, Nenad L; Stojanović, Zoran; Mladenović-Antić, Snezana B; Kocić, Branislava D; Najman, Stevo; Petrović, Nenad D; Uskoković, Dragan P

    2016-02-01

    In the field of oral implantology the loss of bone tissue prevents adequate patient care, and calls for the use of synthetic biomaterials with properties that resemble natural bone. Special attention is paid to the risk of infection after the implantation of these materials. Studies have suggested that some nanocontructs containing metal ions have antimicrobial properties. The aim of this study was to examine the antimicrobial and hemolytic activity of cobalt-substituted hydroxyapatite nanoparticles, compared to hydroxyapatite and hydroxyapatite/poly-lactide-co-glycolide. The antibacterial effects of these powders were tested against two pathogenic bacterial strains: Escherichia coi (ATCC 25922) and Staphylococcus aureus (ATCC 25923), using the disc diffusion method and the quantitative antimicrobial test in a liquid medium. The quantitative antimicrobial test showed that all of the tested biomaterials have some antibacterial properties. The effects of both tests were more prominent in case of S. aureus than in E coli. A higher percentage of cobalt in the crystal structure of cobalt-substituted hydroxyapatite nanoparticles led to an increased antimicrobial activity. All of the presented biomaterial samples were found to be non-hemolytic. Having in mind that the tested of cobalt-substituted hydroxyapatite (Ca/Co-HAp) material in given concentrations shows good hemocompatibility and antimicrobial effects, along with its previously studied biological properties, the conclusion can be reached that it is a potential candidate that could substitute calcium hydroxyapatite as the material of choice for use in bone tissue engineering and clinical practices in orthopedic, oral and maxillofacial surgery.

  12. Reconstruction of bone tissue in the experiment and clinical effectiveness of osteoplasty with tricalcium phosphate in patients with generalized periodontitis

    Directory of Open Access Journals (Sweden)

    Dmitrieva E.O.

    2014-12-01

    Full Text Available Background. The theoretical basis of osteoplasty, fully supported by clinical observations, is that violations occur in periodontitis of correlation between tooth and the surrounding tissues, including the microcirculation. Objective. The aim was experimental evaluation of tissue alterations in bone implant material tricalcium phosphate®, as well as determining the dynamics of clinical and instrumental parameters after its use in the surgical treatment of patients with generalized periodontitis I-III degree for 1 year. Methods. The analysis of quantitative morphological estimation of regenerative processes in osteal tissue in model of osteal defect is carried out at implantation of material amorphous calcium phosphate at this work. It was investigated dynamics of clinical and instrumental parameters after its use in the surgical treatment of patients with generalized periodontitis I-III degree during 1 year. Results. We found out that amorphous calcium phosphate undergo resorbtion and thus optimize bone regeneration. Regeneration is accompanied by decreased specific area of the particles implanted and increased integration index and specific density of trabeculae within the reaction zone. Highest intensity of these processes was ob-served in the period from 15th fill the 30th day after implantation. In patients with chronic generalized periodontitis use of tricalcium phosphate improves most periodontal indices, limits the extent of pathological tooth mobility and gingival recession index, increases capillary resistance, prevents the growth of vertical alveolar ridge resorption. Conclusion. The most significant clinical efficiency of osteoplasty with tricalcium phosphate observed in patients under 35, regardless of the sex of the patients. Citation: Dmitrieva EO. [Reconstruction of bone tissue in the experiment and clinical effectiveness of osteoplasty with tricalcium phosphate in patients with generalized periodontitis]. Morphologia. 2014

  13. The reconstruction principle of bone structure%骨结构的重建理念

    Institute of Scientific and Technical Information of China (English)

    张文贤; 李盛华

    2011-01-01

    背景:在骨折治疗原则上,主要体现在从生物学和机械力学两方面进行骨结构重建,把生物固定与机械固定,髓内固定与髓外固定相结合.目的:介绍骨折治疗、骨结构重建理念的发展历程和研究进展.方法:应用计算机检索中国期刊全文数据库(CNKI:2006-01/2011-05)、Pubmed数据库和Medline database(2006-01/2011-05)数据库有关骨结构的重建理念的文章,检索词分别为"骨结构,重建,理念"和"bone structure,rebuild,principle",语言分别设定为中文和英文.结果与结论:共收集30篇有关骨结构的重建理念的文章,排除重复或类似的同一研究,14篇符合综述要求.骨折的治疗理念已经由机械力学固定体系逐渐转向生物学固定体系.骨折治疗必须着重于寻求骨折稳固和软组织完整之间的一种平衡,植入物和器械设计明显改善.近年来,又出现了数字化虚拟人体技术、生物力学有限元理论、创伤控制论、骨质疏松的药理学研究、用组织工程学理论和技术修复创伤缺损等.总的来说,骨结构重建的理念就是患者为中心,在宏观与微观的层次上选择骨折治疗最合理的方法,引导和促进骨的愈合、功能恢复.%BACKGROUND: In principle, fracture treatment mainly focuses on bone remodeling from the biological and mechanical aspectsto combine mechanical fixation with biological fixation as well as combine intramedullary fixation with extramedullary fixation.OBJECTIVE: To introduce the principle development of fracture treatment and bone remodeling.METHODS: A computer-based search of CNKI (2006-01/2011-05) and PubMed (2006-01/2011-05) for bone remodelingarticles using the keywords of “bone structure, rebuild, principle” in Chinese and English, respectively.RESULTS AND CONCLUSION: In 30 collected articles, 14 were included in result analysis. The treatment concept of fractureshas been gradually changed from mechanical fixation system to

  14. Calcium carbonate-calcium phosphate mixed cement compositions for bone reconstruction.

    Science.gov (United States)

    Combes, C; Bareille, R; Rey, C

    2006-11-01

    The feasibility of making calcium carbonate-calcium phosphate (CaCO(3)-CaP) mixed cements, comprising at least 40% (w/w) CaCO(3) in the dry powder ingredients, has been demonstrated. Several original cement compositions were obtained by mixing metastable crystalline CaCO(3) phases with metastable amorphous or crystalline CaP powders in aqueous medium. The cements set within at most 1 h at 37 degrees C in atmosphere saturated with water. The hardened cement is microporous and exhibits weak compressive strength. The setting reaction appeared to be essentially related to the formation of a highly carbonated nanocrystalline apatite phase by reaction of the metastable CaP phase with part or almost all of the metastable CaCO(3) phase. The recrystallization of metastable CaP varieties led to a final cement consisting of a highly carbonated poorly crystalline apatite analogous to bone mineral associated with various amounts of vaterite and/or aragonite. The presence of controlled amounts of CaCO(3) with a higher solubility than that of the apatite formed in the well-developed CaP cements might be of interest to increase resorption rates in biomedical cement and favors its replacement by bone tissue. Cytotoxicity testing revealed excellent cytocompatibility of CaCO(3)-CaP mixed cement compositions.

  15. Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized Autograft and a Vascularized Fibula

    Directory of Open Access Journals (Sweden)

    Koichi Ogura

    2015-01-01

    Full Text Available Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autograft and a vascularized fibula graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years undergoing reconstruction using a devitalized autograft (pasteurization (n=6, deep freezing (n=5 and a vascularized fibula graft composite for lower extremity malignant bone tumors (femur (n=10, tibia (n=1. Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autograft, 1 frozen autograft and 1 fracture and 1 implant failure (both in pasteurized autografts. Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autograft, our novel method involving a combination of a frozen autograft with a vascularized fibula graft and rigid fixation with a locking plate may offer better outcomes than previously reported allografts or devitalized autografts.

  16. Biodegradable Magnesium Screws Accelerate Fibrous Tissue Mineralization at the Tendon-Bone Insertion in Anterior Cruciate Ligament Reconstruction Model of Rabbit

    Science.gov (United States)

    Wang, Jiali; Xu, Jiankun; Fu, Weimin; Cheng, Wenxiang; Chan, Kaiming; Yung, Patrick Shu-hang; Qin, Ling

    2017-01-01

    The incorporation of tendon graft into bone tunnel is one of the most challenging clinical issues in anterior cruciate ligament (ACL) reconstruction. As a biodegradable metal, Mg has appropriate mechanical strength and osteoinductive effects, thus may be a promising alternative to commercialized products used for graft fixation. Therefore, it was hypothesized that Mg based interference screws would promote tendon graft-bone junction healing when compared to Ti screws. Herein, we compared the effects of Mg and Ti screws on tendon graft healing in rabbits with ACL reconstruction via histological, HR-pQCT and mechanical analysis. The histological results indicated that Mg screws significantly improved the graft healing quality via promoting mineralization at the tendon graft enthesis. Besides, Mg screws significantly promoted bone formation in the peri-screw region at the early healing stage. Importantly, Mg screws exhibited excellent corrosion resistance and the degradation of Mg screws did not induce bone tunnel widening. In tensile testing, there were no significant differences in the load to failure, stress, stiffness and absorption energy between Mg and Ti groups due to the failure mode at the midsubstance. Our findings demonstrate that Mg screws can promote tendon graft healing after ACL reconstruction, implying a potential alternative to Ti screws for clinical applications. PMID:28071744

  17. Inverse modelling-based reconstruction of the Chernobyl source term available for long-range transport

    Directory of Open Access Journals (Sweden)

    X. Davoine

    2007-01-01

    Full Text Available The reconstruction of the Chernobyl accident source term has been previously carried out using core inventories, but also back and forth confrontations between model simulations and activity concentration or deposited activity measurements. The approach presented in this paper is based on inverse modelling techniques. It relies both on the activity concentration measurements and on the adjoint of a chemistry-transport model. The location of the release is assumed to be known, and one is looking for a source term available for long-range transport that depends both on time and altitude. The method relies on the maximum entropy on the mean principle and exploits source positivity. The inversion results are mainly sensitive to two tuning parameters, a mass scale and the scale of the prior errors in the inversion. To overcome this hardship, we resort to the statistical L-curve method to estimate balanced values for these two parameters. Once this is done, many of the retrieved features of the source are robust within a reasonable range of parameter values. Our results favour the acknowledged three-step scenario, with a strong initial release (26 to 27 April, followed by a weak emission period of four days (28 April–1 May and again a release, longer but less intense than the initial one (2 May–6 May. The retrieved quantities of iodine-131, caesium-134 and caesium-137 that have been released are in good agreement with the latest reported estimations. Yet, a stronger apportionment of the total released activity is ascribed to the first period and less to the third one. Finer chronological details are obtained, such as a sequence of eruptive episodes in the first two days, likely related to the modulation of the boundary layer diurnal cycle. In addition, the first two-day release surges are found to have effectively reached an altitude up to the top of the domain (5000 m.

  18. 3D bone mineral density distribution and shape reconstruction of the proximal femur from a single simulated DXA image: an in vitro study

    Science.gov (United States)

    Whitmarsh, Tristan; Humbert, Ludovic; De Craene, Mathieu; del Río Barquero, Luis M.; Fritscher, Karl; Schubert, Rainer; Eckstein, Felix; Link, Thomas; Frangi, Alejandro F.

    2010-03-01

    Area Bone Mineral Density (aBMD) measured by Dual-energy X-ray Absorptiometry (DXA) is an established criterion in the evaluation of hip fracture risk. The evaluation from these planar images, however, is limited to 2D while it has been shown that proper 3D assessment of both the shape and the Bone Mineral Density (BMD) distribution improves the fracture risk estimation. In this work we present a method to reconstruct both the 3D bone shape and 3D BMD distribution of the proximal femur from a single DXA image. A statistical model of shape and a separate statistical model of the BMD distribution were automatically constructed from a set of Quantitative Computed Tomography (QCT) scans. The reconstruction method incorporates a fully automatic intensity based 3D-2D registration process, maximizing the similarity between the DXA and a digitally reconstructed radiograph of the combined model. For the construction of the models, an in vitro dataset of QCT scans of 60 anatomical specimens was used. To evaluate the reconstruction accuracy, experiments were performed on simulated DXA images from the QCT scans of 30 anatomical specimens. Comparisons between the reconstructions and the same subject QCT scans showed a mean shape accuracy of 1.2mm, and a mean density error of 81mg/cm3. The results show that this method is capable of accurately reconstructing both the 3D shape and 3D BMD distribution of the proximal femur from DXA images used in clinical routine, potentially improving the diagnosis of osteoporosis and fracture risk assessments at a low radiation dose and low cost.

  19. Development of a bone reconstruction technique using a solid free-form fabrication (SFF)-based drug releasing scaffold and adipose-derived stem cells.

    Science.gov (United States)

    Lee, Jin Woo; Kim, Ki-Joo; Kang, Kyung Shin; Chen, Shaochen; Rhie, Jong-Won; Cho, Dong-Woo

    2013-07-01

    For tissue regeneration, three essential components of scaffolds, signals (biomolecules), and cells are required. Moreover, because bony defects are three-dimensional in many clinical circumstances, an exact 3D scaffold is important. Therefore, we proposed an effective reconstruction tool for cranial defects using human adipose-derived stem cells (hADSCs) and a 3D functional scaffold fabricated by solid free-form fabrication (SFF) technology that secretes biomolecules. We fabricated poly(propylene fumarate)-based 3D scaffolds with embedded microsphere-deliverable bone morphogenetic protein-2 (BMP-2) by microstereolithography. BMP-2-loaded SFF scaffolds with/without hADSCs (SFF/BMP/hADSCs scaffolds and SFF/BMP scaffolds, respectively) and BMP-2-unloaded SFF scaffolds (SFF scaffolds) were then implanted in rat crania, and in vivo bone formation was observed. Analyses of bone formation areas using micro-computed tomography (micro-CT) showed the superiority of SFF/BMP/hADSCs scaffolds. Hematoxylin and eosin stain, Masson's trichrome stain, and collagen type-I stain supported the results of the micro-CT scan. And human leukocyte antigen-ABC showed that seeded, differentiated hADSCs were well grown and changed to the bone tissue at the inside of the scaffold. Results showed that our combination of a functional 3D scaffold and hADSCs may be a useful tool for improving the reconstruction quality of severe bony defects in which thick bone is required.

  20. No red cell alloimmunization or change of clinical outcome after using fresh frozen cancellous allograft bone for acetabular reconstruction in revision hip arthroplasty: a follow up study

    Directory of Open Access Journals (Sweden)

    Mittag Falk

    2012-09-01

    Full Text Available Abstract Background Possible immunization to blood group or other antigens and subsequent inhibition of remodeling or incorporation after use of untreated human bone allograft was described previously. This study presents the immunological, clinical and radiological results of 30 patients with acetabular revisions using fresh frozen non-irradiated bone allograft. Methods AB0-incompatible (donor-recipient bone transplantation was performed in 22 cases, Rh(D incompatible transplantation in 6 cases. The mean follow up of 23 months included measuring Harris hip score and radiological examination with evaluation of remodeling of the bone graft, implant migration and heterotopic ossification. In addition, all patients were screened for alloimmunization to Rh blood group antigens. Results Compared to the whole study group, there were no differences in clinical or radiological measurements for the groups with AB0- or Rh(D-incompatible bone transplantation. The mean Harris Hip Score was 80.6. X-rays confirmed total remodeling of all allografts with no acetabular loosening. At follow up, blood tests revealed no alloimmunization to Rh blood group donor antigens. Conclusions The use of fresh frozen non-irradiated bone allograft in acetabular revision is a reliable supplement to reconstruction. The risk of alloimmunization to donor-blood group antigens after AB0- or Rh-incompatible allograft transplantation with a negative long-term influence on bone-remodeling or the clinical outcome is negligible.

  1. Fully automated, high speed, tomographic phase object reconstruction using the transport of intensity equation in transmission and reflection configurations.

    Science.gov (United States)

    Nguyen, Thanh; Nehmetallah, George; Tran, Dat; Darudi, Ahmad; Soltani, Peyman

    2015-12-10

    While traditional transport of intensity equation (TIE) based phase retrieval of a phase object is performed through axial translation of the CCD, in this work a tunable lens TIE is employed in both transmission and reflection configurations. These configurations are extended to a 360° tomographic 3D reconstruction through multiple illuminations from different angles by a custom fabricated rotating assembly of the phase object. Synchronization circuitry is developed to control the CCD camera and the Arduino board, which in its turn controls the tunable lens and the stepper motor to automate the tomographic reconstruction process. Finally, a MATLAB based user friendly graphical user interface is developed to control the whole system and perform tomographic reconstruction using both multiplicative and inverse radon based techniques.

  2. Results of the megaprosthesis replacement reconstruction proximal femoral resection bone tumors.

    Science.gov (United States)

    Mazurkiewicz, Tomasz; Warda, Edward; Kopacz, Jacek; Mazurkiewicz, Maria

    2005-12-30

    Background. Proximal femur defects resulting from tumor resections can be repaired with various types of hip endoprostheses. Major surgical procedures involving muscle detachments and extensive endoprosthesis implantation are prone to deep infections and the hip instability. The purpose of our study was to assess the outcome of hip prosthesoplasty after resection of large tumors from the proximal femur. Material and methods. Over the last 5 years, 49 patients have undergone hip prosthesoplasty after tumor resection in the proximal femur for 37 bone metastases and 12 primary neoplasms during the last 5 years. Three total megaprostheses were used, as well as 34 conventional long stem endoprostheses, including 26 bipolar and 12 Austin Moore prostheses. Results. Two patients died shortly after surgery, and another 4 were nonambulatory due to diffusion of the cancer. There were 3 cases of endoprosthesis luxation, 1 deep implant infection and 1 metastasis recurrence. We had 28% excellent functional outcomes and 60% good; the latter were complicated by Trendelenburg gait. Conclusions. Hip instability is the most common complication in prosthesoplasty after tumor resection in the proximal femur.

  3. Applications of Bayesian temperature profile reconstruction to automated comparison with heat transport models and uncertainty quantification of current diffusion

    Energy Technology Data Exchange (ETDEWEB)

    Irishkin, M. [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Imbeaux, F., E-mail: frederic.imbeaux@cea.fr [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Aniel, T.; Artaud, J.F. [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France)

    2015-11-15

    Highlights: • We developed a method for automated comparison of experimental data with models. • A unique platform implements Bayesian analysis and integrated modelling tools. • The method is tokamak-generic and is applied to Tore Supra and JET pulses. • Validation of a heat transport model is carried out. • We quantified the uncertainties due to Te profiles in current diffusion simulations. - Abstract: In the context of present and future long pulse tokamak experiments yielding a growing size of measured data per pulse, automating data consistency analysis and comparisons of measurements with models is a critical matter. To address these issues, the present work describes an expert system that carries out in an integrated and fully automated way (i) a reconstruction of plasma profiles from the measurements, using Bayesian analysis (ii) a prediction of the reconstructed quantities, according to some models and (iii) a comparison of the first two steps. The first application shown is devoted to the development of an automated comparison method between the experimental plasma profiles reconstructed using Bayesian methods and time dependent solutions of the transport equations. The method was applied to model validation of a simple heat transport model with three radial shape options. It has been tested on a database of 21 Tore Supra and 14 JET shots. The second application aims at quantifying uncertainties due to the electron temperature profile in current diffusion simulations. A systematic reconstruction of the Ne, Te, Ti profiles was first carried out for all time slices of the pulse. The Bayesian 95% highest probability intervals on the Te profile reconstruction were then used for (i) data consistency check of the flux consumption and (ii) defining a confidence interval for the current profile simulation. The method has been applied to one Tore Supra pulse and one JET pulse.

  4. Experimental evaluation of the ‘transport-of-intensity’ equation for magnetic phase reconstruction in Lorentz transmission electron microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Kohn, Amit, E-mail: akohn@post.tau.ac.il [Department of Materials Science and Engineering, Faculty of Engineering, Tel Aviv University, 69978 Tel Aviv (Israel); Habibi, Avihay; Mayo, Martin [Department of Materials Engineering, Ben-Gurion University of the Negev, 84105 Beer Sheva (Israel)

    2016-01-15

    The ‘transport-of-intensity’ equation (TIE) is a general phase reconstruction methodology that can be applied to Lorentz transmission electron microscopy (TEM) through the use of Fresnel-contrast (defocused) images. We present an experimental study to test the application of the TIE for quantitative magnetic mapping in Lorentz TEM without aberration correction by examining sub-micrometer sized Ni{sub 80}Fe{sub 20} (Permalloy) elements. For a JEOL JEM 2100F adapted for Lorentz microscopy, we find that quantitative magnetic phase reconstructions are possible for defoci distances ranging between approximately 200 μm and 800 μm. The lower limit originates from competing sources of image intensity variations in Fresnel-contrast images, namely structural defects and diffraction contrast. The upper defocus limit is due to a numerical error in the estimation of the intensity derivative based on three images. For magnetic domains, we show quantitative reconstructions of the product of the magnetic induction vector and thickness in element sizes down to approximately 100 nm in lateral size and 5 nm thick resulting in a minimal detection of 5 T nm. Three types of magnetic structures are tested in terms of phase reconstruction: vortex cores, domain walls, and element edges. We quantify vortex core structures at a diameter of 12 nm while the structures of domain walls and element edges are characterized qualitatively. Finally, we show by image simulations that the conclusions of this experimental study are relevant to other Lorentz TEM in which spherical aberration and defocus are dominant aberrations. - Highlights: • Testing TIE for quantitative magnetic phase reconstruction in Lorentz TEM. • Quantitative magnetic phase reconstructions for defoci distances in 200–800 μm range. • Minimal detection of the product of the magnetic induction and thickness is 5 T nm. • Quantitative phase reconstruction for vortex core structures at 12 nm diameter. • Observations

  5. Evaluation of Medial Acetabular Wall Bone Stock in Patients with Developmental Dysplasia of the Hip Using a Helical Computed Tomography Multiplanar Reconstruction Technique

    Energy Technology Data Exchange (ETDEWEB)

    Rui Yu Liu; Kun Zheng Wang; Chun Sheng Wang; Xiao Qian Dang; Zhi Qin Tong (Second Hospital Affiliated to the Medical College of Xi' an Jiaotong Univ., Xi' an Shaanxi (China))

    2009-08-15

    Background: The technique of medialization has been used to reconstruct acetabula at the level of true acetabula in total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Appreciation of the bone stock in the medial acetabular wall is significant for making an optimal acetabular reconstruction plan and avoiding complications. Purpose: To evaluate the bone stock of the medial acetabular wall and its relation to the degree of subluxation in patients with DDH using computed tomography (CT). Material and Methods: Helical CT scans of 27 hips were obtained from 21 patients with osteoarthritis secondary to DDH who were scheduled for total hip arthroplasty. Eleven hips belonged to Crowe class I, while 16 hips belonged to Crowe class II/III. The raw CT data were reprocessed in various planes by scrolling multiplanar reformation (MPR). Acetabular opening, depth, and medial bone stock, as indicated by the minimum thickness of the medial acetabular wall, were measured in the transverse reformed MPR plane. Results: The minimum thicknesses of the medial acetabular wall in Crowe-I and Crowe-II/III hips were 3.8+-2.1 mm and 7.1+-3.1 mm, respectively, with statistically significant differences between the groups (P<0.05). Furthermore, the bone stock in the medial acetabular wall correlated with the degree of subluxation (R=0.69) and the acetabular depth (R= ;- ;0.71). Conclusion: There was significantly more bone stock in the medial acetabular wall in patients with higher-degree subluxation than there was in the less-severe class. This difference should be taken into consideration when reconstructing acetabula in THA in patients with DDH using the technique of medialization

  6. Aesthetic Multiple-Toe Reconstruction With Combined Iliac Bone Graft and Wraparound Free Anterolateral Thigh Flap-A Case Report and Literature Review.

    Science.gov (United States)

    Kwon, Soo-Ha; Lao, William; Yen, Cheng-I; Lin, Yu-Te; Wu, Katie Pei-Hsuan; Chang, Tommy Nai-Jen

    2017-03-01

    Compared with upper extremity injuries, toe amputations and their replantations are rare because of the difficulty of their relatively thinner soft tissue envelope. Consequently, fewer reconstructive options are available for toes and they are rarely reported in the literature. In this study, we reported a case of right third to fifth toe amputations and their subsequent reconstruction with iliac bone grafts and a free anterolateral thigh flap. After serial debulking and division procedures, 3 toes were divided successfully. Ten months after the initial operation, the patient regained pain-free functional ambulation despite some bone resorption noted on follow-up radiographs. The patient showed high satisfaction on her new toes in terms of aesthetical and functional outcomes. She was able to stand for over 30 minutes without pain. At the 2-year follow-up, the Foot Function Index was 18.3%. Although toe reconstruction is frequently considered unnecessary because of its relative high demand of surgical techniques and little gain on gait; nonetheless, in selected cases, toe reconstruction may still be beneficial if the metatarsophalangeal joints were intact and there is a strong individual desire for aesthetical restoration.

  7. Reconstructing the 3D shape and bone mineral density distribution of the proximal femur from dual-energy X-ray absorptiometry.

    Science.gov (United States)

    Whitmarsh, Tristan; Humbert, Ludovic; De Craene, Mathieu; Del Rio Barquero, Luis M; Frangi, Alejandro F

    2011-12-01

    The accurate diagnosis of osteoporosis has gained increasing importance due to the aging of our society. Areal bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is an established criterion in the diagnosis of osteoporosis. This measure, however, is limited by its two-dimensionality. This work presents a method to reconstruct both the 3D bone shape and 3D BMD distribution of the proximal femur from a single DXA image used in clinical routine. A statistical model of the combined shape and BMD distribution is presented, together with a method for its construction from a set of quantitative computed tomography (QCT) scans. A reconstruction is acquired in an intensity based 3D-2D registration process whereby an instance of the model is found that maximizes the similarity between its projection and the DXA image. Reconstruction experiments were performed on the DXA images of 30 subjects, with a model constructed from a database of QCT scans of 85 subjects. The accuracy was evaluated by comparing the reconstructions with the same subject QCT scans. The method presented here can potentially improve the diagnosis of osteoporosis and fracture risk assessment from the low radiation dose and low cost DXA devices currently used in clinical routine.

  8. Five years follow-up of implant-prosthetic rehabilitation on a patient after mandibular ameloblastoma removal and ridge reconstruction by fibula graft and bone distraction

    Directory of Open Access Journals (Sweden)

    Giacomo Oteri

    2012-01-01

    Full Text Available This case report presents a combination of surgical and prosthetic solutions applied to a case of oral implant rehabilitation in post-oncologic reconstructed mandible. Bone resection due to surgical treatment of large mandibular neoplasm can cause long-span defects. Currently, mandibular fibula free flap graft is widely considered as a reliable technique for restoring this kind of defect. It restores the continuity of removed segment and re-establishes the contour of the lower jaw. However, the limited height of grafted fibula does not allow the insertion of regular length implants, therefore favouring vertical distraction osteogenesis as an important treatment choice. This report presents a patient affected by extensive mandibular ameloblastoma who underwent surgical reconstruction by fibula free flap because of partial mandibular resection. Guided distraction osteoneogenesis technique was applied to grafted bone, in order to obtain adequate bone height and to realize a prosthetically guided placement of 8 fixtures. After osseointegration, the patient was rehabilitated with a full arch, screw-retained prosthetic restoration. At five-years follow up, excellent integration of grafted tissue, steady levels of bone around the fixtures and healthy peri-implant tissues were reported.

  9. Evaluation of a radiation transport modeling method for radioactive bone cement

    Energy Technology Data Exchange (ETDEWEB)

    Kaneko, T S [Department of Radiological Sciences, B170 Med Sci I, University of California, Irvine, CA 92697 (United States); Sehgal, V; Al-Ghazi, M S A L; Ramisinghani, N S [Department of Radiation Oncology, University of California Irvine Medical Center, Orange, CA 92868 (United States); Skinner, H B [St Jude Heritage Medical Group, Fullerton, CA 92835 (United States); Keyak, J H [Departments of Radiological Sciences, Biomedical Engineering, and Mechanical Engineering, University of California, Irvine, CA 92697 (United States)], E-mail: tkaneko@uci.edu

    2010-05-07

    Spinal metastases are a common and serious manifestation of cancer, and are often treated with vertebroplasty/kyphoplasty followed by external beam radiation therapy (EBRT). As an alternative, we have introduced radioactive bone cement, i.e. bone cement incorporated with a radionuclide. In this study, we present a Monte Carlo radiation transport modeling method to calculate dose distributions within vertebrae containing radioactive cement. Model accuracy was evaluated by comparing model-predicted depth-dose curves to those measured experimentally in eight cadaveric vertebrae using radiochromic film. The high-gradient regions of the depth-dose curves differed by radial distances of 0.3-0.9 mm, an improvement over EBRT dosimetry accuracy. The low-gradient regions differed by 0.033-0.055 Gy/h/mCi, which may be important in situations involving prior spinal cord irradiation. Using a more rigorous evaluation of model accuracy, four models predicted the measured dose distribution within the experimental uncertainty, as represented by the 95% confidence interval of the measured log-linear depth-dose curve. The remaining four models required modification to account for marrow lost from the vertebrae during specimen preparation. However, the accuracy of the modified model results indicated that, when this source of uncertainty is accounted for, this modeling method can be used to predict dose distributions in vertebrae containing radioactive cement.

  10. Evaluation of a radiation transport modeling method for radioactive bone cement

    Science.gov (United States)

    Kaneko, T. S.; Sehgal, V.; Skinner, H. B.; Al-Ghazi, M. S. A. L.; Ramisinghani, N. S.; Keyak, J. H.

    2010-05-01

    Spinal metastases are a common and serious manifestation of cancer, and are often treated with vertebroplasty/kyphoplasty followed by external beam radiation therapy (EBRT). As an alternative, we have introduced radioactive bone cement, i.e. bone cement incorporated with a radionuclide. In this study, we present a Monte Carlo radiation transport modeling method to calculate dose distributions within vertebrae containing radioactive cement. Model accuracy was evaluated by comparing model-predicted depth-dose curves to those measured experimentally in eight cadaveric vertebrae using radiochromic film. The high-gradient regions of the depth-dose curves differed by radial distances of 0.3-0.9 mm, an improvement over EBRT dosimetry accuracy. The low-gradient regions differed by 0.033-0.055 Gy/h/mCi, which may be important in situations involving prior spinal cord irradiation. Using a more rigorous evaluation of model accuracy, four models predicted the measured dose distribution within the experimental uncertainty, as represented by the 95% confidence interval of the measured log-linear depth-dose curve. The remaining four models required modification to account for marrow lost from the vertebrae during specimen preparation. However, the accuracy of the modified model results indicated that, when this source of uncertainty is accounted for, this modeling method can be used to predict dose distributions in vertebrae containing radioactive cement.

  11. Reconstruction of congenital microtia-atresia: outcomes with the Medpor/bone-anchored hearing aid-approach.

    Science.gov (United States)

    Romo, Thomas; Morris, Luc G T; Reitzen, Shari D; Ghossaini, Soha N; Wazen, Jack J; Kohan, Darius

    2009-04-01

    Ideal surgery for congenital microtia-atresia would offer excellent cosmetic and hearing rehabilitation, with minimal morbidity. Classic approaches require multiple procedures, including rib cartilage harvest and aural atresia repair. Our facial plastic and otologic team approach incorporates a high-density porous polyethylene (Medpor, Porex Surgical, Newnan, GA) auricular framework, followed by single-stage bone-anchored hearing aid (BAHA) implantation. We evaluated the efficacy, safety, and morbidity of this 2-stage dual system approach. A prospective database of microtia patients was used to identify patients undergoing combined Medpor/BAHA auricular reconstruction and hearing rehabilitation between 2003 and 2006. The first stage involves placement of a Medpor framework beneath a temporoparietal fascia flap, followed by a second-stage procedure for lobule transposition and BAHA implantation. Twenty-five patients (28 ears) were evaluated. Aesthetic quality of the implants was excellent, with a high degree of framework detail visible, and a postauricular crease created in all patients. All patients were satisfied with the cosmetic result. There were no major Medpor complications such as infection, extrusion, loss of implant, or flap necrosis, and a 10.7% incidence of minor complications requiring operative revision. BAHA significantly improved hearing in all patients, with a complication rate of 31.8%, mainly skin overgrowth and cellulitis. The Medpor/BAHA dual plastic-otologic approach to microtia-atresia has produced excellent cosmetic results and hearing outcomes, which compare favorably to traditional microtia-atresia repair. This is a 2-stage aesthetic and functional protocol with an acceptably low rate of complications, which safely and efficiently achieves both aesthetic and functional goals.

  12. Transportation conditions for prompt use of ex vivo expanded and freshly harvested clinical-grade bone marrow mesenchymal stromal/stem cells for bone regeneration.

    Science.gov (United States)

    Veronesi, Elena; Murgia, Alba; Caselli, Anna; Grisendi, Giulia; Piccinno, Maria Serena; Rasini, Valeria; Giordano, Rosaria; Montemurro, Tiziana; Bourin, Philippe; Sensebé, Luc; Rojewski, Markus T; Schrezenmeier, Hubert; Layrolle, Pierre; Ginebra, Maria Pau; Panaitescu, Carmen Bunu; Gómez-Barrena, Enrique; Catani, Fabio; Paolucci, Paolo; Burns, Jorge S; Dominici, Massimo

    2014-03-01

    Successful preliminary studies have encouraged a more translational phase for stem cell research. Nevertheless, advances in the culture of human bone marrow-derived mesenchymal stromal/stem cells (hBM-MSC) and osteoconductive qualities of combined biomaterials can be undermined if necessary cell transportation procedures prove unviable. We aimed at evaluating the effect of transportation conditions on cell function, including the ability to form bone in vivo, using procedures suited to clinical application. hBM-MSC expanded in current Good Manufacturing Practice (cGMP) facilities (cGMP-hBM-MSC) to numbers suitable for therapy were transported overnight within syringes and subsequently tested for viability. Scaled-down experiments mimicking shipment for 18 h at 4°C tested the influence of three different clinical-grade transportation buffers (0.9% saline alone or with 4% human serum albumin [HSA] from two independent sources) compared with cell maintenance medium. Cell viability after shipment was >80% in all cases, enabling evaluation of (1) adhesion to plastic flasks and hydroxyapatite tricalcium phosphate osteoconductive biomaterial (HA/β-TCP 3D scaffold); (2) proliferation rate; (3) ex vivo osteogenic differentiation in contexts of 2D monolayers on plastic and 3D HA/β-TCP scaffolds; and (4) in vivo ectopic bone formation after subcutaneous implantation of cells with HA/β-TCP scaffold into NOD/SCID mice. Von Kossa staining was used to assess ex vivo osteogenic differentiation in 3D cultures, providing a quantifiable test of 3D biomineralization ex vivo as a rapid, cost-effective potency assay. Near-equivalent capacities for cell survival, proliferation, and osteogenic differentiation were found for all transportation buffers. Moreover, cGMP-hBM-MSC transported from a production facility under clinical-grade conditions of 4% HSA in 0.9% saline to a destination 18 h away showed prompt adhesion to HA/β-TCP 3D scaffold and subsequent in vivo bone formation

  13. Anatomical study of the anterolateral and posteromedial bundles of the posterior cruciate ligament for double-bundle reconstruction using the quadruple bone-tunnel technique

    Institute of Scientific and Technical Information of China (English)

    LUO Hao; AO Ying-fang; ZHANG Wei-guang; LIU Sheng-yong; ZHANG Ji-ying; YU Jia-kuo

    2012-01-01

    Background Several techniques have been described for posterior cruciate ligament(PCL)reconstruction.However,double-bundle PCL reconstruction using the quadruple bone-tunnel technique has been seldom reported.The current study investigated this technique,focusing on the anatomy of the femoral and tibial insertions of the anterolateral(AL)and posteromedial(PM)bundles of the PCL.Methods Twenty-two fresh,healthy adult cadaveric knees were dissected and measured.The PCL was divided into the AL bundle and PM bundle at the insertion footprint.The insertion footprints of the AL and PM bundles,their location,size,and the clock positions were measured and described.Results On the femur,the clock position of the footprint of the AL bundle was 11:21±0:23(left)or 0:39±0:23(right),and the PM bundle was 9:50±0:18(left)or 2:10±0:18(right),with the knee flexed at 90 degrees.The distances from the center of the femoral insertions of the AL and PM bundles to the anterior cartilage margins of the medial femoral condyle were(7.79±1.22)mm and(8.36±1.63)mm,respectively.On the tibia,the vertical distances from the center of the tibial insertions of the AL and PM bundles to the tibial articular surface were(3.25±1.20)mm and(6.91±1.57)mm,respectively.Conclusions These results have led to a better definition of the anatomy of the AL and PM bundle footprint of the PCL.The technique of double-bundle PCL reconstruction using quadruple bone-tunnel is feasible.Application of these data during PCL reconstruction using the quadruple bone-tunnel technique may help optimize knee stability.

  14. The strain at bone-implant interface determines the effect of spinopelvic reconstruction following total sacrectomy: a strain gauge analysis in various spinopelvic constructs.

    Directory of Open Access Journals (Sweden)

    Yan Yu

    Full Text Available PURPOSE: There is still some controversy regarding the optimal biomechanical concept for spinopelvic stabilization following total sacrectomy for malignancy. Strains at specific anatomical sites at pelvis/sacrum and implants interfaces have been poorly investigated. Herein, we compared and analyzed the strains applied at key points at the bone-implant interface in four different spinopelvic constructs following total sacrectomy; consequently, we defined a balanced architecture for spinopelvic fusion in that situation. METHODS: Six human cadaveric specimens, from second lumbar vertebra to proximal femur, were used to compare the partial strains at specific sites in a total sacrectomy model. Test constructs included: (1 intact pelvis (control, (2 sacral-rod reconstruction (SRR, (3 bilateral fibular flap reconstruction (BFFR, (4 four-rods reconstruction (FRR, and (5 improved compound reconstruction (ICR. Strains were measured by bonded strain gauges onto the surface of three specific sites (pubic rami, arcuate lines, and posterior spinal rods under a 500 N axial load. RESULTS: ICR caused lower strains at specific sites and, moreover, on stress distribution and symmetry, compared to the other three constructs. Strains at pubic rami and arcuate lines following BFFR were lower than those following SRR, but higher at the posterior spinal rod construct. The different modes of strain distribution reflected different patient's parameter-related conditions. FRR model showed the highest strains at all sites because of the lack of an anterior bracing frame. CONCLUSIONS: The findings of this investigation suggest that both anterior bracing frame and the four-rods load dispersion provide significant load sharing. Additionally, these two constructs decrease the peak strains at bone-implant interface, thus determining the theoretical surgical technique to achieve optimal stress dispersion and balance for spinopelvic reconstruction in early postoperative period

  15. A LONGITUDINAL STUDY TO ASSESS THE TREATMENT OUTCOME FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE – PATELLAR TENDON – BONE GRAFT [BTB

    Directory of Open Access Journals (Sweden)

    Tummala Venkata Suresh

    2016-03-01

    Full Text Available BACKGROUND Reconstruction of ACL and restoration of musculoskeletal function is a fundamental goal of orthopaedic treatment. OBJECTIVES To assess the outcome of knee function after anterior cruciate Ligament reconstruction. MATERIALS AND METHODS This prospective study included 28 patients who underwent ACL reconstruction for two years. The clinical follow-up evaluation was done following the surgery and postoperative rehabilitation. International Knee Documentation Committee (IKDC and Lysholm Score was used to assess the functional outcome. Results were expressed in terms of percentage, proportion and chi-square test. RESULTS According to the IKDC rating scale, 80% of the patients had normal or nearly normal final outcome. The mean Lysholm score was 82. About half of the patients had anterior knee pain, as classified by the IKDC. Patients with early reconstruction had less degenerative changes in the tibiofemoral joint, were subjectively more satisfied to the result, and could return to the pre-injury level of activities. CONCLUSION Our results showed that an ACL reconstruction using BTB autograft leads to good ligamentous stability and function of the knee. Those who underwent early reconstruction had better results. Mild anterior knee pain and osteoarthritis after reconstruction was a common finding.

  16. Xenograft Enriched with Autologous Bone Marrow in Inlay Reconstructions: A Tomographic and Histomorphometric Study in Rabbit Calvaria

    OpenAIRE

    SILVA,MARCELO DE OLIVEIRA E; André Antonio Pelegrine; Alexandre Alves Pinheiro da Silva; Luiz Roberto Manhães Júnior; Oliveira, Rafael de Mello e [UNIFESP; Silvana Gaiba França; Antonio Carlos Aloise; Lydia Masako Ferreira

    2012-01-01

    Objective. The aim of this study was to evaluate the bone healing after the usage of a scaffold enriched with bone marrow. Study Design. Ten rabbits were divided into 2 groups of 5 animals. Bilateral 12 mm diameter defects were created in the parietal bones. In control group Bio-Oss were inserted in both defects and, in experimental group, Bio-Oss enriched with autologous bone marrow were inserted in both defects. In these two groups, one of the calvarial defects was covered with Bio-Gide. Th...

  17. Accuracy and benefits of 3D bone surface modelling: a comparison of two methods of surface data acquisition reconstructed by laser scanning and computed tomography outputs.

    Science.gov (United States)

    Brzobohatá, Hana; Prokop, Josef; Horák, Martin; Jancárek, Alexandr; Velemínská, Jana

    2012-09-01

    The aim of this study is to compare two different methods of frontal bone surface model acquisition. Three dimensional models acquired by laser scanning were compared with models of the same bones acquired by virtual replicas reconstructed from a sequence of computed tomography (CT) images. The influence of volumetric CT data processing (namely thresholding), which immediately preceded the generation of the three-dimensional surface model, was also considered and explored in detail in one sample. Despite identifying certain areas where both models showed deviations across all samples, their conformity can be generally classified as satisfactory, and the differences can be regarded as minimal. The average deviation of registered surface models was 0.27 mm for 90% of the data, and its value was therefore very close to the resolution of the laser scanner used.

  18. 3D curved multiplanar cone beam CT reconstruction for intracochlear position assessment of straight electrodes array. A temporal bone and clinical study.

    Science.gov (United States)

    De Seta, D; Mancini, P; Russo, F Y; Torres, R; Mosnier, I; Bensimon, J L; De Seta, E; Heymann, D; Sterkers, O; Bernardeschi, D; Nguyen, Y

    2016-12-01

    A retrospective review of post-op cone beam CT (CBCT) of 8 adult patients and 14 fresh temporal bones that underwent cochlear implantation with straight flexible electrodes array was performed to determine if the position of a long and flexible electrodes array within the cochlear scalae could be reliably assessed with CBCT. An oto-radiologist and two otologists examined the images and assessed the electrodes position. The temporal bone specimens underwent histological analysis for confirm the exact position. The position of the electrodes was rated as scala tympani, scala vestibule, or intermediate position for the electrodes at 180°, 360° and for the apical electrode. In the patient group, for the electrodes at 180° all observers agreed for scala tympani position except for 1 evaluation, while a discrepancy in 3 patients both for the 360° and for the apical electrode assessment were found. In five temporal bones the evaluations were in discrepancy for the 180° electrode, while at 360° a disagreement between raters on the scalar positioning was seen in six temporal bones. A higher discrepancy between was found in assessment of the scalar position of the apical electrode (average pairwise agreement 45.4%, Fleiss k = 0.13). A good concordance was found between the histological results and the consensus between raters for the electrodes in the basal turn, while low agreement (Cohen's k 0.31, pairwise agreement 50%) was found in the identification of the apical electrode position confirming the difficulty to correct identify the electrode position in the second cochlear turn in temporal bones. In conclusion, CBCT is a reliable radiologic exam to correctly evaluate the position of a lateral wall flexible array in implanted patients using the proposed imaging reconstruction method, while some artefacts impede exact evaluation of the position of the apical electrode in temporal bone and other radiological techniques should be preferred in ex vivo studies.

  19. Vacancy Defect Reconstruction and its Effect on Electron Transport in Si-C Nanotubes

    Directory of Open Access Journals (Sweden)

    S. Choudhary

    2011-01-01

    Full Text Available We investigate the vacancy defect reconstruction and its effect on I-V characteristics in a (4, 0 zigzag and (5, 5 armchair silicon-carbide nanotubes (SiCNTs by applying self consistent non-equilibrium Green’s function formalism in combination with the density-functional theory to a two probe molecular junction constructed from SiCNTs. The results show that single vacancies and di-vacancies in SiCNTs have different reconstructions. A single vacancy when optimized, reconstructs into a 5-1DB configuration in both zigzag and armchair SiCNTs, and a di-vacancy reconstructs into a 5-8-5 configuration in zigzag and into a 5-2DB configuration in armchair SiCNTs. Introduction of vacancy increases the band gap of (4, 0 metallic SiCNT and decreases the bandgap of (5, 5 semiconducting SiCNT, bias voltage dependent current characteristic show reduction in overall current in metallic SiCNT and an increase in overall current in semiconducting SiCNT.

  20. A Nonlinear Solute Transport Model and Data Reconstruction with Parameter Determination in an Undisturbed Soil-Column Experiment

    Directory of Open Access Journals (Sweden)

    Gongsheng Li

    2011-01-01

    Full Text Available A real undisturbed soil-column infiltrating experiment in Zibo, Shandong, China, is investigated, and a nonlinear transport model for a solute ion penetrating through the column is put forward by using nonlinear Freundlich's adsorption isotherm. Since Freundlich's exponent and adsorption coefficient and source/sink terms in the model cannot be measured directly, an inverse problem of determining these parameters is encountered based on additional breakthrough data. Furthermore, an optimal perturbation regularization algorithm is introduced to determine the unknown parameters simultaneously. Numerical simulations are carried out and then the inversion algorithm is applied to solve the real inverse problem and reconstruct the measured data successfully. The computational results show that the nonlinear advection-dispersion equation discussed in this paper can be utilized by hydrogeologists to research solute transport behaviors with nonlinear adsorption in porous medium.

  1. Reconstruction of {sup 131}I radioactive contamination in Ukraine caused by the Chernobyl accident using atmospheric transport modelling

    Energy Technology Data Exchange (ETDEWEB)

    Talerko, Nikolai [Scientific Center for Radiation Medicine, 53 Melnikov Street, Kyiv 04050 (Ukraine)]. E-mail: ntalerko@mail.ru

    2005-07-01

    The evaluation of {sup 131}I air and ground contamination field formation in the territory of Ukraine was made using the model of atmospheric transport LEDI (Lagrangian-Eulerian DIffusion model). The {sup 131}I atmospheric transport over the territory of Ukraine was simulated during the first 12 days after the accident (from 26 April to 7 May 1986) using real aerological information and rain measurement network data. The airborne {sup 131}I concentration and ground deposition fields were calculated as the database for subsequent thyroid dose reconstruction for inhabitants of radioactive contaminated regions. The small-scale deposition field variability is assessed using data of {sup 137}Cs detailed measurements in the territory of Ukraine. The obtained results are compared with available data of radioiodine daily deposition measurements made at the network of meteorological stations in Ukraine and data of the assessments of {sup 131}I soil contamination obtained from the {sup 129}I measurements.

  2. Synthesis and characterization of a nanostructured matrix hydroxyapatite ceramic bone reconstruction; Sintese e caracterizacao de uma matriz ceramica nanoestruturada de hidroxiapatita para reconstituicao ossea

    Energy Technology Data Exchange (ETDEWEB)

    Correa, P.; Camargo, N.H.A.; Silva, D.F. [Universidade do Estado de Santa Catarina (PGCEM/UDESC), SC (Brazil). Programa de Pos-Graduacao em Ciencia e Engenharia de Materiais

    2012-07-01

    The nanostructured ceramics have been shown promise as biomaterials for bone reconstruction. Among calcium phosphates, hydroxyapatite Ca/P ratio = 1.67 mol stands out because of its crystallographic similarity with the mineral bone phase and biocompatibility. This work was based on synthesis and characterization of a nanostructured hydroxyapatite for use in reconstituting bone tissue. The synthesis method for obtaining the bioceramic powder occurred at process of dissolution/precipitation, involving CaO solid/liquid and phosphoric acid required for forming the composition of Ca/P = 1.67 mole. The material recovered from the synthesis was calcined at 900 ° C/2h, providing the hydroxyapatite powder nanometer. This was subjected to mechanical fragmentation process in mill attritor, providing a hydroxyapatite with modified surface morphology. The results presented relate to morphological characterization studies (SEM), mineralogical (XRD), chemical (FTIR) and particle size distribution, using the laser particle size analysis method. Such results showed the formation of hydroxyapatite phase and morphology satisfactory for use in reconstituting bone tissue.

  3. [The use of platelet concentrates: platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in bone reconstruction prior to dental implant surgery].

    Science.gov (United States)

    Baeyens, W; Glineur, R; Evrard, L

    2010-01-01

    The autologous platelet concentrates--Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF)--are used in various medical fields, particularly in oral and maxillofacial surgery. These concentrates contain high levels of growth factors, including the 3 isomers of PDGF (platelet-derived growth factor), 2 of the numerous transforming growth factors (TGF-beta), the insulinlike growth factor (IGF), the epithelial growth factor (EGF) and the vascular endothelial growth factor (VEGF), which are the key elements in wound healing, particularly in bone regeneration. Platelet concentrates are easy to apply in clinical practice and offer potential benefits including rapid wound healing and bone regeneration, and can therefore be considered to be new therapeutic adjuvants. In dental implant surgery they are used in bone reconstruction prior or concomitant to implant procedures, and also for dental extraction socket preservation. Their use result in enhanced bone graft density and maturation. A literature review on the use of PRP/PRF in maxillofacial and dental implant surgery is proposed.

  4. Translational Research: Palatal-derived Ecto-mesenchymal Stem Cells from Human Palate: A New Hope for Alveolar Bone and Cranio-Facial Bone Reconstruction.

    Science.gov (United States)

    Grimm, Wolf Dieter; Dannan, Aous; Giesenhagen, Bernd; Schau, Ingmar; Varga, Gabor; Vukovic, Mark Alexander; Sirak, Sergey Vladimirovich

    2014-05-01

    The management of facial defects has rapidly changed in the last decade. Functional and esthetic requirements have steadily increased along with the refinements of surgery. In the case of advanced atrophy or jaw defects, extensive horizontal and vertical bone augmentation is often unavoidable to enable patients to be fitted with implants. Loss of vertical alveolar bone height is the most common cause for a non primary stability of dental implants in adults. At present, there is no ideal therapeutic approach to cure loss of vertical alveolar bone height and achieve optimal pre-implantological bone regeneration before dental implant placement. Recently, it has been found that specific populations of stem cells and/or progenitor cells could be isolated from different dental resources, namely the dental follicle, the dental pulp and the periodontal ligament. Our research group has cultured palatal-derived stem cells (paldSCs) as dentospheres and further differentiated into various cells of the neuronal and osteogenic lineage, thereby demonstrating their stem cell state. In this publication will be shown whether paldSCs could be differentiated into the osteogenic lineage and, if so, whether these cells are able to regenerate alveolar bone tissue in vivo in an athymic rat model. Furthermore, using these data we have started a proof of principle clinical- and histological controlled study using stem cell-rich palatal tissues for improving the vertical alveolar bone augmentation in critical size defects. The initial results of the study demonstrate the feasibility of using stem cell-mediated tissue engineering to treat alveolar bone defects in humans.

  5. Porous poly(DL-lactic-co-glycolic acid)/calcium phosphate cement composite for reconstruction of bone defects.

    NARCIS (Netherlands)

    Ruhe, P.Q.; Hedberg, E.L.; Padron, N.T.; Spauwen, P.H.M.; Jansen, J.A.; Mikos, A.G.

    2006-01-01

    Calcium phosphate (Ca-P) cements are injectable, self-setting ceramic pastes generally known for their favorable bone response. Ingrowth of bone and subsequent degradation rates can be enhanced by the inclusion of macropores. Initial porosity can be induced by CO(2) foaming during setting of the cem

  6. Stochastic reconstruction and a scaling method to determine effective transport coefficients of a proton exchange membrane fuel cell catalyst layer

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa, R. [Centro de Investigacion en Energia, UNAM, Privada Xochicalco S/N, 62580 Temixco (Mexico); Andaverde, J. [Centro de Investigacion en Ingenieria y Ciencias Aplicadas, UAEM, Av. Universidad 1001, Col. Chamilpa, 62210 Cuernavaca (Mexico); Escobar, B. [Instituto Tecnologico de Cancun, Av. Kabah 3, 77515 Cancun (Mexico); Cano, U. [Instituto de Investigaciones Electricas, Av. Reforma 113, col. Palmira, 62490 Cuernavaca (Mexico)

    2011-02-01

    This work uses a method for the stochastic reconstruction of catalyst layers (CLs) proposing a scaling method to determine effective transport properties in proton exchange membrane fuel cell (PEMFC). The algorithm that generates the numerical grid makes use of available information before and after manufacturing the CL. The structures so generated are characterized statistically by two-point correlation functions and by the resultant pore size distribution. As an example of this method, the continuity equation for charge transport is solved directly on the three-dimensional grid of finite control volumes (FCVs), to determine effective electrical and proton conductivities of different structures. The stochastic reconstruction and the electrical and proton conductivity of a 45 {mu}m side size cubic sample of a CL, represented by more than 3.3 x 10{sup 12} FVCs were realized in a much shorter time compared with non-scaling methods. Variables studied in an example of CL structure were: (i) volume fraction of dispersed electrolyte, (ii) total CL porosity and (iii) pore size distribution. Results for the conduction efficiency for this example are also presented. (author)

  7. Osteocyte metabolism during reconstruction of subchondral bone%软骨下骨病理骨重建过程中骨细胞的代谢机制

    Institute of Scientific and Technical Information of China (English)

    杜明昌; 祖启明; 刘宪民; 刘松波; 陈语; 王琪; 项良碧

    2011-01-01

    背景:骨性关节炎一直被认为是关节软骨的退变和降解.现已逐步认识到软骨下骨结构及分子代谢的病理变化在关节退变的过程中发挥了重要的作用.目的:观察软骨下骨在骨性关节炎进程中结构及细胞、相关因子和信号通道的变化,分析软骨下骨的病理改变对关节软骨退变的影响.方法:使用骨性关节炎、软骨下骨、软骨退变、骨重建、骨代谢等关键词,检索中国知识资源总库与PubMed、Medline、Embase数据库中的相关研究论文,了解骨性关节炎进程中软骨下骨骨代谢平衡破坏后在结构及分子信号机制的病理变化,分析这些病理改变与关节软骨退变的关系.结果与结论:纳入 54篇符合标准的文献.软骨下骨的病理骨重建贯穿骨性关节炎的始终,局部骨细胞的代谢及干细胞分化异常与软骨退变相互影响.通过对软骨下骨病理骨重建过程中骨细胞代谢机制的深入了解,为骨性关节炎提供了新的治疗靶点.%BACKGROUND: Osteoarthritis (OA) is a chronic degenerative joint disorder of a high prevalence that remains the leading causeof disability in aged people. Although articular cartilage breakdown is a major characteristic of OA, several tissues of the joint,including the subchondral bone, play significant roles in the development/progression of OA pathology.OBJECTIVE: To investigate the changes in structure, osteocyte, related factors and signal pathway of subchondral bone duringthe development/pro gression of OA pathology, and analyze the effects of pathological changes of subchondral bone ondegeneration of articular cartilage.METHODS: A computer-based retrieval was performed to research papers in CNKI, PubMed, Medline, Embase databases withthe key words “osteoarthritis, subchondral bone, cartilage degeneration, bone reconstruction, and bone metabolism.”Thepathological changes of subchondral bone structure and molecular signaling mechanism after

  8. Reconstruction of 3D structure using stochastic methods: morphology and transport properties

    Science.gov (United States)

    Karsanina, Marina; Gerke, Kirill; Čapek, Pavel; Vasilyev, Roman; Korost, Dmitry; Skvortsova, Elena

    2013-04-01

    One of the main factors defining numerous flow phenomena in rocks, soils and other porous media, including fluid and solute movements, is pore structure, e.g., pore sizes and their connectivity. Numerous numerical methods were developed to quantify single and multi-phase flow in such media on microscale. Among most popular ones are: 1) a wide range of finite difference/element/volume solutions of Navier-Stokes equations and its simplifications; 2) lattice-Boltzmann method; 3) pore-network models, among others. Each method has some advantages and shortcomings, so that different research teams usually utilize more than one, depending on the study case. Recent progress in 3D imaging of internal structure, e.g., X-ray tomography, FIB-SEM and confocal microscopy, made it possible to obtain digitized input pore parameters for such models, however, a trade-off between resolution and sample size is usually unavoidable. There are situations then only standard two-dimensional information of porous structure is known due to tomography high cost or resolution limitations. However, physical modeling on microscale requires 3D information. There are three main approaches to reconstruct (using 2D cut(s) or some other limited information/properties) porous media: 1) statistical methods (correlation functions and simulated annealing, multi-point statistics, entropy methods), 2) sequential methods (sphere or other granular packs) and 3) morphological methods. Stochastic reconstructions using correlation functions possess some important advantage - they provide a statistical description of the structure, which is known to have relationships with all physical properties. In addition, this method is more flexible for other applications to characterize porous media. Taking different 3D scans of natural and artificial porous materials (sandstones, soils, shales, ceramics) we choose some 2D cut/s as sources of input correlation functions. Based on different types of correlation functions

  9. Reconstruction of bone defect with autograft fibula and retained part of tibia after marginal resection of periosteal osteosarcoma: a case report.

    Science.gov (United States)

    Hu, Tongyu; Chen, Wei; Li, Jianheng; Du, Chenguang; Zhang, Yingze

    2015-06-18

    Periosteal osteosarcoma is a rare subtype of osteosarcoma. Wide surgical removal is the commonly used treatment-method algorithm. However, the limb-salvage procedure of periosteal osteosarcoma in the distal tibia is a technical challenge to orthopedic surgeons because of the scarcity of soft tissue and subcutaneous nature in the anteromedial aspect. We encountered a 16-year-old female patient with periosteal osteosarcoma in the distal half of the left tibia diagnosed preoperatively based upon the CT images and a needle biopsy. A unique identical surgical technique was applied in the case, including marginal resection of the periosteal osteosarcoma with part of the tibia retained at the same level of bone defect and reconstruction using the autologous fibula graft. A combination of cisplatin and doxorubicin was received as chemotherapy after the operation. Postoperative incisional biopsy was performed, and the hematoxylin-eosin-stained results confirmed the diagnosis of periosteal osteosarcoma. The patient was followed up for 11 years. Radiological and clinical evaluation was performed at each follow-up. The retained tibia incorporated well with the fibula autograft, and excellent limb functional recovery was achieved. The patient was free from neoplastic disease at the latest follow-up. In conclusion, young patients with periosteal osteosarcoma without intramedullary involvement can be treated by marginal resection of the lesion with part of the tibia retained at the level of bone defect and reconstructed using a long autologous fibula graft. Subsequent chemotherapy with administration of cisplatin and doxorubicin is recommended.

  10. The use of a modular titanium endoprosthesis in skeletal reconstructions after bone tumor resections: method presentation and analysis of 37 cases

    Directory of Open Access Journals (Sweden)

    Croci Alberto Tesconi

    2000-01-01

    Full Text Available We analyzed 37 patients who underwent segmental wide resection of bone tumors and reconstruction with a modular titanium endoprosthesis at the Orthopaedic Oncology Group, between 1992 and 1998. Twelve patients were male and 25 were female, with a mean age of 30 years (9 - 81. The mean follow-up was 14 months (2 - 48. The diagnoses were: osteosarcoma (14 cases, metastatic carcinoma (10, Ewing's sarcoma (4, giant cell tumor (4, malignant fibrous histiocytoma (3, chondrosarcoma (1, and aneurysmal bone cyst (1. Eleven articulated total knee, 8 partial proximal femur with bipolar acetabulum, 8 partial proximal humerus, 3 total femur, 2 partial proximal tibia, 2 diaphyseal femur, 2 diaphyseal humerus, and 1 total proximal femur with cementless acetabulum endoprosthesis implant procedures were done. The complications related to the procedure included: infection (5 cases, dislocation (3, module loosening (1, and ulnar nerve paresthesia (1. We used the following criteria for the clinical evaluation: presence of pain, range of motion, reconstruction stability, surgical and oncologic complications, and patient acceptance. The results were good in 56.8% of the cases, regular in 32.4% and poor in 10.8%.

  11. Reconstrucción alveolar de maxilar atrófico con injerto de calota craneal: A propósito de dos casos Alveolar bone reconstruction of atrophic maxilla with calvarial bone graft: Two case reports

    Directory of Open Access Journals (Sweden)

    A. Modelo Pérez

    2009-12-01

    Full Text Available La atrofia alveolar del maxilar superior es un reto difícil de solventar en la práctica clínica para la rehabilitación dental sobre implantes. Existen varios métodos de reconstrucción con dicha finalidad. Aunque la elección del método depende de varios factores, de los más importantes son la cantidad de hueso remanente y los deseos del paciente. Presentamos dos casos en los que hemos efectuado la rehabilitación prostodóncica sobre implantes MG Osseous, no removible en uno y removible en el otro. Previa a la colocación de los implantes se llevó a cabo la reconstrucción alveolar con injerto óseo de calota craneal.The alveolar atrophy of superior maxilla is a difficult challenge to resolve in clinical practice for the dental rehabilitation on implants. There are several methods of reconstruction with this purpose. Although the election of the method depends on several factors, most importantly the amount of bone surplus and the desires patient´s. We presented/displayed two cases in which we have carried out the prosthodontist rehabilitation on implants MG Osseous, nonremovable in one and removable in the other. Previous to the positioning of the implants alveolar reconstruction was carried out with calvarial bone graft.

  12. Maxillary reconstruction with particulate bone graft and titanium mesh: a treatment option for large complex odontoma of the maxilla.

    Science.gov (United States)

    Utumi, Estevam Rubens; Cremonini, Caio Cesar; Pedron, Irineu Gregnanin; Zambon, Camila Eduarda; Cavalcanti, Marcelo Gusmão Paraíso; Ceccheti, Marcelo Minharro

    2011-07-01

    Odontomas are the most common type of odontogenic tumor and are generally asymptomatic. The purpose of this paper was to describe the case of a complex odontoma in a patient who had asymptomatic swelling in the central maxillary region, along with unerupted central and lateral incisors. In this case, surgical excision of the lesion was performed and an iliac bone graft was introduced into the defect area with a titanium mesh covering up the grafted harvesting bone. After 2 years of followup, no recurrence was identified. Patient followup is still in progress to evaluate bone graft resorption, and the patient awaits complete bone development. Oral rehabilitation with an osseointegrated titanium implant is expected in the future. An option of the large complex odontoma treatment is discussed.

  13. Reduction of bone resorption by the application of fibrin glue in the reconstruction of the alveolar cleft.

    Science.gov (United States)

    Segura-Castillo, José L; Aguirre-Camacho, Humberto; González-Ojeda, Alejandro; Michel-Perez, Jorge

    2005-01-01

    A major complication in 30% to 75% of cases of surgical treatment of alveolar cleft is resorption of the bone graft. A treatment alternative is the application of fibrin glue, which has the capacity to favor the integration of the graft. The main objective of the study was to evaluate if the use of the fibrin glue reduces bone resorption when it is applied locally. The authors designed a randomized clinical trial. Patients were divided into two groups: group 1, fibrin glue; and group 2, control. Pre- and postoperative graft volume, bone density, bone quality (Lekholm and Zarb, and Norton and Gamble classifications), and postoperative complications were evaluated. The follow-up for all patients was 3 months after discharge. Twenty-seven patients were surgically treated, 13 in group 1 and 14 in group 2. Group 1 had increased graft volume compared with group 2 (64.32 cm v 21.70 cm; P 0.076). Bone quality was type 1, 2 and 3 and 4 in group 1. Resorption in group 2 was 62.26%; in group 1, it was 29.72% (P > 0.081). The observed complications were infection and dehiscence of sutures (P > 0.537). The authors conclude that the fibrin glue significantly diminishes bone resorption, allowing improved graft integration and quality.

  14. Xenograft Enriched with Autologous Bone Marrow in Inlay Reconstructions: A Tomographic and Histomorphometric Study in Rabbit Calvaria

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    Marcelo de Oliveira e Silva

    2012-01-01

    Full Text Available Objective. The aim of this study was to evaluate the bone healing after the usage of a scaffold enriched with bone marrow. Study Design. Ten rabbits were divided into 2 groups of 5 animals. Bilateral 12 mm diameter defects were created in the parietal bones. In control group Bio-Oss were inserted in both defects and, in experimental group, Bio-Oss enriched with autologous bone marrow were inserted in both defects. In these two groups, one of the calvarial defects was covered with Bio-Gide. The rabbits were sacrified 8 weeks after surgery and both CT and histomorphometric analysis were done. Results. The CT showed a lower remaining defect area in the experimental group covered with Bio-Gide when compared with control group, with and without Bio-Gide. The histomorphometrics showed no difference between groups regarding the non-vital mineralized tissue area. For vital mineralized tissue area, the experimental group covered with Bio-Gide obtained a higher percentage area when compared with control group, with and without Bio-Gide. For non-mineralized tissue area, the experimental group covered with Bio-Gide obtained a lower percentage area when compared with control group, with and without Bio-Gide. Conclusion. Both autologous bone marrow and membrane can contribute to the enhancement of bone healing.

  15. Two-strand posterior cruciate ligament reconstruction with a quadriceps tendon-patellar bone autograft: technical considerations and clinical results.

    Science.gov (United States)

    Noyes, Frank R; Barber-Westin, Sue D

    2006-01-01

    In patients with complete posterior cruciate ligament (PCL) ruptures in which 10 mm or more of increased posterior tibial translation is detected, associated knee disorders must be treated at the same time as the PCL injury. Varus malalignment and any abnormal medial or lateral ligament deficiency must be corrected before or with PCL reconstruction to avoid the risk of failure of the PCL graft. Gait retraining is recommended for patients with abnormal knee hyperextension patterns before ligament reconstruction is performed. Advances in PCL reconstruction include the use of a two-strand graft that may be placed using either a tibial inlay or an all-arthroscopic tibial tunnel technique. Biomechanical studies have shown a reduction in graft tension and improved load sharing in these constructs compared with single-strand reconstructions. The tibial inlay method can be used in athletic patients, and it also is required in PCL revisions in which a prior tibial tunnel must be avoided to achieve graft fixation. The tibial tunnel technique is used to treat dislocated knees for which reconstruction of multiple knee ligaments is required or when prior arterial injury or posterior skin or muscle damage limits the indications for a posterior open approach. Postoperative rehabilitation should protect the PCL graft from high forces and repetitive cyclic knee motions during the first 4 weeks postoperatively.

  16. Bone tunnel diameter measured with CT after anterior cruciate ligament reconstruction using double-bundle auto-hamstring tendors: Clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Soo Jeong; Yoon, Young Cheol; Bae, So Young; Wang, Joon Ho [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    To evaluate the correlation between bone tunnel diameter after anterior cruciate ligament (ACL) reconstruction measured by computed tomography (CT) using multiplanar reconstruction (MPR) and stability or clinical scores. Forty-seven patients (41 men and 6 women, mean age: 34 years) who had undergone ACL reconstruction with the double bundle technique using auto-hamstring graft and had subsequently received CT scans immediately after the surgery (T1: range, 1-4 days, mean, 2.5 days) and at a later time (T2: range, 297-644 days, mean, 410.4 days) were enrolled in this study. The diameter of each tunnel (two femoral and two tibial) at both T1 and T2 were independently measured using MPR technique by two radiologists. Stability and clinical scores were evaluated with a KT-2000 arthrometer, International Knee Documentation Committee objective scores, and the Lysholm score. Statistical analysis of the correlation between the diameter at T2 or the interval diameter change ratio ([T2 - T1] / T1) and clinical scores or stability was investigated. The tibial bone tunnels for the anteromedial bundles were significantly widened at T2 compared with T1 (observer 1, 0.578 mm to 0.698 mm, p value of < 0.001; observer 2, 0.581 mm to 0.707 mm, p value of < 0.001). There was no significant correlation between the diameter at T2 and stability or clinical scores and between the interval change ratio ([T2 - T1] / T1) and stability or clinical scores (corrected p values for all were 1.0). Intraobserver agreement for measurements was excellent (> 0.8) for both observers. Interobserver agreement for measurement was excellent (> 0.8) except for the most distal portion of the femoral bone tunnel for anterior medial bundle in immediate postoperative CT, which showed moderate agreement (concordance correlation coefficient = 0.6311).Neither the diameter nor its change ratio during interval follow-up is correlated with stability or clinical scores.

  17. 人工全髋关节置换术中髋臼骨缺损的重建%Reconstruction of acetabular bone deficiency in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    杨波; 林进; 翁习生; 金今; 赵庆; 邱贵兴

    2009-01-01

    Objective To discuss the characteristics and reconstruction strategies of acetabular bone deficiency in total hip arthroplasty in order to find the optimal resolution for this clinical puzzle. Methods Clinical and radiological materials of 37 patients (37 hips) with acetabular deficiency who underwent primary or revision total hip arthreplasty were analyzed retrospectively from May 1998 to August 2008. According to the common classification system for acetabular bone deficiency-the AAOS classification system, the acetabular bone defect was reconstructed using morsellized or structural bone grafting, accessory acetabular hardware (ring, cup or cage) together with cemented or cementless acetabular component respectively. All patients were followed up regularly to assess their hip function improvement by measuring the Harris hip score and to find out the grafting bone healing, absorption and position of the prosthesis by plain radiographic examination. Results There were 11 primary and 26 revision total hip arthroplasty. There were 9 hips of AAOS-type Ⅰ defect, 13 of type Ⅱ and 15 of type Ⅲ. Morsollized bone grafting was used in 24 cases, bulk structural bone grafting in 6 cases and mixed bone grafting in 7 cases. Twenty-one patients used cementless prosthesis and 16 used cemented prosthesis. The average follow-up period was 53.7 months (6.5 to 130.5 months), the average preoperative Harris hip score was 42±8 with contrast to 87±5 of post-operation. Statistically significant difference was found according to t-test with P value less than 0.05. Major or complete healing of grafting bone was obtained at the latest follow-up. Conclusions Acetabular bone defect during primary or revision total hip arthroplasty should be reconstructed according to its characteristics and severity. For relatively simple AAOS type Ⅰ and type Ⅱ cases, morsellized or bulk structural bone grafting together with cementless prosthesis could achieve favorable initial stability, but for

  18. Correção da falha óssea femoral e tibial pelo método do transporte ósseo de Ilizarov Femoral and tibial bone loss correction using Ilizarov's bone transport

    Directory of Open Access Journals (Sweden)

    Celso Herminio Ferraz Picado

    2000-12-01

    pacientes ficaram satisfeitos com o resultado do tratamento. Concluímos que a resposta biológica ao transporte ósseo é formidável, com a formação do regenerado reparando grandes falhas ósseas. Entretanto, consideramos que o aparelho circular externo preconizado por Ilizarov traz consigo diversas complicações principalmente relacionadas a presença dos fios transfixantes, causando sofrimento para os pacientes, principalmente quando instalados no fêmur.Eleven patients carrying diaphyseal bone fissure secondary to ressection of infected bone segments, 5 in the femur and 6 in the tibia, submitted to the Ilizarov bone transport technique were retrospectively analyzed. In the group of patients with femoral lesion the bone fissure varied from 7 cm to 12 cm, and in two there was a 2 cm shortening of the limb. In the group with tibial lesion the bone fissure varied from 2.5 cm to 10 cm, with limb shortening in two patients, respectively 1.5 cm and 2 cm. The mean follow-up period since the end of the treatment until evaluation was 49 months for the femoral lesion patients and 28.3 months for the tibial lesion patients. The femoral transports were bifocal and the tibial transports were bifocal in 4 patients and trifocal in 2. In all, patients formation of regenerate occurred. Consolidation of the target focus was naturally obtained in 7 patients; one patient needed bone grafting to obtain the focus consolidation. In three patients the nonunion of the target focus demanded modification of the treatment method with the external circular fixator withdrawal. In all the patients infection adjacent to the wires was observed. There was rupture of the wires in all assemblies made in the thigh. All the wires lost the tension initially imposed to them. Two patients submitted to femoral transport evolved with septic arthritis of the knee. Mobility of the knee was severely impaired in the patients submitted to femoral transport, and the same was observed in relation to the ankle of

  19. Transport distraction osteogenesis as a method of reconstruction of the temporomandibular joint following gap arthroplasty for post-traumatic ankylosis in children: a clinical and radiological prospective assessment of outcome.

    Science.gov (United States)

    Bansal, V; Singh, S; Garg, N; Dubey, P

    2014-02-01

    This clinical and radiographic study investigated the use of transport distraction osteogenesis in unilateral temporomandibular joint (TMJ) ankylosis patients. Six patients aged between 4 and 8 years were selected for the study; the mean preoperative maximal inter-incisal opening (MIO) was 3.5mm without lateral and protrusive mandibular movements. The ankylotic mass along with the posterior border of the ascending ramus was exposed via 'lazy-S' incision. A gap arthroplasty was performed, followed by a 'reverse L' osteotomy on the posterior border of the ramus. In-house manufactured extraoral distraction devices were used for this prospective study. Follow-up clinical and radiographic evaluation was carried out for 13-27 months after completion of the activation period. After a mean follow-up of 19 months, the mean MIO was 29.1mm and the lateral and protrusive movements changed from none to slight. Cone beam computed tomography images of all patients showed remodelled neocondyle created by transport distraction osteogenesis with no statistically significant differences observed for average cancellous bone density, trabecular number, and trabecular spacing between the neocondyle of the operated side (test) and the condyle of the non-operated side (control). Neocondyle formation by transport distraction osteogenesis using the in-house distraction device is a promising treatment option for TMJ reconstruction in ankylosis patients.

  20. Bone effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor, in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Blevins, Thomas C; Farooki, Azeez

    2017-01-01

    Canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor approved for the treatment of type 2 diabetes mellitus (T2DM), lowers blood glucose by inhibiting renal glucose reabsorption and increasing urinary glucose excretion. It has been reported that SGLT2 inhibitors may have potential adverse effects on bone, including increased fracture risk and decreased bone mineral density (BMD). Across clinical studies, canagliflozin was not associated with meaningful changes in serum or urine calcium, vitamin D, or parathyroid hormone. Minimal increases in serum phosphate and magnesium that were within normal limits were seen with canagliflozin versus placebo. Canagliflozin was associated with increases in serum collagen type 1 beta-carboxy telopeptide (beta-CTX), a bone resorption marker, and osteocalcin, a bone formation marker. Decreases in total hip BMD were seen with canagliflozin 100 and 300 mg versus placebo after 2 years (-1.7%, -2.1%, -0.8%; differences of -0.9% and -1.2%), but not at other skeletal sites (normal age-related bone loss, ~0.5-1.0%/year). Changes in beta-CTX and total hip BMD were significantly associated with weight loss, which is known to increase bone resorption markers and decrease BMD. Canagliflozin was associated with a higher fracture incidence in an interim analysis of the CANagliflozin cardioVascular Assessment Study (CANVAS) in patients with a history or high risk of cardiovascular disease (incidence per 100 patient-years of 1.6, 1.6, and 1.1 with canagliflozin 100 and 300 mg and placebo), but not in other clinical studies of patients with T2DM. Fractures tended to occur as early as 12 weeks after initiating treatment and were primarily located in the distal parts of the upper and lower extremities. The reason for increased fracture risk with canagliflozin treatment is unknown, but is likely not related to a direct effect of canagliflozin on bone-related biomarkers. Data from ongoing canagliflozin studies, including CANVAS, will

  1. Use of a strontium-enriched calcium phosphate cement in accelerating the healing of soft-tissue tendon graft within the bone tunnel in a rabbit model of anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Kuang, G M; Yau, W P; Lu, W W; Chiu, K Y

    2013-07-01

    We investigated whether strontium-enriched calcium phosphate cement (Sr-CPC)-treated soft-tissue tendon graft results in accelerated healing within the bone tunnel in reconstruction of the anterior cruciate ligament (ACL). A total of 30 single-bundle ACL reconstructions using tendo Achillis allograft were performed in 15 rabbits. The graft on the tested limb was treated with Sr-CPC, whereas that on the contralateral limb was untreated and served as a control. At timepoints three, six, nine, 12 and 24 weeks after surgery, three animals were killed for histological examination. At six weeks, the graft-bone interface in the control group was filled in with fibrovascular tissue. However, the gap in the Sr-CPC group had already been completely filled in with new bone, and there was evidence of the early formation of Sharpey fibres. At 24 weeks, remodelling into a normal ACL-bone-like insertion was found in the Sr-CPC group. Coating of Sr-CPC on soft tissue tendon allograft leads to accelerated graft healing within the bone tunnel in a rabbit model of ACL reconstruction using Achilles tendon allograft.

  2. Research progress on Chinese herbs for bone reconstruction%中药用于骨组织修复重建的研究进展

    Institute of Scientific and Technical Information of China (English)

    李源静; 刘文静; 杨岚; 郭吕华

    2013-01-01

      With extensive use of dental implant therapy, how to improve the patients’ bone deficiencies induced by tooth loss, and promote the early osseointegration after implant operation has become a hot spot subject. In re-cent years, clinical and experimental researches have found Chinese herbs played a role in the rate and degree of implant osseointegration. This article will review the researches of Chinese herbs for bone reconstruction.%  随着口腔种植修复技术的广泛应用,如何改善缺牙患者的骨质和骨量的不足,促进牙种植后的早期骨结合,已成为备受关注的课题。近年来,中医药用于骨组织修复重建的临床和实验研究发现,其对骨整合的速度和骨结合能力有一定的作用,本文就有关中药对骨修复重建方面的研究综述如下。

  3. The Comparative Efficacy of the Masquelet versus Titanium Mesh Cage Reconstruction Techniques for the Treatment of Large Long Bone Deficiencies

    Science.gov (United States)

    2014-10-01

    conducted at the Department of Orthopaedic Surgery & Rehabilitation , University of Texas Medical Branch, Galveston, TX, with a primary objective to assess... amputation as per the patient’s request. There are 2 additional eligible patients who are currently in pre-reconstruction phase of the defect management...and, in many instances culminates in amputation . The present clinical study addresses this issue by assessing and comparing two new Food & Drug

  4. Comparison of volumetric bone mineral density in the operated and contralateral knee after anterior cruciate ligament and reconstruction: A 1-year follow-up study using peripheral quantitative computed tomography.

    Science.gov (United States)

    Mündermann, Annegret; Payer, Nina; Felmet, Gernot; Riehle, Hartmut

    2015-12-01

    The purpose of this study was to quantify changes in volumetric bone mineral density (vBMD) in the tibial plateau of the operated and contralateral leg measured using peripheral quantitative computed tomography (pQCT) before and 3, 6, and 12 months after anterior cruciate ligament (ACL) reconstruction. The ACL was reconstructed with a hamstring tendon autograft using press-fit fixation. pQCT measurements of the proximal tibia were obtained in 61 patients after ACL reconstruction, and total, cortical, and trabecular vBMD were calculated. vBMD in the operated leg decreased from baseline to 3 months (-12% [total], -11% [cortical], and -12.6% [trabecular]; preconstruction contributed to loss in bone mineral density within the first year after surgery. The role of factors such as time of weight-bearing, joint mechanics, post-traumatic inflammatory reactions, or genetic predisposition in modulating the development of posttraumatic knee osteoarthritis after ACL injury should be further elucidated.

  5. Repair and reconstruction of segmental long bone defect:Theory and application advances%长骨节段性缺损修复重建的理论及应用进展

    Institute of Scientific and Technical Information of China (English)

    李敏; 陈国奋; 王健; 史占军; Shaikh Atik Badshah; 郑少伟

    2013-01-01

    BACKGROUND:Various methods have been reported for the repair and reconstruction of long bone segmental defect, but al of them have different advantages and disadvantages which limit their wide application. And this stil presents as a huge problem for many orthopaedics. OBJECTIVE:To review the latest research on reconstruction and repair of long bone segmental defects at national and international level. METHODS:A computer-based retrieval was conducted in PubMed database, CNKI database and VIP database by the first author for the articles published from January 1990 to December 2012, on the repair and reconstruction of long bone segmental defect with the key words of“bone defect, long bone reconstruction, tissue engineering of bone, scaffolds, bone reconstruction, bone graft, bone tumor, tumor resection, musculoskeletal tumors, regeneration, autografts”in English and“large segment, bone defects, bone tumors, soft tissue tumors, tumor resection, tissue engineering, bone graft”in Chinese. A total of 104 articles were screened out, and final y, 52 articles were included for further research. RESULTS AND CONCLUSION:Traditional method for the repair of long bone segmental defect includes autologous or al ogeneic bone graft, bone lengthening and artificial prosthesis replacement. The development of prosthesis that was suitable for child limb salvage and consistent with the child growth characteristics has become the chal enge to child limb salvage. In order to solve the problem, we designed the prosthesis that can continuously extent, and applied for the limb salvage reconstruction of tumor. With the development of medical technology, al kinds of artificial bone, especial y bone tissue engineering and gene treatment are being gradual y used to repair bone defect, which wil further enhance the clinical evaluation of bone defect repair, and that is the direction of further research.%背景:长骨节段性骨缺损修复重建方法众多,各有优缺点,限

  6. Evaluation of transport conditions for autologous bone marrow-derived mesenchymal stromal cells for therapeutic application in horses.

    Science.gov (United States)

    Espina, Miguel; Jülke, Henriette; Brehm, Walter; Ribitsch, Iris; Winter, Karsten; Delling, Uta

    2016-01-01

    Background. Mesenchymal stromal cells (MSCs) are increasingly used for clinical applications in equine patients. For MSC isolation and expansion, a laboratory step is mandatory, after which the cells are sent back to the attending veterinarian. Preserving the biological properties of MSCs during this transport is paramount. The goal of the study was to compare transport-related parameters (transport container, media, temperature, time, cell concentration) that potentially influence characteristics of culture expanded equine MSCs. Methods. The study was arranged in three parts comparing (I) five different transport containers (cryotube, two types of plastic syringes, glass syringe, CellSeal), (II) seven different transport media, four temperatures (4 °C vs. room temperature; -20 °C vs. -80 °C), four time frames (24 h vs. 48 h; 48 h vs. 72 h), and (III) three MSC concentrations (5 × 10(6), 10 × 10(6), 20 × 10(6) MSC/ml). Cell viability (Trypan Blue exclusion; percent and total number viable cell), proliferation and trilineage differentiation capacity were assessed for each test condition. Further, the recovered volume of the suspension was determined in part I. Each condition was evaluated using samples of six horses (n = 6) and differentiation protocols were performed in duplicates. Results. In part I of the study, no significant differences in any of the parameters were found when comparing transport containers at room temperature. The glass syringe was selected for all subsequent evaluations (highest recoverable volume of cell suspension and cell viability). In part II, media, temperatures, or time frames had also no significant influence on cell viability, likely due to the large number of comparisons and small sample size. Highest cell viability was observed using autologous bone marrow supernatant as transport medium, and "transport" at 4 °C for 24 h (70.6% vs. control group 75.3%); this was not significant. Contrary, viability was unacceptably low (cell

  7. A Case-Control Study Comparing Bone Bruising and Intra-articular Injuries in Patients Undergoing Anterior Cruciate Ligament Reconstruction With and Without Medial Collateral Ligament Tears

    Science.gov (United States)

    Kluczynski, Melissa A.; Marzo, John M.; Rauh, Michael A.; Bernas, Geoffrey A.; Bisson, Leslie J.

    2016-01-01

    Background: Concomitant injuries can occur in patients with combined anterior cruciate ligament (ACL) and medial collateral ligament (MCL) tears; however, no studies have compared these injuries in patients undergoing ACL reconstruction with an MCL tear to those with an intact MCL. Purpose: To compare bone bruising, meniscus tears, and chondral lesions in patients undergoing ACL reconstruction with an MCL tear (cases) to those with an intact MCL (controls). Study Design: Case-control study; Level of evidence, 3. Methods: Thirty-two cases and 352 controls were identified from a prospective registry. Bone bruising was confirmed on magnetic resonance imaging, and meniscus tears and chondral lesions were confirmed arthroscopically. Demographics and concomitant injuries were compared between cases and controls using exact chi-square tests. Multivariate logistic regression was used to calculate odds ratios (ORs) and 95% CIs adjusted for age, sex, body mass index, and mechanism and type of injury. Results: Cases had significantly more contact injuries than controls (58.1% vs 21.3%, P < .0001). The prevalence and odds of bone bruising of the lateral tibial plateau (89.7% vs 84.6%; P = .59; OR, 3.53; 95% CI, 0.45-27.71), lateral femoral condyle (82.8% vs 72.8%; P = .28; OR, 1.94; 95% CI, 0.64-5.88), medial tibial plateau (20.7% vs 31.7%; P = 0.29; OR, 0.53; 95% CI, 0.19-1.53), and medial femoral condyle (6.9% vs 8.3%; P ≥ .999; OR, 1.07; 95% CI, 0.21-5.40) did not differ significantly between cases and controls. The prevalence and odds of lateral meniscus tears (53.3% vs 43%; P = .34; OR, 1.85; 95% CI, 0.76-4.52), medial meniscus tears (31.3% vs 33.5%; P = .85; OR, 0.90; 95% CI, 0.37-2.21), and chondral lesions (16% vs 10.8%; P = .50; OR, 0.70; 95% CI, 0.15-3.21) also did not significantly differ between cases and controls. Conclusion: ACL-MCL injuries were most often due to a contact mechanism, whereas ACL tears without associated MCL injury were more frequently due to a

  8. Oxygen isotope composition of North American bobcat (Lynx rufus) and puma (Puma concolor) bone phosphate: implications for provenance and climate reconstruction.

    Science.gov (United States)

    Pietsch, Stephanie J; Tütken, Thomas

    2016-01-01

    Feline carnivores are threatened by illegal wildlife trade. Tracing the provenance of unknown felid tissues via stable isotope analysis could provide important information in wildlife crime investigations. The oxygen isotope composition of mammalian skeletal phosphate (δ(18)Op) is widely applied to trace the origin of animal remains and to reconstruct migratory patterns in palaeontological, archaeological, ecological and wildlife forensic applications. Teeth and bones of terrestrial mammals form at constant body temperature in isotope equilibrium with body water, which is predominantly controlled by ingested meteoric water (δ(18)Ow) that varies systematically with latitude, altitude and climate. Here we analysed δ(18)Op of 106 North American puma and bobcat bones of known geographic origin to establish the first δ(18)Op-δ(18)Ow regression for feline carnivores: δ(18)Op = 0.40(±0.04) * δ(18)Ow + 20.10(±0.40) (R(2) = 0.46, n = 106). This was compared with those from their respective prey species (deer and rabbit), a canid carnivore (fox) and other placental mammals. Effects of species, sex and relative humidity on the feline δ(18)Op-δ(18)Ow correlation were analysed and additional intra-individual tissue comparisons (hair δ(18)Oh vs. bone δ(18)Op) were performed for some bobcat individuals. Bobcats and pumas exhibited only a moderate δ(18)Op-δ(18)Ow correlation, which differed from canid carnivores and other placental mammals. However, feline δ(18)Op values revealed a moderate relation with δ(18)Ow, which lacks for the δ(18)Oh of hair from the same bobcat individuals. This indicates a difference in oxygen isotope routing from body water to bioapatite and hair. Most herbivores and omnivores track δ(18)Ow in their bioapatite δ(18)Op values much better, whereas δ(18)Op and especially δ(18)Oh values of feline carnivores are less precise proxies for meteoric water δ(18)Ow values and thus for provenance determination in wildlife

  9. Large Segment Bone Allograft Reconstruction Following Femur Tumors Resection%大段异体骨移植重建股骨肿瘤性缺损

    Institute of Scientific and Technical Information of China (English)

    贾金鹏; 毕文志; 韩纲; 王威; 许猛; 李静东

    2012-01-01

    目的 探讨大段异体骨移植在股骨肿瘤扩大切除后缺损重建中的作用及临床效果.方法 回顾性分析从2005年1月至2010年1月共30例患者.均行股骨肿瘤保肢手术并采用大段异体骨重建肿瘤切除后缺损的患者.结果 22例患者获得随访,8例患者失访.10例患者死于多发转移.12例存活的患者随访时间为20个月至7年,平均随访时间4.2年.所有患者术后X线片显示异体骨位置良好.6例发生延迟愈合或不愈合.其中有5例发生应力性骨折,1例患者发生深部感染.2例患者发生内固定失败.1例患者局部复发.所有患者中未发现明显的排斥反应.结论 大段异体骨移植能够获重建股骨肿瘤后较大的骨缺损,满足了部分股骨肿瘤保肢治疗的需要,是股骨肿瘤保肢治疗中一种可以选择的方法.%Objective Probe into the feasibility of the clinical outcome of large segment bone allograft for reconstruction of the defect after femur tumor resection. Methods During January 2005 to January 2010, 30 patients were carried out limb-spanng surgery due to femur tumors, and large segment bone allograft was used to reconstruction the bone defects after tumor resection. Results 22 patients were followed up; 8 patients were lost of follow-up. 10 patients died of generalized metastases. Patients were followed up from 20 months to 7 years. The mean follow-up was 4. 2 years. There were 6 patients had delayed union or nonunion, 5 patients had stress fractures, 1 patient occurred primary deep infection. Failure of the internal fixation system occurred in 2 patients, lpatient had local recurrences. No evident immune rejection was observed. Conclusions Large segment bone allograft can meet to the present demand in reconstruction of the massive defect following femur tumor resection, and still to be a very useful alternative to prosthesis in limb-sparing surgery of femur tumors.

  10. In silico multi-scale model of transport and dynamic seeding in a bone tissue engineering perfusion bioreactor.

    Science.gov (United States)

    Spencer, T J; Hidalgo-Bastida, L A; Cartmell, S H; Halliday, I; Care, C M

    2013-04-01

    Computer simulations can potentially be used to design, predict, and inform properties for tissue engineering perfusion bioreactors. In this work, we investigate the flow properties that result from a particular poly-L-lactide porous scaffold and a particular choice of perfusion bioreactor vessel design used in bone tissue engineering. We also propose a model to investigate the dynamic seeding properties such as the homogeneity (or lack of) of the cellular distribution within the scaffold of the perfusion bioreactor: a pre-requisite for the subsequent successful uniform growth of a viable bone tissue engineered construct. Flows inside geometrically complex scaffolds have been investigated previously and results shown at these pore scales. Here, it is our aim to show accurately that through the use of modern high performance computers that the bioreactor device scale that encloses a scaffold can affect the flows and stresses within the pores throughout the scaffold which has implications for bioreactor design, control, and use. Central to this work is that the boundary conditions are derived from micro computed tomography scans of both a device chamber and scaffold in order to avoid generalizations and uncertainties. Dynamic seeding methods have also been shown to provide certain advantages over static seeding methods. We propose here a novel coupled model for dynamic seeding accounting for flow, species mass transport and cell advection-diffusion-attachment tuned for bone tissue engineering. The model highlights the timescale differences between different species suggesting that traditional homogeneous porous flow models of transport must be applied with caution to perfusion bioreactors. Our in silico data illustrate the extent to which these experiments have the potential to contribute to future design and development of large-scale bioreactors.

  11. Long-term bone loss after renal transportation. Comparison of immunosuppressive regimens

    Energy Technology Data Exchange (ETDEWEB)

    Menzies, B.; Rigby, R.; Hawley, CJ.M.; Hardie, I.R. [Princess Alexandra Hospital, Renal Transplant Unit, Woolloongabba (Australia); McIntyre, H.D. [Mater Adult Hospital, Department of Medicine, South Brisbane (Australia); Perry-Keene, D.A. [Royal Brisbane Hospital, Department of Endocrinology, Herston, Queensland (Australia)

    1995-02-01

    Serial measurements of serum and urine markers of bone metabolism and of forearm bone density (BMD) by dual photon absorptiometry were performed in 22 patients undergoing renal transplantation in 1986. Patients were randomised to immunosuppression with (1) cyclosporin alone (CsA group, n = 10), (2) cyclosporin for 3 months followed by azathioprine-prednisone (CsA/AzP group, n = 3) or (3) long-term azathioprine-prednisone (LT AzP group, n = 9). As no reduction in bone mineral density (BMD) was noted in the first 6 months, groups 2 and 3 were considered together (AzP group, n = 12). Mean{+-}SEM BMD fell by 19{+-}2% at 36 months (n = 19,m p<0.01), with similar reductions seen in the CsA and AzP groups. At 60 months, BMD of the AzP group was 25{+-}3% below baseline (p<0.01), while the CsA group were only 5{+-}4% belov baseline (p = NS vs baseline, p<0.05 vs AzP group). The degree of reduction in BMD over 5 years correlated with total glucocorticoid dose (r = 0.63, p<0.05), but not with biochemical markers of bone turnover. Serum alkaline phosphatase fell post-transplant in patients treated with AzP, but not in the CsA group. These results demonstrate significant loss of forearm bone mineral with long-term follow-up after renal transplantation, but suggest that patients treated with cyclosporin monotherapy may be at lower risk of this complication. (au) (15 refs.).

  12. COMPARATIVE STUDY OF CLINICAL OUTCOME OF ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION BONE PATELLAR TENDON BONE GRAFT V/S HAMSTRING GRAFT

    Directory of Open Access Journals (Sweden)

    Priyank

    2015-08-01

    fulfilling the predetermined inclusion and exclusion criteria were included in the study. STATISTICAL METHODS : Intergroup comparison was analysed by K - Independent sample t test. Intragroup comparison was analysed by Paired t - test. RESULTS : Patients were divided into two groups and treated with using Bone - patellar tendon - bone graft and Hamstring graft respectively. Mean age group of patients was 29.16 yrs. (range 16 - 51yrs and 30.88 yrs. (range 19 - 48yrs in group A and B respectively we found the incidence of ACL injury in 15 - 44 years age group to be greater than twice the general population. A mean delay in surgery of 4.66 months (range 2 - 12 months since the time of injury in group A and 4.46 months (range 2 - 7 months in group B was observed. Subjective IKDC evaluation was done at the end of 12 months. Ther e was no difference in both the groups in the terms of effusion, passive motion, knee compartment findings, ligament examination, X - ray findings. Functional test and IKDC grade of both the groups showed statistically very highly significant improvement. Ho wever, there was statistically very high Harvest site pathology in group A. CONCLUSION : We found that there is statistically no significant difference in the overall clinical outcome between hamstring autograft with transfix and bone - patellar tendon bone autograft with interference screw except that the patellar tendon group had a greater tendency of having donor site morbidity compared to the hamstring tendon group.

  13. Do Newer-Generation Bioabsorbable Screws Become Incorporated into Bone at Two Years After ACL Reconstruction with Patellar Tendon Graft?

    Science.gov (United States)

    Cox, Charles L.; Spindler, Kurt P.; Leonard, James P.; Morris, Brent J.; Dunn, Warren R.; Reinke, Emily K.

    2014-01-01

    Background: Bioabsorbable interference screws are used frequently for graft fixation in ACL (anterior cruciate ligament) reconstruction. The resorption properties of many available screws that are marketed as bioabsorbable are not well defined. The CALAXO (Smith & Nephew Endoscopy) and MILAGRO (DePuy Synthes) bioabsorbable screws contain polymers of poly(lactic-co-glycolic acid) (PLGA) plus additives to encourage osseointegration over time. The purpose of this study was to evaluate radiographic and magnetic resonance imaging (MRI) properties and compare patient-reported outcomes at a minimum of two years of follow-up after ACL reconstruction using CALAXO or MILAGRO bioabsorbable interference screws. Methods: A cohort of patients who underwent ACL reconstruction in which the fixation used was either CALAXO or MILAGRO screws returned for repeat radiographs for evaluation of tunnel widening, repeat MRI for evaluation of graft integrity and screw breakdown, and completion of the pain and symptom items of the KOOS (Knee injury and Osteoarthritis Outcome Score) questionnaire. Results: At a mean of three years (range, 2.5 to 4.0 years) after surgery, thirty-one patients with sixty-two CALAXO screws and thirty-six patients with seventy-two MILAGRO screws returned for repeat evaluation. Two blinded, independent reviewers found no significant differences between the two screw types when comparing radiographs for tibial or femoral tunnel widening or MRIs for graft integrity, tibial and femoral foreign body reactions, or femoral screw degradation. Both reviewers found a significant difference between the two screw types when comparing tibial screw degradation properties (p MILAGRO screws were more likely to be rated as intact. No significant differences were noted between the two screw types when comparing the two KOOS subscales. Conclusions: CALAXO screws in the tibial tunnel were more likely to be rated as degraded or partially degraded compared with MILAGRO screws at a mean

  14. Reconstruction of complex passageways for simulations of transport phenomena: development of a graphical user interface for biological applications.

    Science.gov (United States)

    Godo, M N; Morgan, K T; Richardson, R B; Kimbell, J S

    1995-07-01

    Flow of fluids, such as blood, lymph and air, plays a major role in the normal physiology of all living organisms. Within individual organ systems, flow fields may significantly influence the transport of solutes, including nutrients and chemical toxicants, to and from the confining vessel walls (epithelia and endothelia). Computational fluid dynamics (CFD) provides a potentially useful tool for biologists and toxicologists investigating solute disposition in these flow fields in both normal and disease states. Application of CFD is dependent upon generation of accurate representations of the geometry of the system of interest in the form of a computational reconstruction. The present investigations, which were based on studies of the toxicology of inhaled reactive gases in the respiratory tract of rodents, provide computer programs for the generation of finite element meshes from serial tissue cross-sections. These programs, which interface with a commercial finite element fluid dynamics simulation package (FIDAP 7.05, Fluid Dynamics International, Evanston, IL), permit simulation of fluid flow in the complex geometries and local solute mass flux to the vessel walls of biological systems. The use of these programs and their application to studies of respiratory tract toxicology are described.

  15. Evaluation of transport conditions for autologous bone marrow-derived mesenchymal stromal cells for therapeutic application in horses

    Directory of Open Access Journals (Sweden)

    Miguel Espina

    2016-03-01

    Full Text Available Background. Mesenchymal stromal cells (MSCs are increasingly used for clinical applications in equine patients. For MSC isolation and expansion, a laboratory step is mandatory, after which the cells are sent back to the attending veterinarian. Preserving the biological properties of MSCs during this transport is paramount. The goal of the study was to compare transport-related parameters (transport container, media, temperature, time, cell concentration that potentially influence characteristics of culture expanded equine MSCs. Methods. The study was arranged in three parts comparing (I five different transport containers (cryotube, two types of plastic syringes, glass syringe, CellSeal, (II seven different transport media, four temperatures (4 °C vs. room temperature; −20 °C vs. −80 °C, four time frames (24 h vs. 48 h; 48 h vs. 72 h, and (III three MSC concentrations (5 × 106, 10 × 106, 20 × 106 MSC/ml. Cell viability (Trypan Blue exclusion; percent and total number viable cell, proliferation and trilineage differentiation capacity were assessed for each test condition. Further, the recovered volume of the suspension was determined in part I. Each condition was evaluated using samples of six horses (n = 6 and differentiation protocols were performed in duplicates. Results. In part I of the study, no significant differences in any of the parameters were found when comparing transport containers at room temperature. The glass syringe was selected for all subsequent evaluations (highest recoverable volume of cell suspension and cell viability. In part II, media, temperatures, or time frames had also no significant influence on cell viability, likely due to the large number of comparisons and small sample size. Highest cell viability was observed using autologous bone marrow supernatant as transport medium, and “transport” at 4 °C for 24 h (70.6% vs. control group 75.3%; this was not significant. Contrary, viability was unacceptably

  16. 内踝复合组织缺损的修复重建%Reconstruction of bone and skin defect at medial malleolns

    Institute of Scientific and Technical Information of China (English)

    韩清銮; 栗威; 范洪进; 张清林; 张志

    2015-01-01

    目的 探讨内踝复合组织缺损的修复重建方法. 方法 2013年1月至2015年1月,共收治内踝复合组织缺损患者11例,按损伤程度对病例进行分型(分四型),根据类型,选用皮瓣、血管、神经、肌腱移植、皮瓣串联髂骨瓣移植修复,或直接踝关节融合、截肢等治疗;髂骨瓣供区给予保留部分髂前上棘并重建肌肉起止点,皮瓣供区给予植皮闭合创面. 结果 术后随访l~24个月,除截肢和踝关节融合各1例外,其余9例患者行踝关节修复重建保留踝关节,有1例感染,其他患者均愈合良好,不同程度恢复了踝关节功能,AOFAS踝-后足评分系统:优4例,良4例,差1例. 结论 内踝复合组织缺损四分类方法可以用来指导治疗方案的选择,皮瓣串联髂骨瓣等为主的复合组织移植是内踝缺损修复重建的可行方法.%Objective To investigate the operative method and clinical rusults of repairing and reconstruction for bone and skin defect at medial malleolus.Methods Form January,2013 to January,2015,11 cases of patients with malleolus complex tissue defect were treated.According to the degree of damage to the cases were divided into four types,according to the type,selected flap,blood vessels,nerves,tendon graft,flap series connection iliac bone flap graft to repair,or direct ankle fusion,amputation to therapy.The Iliac flap donor site remained part of the anterior superior iliac spine and rebuild muscle starting and ending point,the donor sites wound was closed by skin graft.Results Followed-up of 1-24 months,in addition to amputation and ankle fusion each one exception,the remaining 9 patients underwent ankle reconstruction to reserve ankle.One case acquired infection,other 8 patients healed well,had different degree of recovery of the ankle function,the ankle function had recovery in different degree.AOFAS ankle-hindfoot score system:excellent in 4 cases,good in 4 cases,and poor in 1 case.Conclusion Ankle complex tissue

  17. Using the Carbon Isotope Ratios of Bison Tooth Enamel and Bone Collagen as a Quantitative Proxy for Reconstructing Grassland Vegetation and Paleotemperatures

    Science.gov (United States)

    Hoppe, K. A.; Paytan, A.; Chamberlain, P.

    2005-12-01

    The carbon isotope ratios of tissues from grazing herbivores reflect the average carbon isotope ratios of local grasslands, which vary with the abundance of cool-season (C-3) versus warm-season (C-4) grasses. Since the C-3/C-4 ratios of grasslands correlate with climate, the carbon isotope ratios of fossil grazers may serve as a proxy for reconstructing paleovegetation and paleoclimatic conditions. Analyses of fossil and subfossil bison hold particular promise for use as a proxy for paleoenvironmental conditions in North America because bison remains are abundant in Holocene and Pleistocene deposits across most of the continent. However, the accuracy and precision of paleoenvironmental reconstructions based on bison is currently uncertain because the relationship between bison isotope and the abundance of C-3 and C-4 grasses has not been precisely quantified across different environments. We have analyzed the carbon isotope ratios of tooth enamel carbonate and bone collagen from 88 modern free ranging bison ( Bison bison) from ten locations in the Central United States. The C-4 biomass at these locations ranged from less than 1 percent to 95 percent of the total grass biomass. The mean carbon isotope ratios of enamel for each population correlated well with the local abundance of C-4 grasses (R2 = 0.93, p = 0.0001) and with variations in mean annual temperatures (R2 = 0.83, p = 0.001). The mean carbon isotope ratios of collagen for each population also correlated well with the C-4 grass abundance (R2 = 0.97, p = 0.0001) and mean annual temperature (R2 = 0.84, p = 0.0002). Enamel and collagen display similar variability (mean standard deviation = 0.7 per mil), and the variability does not change with climate, habitat, or C-4 abundance. These results demonstrate that analyses of the carbon isotope ratios of fossil bison can be used as a quantitative proxy for reconstructing grassland C-3/C-4 ratios and paleotemperatures, and they will serve as a baseline for

  18. Reconstruction of a missed posterior locked shoulder fracture-dislocation with bone graft and lesser tuberosity transfer: a case report

    Directory of Open Access Journals (Sweden)

    Chalidis Byron E

    2008-08-01

    Full Text Available Abstract Introduction Posterior shoulder fracture-dislocation is a rare emergency condition with poor prognosis when there is a delay in diagnosis and presence of associated injuries. Case presentation We present a case of a neglected four-part fracture-dislocation of the proximal humerus in a 34-year-old Greek woman. Except from the substantially displaced and comminuted tuberosity fractures, an anterolateral defect of approximately 50% of the articular surface was apparent. Open reduction of the humeral head was followed by reconstruction of the proximal humerus with allograft impaction, transfer of lesser tuberosity to the humeral defect and anatomic fixation of the greater tuberosity and humeral neck fractures. At two and a half years postoperatively, the humeral head was revascularised and properly articulated with the glenoid fossa. Conclusion The presented case underlines the variability of injury pattern, the potential of missed diagnosis and the need for preserving the humeral head in young patients regardless of the amount of articular surface defect and disruption of soft tissue attachments.

  19. Implants composed of carbon fiber mesh and bone-marrow-derived, chondrocyte-enriched cultures for joint surface reconstruction.

    Science.gov (United States)

    Robinson, D; Efrat, M; Mendes, D G; Halperin, N; Nevo, Z

    1993-01-01

    The current study integrates two distinct approaches in joint resurfacing into a combined type of implant, composed of carbon fiber mesh impregnated and coated with a hyaluronic-acid-based delivery substance containing cultured cells. Rabbit autogeneic chondrocyte-enriched cultures obtained from mesenchymal stem cells (chondroprogenitor cells) derived from adult rabbit bone marrow were grown in vitro under conditions favoring chondrogenesis. The improvement in quality of repair when a combined implant containing both cells and a carbon scaffold was used, in comparison to the utilization of carbon fiber mesh alone, was clearly demonstrated using clinical, histological, biochemical, and biomechanical examinations. Evaluations of the joints were performed at 6 weeks and 6 months after implantation. The repair tissue in the cell-implanted joints consisted of a typical hyaline cartilage, which was more cellular and thicker than the repair tissue in the hyaluronic-acid-impregnated carbon-fiber-implanted control joints. The hyaline cartilage in the experimental group formed a superficial layer above the carbon fibers, flush with the joint surface. In the controls, in which carbon fiber and the delivery substance alone were implanted, a histologically and biochemically fibrous tissue that was inferior biomechanically to the new cartilage was formed by the cells containing implants.

  20. Alcohol-inactivated autograft replantation in reconstruction of bone defects in management of malignant bone tumors%酒精灭活瘤段骨在重建恶性骨肿瘤骨缺损中的应用

    Institute of Scientific and Technical Information of China (English)

    许宋锋; 刘江; 聂鑫; 于秀淳; 徐明; 王冰; 郑凯; 付志厚; 宋若先

    2015-01-01

    Objective To evaluate the clinical outcomes of alcohol-inactivated autograft replantation in reconstruction of bone defects in management of malignant bone tumors,and to analyze the related factors affecting the survival rate and functional results.Methods The clinical data of 53 patients with malignant bone tumors who were admitted and treated by alcohol-inactivated autograft replantation from January 1995 to June 2013 were retrospectively analyzed.The mean age was 17.7 years old (range: 9-49 years ).Twenty-three neoplasms were located in the distal femur,2 neoplasms in the middle femur,20 neoplasms in the proximal tibia,3 neoplasms in the distal tibia,3 neoplasms in the proximal humerus,1 neoplasm in the sacrum and 1 neoplasm in the ilium respectively.According to the Enneking system,48 patients were identiifed as stage Ⅱb and 5 patients as stage Ⅲ.Forty-four patients were diagnosed as osteosarcoma,6 patients as Ewing's sarcoma,1 patient as rhabdomyosarcoma,1 patient as chondrosarcoma,and 1 patient as non-Hodgkin's lymphoma.The postoperative results were evaluated according to the Musculoskeletal Tumor Society ( MSTS ) system and the International Society of Limb Salvage ( ISOLS ) graft evaluation method.A statistical analysis of the correlation among all the related factors,survival and postoperative function was conducted.Results The mean follow-up period was 55 months ( range: 13-216 months ).Thirty-nine patients were treated with wide resection and 14 patients with marginal resection.The average length of alcohol-inactivated autograft was 16.3 cm ( range: 5-26 cm ).The recurrence rate was 22.9%( 11/48 ) in stage Ⅱb group,and there were 9 cases of pulmonary metastases with the metastasis rate of 18.8%,6 death cases and 5 cases of survival with tumors.The recurrence rate was 15.9%( 7/44 ) in osteosarcoma group,and there were 6 cases of pulmonary metastases with the metastasis rate of 13.6%and 35 cases of survival during the follow-up of 3 years

  1. Low-dose rhBMP2/7 heterodimer to reconstruct peri-implant bone defects: a micro-CT evaluation

    NARCIS (Netherlands)

    Wang, J.; Zheng, Y.; Zhao, J.; Liu, T.; Gao, L.; Gu, Z.; Wu, G.

    2012-01-01

    Objectives To delineate the dynamic micro-architectures of bone induced by low-dose bone morphogenetic protein (BMP)-2/7 heterodimer in peri-implant bone defects compared to BMP2 and BMP7 homodimer. Material and Methods Peri-implant bone defects (8 mm in diameter, 4 mm in depth) were created surroun

  2. 髋臼周围恶性骨肿瘤的切除与重建%Resection and reconstruction for malignant bone tumors involving the acetabulum

    Institute of Scientific and Technical Information of China (English)

    邹昌业; 王晋; 黄纲; 尹军强; 谢显彪; 王永谦; 沈靖南

    2013-01-01

    Background:The location of the malignant tumors involving the acetabulum are comparatively deep, and they are usually very closed to some vital blood vessels, nerves and visceral organs, thus are very difficult to be resected. Methods to restore the continuity of pelvis and the function of acetabulum still need further improving. Objective: To investigate the methods and effects of the resection and reconstruction for malignant tumors involving the acetabulum. Methods:Retrospectively study 22 cases of resection and reconstruction for malignant bone tumors involving the acetabu-lum during January 2004 to December 2010. Analyze the survival of the patients, the recurrence and metastasis of the tu-mor, and the complications after the surgery, then evaluate the function of the patients via MSTS score system. Results:All the 22 patients were followed up for a mean period of 37.0 months (7.1 to 84.3 months). 15 patients gained a disease-free survival, 5 patients died of recurrence and metastasis of tumor, and 2 patients survived with the tumor. 7 pa-tients underwent local recurrence, which leads to a local recurrence rate of 31.82%. The mean interval from the operation to the local recurrence was 17.1 months (3 to 41.2 months). 4 patients had lung metastasis with an interval of 5.8 to 38.1 months after the operation, the mean interval was 16.6 months. The mean MSTS score detected six months after the opera-tion was 68.6%(32.5%-83.7%). Conclusions:Treat the malignant bone tumor involving the acetabulum with extensive resection and reconstruct the acetabu-lum with customized modular prostheses according to the degree of bone defects can achieve satisfactory curative effects and good function of the acetabulum .%  累及髋臼的恶性肿瘤由于位置较深,毗邻重要的血管神经和内脏器官,因而切除困难。切除后如何恢复骨盆连续性和髋臼功能的方法仍需完善。目的:探讨累及髋关节恶性肿瘤切除和重建的方法和

  3. Olecranon bone graft: revisited.

    Science.gov (United States)

    Mersa, Berkan; Ozcelik, Ismail Bulent; Kabakas, Fatih; Sacak, Bulent; Aydin, Atakan

    2010-09-01

    Autogenous bone grafts are frequently in use in the field of reconstructive upper extremity surgery. Cancellous bone grafts are applied to traumatic osseous defects, nonunions, defects after the resection of benign bone tumors, arthrodesis, and osteotomy procedures. Cancellous bone grafts do not only have benefits such as rapid revascularization, but they also have mechanical advantages. Despite the proximity to the primary surgical field, cancellous olecranon grafts have not gained the popularity they deserve in the field of reconstructive hand surgery. In this study, the properties, advantages, and technical details of harvesting cancellous olecranon grafts are discussed.

  4. Applied anatomy of ankle lateral ligament reconstruction with periostum-patellar tendon-bone autogenous graft%自体髌骨膜-髌韧带-骨瓣重建踝外侧韧带的应用解剖

    Institute of Scientific and Technical Information of China (English)

    孙强; 周捍东; 郑加法

    2011-01-01

    目的 为自体髌骨膜-髌韧带-骨瓣重建踝关节外侧韧带提供解剖学基础.方法 在6侧经防腐同定的成人下肢标本及6侧新鲜标本上观测踝关节外侧韧带起止点及走行径路、髌韧带的解剖形态与起止点,在新鲜标本上摹拟重建手术.结果 髌韧带位置恒定,解剖层次表浅,切取方便,髌骨膜-髌韧带一骨瓣的髌韧带长度(4.1±0.4)cm,距腓前韧带长度(2.4±0.5)cm,跟腓韧带长度(3.1±0.4)cm.结论 (1)髌骨膜-髌韧带-骨瓣的髌韧带具有足够的长度,可形成移植供体;(2)髌骨膜-髌韧带-骨瓣复合体两端分别与骨及软骨创面固定,容易成活和恢复功能;(3)采用自体髌骨膜-髌韧带-骨瓣重建踝外侧韧带具有可行性.%Objective To provide anatomic basis for free autogenous periostum- patellar tendon-bone grafts to reconstruct the lateral ankle ligament.Methods The anatomic properties of lateral ankle and patellar ligaments were observed and measured on 12 adult cadavers, and the reconstruction of the lateral ankle ligament were simulated on 6 fresh specimens.Results The constant locations of the patellar ligament were easy to be incised; The lengths of the patellar ligaments and the calacaneofibular and anterior talofibular ligaments were (41.0 ±4.0)mm, (24.3 ±4.6)mm and (31.3 ±4.2)mm, respectively.Conclusions The anatomic properties of periostum-patellar tendon-bone was similar to that of lateral ankle ligaments, There were periostum-patellar tendon-bone ligament tissue with enough length for the lateral ankle joint ligaments reconstruction.The grafted periostum- patellar tendon-bone easily can survive on recipient site.Autogenous periostum- patellar tendon-bone Grafts could to be used to reconstruct the lateral ankle joint ligaments.

  5. 关节镜下自体、异体骨-髌腱-骨与半腱肌腱3种重建后交叉韧带方法的比较%A comparative study on arthroscopic posterior cruciate ligament reconstruction using bone-patellar tendon-bone allograft, bone-patellar tendon-bone autograft and semitendinosus tendon autograft

    Institute of Scientific and Technical Information of China (English)

    郑小飞; 黄华扬; 张余; 李凭跃; 尹庆水

    2009-01-01

    现为胫骨隧道外口持续果酱样液体流出,经换药、激素或消炎痛治疗后痊愈.结论:关节镜下自体、异体骨-髌腱-骨与半腱肌腱移植重建后交叉韧带均取得满意的结果,并且疗效相似.%BACKGROUND: There are many methods for posterior cruciate ligament (PCL) reconstruction, which is involved in many graft materials, but few studies aim to compare the differences in outcomes of different grafts for PCL reconstruction. OBJECTIVE: To compare the clinical results of arthroscopic PLC reconstruction with bone-patellar tendon-bone (B-PT-B) autograft, B-TP-B allograft and semitendinosus tendon autograft. DESIGN, TIME AND SETTING: A retrospective case analysis was completed in the Department of Orthopedics, Guangzhou General Hospital of Guangzhou Area Military Command of Chinese PLA from January 2000 to September 2005. MATERIALS: Totally 76 patients underwent arthroscopic PLC reconstruction from January 2000 to September 2005, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. METHODS: A retrospective analysis was performed in 76 patients underwent arthroscopic PCL reconstruction, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. Postoperative body temperature was examined duration hospitalization. The follow-up parameters included International Knee Documentation Committee (IKDC) scores, Lysholm knee joint scores, and KT-1000 evaluation.MAIN OUTCOME MEASURES: ①Range of motion. ②joint stability: posterior draw test and KT-1000 test. ③overall function of knee: IKDC scores and Lysholm scores; ④complications and side effect. RESULTS: The time of follow-up visit was 26-79 months. Differences were no statistically significant among the IKDC scores, Lysholm scores, KT-1000 side-side difference, the positive rate of posterior draw test in three groups of patients with PCL

  6. Research on the Application of Bone Allograft Acetabular Bone Defect Reconstruction in Hip Revision%同种异体骨移植在髋关节翻修髋臼骨缺损重建中的应用研究

    Institute of Scientific and Technical Information of China (English)

    李强; 刘敏; 沈民仁; 钟进军

    2013-01-01

    目的:探讨同种异体骨移植在髋关节翻修髋臼骨缺损重建中的应用,评价同种异体骨在人工髋关节翻修术中的应用价值.方法:25例全髋关节翻修髋臼缺损病例,术中均应用同种异体松质骨重建髋臼骨缺损,随访时间8~24个月.结果:25例临床愈合,未发生并发症,有效率为100%.结论:同种异体松质骨治疗髋关节翻修髋臼骨缺损疗效可靠.达到了髋臼重建、修复骨缺损和固定假体的治疗目的.%Objective:To estimate the application value of allogeneic bone transplantation to reconstruct the defect of acetabulum in revision of total hip arthroplasty. Methods:In this study,retrospective analysis was conducted by using the data of 25 patients who had undergone the revision of total hip arthroplasty from December 2006 to March 2012. Bone defects of acetabulum in all of these cases were reconstructed using allogeneic bone transplantation. All patients had been followed from 8 to 24 months. Results: All these 25 cases were healed in clime without complications. The effective and excellent rate is 100%. Harris hip scores and imageological examination were used as healing standard. Conclusion: Reconstructing the defect of acetabulum with allogeneic bone is reliable in revision of total hip arthroplasty and could achieve the goal of rebuilding acetabulum, repairing bone defect and fixing prosthesis.

  7. Comparison of transtibial and transportal techniques in drilling femoral tunnels during anterior cruciate ligament reconstruction using 3D-CAD models

    Directory of Open Access Journals (Sweden)

    Tashiro Y

    2014-04-01

    Full Text Available Yasutaka Tashiro,1 Ken Okazaki,1 Munenori Uemura,2 Kazutaka Toyoda,2 Kanji Osaki,1 Hirokazu Matsubara,1 Makoto Hashizume,2 Yukihide Iwamoto1 1Department of Orthopaedic Surgery, 2Department of Advanced Medical Initiatives, Kyushu University Hospital, Fukuoka, Japan Purpose: The purpose of this study was to assess the differences in bone tunnel apertures between the trans-accessory medial portal (trans-AMP technique and the transtibial (TT technique in double-bundle anterior cruciate ligament reconstruction. The extent of ovalization and the frequency of overlap of the two tunnel apertures were compared. Methods: The simulation of femoral tunnel drilling with the TT and the trans-AMP techniques was performed using three-dimensional computer aided design models from two volunteers. The incidence angle of drilling against the intercondylar wall, the femoral tunnel position, the ovalization, and the overlap were analyzed. The aperture and location of the tunnels were also examined in real anterior cruciate ligament reconstruction cases (n=36. Results: The surgical simulation showed that a lower drill incident angle induced by the TT technique made the apertures of two tunnels more ovalized, located anteromedial tunnels in a shallower position to prevent posterior wall blow out, and led to a higher frequency of tunnel overlap. The trans-AMP group had tunnel places within the footprint and had less ovalization and overlap. The results of analysis for tunnels in the clinical cases were consistent with results from the surgical simulation. Conclusion: In the TT technique, the shallow anteromedial tunnel location and more ovalized tunnel aperture can lead to a higher frequency of tunnel overlap. Compared with the TT technique, the trans-AMP technique was more useful in preparing femoral tunnels anatomically and avoiding tunnel ovalization and overlapping in double-bundle anterior cruciate ligament reconstruction. Keywords: anterior cruciate ligament

  8. Analysis of reconstruction using non-vascularized iliac bone graft for patients with mandibular defects%非血管化髂骨移植重建下颌骨缺损的临床分析

    Institute of Scientific and Technical Information of China (English)

    谢富强; 孙健

    2012-01-01

    Objective To make a clinical retrospective analysis of reconstruction using autogenous non-vascularized iliac bone graft for patients with mandibular defects, and then to evaluate the treatment effectiveness and operation announcements of this method. Methods 34 patients who were suffered from discontinued mandibule because of tumor or trauma, were treated with autogenous non-vascularized iliac bone graft. The surgery technique, postoperative outcomes and complications were analyzed. Results In 34 patients adopted non-vascularized iliac bone graft, 31 patients adopted rigid internal fixation with titanium mini plate, 3 patients with bridging titanium plate. 27 bone grafts survived completely, the overall success rate was 79.41%. 3(8.82%) of the bone grafts healed after infection, 4(11.76%) bone grafts lost because of infection. Conclusion The autogenous non-vascularized iliac bone graft is one of the most important way for the reconstruction of mandibular defects. The methods of internal fixation includes titanium mini pate and bridging titanium plate.%目的 对非血管化髂骨移植重建下颌骨缺损的病例进行临床回顾性分析,探讨其治疗效果及手术注意事项.方法 选择因肿瘤和外伤致下颌骨缺损后行自体非血管化髂骨同期移植重建术修复的34例患者为研究对象,分析其手术方法、术后效果及并发症的发生情况.结果 采用游离非血管化髂骨同期移植重建下颌骨缺损的34例患者中,小钛板双排内固定31例,重建板内固定3例.34例患者中,成功病例27例(79.41%),良好病例3例(8.82%),失败病例4例(11.76%).失败原因均为感染而取出植入骨.结论 自体非血管化髂骨移植重建术是下颌骨缺损重建的重要方法之一,内固定的方式有小钛板和重建板.

  9. Advancement of the role of Toll-like receptors in bone reconstruction%Toll样受体在骨改建中的作用

    Institute of Scientific and Technical Information of China (English)

    孙晗; 侯旭; 于文雯; 齐佳; 刘继明; 娄译心; 孙新华

    2015-01-01

    As pattern recognition receptors, Toll-like receptor(TLR) plays an important role in the recognition of invasive pathogenic microorganism in early innate immunity. TLR also plays apivotal role in the innate immunity and adaptive immunity of higher vertebrates. Bone, which belongs to the dynamic organization, plays the role of shaping and maintaining form through continuous formation and absorption. Absorption and reconstruction rely on the combined action of the osteoblast and osteoclast. These cells received accommodation by various internal and external factors. A recent study found that TLR also plays an important role in regulating bone remodeling, primarily in the differentiation as well as the maturation and function of the osteoblast and osteoclast. The study can provide important information for seeking a better method of moving orthodontic tooth by clarifying the mechanism in which TLRs control bone reconstruction. This article reviewed the TLRs’ role in bone reconstruction.%Toll样受体(TLR)是一种模式识别受体,在早期固有免疫中对入侵病原微生物的识别发挥重要作用,并在高等脊椎动物的固有免疫和适应性免疫中起着枢纽作用。骨是一种动态性组织,它通过不断地形成和吸收以起到塑形的作用。这种吸收和重建依赖于成骨细胞和破骨细胞的共同作用,这些细胞同时受到多种内外因子的调节作用。近来研究发现,TLR对骨改建也具有重要的调控作用,主要是在成骨细胞及破骨细胞分化、成熟及其功能中发挥作用。阐明TLR调控骨改建的机制将为更有效的正畸牙移动方式提供重要信息,本文将对TLR在骨改建

  10. Mandibular Reconstruction, State of the Art

    Directory of Open Access Journals (Sweden)

    Julio ACERO

    2011-08-01

    Full Text Available SUMMARY: Mandibular bone loss can result in severe aesthetic and functional consequences for the patient, posing a challenge to the reconstructive maxillo-facial surgeon. Advent of microvascular surgery revolutionized mandible reconstruction introducing the possibility to transfer vascularized bone and soft tissues with high success rate. Major donor sites are the fibula, iliac crest and scapula. Planning of the reconstruction and advantages and disadvantages of the different reconstructive methods are discussed. The iliac crest provides an excellent bone for mandibular reconstruction but has some limits concerning length and versatility of soft tissues. The fibula permits the repair of large mandibular defects due to its length while the scapular osteocutaneous flap allows for the reconstruction of limited bone defects associated with large soft tissue defects. Nonvascularized reconstructive methods are associated with higher failure rates but can be considered in selected cases.

  11. One-stage arthroscopic reconstruction of both cruciate ligaments using Achilles tendon-bone allografts%关节镜下同种异体跟腱骨一期重建膝关节前后交叉韧带

    Institute of Scientific and Technical Information of China (English)

    史德海; 李东会; 刘斌; 金文涛; 蔡道章

    2009-01-01

    Objective To evaluate one-stage arthroscopic reconstruction of anterior crueiate ligament (ACL)and posterior cruciate ligament(PCL)using Achilles tendon-bone allografts. Methods From July 2000 to February 2005.we treated 15 patients(11 males and 4 females)whose ACL and PCL were ruptured at one knee but the eontralateral knee was intact.Their associated meniscus injuries were treated arthroscopically according to established procedures prior to ligament reconstruction.Thirty Achilles tendon-bone allografts were used to reconstruct torn ACL and PCL in 15 knees at one stage.Reconstruction of both ligaments was performed at subacute or chronic phase(>3 to 8 weeks)in 12 casses,and at acute phase in 3 cases(3周)重建12例,急性期(<3周)重建3例.手术前后采用IKDC和Lysholm评分系统对患膝关节功能进行评估,随访结果与对侧健康膝火节进行比较.结果 所有患者均获得36~40个月(平均38个月)随访.根据IKDC评分,术前所有患膝关节功能都严重异常,术后9例患膝功能改善为止常,5例接近正常,1例异常.Lysholm评分由术前平均(56±5)分改善为术后(90±4)分,差异有统汁学意义(t=15.660,P<0.05.结论同种异体跟腱骨可用于关节镜下重建膝关节前后交叉韧带,疗效满意.

  12. [Bone transplant].

    Science.gov (United States)

    San Julián, M; Valentí, A

    2006-01-01

    We describe the methodology of the Bone and Soft Tissue Bank, from extraction and storage until use. Since the year 1986, with the creation of the Bone Bank in the University Clinic of Navarra, more than 3,000 grafts have been used for very different types of surgery. Bone grafts can be classified into cortical and spongy; the former are principally used in surgery to save tumour patients, in large post-traumatic reconstructions and in replacement surgery where there are massive bone defects and a structural support is required. The spongy grafts are the most used due to their numerous indications; they are especially useful in filling cavities that require a significant quantity of graft when the autograft is insufficient, or as a complement. They are also of special help in treating fractures when there is bone loss and in the treatment of delays in consolidation and pseudoarthrosis in little vascularized and atrophic zones. They are also used in prosthetic surgery against the presence of cavity type defects. Allografts of soft tissues are specially recognised in multiple ligament injuries that require reconstructions. Nowadays, the most utilised are those employed in surgery of the anterior cruciate ligament although they can be used for filling any ligament or tendon defect. The principal difficulties of the cortical allografts are in the consolidation of the ends with the bone itself and in tumour surgery, given that these are patients immunodepressed by the treatment, the incidence of infection is increased with respect to spongy grafts and soft tissues, which is irrelevant. In short, the increasingly widespread use of allografts is an essential therapeutic weapon in orthopaedic surgery and traumatology. It must be used by expert hands.

  13. ''Black Bone'' MRI: a potential alternative to CT with three-dimensional reconstruction of the craniofacial skeleton in the diagnosis of craniosynostosis

    Energy Technology Data Exchange (ETDEWEB)

    Eley, Karen A. [University of Oxford, John Radcliffe Hospital, Nuffield Department of Surgical Sciences, Oxford (United Kingdom); University of Cambridge, Addenbrookes Hospital, Department of Radiology, Cambridge (United Kingdom); Watt-Smith, Stephen R. [University of Oxford, John Radcliffe Hospital, Nuffield Department of Surgical Sciences, Oxford (United Kingdom); University College London, Eastman Dental Institute, London (United Kingdom); Sheerin, Fintan [University of Oxford, John Radcliffe Hospital, Nuffield Department of Surgical Sciences, Oxford (United Kingdom); Oxford University Hospitals NHS Trust, Oxford (United Kingdom); Golding, Stephen J. [University of Oxford, John Radcliffe Hospital, Nuffield Department of Surgical Sciences, Oxford (United Kingdom)

    2014-10-15

    To determine the potential of novel gradient echo parameters, ''Black Bone'' MRI as an alternative to CT in the identification of normal and prematurely fused cranial sutures both in 2D and 3D imaging. Thirteen children with a clinical diagnosis of craniosynostosis underwent ''Black Bone'' MRI in addition to routine cranial CT. ''Black Bone'' datasets were compared to CT and clinical findings. ''Black Bone'' imaging was subsequently used to develop 3D reformats of the craniofacial skeleton to enhance further visualisation of the cranial sutures. Patent cranial sutures were consistently identified on ''Black Bone'' MRI as areas of increased signal intensity. In children with craniosynostosis the affected suture was absent, whilst the remaining patent sutures could be visualised, consistent with CT and clinical findings. Segmentation of the ''Black Bone'' MRI datasets was successful with both threshold and volume rendering techniques. The cranial sutures, where patent, could be visualised throughout their path. Patent cranial sutures appear as areas of increased signal intensity on ''Black Bone'' MRI distinct from the cranial bone, demonstrating considerable clinical potential as a non-ionising alternative to CT in the diagnosis of craniosynostosis. (orig.)

  14. Transport of airborne Picea schrenkiana pollen on the northern slope of Tianshan Mountains (Xinjiang, China) and its implication for paleoenvironmental reconstruction.

    Science.gov (United States)

    Pan, Yanfang; Yan, Shun; Behling, Hermann; Mu, Guijin

    2013-06-01

    The understanding of airborne pollen transportation is crucial for the reconstruction of the paleoenvironment. Under favorable conditions, a considerable amount of long-distance-transported pollen can be deposited far from its place of origin. In extreme arid regions, in most cases, such situations occur and increase the difficulty to interpret fossil pollen records. In this study, three sets of Cour airborne pollen trap were installed on the northern slope of Tianshan Mountains to collect airborne Picea schrenkiana (spruce) pollen grains from July 2001 to July 2006. The results indicate that Picea pollen disperses extensively and transports widely in the lower atmosphere far away from spruce forest. The airborne Picea pollen dispersal period is mainly concentrated between mid-May and July. In desert area, weekly Picea pollen began to increase and peaked suddenly in concentration. Also, annual pollen indices do not decline even when the distance increased was probably related to the strong wind may pick up the deposited pollen grains from the topsoil into the air stream, leading to an increase of pollen concentration in the air that is irrelevant to the normal and natural course of pollen transport and deposition. This, in turn, may lead to erroneous interpretations of the pollen data in the arid region. This study provided insight into the shift in the Picea pollen season regarding climate change in arid areas. It is recorded that the pollen pollination period starts earlier and the duration became longer. The results also showed that the temperature of May and June was positively correlated with the Picea pollen production. Furthermore, the transport of airborne Picea pollen data is useful for interpreting fossil pollen records from extreme arid regions.

  15. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor; Bone tumor - benign ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  16. Depth profile reconstructions of electronic transport properties in H{sup +} MeV-energy ion-implanted n-Si wafers using photocarrier radiometry

    Energy Technology Data Exchange (ETDEWEB)

    Tai, Rui; Wang, Chinhua, E-mail: chinhua.wang@suda.edu.cn; Hu, Jingpei [Institute of Modern Optical Technologies and Collaborative Innovation Center of Suzhou Nano Science and Technology, Jiangsu Key Lab of Advanced Optical Manufacturing Technologies and MOE Key Lab of Modern Optical Technologies, Soochow University, Suzhou 215006 (China); Mandelis, Andreas [Center for Advanced Diffusion-Wave Technologies, Department of Mechanical and Industrial Engineering, University of Toronto, Ontario M5S 3G8 (Canada)

    2014-07-21

    A depth profiling technique using photocarrier radiometry (PCR) is demonstrated and used for the reconstruction of continuously varying electronic transport properties (carrier lifetime and electronic diffusivity) in the interim region between the ion residence layer and the bulk crystalline layer in H{sup +} implanted semiconductor wafers with high implantation energies (∼MeV). This defect-rich region, which is normally assumed to be part of the homogeneous “substrate” in all existing two- and three-layer models, was sliced into many virtual thin layers along the depth direction so that the continuously and monotonically variable electronic properties across its thickness can be considered uniform within each virtual layer. The depth profile reconstruction of both carrier life time and diffusivity in H{sup +} implanted wafers with several implantation doses (3 × 10{sup 14}, 3 × 10{sup 15}, and 3 × 10{sup 16} cm{sup −2}) and different implantation energies (from 0.75 to 2.0 MeV) is presented. This all-optical PCR method provides a fast non-destructive way of characterizing sub-surface process-induced electronic defect profiles in devices under fabrication at any intermediate stage before final metallization and possibly lead to process correction and optimization well before electrical testing and defect diagnosis becomes possible.

  17. Three-dimensional reconstruction of Haversian systems in human cortical bone using synchrotron radiation-based micro-CT: morphology and quantification of branching and transverse connections across age.

    Science.gov (United States)

    Maggiano, Isabel S; Maggiano, Corey M; Clement, John G; Thomas, C David L; Carter, Yasmin; Cooper, David M L

    2016-05-01

    This study uses synchrotron radiation-based micro-computed tomography (CT) scans to reconstruct three-dimensional networks of Haversian systems in human cortical bone in order to observe and analyse interconnectivity of Haversian systems and the development of total Haversian networks across different ages. A better knowledge of how Haversian systems interact with each other is essential to improve understanding of remodeling mechanisms and bone maintenance; however, previous methodological approaches (e.g. serial sections) did not reveal enough detail to follow the specific morphology of Haversian branching, for example. Accordingly, the aim of the present study was to identify the morphological diversity of branching patterns and transverse connections, and to understand how they change with age. Two types of branching morphologies were identified: lateral branching, resulting in small osteon branches bifurcating off of larger Haversian canals; and dichotomous branching, the formation of two new osteonal branches from one. The reconstructions in this study also suggest that Haversian systems frequently target previously existing systems as a path for their course, resulting in a cross-sectional morphology frequently referred to as 'type II osteons'. Transverse connections were diverse in their course from linear to oblique to curvy. Quantitative assessment of age-related trends indicates that while in younger human individuals transverse connections were most common, in older individuals more evidence of connections resulting from Haversian systems growing inside previously existing systems was found. Despite these changes in morphological characteristics, a relatively constant degree of overall interconnectivity is maintained throughout life. Altogether, the present study reveals important details about Haversian systems and their relation to each other that can be used towards a better understanding of cortical bone remodeling as well as a more accurate

  18. Simultaneous treatment of tibial bone and soft-tissue defects with bone transport%外固定支架骨搬运技术一期治疗胫骨缺损合并软组织缺损

    Institute of Scientific and Technical Information of China (English)

    钟万润; 汪春阳; 韩培; 文根; 陆晟迪; 程鹏飞; 柴益民

    2014-01-01

    Objective To explore the curative efficacy of simultaneous treatment of tibial bone and soft-tissue defects with external fixator and bone transport.Methods From February 2006 to October 2012,7 patients with tibial bone and soft tissue defects were treated by bone transport at our department.They were 4 men and 3 women,with an average age of 31.8 years (from 16 to 52 years).All their fractures were Gustlio type Ⅲ B and 3 of them were complicated with infection.Their average Mangled Extremity Severity Score (MESS) was 4.8 points (from 4 to 6 points).Their average soft tissue loss after debridement was 30.4 cm2 (from 12 to 70 cm2),and their average bone defect was 9.2 cm long (from 4 to 17 cm).Distal tibial osteotomy for proximal migration to repair the bone defect was used in 4 cases of proximal tibial defect while proximal tibial osteotomy for distal migration was used in the other 3 cases of distal defect.The wounds were covered by vacuum sealing drainage (VSD) dressing or filled with povidone-iodine gauze.Results The average follow-up period was 19.3 months (from 9 to 36 months).Bone defects were repaired in all.Primary bone healing was achieved in 5 cases while bone grafting had to be performed in the other 2 cases to repair bone non-union after bone transport.The average healing index (healing time/defect length) was 1.8 month/cm.The wounds were healed in all the 7 cases,6 of which obtained primary healing and one of which healed after skin grafting.The average time for wound healing was 3.3 months (from 2.5 to 6.0 months).Footdrop was observed in 2 cases and pin track infection in one.Conclusion Simultaneous treatment of complex defects at lower extremity with external fixator and bone transport should be recommended,because it is simple and efficient.%目的 探讨应用外固定支架骨搬运技术一期修复胫骨缺损合并软组织缺损的可行性及疗效.方法 回顾性分析2006年2月至2012年10月收治的7例小腿开放性损伤合

  19. The use of transport and diffusion equations in the three-dimensional reconstruction of computerized tomographic images

    Energy Technology Data Exchange (ETDEWEB)

    Pires, Sandrerley Ramos, E-mail: sandrerley@eee.ufg.br [Escola de Engenharia Eletrica e de Computacao - EEEC, Universidade Federal de Goias - UFG, Goiania, GO (Brazil); Flores, Edna Lucia; Pires, Dulcineia Goncalves F.; Carrijo, Gilberto Arantes; Veiga, Antonio Claudio Paschoarelli [Faculdade de Engenharia Eletrica - FEELT, Universidade Federal de Uberlandia - UFU, Uberlandia, MG (Brazil); Barcelos, Celia Aparecida Z. [Faculdade de Matematica, Universidade Federal de Uberlandia - UFU, Uberlandia, MG (Brazil)

    2012-09-15

    The visualization of a computerized tomographic (TC) exam in 3D increases the quality of the medical diagnosis and, consequently, the success probability in the treatment. To obtain a high quality image it is necessary to obtain slices which are close to one another. Motivated towards the goal of reaching an improved balance between quantity of slices and visualization quality, this research work presents a digital inpainting technique of 3D interpolation for CT slices used in the visualization of human body structures. The inpainting is carried out via non-linear partial differential equations (PDE). The PDE's have been used, in the image-processing context to fill in the damaged regions in a digital 2D image. Inspired by this idea, this article proposes an interpolation method for the filling in of the empty regions between the CT slices. To do it, considering the high similarity between two consecutive real slice, the first step of the proposed method is to create the virtual slices. The virtual slices contain all similarity between the intercalated slices and, when there are not similarities between real slices, the virtual slices will contain indefinite portions. In the second step of the proposed method, the created virtual slices will be used together with the real slices images, in the reconstruction of the structure in three dimensions, mapped onto the exam. The proposed method is capable of reconstructing the curvatures of the patient's internal structures without using slices that are close to one another. The experiments carried out show the proposed method's efficiency. (author)

  20. Correlation between absence of bone remodeling compartment canopies, reversal phase arrest, and deficient bone formation in post-menopausal osteoporosis

    DEFF Research Database (Denmark)

    Levin Andersen, Thomas; Hauge, Ellen M; Rolighed, Lars;

    2014-01-01

    Bone remodeling compartments (BRCs) were recently recognized to be present in patients with primary hyperparathyroidism and critical for bone reconstruction in multiple myeloma and endogenous Cushing's syndrome. The BRCs are outlined by a cellular canopy separating the bone remodeling events...

  1. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 2: Bone graft, implant and reconstructive surgery.

    Science.gov (United States)

    Simonpieri, Alain; Del Corso, Marco; Vervelle, Alain; Jimbo, Ryo; Inchingolo, Francesco; Sammartino, Gilberto; Dohan Ehrenfest, David M

    2012-06-01

    Platelet concentrates for surgical use are innovative tools of regenerative medicine, and were widely tested in oral and maxillofacial surgery. Unfortunately, the literature on the topic is contradictory and the published data are difficult to sort and interpret. In bone graft, implant and reconstructive surgery, the literature is particularly dense about the use of the various forms of Platelet-Rich Plasma (PRP) - Pure Platelet-Rich Plasma (P-PRP) or Leukocyte- and Platelet-Rich Plasma (L-PRP) - but still limited about Platelet-Rich Fibrin (PRF) subfamilies. In this second article, we describe and discuss the current published knowledge about the use of PRP and PRF during implant placement (particularly as surface treatment for the stimulation of osseointegration), the treatment of peri-implant bone defects (after peri-implantitis, during implantation in an insufficient bone volume or during immediate post-extraction or post-avulsion implantation), the sinuslift procedures and various complex implant-supported treatments. Other potential applications of the platelet concentrates are also highlighted in maxillofacial reconstructive surgery, for the treatment of patients using bisphosphonates, anticoagulants or with post-tumoral irradiated maxilla. Finally, we particularly insist on the perspectives in this field, through the description and illustration of the use of L-PRF (Leukocyte- and Platelet-Rich Fibrin) clots and membranes during the regeneration of peri-implant bone defects, during the sinus-lift procedure and during complex implant-supported rehabilitations. The use of L-PRF allowed to define a new therapeutic concept called the Natural Bone Regeneration (NBR) for the reconstruction of the alveolar ridges at the gingival and bone levels. As it is illustrated in this article, the NBR principles allow to push away some technical limits of global implant-supported rehabilitations, particularly when combined with other powerful biotechnological tools

  2. Synthesis and characterization of biocements from fossilized calcareous shells: innovation in reconstruction and regeneration of bone tissue; Sintese e caracterizacao de um biocimento a partir de conchas calcarias fossilizadas: inovacao na reconstituicao e regeneracao de tecidos osseos

    Energy Technology Data Exchange (ETDEWEB)

    Silva, D.F.; Camargo, N.H.A.; Gemelli, E. [Universidade do Estado de Santa Catarina (CCT/UDESC), Joinville, SC (Brazil). Centro de Ciencias Tecnologicas. Programa de Pos-Graduacao em Ciencias e Engenharia de Materiais; Angioletto, E.; Bernardin, A.M., E-mail: by-daya@hotmail.com [Universidade do Extremo Sul Catarinense (UNESC), SC (Brazil)

    2011-07-01

    It is known that with the loss of a certain critical volume of bone, about one cm{sup 3}, the bone structure is unable to regenerate spontaneously, causing the need for better treatment for the patient. The present research aimed to use calcium carbonate (CaCO{sub 3}) from fossilized shells as raw material in the synthesis of microstructured biocement. Biocement compositions were elaborated in concentrations of 1, 0.75, 0.5 and 0.25 moles of H{sub 3}PO{sub 4}, mixed with 4% of Na{sub 2}PO{sub 4} and 1% of KH2PO4 respectively. The wet way synthesis method was used for the reaction / dissolution of CaCO{sub 3} formation of calcium phosphate by the addition of H{sub 3}PO{sub 4}. With the method of synthesis post microstructured calcium phosphate hydrate was obtained. A modification of the phases in the compositions, was found and it varied according to acid concentration. The biocements obtained from heat treatment at 1300 deg C/2h presented brushite phase, which are composed of fine crystals that favour their application in bone regeneration and reconstructions. (author)

  3. No negative effects of bone impaction grafting with bone and ceramic mixtures.

    NARCIS (Netherlands)

    Arts, J.J.C.; Gardeniers, J.W.M.; Welten, M.L.M.; Verdonschot, N.J.J.; Schreurs, B.W.; Buma, P.

    2005-01-01

    Reconstructing large loaded bone defects with ceramic bone graft extenders is tempting considering the expected future donor bone shortage. However, whether there are negative effects is unknown. Standardized large defects in the acetabulum of goats were created and subsequently reconstructed with m

  4. Note: simultaneous measurements of magnetization and electrical transport signal by a reconstructed superconducting quantum interference device magnetometer.

    Science.gov (United States)

    Wang, H L; Yu, X Z; Wang, S L; Chen, L; Zhao, J H

    2013-08-01

    We have developed a sample rod which makes the conventional superconducting quantum interference device magnetometer capable of performing magnetization and electrical transport measurements simultaneously. The sample holder attached to the end of a 140 cm long sample rod is a nonmagnetic drinking straw or a 1.5 mm wide silicon strip with small magnetic background signal. Ferromagnetic semiconductor (Ga,Mn)As films are used to test the new sample rod, and the results are in good agreement with previous report.

  5. Management of traumatic tibial diaphyseal bone defect by “induced-membrane technique”

    Directory of Open Access Journals (Sweden)

    Gaurav Gupta

    2016-01-01

    Full Text Available Background: Gap nonunion of long bones is a challenging problem, due to the limitation of conventional reconstructive techniques more so if associated with infection and soft tissue defect. Treatment options such as autograft with non-vascularized fibula and cancellous bone graft, vascularized bone graft, and bone transportation are highly demanding on the part of surgeons and hospital setups and have many drawbacks. This study aims to analyze the outcome of patients with wide diaphyseal bone gap treated with induced-membrane technique (Masquelet technique.Materials and Methods: This study included 9 patients (7 males and 2 females, all with tibial bone-gap. Eight of the 9 patients were infected and in 3 patients there was associated large soft tissue defect requiring flap cover. This technique is two-stage procedure. Stage I surgery included debridement, fracture stabilization, application of spacer between bone ends, and soft tissue reconstruction. Stage II surgery included removal of spacer with preservation of induced membrane formed at spacer surface and filling the bone-gap with morselized iliac crest bone-graft within the membrane sleeve. Average bone-gap of 5.2 cm was treated. The spacer was always found to be encapsulated by a thick glistening membrane which did not collapse after its removal. All patients were followed up for an average period of 21.5 months. Results: Serial Radiographs showed regular uptake of autograft and thus consolidation within themselves in the region of bone gap and also with host bone. Bone-union was documented in all patients and all patients are walking full weight-bearing without support. Conclusions: The study highlights that the technique provide effective and practical management for difficult gap nonunion. It does not require specialized equipment, investigations, and surgery. Thus, it provides a reasonable alternative to the developing infrastructures and is a reliable and reproducible technique.

  6. Sequestration of rhBMP-2 into self-assembled polyelectrolyte complexes promotes anatomic localization of new bone in a porcine model of spinal reconstructive surgery.

    Science.gov (United States)

    Abbah, Sunny-Akogwu; Lam, Wing Moon Raymond; Hu, Tao; Goh, James; Wong, Hee-Kit

    2014-06-01

    Efficient and therapeutically safe delivery of recombinant human bone morphogenetic protein 2 (rhBMP-2) continues to be a central issue in bone tissue engineering. Recent evidence indicates that layer-by-layer self-assembly of polyelectrolyte complexes (PECs) can be used to recreate synthetic matrix environments that would act as tuneable reservoirs for delicate biomolecules and cells. Although preliminary in vitro as well as small-animal in vivo studies support this premise, translation into clinically relevant bone defect volumes in larger animal models remains unreported. Here we explored the use of native heparin-based PEC, deposited on a hydrated alginate gel template, to load bioactive rhBMP-2 and to facilitate lumbar interbody spinal fusion in pigs. We observed that triple PEC deposits with the highest protein sequestration efficiency and immobilization capacity promoted higher volume of new bone formation when compared with single PEC with low sequestration efficiency and immobilization capacity. This also resulted in a significantly enhanced biomechanical stability of the fused spinal segment when compared with PEC carriers with relatively low protein sequestration and immobilization capacities (pcollagen sponge carriers. We conclude that this growth factor sequestration platform is effective in the healing of clinically relevant bone defect volume and could overcome some of the safety concerns and limitations currently associated with rhBMP-2 therapy such as excessive heterotopic ossification.

  7. 组织工程骨材料在运动性骨缺损修复中的评价%Evaluation of materials of bone tissue engineering in athletic bone defects reconstruction

    Institute of Scientific and Technical Information of China (English)

    李华

    2011-01-01

    目的:评价组织工程化人工骨材料的性能和应用,找合理的骨缺损修复材料.方法:以"组织工程,缺损,工骨,米材料" 为中文关键词;以"tissue engineering,bone defect,artificial bone,biological degradation"为英文关键词,用计算机检索1993-01/2009-10相关文章.纳入与有关组织工程相关的文章;排除重复研究或Meta分析类文章.以30篇文献为主,点进行了讨论组织工程纳米级人工骨材料的种类及其性能.结果:可生物降解并具有生物活性的组织工程人工骨材料可作为一种较理想的支架材料应用于骨缺损修复组织工程.修复效果相当或接近自体骨,源充足,无免疫排斥反应,避免取自体骨给患者带来的痛苦和并发症,影响运动员重返赛场,动员患者乐于接受.复合材料人工骨在解除运动员患者的后顾之忧的同时,带来巨大的社会效益.基于纳米羟基磷灰石复合重组人骨形态发生蛋白2制成的支架,但具有理想的生物相容性、生物降解性和较高的亲和性,且能提高了骨诱导活性,够促进新骨的形成.可生物降解并具有生物活性的组织工程人工骨材料在临床使用的初步情况表明,人体生物相容性良好,免疫排斥反应,合情况良好.结论:骨缺损是常见的运动损伤,直为运动损伤研究热点.组织工程化骨缺损修复的研究近年来发展迅速,运动损伤骨缺损修复带来了契机.组织工程复合材料可以发挥不同材料的优势,补单一材料的不足,一种比较理想的支架材料.%OBJECTIVE: To evaluate the disposition and application of tissue-engineered artificial bone materials, in order to find a reasonable repair material for bone defect.METHODS: Taking "tissue engineering, bone defect, artificial bone, nanomaterials" in Chinese, and "tissue engineering, bone defect, artificial bone, biological degradation" in English as search terms, the articles between January 1993 and October 2009were

  8. ACL reconstruction

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007208.htm ACL reconstruction To use the sharing features on this page, please enable JavaScript. ACL reconstruction is surgery to reconstruct the ligament in ...

  9. Posterior maxillary sandwich osteotomy combined with sinus grafting with bone morphogenetic protein-2 for alveolar reconstruction for dental implants: report of four cases.

    Science.gov (United States)

    Jensen, Ole T; Cottam, Jared

    2013-01-01

    Four patients underwent posterior sandwich osteotomy combined with sinus floor grafting using bone morphogenetic protein-2 and other grafting materials. The patients were treated over a period of 4 years. Two to four implants were placed in each site subsequently. Of the 12 implants placed, none failed. Alveolar crest bone levels appeared to be stable over time, with an average vertical gain of about 5 mm. Overall vertical gain, including the sinus graft, exceeded 13 mm in all patients. The procedure appears to hold promise for combined vertical alveolar defects and prominent pneumatization of the posterior maxilla.

  10. Reconstruction of irradiated mandible after segmental resection of osteoradionecrosis-a technique employing a microvascular latissimus dorsi flap and subsequent particulate iliac bone grafting

    DEFF Research Database (Denmark)

    Hillerup, Soren; Elberg, Jens Jorgen; Thorn, Jens Jorgen;

    2014-01-01

    The fibula osteocutaneous flap has revolutionized the options of mandibular segmental defect bridging in osteoradionecrosis (ORN). In selected cases, however, the fibula flap is not an option because of atherosclerosis or other features that compromise the vascularity of the lower leg and foot...... of uneventful graft healing with restitution of osseous continuity, mandibular height, symmetry and function, and avoidance of reconstruction plate fracture....

  11. Mandibular reconstruction: a histological and histomorphometric study on the use of autogenous scaffolds, particulate cortico-cancellous bone grafts and platelet rich plasma in goats.

    NARCIS (Netherlands)

    Fennis, J.P.M.; Stoelinga, P.J.W.; Jansen, J.A.

    2004-01-01

    Twenty-eight goats underwent a continuity resection of the mandibular angle. In all goats primary reconstruction was carried out using specially designed pre-shaped osteosynthesis plates and monocortical screws. The original cortical scaffold was used to bridge the defect, filled with an autogenous

  12. Pitfalls in comparing modern hair and fossil bone collagen C and N isotopic data to reconstruct ancient diets: a case study with cave bears (Ursus spelaeus).

    Science.gov (United States)

    Bocherens, Hervé; Grandal-d'Anglade, Aurora; Hobson, Keith A

    2014-01-01

    Stable isotope analyses provide one of the few means to evaluate diet of extinct taxa. However, interpreting isotope data from bone collagen of extinct animals based on isotopic patterns in different tissues of modern animal proxies is precarious. For example, three corrections are needed before making comparisons of recent hair and ancient bone collagen: calibration of carbon-13 variations in atmospheric CO2, different isotopic discrimination between diet-hair keratin and diet-bone collagen, and time averaging of bone collagen versus short-term record in hair keratin. Recently, Robu et al. [Isotopic evidence for dietary flexibility among European Late Pleistocene cave bears (Ursus spelaeus). Can J Zool. 2013;91:227-234] published an article comparing extant carbon (δ(13)C) and nitrogen (δ(15)N) stable isotopic data of European cave bear bone collagen with those of Yellowstone Park grizzly bear hair in order to test the prevailing assumption of a largely vegetarian diet among cave bears. The authors concluded that cave bears were carnivores. This work is unfortunately unfounded as the authors failed to consider the necessary corrections listed above. When these corrections are applied to the Romanian cave bears, these individuals can be then interpreted without involving consumption of high trophic-level food, and environmental changes are probably the reason for the unusual isotopic composition of these cave bears in comparison with other European cave bears, rather than a change of diet. We caution researchers to pay careful attention to these factors when interpreting feeding ecology of extinct fauna using stable isotope techniques.

  13. Motion-preserving wrist reconstruction using a microsurgical medial femur condylus bone graft and radio-scapho-lunate (RSL limited fusion after osteomyelitis following open distal radius fracture

    Directory of Open Access Journals (Sweden)

    Steinmann, Claudia

    2015-06-01

    Full Text Available This case presents the microsurgical management in the rare situation after sequestering osteomyelitis of the distal radius to achieve both bony stability and partially preserved wrist motion. A 38-year-old patient underwent after sequestrectomy microsurgical reconstruction using a medial femoral condyle as a prerequisite for simultaneous motion-preserving radio-scapho-lunate (RSL fusion. As a result, 11 months postoperatively, a good functional result was achieved with range of motion of 60° in extension/flexion and 40° in ulnar/radial deviation and grip strength of 12 kg correspondeding to 33% of the dominant contralateral side. Upper extremity usability as measured by Disability of Arm Shoulder and Hand (DASH questionnaire improved from preoperative 24 to after the reconstruction and enabled the patient to resume his work without pain.

  14. 35例自体髂骨同期修复重建下颌骨缺损回顾性分析%Contemporary reconstruction of mandibular defects with autogenons iliac bone graft: a retrospective report of 35 cases

    Institute of Scientific and Technical Information of China (English)

    王翔; 朱飞; 尚政军

    2013-01-01

    Objective:This study is to retrospectively evaluate the clinical data of patients with mandibular defects using autogenous iliac bone graft for contemporary mandibular reconstruction,and then to compare success rate of vascularized/non-vascularized iliac bone grafts for the reconstruction of segmental/partial mandible defect.Method:Patients who underwent immediate mandibular reconstruction at the Department of Oral and Maxillofacial Surgery,School and Hospital of Stomatology,Wuhan University,between January 2008 and December 2010 were reviewed.The evaluated contents included gender,age,pathologic disorder,site and size of mandibular defect and success rate of iliac bone grafts.Result:Clinical data of 35 patients were collected for analysis.There were 19 male and 16 female patients.The average age was 39 years.The reasons resulting in the mandibular defect were non-tumorous diseases in 4 (11.6 %) patients,benign neoplasms in 22 (62.7 %) and malignancies in 9 (25.7 %).The average length of vascularized and non-vascularized iliac bone grafts was (5.9±1.2)cm and (5.5±1.4)cm,respectively (P =0.407).The overall success rate of vascularized and non-vascularized iliac bone grafts was 100 % and 76.2 %,respectively (P <0.05).The success rate of non-vascularized iliac bone grafts used for segmental and partial mandible defect was 91.7 % and 55.6 %,respectively (P =0.055).The success rate of nonvascularized iliac bone grafts larger then 5.5 cm and less than 5.5 cm was 63.6 % and 91.7 %,respectively (P =0.311).Conclusion:Vascularized iliac bone graft is suitable for segmental and partial defects less than 9 cm in length of body of the mandible; Non-vascularized iliac graft remains a usable choice in mandibler reconstruction of partial defects less than 5.5cm in length.%目的:对同期行自体游离髂骨修复重建下颌骨缺损患者的临床资料进行回顾性分析,比较非血管化/血管化两种髂骨移植形式修复下颌骨部分或节段

  15. Comparative in vitro study of the proliferation and growth of ovine osteoblast-like cells on various alloplastic biomaterials manufactured for augmentation and reconstruction of tissue or bone defects.

    Science.gov (United States)

    Schmitt, Sandra C; Wiedmann-Al-Ahmad, Margit; Kuschnierz, Jens; Al-Ahmad, Ali; Huebner, Ute; Schmelzeisen, Rainer; Gutwald, Ralf

    2008-03-01

    In this in vitro study ovine osteoblast-like cells were cultured on seven different alloplastic biomaterials used for augmentation and for reconstruction of bone defects in dental and craniomaxillofacial surgery. The aim of this study was to examine the growth behaviour (viability, cell density and morphology) of ovine osteoblast-like cells on the investigated biomaterials to get knowledge which biomaterial is qualified to act as a cell carrier system in further in vivo experiments. The biomaterials were either synthetically manufactured or of natural origin. As synthetically manufactured biomaterials Ethisorb, MakroSorb, PalacosR, and PDS film were used. As biomaterials of natural origin BeriplastP, Bio-Oss and Titanmesh were investigated. The cell proliferation and cell colonization were analyzed by a proliferation assay and scanning electron microscopy. Osteoblast-like cells proliferated and attached on all biomaterials, except on Beriplast. On Ethisorb the highest cell proliferation rate was measured followed by PalacosR. Both biomaterials offer suitable growth and proliferation conditions for ovine osteoblast-like cells. The proliferation rates of Bio-Oss, MakroSorb, PDS-film and Titanmesh were low and SEM examinations of these materials showed less spread osteoblast-like cells. The results showed that ovine osteoblast-like cells appear to be sensitive to substrate composition and topography. This in vitro study provides the basis for further in vivo studies using the sheep model to examine the biocompatibility and the long-term interaction between the test material and tissue (bone regeneration).

  16. A new variant of scaphoid reconstruction: Treatment of scaphoid non-union with avascular bone interponate and high compression screw (Synthes

    Directory of Open Access Journals (Sweden)

    Eder, Christian

    2015-08-01

    Full Text Available Scaphoid fractures as frequently overseen injuries often result in scaphoid non-unions, that need to be treated to prevent carpal collapse and secondary cartilage damage. Vital bone tissue and compression of fracture and bone graft ends seem to be crucial in for ossification and final bone healing. In the present study we compare our results using a high compression screw (HCS Synthes to results in the literature using different kinds of internal fixation including compression screws of various types. We present 22 patients with scaphoid non-unions treated with a bone graft and a HCS Synthes. We evaluated our post-operative results. The Manchester-Modified Disability of the Shoulder, Arm and Hand–Score (M-Dash imposed with an average of 29.8 points (MD=29 / SD=9.46 / MIN=18 / MAX=48. None of the re-evaluated patients sorrowed for pain in rest. Five patients stated pain (ranging from 4 to 8 on numeric analogue scale after heavy burden (e.g. boxing, weight lifting.In exploring the range of motion of the operated hand we deliver the following results: dorsal extension: average 72.73° (MD=80° / SD=17.23° / MIN=30° / MAX=85°, flexion: average 73.64° (MD=80° / SD=8.97° / MIN=60° / MAX=80°, ulnar deviation: average 39.09°, (MD=40° / SD=2.02° / MIN=35° / MAX=40°, radial deviation: average 29.09°, (MD=30° / SD=3.01° / MIN=20° / MAX=30°. Additionally a performance testing was conducted: fist clenching sign: complete without pain in 100%, pinch grip: complete in 100%, moderate pain in n=1 (8.33%, opposition digitus manus I–V complete in 100%, moderate pain n=2 (16.67%. Three patients with persisting fracture gap had a scaphoid bone fractured in the proximal third; one patient even with a very small proximal fragment. One persisting non-union was localized in the middle third (period between injury and operation = . In conclusion, our patients showed better healing rates compared to results presented in the literature. Non

  17. Bone Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging ... the limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided ...

  18. 组合生物重建用于四肢骨肿瘤切除后骨缺损修复%The combinative biological reconstruction of bony defect following limb bone tumor resections

    Institute of Scientific and Technical Information of China (English)

    李靖; 王臻; 郭征; 陈国景; 石磊

    2016-01-01

    -bearing bone and vascularized fibular flap for the reconstruction of bony defects following tumor resection,guiding clinical practice.Methods From March 2007 to June 2013,we enrolled 63 patients who had combinative biological reconstruction after bone tumor resection (11 in humerus,22 in femur,21 in tibia,4 in calcaneus).There were 36 male and 27 female in this series.The average age at time of operation was 20 years,ranging from 9 to 48 years.The follow-up ranged from 16 to 102 months with average of 48 months.We investigated the X-ray and CT images for all patients and histological findings of two patients.Patients were assessed functionally with the Musculoskeletal Tumor Society 93 score.Results Three patients with local soft tissue recurrence and one patient with infection underwent amputation.The survival of construct was 93.6%.Bone union achieved in all cases with the average MSTS score of 92.8%.Bone union ranged from 11 to 28 months in allograft group and 9 to 14 months in devitalized tumor bearing bone group.Significant difference of bone union time was found between two groups (Z=-3.638,P=0.000).Viability of the fibular grafts was verified in 58 of 63 patients (92%).Three types of images were observed in complex.Osteopenia and spongy change in fibula were found in 51 patients (81%) with stable fixation of the complex.Five complexes with failed blood supply of fibula and stable fixation revealed no density change of fibula,small amount of callous formation and relative delayed union.In seven complexes (11%) with unstable complex due to patients' incompliance,fibula reacted with dense hypertrophy and microfracture.Fusion of grafts with amount of callus was obviously observed.Union at allograft-host bone junctions occurred by residual host bone-derived external callus and fibular-derived internal callus that bridged the junction and filled the gap between abutting cortices.Callus from fibular graft was mature than that from periosteum of residual host bone

  19. Effect of duration of exposure to RaCl{sub 2} and a radium apatite from freshwater mussels on intestinal transport and bone deposition of radium

    Energy Technology Data Exchange (ETDEWEB)

    Domel, R.U. [Australian Nuclear Science and Technology Organsiation, Lucas Heights, NSW (Australia). Environment Division; Beal, A.M. [University of New South Wales, NSW (Australia). Biological Science

    1997-10-01

    Natural leaching of uranium ore bodies can result in {sup 226}Ra pollution of adjacent waterways and consequent incorporation of radium into the food chain. Mining has the potential to augment this effect. In the Magela flood plain, Northern Territory, the freshwater mussel (Velesunio angasi) concentrates radium in its tissues as a phosphate compound. The availability of mussel radium for uptake and tissue incorporation was assessed relative to radium chloride using rats. The results were compared for jejunal transport (in situ in vivo, ligated segment using anaesthetised animals) and feed trial experiments. In addition, the influence of age and duration of dosage (hours in the case of the jejunal transport and weeks in the feed trial studies) were investigated. Mussel radium transport across the jejunum of adults and juveniles (<0.3%) was very small when compared to radium chloride (50% injected dose). The amount of mussel radium available for intestinal uptake in the feed trials was also low (<0.5%) but significant when compared to the uptake of radium chloride (< 1.5%). Incorporation of mussel radium into bone was less than that of radium chloride (p=0.0001) for both adults and juveniles. Extrapolation of the data from the animal model to humans suggests that eating these mussels carries with it only a low risk of exceeding the Annual Limit of Intake (ALI) set for members of the public, even in juveniles 18 refs., 5 figs.

  20. Reconstruction of compound tibial and soft tissue loss using a traction histogenesis technique.

    Science.gov (United States)

    Lenoble, E; Lewertowski, J M; Goutallier, D

    1995-08-01

    We used simultaneous bone and soft tissue transport for reconstruction of large compound tissue loss in the lower leg. We report the results and complications of a 12-patient series. The average age of the patients was 31.2 years (range 20 to 48 years). Seven patients had grade IIIB open tibial fractures, three had complications after grade II or IIIA, and two had an en-bloc resection of bone, muscle, and skin for a malignant bone tumor. Arteriography was routinely performed, and demonstrated at least one patent tibial artery. Every patient had normal sensibility of the sole. The first stage of the reconstruction was an aggressive excision of the all necrotic skin, muscle, and bone. The Ilizarov external fixator was applied and wires were secured under a tension of 100 kg, using a dynamometric tensioner. Cutaneous tissue loss was not replaced in 10 patients, when the bone was not exposed. A medial gastrocnemius flap was performed in two patients and lengthened with the bone. Corticotomy was performed 15 days after the first stage with careful respect for the periosteum. Distraction was initiated 15 days after the corticotomy. The average bone defect was 12.5 cm after initial excision. An average of 9 operative procedures and 18 months of treatment were required before bony union. The mean duration of bone transport was 6.5 months, and the mean duration of external fixation was 12 months. The final functional results were fair and only two patients returned to work. One patient had a below-knee amputation after 10 months of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Clinical application of canal wall reconstruction with homograft cortical bone plate in canal wall down tympanoplasty%自体皮质骨外耳道重建在开放式鼓室成形术中的应用

    Institute of Scientific and Technical Information of China (English)

    马喆; 习国平; 张社江; 蔡爱军; 郝艳芳; 梁宝莲

    2012-01-01

    目的 对开放式鼓室成形术中利用自体皮质骨行外耳道重建的方法及疗效进行评价.方法 将接受手术治疗的胆脂瘤型中耳炎患者49例(49耳)分为两组.实验组,行开放式鼓室成形术+自体皮质骨外耳道重建术25例(耳);对照组,行常规开放式鼓室成形术+耳甲腔成形术24例(耳).术后随访6 ~ 36个月,观察两组患者术后听力结果、干耳率情况.结果 以术后语言频率气骨导差缩小>15 dB或气导听阈<40 dB为有效标准,实验组有效率68% (17/25),对照组有效率62.5% (15/24),组间比较无统计学意义(x2=0.1635,P>0.05).实验组干耳率为92.5%(23/25),明显高于对照组58.33%(14/24),差异有统计学意义(x2=4.363 6,P <0.05).实验组重建后的外耳道结构正常,无闭锁或狭窄情况发生.中耳乳突腔均接近正常.全部病例均无胆脂瘤复发.结论 开放式鼓室成形术加自体皮质骨外耳道重建术,能有效清除中耳病灶组织、恢复外耳道和中耳的结构,术后听力结果满意,干耳率高,是较为理想的手术方式.%Objective To evaluate the therapy of canal wall down tympanoplasty and canal reconstruction with homo-graft cortical bone plate. Methods Retrospective case review. 49 patients were divided into 2 groups. The experimental group that included 25 ears underwent canal wall down tympanoplasty and canal reconstruction with homograft cortical bone plate, while the control group that included 24 ears underwent regular canal wall down tympanoplasty with canal reconstruction. Follow up lasted 6-36 months and postoperative hearing and dry ear rate were evaluated. Results The criteria for success were defined as AB gap closure over 15 dB HL or air conduction threshold less than 40 dB HL (using the mean of 0. 5-, 1-, and 2-KHz threshold values). The experimental group's effective rate was 68% (17/25) and the control group's was 62. 5% (15/24). No significant difference was found between the

  2. Clinical study of bone tunnel expansion in anterior cruciate ligament reconstruction%前交叉韧带重建术后骨道增宽的临床研究

    Institute of Scientific and Technical Information of China (English)

    王成; 敖英芳

    2008-01-01

    Objectives To mesasure the size and change of bone tunnel in arthroscopic assisted anterior cruciate ligament(ACL)reconstruction with hamstring tendon autograft by X-ray,and evaluate the incidence,extent,shape and reasons of the bone tunnel expansion and analyze the relationship between bone tunnel expansion and clinical results.Methods Fifty-one cases of arthroscopie ACL reconstruction with hamstring tendon autograft were performed,and they were followed up at average of 16 months postoperatively.The diameter,shape,position and angle of femoral and tibial bone tunnel were measured using X-ray,and other clinical information had been collected including gender,age,method of tibial fixation.range of motion,KT 2000 and evaluation of muscle strength and so on.All data were entered into the computerized relational database to analyze and compare using the chisquare test and correlation analysis.Results The incidence of tunnel expasion after ACL reconstruction was 85%-94%in femoral tunnel and 65%in tibial tunnel.The extent of tunnel expansion was 51%-53%in femoral tunnel and 40%-44%in tibial tunnel.The most common shape of tibial tunnel was type O in the A-P X-ray view and type V in the lateral X-ray view.Femoral tunnels anterior to the expected ones were more likely to enlarge.Tibial tunnels anterior to the expected ones were easier to expand.An acute tibial or femoral tunnel angle could result in the femoral tunnel expansion.Conclusions The incidence and extent of bone tunnel expansion in arthroscopic ACL reconstruction with hamstring tendon autograft are more significant in femoral tunnel than in tibial tunnel.Bone tunnel expansion is correlated to patients'age,height,BMI and location of the tunnel.The main factors related to bone tunnel expansion are the location and angle of the tunnel.%目的 分析前交叉韧带(ACL)重建术后骨道增宽的发生率、增宽程度、骨道形状、相关因素及其与临床效果的关系.方法 回顾性研究应用胭绳

  3. Bone Densitometry (Bone Density Scan)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Densitometry (DEXA) Bone densitometry, also called dual-energy ... limitations of DEXA Bone Densitometry? What is a Bone Density Scan (DEXA)? Bone density scanning, also called ...

  4. Dietary reconstruction of the individuals interred in the Bronze Age burial cist of Ondarre (Aralar, Guipuzcoa through carbon and nitrogen stable isotope analysis on bone collagen

    Directory of Open Access Journals (Sweden)

    Teresa Fernández-Crespo

    2017-01-01

    Full Text Available The results of carbon and nitrogen stable isotope analysis on bone collagen of the individuals interred in the Bronze Age (II millennium cal. BC cist burial of Ondarre suggest a mixed diet based on C3 plants and mainly domesticated terrestrial animals. As observed in other contemporary sites in Iberia and the Balearic islands, marine and freshwater resources and C4 plants do not seem to have played an important role in everyday life subsistence. The observed high protein consumption may relate to the status of the people interred and/or to a dominant livestock economy where animal products would have a great importance in diet.

  5. Some Physical, Chemical, and Biological Parameters of Samples of Scleractinium Coral Aquaculture Skeleton Used for Reconstruction/Engineering of the Bone Tissue.

    Science.gov (United States)

    Popov, A A; Sergeeva, N S; Britaev, T A; Komlev, V S; Sviridova, I K; Kirsanova, V A; Akhmedova, S A; Dgebuadze, P Yu; Teterina, A Yu; Kuvshinova, E A; Schanskii, Ya D

    2015-08-01

    Physical and chemical (phase and chemical composition, dynamics of resorption, and strength properties), and biological (cytological compatibility and scaffold properties of the surface) properties of samples of scleractinium coral skeletons from aquacultures of three types and corresponding samples of natural coral skeletons (Pocillopora verrucosa, Acropora formosa, and Acropora nobilis) were studied. Samples of scleractinium coral aquaculture skeleton of A. nobilis, A. formosa, and P. verrucosa met the requirements (all study parameters) to materials for osteoplasty and 3D-scaffolds for engineering of bone tissue.

  6. Glutamate signalling in bone.

    Directory of Open Access Journals (Sweden)

    Karen eBrakspear

    2012-08-01

    Full Text Available Mechanical loading plays a key role in the physiology of bone, allowing bone to functionally adapt to its environment, however characterisation of the signalling events linking load to bone formation is incomplete. A screen for genes associated with mechanical load-induced bone formation identified the glutamate transporter GLAST, implicating the excitatory amino acid, glutamate, in the mechanoresponse. When an osteogenic load (10N, 10Hz was externally applied to the rat ulna, GLAST (EAAT1 mRNA, was significantly down-regulated in osteocytes in the loaded limb. Functional components from each stage of the glutamate signalling pathway have since been identified within bone, including proteins necessary for calcium-mediated glutamate exocytosis, receptors, transporters and signal propagation. Activation of ionotropic glutamate receptors has been shown to regulate the phenotype of osteoblasts and osteoclasts in vitro and bone mass in vivo. Furthermore, glutamatergic nerves have been identified in the vicinity of bone cells expressing glutamate receptors in vivo. However, it is not yet known how a glutamate signalling event is initiated in bone or its physiological significance. This review will examine the role of the glutamate signalling pathway in bone, with emphasis on the functions of glutamate transporters in osteoblasts.

  7. Bone printing: new frontiers in the treatment of bone defects.

    Science.gov (United States)

    Arealis, Georgios; Nikolaou, Vasileios S

    2015-12-01

    Bone defects can be congenital or acquired resulting from trauma, infection, neoplasm and failed arthroplasty. The osseous reconstruction of these defects is challenging. Unfortunately, none of the current techniques for the repair of bone defects has proven to be fully satisfactory. Bone tissue engineering (BTE) is the field of regenerative medicine (RM) that focuses on alternative treatment options for bone defects that will ideally address all the issues of the traditional techniques in treating large bone defects. However, current techniques of BTE is laborious and have their own shortcomings. More recently, 2D and 3D bone printing has been introduced to overcome most of the limitations of bone grafts and BTE. So far, results are extremely promising, setting new frontiers in the management of bone defects.

  8. Virtual Temporal Bone Anatomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Background The Visible Human Project(VHP) initiated by the U.S. National Library of Medicine has drawn much attention and interests from around the world. The Visible Chinese Human (VCH) project has started in China. The current study aims at acquiring a feasible virtual methodology for reconstructing the temporal bone of the Chinese population, which may provide an accurate 3-D model of important temporal bone structures that can be used in teaching and patient care for medical scientists and clinicians. Methods A series of sectional images of the temporal bone were generated from section slices of a female cadaver head. On each sectional image, SOIs (structures of interest) were segmented by carefully defining their contours and filling their areas with certain gray scale values. The processed volume data were then inducted into the 3D Slicer software(developed by the Surgical Planning Lab at Brigham and Women's Hospital and the MIT AI Lab) for resegmentation and generation of a set of tagged images of the SOIs. 3D surface models of SOIs were then reconstructed from these images. Results The temporal bone and structures in the temporal bone, including the tympanic cavity, mastoid cells, sigmoid sinus and internal carotid artery, were successfully reconstructed. The orientation of and spatial relationship among these structures were easily visualized in the reconstructed surface models. Conclusion The 3D Slicer software can be used for 3-dimensional visualization of anatomic structures in the temporal bone, which will greatly facilitate the advance of knowledge and techniques critical for studying and treating disorders involving the temporal bone.

  9. 脊柱定量CT重建参数对骨密度测量的影响%The Effect Reconstruction Parameters of Spine QCT on Bone Mineral Density

    Institute of Scientific and Technical Information of China (English)

    王予生; 过哲; 赵海竹; 王策; 张磊; 赵英威; 于爱红; 程晓光

    2011-01-01

    Purpose To optimize the scan protocol for accurate quantitative computed tomography (QCT) bone mineral density (BMD) measurements with low radiation dose. Material and Methods European Spine Phantom (ESP) and QCT calibration Phantom (Image Analysis,Inc,US,Q2208) were scanned with a Toshiba 16-sclice CT scanner. Tube voltage and tube current were 120KV and 50mA to 350mA. Slice thickness was 1 x 16mm with table height of 73cm. Scan range was 10cm. FOV was 40cm. Reconstruction matrix was 512 X 512 and reconstruction interval was 0.8cm. Dose length product (DLP) was recorded. Images of ESP were reconstructed using standard algorithm (FC 03) and bone algorithm (FC 30). Reconstructed data were transferred to BMD workstation. BMD was measured using QCT PRO· 3D spine BMD application module (version 4.0,mindways software Inc). Statistical analysis was performed using SPSS 15.0. Results The correlation coefficient of BMD with mAs of FC03 and FC 30 were 0.401 (P 0.05),respectively. The correlation coefficient of mAs with DLP is 0.999 (P < 0.01). The difference of BMD between FC03 and FC30 was statistically significant (t=-13.089,P< 0.01). There were statistically significant differences between the BMD of FC 03 and standard value of ESP (t= -19.220,P < 0.0i). The BMD of FC 30 and standard value of ESP were not statistically different (t=0.506,P =0.616). Conclusion Reconstruction parameters of QCT affect the measured value of BMD. Images reconstructed using bone algorithm (FC 30) exclude interfering factors and increase the accuracy of the BMD measurement. Reconstruction parameters should be taken into account when the scan protocols were formulated.%目的 优化CT扫描协议,使定量CT (QCT)骨密度(BMD)测量值更精确,辐射剂量更低.材料与方法 采用欧洲脊柱体模(ESP)与QCT校准体模一起进行不同毫安秒的CT螺旋扫描.扫描参数:管电压120kV,管电流50~350mA,层厚1×16mm,床高73cm,扫描范围10cm,视野(FOV)40c,重建矩阵:512×512

  10. [Joint reconstruction with autologous bone cylinder and locked intramedullary nail: proximal humeral shaft fracture with ipsilateral reverse Hill-Sachs lesion].

    Science.gov (United States)

    Osterhoff, G; Hepp, P; Engel, T; Josten, C

    2009-03-01

    The case of a 51-year-old patient is presented, with a humeral shaft fracture in combination with an ipsilateral reverse Hill-Sachs lesion, presumably after posterior shoulder dislocation as a result of an electrical accident followed by a fall from a ladder. After corresponding diagnostics, osteosynthesis of the shaft fracture was performed with a locked antegrade intramedullary nail. Simultaneously the reverse Hill-Sachs lesion was elevated und supplemented with the bone core that accrues during drilling of the nail entrance. In the follow-up period good fragment alignment, persistent joint stability and freedom of pain could be observed. On the basis of this case and the current literature the injury mechanism and potential therapy alternatives are discussed.

  11. Bones of the Earth

    Science.gov (United States)

    Correa, Jose Miguel

    2014-01-01

    The film "Bones of the Earth" (Riglin, Cunninham & Correa, 2014) is an experience in collective inquiry and visual creation based on arts-based research. Starting from the meeting of different subjectivities and through dialogue, planning, shooting and editing, an audiovisual text that reconstructs a reflexive process of collective…

  12. The BoneXpert method for automated determination of skeletal maturity

    DEFF Research Database (Denmark)

    Thodberg, Hans Henrik; Kreiborg, Sven; Juul, Anders

    2009-01-01

    Bone age rating is associated with a considerable variability from the human interpretation, and this is the motivation for presenting a new method for automated determination of bone age (skeletal maturity). The method, called BoneXpert, reconstructs, from radiographs of the hand, the borders...... of 15 bones automatically and then computes "intrinsic" bone ages for each of 13 bones (radius, ulna, and 11 short bones). Finally, it transforms the intrinsic bone ages into Greulich Pyle (GP) or Tanner Whitehouse (TW) bone age. The bone reconstruction method automatically rejects images with abnormal...

  13. Investigation of amino acid δ 13C signatures in bone collagen to reconstruct human palaeodiets using liquid chromatography-isotope ratio mass spectrometry

    Science.gov (United States)

    Choy, Kyungcheol; Smith, Colin I.; Fuller, Benjamin T.; Richards, Michael P.

    2010-11-01

    This research presents the individual amino acid δ 13C values in bone collagen of humans ( n = 9) and animals ( n = 27) from two prehistoric shell midden sites in Korea. We obtained complete baseline separation of 16 of the 18 amino acids found in bone collagen by using liquid chromatography-isotope ratio mass spectrometry (LC-IRMS). The isotopic results reveal that the humans and animals in the two sites had similar patterns in essential amino acids (EAAs) and non-essential amino acids (NEAAs). The EAA and NEAA δ 13C values in humans are intermediate between those in marine and terrestrial animals. However, the threonine δ 13C values in humans and animals measured in this study are more highly enriched than those of other amino acids. At both sites, all amino acids in marine animals are 13C-enriched relative to those of the terrestrial animals. The isotopic evidence suggests that the Tongsamdong human had EAAs and NEAAs from marine food resources, while the Nukdo humans mainly had EAAs from terrestrial food resources but obtained NEAAs from both terrestrial and marine resources. The δ 13C isotopic differences in amino acids between marine and terrestrial animals were the largest for glycine (NEAA) and histidine (EAA) and the smallest for tyrosine (NEAA) and phenylalanine (EAA). In addition, threonine among the EAAs also had a large difference (˜8‰) in δ 13C values between marine and terrestrial animals, and has the potential to be used as an isotopic marker in palaeodietary studies. Threonine δ 13C values were used in conjunction with the established Δ 13C Glycine-phenylalanine values and produced three distinct dietary groups (terrestrial, omnivorous, and marine). In addition, threonine δ 13C values and Δ 13C Serine-phenylalanine values were discovered to separate between two dietary groups (terrestrial vs. marine), and these δ 13C values may provide a potential new indicator for investigating the distinction between marine and terrestrial protein

  14. Supporting screws combined with bone cement filling for reconstructing tibial bone defect in knee arthroplasty%支撑螺钉结合骨水泥填充重建膝关节置换术中胫骨平台骨缺损

    Institute of Scientific and Technical Information of China (English)

    黄海; 张喜才

    2014-01-01

    Objective To observe the clinical effect of supporting screws combined with bone cement filling on reconstructing tibial bone defect in knee arthroplasty.Methods Thirty-one patients (47 lateral tibial plateau structural bone defect) underwent total knee replacement.After conventional tibial osteotomy,2 or 3 pieces of supporting screws were screwed according to bone defect area,and bone cement was pressurely filled,and then the tibial prosthesis was installed.The knee rehabilitation training was strengthened and the effect was regular followed up after the operation.Results Thirty-one patients were followed up for 1-5 years,average 2.8 years.The pain of the knee completely disappeared after operation,and the stability and function of the knee were good.The KSS knee score were 87 to 95 points,an average of 92.4 points,which were significantly improved after operation (t =6.41,P < 0.01).In the last follow-up through X-ray examination,there were no prosthesis loosening or signs of infection,no bone cement filling zone interface lucency or supporting screw loosening,displacement or other complications.Conclusions Supporting screws combined with bone cement filling technique can effectively resolve the tibial knee replacement of large bone defects,and the short-term curative effect is satisfactory.So it is one of the ideal methods for senile patients.%目的 观察支撑螺钉结合骨水泥填充重建膝关节置换术中胫骨平台骨缺损的临床疗效.方法 对31例47侧重度胫骨平台结构性骨缺损患者行全膝关节置换术,常规胫骨平台截骨,截骨后根据骨缺损面积,拧入2~3枚支撑螺钉,加压填充骨水泥,安置胫骨骨水泥假体.术后加强膝关节功能康复训练并定期随访疗效.结果 31例患者术后随访1~5年,平均2.8年,术后疼痛完全消失,膝关节稳定性及功能均良好.膝关节KSS评分87~95分,平均92.4分,较术前显著改善(t=6.41,P<0.01).术后末次随访复查X线片未见

  15. [Potentials of 3D-modeling in reconstructive orbital surgery].

    Science.gov (United States)

    Butsan, S B; Khokhlachev, S B; Ĭigitaliev, Sh N; Zaiakin, Ia A

    2012-01-01

    A technique of bone reconstructive surgery of orbitofrontonasomalar region using 3D-modeling based on multispiral computer tomography data is presented. The efficacy of intraoperative templates created using 3D-modeling was showed for harvesting and modeling of bone calvarial autografts. The steps of reconstructive procedure are explained in details for repair of medial and inferior orbital fractures.

  16. 肿瘤型假体应用与骨巨细胞瘤治疗后的骨缺损重建%Application of tumor-type prosthesis and reconstruction of bone defects following treatment of giant cell tumor of bone

    Institute of Scientific and Technical Information of China (English)

    刘威; 张绍昆; 闫明; 牛丰

    2011-01-01

    reconstruction work was operated based on the diverse situations of damages of bone caused by surgery. It can be seen that choosing tumor-type prosthesis to cure the giant cell tumor of bone is a better approach, according to the comparision of various bone reconstruction ways. It can not only enable the patients to acquire the instant stability of affected limbs or spines, also has less complication.Compared to other reconstruction ways, it apparently lowers rate of after-surgical recu rrence, and makes the tumor be removed extensively. However, the application of tumor-type prosthesis does not implicate the disappearence of the recurrence of after-surgical tumor. Recently, the research of signal path from giant cell tumor of bone has made progress, providing a new therapy for lowering the rate of after-surgical recurrence and inoperable patients, which maybe increase the outcome of the therapy.

  17. Bone within a bone

    Energy Technology Data Exchange (ETDEWEB)

    Williams, H.J.; Davies, A.M. E-mail: wendy.turner@roh.nhs.uk; Chapman, S

    2004-02-01

    The 'bone within a bone' appearance is a well-recognized radiological term with a variety of causes. It is important to recognize this appearance and also to be aware of the differential diagnosis. A number of common conditions infrequently cause this appearance. Other causes are rare and some remain primarily of historical interest, as they are no longer encountered in clinical practice. In this review we illustrate some of the conditions that can give the bone within a bone appearance and discuss the physiological and pathological aetiology of each where known.

  18. Canal Wall Reconstruction Mastoidectomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To investigate the advantages of canal wall reconstruction (CWR) mastoidectomy, a single-stage technique for cholesteatoma removal and posterior external canal wall reconstruction, over the open and closed procedures in terms of cholesteatoma recurrence. Methods: Between June 2002 and December 2005, 38 patients (40 ears) with cholesteatoma were admited to Sun Yat-Sen Memorial Hospital and received surgical treatments. Of these patients, 25 were male with ages ranging between 11 and 60 years (mean = 31.6 years) and 13 were female with ages ranging between 20 and 65 years (mean = 38.8 years). Canal wall reconstruction (CWR)mastoidectomy was performed in 31 ears and canal wall down (CWD) mastoidectomy in 9 ears. Concha cartilage was used for ear canal wall reconstruction in 22 of the 31 CWR procedures and cortical mastoid bone was used in the remaining 9 cases. Results At 0.5 to 4 years follow up, all but one patients remained free of signs of cholesteatoma recurrence, i.e., no retraction pocket or cholesteatoma matrix. One patient, a smoker, needed revision surgery due to cholesteatoma recurrence 1.5 year after the initial operation. The recurrence rate was therefore 3.2% (1/31). Cholesteatoma recurrence was monitored using postoperative CT scans whenever possible. In the case that needed a revision procedure, a retraction pocket was identified by otoendoscopy in the pars flacida area that eventually evolved into a cholesteatoma. A pocket extending to the epitympanum filled with cholesteatoma matrix was confirmed during the revision operation, A decision to perform a modified mastoidectomy was made as the patient refused to quit smoking. The mean air-bone gap in pure tone threshold was 45 dB before surgery and 25 dB after (p < 0.05). There was no difference between using concha cartilage and cortical mastoid bone for the reconstruction regarding air-bone gap improvement, CT findings and otoendoscopic results. Conclusion CWR mastoidectomy can be used for

  19. Synthesis of CAD/CAM, robotics and biomaterial implant fabrication: single-step reconstruction in computer-aided frontotemporal bone resection.

    Science.gov (United States)

    Weihe, S; Wehmöller, M; Schliephake, H; Hassfeld, S; Tschakaloff, A; Raczkowsky, J; Eufinger, H

    2000-10-01

    The preoperative manufacturing of individual skull implants, developed by an interdisciplinary research group at Ruhr-University Bochum, is based on the use of titanium as the most common material for implants at present. Using the existing technology for materials that can be milled or moulded, customized implants may be manufactured as well. The goal of the study was to examine biodegradable materials and to evaluate the practicability of intraoperative instrument navigation and robotics. Data acquisition of an adult sheep's head was performed with helical computer tomography (CT). The data were transferred onto a computer aided design/computer aided manufacturing system (CAD/CAM system), and two complex defects in the frontotemporal skull were designed. Standard individual titanium implants were milled for both of the defects. Additionally, for one of the defects a resection template, as well as a mould for the biodegradable poly(D,L-lactide) (PDLLA) implant, were fabricated by the CAD/CAM system. A surgeon carried out the first bone resection (#1) for the prefabricated titanium implant using the resection template and an oscillating saw. The robot system Stäubli RX90CR, modified for clinical use, carried out the other resection (#2). Both titanium implants and the PDLLA implant were inserted in their respective defects to compare the precision of their fit. A critical comparison of both implant materials and both resection types shows that fabrication of a PDLLA implant and robot resection are already possible. At present, the titanium implant and resection using a template are more convincing due to the higher precision and practicability.

  20. Osteotransductive bone cements.

    Science.gov (United States)

    Driessens, F C; Planell, J A; Boltong, M G; Khairoun, I; Ginebra, M P

    1998-01-01

    Calcium phosphate bone cements (CPBCs) are osteotransductive, i.e. after implantation in bone they are transformed into new bone tissue. Furthermore, due to the fact that they are mouldable, their osteointegration is immediate. Their chemistry has been established previously. Some CPBCs contain amorphous calcium phosphate (ACP) and set by a sol-gel transition. The others are crystalline and can give as the reaction product dicalcium phosphate dihydrate (DCPD), calcium-deficient hydroxyapatite (CDHA), carbonated apatite (CA) or hydroxyapatite (HA). Mixed-type gypsum-DCPD cements are also described. In vivo rates of osteotransduction vary as follows: gypsum-DCPD > DCPD > CDHA approximately CA > HA. The osteotransduction of CDHA-type cements may be increased by adding dicalcium phosphate anhydrous (DCP) and/or CaCO3 to the cement powder. CPBCs can be used for healing of bone defects, bone augmentation and bone reconstruction. Incorporation of drugs like antibiotics and bone morphogenetic protein is envisaged. Load-bearing applications are allowed for CHDA-type, CA-type and HA-type CPBCs as they have a higher compressive strength than human trabecular bone (10 MPa).

  1. No effect of Osteoset, a bone graft substitute, on bone healing in humans: a prospective randomized double-blind study

    DEFF Research Database (Denmark)

    Petruskevicius, Juozas; Nielsen, Mette Strange; Kaalund, Søren;

    2002-01-01

    We studied the effects of a newly marketed bone substitute, Osteoset, on bone healing in a tibial defect in humans. 20 patients undergoing an ACL (anterior cruciate ligament) reconstruction with bone-patella tendon-bone graft were block-randomized into 2 groups of 10 each. In the treatment group...

  2. Bone-patellar tendon-bone graft in anterior cruciate ligament reconstruction: allograft versus autograft%自体与异体骨-髌腱-骨移植物重建膝前十字韧带的远期疗效观察

    Institute of Scientific and Technical Information of China (English)

    李卫平; 宋斌; 黄建荣; 沈慧勇; 杨睿; 宋洋

    2008-01-01

    目的 比较自体与异体骨-髌腱-骨(bone-patella tendon-bone,B-PT-B)移植物关节镜下重建膝关节前十字韧带(anterior cruciate ligament,ACL)的远期临床疗效.方法 对66例膝ACL断裂患者分别采用自体与异体B-PT-B移植物重建,其中自体组31例,异体组35例;观察两组手术前后生化、免疫学指标的变化以及全身和膝关节局部反应,以Lysholm评分及Larson评分比较术后疗效.结果 自体组29例获随访,随访时间5~10年,平均7年;异体组32例获随访,随访时间5~6.5年,平均6年.术后两组发热时间无明显差异,术后生化、免疫学指标均无明显异常.Lysholm评分:自体组(93.28±3.12)分,异体组(93.15±3.22)分,两组比较差异无统计学意义(P>0.05).Lamon评分:自体组(93.12±2.15)分,异体组(92.75±3.25)分,两组比较差异无统计学意义(P>0.05).术后复查X线片及MRI示:自体组5例出现骨隧道扩大,异体组6例出现骨隧道扩大.术后两组均有1例发生化脓性关节炎;异体组9例冈出现不同程度排斥反应而行镜下冲洗或穿刺冲洗,但无一例取出移植物;异体组1例患者术后移植物发生断裂而行重建术.结论 异体与自体B-PT-B移植物重建ACL远期临床疗效相近,可以获得较为满意的关节活动度及关节稳定性,均为重建ACL的良好移植物.%Objective To compare the clinical curative effect between autograft and allograft bone patella tendon-bone (B-PT-B) transplant to reconstruct anterior cruciate ligament (ACL) arthroseopically.Methods ACL reconstruction using autograft and allograft B-PT-B were performed in 66 patients in the study,autograft group had 31 cases,allograft group had 35 cases; observe the biochemistry,immunology and the response of knee joint pre-and postoperation,observe the therapeutic effect after operation,Lysholm and Larson were used to compare the knee function pre-and postoperation.Results Twenty-nine cases in autograft group were followed up for

  3. 补肾固齿丸对大鼠实验性牙周炎牙槽骨重建的影响%Effects of Bushen Guchi Bolus on alveolar bone reconstruction of periodontitis rats

    Institute of Scientific and Technical Information of China (English)

    丁一; 杨恒; 文钦

    2011-01-01

    Objective To explore the influence of Bushen Guchi Bolus on the alveolar bone reconstruction of rats with experimental periodontitis, and to investigate the treatment mechanism of the drug. Methods The model of experimental periodontitis were established by means of steel wire, high-carbohydrate diet and periopathogens inoculation in rats. Then Bushen Guchi Bolus was given to rats of treatment group at a dose of 0.8 g/(kg · d) by gastric injection for 30 d, and 10 ml/(kg · d) normal saline was give to rats of normal control and model group for same period. All rats were killed at then end of treatment. The contents of osteocal-cin (OCN) and pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP) in the serum were observed by radioimmunoassay ( RIA). Micro-CT and software digitized specimens were reconstructed three-dimensionally for parameter assessment of alveolar bone (including bone volume /total volume, trabecular number, and trabecular separation). Results Rat experimental periodontitis models were successfully established by steel wire, high-carbohydrate diet and periopathogens inoculation. After 30 days' treatment of Bushen Guchi Bolus, the level of OCN and ICTP in the serum were decreased in treatment group (0. 859 1 ±0. 156 9 and 2.038 6 ±0.407 5, P 0. 05). In addition, Tb. Sp in the treatment group (0.575 1 ±0.020 0) was inferior to that of the model group (0. 611 0 ± 0. 030 00, P < 0.05). Conclusion Bushen Guchi Bolus improves alveolar bone reconstruction of rats with experimental periodontitis.%目的 研究补肾固齿丸对大鼠实验性牙周炎牙槽骨重建的影响,进一步探讨补肾固齿丸对牙周炎的治疗机制.方法 成功建立大鼠牙周炎模型之后,大鼠分为正常组、牙周炎模型组、补肾固齿丸组,给予补肾固齿丸治疗,采用放射免疫法测定血清骨钙蛋白与Ⅰ型胶原交联C端肽浓度,同时采用显微CT对大鼠牙槽骨进行三维重建,以评价补肾固齿

  4. Evidence-Based ACL Reconstruction

    Directory of Open Access Journals (Sweden)

    E. Carlos RODRIGUEZ-MERCHAN

    2015-01-01

    Full Text Available There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACLreconstruction. The purpose of this article is to answer the following questions: 1 Bone patellar tendon bone (BPTB reconstruction or hamstring reconstruction (HR; 2 Double bundle or single bundle; 3 Allograft or authograft; 4 Early or late reconstruction; 5 Rate of return to sports after ACL reconstruction; 6 Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analysesfocused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years.

  5. Penile reconstruction

    Institute of Scientific and Technical Information of China (English)

    Giulio Garaffa; Salvatore Sansalone; David J Ralph

    2013-01-01

    During the most recent years,a variety of new techniques of penile reconstruction have been described in the literature.This paper focuses on the most recent advances in male genital reconstruction after trauma,excision of benign and malignant disease,in gender reassignment surgery and aphallia with emphasis on surgical technique,cosmetic and functional outcome.

  6. Bone Markers

    Science.gov (United States)

    ... markers may be seen in conditions such as: Osteoporosis Paget disease Cancer that has spread to the bone (metastatic bone disease) Hyperparathyroidism Hyperthyroidism Osteomalacia in adults and rickets in children—lack of bone mineralization, ...

  7. Bone scan

    Science.gov (United States)

    ... legs, or spine fractures) Diagnose a bone infection (osteomyelitis) Diagnose or determine the cause of bone pain, ... 2015:chap 43. Read More Broken bone Metabolism Osteomyelitis Review Date 12/10/2015 Updated by: Jatin ...

  8. Bone Cancer

    Science.gov (United States)

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another ... more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 and ...

  9. Bone Diseases

    Science.gov (United States)

    Your bones help you move, give you shape and support your body. They are living tissues that rebuild constantly ... childhood and your teens, your body adds new bone faster than it removes old bone. After about ...

  10. Ligament reconstruction.

    Science.gov (United States)

    Glickel, Steven Z; Gupta, Salil

    2006-05-01

    Volar ligament reconstruction is an effective technique for treating symptomatic laxity of the CMC joint of the thumb. The laxity may bea manifestation of generalized ligament laxity,post-traumatic, or metabolic (Ehler-Danlos). There construction reduces the shear forces on the joint that contribute to the development and persistence of inflammation. Although there have been only a few reports of the results of volar ligament reconstruction, the use of the procedure to treat Stage I and Stage II disease gives good to excellent results consistently. More advanced stages of disease are best treated by trapeziectomy, with or without ligament reconstruction.

  11. 自体骨-髌腱(中1/3)-骨重建后交叉韧带的中长期临床观察研究%Arthroscopic reconstruction of the posterior cruciate ligament using single-bundle bone-patella tendon-bone graft with moderate to long term follow-up

    Institute of Scientific and Technical Information of China (English)

    刘平; 敖英芳; 王健全; 崔国庆; 安华; 刘晓鹏

    2009-01-01

    Objectives To evaluate the 4- to 10- year results of arthroscopic reconstruction of the posterior cruciate ligament (PCL) using single-bundle bone-patella tendon-bone graft, and to find out the principle and influential factor of the isolated PCL reconstruction. Methods From May 1998 to July 2004 the data of 29 patients with isolated PCL reconstruction retrospectively investigated,using single-bundle bone-patella tendon-bone graft. Twenty-two cases were followed up with average 7.1 years (5-10 years). Follow-up included the subjective knee function evaluation, KT2000, Biodex and the radiographic assessment. Results The mean final follow-up IKDC score, Lysholm score, and Tegner score of the 22 cases were 89.4±8.1, 94.5±9.2, and 6.9±2.6 respectively. There were statistically significant improvements in them when compared with preoperative data respectively (P<0.01). The average posterior displacement measured with KT2000 was (4.9±1.1)mm (90°flexion) and (4.3±1.2)mm (30°flexion) respectively. At the final follow-up, KT2000 examination revealed ≥6 mm of posterior laxity in 6 patients (group A), and ≤5 mm posterior laxity in 16 patients (group A). A statistically significant improvement was noted in comparing the mean final follow-up IKDC score, Lysholm score, and Tegner score between the group A and B (P<0.01). The average time from injury to surgery of group A and B was (17.6±3.9) months and (2.9±2.1) months respectively, the difference was statistically significant (P<0.01). The data was received from the Biodex dynamometer for the 22 patients who were followed up in clinic service. Patients achieved(90±22)% (60°/s) and (87±19)% (120°/s) recovery of the extensor peak torque respectively, for the flexor peak torque patients achieved (93±16)% (60°/s) and (92±20)%(120°/s) respectively, the difference between the peak torque of extensor and flexor in the same condition was statistically significant (P<0.01). X-ray findings: 8 of the 22 patients (36

  12. Repositioning template for mandibular reconstruction with fibular free flap: an alternative technique to pre-plating and virtual surgical planning

    OpenAIRE

    Berrone, M.; Crosetti, E.; Succo, G

    2014-01-01

    SUMMARY Oral malignancies involving the mandibular bone require a complex reconstructive plan. Mandibular reconstruction with a fibular free flap is currently considered the best choice for functional and aesthetic rehabilitation after oncological surgery. This flap can be modelled with multiple osteotomies and can provide bone, muscle and skin for composite reconstruction. One of the most delicate aspects of mandibular reconstruction is the technique of bone modelling; the risk of prolonging...

  13. Coralline hydroxyapatite in complex acetabular reconstruction.

    Science.gov (United States)

    Wasielewski, Ray C; Sheridan, Kate C; Lubbers, Melissa A

    2008-04-01

    This retrospective study examined whether a coralline hydroxyapatite bone graft substitute adequately repaired bone defects during complex acetabular reconstructions. Seventeen patients who underwent acetabular revision using Pro Osteon 500 were assessed to determine whether any cups required re-revision, whether bone had incorporated into the coralline hydroxyapatite grafts, and whether the coralline hydroxyapatite grafts resorbed with time. At latest follow-up, no cups required re-revision, but 1 had failed. Radiographic evidence of bone incorporation was observed in every coralline hydroxyapatite graft. Graft resorption was not observed.

  14. Climate Reconstructions

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Paleoclimatology Program archives reconstructions of past climatic conditions derived from paleoclimate proxies, in addition to the Program's large holdings...

  15. Breast Reconstruction

    Science.gov (United States)

    ... senos Preguntas Para el Médico Datos Para la Vida Komen El cuidado de sus senos:Consejos útiles ... that can help . Federal law requires most insurance plans cover the cost of breast reconstruction. Learn more ...

  16. Effect of the attachment remnant preservation on tendon-bone healing in a rabbit model of anterior cruciate ligament reconstruction%保留残迹对前交叉韧带移植物腱骨愈合影响的实验研究

    Institute of Scientific and Technical Information of China (English)

    赵宗峤; 吴波; 李士光; 孙磊

    2012-01-01

    目的 探讨保留残迹重建前交叉韧带对移植物腱骨愈合的影响.方法 32只新西兰兔一期行双侧前交叉韧带重建术,一侧保留残端纤维,对侧切除残端纤维.重建术后6、12、18及24周时,采用HE染色、甲苯胺蓝染色观测,分析移植物腱骨愈合变化情况.结果 重建术后各观察时间点上,保留残迹组移植物腱骨界面组织构建更接近正常,术后24周时保留残迹组腱骨界面软骨细胞含量明显高于切除残迹组[(56.5±2.4) vs (45.7±2.7),P<0.05].结论 保留残迹重建前交叉韧带有助于移植物腱骨愈合.%Objective To investigate the effect of attachment remnant preservation on the healing of tendon-bone interface in a rabbit model of anterior cruciate ligament (ACL) reconstruction. Methods 32 New Zealand rabbits were involved and both knees of each rabbit received transection of anterior cruciate ligament simultaneously. ACL of one knee was reconstructed with preservation of the residual portion of ligament, and the contralateral one was reconstructed with excision of the remnant. At6, 12, 18, and 24 weeks after reconstruction, the healing status and morphology of tendon-bone interface were observed in vitro by hemaetoxylin-eosin staining and Toluidine Blue staining. Results At each observation time point, the morphology and structure of tendon-bone interface in the remnant-preserved group were improved similar to normal, and the number of chondrocytes at the interface was significantly increased in the remnant-preserved group compared with that of control group [ (56. 5 ±2. 4) vs (45. 7 ±2. 7) , P <0. 05]. Conclusions The preservation of attachment remnant in anterior cruciate ligament reconstruction could enhance the healing of tendon-bone interface.

  17. 乳突尖部分切除加自体骨粉鼓室上壁重建在鼓室成形术中的应用%Mastoidale partial resection and superior tympanic wall reconstruction with autogenous bone meal in tympanoplasty

    Institute of Scientific and Technical Information of China (English)

    陈学华; 纪树芳; 李卡凡; 梅晓峰

    2013-01-01

    Objective To explore the value of mastoidale partial resection and superior tympanic wall reconstruction with autogenous bone meal in tympanoplasty. Methods A total of 42 patients with chronic suppurative otitis media (CSOM) were treated with open tympanoplasty. Among these patients,22 patients were treated with autologous bone hearing reconstruction (autologous bone group) and 20 patients were treated with titanium auricular bone reconstruction (titanium auricular bone group) . The dry ear rate,dry ear time,external auditory canal shape,hearing and complication were observed after operation in the two groups. Results The postauricular incisions of all patients in the two groups were primary healing,and there was no postoperative complications such as vertigo, facial nerve paralysis and tinnitus and tinnitus, etc. After operation, the mastoid cavity recovered with good epithelization, and without escharosis, otopiesis or adhesion. The dry ear rate in autologous bone group and titanium auricular bone group was 95.5% (21/22)and 95.0% (19/20) .respectively;there was no significant difference in dry ear rate between the two groups ( P > 0. 05 ). There was no significant difference in dry ear time between the two groups (P >0.05). Before treatment,there was no significant difference in air conduction auditory threshold and air-bone gap between the two groups (P >0. 05). The air conduction auditory threshold and air-bone gap after treatment were significantly lower than those before treatment in the two group(P <0. 05). After treatment, the air conduction auditory threshold and air-bone gap in titanium auricular bone group were significantly lower than those in autologous bone group (P < 0. 05). Conclusions Facial nerve monitoring can effectively identify the exposed facial nerve or thin bone canal facial nerve,and could avoid facial nerve injury during surgery. The mastoidale partial resection and superior tympanic wall reconstruction with autogenous bone meal

  18. Biomaterials for craniofacial reconstruction

    Directory of Open Access Journals (Sweden)

    Neumann, Andreas

    2009-01-01

    Full Text Available Biomaterials for reconstruction of bony defects of the skull comprise of osteosynthetic materials applied after osteotomies or traumatic fractures and materials to fill bony defects which result from malformation, trauma or tumor resections. Other applications concern functional augmentations for dental implants or aesthetic augmentations in the facial region.For ostheosynthesis, mini- and microplates made from titanium alloys provide major advantages concerning biocompatibility, stability and individual fitting to the implant bed. The necessity of removing asymptomatic plates and screws after fracture healing is still a controversial issue. Risks and costs of secondary surgery for removal face a low rate of complications (due to corrosion products when the material remains in situ. Resorbable osteosynthesis systems have similar mechanical stability and are especially useful in the growing skull.The huge variety of biomaterials for the reconstruction of bony defects makes it difficult to decide which material is adequate for which indication and for which site. The optimal biomaterial that meets every requirement (e.g. biocompatibility, stability, intraoperative fitting, product safety, low costs etc. does not exist. The different material types are (autogenic bone and many alloplastics such as metals (mainly titanium, ceramics, plastics and composites. Future developments aim to improve physical and biological properties, especially regarding surface interactions. To date, tissue engineered bone is far from routine clinical application.

  19. 关节镜下同种异体跟腱四骨道双束解剖重建前交叉韧带的临床研究%Clinical study of arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    苑广科; 韦良心; 焦兆德; 殷鹏

    2014-01-01

    Objective To explore the treatment method and clinical effect of arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament (ACL). Methods A total of 32 cases undergone arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament were in this study. Preoperative and postoperative follow-up and Lysholm score were applied in the analysis of knee joint function and curative effect. Results The result of Lysholm score showed that there were 31 good cases (96.9%) and 1 fair case (3.1%). The good rate was 96.9%. Conclusion The surgery of arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament can effectively recover the stability and knee function in anterior-posterior dimension and spin. This reconstruction is close to the reconstruction of anatomic biomechanics. The application of tendon allograft transplant can reduce operation time and trauma, and it is a good choice for double-bundle anterior cruciate ligament reconstruction.%目的:探讨关节镜下应用同种异体跟腱四骨道双束解剖重建前交叉韧带(ACL)的手术方法和临床疗效。方法32例采用关节镜下同种异体跟腱四骨道双束解剖重建方法的前交叉韧带损伤患者,通过术前及术后随访, Lysholm评分表进行膝关节功能的评估和疗效分析。结果按照Lysholm评分表,31例患者(96.9%)分级评价优良,1例一般(3.1%),优良率达到96.9%。结论关节镜下同种异体跟腱四骨道双束解剖重建前交叉韧带,能够有效的恢复膝关节的前后向及旋转稳定性,更接近于解剖生物力学重建,同种异体跟腱移植物的应用可以缩短手术时间,减少创伤,是双束解剖重建ACL的良好选择之一。

  20. Virtual temporal bone

    Institute of Scientific and Technical Information of China (English)

    QIU Ming-guo; ZHANG Shao-xiang; LIU Zheng-jin; TAN Li-wen; WANG Yu-su; DENG Jun-hui; TANG Ze-sheng

    2002-01-01

    Objective:To provide the virtual model of the temporal bone for improving 3-dimension (3D) visualization of the inner ear. Methods: Plastination technique was used to make equidistant serial thin sections 1.0 mm in thickness. On SGI workstation, a Contours+Marching Cubes algorithm was selected to reconstruct the temporal bone and intratemporal structures in 3D, then to view the middle ear, inner ear, and intratemporal structures which imitate the scenes observed by the traditional endoscopy. Results: The virtual model of the temporal bone was successfully constructed, with all reconstructed structures being represented individually or jointly and being rotated continuously in any plane. Virtual endoscopy improved 3D visualization of the middle ear, inner ear, and intratemporal structures. Conclusion: The reconstructed model can be used for the medical students to rehearse or review the surgeries on this part and for the surgeons to develop a new approach for operation. Virtual otoscopy stands as a promising new visualization technique for elucidating the structure and relation of the middle ear, inner ear, and intratemporal structures.

  1. Anterior cruciate ligament reconstruction with bone patellar tendon bone autograft, irradiated versus non-irradiated deep frozen allograft%自体与γ射线照射和非照射异体骨-髌腱-骨重建前十字韧带的比较研究

    Institute of Scientific and Technical Information of China (English)

    孙康; 田少奇; 张积华; 张才龙; 夏长所; 于腾波

    2009-01-01

    Objective Analyze the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with bone patellar tendon bone (B-PT-B) allograft or autograft. Methods A total of 107 patients underwent same arthroscopie ACL reconstruction technique were randomized into three groups (A: autograft 36, B: non-irradiated deep-frozen allograft 36, C: irradiated allograft 35). Before surgery and at follow-up, patients were evaluated by general conditions, pivot shift test, Lachman and Anterior Drawer Test (ADT), KT-2000 arthrometer testing, Daniel one-leg hop test, overall IKDC rating, Lysholm and Tegner activ-ity score. Results A total of 103 patients were available for full evaluation. The mean follow-up time of A, B and C groups were 39.5, 36.3 and 37.6 months respectively. 1) In A group, patellar fracture occurred in 1 patient and anterior knee pain occurred in 2. In B group, 1 patient had late septic infection. Patients in the B and C groups underwent shorter operation time and longer fever time. There was no difference between the three groups in hospital stay time. 2) According to pivot shift test, Lachman test, ADT, and KT-2000 arthrom-eter testing, differences were found between C group to A or B groups, while no statistically significant dif-ferences between A and B groups. The failure rate in C group (36%) was higher than that with A (8%) and B group (9%). According to Daniel one-leg hop test, the overall IKDC, Lysholm and Tegner activity score, no differences were found between the three groups. Conclusion Patients underwent ACL reconstruction with B-PT-B non-irradiated deep-frozen allograft or autograft had similar clinical outcomes. Non-irradiated B-PT-B allograft is a reasonable alternative to autograft. While the anterior and rotational stability decreased signifi-cantly, when irradiated B-PT-B allograft was used.%目的 比较自体与γ射线照射和非照射异体骨-髌腱-骨(bone patellar tendon bone,B-PT-B)重

  2. Bone Densitometry (Bone Density Scan)

    Science.gov (United States)

    ... of DXA Bone Densitometry? What is a Bone Density Scan (DXA)? Bone density scanning, also called dual-energy x-ray absorptiometry ( ... is today's established standard for measuring bone mineral density (BMD). An x-ray (radiograph) is a noninvasive ...

  3. Reconstruction of {sup 137}Cs signal in Cuba using {sup 7}Be as tracer of vertical transport processes in the atmosphere

    Energy Technology Data Exchange (ETDEWEB)

    Alonso Hernandez, C.M. E-mail: carlos@ceac.perla.inf.cu; Cartas Aguila, H.; Diaz Asencio, M.; Munoz Caravaca, A

    2004-07-01

    Levels of {sup 137}Cs and {sup 7}Be in aerosols have been measured in the region of Cienfuegos (Cuba) during the period 1994-1998. {sup 137}Cs showed the same seasonal trend as {sup 7}Be and the monthly regimes of precipitation seemed to be responsible for the observed pattern. The {sup 137}Cs/{sup 7}Be ratio obtained in Cienfuegos and Miami (FL) in this period was used to calibrate the long-term database of {sup 137}Cs concentrations recorded in Miami (250 km from Cienfuegos). The database was then employed to reconstruct the {sup 137}Cs monthly concentrations in Cienfuegos since 1957.

  4. Nonlinear Reconstruction

    CERN Document Server

    Zhu, Hong-Ming; Pen, Ue-Li; Chen, Xuelei; Yu, Hao-Ran

    2016-01-01

    We present a direct approach to non-parametrically reconstruct the linear density field from an observed non-linear map. We solve for the unique displacement potential consistent with the non-linear density and positive definite coordinate transformation using a multigrid algorithm. We show that we recover the linear initial conditions up to $k\\sim 1\\ h/\\mathrm{Mpc}$ with minimal computational cost. This reconstruction approach generalizes the linear displacement theory to fully non-linear fields, potentially substantially expanding the BAO and RSD information content of dense large scale structure surveys, including for example SDSS main sample and 21cm intensity mapping.

  5. Bone marrow aspiration

    Science.gov (United States)

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  6. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  7. Osteogenic Matrix Cell Sheets Facilitate Osteogenesis in Irradiated Rat Bone

    Directory of Open Access Journals (Sweden)

    Yoshinobu Uchihara

    2015-01-01

    Full Text Available Reconstruction of large bone defects after resection of malignant musculoskeletal tumors is a significant challenge in orthopedic surgery. Extracorporeal autogenous irradiated bone grafting is a treatment option for bone reconstruction. However, nonunion often occurs because the osteogenic capacity is lost by irradiation. In the present study, we established an autogenous irradiated bone graft model in the rat femur to assess whether osteogenic matrix cell sheets improve osteogenesis of the irradiated bone. Osteogenic matrix cell sheets were prepared from bone marrow-derived stromal cells and co-transplanted with irradiated bone. X-ray images at 4 weeks after transplantation showed bridging callus formation around the irradiated bone. Micro-computed tomography images at 12 weeks postoperatively showed abundant callus formation in the whole circumference of the irradiated bone. Histology showed bone union between the irradiated bone and host femur. Mechanical testing showed that the failure force at the irradiated bone site was significantly higher than in the control group. Our study indicates that osteogenic matrix cell sheet transplantation might be a powerful method to facilitate osteogenesis in irradiated bones, which may become a treatment option for reconstruction of bone defects after resection of malignant musculoskeletal tumors.

  8. No effect of bone morphogenetic protein-7 (OP-1) on the incorporation of impacted bone grafts in a realistic acetabular model.

    NARCIS (Netherlands)

    Buma, P.; Arts, J.J.C.; Gardeniers, J.W.M.; Verdonschot, N.J.J.; Schreurs, B.W.

    2008-01-01

    Bone morphogenetic proteins (BMPs) accelerate bone repair in experimental and clinical conditions. Impacted Morsellized Cancellous Bone grafts (MCB) are successfully used to reconstruct bone defects after failed hip implants. The main question in this study was if BMP-7 (OP-1) mixed with MCB could a

  9. Reconstruction de la surface de Fermi dans l'etat normal d'un supraconducteur a haute Tc: Une etude du transport electrique en champ magnetique intense

    Science.gov (United States)

    Le Boeuf, David

    Des mesures de resistance longitudinale et de resistance de Hall en champ magnetique intense transverse (perpendiculaire aux plans CuO2) ont ete effectuees au sein de monocristaux de YBa2Cu3Oy (YBCO) demacles, ordonnes et de grande purete, afin d'etudier l'etat fondamental des supraconducteurs a haute Tc dans le regime sous-dope. Cette etude a ete realisee en fonction du dopage et de l'orientation du courant d'excitation J par rapport a l'axe orthorhombique b de la structure cristalline. Les mesures en champ magnetique intense revelent par suppression de la supraconductivite des oscillations magnetiques des resistances longitudinale et de Hall dans YBa2Cu 3O6.51 et YBa2Cu4O8. La conformite du comportement de ces oscillations quantiques au formalisme de Lifshitz-Kosevich, apporte la preuve de l'existence d'une surface de Fermi fermee a caractere quasi-2D, abritant des quasiparticules coherentes respectant la statistique de Fermi-Dirac, dans la phase pseudogap d'YBCO. La faible frequence des oscillations quantiques, combinee avec l'etude de la partie monotone de la resistance de Hall en fonction de la temperature indique que la surface de Fermi d'YBCO sous-dope comprend une petite poche de Fermi occupee par des porteurs de charge negative. Cette particularite de la surface de Fermi dans le regime sous-dope incompatible avec les calculs de structure de bande est en fort contraste avec la structure electronique presente dans le regime surdope. Cette observation implique ainsi l'existence d'un point critique quantique dans le diagramme de phase d'YBCO, au voisinage duquel la surface de Fermi doit subir une reconstruction induite par l'etablissement d'une brisure de la symetrie de translation du reseau cristallin sous-jacent. Enfin, l'etude en fonction du dopage de la resistance de Hall et de la resistance longitudinale en champ magnetique intense suggere qu'un ordre du type onde de densite (DW) est responsable de la reconstruction de la surface de Fermi. L'analogie de

  10. ACL reconstruction with irradiated versus non-irradiated deep-frozen bone-patellar tendon-bone allograft: a prospective randomized clinical study%γ射线照射与非照射同种异体骨-髌腱-骨重建前交叉韧带的临床前瞻性比较研究

    Institute of Scientific and Technical Information of China (English)

    孙康; 田少奇; 张积华; 张才龙; 夏长所; 于腾波

    2009-01-01

    目的 比较研究经γ射线照射与单纯深低温冷冻保存的同种异体骨-髌腱-骨(B-PT-B)重建前交叉韧带(ACL)的临床疗效.方法 将66例ACL断裂患者术前电脑随机抽样分组法分为两组:A组为深低温冷冻保存+γ射线照射34例,B组为单纯深低温冷冻保存32例.两组手术均由同一术者采用标准关节镜技术完成.手术前后通过一般情况比较、膝关节活动度、轴移试验、Lachman试验及前抽屉试验(ADT)、Daniel单腿水平跳跃与Hamer垂直跳跃试验、国际膝关节文献委员会(IKDC)评分及KT-2000检测对临床疗效进行评价.结果 术后63例得到完整随访(A组32例,B组31例),3例失访,A组平均随访38.3个月,B组平均随访37.7个月.B组迟发感染1例.两组住院时间和术后发热天数等一般情况比较差异无统计学意义(P>0.05),但A组术后平均发热时间(8.9 d)与B组(7.8 d)相比有延长的趋势.理学检查:两组伸屈膝差异均无统计学意义(P>0.05);但Lachman试验和ADT结果比较差异有统计学意义(P5 mm,两组比较差异均有统计学意义(P0.05),但A组术后患肢功能水平及IKDC评分均有降低的趋势.结论 γ射线照射后的同种异体B-PT-B重建ACL的关节稳定性较差,应慎用.%Objective To compare the clinical outcomes of irradiated versus non-irradiated deepfrozen bone-patellar tendon-bone (B-PF-B) ullograft in anterior cruciate ligament (ACL) reconstruction. Methods A total of 66 patients undergoing arthroecopic ACL reconstruction were prospectively random-ized consecutively into two groups, ie, Group A ( irradiated deep-frozen allograft, n = 34) and Group B ( non-irradiated deep-frozen allograft, n = 32). All ACL reconstructions were done by the same senior surgeon with the same arthroscopic technique. Before and after surgery, the clinical results were compared in aspects of general conditions, range of motion ( ROM), Pivot shift test, Lachman and Anterior Drawer Test (ADT), Daniel

  11. Thiazide diuretics directly induce osteoblast differentiation and mineralized nodule formation by interacting with a sodium chloride co-transporter in bone.

    Science.gov (United States)

    Dvorak, Melita M; De Joussineau, Cyrille; Carter, D Howard; Pisitkun, Trairak; Knepper, Mark A; Gamba, Gerardo; Kemp, Paul J; Riccardi, Daniela

    2007-09-01

    Thiazide diuretics are used worldwide as a first-choice drug for patients with uncomplicated hypertension. In addition to their antihypertensive effect, thiazides increase bone mineral density and reduce the prevalence of fractures. Traditionally, these effects have been attributed to increased renal calcium reabsorption that occurs secondary to the inhibition of the thiazide-sensitive sodium chloride cotransporter (NCC) in the distal tubule. The aim of the current study was to determine whether thiazides exert a direct bone-forming effect independent of their renal action. We found that the osteoblasts of human and rat bone also express NCC, suggesting that these bone-forming cells may be an additional target for thiazides. In vitro, NCC protein was virtually absent in proliferating human and fetal rat osteoblasts, whereas its expression dramatically increased during differentiation. Thiazides did not affect osteoblast proliferation, but directly stimulated the production of the osteoblast differentiation markers runt-related transcription factor 2 (runx2) and osteopontin. Using overexpression/knockdown studies in fetal rat calvarial cells, we show that thiazides increase the formation of mineralized nodules, but loop diuretics do not. Overall, our study demonstrates that thiazides directly stimulate osteoblast differentiation and bone mineral formation independent of their effects in the kidney. Therefore, in addition to their use as antihypertensive drugs, our results suggest that thiazides may find a role in the prevention and treatment of osteoporosis.

  12. Animal Experiment of Periodontal Defect Reconstruction Using Collagen-hydroxyapatite Artificial Bone Plus Collagen Membrane%胶原—羟基磷灰石人工骨与胶原膜引导牙周组织再生的动物实验研究

    Institute of Scientific and Technical Information of China (English)

    吴文蕾; 葛久禹; 李升; 黄晓峰; 陈湘华

    2011-01-01

    目的:将胶原—羟基磷灰石人工骨与胶原膜联合应用于修复牙周缺损的动物实验,探讨其用于引导牙周组织再生的可行性.方法:人工构建4只成年Beagle犬下颌后牙区牙周缺损模型,分别随机采用:胶原—羟基磷灰石人工骨/胶原膜、胶原—羟基磷灰石人工骨、空白对照治疗,每组8颗牙,12周后处死动物,进行组织学观察并测量新生组织高度.结果:与单纯植入胶原—羟基磷灰石人工骨组相比,胶原—羟基磷灰石人工骨/胶原膜组获得了更多的新附着,表现为有较多的新生牙槽骨、新生牙周膜和新生牙骨质样组织生长,2组之间新生组织差异有显著性(P<0.05).结论:胶原—羟基磷灰石人工骨与胶原膜联合运用修复牙周牙槽骨缺损引导牙周组织再生的效果优于单纯植入人工骨.%Objective: To investigate the possibility of using collagen-hydroxyapatite artificial bone plus collagen membrane in the reconstruction of periodontal defect. Methods: Four beagle dogs were constructed periodontal defect in mandibular premolars or molars. 24 teeth were divided into three groups randomly. They were collagen - hydroxyapatite artificial bone plus collagen membrane, collagen-hydroxyapatite artificial bone and blank control. The dogs were sacrificed 12 weeks post-surgery, and healing was evaluated histologically. Results: Periodontal defects implanted with collagen - hydroxyapatite artificial bone plus collagen membrane got more neonatal alveolar bone (P<0. 05) , periodontal membrane (P<0. 05) and cementum- like tissue (P<0. 05) than the group with collagen-hydroxyapatite artificial bone only. Conclusion: Collagen-hydroxyapatite artificial bone plus collagen membrane is better than artificial bone only in periodontal regeneration.

  13. Breast Reconstruction Alternatives

    Science.gov (United States)

    ... Breast Reconstruction Surgery Breast Cancer Breast Reconstruction Surgery Breast Reconstruction Alternatives Some women who have had a ... chest. What if I choose not to get breast reconstruction? Some women decide not to have any ...

  14. Smooth Reconstruction

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Eighty percent of the reconstruction projects in Sichuan Province will be completed by the end of the year Despite ruins still seen everywhere in the earthquake-hit areas in Sichuan (Province, new buildings have been completed, and many people have moved into new houses. Through cameras of the media, the faces, once painful and melancholy after last year’s earthquake, now look confident and firm, gratifying people all over the

  15. Maxillary reconstruction

    Directory of Open Access Journals (Sweden)

    Brown James

    2007-12-01

    Full Text Available This article aims to discuss the various defects that occur with maxillectomy with a full review of the literature and discussion of the advantages and disadvantages of the various techniques described. Reconstruction of the maxilla can be relatively simple for the standard low maxillectomy that does not involve the orbital floor (Class 2. In this situation the structure of the face is less damaged and the there are multiple reconstructive options for the restoration of the maxilla and dental alveolus. If the maxillectomy includes the orbit (Class 4 then problems involving the eye (enopthalmos, orbital dystopia, ectropion and diplopia are avoided which simplifies the reconstruction. Most controversy is associated with the maxillectomy that involves the orbital floor and dental alveolus (Class 3. A case is made for the use of the iliac crest with internal oblique as an ideal option but there are other methods, which may provide a similar result. A multidisciplinary approach to these patients is emphasised which should include a prosthodontist with a special expertise for these defects.

  16. Quantitative computed tomography and cranial burr holes: a model to evaluate the quality of cranial reconstruction in humans.

    Science.gov (United States)

    Worm, Paulo Valdeci; Ferreira, Nelson Pires; Ferreira, Marcelo Paglioli; Kraemer, Jorge Luiz; Lenhardt, Rene; Alves, Ronnie Peterson Marcondes; Wunderlich, Ricardo Castilho; Collares, Marcus Vinicius Martins

    2012-05-01

    Current methods to evaluate the biologic development of bone grafts in human beings do not quantify results accurately. Cranial burr holes are standardized critical bone defects, and the differences between bone powder and bone grafts have been determined in numerous experimental studies. This study evaluated quantitative computed tomography (QCT) as a method to objectively measure cranial bone density after cranial reconstruction with autografts. In each of 8 patients, 2 of 4 surgical burr holes were reconstructed with autogenous wet bone powder collected during skull trephination, and the other 2 holes, with a circular cortical bone fragment removed from the inner table of the cranial bone flap. After 12 months, the reconstructed areas and a sample of normal bone were studied using three-dimensional QCT; bone density was measured in Hounsfield units (HU). Mean (SD) bone density was 1535.89 (141) HU for normal bone (P holes is an excellent model to accurately measure the quality of new bone in cranial reconstructions and also seems to be an appropriate choice of experimental model to clinically test any cranial bone or bone substitute reconstruction.

  17. Quantitative evaluation of regularized phase retrieval algorithms on bone scaffolds seeded with bone cells

    Science.gov (United States)

    Weber, L.; Langer, M.; Tavella, S.; Ruggiu, A.; Peyrin, F.

    2016-05-01

    In the field of regenerative medicine, there has been a growing interest in studying the combination of bone scaffolds and cells that can maximize newly formed bone. In-line phase-contrast x-ray tomography was used to image porous bone scaffolds (Skelite©), seeded with bone forming cells. This technique allows the quantification of both mineralized and soft tissue, unlike with classical x-ray micro-computed tomography. Phase contrast images were acquired at four distances. The reconstruction is typically performed in two successive steps: phase retrieval and tomographic reconstruction. In this work, different regularization methods were applied to the phase retrieval process. The application of a priori terms for heterogeneous objects enables quantitative 3D imaging of not only bone morphology, mineralization, and soft tissue formation, but also cells trapped in the pre-bone matrix. A statistical study was performed to derive statistically significant information on the different culture conditions.

  18. Does collagen trigger the recruitment of osteoblasts into vacated bone resorption lacunae during bone remodeling?

    DEFF Research Database (Denmark)

    Abdelgawad, Mohamed Essameldin; Søe, Kent; Andersen, Thomas Levin;

    2014-01-01

    Osteoblast recruitment during bone remodeling is obligatory to re-construct the bone resorbed by the osteoclast. This recruitment is believed to be triggered by osteoclast products and is therefore likely to start early during the remodeling cycle. Several osteoclast products with osteoblast recr...

  19. Harvesting olecranon bone graft in adults by using bone biopsy trephine

    Directory of Open Access Journals (Sweden)

    Fatih Kabakas

    2016-08-01

    Conclusion: Bone graft harvesting with trephine is technically easy and fast, and donor site morbidity is diminished compared other methods and donor sites. It can be performed under axillary anesthesia and provides adequate amounts of bone graft for upper extremity reconstructions. [Hand Microsurg 2016; 5(2.000: 44-49

  20. Bone Morphogenetic Protein-2 Nonviral Gene Therapy in a Goat Iliac Crest Model for Bone Formation

    NARCIS (Netherlands)

    Loozen, Loek D.; van der Helm, Yvonne J. M.; Oner, F. Cumhur; Dhert, W.J.A.; Kruyt, Moyo C.; Alblas, Jacqueline

    2015-01-01

    Treatment and reconstruction of large bone defects, delayed unions, and nonunions is challenging and has resulted in an ongoing search for novel tissue-engineered therapies. Bone morphogenetic protein-2 (BMP-2) gene therapy is a promising strategy to provide sustained production of BMP-2 locally. Al

  1. Single-staged resections and 3D reconstructions of the nasion, glabella, medial orbital wall, and frontal sinus and bone: Long-term outcome and review of the literature

    Directory of Open Access Journals (Sweden)

    Jeremy Ciporen

    2016-01-01

    Conclusions: Advances in technology are allowing neurosurgeons unprecedented opportunities to design complex yet feasible single-stage craniofacial reconstructions that improve a patient′s quality of life by enhancing facial contours, aesthetics, and symmetry.

  2. Reconstrucción del maxilar superior mediante transporte del proceso alveolar: Presentación de un caso Reconstruction of the maxilla by means of transport of the alveolar process: A case report

    OpenAIRE

    Bilbao, A; R. Cobo; Hernández, M; Rocha, R.; J.M. Albertos

    2006-01-01

    La osteogénesis mediante distracción aplicada a la reconstrucción del proceso alveolar es una técnica sobradamente contrastada en la literatura, al igual que la utilización del transporte óseo en la reconstrucción de defectos segmentarios mandibulares. Presentamos en este artículo un caso de reconstrucción de un defecto segmentario del maxilar superior mediante transporte de proceso alveolar y su posterior rehabilitación protésica implantosoportada. Mostramos tanto la técnica quirúrgica como ...

  3. A comparative study on arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone between allograft and autograft%自体和异体骨-髌腱骨移植物重建膝前十字韧带的比较研究

    Institute of Scientific and Technical Information of China (English)

    江东; 王永健; 程序; 余家阔; 敖英芳; 于长隆; 王健全; 崔国庆; 胡跃林; 田得祥; 龚熹

    2008-01-01

    Objective To compare clinical results of arthroscopic anterior cruciate ligament(ACL) reconstruction with bone-patellar tendon-bone(B-PT-B) between allograft and autograft.Methods Twentyseven patients underwent ACL reconstruction using irradiated deep-frozen B-PT-B allograft,including 18 males and 9 females,with an average age of 25.5 years(range,16-49 years).Twenty-five patients underwent the same operation but using autograft B-PT-B,including 19 males and 6 females,with an average age of 26.7 years (range,18-43 years).The same arthroscopie technique was used to perform the reconstruction.Postoperative temperature,erythrocyte sedimentation rate,C reactive protein examined.During follow-up,parameters included International Knee Documentation Committee (IKDC) scores,Tegner scores,Lysholm scores,anterior knee pain and KT-2000 side-to-side difference.Muscle strength were measured by the Biodex dynamometer.Results The average follow-up was 37.1 (range,30-48) months in the allograft group and 36.3 (range,30-54) months in the autograft group.No significant difference was found for IKDC scores (89.5/86.5),Lysholm scores (93.0/94.6),Tegner scores (8.0/7.7),anterior knee pain (44.4%/72.0%)and side-to-side difference[30°: (1.72±1.73) mm vs (1.16±1.32) mm; 90°:(1.37±1.90) nun vs (-0.08±1.62)mm].Quadriceps muscle strength recovered to 82.7%/82.8% (60°/s and 120°/s) and 86.6%/85.3% (60°/sand 120°/s) for the allograft and autograft group with no significant difference.Conclusion There was no significant difference with stability and muscle strength recovery between B-PT-B aUograft and autograft.%目的 比较异体和自体骨-髌腱-骨(B-Pt-B)移植物重建膝关节前十字韧带(ACL)的临床效果.方法 27例ACL断裂患者接受关节镜下异体B-PT-B重建ACL手术,男18例,女9例;年龄16~49岁,平均25.5岁.同期25例ACL断裂患者接受关节镜下自体B-PT-B重建ACL手术,男19例,女6例;18~43岁,平均26.7岁.两组患者均采用相同的

  4. CT图像后处理重建膝关节三维模型:3D-CT评估前交叉韧带重建后的骨道差异%Reconstruction of three-dimensional models of knee joint using CT image post-processing technique:evaluation of bone tunnel difference after anterior cruciate ligament reconstruction using three-dimensional computed tomography

    Institute of Scientific and Technical Information of China (English)

    高冠奇; 张克远

    2015-01-01

    背景:有研究表明影响前交叉韧带重建手术效果的因素主要取决于骨道的位置,而目前对骨道位置的研究仍存在一定争议。目的:探讨3D-CT对关节镜辅助下前交叉韧带重建后骨道评估的临床价值。方法:对2014年1月至8月收治的58例前交叉韧带损伤患者行关节镜下前交叉韧带重建。股骨端采用Endobutton固定,胫骨端使用可吸收界面钉固定。分别对58个膝关节进行双源CT扫描,使用CT图像后处理工作站重建膝关节三维模型,再现股骨外髁内侧壁及重建后单束骨道,胫骨平台及骨道。根据Lysholm评分分级办法,将随访时Lysholm评分≥80分病例作为优良组,80分以下为不良组,标记、测量股骨及胫骨骨道中心点的相对位置,比较两者的位置关系。结果与结论:3D-CT 三维重建法清晰地反映了膝关节前交叉韧带重建后的骨道及其出入口的位置、固定物及移植物等情况。膝关节功能优良组与不良组患者的术侧膝关节的股骨骨道中心位置之间差异有显著性意义(P 0.05)。结果证实,3D-CT能够清晰重建骨隧道及前交叉韧带移植物的图像,临床上可用于评估骨隧道定位与移植物走形的关系。%BACKGROUND:Studies have shown that factors affecting the outcomes of anterior cruciate ligament reconstruction mainly depend on the position of bone tunnels. However, there stil exists certain controversy over the researches on the position of bone tunnels. OBJECTIVE:To investigate the clinical value of three-dimensional computed tomography on postoperative evaluation of bone tunnel after anterior cruciate ligament reconstruction under arthroscopic assistance. METHODS:Fifty-eight patients with anterior cruciate ligament injury who received the treatment from January 2014 to August 2014 underwent anterior cruciate ligament reconstruction under arthroscopic assistance. The femoral end was fixed using an

  5. Three-dimensional reconstruction of entire vertebral bodies

    DEFF Research Database (Denmark)

    Odgaard, A.; Andersen, K.; Ullerup, R.;

    1994-01-01

    This paper describes a technique for 3-D reconstruction of large cancellous bone regions. The output is a 3-D array describing the original cancellous bone region, and the output can be used for any kind of measurement of the bone architecture. The technique was developed as a tool for researchers...... information. The technique is based on automated serial sectioning, and all steps from specimen preparation to image segmentation are described in detail. Examples of 3-D reconstructed vertebral bodies are given. By use of the described technique, between 300 and 600 sections can be made and registered per...... conducting experimental and clinical studies related to cancellous bone architecture and, ultimately, to cancellous bone quality. A set of new and unbiased methods for quantification of cancellous bone has been a stimulus for the development of the technique, as the quantification methods rely on 3-D...

  6. Expression of glucose transporter protein-1 in benign and malignant bone tumors and its clinical significance%Glut-1在良恶性骨肿瘤中的表达及临床意义

    Institute of Scientific and Technical Information of China (English)

    樊健; 俞光荣; 袁锋; 陈凯; 梅炯; 易祥华

    2013-01-01

    Objective To investigate the expression of glucose transporter protein-1 (Glut-1) in normal bone tissue,benign and malignant bone tumors and its clinical significance.Methods Immunohistochemical staining was applied to detect Glut-1 expression in 32 cases of bone osteosarcoma,10 cases of osteochondroma and 10 specimens of normal bone tissue.The expression of Glut-1 protein was also examined by Wester-blotting method in fresh specimens of osteosarcoma and normal bone tissue.Results Immunohistochemistry showed positive expression of Glut-1 in 31cases of osteosarcoma (96.9%),including strongly positive in 20 cases (62.5%) and weakly positive in 1 case.All osteochondroma specimens presented negative staining for Glut-1,except one case presenting weakly positive,while no positive expression of Glut-1 was detected in normal bone tissue.Westernblot showed the gray value increased significantly in 3 fresh specimens of osteosarcoma compared to normal bone tissue(P < 0.05).Conclusion Glut-1 protein is positively expressed in osteosarcoma,which indicates that Glut-1 may be used to assess malignancy of bone tumors and as a potential target for treatment of bone tumors.%目的 探讨葡萄糖转运蛋白1 (Glut-1)在人正常骨组织及良恶性骨肿瘤中的表达及临床意义.方法 应用免疫组化检测32例骨肉瘤、10例骨软骨瘤及10例正常骨组织标本中Glut-1表达水平;应用Westem-Blot检测3例新鲜骨肉瘤标本及正常骨组织中Glut-1的蛋白表达情况.结果 免疫组化检验32例骨肉瘤标本阳性和强阳性31例(96.9%),其中强阳性20例(62.5%),仅有1例呈弱阳性;骨软骨瘤标本除1例为弱阳性其余都为阴性,正常骨组织中未见Glut-1阳性表达.West-blot显示3例新鲜骨肉瘤标本灰度比较正常骨组织明显增大(P<0.05).结论 Glut-1在骨肉瘤组织中呈高水平表达,可作为判断骨肉瘤恶性程度参考及可能的治疗靶点.

  7. Bone tissue engineering: from bench to bedside

    Directory of Open Access Journals (Sweden)

    Maria A. Woodruff

    2012-10-01

    Full Text Available The drive to develop bone grafts for the filling of major gaps in the skeletal structure has led to a major research thrust towards developing biomaterials for bone engineering. Unfortunately, from a clinical perspective, the promise of bone tissue engineering which was so vibrant a decade ago has so far failed to deliver the anticipated results of becoming a routine therapeutic application in reconstructive surgery. Here we describe our bench to bedside concept, the first clinical results and a detailed analysis of long-term bone regeneration studies in preclinical animal models, exploiting methods of micro- and nano analysis of biodegradable composite scaffolds.

  8. Afghanistan Reconstruction

    Institute of Scientific and Technical Information of China (English)

    Fu Xiaoqiang

    2006-01-01

    @@ The Karzai regime has made some progress over the past four years and a half in the post-war reconstruction.However, Taliban's destruction and drug economy are still having serious impacts on the security and stability of Afghanistan.Hence the settlement of the two problems has become a crux of affecting the country' s future.Moreover, the Karzai regime is yet to handle a series of hot potatoes in the fields of central government' s authority, military and police building-up and foreign relations as well.

  9. EFFECTIVENESS OF BONE-ANTERIOR CRUCIATE LIGAMENT-BONE ALLOGRAFT IN RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT UNDER ARTHROSCOPE%关节镜下同种异体骨-前交叉韧带-骨移植重建前交叉韧带的疗效分析

    Institute of Scientific and Technical Information of China (English)

    郭珊成; 张峡; 郝勇

    2011-01-01

    structure of the knee.To evaluate the method and outcome of bone-ACL-bone (B-ACL-B) allograft under arthroscope in reconstruction of ACL.Methods Between October 2007 and February 2010, arthroscopic ACL reconstruction with deep-freezing B-ACL-B allograft was performed on 22 patients with ACL ruptures.There were 15 males and 7 females with an average age of 27.6 years (range, 19-55 years).The causes of ACL rupture were sport trauma in 12 cases, falling injury in 1 case, heavy crush in 2 cases,and traffic accident in 7 cases.The locations were the left knee in 14 cases and the right knee in 8 cases.The disease duration was 7 days to 12 months (median, 65 days).Nineteen patients showed the positive results of anterior drawer test and pivot shift test, and 21 patients showed the positive results of Lachman test.According to International Knee Documentation Committee (IKDC) criteria, there were 5 abnormal and 17 severely abnormal.The subjective IKDC score was 49.6 ± 6.9.The Lysholm score was 48.5 ± 5.3.The Tegner scale scores were 6.8 ± 1.2 before injury and 2.1 ± 0.5 before operation.The MRI showed the ACL injuries in 18 of 20 patients.Results The mean operative time was 75 minutes (range, 65-85 minutes); the mean blood loss was 110 mL (range, 80-150 mL).All incisions healed by first intention.No immunologic rejection and deep vein thrombosis of lower limbs occurred.All patients were followed up 7-34 months (mean, 18 months).At last follow-up, the flexion of the knee ranged from 125 to 135° (mean, 130.5°).Two patients showed the positive results of anterior drawer test, 1 patient showed the positive result of pivot shift test, and 3 patients showed the positive results of Lachman test.According to the IKDC criteria, 10 patients rated as normal, 11 patients as nearly normal, 1 patient as abnormal.The subjective IKDC score was 90.0 ± 5.8, showing significant difference when compared with preoperative one (t=4.653, P=0.021).The Lysholm score was 91.6 ± 7.1, showing

  10. Curative effect of bone transport for infectious large segmental bone defect after surgical treatment for tibial fracture%骨搬移术治疗胫骨骨折术后感染性大段骨缺损的疗效分析

    Institute of Scientific and Technical Information of China (English)

    郝光亮; 张贵春; 曹学成

    2014-01-01

    transport technique. Objective:To explore the curative effect of bone transport technique in treating infectious large segmental bone defect after surgery for tibial fracture. Methods:Forty patients with infectious large segmental bone defect after tibial fracture operation admitted to our hospital from September 2010 to September 2014 were enrolled in the study and randomly divided into two groups. Osteotomy was performed in group A by Orthofix external fixing lengthening, and osteotomy was performed in group B by Ilizarov ring fix-ing lengthening. Operation time, blood loss, HHS knee function score, Baird-Jackson ankle function score were compared between groups. Results:Compared to those in Ilizarov group, the operation time was significantly shortened and intraoperative blood loss was significantly decreased (P Conclusions:The bone transport technique can achieve good curative effect on infectious large segmental bone defect after tibial fracture operation. Both Orthofix external fixing lengthening and Ilizarov ring fixing lengthening can improve the knee and ankle joint function. The former can reduce the operation trauma and increase operation safety, but malunion and offset may occur in the procedure. More intraoperative needles will be implanted in Ilizarov lengthening, and skin flap ne-crosis and vascular injury may occur when moving. So it can not be used in the patients with large segment bone defect of tibia and the wound covered with skin flap.

  11. Bones of the Earth

    Directory of Open Access Journals (Sweden)

    Jose Miguel Correa

    2014-06-01

    Full Text Available The film Bones of the Earth (Riglin, Cunninham & Correa, 2014 is an experience in collective inquiry and visual creation based on arts-based research. Starting from the meeting of different subjectivities and through dialogue, planning, shooting and editing, an audiovisual text that reconstructs a reflexive process of collective creation is built. A sense of community, on-going inquiry, connections and social commitment inform the creative process. As a result, the video’s nearly five intense minutes are a metaphor for the search for personal meaning, connection with nature and intersubjective positioning in a world that undergoes constant change.

  12. Reconstrucción craneofacial compleja: malla de titanio, hueso autólogo preservado en óxido de etileno y reconstrucciones tridimensionales en polimetilmetacrilato (HTR-PMI Complex craneofacial reconstruction: titanium mesh, autologous bone preserved in ethylene oxide and tridimensional polimetilmetacrilate implants (HTR-PMI

    Directory of Open Access Journals (Sweden)

    G. Flores-Lima

    2010-03-01

    Full Text Available La evolución de la Cirugía Craneofacial se inicio con Jean Paul Tessier, quien en 1967 preconizó el uso de injertos autólogos de hueso fresco en gran cantidad para cubrir extensas brechas óseas en la corrección de disóstosis craneofacial. Recientemente, diferentes tipos de reconstrucción utilizando hueso autólogo preservado en oxido de etileno y materiales como el polimetilmetacrilato poroso confeccionado a medida, han permitido también la corrección de grandes defectos óseos craneofaciales. Presentamos nuestra experiencia inicial en el uso de estas técnicas a través de un análisis retrospectivo sobre 21 pacientes operados por un equipo multidisciplinario entre Enero del 2007 y Marzo del 2009 en el Hospital Militar, Centro Panamericano de Ojos y Hospital de Diagnóstico de El Salvador, en los que se utilizaron formas alternativas pera reconstrucción de calota craneana, piso de órbita, fosa craneal anterior, área órbito-cigomática y maxilar superior. No registramos casos de infección o retirada de material de osteosíntesis aloplástico o de los injertos autólogos, ni hubo fístulas. Si se presentó una úlcera postraumática en una zona de unión de tejido desvitalizado, que se resolvió con tratamiento conservador. Los resultados estéticos obtenidos fueron de aceptables a buenos. Como conclusión, el equipo multidisciplinario, la combinación de técnicas quirúrgicas y el uso de material protésico para la reconstrucción craneofacial compleja ha dado como resultado avances significativos desde el punto de vista funcional y estético ante lesiones que involucran esta compleja área anatómica.The evolution of craniofacial surgery began with Jean Paul Tessier, who in 1967 supported the use of fresh autologous bone to cover bone defects in the craniofacial area. Recently different types of reconstructions using autologous bone preserved in ethylene oxide and advanced custom-made polimetacrilate implants that have allowed

  13. Histological Study of Herbal Medicine for Kidney Tonification on Tendon -Bone Healing after Anterior Cruciate Ligament Reconstruction in Rabbits%补肾中药促进兔前交叉韧带重建术后腱-骨愈合的组织学观察

    Institute of Scientific and Technical Information of China (English)

    杨伟毅; 潘建科; 谢辉; 洪坤豪; 曹学伟; 刘军

    2016-01-01

    目的:观察中药干预兔前交叉韧带重建术后腱—骨愈合的组织学变化,探讨中药对腱—骨愈合的促进作用。方法将36只新西兰大白兔随机分为温补肾阳组、滋补肾阴组和空白对照组三组,每组12只。构建兔前交叉韧带重建术后模型,使用中药干预并制备组织标本,光镜下观察腱—骨愈合情况,评价各组腱—骨界面的组织学变化。结果 HE 染色显示滋补肾阴组的腱—骨界面区内成纤维细胞、软骨细胞的生长情况优于温补肾阳组,温补肾阳组优于空白对照组。Masson 染色显示滋补肾阴组的胶原纤维增生情况最优,温补肾阳组次之,空白对照组的胶原纤维增生最慢。结论补肾中药能促进前交叉韧带重建术后的腱—骨愈合,但其具体作用机制尚需进一步的研究加以阐释。%Objective To observe the histological changes in tendon - bone healing after anterior cruciate ligament(ACL)reconstruction in the intervention of herbal medicine in the rabbits so as to explore the enhancing effect of herbal medicine on tendon - bone healing. Methods Thirty - six New Zealand rab-bits were randomly divided into a kidney yang tonification group,a kidney yin nourishment group and a blank control group,12 rabbits in each one. The models of ACL reconstruction were prepared. After the intervention of herbal medicine,the histological specimen was collected. The tendon - bone healing condition was observed under optic microscope. The histological changes on the interface of tendon and bone were assessed. Results HE staining indicated that the growth of fibrocytes and chondracyes on tendon - bone interface in the kidney yin nourishment group was better than that in the kidney yang tonification and the result in the kidney yang tonification group was better than that in the blank control group. Masson staining showed that fi-brocytes was proliferated the best in the kidney yin nourishment group

  14. Bone cutting.

    Science.gov (United States)

    Giraud, J Y; Villemin, S; Darmana, R; Cahuzac, J P; Autefage, A; Morucci, J P

    1991-02-01

    Bone cutting has always been a problem for surgeons because bone is a hard living material, and many osteotomes are still very crude tools. Technical improvement of these surgical tools has first been their motorization. Studies of the bone cutting process have indicated better features for conventional tools. Several non-conventional osteotomes, particularly ultrasonic osteotomes are described. Some studies on the possible use of lasers for bone cutting are also reported. Use of a pressurised water jet is also briefly examined. Despite their advantages, non-conventional tools still require improvement if they are to be used by surgeons.

  15. CGF 联合骨代用品及口腔修复膜在颌骨囊肿手术中的应用%Application of CGF combined with biodegradable coral-hydroxyapatite ceramic and oral biofilm in reconstruction of bone defects after removal of jaw cysts

    Institute of Scientific and Technical Information of China (English)

    李伯友; 苏铭扬; 李阳; 林璇; 吴熙凤; 高永波

    2016-01-01

    Objective:To investigate the clinical effect of CGF combined with biodegradable coral-hydroxyapatite ceramic and oral biofilm on guiding bone regeneration after removal of jaw cysts.Methods:Forty-five cases of jaw cysts were treated by curettage.The diameter of bone defect ranged from 1.0-4.0 cm.Bone de-fects were filled with CGF and biodegradable coral-hydroxyapatite ceramic.CGF and oral repairing film The area of bone defect were covered by CGF and oral repairing film.All cases were followed-up for 3-12 months.According to the clinical observation and radiological examination,the effect of the treatment was evalua-ted.Results:Forty-five patients were healed by first intention after operation.Three months followed-up after op-eration,the line between biodegradable coral-hydroxyapatite ceramic and surrounding bone disappeared,and bone reticulate structure were observed in jaw cysts with diameter less than 2 cm.The line between coral-hydroxyapa-tite ceramic and surrounding bone were blurry with nine months followed-up.Biodegradable coral-hydroxyapatite ceramic,the new bone tissue and the surrounding bone grown well in jaw cysts with diameter greater than 2 cm in 1 years followed-up.Conclusion:CGF combined with biodegradable coralline hydroxyapatite and oral repairing film could have good effect on reconstruction of bone defects.%目的:观察浓缩生长因子( CGF)联合羟基磷灰石生物陶瓷及口腔修复膜在颌骨囊肿手术中促进骨组织愈合的临床效果。方法:45例颌骨囊肿患者行囊肿刮除术,采用浓缩生长因子及羟基磷灰石生物陶瓷混合物填充骨腔,CGF膜及口腔修复膜双层覆盖在骨缺损区表面。术后随访3~12个月,通过临床和影像学检查评估治疗效果。结果:45例患者术后伤口均为Ⅰ期愈合。直径<2 cm的骨缺损在术后3个月羟基磷灰石生物陶瓷与周围骨组织界限消失,可见正常网纹结构的骨小梁。直径>2 cm

  16. Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology.

    Science.gov (United States)

    Cohen, Adir; Laviv, Amir; Berman, Phillip; Nashef, Rizan; Abu-Tair, Jawad

    2009-11-01

    Mandibular reconstruction can be challenging for the surgeon wishing to restore its unique geometry. Reconstruction can be achieved with titanium bone plates followed by autogenous bone grafting. Incorporation of the bone graft into the mandible provides continuity and strength required for proper esthetics and function and permitting dental implant rehabilitation at a later stage. Precious time in the operating room is invested in plate contouring to reconstruct the mandible. Rapid prototyping technologies can construct physical models from computer-aided design via 3-dimensional (3D) printers. A prefabricated 3D model is achieved, which assists in accurate contouring of plates and/or planning of bone graft harvest geometry before surgery. The 2 most commonly used rapid prototyping technologies are stereolithography and 3D printing (3DP). Three-dimensional printing is advantageous to stereolithography for better accuracy, quicker printing time, and lower cost. We present 3 clinical cases based on 3DP modeling technology. Models were fabricated before the resection of mandibular ameloblastoma and were used to prepare bridging plates before the first stage of reconstruction. In 1 case, another model was fabricated and used as a template for iliac crest bone graft in the second stage of reconstruction. The 3DP technology provided a precise, fast, and cheap mandibular reconstruction, which aids in shortened operation time (and therefore decreased exposure time to general anesthesia, decreased blood loss, and shorter wound exposure time) and easier surgical procedure.

  17. Alpha-tricalcium phosphate cement in the reconstruction of bone defects in rats Cimento de alfa-tricálcio-fosfato na reconstrução de defeitos ósseos em ratos

    Directory of Open Access Journals (Sweden)

    João Gabriel Souza Pinto

    2011-04-01

    Full Text Available PURPOSE: To evaluate the ability of a mixture of α-TCP and autogenous bone (AB vs. α-TCP alone and AB alone to promote new bone formation and tissue repair in bone defects. METHODS: Bone defects surgically created in 15 male Wistar rats were divided into four groups: Group I (AB, Group II (α-TCP, Group III (α-TCP+AB assessed by light microscopy, and Group IV (α-TCP+AB assessed by scanning electron microscopy. Bone repair findings were assessed at 30, 60, and 120 days postoperatively. RESULTS: The histological findings obtained in Groups I (p=0.459, II (p=0.368, and III (p=0.459 and at 30 days (p=0.717, 60 days (p=0.717, and 120 days (p=0.779 did not show statistically significant differences. Scanning electron microscopy revealed direct contact between the α-TCP+AB implant and the bone tissue at 120 days. CONCLUSION: The α-TCP implant is effective alternative bone substitutes for the treatment of critical size bone defects.OBJETIVO: Avaliar a capacidade da mistura de α-TCP e osso autógeno (OA Vs somente α-TCP e somente OA em promover a neoformação óssea e reparo tecidual em defeitos ósseos. MÉTODOS: Foram criados cirurgicamente defeitos ósseos em 15 ratos Wistar machos, distribuídos em quatro grupos: Grupo I (OA, Grupo II (α-TCP, Grupo III (α-TCP + OA avaliado por microscopia de luz e Grupo IV (α-TCP + OA avaliado por microscopia eletrônica de varredura. Os resultados da reparação óssea foram avaliados em 30, 60 e 120 dias. RESULTADOS:os achados histológicos obtidos nos grupos I (p = 0,459, II (p = 0,368 e III (p = 0,459 e aos 30 dias (p = 0,717, 60 dias (p = 0,717, e 120 dias (p = 0,779 não apresentaram diferenças estatisticamente significativas. A análise por microscopia eletrônica de varredura revelou contacto direto entre o implante de α-TCP + AO e o tecido ósseo aos 120 dias. CONCLUSÃO: O implante de α-TCP é alternativa eficaz como substitutos ósseos para o tratamento de defeitos ósseos de tamanho crítico.

  18. Anterior and middle skull base reconstruction after tumor resection

    Institute of Scientific and Technical Information of China (English)

    WANG Bo; WU Sheng-tian; LI Zhi; LIU Pi-nan

    2010-01-01

    Background Surgical management of skull base tumors is still challenging today due to its sophisticated operation procedure. Surgeons who specialize in skull base surgery are making endeavor to promote the outcome of patients with skull base tumor. A reliable skull base reconstruction after tumor resection is of paramount importance in avoiding life-threatening complications, such as cerebrospinal fluid leakage and intracranial infection. This study aimed at investigating the indication, operation approach and operation technique of anterior and middle skull base reconstruction.Methods A retrospective analysis was carried out on 44 patients who underwent anterior and middle skull base reconstruction in the Department of Neurosurgery at Beijing Tiantan Hospital between March 2005 and March 2008. Different surgical approaches were selected according to the different regions involved by the tumor. Microsurgery was carried out for tumor resection and combined endoscopic surgery was performed in some cases. According to the different locations and sizes of various defects after tumor resection, an individualized skull base soft tissue reconstruction was carried out for each case with artificial materials, pedicled flaps, free autologous tissue, and free vascularized muscle flaps, separately. A skull base bone reconstruction was carried out in some cases simultaneously.Results Soft tissue reconstruction was performed in all 44 cases with a fascia lata repair in 9 cases, a free vascularized muscle flap in 1 case, a pedicled muscle flap in 14 cases, and a pedicled periosteal flap in 20 cases. Skull base bone reconstruction was performed on 10 cases simultaneously. The materials for bone reconstruction included titanium mesh, free autogenous bone, and a Medpor implant. The result of skull base reconstruction was satisfactory in all patients. Postoperative early-stage complications occurred in 10 cases with full recovery after conventional treatment.Conclusions The specific

  19. Mass transport of low density lipoprotein in reconstructed hemodynamic environments of human carotid arteries: the role of volume and solute flux through the endothelium.

    Science.gov (United States)

    Kim, Sungho; Giddens, Don P

    2015-04-01

    The accumulation of low density lipoprotein (LDL) in the arterial intima is a critical step in the initiation and progression of atheromatous lesions. In this study we examine subject-specific LDL transport into the intima of carotid bifurcations in three human subjects using a three-pore model for LDL mass transfer. Subject-specific carotid artery computational models were derived using magnetic resonance imaging (MRI) to obtain the geometry and phase-contract MRI (PC-MRI) to acquire pulsatile inflow and outflow boundary conditions for each subject. The subjects were selected to represent a wide range of anatomical configurations and different stages of atherosclerotic development from mild to moderate intimal thickening. A fluid-solid interaction (FSI) model was implemented in the computational fluid dynamics (CFD) approach in order to consider the effects of a compliant vessel on wall shear stress (WSS). The WSS-dependent response of the endothelium to LDL mass transfer was modeled by multiple pathways to include the contributions of leaky junctions, normal junctions, and transcytosis to LDL solute and plasma volume flux from the lumen into the intima. Time averaged WSS (TAWSS) over the cardiac cycle was computed to represent the spatial WSS distribution, and wall thickness (WTH) was determined from black blood MRI (BBMRI) so as to visualize intimal thickening patterns in the bifurcations. The regions which are exposed to low TAWSS correspond to elevated WTH and higher mass and volume flux via the leaky junctions. In all subjects, the maximum LDL solute flux was observed to be immediately downstream of the stenosis, supporting observations that existing atherosclerotic lesions tend to progress in the downstream direction of the stenosis.

  20. Efficacy of rhBMP-2 loaded PCL/PLGA/β-TCP guided bone regeneration membrane fabricated by 3D printing technology for reconstruction of calvaria defects in rabbit.

    Science.gov (United States)

    Shim, Jin-Hyung; Yoon, Min-Chul; Jeong, Chang-Mo; Jang, Jinah; Jeong, Sung-In; Cho, Dong-Woo; Huh, Jung-Bo

    2014-11-10

    We successfully fabricated a three-dimensional (3D) printing-based PCL/PLGA/β-TCP guided bone regeneration (GBR) membrane that slowly released rhBMP-2. To impregnate the GBR membrane with intact rhBMP-2, collagen solution encapsulating rhBMP-2 (5 µg ml(-1)) was infused into pores of a PCL/PLGA/β-TCP membrane constructed using a 3D printing system with four dispensing heads. In a release profile test, sustained release of rhBMP-2 was observed for up to 28 d. To investigate the efficacy of the GBR membrane on bone regeneration, PCL/PLGA/β-TCP membranes with or without rhBMP-2 were implanted in an 8 mm calvaria defect of rabbits. Bone formation was evaluated at weeks 4 and 8 histologically and histomorphometrically. A space making ability of the GBR membrane was successfully maintained in both groups, and significantly more new bone was formed at post-implantation weeks 4 and 8 by rhBMP-2 loaded GBR membranes. Interestingly, implantation with rhBMP-2 loaded GBR membranes led to almost entire healing of calvaria defects within 8 weeks.

  1. A physical mechanism for coupling bone resorption and formation in adult human bone

    DEFF Research Database (Denmark)

    Andersen, Thomas Levin; Sondergaard, Teis Esben; Skorzynska, Katarzyna Ewa

    2009-01-01

    During skeletal remodeling, pre-osteoclasts and pre-osteoblasts are targeted to critical sites of the bone to resorb and reconstruct bone matrix, respectively. Coordination of site-specific recruitment of these two cell types is a prerequisite to maintain the specific architecture of each bone...... within strict limits throughout adult life. Here, we determined that the bone marrow microanatomy adjacent to remodeling areas is a central player in this process. By using histomorphometry and multiple immunostainings, we demonstrated in biopsies exhibiting coupled bone resorption and formation...... that osteoclasts and osteoblasts on the bone surface were always covered by a canopy of flat cells expressing osteoblast markers. In contrast, in biopsies in which this canopy was disrupted, bone formation was deficient. Three-dimensional visualizations revealed that this canopy covered the entire remodeling site...

  2. Three-dimensional virtual bone bank system workflow for structural bone allograft selection: a technical report.

    Science.gov (United States)

    Ritacco, Lucas Eduardo; Farfalli, German Luis; Milano, Federico Edgardo; Ayerza, Miguel Angel; Muscolo, Domingo Luis; Aponte-Tinao, Luis

    2013-01-01

    Structural bone allograft has been used in bone defect reconstruction during the last fifty years with acceptable results. However, allograft selection methods were based on 2-dimensional templates using X-rays. Thanks to preoperative planning platforms, three-dimensional (3D) CT-derived bone models were used to define size and shape comparison between host and donor. The purpose of this study was to describe the workflow of this virtual technique in order to explain how to choose the best allograft using a virtual bone bank system. We measured all bones in a 3D virtual environment determining the best match. The use of a virtual bone bank system has allowed optimizing the allograft selection in a bone bank, providing more information to the surgeons before surgery. In conclusion, 3D preoperative planning in a virtual environment for allograft selection is an important and helpful tool in order to achieve a good match between host and donor.

  3. 富血小板血浆复合物促进兔前交叉韧带重建后腱骨愈合的组织学研究%Platelet rich plasma complex helps tendon-bone healing after reconstruction of the anterior cruciate ligament in rabbits

    Institute of Scientific and Technical Information of China (English)

    翟文亮; 陈界文; 练克俭; 郭以河

    2011-01-01

    目的探讨富血小板血浆(PRP)复合小牛脱蛋白松质骨(DPB)对兔前交叉韧带(ACL)重建术后腱骨愈合的影响。 方法取36只成年新西兰大白兔,随机分为3组:PRP+ DPB组,PRP组,空白对照组,每组12只。建立右侧膝关节ACL完全断裂模型,行白体半腱肌重建ACL。于PRP+ DPB组和PRP组骨隧道内分别植入PRP凝胶结合DPB和PRP凝胶,空白对照组骨隧道内单纯植入肌腱。术后6、12、18周行大体观察、组织学、免疫组化评价腱骨愈合情况。 结果大体观察术后各个时间点,与其他2组比较,PRP+ DPB组移植肌腱与骨隧道壁纤维组织连接更为致密。HE染色显示PRP+DPB组在各时间点腱骨界面的胶原纤维连接及纤维组织分级结果均优于其他2组。PRP+ DPB组、PRP组及空白对照组标本术后6周时TGF-β1表达量平均分别为119.5±9.3、93.0±7.3、73.3±5.4,12周时平均分别为76.8±5.7、48.0±6.7、26.8±4.7;术后6周时VEGF的表达量平均分别为117.5±8.4、90.5±8.2、69.8±5.8,12周时平均分别为76.6±5.7、48.0±6.7、26.8±4.7,以上指标3组之间两两比较差异均有统计学意义(P<0.05),PRP+DPB组优于其他2组。术后18周时3组标本TGF-β1及VEGF的表达量差异均无统计学意义(P>0.05)。 结论在兔膝关节ACL重建模型中,PRP复合DPB能促进术后的腱骨愈合。%ObjectiveTo observe the effect of platelet-rich plasma (PRP) combined with deproteinized bone (DPB) of calf as the bone tunnel filling on tendon-bone healing after anterior cruciate ligament (ACL) reconstruction in rabbits.MethodsThirty-six healthy, skeletally mature New Zealand white rabbits were used to create models of totally ruptured ACL at the right knee and then the right ruptured ACLs were reconstructed with semitendinosus tendon autografts. After ACL reconstruction, the 36 rabbits were randomly divided into 3 equal groups for different bone tunnel fillings. PRP + DPB, PRP and

  4. Reconstructive Urology

    Directory of Open Access Journals (Sweden)

    Fikret Fatih Önol

    2014-11-01

    Full Text Available In the treatment of urethral stricture, Buccal Mucosa Graft (BMG and reconstruction is applied with different patch techniques. Recently often prefered, this approach is, in bulber urethra strictures of BMG’s; by “ventral onley”, in pendulous urethra because of thinner spingiosis body, which provides support and nutrition of graft; by means of “dorsal inley” being anastomosis. In the research that Cordon et al. did, they compared conventional BMJ “onley” urethroplast and “pseudo-spongioplasty” which base on periurethral vascular tissues to be nourished by closing onto graft. In repairment of front urethras that spongiosis supportive tissue is insufficient, this method is defined as peripheral dartos [çevre dartos?] and buck’s fascia being mobilized and being combined on BMG patch. Between the years 2007 and 2012, assessment of 56 patients with conventional “ventral onley” BMG urethroplast and 46 patients with “pseudo-spongioplasty” were reported to have similar success rates (80% to 84% in 3.5 year follow-up on average. While 74% of the patients that were applied pseudo-spongioplasty had disease present at distal urethra (pendulous, bulbopendulous, 82% of the patients which were applied conventional onley urethroplast had stricture at proximal (bulber urethra yet. Also lenght of the stricture at the pseudo-spongioplasty group was longer in a statistically significant way (5.8 cm to 4.7 cm on average, p=0.028. This study which Cordon et al. did, shows that conditions in which conventional sponjiyoplasti is not possible, periurethral vascular tissues are adequate to nourish BMG. Even it is an important technique in terms of bringing a new point of view to today’s practice, data especially about complications that may show up after pseudo-spongioplasty usage on long distal strictures (e.g. appearance of urethral diverticulum is not reported. Along with this we think that, providing an oppurtinity to patch directly

  5. Bioresorbable and nonresorbable polymers for bone tissue engineering.

    Science.gov (United States)

    Girones Molera, Jordi; Mendez, José Alberto; San Roman, Julio

    2012-01-01

    In recent years, bone tissue engineering has emerged as one of the main research areas in the field of regenerative biomedicine. Frequency and relevance age-related diseases, such as healing and regeneration of bone tissues, are rising due to increasing life expectancy. Even though bone tissue has excellent self-regeneration ability, when bone defects exceed a critical size, impaired bone formation can occur and surgical intervention becomes mandatory. Bone tissue engineering represents an alternative approach to conventional bone transplants. The main aim of tissue engineering is to repair, regenerate or reconstruct damaged or degenerative tissue. This review presents an overview on the main materials, techniques and strategies in the field of bone tissue engineering. Whilst presenting some reviews recently published that deepen on each of the sections of the paper, this review article aims to present some of the most relevant advances, both in terms of new materials and strategies, currently being developed for bone repair and regeneration.

  6. Traumatic Forefoot Reconstructions With Free Perforator Flaps.

    Science.gov (United States)

    Zhu, Yue-Liang; He, Xiao-Qing; Wang, Yi; Lv, Qian; Fan, Xin-Yv; Xu, Yong-Qing

    2015-01-01

    The forefoot is critical to normal walking; thus, any reconstruction of forefoot defects, including the soft tissues, must be carefully done. The free perforator flap, with its physiologic circulation, lower donor site morbidity, and minimal thickness is the most popular technique in plastic and microsurgery, and is theoretically the most suitable for such forefoot reconstruction. However, these flaps are generally recognized as more difficult and time-consuming to create than other flaps. In 41 patients with traumatic forefoot defects, we reconstructed the forefoot integument using 5 types of free perforator flaps. The overall functional and cosmetic outcomes were excellent. Three flaps required repeat exploration; one survived. The most common complications were insufficient perfusion and the need for second debulking. The key to our success was thoroughly debriding devitalized bone and soft tissue before attaching the flap. Forefoot reconstruction with a free perforator flap provides better function, better cosmesis, better weightbearing, and better gait than the other flaps we have used.

  7. Bone x-ray

    Science.gov (United States)

    ... or broken bone Bone tumors Degenerative bone conditions Osteomyelitis (inflammation of the bone caused by an infection) ... Multiple myeloma Osgood-Schlatter disease Osteogenesis imperfecta Osteomalacia Osteomyelitis Paget disease of the bone Rickets X-ray ...

  8. Outcome of limb reconstruction system in open tibial diaphyseal fractures

    Directory of Open Access Journals (Sweden)

    Anand Ajmera

    2015-01-01

    Full Text Available Background: Management of open tibial diaphyseal fractures with bone loss is a matter of debate. The treatment options range from external fixators, nailing, ring fixators or grafting with or without plastic reconstruction. All the procedures have their own set of complications, like acute docking problems, shortening, difficulty in soft tissue management, chronic infection, increased morbidity, multiple surgeries, longer hospital stay, mal union, nonunion and higher patient dissatisfaction. We evaluated the outcome of the limb reconstruction system (LRS in the treatment of open fractures of tibial diaphysis with bone loss as a definative mode of treatment to achieve union, as well as limb lengthening, simultaneously. Materials and Methods: Thirty open fractures of tibial diaphysis with bone loss of at least 4 cm or more with a mean age 32.5 years were treated by using the LRS after debridement. Distraction osteogenesis at rate of 1 mm/day was done away from the fracture site to maintain the limb length. On the approximation of fracture ends, the dynamized LRS was left for further 15-20 weeks and patient was mobilized with weight bearing to achieve union. Functional assessment was done by Association for the Study and Application of the Methods of Illizarov (ASAMI criteria. Results: Mean followup period was 15 months. The mean bone loss was 5.5 cm (range 4-9 cm. The mean duration of bone transport was 13 weeks (range 8-30 weeks with a mean time for LRS in place was 44 weeks (range 24-51 weeks. The mean implant index was 56.4 days/cm. Mean union time was 52 weeks (range 31-60 weeks with mean union index of 74.5 days/cm. Bony results as per the ASAMI scoring were excellent in 76% (19/25, good in 12% (3/25 and fair in 4% (1/25 with union in all except 2 patients, which showed poor results (8% with only 2 patients having leg length discrepancy more than 2.5 cm. Functional results were excellent in 84% (21/25, good in 8% (2/25, fair in 8% (2/25. Pin

  9. Hanford Environmental Dose Reconstruction Project

    Energy Technology Data Exchange (ETDEWEB)

    Finch, S.M.; McMakin, A.H. (comps.)

    1992-02-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): source terms; environmental transport; environmental monitoring data; demography, food consumption, and agriculture; environmental pathways and dose estimates.

  10. 膝关节持续被动活动对兔重建前交叉韧带腱骨愈合的影响%The effects of continuous passive motion on tendon-bone healing of the tendon autograft used for anterior cruciate ligament reconstruction in a rabbit model

    Institute of Scientific and Technical Information of China (English)

    黄红拾; 敖英芳; 王永健; 李雪

    2008-01-01

    Objective To study the effects of continuous passive motion on the tendon-bone healing of the semitendinous tendon autograft used for anterior cruciate ligament (ACL) reconstruction in rabbits.Methods In 12 healthy 8-month-old male rabbits, an ACL reconstruction was performed by using double semitendinous tendon autograft. Postoperatively these animals were treated by either continuous passive motion(CPM) or cage activity. Specimens of the grafts were collected at 6, 12, 24 weeks postoperatively.Histological change in the tendon-bone healing was studied by haematoxylin-eosin and toluidine blue.Results There was more new fiber tissue in the anterior half of the interface. Osteoclasts were most numerous at the tunnel aperture and in the anterior half of the interface. Cartilage in the tendon-bone interface was localized to the posterior aspect of tunnels, the area where compressive stress would be predicted. CPM group developed a denser connective tissue with less vascularity and cellularity. The bone tunnel had more areas with ingrowing denser connective tissue compared with cage activity specimens. With the growth of Sharpery's fibers and fibrocartilage into the interface, a direct ligament insertion was found. In the CPM specimens, the interface tissue was more mature and the direct insertion was broader and more structured. Conclusions Compressive stress promotes chondroid formation, and the tension promotes fiber formation. Tendon-bone healing may be optimized by CPM after tendon transplantation into a bone tunnel.%目的 通过兔半腱肌腱腱后固定方法重建前交叉韧带(ACL)实验动物模型,研究持续被动活动(CPM)对移植物隧道内腱骨界面的组织学转归影响.方法 对12只雄性新西兰大白兔右侧后肢膝关节行自体双股半腱肌腱移植重建ACL.术后随机分为两组:CPM组(n=6)术后第2天开始早期CPM康复6周;自由活动组(n=6)笼养.分别于术后第6、12、24周取材,采用HE和甲苯胺蓝染色

  11. Improved dopamine transporter binding activity after bone marrow mesenchymal stem cell transplantation in a rat model of Parkinson's disease: small animal positron emission tomography study with F-18 FP-CIT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Bok-Nam; Lee, Kwanjae; An, Young-Sil [School of Medicine, Ajou University, Department of Nuclear Medicine and Molecular Imaging, Woncheon-dong, Yeongtong-gu, Gyeonggi-do, Suwon (Korea, Republic of); Kim, Jang-Hee; Park, So Hyun [Ajou University School of Medicine, Department of Pathology, Suwon (Korea, Republic of)

    2015-05-01

    We evaluated the effects of bone marrow-derived mesenchymal stem cells (BMSCs) in a model of Parkinson's disease (PD) using serial F-18 fluoropropylcarbomethoxyiodophenylnortropane (FP-CIT) PET. Hemiparkinsonian rats were treated with intravenously injected BMSCs, and animals without stem cell therapy were used as the controls. Serial FP-CIT PET was performed after therapy. The ratio of FP-CIT uptake in the lesion side to uptake in the normal side was measured. The changes in FP-CIT uptake were also analyzed using SPM. Behavioural and histological changes were observed using the rotational test and tyrosine hydroxylase (TH)-reactive cells. FP-CIT uptake ratio was significantly different in the BMSCs treated group (n = 28) at each time point. In contrast, there was no difference in the ratio in control rats (n = 25) at any time point. SPM analysis also revealed that dopamine transporter binding activity was enhanced in the right basal ganglia area in only the BMSC therapy group. In addition, rats that received BMSC therapy also exhibited significantly improved rotational behaviour and preservation of TH-positive neurons compared to controls. The therapeutic effect of intravenously injected BMSCs in a rat model of PD was confirmed by dopamine transporter PET imaging, rotational functional studies, and histopathological evaluation. (orig.)

  12. Bone pain

    DEFF Research Database (Denmark)

    Frost, Charlotte Ørsted; Hansen, Rikke Rie; Heegaard, Anne-Marie

    2016-01-01

    Skeletal conditions are common causes of chronic pain and there is an unmet medical need for improved treatment options. Bone pain is currently managed with disease modifying agents and/or analgesics depending on the condition. Disease modifying agents affect the underlying pathophysiology...... of the disease and reduce as a secondary effect bone pain. Antiresorptive and anabolic agents, such as bisphosphonates and intermittent parathyroid hormone (1-34), respectively, have proven effective as pain relieving agents. Cathepsin K inhibitors and anti-sclerostin antibodies hold, due to their disease...... modifying effects, promise of a pain relieving effect. NSAIDs and opioids are widely employed in the treatment of bone pain. However, recent preclinical findings demonstrating a unique neuronal innervation of bone tissue and sprouting of sensory nerve fibers open for new treatment possibilities....

  13. Bone graft

    Science.gov (United States)

    ... around the area. The bone graft can be held in place with pins, plates, or screws. Why ... Orthopaedic Surgery, San Francosco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the ...

  14. 关节镜下自体骨-半腱肌股薄肌腱双束重建膝关节后交叉韧带%Double-bundle posterior cruciate ligament reconstruction using bone-semitendinosns and gracilis tendons under arthroscope

    Institute of Scientific and Technical Information of China (English)

    孙英华; 焦兆德; 王莉; 王燕青

    2008-01-01

    目的 探讨关节镜下应用自体骨-半腱肌股薄肌腱双束重建膝关节后交叉韧带(PCL)的方法及疗效.方法 回顾性分析2004年3月至2007年3月在关节镜下应用自体骨-半腱肌股薄肌腱双束重建膝关节PCL 16例患者的临床资料.术中用环钻钻取肌腱附着点柱状骨块,建立股骨双骨道及胫骨骨道,确保移植物在股骨及胫骨骨道内紧密固定.术前及术后12个月时用Lysholm评分评定膝关节功能.结果 16例患者术前Lysholm评分平均为57分(43~65分),术后12个月时平均为86分(68~92分),总优良率87.5%.术后无感染等并发症.结论 关节镜下应用自体骨-半腱肌股薄肌腱双束重建膝关节PCL可有效改善膝关节稳定性.术中股骨及胫骨骨道精确定位、术后系统康复治疗是确保手术疗效的关键.%Objective To evaluate the method and effect of double-bundle posterior cruciate ligament (PCL) reconstruction using bone-semitendinosus and gracilis tendons under arthroscope.Methods The data of 16 patients was reviewed,who had underwent arthroscopic PCL reconstruction using the bone-semitendinosus and gracilis tendons from March 2004 to March 2007.A special technique using trephine was allowed for the cylindrical bone plugs attached to the semitendinosus and gracilis tendons.The femoral double-tunnel and the tibial tunnel were prepared,and the adequate press-fit fixations of tendon grafts were ensured within them.Results All patients were followed up.Before operation,the mean Lysholm score was 57 points (43-65 points).While 12 months later after operation,the mean Lysholm score was 86 points (68-92 points).The excellent and good results were obtained in 87.5%.Conclusions Arthroscopic PCL reconstruction using bone-semitendinosns and gracilis tendons can effectively improve the stability of the knee joint.The key to achieve a good treatment is that precise positions of femoral and tibial tunnels in operation and systematic rehabilitation

  15. Role of platelet-rich plasma in tendon-bone healing after anterior cruciate ligament reconstruction with tendon allograft%富血小板血浆凝胶在同种异体肌腱重建前交叉韧带后腱-骨愈合中的作用

    Institute of Scientific and Technical Information of China (English)

    王亚斌; 于绍斌; 董启榕

    2010-01-01

    目的 观察富血小板血浆(platelet-rich plasma,PRP)凝胶对同种异体跟腱重建兔前交叉韧带(ACL)后腱一骨愈合的影响.方法 24只兔行双侧ACL重建;一侧膝关节移植物予自体PRP凝胶预处理(实验组),另一侧膝关节移植物不予处理(对照组).于术后2,6和12周行组织学、免疫组化和生物力学评价.结果 2周和6周时Burak评分实验组高于对照组.12周时对照组腱-骨界面为成熟瘢痕组织,而实验组显示该界面为成熟纤维软骨带.免疫组化显示实验组血管内皮生长因子(VEGF)的阳性表达在早期较对照组高,TGF-β1的表达持续高于对照组.生物力学分析显示2周及6周时实验组极限负荷[(15.3±2.9)N、(33.2±6.9)N]明显高于对照组((7.9±1.4)N、(23.7±4.9)N](P<0.05).结论 PRP凝胶可促进同种异体移植肌腱早期腱-骨愈合.%Objective To observe the effect of platelet-rich plasma(PRP)gel on tendon-bone healing following tendon allograft reconstruction of anterior cruciate ligament(ACL).Methods Bilateral ACL reconstructions using Achilles tendon allografts were performed in 24 New Zealand white rabbits matured skeletally.One knee joint was pretreated with the allograft PRP gel(served as experimental group),while the contralateral knee joint was free from treatment with PRP(served as control group).The reconstructions were assessed histologically,immunohistochemically and biomechanically at 2,6 and 12 weeks.Results At 2 and 6 weeks,Burak scores of experimental group were higher than control group.At 12 weeks,the grafts showed a mature zone of fibrocartilage in experimental group but mature scar tissues on the tendon-bone surface.Immunohistochemistry demonstrated early higher expression of VEGF in experimental group than control group and continually higher expression of TGF-β1 in experimental than control group.In contrast,the grafts of the controls group revealed the development of mature scar tissue resembling Sharpey fibers

  16. A composite demineralized bone matrix--self assembling peptide scaffold for enhancing cell and growth factor activity in bone marrow.

    Science.gov (United States)

    Hou, Tianyong; Li, Zhiqiang; Luo, Fei; Xie, Zhao; Wu, Xuehui; Xing, Junchao; Dong, Shiwu; Xu, Jianzhong

    2014-07-01

    The need for suitable bone grafts is high; however, there are limitations to all current graft sources, such as limited availability, the invasive harvest procedure, insufficient osteoinductive properties, poor biocompatibility, ethical problems, and degradation properties. The lack of osteoinductive properties is a common problem. As an allogenic bone graft, demineralized bone matrix (DBM) can overcome issues such as limited sources and comorbidities caused by invasive harvest; however, DBM is not sufficiently osteoinductive. Bone marrow has been known to magnify osteoinductive components for bone reconstruction because it contains osteogenic cells and factors. Mesenchymal stem cells (MSCs) derived from bone marrow are the gold standard for cell seeding in tissue-engineered biomaterials for bone repair, and these cells have demonstrated beneficial effects. However, the associated high cost and the complicated procedures limit the use of tissue-engineered bone constructs. To easily enrich more osteogenic cells and factors to DBM by selective cell retention technology, DBM is modified by a nanoscale self-assembling peptide (SAP) to form a composite DBM/SAP scaffold. By decreasing the pore size and increasing the charge interaction, DBM/SAP scaffolds possess a much higher enriching yield for osteogenic cells and factors compared with DBM alone scaffolds. At the same time, SAP can build a cellular microenvironment for cell adhesion, proliferation, and differentiation that promotes bone reconstruction. As a result, a suitable bone graft fabricated by DBM/SAP scaffolds and bone marrow represents a new strategy and product for bone transplantation in the clinic.

  17. Development of Composite Scaffolds for Load Bearing Segmental Bone Defects

    Science.gov (United States)

    2013-07-01

    composite scaffolds designed to serve as bone regenerative therapies . We analyzed the benefits and drawbacks of different composite scaffold...related to fractures, sport and blast injuries. Diseases include bone cancer (osteosarcoma), tumor resection and reconstruction, osteoporosis ...selection for the scaffold has a direct impact on the biological and physical properties of the construct, there are some factors contributing to the

  18. Low Bone Density

    Science.gov (United States)

    ... Information › Bone Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your ... compared to people with normal bone density. Detecting Low Bone Density A bone density test will determine ...

  19. Giant cell tumor of bone: Multimodal approach

    Directory of Open Access Journals (Sweden)

    Gupta A

    2007-01-01

    Full Text Available Background: The clinical behavior and treatment of giant cell tumor of bone is still perplexing. The aim of this study is to clarify the clinico-pathological correlation of tumor and its relevance in treatment and prognosis. Materials and Methods: Ninety -three cases of giant cell tumor were treated during 1980-1990 by different methods. The age of the patients varied from 18-58 yrs with male and female ratio as 5:4. The upper end of the tibia was most commonly involved (n=31, followed by the lower end of the femur(n=21, distal end of radius(n=14,upper end of fibula (n=9,proximal end of femur(n=5, upper end of the humerus(n=3, iliac bone(n=2,phalanx (n=2 and spine(n=1. The tumors were also encountered on uncommon sites like metacarpals (n=4 and metatarsal(n=1. Fifty four cases were treated by curettage and bone grafting. Wide excision and reconstruction was performed in twenty two cases . Nine cases were treated by wide excision while primary amputation was performed in four cases. One case required only curettage. Three inaccessible lesions of ilium and spine were treated by radiotherapy. Results: 19 of 54 treated by curettage and bone grafting showed a recurrence. The repeat curettage and bone grafting was performed in 18 cases while amputation was done in one. One each out of the cases treated by wide excision and reconstruction and wide excision alone recurred. In this study we observed that though curettage and bone grafting is still the most commonly adopted treatment, wide excision of tumor with reconstruction has shown lesser recurrence. Conclusion: For radiologically well-contained and histologically typical tumor, curettage and autogenous bone grafting is the treatment of choice . The typical tumors with radiologically deficient cortex, clinically aggressive tumors and tumors with histological Grade III should be treated by wide excision and reconstruction.

  20. The use of absorbable membranes for Guided Bone Regeneration in horizontal localized bone defects.

    Directory of Open Access Journals (Sweden)

    Adamantia VLACHAKI

    2016-08-01

    Full Text Available SUMMARY: One of the most widely used techniques for the reconstruction of horizontal alveolar defects is Guided Bone Regeneration (GBR. Aim of this literature review is to present and evaluate the clinical techniques for horizontal GBR in localized bone defects with the use of bone grafts and barrier absorbable membranes. In order to accomplish this literature review, a survey in website Pubmed was carried out, with key words: GBR in horizontal defects, GBR in localized defects, bone substitutes, absorbable membranes. Experimental animal studies, studies which described the autogenous block techniques and studies which described GBR with nonabsorbable membranes were excluded from this literature review. GBR was found to be a well document and predictable technique for horizontal localized bone defects, in order to place dental implants. Also the use of xenogenous bone graft in combination with absorbable membrane presents a lot of encouraging results, with high success and survival implant rate.

  1. Anterior Cruciate Ligament Reconstruction: A 2015 global perspective of the Magellan Society

    Directory of Open Access Journals (Sweden)

    Yee Han Dave Lee

    2015-10-01

    Conclusion: Based on the survey, hamstring transportal anatomic single-bundle ACL reconstruction with meniscus preservation is the preferred ACL reconstruction technique of high-volume fellowship-trained sports surgeons.

  2. Bone marrow transplant

    Science.gov (United States)

    Transplant - bone marrow; Stem cell transplant; Hematopoietic stem cell transplant; Reduced intensity nonmyeloablative transplant; Mini transplant; Allogenic bone marrow transplant; Autologous bone marrow transplant; Umbilical ...

  3. 可吸收微型骨锚在腱性锤状指损伤治疗中的重建作用%The reconstructing effect of absorbable Mini-bone anchor in the treatment of tendinous mallet finger injuries

    Institute of Scientific and Technical Information of China (English)

    牛晓锋; 肖良宝; 曾海燕; 易建华; 胡军

    2015-01-01

    目的:观察可吸收Mitek微型骨锚在修复腱性锤状指损伤中的疗效,并对可能存在的并发症进行评估。方法回顾性分析2008年9月—2011年5月治疗的22例腱性锤状指损伤,均采用可吸收Mitek微型骨锚重建伸肌腱止点,根据Watson-Jones分型,Ⅱ型14例,Ⅲ型8例。随访期间记录远指间关节活动范围、X线平片检查结果、主观满意程度及手术并发症情况,并按照Crawford功能评分标准评估疗效。结果伤指功能优18例,良3例,可1例。X线平片检查未见锚钉滑脱、局部骨质吸收。无皮肤溃疡或坏死、组织排斥反应、畸形复发等并发症。结论可吸收Mitek微型骨锚是修复腱性锤状指损伤的可靠方法,手术简便,并发症较少,作用确切。%Objective To observe the treatment outcome of absorbable min-bone anchor for rehabilitating the tendinous Mallet finger injuries, and evaluate the possible complications. Methods Between June 2008 and May 2011, 22 cases of tendinous Mallet finger injuries treated by using absorbable Mitek mini-bone anchor were retrospectively reviewed. According to the Watson-Jones classification, 14 cases of type II, 8 cases of type III. During the follow up, distal interphalangeal joint range of motion, X-ray results, subjective satisfaction of patients and corresponding complications were recorded, and curative effects were evaluated by Crawford functional scoring standard. Results Functional scores were excellent in 18 cases, good in 3 cases, fair in 1 case. X-ray results showed no slippage or loose of anchor, and no local bone absorption. There were no skin ulcer, pain, deformity recurrence and other complications. Conclusion Absorbable mini-bone anchor is a simple and effective treatment modality to reconstruct the tendinous Mallet finger injuries ,with less complications and exact curative effects.

  4. Neuromagnetic source reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, P.S.; Mosher, J.C. [Los Alamos National Lab., NM (United States); Leahy, R.M. [University of Southern California, Los Angeles, CA (United States)

    1994-12-31

    In neuromagnetic source reconstruction, a functional map of neural activity is constructed from noninvasive magnetoencephalographic (MEG) measurements. The overall reconstruction problem is under-determined, so some form of source modeling must be applied. We review the two main classes of reconstruction techniques-parametric current dipole models and nonparametric distributed source reconstructions. Current dipole reconstructions use a physically plausible source model, but are limited to cases in which the neural currents are expected to be highly sparse and localized. Distributed source reconstructions can be applied to a wider variety of cases, but must incorporate an implicit source, model in order to arrive at a single reconstruction. We examine distributed source reconstruction in a Bayesian framework to highlight the implicit nonphysical Gaussian assumptions of minimum norm based reconstruction algorithms. We conclude with a brief discussion of alternative non-Gaussian approachs.

  5. Bone regeneration: current concepts and future directions

    Directory of Open Access Journals (Sweden)

    McGonagle Dennis

    2011-05-01

    Full Text Available Abstract Bone regeneration is a complex, well-orchestrated physiological process of bone formation, which can be seen during normal fracture healing, and is involved in continuous remodelling throughout adult life. However, there are complex clinical conditions in which bone regeneration is required in large quantity, such as for skeletal reconstruction of large bone defects created by trauma, infection, tumour resection and skeletal abnormalities, or cases in which the regenerative process is compromised, including avascular necrosis, atrophic non-unions and osteoporosis. Currently, there is a plethora of different strategies to augment the impaired or 'insufficient' bone-regeneration process, including the 'gold standard' autologous bone graft, free fibula vascularised graft, allograft implantation, and use of growth factors, osteoconductive scaffolds, osteoprogenitor cells and distraction osteogenesis. Improved 'local' strategies in terms of tissue engineering and gene therapy, or even 'systemic' enhancement of bone repair, are under intense investigation, in an effort to overcome the limitations of the current methods, to produce bone-graft substitutes with biomechanical properties that are as identical to normal bone as possible, to accelerate the overall regeneration process, or even to address systemic conditions, such as skeletal disorders and osteoporosis.

  6. Bone mineral content and bone metabolism in young adults with severe periodontitis

    DEFF Research Database (Denmark)

    Wowern von, N.; Westergaard, J.; Kollerup, G.

    2001-01-01

    Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis......Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis...

  7. Mandibular reconstruction with composite microvascular tissue transfer

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, J.J. III; Wooden, W.A. (Emory Univ. School of Medicine, Atlanta, GA (USA))

    1990-10-01

    Microvascular free tissue transfer has provided a variety of methods of restoring vascularized bone and soft tissue to difficult defects created by tumor resection and trauma. Over 7 years, 26 patients have undergone 28 free flaps for mandibular reconstruction, 15 for primary squamous cell carcinoma of the floor of the mouth or tongue, 7 for recurrent tumor, and 6 for other reasons (lymphangioma (1), infection (1), gunshot wound (1), and osteoradionecrosis (3)). Primary reconstruction was performed in 19 cases and secondary in 9. All repairs were composite flaps including 12 scapula, 5 radial forearm, 3 fibula, 2 serratus, and 6 deep circumflex iliac artery. Mandibular defects included the symphysis alone (7), symphysis and body (5), symphysis-body-ramus condyle (2), body or ramus (13), and bilateral body (1). Fourteen patients had received prior radiotherapy to adjuvant or curative doses. Eight received postoperative radiotherapy. All patients had initially successful vascularized reconstruction by clinical examination (28) and positive radionuclide scan (22 of 22). Bony stability was achieved in 25 of 26 patients and oral continence in 24 of 26. One complete flap loss occurred at 14 days. Complications of some degree developed in 22 patients including partial skin necrosis (3), orocutaneous fistula (3), plate exposure (1), donor site infection (3), fracture of reconstruction (1), and fracture of the radius (1). Microvascular transfer of bone and soft tissue allows a reliable reconstruction--despite previous radiotherapy, infection, foreign body, or surgery--in almost every situation in which mandible and soft tissue are absent. Bony union, a healed wound, and reasonable function and appearance are likely despite early fistula, skin loss, or metal plate or bone exposure.

  8. Hanford Environmental Dose Reconstruction Project

    Energy Technology Data Exchange (ETDEWEB)

    Finch, S.M.; McMakin, A.H. (comps.)

    1991-01-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is being managed and conducted by the Pacific Northwest Laboratory (PNL) under the direction of an independent Technical Steering Panel (TSP). The TSP consists of experts in environmental pathways, epidemiology, surface-water transport, ground-water transport, statistics, demography, agriculture, meteorology, nuclear engineering, radiation dosimetry, and cultural anthropology. Included are appointed technical members representing the states of Oregon and Washington, a representative of Native American tribes, and an individual representing the public. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on human (dose estimates): Source Terms; Environmental Transport; Environmental Monitoring Data; Demographics, Agriculture, Food Habits and; Environmental Pathways and Dose Estimates.

  9. Como mensurar o alargamento dos túneis ósseos na cirurgia de reconstrução do ligamento cruzado anterior? descrição de uma técnica How can bone tunnel enlargement in anterior cruciate ligament reconstruction surgery be measured? description of a technique

    Directory of Open Access Journals (Sweden)

    Adriano Barros de Aguiar Leonardi

    2011-01-01

    Full Text Available OBJETIVO: Constatar a presença do alargamento do túnel ósseo tibial após a cirurgia de reconstrução do ligamento cruzado anterior usando enxerto quádruplo de tendões flexores e propor uma nova técnica para sua mensuração. MÉTODOS: O estudo durou seis meses, com 25 pacientes de idades variando entre 18 e 43 anos. A avaliação baseou-se em radiografias realizadas no pós-operatório imediato, terceiro e sexto meses de evolução das operações de reconstrução dos ligamentos cruzados anteriores reconstruídos com os enxertos do tendão do músculo semitendíneo e do músculo grácil, fixados no fêmur com parafuso transverso metálico e, na tíbia, com parafuso de interferência. As radiografias foram avaliadas pelo valor relativo entre o diâmetro do túnel e do osso, ambos 2cm abaixo do côndilo tibial medial. RESULTADOS: Aumento significativo dos diâmetros dos túneis, de 20,56% para radiografias na incidência anteroposterior e de 26,48% na incidência de perfil. O alargamento esteve presente em 48% das radiografias AP e perfil, porém esteve presente nas duas incidências em apenas 16% dos casos. CONCLUSÕES: O alargamento dos túneis ósseos é um fenômeno presente nos primeiros meses após a cirurgia de reconstrução do ligamento cruzado anterior. A técnica de mensuração proposta neste estudo é suficiente para sua detecção.OBJECTIVE: To assess the presence of tibial bone tunnel enlargement after surgery to reconstruct the anterior cruciate ligament using quadruple flexor tendon grafts, and to propose a new technique for its measurement. METHODS: The study involved 25 patients aged 18-43 years over a six-month period. The assessment was based on radiographs taken immediately postoperatively and in the third and sixth months of evolution after operations to reconstruct the anterior cruciate ligament using grafts from the tendons of the semitendinosus and gracilis muscles, fixed in the femur with a transverse metal

  10. 多层螺旋CT骨三维重建在肋骨及肋软骨骨折的诊断价值%The Diagnostic Value of Multi-slice Spiral CT 3D Bone Reconstruction on Rib and Rib Cartilage Fractures

    Institute of Scientific and Technical Information of China (English)

    苏杨; 刘静; 王江玥

    2016-01-01

    Objective To explore the application value of multi-slice spiral CT (MSCT) three-dimensional (3D) bone reconstruction on the diagnosis of rib and rib cartilage fractures.Methods Forty-three cases of patients with chest injury were treated as the study objects. All of them underwent multi-slice spiral CT scanning. Volume rendering (VR), maximum intensity projection (MIP) and multi planar reconstruction (MPR) were used for 3D reconstruction of ribs and rib cartilage. Compared with routine CT scan, the diagnostic advantages of MSCT 3D reconstruction were analyzed.Results Forty-three cases had rib fractures, a total of 122 ribs. Single fractures accounted for 30.23% and multiple fractures accounted for 69.77%; The axillary segment of rib fracture was common, accounting for 95.65%, 15 cases had rib cartilage fractures, a total of 23, 24 cases were detected with complications by MSCT. The accuracy rate of MSCT 3D reconstruction in the diagnosis of rib and rib cartilage fractures (98.36%, 95.65%) were significantly higher than those of CT scan (72.95%, 13.04%) (P<0.05).Conclusion The accuracy of MSCT in the diagnosis of rib and cartilage fractures is high. It can be used as an ideal imaging method for the diagnosis of the disease.%目的:探讨多层螺旋CT(multi-slice spiral computed tomography, MSCT)骨三维重建在诊断肋骨及肋软骨骨折中的应用价值。方法选取43例胸部外伤患者为研究对象,均行多层螺旋CT扫描,运用容积重建(volume rendering, VR)、最大密度投影(maximum intensity projection, MIP)、多平面重建(multi planar reconstruction, MPR)三维重建肋骨及肋软骨,并与常规CT平扫对比,分析MSCT三维重建的诊断优势。结果43例肋骨骨折,共122根;其中单发骨折占30.23%,多发骨折占69.77%;肋骨骨折腋段较为常见,占95.65%;15例肋软骨骨折,共23根;MSCT检出24例外伤后并发症。MSCT三维重建技术诊断肋骨及肋软骨骨折的准确率为98

  11. 骨骼重建与自体脂肪移植在面部整形中的应用%Bone reconstruction with autologous fat transplantation in facial plasty

    Institute of Scientific and Technical Information of China (English)

    聂云飞; 李小林; 巫国辉

    2012-01-01

    BACKGROUND: The use of autologous fat transplantation, liposuction, fillers, Botox, lasers and radiofrequency has become absolutely necessary prelude or accompaniment in facial plasty. OBJECTIVE: To retrospectively analyze effect of face lift and fat injection on facial rejuvenation. METHODS: Articles addressing face anatomy, ageing and facial fat transplantation, excluding repetitive studies, were identified by searching PubMed (1893-01 to 2011-12) using the keywords of "bone, facial, autologous fat transplantation, facial plastic, superficial musculoaponeuroticsystem (SMAS)". Finally, 47 articles were summarized. RESULTS AND CONCLUSION: Pigment patch, wrinkle and ptosis are the main features in facial ageing. The mandibular angle is blunt with aging. Bone resorption mainly exist in the orbital rim, piriform aperture, alveolar bone maxilla notch, chin projection and mandibular angle. SMAS do not change obviously. Fat injection is the direct method for facial volume. Totally 1 936 results of facial profiles moulding show that face lift and fat injection get satisfactory outcome for the elderly with facial emaciation, and patients with hemifacial atrophy can almost have normal facial profile. Facial fat injection cannot only recover face plump and ascend profile curve, but also improve facial skin texture and tinct.%背景:面部整形中自体脂肪注射、脂肪抽吸、填充剂、肉毒素、激光和射频等技术的应用成了不可或缺的前奏或伴奏.目的:回顾性总结分析面部提升术和脂肪注射技术在面部年轻化中的作用.方法:以英文检索词"bone,facial,autologous fat transplantation,facial plastic,superfical musculoaponeuroticsystem(SMAS)"为主,由第一作者重点检索1893-01/2011-12 PubMed数据有关面部解剖与老化及面部脂肪移植技术相关的文献,排除重复性研究.保留47篇文献进行归纳总结.结果与结论:面部老龄化主要存在3个表现:色斑、皱纹、松垂.随着

  12. Bone biopsy (image)

    Science.gov (United States)

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  13. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... needle is gently pushed and twisted into the bone. Once the sample is obtained, the needle is ... sample is sent to a lab for examination. Bone biopsy may also be done under general anesthesia ...

  14. Facts about Broken Bones

    Science.gov (United States)

    ... Room? What Happens in the Operating Room? Broken Bones KidsHealth > For Kids > Broken Bones Print A A ... sticking through the skin . What Happens When a Bone Breaks? It hurts to break a bone! It's ...

  15. Calcium and bones

    Science.gov (United States)

    Bone strength and calcium ... calcium (as well as phosphorus) to make healthy bones. Bones are the main storage site of calcium in ... your body does not absorb enough calcium, your bones can get weak or will not grow properly. ...

  16. Broken Bones (For Parents)

    Science.gov (United States)

    ... Feeding Your 1- to 2-Year-Old Broken Bones KidsHealth > For Parents > Broken Bones Print A A ... bone fragments in place. When Will a Broken Bone Heal? Fractures heal at different rates, depending upon ...

  17. Regenerate augmentation with bone marrow concentrate after traumatic bone loss.

    Science.gov (United States)

    Gessmann, Jan; Köller, Manfred; Godry, Holger; Schildhauer, Thomas Armin; Seybold, Dominik

    2012-01-01

    Distraction osteogenesis after post-traumatic segmental bone loss of the tibia is a complex and time-consuming procedure that is often complicated due to prolonged consolidation or complete insufficiency of the regenerate. The aim of this feasibility study was to investigate the potential of bone marrow aspiration concentrate (BMAC) for percutaneous regenerate augmentation to accelerate bony consolidation of the regenerate. Eight patients (age 22-64) with an average posttraumatic bone defect of 82.4 mm and concomitant risk factors (nicotine abuse, soft-tissue defects, obesity and/or circulatory disorders) were treated with a modified Ilizarov external frame using an intramedullary cable transportation system. At the end of the distraction phase, each patient was treated with a percutaneously injection of autologous BMAC into the centre of the regenerate. The concentration factor was analysed using flow cytometry. The mean follow up after frame removal was 10 (4-15) months. With a mean healing index (HI) of 36.9 d/cm, bony consolidation of the regenerate was achieved in all eight cases. The mean concentration factor of the bone marrow aspirate was 4.6 (SD 1.23). No further operations concerning the regenerate were needed and no adverse effects were observed with the BMAC procedure. This procedure can be used for augmentation of the regenerate in cases of segmental bone transport. Further studies with a larger number of patients and control groups are needed to evaluate a possible higher success rate and accelerating effects on regenerate healing.

  18. Breast reconstruction after mastectomy

    Directory of Open Access Journals (Sweden)

    Daniel eSchmauss

    2016-01-01

    Full Text Available Breast cancer is the leading cause of cancer death in women worldwide. Its surgical approach has become less and less mutilating in the last decades. However, the overall number of breast reconstructions has significantly increased lately. Nowadays breast reconstruction should be individualized at its best, first of all taking into consideration oncological aspects of the tumor, neo-/adjuvant treatment and genetic predisposition, but also its timing (immediate versus delayed breast reconstruction, as well as the patient’s condition and wish. This article gives an overview over the various possibilities of breast reconstruction, including implant- and expander-based reconstruction, flap-based reconstruction (vascularized autologous tissue, the combination of implant and flap, reconstruction using non-vascularized autologous fat, as well as refinement surgery after breast reconstruction.

  19. Bone densitometry

    DEFF Research Database (Denmark)

    Ravn, Pernille; Alexandersen, P; Møllgaard, A

    1999-01-01

    The bisphosphonates have been introduced as alternatives to hormone replacement therapy (HRT) for the treatment and prevention of postmenopausal osteoporosis. The expected increasing application in at clinical practice demands cost-effective and easily handled methods to monitor the effect on bone...

  20. Stereo morphology of temporal bone and ear

    Institute of Scientific and Technical Information of China (English)

    戴朴; 刘阳; 姜泗长; 方耀云; 王今; 杨伟炎

    2004-01-01

    Background The temporal bone has the most complicated anatomic feature among the whole human body, which always challenges otolaryngologists. This study was to study three-dimensional (3D) morphology of the temporal bone and the ear by means of a computer image processing technique, for the purpose of providing a 3D image to help in pathological, diagnostic and surgical procedures. Methods Forty sets of temporal bone celloidin serial sections with reference points were prepared and the contours of selected structures and reference points were entered into a graphics programme. The technique of computer-aided 3D reconstruction was applied to obtain 3D images and parameters of the temporal bones and the ears. Stereo views of the ossicles (n=5), the facial nerves (n=11), the posterior tympanic sinuses (n=11), the posterior ampullary nerves (n=4), the endolymphatic ducts and sacs (n=5), and the bony and membranous labyrinth (n=1) were reconstructed. Results Three-dimensional images, including the cochlea, the ossicles, the nerves, the tendons and the endolymphatic fluid system in the temporal bone, were obtained. Stereo picture pairs and 3D parameters of spatial dimensions, angle and volume for these reconstructed structures were calculated. The arrangement of the ossicles, spatial relationship of the bony and membranous labyrinth, the whole course of the facial nerves, the endolymphatic sac and posterior tympanic cavity were clearly observable. Stereo picture pairs made the spatial relationships among the above-mentioned structures much clearer. The operation of the posterior ampullary nerve transection was designed and simulated on the graphic computer based on 3D anatomic investigations. Conclusion The technique of computer-aided 3D reconstruction provides a new tool to observe the morphology of the temporal bone and thus may allow design and study of new surgical approaches.

  1. Reconstruction of the extensor mechanism after major knee resection.

    Science.gov (United States)

    Mavrogenis, Andreas F; Angelini, Andrea; Pala, Elisa; Sakellariou, Vasileios I; Ruggieri, Pietro; Papagelopoulos, Panayiotis J

    2012-05-01

    In periarticular knee resections, the relative lack of soft tissue coverage and need to reattach the extensor mechanism after en bloc resection of the tibial tuberosity with the tumor specimen complicate reconstructions and decrease postoperative function and stability of the knee joint. Distal femoral reconstructions are less problematic; muscular attachments are relatively few, neurovascular structures are not immediately adjacent to bone, and the knee extensor mechanism is usually not compromised from bone tumors. In the proximal tibia, the close proximity of the neurovascular structures in the popliteal fossa and peroneal nerve at the lateral aspect of the leg make reconstruction more difficult. Poor function is mostly related to unreliable options for knee extensor mechanism reattachment and poor soft tissue coverage. Successful and reliable attachment of the soft tissues has been a significant advance that improved functional outcomes.This article describes techniques for the reconstruction of the extensor mechanism of the knee after proximal tibia resections. Combined reconstruction techniques using direct reattachment of the patellar tendon with synthetic materials to megaprosthetic or allograft reconstructions for immediate stability, augmentation with autologous bone graft or substitutes at the attachment site, and coverage with the medial gastrocnemius muscle flap and supplementary flaps for long-term stability of the reattachment are currently considered the gold standard.

  2. Reoperative midface reconstruction.

    Science.gov (United States)

    Acero, Julio; García, Eloy

    2011-02-01

    Reoperative reconstruction of the midface is a challenging issue because of the complexity of this region and the severity of the aesthetic and functional sequela related to the absence or failure of a primary reconstruction. The different situations that can lead to the indication of a reoperative reconstructive procedure after previous oncologic ablative procedures in the midface are reviewed. Surgical techniques, anatomic problems, and limitations affecting the reoperative reconstruction in this region of the head and neck are discussed.

  3. Genome-scale reconstruction of the Saccharomyces cerevisiae metabolic network

    DEFF Research Database (Denmark)

    Förster, Jochen; Famili, I.; Fu, P.;

    2003-01-01

    The metabolic network in the yeast Saccharomyces cerevisiae was reconstructed using currently available genomic, biochemical, and physiological information. The metabolic reactions were compartmentalized between the cytosol and the mitochondria, and transport steps between the compartments...... containing 1175 metabolic reactions and 584 metabolites. The number of gene functions included in the reconstructed network corresponds to similar to16% of all characterized ORFs in S. cerevisiae. Using the reconstructed network, the metabolic capabilities of S. cerevisiae were calculated and compared...

  4. 重组骨形成蛋白-2与珊瑚人工骨复合物应用于拔牙窝修复的动物实验研究%The effects of coral artificial bone composite of recombinant hmnan bone morphogenetic protein-2 on reconstruction of extraction sockets:an experimetal study on dogs

    Institute of Scientific and Technical Information of China (English)

    孔卫东; 林巍; 李小兰; 邓国珍; 沈丽佳

    2001-01-01

    Aim:To evaluate the bone repairing ability of coral artificial bone composite of rhBMP -2(rhBMP-2/CAB) and coral artificial bone(CAB) implanted into immediate extraction sockets. Meth-ods: 12 adult dogs served as the experimental animals. Immediately after extraction of the upper secondand third incisors, the alveolar septum between extraction sockets was resected bilaterally. RhBMP-2/CAB and CAB were implanted respectively into each extraction site. The animals were sacrificed at the 4th, 8th and 12th weeks respectively after implantation. The bone repairing ability of the two grafts wasanalyzed with histologic and image analysis system. Results: RhBMP - 2/CAB has a good effect on therepairing ability of extraction sockets. The implants were absorbed gradually after they were implanted in-to extraction sockets. In the meantime, the new bone was formed in extraction sockets. The implants werereplaced completely by bone at 12 weeks. The ratio of new bone formation of rhBMP-2/CAB was signif-icantly higher than that of CAB at different period( P < 0.05). Conclusion: The repairing ability and ef-fect of rbBMP -2/CAB in extraction sockets are obviously better than those of CAB.%目的:探讨重组骨形成蛋白 - 2(recombinant human bone morphogenetic protein , rhBMP - 2)/ 珊瑚人工骨复合物(复合骨)与珊瑚人工骨(珊瑚骨)在拔牙窝修复中的作用。方法:12只成年狗作为实验动物,拔除两侧上颌第2及第3切牙,并去除牙槽窝之间的牙槽间隔,一侧随即植入复合骨,对侧植人珊瑚骨作为对照。并于植骨后4、8、12周取材,采用组织学观察及计算机图像分析方法,观察比较两种植入材料在拔牙窝内的骨修复能力及修复效果。结果:复合骨具有较强的骨修复作用,植入牙槽窝后,材料被逐渐降解吸收,新骨不断形成,12周后,植入材料完全被成熟的骨组织取代;图像分析结果显示复合骨组新生骨形成的比值明

  5. A short-term zinc-deficient diet decreases bone formation through down-regulated BMP2 in rat bone.

    Science.gov (United States)

    Suzuki, Takako; Katsumata, Shin-Ichi; Matsuzaki, Hiroshi; Suzuki, Kazuharu

    2016-07-01

    We investigated the effects of a short-term dietary zinc deficiency on bone metabolism. Zinc deficiency increased the mRNA expression of zinc uptake transporters such as Zip1, Zip13, and Zip14 in bone. However, zinc deficiency might not maintain zinc storage in bone, resulting in a decrease in bone formation through downregulation of the expression levels of osteoblastogenesis-related genes.

  6. Surfaces, Digitisations and Reconstructions

    DEFF Research Database (Denmark)

    2015-01-01

    We present a new digital reconstruction of r-regular sets in three-dimensional Euclidean space. We introduce a vector field and analyse the relation between the topologies of the boundaries of the r-regular set and its reconstruction. This reconstruction can be carried out faster than prior models...

  7. 肿瘤型膝关节假体术后并发症214例分析%Complications after the reconstruction of bone defects in the knee with tumor endoprostheses

    Institute of Scientific and Technical Information of China (English)

    覃澍; 董扬

    2016-01-01

    Objective To retrospectively analyze the prosthesis survival and complications after custom-made tumor prosthesis replacement of the knee joint. Methods Data of 214 patients with bone tumors around knee joints who underwent custom-prosthetic replacement from January 2003 to January 2013, were retrospectively analyzed. The diagnoses were osteosarcoma ( n = 136 ), giant cell tumor ( n = 49 ), aneurysmal bone cyst ( n = 1 ), fasciculated sarcoma ( n = 3 ), malignant fibrous histiocytoma ( n = 10 ), chondrosarcoma ( n = 6 ), chondroblastoma ( n = 1 ), metastatic tumor ( n = 4 ) and other types of bone tumors ( n = 3 ). The distal femur was affected in 150 patients and the proximal tibia in 64. Results Totally 187 patients were followed up for a mean period of 47 months ( range: 16 -122 months ). Complications occurred in 47 patients: early stage infection or nonunion of wounds ( n = 15 ), peroneal palsy ( n = 3 ), late infection ( n = 5 ), aseptic loosening ( n = 15 ), breakage of the prosthesis ( n = 4 ) and periprosthetic fracture ( n = 5 ). Conclusions The complication rate of proximal tibia tumor is higher than the rate of the distal femur. Common complications of tumor prosthesis replacement of the knee joint are: aseptic loosening, infection or nonunion of wounds, peroneal palsy, late infection, aseptic loosening, breakage of prosthesis and periprosthetic fracture. Common complications of tumor prosthesis replacement of the knee joint can be treated and prevented.%目的:分析肿瘤型膝关节假体置换术后并发症的发生情况以及处理方式。方法回顾性分析2003年1月至2012年1月,在我院行膝关节假体置换的214例术后并发症发生情况;其中骨肉瘤136例,骨巨细胞瘤49例,动脉瘤样股囊肿1例,梭形细胞肉瘤3例,恶性纤维组织细胞瘤10例,软骨肉瘤6例,软骨母细胞瘤1例,软骨细胞瘤1例,转移癌4例,其它骨肿瘤3例;根据位置分类,发生于股骨远端150

  8. Reconstruction of conjunctival sac using Hydroxyapatite composite bone chip and oral mucosa transplantation%羟基磷灰石复合人工骨片植入联合唇黏膜移植结膜囊成形术

    Institute of Scientific and Technical Information of China (English)

    高云仙; 赵勇; 任兵; 高晓唯

    2010-01-01

    目的 探讨同期羟基磷灰石复合人工骨(HA)植入联合唇黏膜移植结膜囊成形术的手术方法及临床效果.方法 对16例HA义眼座植入术后眼座内陷及下移、结膜囊缩窄患者行HA人工骨植入及唇黏膜移植结膜囊成形术,观察术后义眼座内陷和(或)下移矫正、上睑沟凹陷矫正、结膜囊成形情况,义眼座有无外露、感染及HA人工骨有无移位.结果 移植唇黏膜全部成活,眼座内陷、移位及上睑沟凹陷基本矫正,眼座无外露,人工骨无移位,患者基本满意.结论 羟基磷灰石复合人工骨片植入联合唇黏膜移植结膜囊成形术是治疗HA义眼座植入术后眼座内陷及下移、结膜囊缩窄的理想方法.%Objective To observe the therapeutic effect and the surgical methods of implantation of Hydroxypatite piece combined with transplantation of lip mucous in conjunctival reconstruction. Methods Sixteen patients (16 eyes) suffered from conjuctival sac stenosis and sunk socket were treated with implantation of Hydroxypatite piece combined with transplantation of lip mucous in conjunctival reconstruction. We observed the rectified sunk socket, the shaping of conjunctival sac, the motion of prosthetic eyes and the implants exposure or infection. Results The sunk socket of all eyes was corrected obviously and the conjunctival sac was shaped well. No implants exposed or infected. Conclusions Implantation of Hydroxypatite piece combined with transplantation of lip mucous in conjunctival is an ideal method to treat sunk socket with narrow conjunctival sac.

  9. Review of methods used in the reconstruction and rehabilitation of the maxillofacial region.

    LENUS (Irish Health Repository)

    O'Fearraigh, Pádraig

    2010-04-23

    Maxillofacial and dental defects often have detrimental effects on patient health and appearance. A holistic approach of restoring lost dentition along with bone and soft tissue is now the standard treatment of these defects. Recent improvements in reconstructive techniques, especially osseointegration, microvascular free tissue transfer, and improvements in bone engineering, have yielded excellent functional and aesthetic outcomes. This article reviews the literature on these modern reconstructive and rehabilitation techniques.

  10. Treatment of persistent extraarticular infection using a temporary cement spacer on the tibia after ACL reconstruction.

    Science.gov (United States)

    Jung, Kwang Am; Lee, Soo Chan; Song, Moon Bok; Lee, Choon Key

    2008-01-01

    Postoperative infection after anterior cruciate ligament (ACL) reconstruction is an uncommon but serious complication. Although several treatments for intraarticular infection have been reported, no report has been recorded on the treatment of persistent extraarticular infections. The authors experienced reconstructed graft removal due to a refractory extraarticular infection on tibia. Early ACL reimplantation was performed using a temporary cement spacer containing antibiotics and a irradiated bone patellar tendon bone allograft.

  11. Septic arthritis following anterior cruciate ligament reconstruction using tendon allografts--Florida and Louisiana, 2000.

    Science.gov (United States)

    2001-12-01

    In the United States, approximately 50,000 knee surgeries are performed each year for repairing anterior cruciate ligament (ACL) injuries. Tissue allografts frequently are used for ACL reconstruction, and septic arthritis is a rare complication of such procedures. This report describes four patients who acquired postsurgical septic arthritis probably associated with contaminated bone-tendon-bone allografts used for ACL reconstruction. Effective sterilization methods that do not functionally alter musculoskeletal tissue are needed to prevent allograft-related infections.

  12. Bone grafting simultaneous to implant placement. Presentation of a case.

    Science.gov (United States)

    Peñarrocha-Diago, Miguel; Gómez-Adrián, Maria Dolores; García-Mira, Berta; Ivorra-Sais, Mariola

    2005-01-01

    Bone defects at mandibular alveolar crest level complicate the placement of dental implants in the ideal location. Surgical reconstruction using autologous bone grafts allows implant fixation in an esthetic and functional manner. We describe a patient with large mandibular bone loss secondary to periodontal inflammatory processes. Reconstruction of the mandibular alveolar process was carried out using onlay block bone grafts harvested from the mandible. The grafts were stabilized by positioning the dental implants through them--a procedure that moreover afforded good primary implant fixation. After two years of follow-up the clinical and radiological outcome is good. In the lower jaw, where bone regeneration is complicated, we were able to achieve good results in this patient--minimizing the corresponding waiting time by grafting and placing the implants in the same surgical step.

  13. Should I Have Breast Reconstruction?

    Science.gov (United States)

    ... Reconstruction Surgery Breast Cancer Breast Reconstruction Surgery Should I Get Breast Reconstruction Surgery? Women who have surgery ... It usually responds well to treatment. What if I choose not to have breast reconstruction? Many women ...

  14. Avaliação de método para reconstrução acetabular com uso de enxerto ósseo homólogo e implante cimentado Evaluation of a method of acetabular reconstruction using homologous bone graft and cemented implant

    Directory of Open Access Journals (Sweden)

    Milton Valdomiro Roos

    2008-09-01

    étodo apresentou alto índice de sobrevida da reconstrução acetabular e resultados clínicos satisfatórios em seguimento médio de 8,3 anos. Constatou-se maior sobrevida nos casos que foram realizados utilizando blocos ósseos, apesar de a cavidade ser de maior dimensão.OBJECTIVE: To make a clinical and radiographic evaluation of 43 hips in 43 patients submitted to surgical treatment for acetabular reconstruction of the hip after aseptic loosening of the implant, using the classification developed and adopted by the Hip Surgery Service of the Fracture Emergency Unit in Passo Fundo, State of Rio Grande do Sul (Method of the 75 mm. METHODS: A retrospective study was performed with 88 patients (90 hips submitted to surgical treatment for acetabular reconstruction after aseptic loosening of the implant, from August 1994 to October 2000. Out of those patients, 43 (43 hips met all inclusion requirements for this study. Migration of an implant longer than 5 mm in any direction, or the progression of radiolucent lines of more than 2 mm in width in the zones limited by DeLee and Charnley, combined with pain were considered a failed reconstruction due to loosening. RESULTS: From the total number of patients evaluated, 29 cases (67.4% were submitted to acetabular reconstruction with "crouton" plicated graft (1 cm³; the other 14 cases (32.6% were submitted to acetabular reconstruction with block graft. The post-operative clinical classification according to the criteria of D'Aubignè et al modified by Charnley, considered the results achieved as follows: 83.7% satisfactory, and 16.3% unsatisfactory, with a minimum follow-up of six years. According to the criteria established, seven patients (16.3% presented reconstruction failure due to loosening: six with the plicated graft (20.7% of the 29 grafts with plicated bone and one with block graft (7.1% of the 14 block grafts. On the average, the failures occurred at 7.25 years. CONCLUSION: Based on the results achieved and using the

  15. Avaliação de método para reconstrução acetabular com uso de enxerto ósseo homólogo e implante cimentado Evaluation of a method of acetabular reconstruction using homologous bone graft and cemented implant

    Directory of Open Access Journals (Sweden)

    Milton Valdomiro Roos

    2008-10-01

    étodo apresentou alto índice de sobrevida da reconstrução acetabular e resultados clínicos satisfatórios em seguimento médio de 8,3 anos. Constatou-se maior sobrevida nos casos que foram realizados utilizando blocos ósseos, apesar de a cavidade ser de maior dimensão.OBJECTIVE: To make a clinical and radiographic evaluation of 43 hips in 43 patients submitted to surgical treatment for acetabular reconstruction of the hip after aseptic loosening of the implant, using the classification developed and adopted by the Hip Surgery Service of the Fracture Emergency Unit in Passo Fundo, State of Rio Grande do Sul (Method of the 75 mm. METHODS: A retrospective study was performed with 88 patients (90 hips submitted to surgical treatment for acetabular reconstruction after aseptic loosening of the implant, from August 1994 to October 2000. Out of those patients, 43 (43 hips met all inclusion requirements for this study. Migration of an implant longer than 5 mm in any direction, or the progression of radiolucent lines of more than 2 mm in width in the zones limited by DeLee and Charnley, combined with pain were considered a failed reconstruction due to loosening. RESULTS: From the total number of patients evaluated, 29 cases (67.4% were submitted to acetabular reconstruction with "crouton" plicated graft (1 cm³; the other 14 cases (32.6% were submitted to acetabular reconstruction with block graft. The post-operative clinical classification according to the criteria of D'Aubignè et al modified by Charnley, considered the results achieved as follows: 83.7% satisfactory, and 16.3% unsatisfactory, with a minimum follow-up of six years. According to the criteria established, seven patients (16.3% presented reconstruction failure due to loosening: six with the plicated graft (20.7% of the 29 grafts with plicated bone and one with block graft (7.1% of the 14 block grafts. On the average, the failures occurred at 7.25 years. CONCLUSION: Based on the results achieved and using the

  16. Electrospun Hydroxyapatite-Containing Chitosan Nanofibers Crosslinked with Genipin for Bone Tissue Engineering

    OpenAIRE

    Frohbergh, Michael E.; Katsman, Anna; Botta, Gregory P.; Lazarovici, Phillip; Schauer, Caroline L.; Wegst, Ulrike G.K.; Lelkes, Peter I

    2012-01-01

    Reconstruction of large bone defects remains problematic in orthopedic and craniofacial clinical practice. Autografts are limited in supply and are associated with donor site morbidity while other materials show poor integration with the host’s own bone. This lack of integration is often due to the absence of periosteum, the outer layer of bone that contains osteoprogenitor cells and is critical for the growth and remodeling of bone tissue. In this study we developed a one-step platform to el...

  17. [Breast reconstruction after mastectomy].

    Science.gov (United States)

    Ho Quoc, C; Delay, E

    2013-02-01

    The mutilating surgery for breast cancer causes deep somatic and psychological sequelae. Breast reconstruction can mitigate these effects and permit the patient to help rebuild their lives. The purpose of this paper is to focus on breast reconstruction techniques and on factors involved in breast reconstruction. The methods of breast reconstruction are presented: objectives, indications, different techniques, operative risks, and long-term monitoring. Many different techniques can now allow breast reconstruction in most patients. Clinical cases are also presented in order to understand the results we expect from a breast reconstruction. Breast reconstruction provides many benefits for patients in terms of rehabilitation, wellness, and quality of life. In our mind, breast reconstruction should be considered more as an opportunity and a positive choice (the patient can decide to do it), than as an obligation (that the patient would suffer). The consultation with the surgeon who will perform the reconstruction is an important step to give all necessary informations. It is really important that the patient could speak again with him before undergoing reconstruction, if she has any doubt. The quality of information given by medical doctors is essential to the success of psychological intervention. This article was written in a simple, and understandable way to help gynecologists giving the best information to their patients. It is maybe also possible to let them a copy of this article, which would enable them to have a written support and would facilitate future consultation with the surgeon who will perform the reconstruction.

  18. Deconstruction-Construction-Reconstruction:On Chinese Americans' Ethnic Identification in Fae Myenne Ng's Bone%解构-建构-重建--伍慧明《骨》中美国华裔的族裔身份探寻历程

    Institute of Scientific and Technical Information of China (English)

    周燕萍

    2014-01-01

    身份问题对于散居海外、生存在多重文化夹缝中的美国华人是一个无法规避的问题,美籍华裔作家伍慧明首部作品直接以“骨”命名,体现了美国华裔族裔身份认同过程中的取向。以后殖民身份理论为支点,分析《骨》中美国华裔在族裔身份探寻过程中所经历的中式身份解构、美式身份建构及杂糅式身份的重建历程。%Identity has been the top concern for diaspora Chinese Americans who are under multi-cultures. Chinese American writer Fae Myenne Ng entitles her debut Bone to excavate Chinese Americans'ethnic identification orien-tation. Using post-colonial identity as theoretical foundation, this thesis intends to analyze Chinese Americans' de-construction of Chinese identity, construction of American identity and reconstruction of a hybrid identity.

  19. 骨肿瘤初次保肢手术后生物性重建失败的肿瘤假体翻修术%Tumor prosthetic revision in patients with failed biological reconstruction after limb salvage surgery of primary bone tumors

    Institute of Scientific and Technical Information of China (English)

    黄国全; 古明达; 张坚颖; 赵国庆; 谢龙峰

    2007-01-01

    目的 评估骨肿瘤初次保肢手术后生物性重建失败的肿瘤假体翻修的疗效.方法 2004至2006年,13例骨肉瘤和3例骨巨细胞瘤患者在香港威尔斯亲王医院接受手术治疗.15例患者应用同种异体骨重建,另1例患者应用带血管腓骨移植重建骨缺损.应用肿瘤型假体进行翻修手术的重建.翻修术后患者膝关节活动范围良好时,订制的可延长假体接受延长手术.结果 患者平均年龄23.2岁(13~43岁),平均随诊26.4个月(6~47个月).翻修手术的原因包括:7例患者出现同种异体骨骨折或软骨下骨塌陷,5例患者骨不愈合,3例患者异体骨感染,1例患者膝关节僵硬.翻修手术的假体包括10例患者应用订制型假体,其他患者应用组合式假体.翻修手术的部位包括9例股骨远端假体,6例胫骨近端假体和1例股骨中段假体.订制假体中6例是可延长假体,假体的延长方式中5例是微创延长、1例无创延长.翻修手术后,膝关节活动改善,平均从18.1° (0°~90°) 至 91.9° (50°~120°).下肢缩短不等长畸形从平均5 cm (2~11.5 cm) 纠正至平均1.5 cm (0~4 cm).翻修术后患肢功能MSTS评分从34.6% 改善到89.2%.翻修术后2例患者出现部分皮肤坏死,1例患者出现腓总神经麻痹,以后部分恢复,1例患者出现胫骨裂纹骨折;没有感染和植入物失败.结论 保肢手术后生物学重建失败所引起下肢缩短和僵硬,应用人工假体翻修是可行的,早期效果令人鼓舞.膝关节僵硬患者可获得良好的关节活动度.严重的下肢缩短畸形通过可伸长假体逐渐获得纠正.%Objective To report the result of tumor prosthetic revision in patients with failed previous reconstruction after limb salvage surgery of primary bone tumors. Methods 16 patients were operated from 2004 to 2006. The primary diagnosis was osteosarcoma in thirteen and giant cell tumor of bone in three. Fifteen patients had allograft reconstruction. One

  20. 关节镜下同种异体骨-髌腱-骨双束重建膝关节前交叉韧带的临床比较研究%Comparison between Double- and Single-bundle Arthroscopic Anterior Cructiate Ligament Reconstruction Using Bonepatellar Tendon-bone Allograft

    Institute of Scientific and Technical Information of China (English)

    江东; 敖英芳; 谢兴; 龚熹; 陈连旭; 罗浩; 王永健; 余家阔

    2011-01-01

    Objective To evaluate the mid-term clinical results of arthroscopic double-bundle anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BPTB) allograft. Methods The study was carried on 61 patients with broken ACL, who received arthroscopic ACL reconstruction by using BPTB between July 2003 and July 2007. According to the operation and graft types, the patients were divided into 3 groups; BPTB double-bundle allograft group (20 patients) , BPTB single-bundle allograft group (21 patients) , and BPTB single-bundle autograft group (20 patients). Median follow-up were (41.6 ±3.0) , (42.3 ±3.9), and (42.5 ±2.7) months respectively in the 3 groups. At the follow-up, the clinical outcome of the patients was evaluated by assessing the International Knee Documentation Committee ( IKDC) 2000 subjective scores, Lysholm scores, Tegner scores, anterior knee pain, routine KT-2000 and back-pushing KT-2000 side-to-side difference, thigh circumference difference and Biodex isokinetic dynamometer system. Results No significant difference was found in terms of the IKDC2000 scores, Lysholm scores, Tegner scores, thigh circumference difference, muscle strength and routine KT-2000 side-to-side difference (P>0. 05). The Pivot-shift positive rate (5% ,1/20) of the BPTB double-bundle allograft group was 1/6 of that of the BPTB single-bundle allograft group (29% , 6/21) and 1/4 of that of the BPTB single-bundle autograft group (20% , 4/20) . Compared to the single-bundle groups, significant less back-pushing KT-2000 anterior laxity at 30° (median: 15 dl-0. 5 mm, 20 dl-0. 5 mm, and 30 dl-0. 9 mm) was revealed in the BPTB double-bundle allograft group (P < 0. 05). The BPTB double-bundle allograft group ( 15% , 3/20) and the BPTB single-bundle allograft group ( 10% , 2/21 ) showed significant less anterior knee pain than that of the BPTB single-bundle autograft group (75% , 15/20, x2 =24. 201, P = 0. 000). Conclusions The double-bundle ACL reconstruction with BPTB

  1. Reconstruction of anterior cruciate ligament with bone-anterior cruciate ligamentbone allograft in rabbits: a prophase study with histology and biomechanics%兔异体骨-前交叉韧带-骨移植重建前交叉韧带术后早期组织学与生物力学观察

    Institute of Scientific and Technical Information of China (English)

    郭珊成; 张峡; 郝勇

    2011-01-01

    Objective To observe the prophase histology and biomechanics in the reconstructed anterior cruciate ligament (ACL) with bone-anterior cruciate ligament-bone ( B-ACL-B ) allograft in rabbits.Methods Based on the study of anatomy, histology and biomechanics of normal rabbit ruciate ligaments,ACLs were reconstructed with B-ACL-B complex allografts in rabbits. Twenty-four skeletally matured New Zealand white rabbits underwent ACL reconstruction with aseptically harvested fresh-frozen B-ACL-B allograft on one knee randomly. No any immunosuppressive agent was used intra-operative and post-operatively. Gross observation, histological examination and biomechanics test were performed in these groups at 3, 6 and 12 weeks after operation. The opposite side of normal ACL served as control. Results In the early period, the allograft tissue underwent a gradually healing process including the graft necrosis, cellular migration and collagen formation. After operation, a lot of fibroblasts were found in each period, especially at 6 weeks. The virgin collagen fibers crimped and degenerated, and the new collagen fibers were formed. At 12 weeks, the new collagen fibers organized regularly and tightly. The maximum loads of the allograft was 5.5% (5.6 ±0.9 N) after 3 weeks, and 14. 5% ( 14.9 ±2.3 N) after 6 weeks, and 41.5% (42.6 ± 3.7 N) after 12 weeks. The maximum loads of the control group was 102.6 ± 7.8. There was significant difference among 4 groups in maximum loads (P <0.05 ). Conclusion The ACL reconstructed with graft of same anatomic and histological tissue can achieve a good result in prophase histological and biomechanics.%目的 对兔同种异体骨-前交叉韧带-骨(bone-anterior cruciate ligament-bone,B-ACL-B)移植重建ACL术后早期(12周)移植物进行组织学观察及生物力学测试.方法 24只骨骼成熟新西兰大白兔,用新鲜冰冻异体B-ACL-B移植重建兔前交叉韧带,术中及术后均不使用免疫抑制剂.分别于术后3、6

  2. Characteristics of flexed knee gait and functional outcome of a patient who underwent knee reconstruction with a hingeless prosthesis for bone tumor resection: a case report with gait analysis and comparison with healthy subjects.

    Science.gov (United States)

    Okita, Y; Tatematsu, N; Nagai, K; Nakayama, T; Nakamata, T; Okamoto, T; Toguchida, J; Ichihashi, N; Tsuboyama, T

    2013-12-01

    We report on a patient after knee reconstruction for osteosarcoma in the distal femur using a hingeless prosthesis K-MAX KNEE system K-5 who walked without ipsilateral knee extension in the latter half of the stance phase (flexed knee gait). We evaluated the patient using three-dimensional gait analysis and isokinetic knee strength measurement, and compared the patient with five healthy subjects. The Musculoskeletal Tumor Society (MSTS) score was also used for evaluation. The patient kept his operated knee flexed during mid stance. The maximal ankle plantarflexion internal moment was lower on the ipsilateral side than on the contralateral side, and lower than in the healthy subjects. The negative ankle power during the stance phase was generally stronger on the ipsilateral side than on the contralateral side, and also in the healthy subjects. Unusual contralateral hip flexion occurred after the initial contact, indicating increased joint load on the ipsilateral ankle and the contralateral hip. The ratios of the peak knee extension/flexion torque were 0.7 on the ipsilateral side, 1.9 on the contralateral side, and 1.7 in the healthy subjects. The MSTS score of the patient was 23/30 (76.6%). Flexed knee gait might account for the reduction of ipsilateral hip flexion and ankle plantarflexion moment during the late stance phase. These results suggest the importance of focusing more on the ipsilateral ankle joint and the contralateral hip joint to maintain the function of the entire limb joints of the patients with flexed knee gait.

  3. Chest wall reconstruction in a pediatric patient with ectopia cordis.

    Science.gov (United States)

    Mohan, Raja; Peralta, Mat; Perez, Ramiro; Rosenkranz, Eliot R; Panthaki, Zubin J

    2010-08-01

    Ectopia cordis is defined as a congenital malposition of the heart outside of the thoracic cavity. It is a rare condition, and complete ectopia cordis can be a fatal condition. Successful surgical reconstruction of this defect has been reported but is uncommon. The general approach to reconstructing the chest wall involves repositioning the heart and providing adequate coverage of the chest wall defect. We describe our experience with a patient who had complete thoracic ectopia cordis treated with staged chest wall reconstruction. The first stage involved temporary closure with synthetic material, and the second stage involved definitive reconstruction with autologous bone and cartilage grafts supported with plates. The patient has been active and without complaints since the second stage and is awaiting tracheal decannulation. There have been a few descriptions of how to approach chest wall reconstruction in patients with ectopia cordis. The 2 stage method described can be considered to repair the chest wall defect in complete thoracic ectopia cordis.

  4. 3D打印导航模板辅助个性化非限制性肿瘤型假体重建术治疗膝关节周围恶性骨肿瘤的疗效%EFFECT OF THREE-DIMENSIONAL PRINTING NAVIGATION TEMPLATES ASSISTING RECONSTRUCTION WITH PERSONALIZED UNRESTRICTED TOTAL KNEE PROSTHESIS FOR TREATING MALIGANANT BONE TUMORS AROUND KNEES

    Institute of Scientific and Technical Information of China (English)

    黄敏强; 丁焕文; 陈志源; 滕强; 王虹

    2016-01-01

    Objective To evaluate the effectiveness of three-dimensional (3D) printing navigation templates assisting reconstruction with personalized unrestricted total knee prosthesis to treat maliganant bone tumors around the knee.Methods Between March 2007 and September 2014,43 patients with malignant tumor around the knee were divided into 2 groups:3D printing navigation templates assisting reconstruction with personalized unrestricted total knee prosthesis were used in 21 cases (trial group),and conventional tumor resection and reconstruction with hinged total knee prosthesis were used in 22 cases (control group).There was no significant difference in age,gender,tumor location,pathological diagnosis,tumor stage,diameter of tumor,disease duration,and preoperative visual analogue scale (VAS) score between 2 groups (P>0.05),which were comparable.Intraoperative length of tumor resection and blood loss were recorded and compared,and the postoperative complications and tumor recurrence were observed.The Musculoskeletal Tumor Society (MSTS) score was used to evaluate knee joint function.Results The operations were completed successfully in the patients of 2 groups and postoperative pathological results were negative in tumor resection margin.All the patients were followed up 12-77 months (mean,36.7 months).There was no significant difference in the length of tumor resection and blood loss between trial group and control group (t=1.01,P=0.32;t=-0.76,P=0.45).In trial group,the resection range and reconstruction results were consistent with preoperative computer simulation;postoperative complications happened in 2 cases (9.52%);1 case of immunological rejection and 1 case of infection);2 cases (9.52%) had recurrence of osteosarcoma and pulmonary metastasis at 1 year after operation.In the control group,complication occurred in 6 cases (27.27%;2 cases of periprosthetic fractures,2 cases of infection,1 case of incision nonunion,and 1 case of common peroneal nerve injury);4

  5. Patellofemoral Pressure Changes After Static and Dynamic Medial Patellofemoral Ligament Reconstructions

    NARCIS (Netherlands)

    Rood, A.; Hannink, G.; Lenting, A.; Groenen, K.; Koeter, S.; Verdonschot, N.J.; Kampen, A. van

    2015-01-01

    BACKGROUND: Reconstructing the medial patellofemoral ligament (MPFL) has become a key procedure for stabilizing the patella. Different techniques to reconstruct the MPFL have been described: static techniques in which the graft is fixed rigidly to the bone or dynamic techniques with soft tissue fixa

  6. Patellofemoral pressure changes after static and dynamic medial patellofemoral ligament reconstructions

    NARCIS (Netherlands)

    Rood, A.; Hannink, G.; Lenting, A.; Groenen, K.; Koëter, S.; Verdonschot, N.J.J.; Kampen, van A.

    2015-01-01

    Background: Reconstructing the medial patellofemoral ligament (MPFL) has become a key procedure for stabilizing the patella. Different techniques to reconstruct the MPFL have been described: static techniques in which the graft is fixed rigidly to the bone or dynamic techniques with soft tissue fixa

  7. Acetabular allograft reconstruction in total hip arthroplasty. Part I: Current concepts in biomechanics.

    Science.gov (United States)

    Stiehl, J B

    1991-04-01

    Allograft reconstruction has become an essential tool for restoration of acetabular bone stock lost in failed total hip arthroplasty or resected in tumor reconstruction. This first segment of a two-part review will discuss the current status of allograft applications, together with pertinent biologic and biochemical aspects. Part II will address surgical considerations and recent clinical experience.

  8. 碳酸化羟基磷灰石支架及其细胞因子复合物修复鼠胫骨缺损的实验研究%In Vivo Study on Tibia Bone Defect Reconstruction with Carbonated Hydroxyapatite Scaffold and Its Cytokines Composite in SD Rats

    Institute of Scientific and Technical Information of China (English)

    于丽凤; 汪安; 陈建荣; 张磊

    2014-01-01

    目的:通过动物实验检测碳酸化羟基磷灰石支架材料(carbonated hydroxyapatite,CAP)的骨传导性和生物吸收性。并探讨骨形成蛋白-2(rhBMP-2)、重组人巨噬细胞集落刺激因子(rhM-CSF)对CAP成骨特性和生物吸收的影响。方法:选取45只雄性SD大鼠,制备双侧胫骨临界性骨缺损模型,以复合骨形成蛋白-2(rhBMP-2)的碳酸化羟基磷灰石支架材料、复合重组人巨噬细胞集落刺激因子(rhM-CSF)的碳酸化羟基磷灰石支架材料、单纯的碳酸化羟基磷灰石支架材料作为实验组,羟基磷灰石(hydroxyapatite,HAP)作为对照组,植入大鼠胫骨缺损处,并设立空白对照组。术后2、4和8周,通过组织学观察对比新骨形成和材料吸收降解情况。结果:实验组和对照组材料均能完全充填骨缺损,材料界面与骨组织结合紧密,显示了良好的生物相容性和成骨性能。随着植入时间的延长,实验组材料可逐渐降解并被新生骨爬行替代,而对照组未见显著降解和新生骨替代。rhM-CSF能够促进碳酸化羟基磷灰石材料的降解,与CAP组、CAP/rhBMP-2复合物组比较,差异有统计学意义。结论:CAP具有出色的骨传导性和生物吸收性,是一种良好的骨再生移植物。且该支架材料的成骨性和生物降解能够被成骨及破骨细胞因子所调控。%Objective: ① To evaluate the osteoconductivity and bioresorbability of the carbonated hydroxyapatite (CAP) scaffold. ②To evaluate the effects of rhBMP-2 and rhM-CSF on bone defect reconstruction with CAP scaffold. Methods:45 male SD rats were comprised in this experiment and randomly divided into 5 groups. A 4 mm ×4 mm critical-size bone defect was created in both sides of tibia in all rats. Group A, CAP was placed into the defect; Group B, placed with CAP/rhBMP-2; Group C, CAP/rhM-CSF was placed; Group D, HAP was placed; and Group E, bone defect left

  9. Revisions of endoprosthetic reconstructions after limb salvage in musculoskeletal oncology

    NARCIS (Netherlands)

    Renard, AJS; Veth, RPH; Schreuder, HWB; van Horn, J; Keller, A; Schraffordt Koops, H.

    1998-01-01

    Of 91 limb-salvage procedures using prosthetic reconstructions because of primary or metastatic bone and soft-tissue tumors 26 revisions were performed in 16 patients. Revision was due to polyethylene wear (9 cases), aseptic loosening (8 cases), recurrent hip dislocation (3 cases), prosthetic stem f

  10. Carbon nanotube-based bioceramic grafts for electrotherapy of bone.

    Science.gov (United States)

    Mata, D; Horovistiz, A L; Branco, I; Ferro, M; Ferreira, N M; Belmonte, M; Lopes, M A; Silva, R F; Oliveira, F J

    2014-01-01

    Bone complexity demands the engineering of new scaffolding solutions for its reconstructive surgery. Emerging bone grafts should offer not only mechanical support but also functional properties to explore innovative bone therapies. Following this, ceramic bone grafts of Glass/hydroxyapatite (HA) reinforced with conductive carbon nanotubes (CNTs) - CNT/Glass/HA - were prepared for bone electrotherapy purposes. Computer-aided 3D microstructural reconstructions and TEM analysis of CNT/Glass/HA composites provided details on the CNT 3D network and further correlation to their functional properties. CNTs are arranged as sub-micrometric sized ropes bridging homogenously distributed ellipsoid-shaped agglomerates. This arrangement yielded composites with a percolation threshold of pc=1.5vol.%. At 4.4vol.% of CNTs, thermal and electrical conductivities of 1.5W·m(-1)·K(-1) and 55S·m(-1), respectively, were obtained, matching relevant requisites in electrical stimulation protocols. While the former avoids bone damaging from Joule's heat generation, the latter might allow the confinement of external electrical fields through the conductive material if used for in vivo electrical stimulation. Moreover, the electrically conductive bone grafts have better mechanical properties than those of the natural cortical bone. Overall, these highly conductive materials with controlled size CNT agglomerates might accelerate bone bonding and maximize the delivery of electrical stimulation during electrotherapy practices.

  11. Dating of cremated bones

    NARCIS (Netherlands)

    Lanting, JN; Aerts-Bijma, AT; van der Plicht, J; Boaretto, E.; Carmi, I.

    2001-01-01

    When dating unburnt bone, bone collagen, the organic fraction of the bone, is used. Collagen does not survive the heat of the cremation pyre, so dating of cremated bone has been considered impossible. Structural carbonate in the mineral fraction of the bone, however, survives the cremation process.

  12. [Surgical reconstruction of large defects of the nose].

    Science.gov (United States)

    Hofer, S O P; Mureau, M A M

    2008-07-26

    --Skin cancer of the face is the most prevalent type of cancer. The large increase of the incidence of this type of cancer in recent years has resulted in an increase of skin cancer resections in the face. --Nasal defects are the most challenging of these facial defects. Nasal reconstruction requires reconstruction of three tissue layers: the inner mucosal lining, supporting structures (cartilage or bone) and the outer cutaneous lining. --The new inner lining should consist of well-vascularized thin tissue to prevent rejection of cartilage or bone in the supporting layer. For example, septal mucosa or skin can be used in various ways to reconstruct the inner lining. --The new supporting structures, consisting of transplanted cartilage or bone, should be strong enough to prevent contraction of the soft tissues--inner and outer lining--during wound healing. --The outer lining is reconstructed per subunit of the nose, e.g. nostril, ala nasi or ridge of the nose. Usually a paramedian forehead flap is used for the reconstruction of the outer lining.

  13. Reconstruction of the extensor mechanism after proximal tibia endoprosthetic replacement.

    Science.gov (United States)

    Bickels, J; Wittig, J C; Kollender, Y; Neff, R S; Kellar-Graney, K; Meller, I; Malawer, M M

    2001-10-01

    The proximal tibia is a difficult area in which to perform a wide resection of a bone tumor. This difficulty is due to the intimate relationship of tumor in this location to the nerves and blood vessels of the leg, inadequate soft tissue coverage after endoprosthetic reconstruction, and the need to reconstruct the extensor mechanism. Competence of the extensor mechanism is the major determinant of functional outcome of these patients. Between 1980 and 1997, 55 patients underwent proximal tibia resection with endoprosthetic reconstruction for a variety of malignant and benign-aggressive tumors. Reconstruction of the extensor mechanism included reattachment of the patellar tendon to the prosthesis with a Dacron tape, reinforcement with autologous bone-graft, and attachment of an overlying gastrocnemius flap. All patients were followed for a minimum of 2 years; 6 patients (11%) had a transient peroneal nerve palsy, 4 patients (7.2%) had a fasciocutaneous flap necrosis, and 2 patients (3.6%) had a deep wound infection. Full extension to extension lag of 20 degrees was achieved in 44 patients, and 8 patients required secondary reinforcement of the patellar tendon. Function was estimated to be good to excellent in 48 patients (87%). Reattachment of the patellar tendon to the prosthesis and reinforcement with an autologous bone-graft and a gastrocnemius flap are reliable means to restore extension after proximal tibia endoprosthetic reconstruction.

  14. Application of allogeneic deep-frozen tendon of lower limb with one-end bone block in reconstruction of anterior cruciate ligament%一端带骨块同种异体深冻下肢肌腱重建前交叉韧带的应用

    Institute of Scientific and Technical Information of China (English)

    张义龙; 李宁; 李志怀; 刘建丰; 宋有鑫; 李哲; 刘正蓬

    2011-01-01

    背景:关节镜辅助下重建前交叉韧带的移植物及固定方法的选择存在很多争论,各种固定方法均有其优缺点.目的:评估一端带骨块深冻同种异体肌腱股骨侧嵌入重建膝关节前交叉韧带的效果.方法:纳入2008-01/2009-09 在承德医学院附属医院骨科就诊的15例关节损伤患者(15膝),经关节镜检查证实为前交叉韧带断裂,其中运动损伤7例,交通事故伤6例,摔伤2例.均于关节镜下行一端带骨块的同种异体腱前交叉韧带重建术,记录患者膝关节Lysholm功能评分、KT-1000测量值.结果与结论:对15例患者随访12~24个月,均未发生血管神经损伤、排异、感染等并发症.KT-1000测量值术前双侧膝关节前向松弛度差值为3~5 mm 4例(27%),6~10 mm 9例(60%),>10 mm 2例(13%);末次随访时0~2 mm 12例(80%),3~5 mm 3例(20%).同时,Lysholm膝关节功能评分也由术前的(65.60±10.13)分提高到末次随访时的(90.93±4.06)分(P < 0.05).说明嵌入骨块在重建膝关节前交叉韧带中可增加股骨侧固定的可靠性,治疗效果满意.%BACKGROUND: There are a lot of debates on selections of grafts and ways of fixation methods about ansterior cruciate ligament (ACL) reconstruction. Each fixation has its advantages and disadvantages.OBJECTIVE: To evaluate the effectiveness of allogeneic deep froze tendon of lower limb with one-end bone block in ACL reconstruction.METHODS: Fifteen knees with ACL tear, of which, 7 knees were caused by athletic injury, 6 knees by traffic accident, and 2 knees by falling. ACL tear was verified by arthroscopy, and all the damaged ACL were reconstructed with allograft tendons by inserting technique under arthroscopy. The value of KT-1000 and the Lysholm scores were recorded before operations and at follow-up.RESULTS AND CONCLUSION: All cases were followed up for 12-24 months. No severe complication, such as vascular nerve injury, rejection or infection, occurred. The KT-1000 measurement

  15. 成人上颌牙牙根吸收及牙槽骨改建的 CBCT分析%Evaluation for apical root resorption and alveolar bone reconstruction in-duced by orthodontic treatment of maxillary in adult patients by CBCT

    Institute of Scientific and Technical Information of China (English)

    杨亚欣; 杨亚普; 王晨曦; 王鹿鸣; 张月兰

    2016-01-01

    目的:探讨正畸治疗的上颌前突患者上颌牙牙根吸收及牙槽骨改建情况。方法:选取上颌前突患者15例,均拔除上下颌第一前磨牙进行治疗。治疗前及拔牙间隙关闭后分别拍摄CBCT,观察牙根吸收及中切牙区牙槽骨改建情况。结果:拔牙间隙关闭后,所有患者均被检测出有牙根吸收,中切牙、侧切牙、尖牙和第二前磨牙吸收量分别为(0.415±0.118)、(0.972±0.288)、(0.466±0.718)和(0.283±0.339) mm。在中切牙颈部唇侧、根尖舌侧牙槽骨增厚,颈部舌侧、根中唇侧、根尖唇侧牙槽骨变薄,牙齿倾斜移动;在颈部、根中部以及根尖部水平总牙槽骨厚度的改变不具有统计学意义(P>0.05)。结论:正畸治疗后几乎所有牙齿均有一定程度的牙根吸收。前牙在内收过程中倾斜移动。%Aim:To evaluate orthodontically induced apical root resorption and alveolar bone reconstruction in maxil -lary teeth.Methods:A total of 15 patients receiving standardized orthodontic fixed appliance treatment with straight wire technique and first premolar extraction .Cone beam computed tomography ( CBCT ) examination was performed before and after closing the extraction space to observe the prevalence and severity of apical root resorption and alveolar bone recon -struction of central incisor .Results: After closing the spaces , apical root resorption was detected in all the patients; the apical root resorption values of central incisor , lateral incisor, canine and second premolar were ( 0.415 ±0.118 ), (0.972 ±0.288),(0.466 ±0.718) and (0.283 ±0.339) mm, respectively.Alveolar bone width increased significantly at the coronal level of labial side and the apical level of lingual side , decreased at the coronal level of lingual side and the apical level of labial side , and the teeth tipping moved;but the total alveolar bone width changes had no significance at co

  16. Three-dimensional Finite Element Analysis and Biomechanical Study on Reconstruction of the Large Defect of Proximal Femur with Allograft Prosthesis Composite in Clinical Bone-Healing Phase%复合移植重建股骨近段大段骨缺损骨临床愈合期的三维有限元分析

    Institute of Scientific and Technical Information of China (English)

    行斌斌; 段宏; 屠重棋; 陈和仲; 罗教明

    2009-01-01

    Three-dimensional finite element models of the large defect of proximal femur were reconstructed with allograft prosthesis composite in clinical bone-healing phase;current model was under the given conditions of 138mm-intramedullary stem-length of host bone and 135mm defect-length of proximal femur. The femur was constructed with efilm software from CT data,then three-dimensional concrete models were created by using Proe-Wildfire software;the three-dimensional finite element models of allograft prosthesis composite were made in ANSYS11 software. Loads were simulated using the peaking values during stance walking. The stress on femur-cement-callus-prostheses and the influence of stress on the clinical bone-healing phase were analysed.The highest stress value of femur is on the medial side of the tip of the prostheses. The highest stress value of cement mantle is on the medical side of the cement mantle at the tip of the stem. The highest stress value of the prostheses is on the medial side near the upper 4cm of the stem tip. The highest stress value on the callus is at the medial side of the callus layer. The highest stress value on every part is under the corresponding fatigue strength. Clinical bone-healing phase model is well enough for stance walking.%建立同种异体骨与人工关节复合移植重建股骨近段大段骨缺损骨临床愈合期的三维有限元模型,设定股骨近段骨缺损长度为135 mm,假体柄植入宿主股骨髓腔内长度为138 mm,首先采用efilm软件对股骨CT扫描图像进行三维重建,将重建数据及测量的假体参数导入ProeWildfire3.0软件建立三维实体模型,而后在ANSYS11.0中建立三维有限元模型,以下肢稳态步行的峰值负荷生理加载,得出载荷对股骨、骨痂、骨水泥及假体应力分布的影响.股骨应力值在假体柄尖端内侧处达到最大值,骨水泥壳应力最大值位于假体柄尖端骨水泥壳内侧,假体应力最大值位于假体柄尖端近端4

  17. Cosmic Tidal Reconstruction

    CERN Document Server

    Zhu, Hong-Ming; Yu, Yu; Er, Xinzhong; Chen, Xuelei

    2015-01-01

    The gravitational coupling of a long wavelength tidal field with small scale density fluctuations leads to anisotropic distortions of the locally measured small scale matter correlation function. Since the local correlation function is statistically isotropic in the absence of such tidal interactions, the tidal distortions can be used to reconstruct the long wavelength tidal field and large scale density field in analogy with the cosmic microwave background lensing reconstruction. In this paper we present in detail a formalism for the cosmic tidal reconstruction and test the reconstruction in numerical simulations. We find that the density field on large scales can be reconstructed with good accuracy and the cross correlation coefficient between the reconstructed density field and the original density field is greater than 0.9 on large scales ($k\\lesssim0.1h/\\mathrm{Mpc}$). This is useful in the 21cm intensity mapping survey, where the long wavelength radial modes are lost due to foreground subtraction proces...

  18. Clinical application of multislice spiral CT for temporal bone and multiple post-processing reconstruction techniques for infant cochlear implantation%颞骨MSCT及多种后处理技术在婴幼儿人工耳蜗植入术中的临床应用

    Institute of Scientific and Technical Information of China (English)

    陈彩龙; 林美福; 周硕; 王恩成; 陈国宝; 陈文新

    2015-01-01

    Objective To investigate the clinical application value of multislice spiral CT (MSCT) for temporal bone and multiple post-processing reconstruction techniques for infant cochlear implantation.Methods Fifty preoperative patients and two postoperative patients with severe sensorineural hearing loss (SNHL) underwent high-resolution temporal bone MSCT.Double-threshold reconstruction,transparent imaging and three-dimensional fusion,double-oblique diameter multiplanar reconstruction,and curved planar reconstruction were used to measure the distance between the vertical facial nerve and external acoustic canal and the round window breadth,as well as analyze the inner ear structure.Results ①Out of 50 preoperative patients,7 showed inner ear malformations,9 presented chronic tympanomastoiditis,and 34 exhibited normal ear structure.The probability of inner ear malformations was 14.0%.Before cochlear implantation,the inner ear structure and ossicular chain were clearly observed in all the patients enrolled in this study.The distance between the vertical facial nerve and external acoustic canal was (0.33±0.057) cm on the right side and (0.33±0.068) cm on the left side.The round window breadth was (0.14±0.027) cm on the right side and (0.14±0.025) cm on the left side.②The electrodes and postoperative changes were clearly detected in two patients with cochlear implants.Conclusions Inner ear malformations were clearly shown by high-resolution temporal bone scanning in a number of SNHL patients.Multiple post-processing techniques can significantly obtain precise information on the temporal anatomical structure before cochlear implantation and provide accurate assessment of the operation.%目的 探讨颞骨多层螺旋CT(MSCT)及多种后处理技术在婴幼儿人工耳蜗植入术中的临床应用价值.方法 对50例术前和2例术后重度感音神经性耳聋(SNHL)患者行颞骨高分辨率CT平扫,应用双斜径多平面重建、面神经曲面重建、双

  19. Treatment of cubital tunnel syndrome with ulnar nerve anterior submuscular transposition and medial epicondyle muscle group in situ reconstruction via a bone tunnel%尺神经肌下前置肱骨内上髁肌群经骨道原位重建治疗肘管综合征

    Institute of Scientific and Technical Information of China (English)

    张小路; 林其仁

    2014-01-01

    Objective To investigate the clinical effectiveness of treating moderate to severe cubital tunnel syndrome with ulnar nerve decompression,anterior submuscular transposition and medial epicondyle muscle group in situ reconstruction via a bone tunnel.Methods The clinical data of 45 cases of moderate to severe cubital tunnel syndrome diagnosed between January 2005 and October 2012 were analyzed.The ulnar nerve was decompressed and its perfnsion by the superior ulnar collateral artery was observed under the surgical microscope intraoperatively.After ulnar nerve was transposed anteriorly,the detached medial epicondyle muscle group was reconstructed in situ through a bone tuunel under direct view.The size of the new ulnar nerve tunnel and mobility of the ulnar nerve were observed.Postoperative recovery was follow-up including pain,sensation,muscular atrophy recovery,claw hand,grip strength,wrist flexion and forearm pronation.Results All 45 cases were follow-up for 6 to 18 months.Intraoperative microscopic observation showed good ulnar nerve perfusion by the superior ulnar collateral artery.Reattachment of the medial epicondyle muscle group was secure.The newly formed cubital tunnel could allow an 8 mm dilator without tension in elbow full extension position.Ulnar nerve could glide freely upon elbow flexion and extension.According to the cubital tunnel syndrome function evaluation standard suggested by Gu Yudong,the results were graded as excellent in 20 cases,good in 17 cases,and fair in 8 cases.The overall excellent and good rate was 82.22%.Wrist flexion and forearm pronation force recovered to preoperative level in all the patients 3 months after the operation.Conclusion Including superior ulnar collateral artery in the anterior transposition of the ulnar nerve provides good blood supply to the nerve and benefits nerve recovery.In situ reconstruction of the medial epicondyle muscle group through a bone tunnel puts the ulnar nerve anderneath flexor carpi ulnaris and

  20. Human maxillary sinus floor elevation as a model for bone regeneration enabling the application of one-step surgical procedures

    NARCIS (Netherlands)

    Farre-Guasch, E.; Prins, H.J.; Overman, J.R.; ten Bruggenkate, C.M.; Schulten, E.A.J.M.; Helder, M.N.; Klein-Nulend, J.

    2013-01-01

    Bone loss in the oral and maxillofacial region caused by trauma, tumors, congenital disorders, or degenerative diseases is a health care problem worldwide. To restore (reconstruct) these bone defects, human or animal bone grafts or alloplastic (synthetic) materials have been used. However, several d

  1. Ptychographic ultrafast pulse reconstruction

    CERN Document Server

    Spangenberg, D; Brügmann, M H; Feurer, T

    2014-01-01

    We demonstrate a new ultrafast pulse reconstruction modality which is somewhat reminiscent of frequency resolved optical gating but uses a modified setup and a conceptually different reconstruction algorithm that is derived from ptychography. Even though it is a second order correlation scheme it shows no time ambiguity. Moreover, the number of spectra to record is considerably smaller than in most other related schemes which, together with a robust algorithm, leads to extremely fast convergence of the reconstruction.

  2. In vitro osteoinduction of demineralized bone.

    Science.gov (United States)

    Torricelli, P; Fini, M; Giavaresi, G; Giardino, R

    1998-05-01

    Among numerous available materials for osseous repair and reconstruction, those presenting osteoinductive characteristics and promoting bone regeneration are preferable. Fresh autologous bone is one of the most effective, but it has some disadvantages and risks. Demineralized bone matrix (DBM) is considered to be a valid alternative, because it seems to show osteogenic potential, ascribed to the presence of bone morphogenetic proteins. In addition it can be prepared without difficulty and preserved without losing osteoinductive properties. The aim of the study was to evaluate the osteoinductive ability of xenogenic DBM, by testing DBM powder obtained from rabbit long bones, in cell culture of murine fibroblasts, alone or associated with electromagnetic field (EMF), that are known to exhibit biologic effects on cells: in particular they are used in orthopedics to improve bone formation. At the end of experiment, alkaline phosphatase (ALP) activity, calcium levels and cell proliferation and morphology were evaluated. A statistically significant stimulation of ALP activity and cell proliferation and a morphological change of fibroblasts were found. The results obtained show how DBM and EMF have different effects on cells, and that together they have synergic action toward bone induction.

  3. A Brief History of Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Nikolaos Davarinos

    2014-01-01

    Full Text Available Reconstructions of the anterior cruciate ligament (ACL are among the most frequently performed procedures in knee surgery nowadays. The history of ACL surgery can be traced as far back as the Egyptian times. The early years reflect the efforts to establish a viable, consistently successful reconstruction technique while, during the early 20th century, we witness an increasing awareness of, and interest in, the ligament and its lesions. Finally, we highlight the most important steps in the evolution of the ACL reconstruction surgery by discussing the various techniques spanning the years using not only autologous grafts (fascia lata, meniscal, hamstring, patella tendon, bone-patella tendon-bone, and double bundle grafts but also synthetic ones and allografts.

  4. Free forearm flap and free iliac bone reconstruct the composite tissue defects of the floor of mouth and the lower part of face in the same period%游离前臂皮瓣联合髂骨同期修复重建口底及面下部的复合性组织缺损

    Institute of Scientific and Technical Information of China (English)

    徐锦程; 卢保全; 黄全顺; 李建成; 张凯; 廖圣恺; 徐涛

    2011-01-01

    目的 探讨游离前臂皮瓣联合游离髂骨进行口底及面下部复合型组织缺损同期修复重建的临床疗效。 方法 术前对11例口底及面下部复合型组织缺损的范围及外形进行认真的评估,设计出与缺损区相匹配的个体化前臂皮瓣。术中先行成型钛板恢复缺损下颌骨基本的外形及咬合关系,然后用来复锯切取设计塑型的游离髂骨并移植固定于钛板的内侧,从而恢复缺损下颌骨的连续性。 结果 11例前臂皮瓣及髂骨全部成活,成功率100%。本组患者经随访6~ 12个月,修复区外形虽显不同程度的臃肿,但饮食、吞咽等口腔功能得到了改善,有7例可进普食,有4例可进流质饮食,同时可参与社会活动中日常的语言交流,皮瓣的感觉功能及外形恢复满意。 结论 适形游离前臂皮瓣联合游离髂骨对口底及面下部复合型组织缺损同期修复重建,是修复口底及面下部复合型组织缺损较为理想的方法之一,既达到安全、实用的预后效果,又可明显提高患者的生存质量,值得临床借鉴并使用。%Objective To probe into the clinical efficiency of reconstruction to person who had composite tissue defect of the floor of mouth and the lower part of face with the free forearm flap and free iliac bone in the same term. Methods Before the surgery, the surgeon should carefully evaluate the scope and shape of defects in 11 cases who had the composite tissue defects of the floor of mouth and the lower part of face, to design the individual forearm flap, so that it matches with the defect region. During surgery, the first resumption of defects using titanium plates forming the basic shape of mandible and the occlusal relationship, then used to re-sawing to take modeling of the iliac bone, transplanted free iliac bone and fixed after the inside of the titanium plate, thereby restoring the continuity of mandible missing. Results Free

  5. Smoking and Bone Health

    Science.gov (United States)

    ... supported by your browser. Home Bone Basics Lifestyle Smoking and Bone Health Publication available in: PDF (85 ... late to adopt new habits for healthy bones. Smoking and Osteoporosis Cigarette smoking was first identified as ...

  6. TKA 术中螺钉附加骨水泥结合髓内延长杆修复胫骨平台骨缺损重建关节稳定性%Supporing Screws and Bbone Cement Filling Combined with Intramedullary Stem for Reconstruc-ting Tibial Bone Defect and Joint Stability in Total Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    潘文杰; 贺艳; 马建兵; 肖琳; 卿忠; 王曦; 姚舒馨; 武淑芳

    2016-01-01

    Objective To observe the early clinical effect of Supporing screws and bone cement filling combined with intr-amedullary stem for reconstructing tibial noncontained bone defect and joint stability in primary total knee arthroplasty. Meth-ods From May 2012 to October 2015,16 patients(21 knees)with tibial plateau noncontained bone defects including 4 men (5knees)and12 women(16 knees)underwent primary total knee arthmplasty. The average age of the patients was 70. 5 years old ranging from 65 to 76 years. The average weight was 75. 6 kg ranging from 68. 5 kg to 92 kg,and the average body height was 171. 1 cm ranging from 155 cm to 180 cm. The diagnoses of the patients were osteoarthritis in 13 cases(16 knees)and rheumatoid arthritis in 2 cases(4 knees),Kashin-Bek syndrome in 1 case(1 knee). The preoperative range of movement (ROM)was(69. 8 ± 9. 8)°. According to Knee Society score(KSS)criterion,the clinical score of preoperation was(31. 9 ± 8. 8)and functional score was(33. 1 ± 9. 1)During operation,the average depth of tibial plateau defect was 19. 8 mm before tibial osteotomy. The conventional tibial osteotomy of 10. 0 mm was performed,the average depth of the residual bone defect was10. 5 mm. Sclerotic bone was thoroughly removed,2 or 3 pieces of supporting screws were inserted according to bone defect area and morphology,and bone cement was pressurely filled,and then the tibial prosthesis with stem was installed. Results All the cases were followed up of 26. 5 months(range,3 to 36months). All the patients can walk without crutch and self-care 1 month after operation,The enstrophy or ecstrophy or contraction anisotrophy were completely rectified right after operation,and the pain of knee was totally reliefed,At the latest follow-up,the KSS clinical score was knee score(90. 3 ± 9. 0)and functional score was(91. 4 ± 8. 3). The ROM of the knee joint was(115 ± 8. 8)°. In the final follow-up through the X-ray measurement, the position of the prosthesis was good

  7. A RARE CASE PRESENTATION OF SIMPLE BONE CYST IN CLAVICLE

    Directory of Open Access Journals (Sweden)

    Vittal

    2015-05-01

    Full Text Available Simple bone cyst represent approximately 3% of all primary bone tumors sampled for biopsy and nearly always occur during the first two decades of life. They are common in metaphyseal region of long bones. Clavicle is rare s ite for this lesion and not many have been reported in literature. We report a case of Histopathologically confirmed Simple bone cyst in a 65 yr s old manual laborer who presented with pain and swelling of long duration. The occurrence of this lesion at unu sual age and at unusual location carries a lot of diagnostic dilemma and various differentials like ABC , Eosinophilic granuloma , and enchondroma were considered only to confirm simple bone cyst on HPE . The symptoms were relieved after resection of lesion. Clavicle was reconstructed with tricortical iliac crest bone graft. At 18th month follow up the patient had no recurrences and had a good functional outcome .

  8. Bone formation by autogenous grafting of cultured bone/porous ceramic constructs in a dog

    Energy Technology Data Exchange (ETDEWEB)

    Iida, J.; Ueda, Y.; Ohgushi, H.; Takakura, Y. [Nara Medical Univ., Kashihara (Japan). Dept. of Orthopedic Surgery; Yoshikawa, T. [Nara Medical Univ., Kashihara (Japan). Dept. of Orthopedic Surgery; Nara Medical Univ., Kashihara (Japan). Dept. of Phathology; Uemura, T.; Tateishi, T. [National Inst. for Advanced Interdisciplinary Research (NAIR), Ibaraki (Japan). Tsukuba Research Center; Enomoto, Y.; Ichijima, K. [Nara Medical Univ., Kashihara (Japan). Dept. of Phathology

    2001-07-01

    Five ml of bone marrow was collected from the humerus of a 6 month old female dog by needle aspiration. The marrow was cultured in T-75 flask and expand the marrow mesenchymal cells. After 1 week in primary culture, cells were released by trypsin treatment, concentrated and loaded onto porous hydroxyapatite (HA) blocks. The marrow/HA constructs were subcultured in the presence of dexamethasone and beta-glycerophosphate (osteogenic medium). After 2 weeks of subculture, the autogenous cultured bone/HA constructs were subcutaneously implanted into the back of the dog. Histological findings of the constructs at 3 weeks after implantation revealed thick layer of lamellar bone together with active osteoblasts lining in many pore areas of the HA. High alkaline phosphatase activity could be detected in the construct. These results indicate that autogenous cultured bone/HA constructs can produce extensive bone formation after implantation in a large animal(dog). Therefore, based upon the fact that human marrow-derived culture bone/HA construct possesses osteogenic potential when it is grafted into nude mice, it can be expected that autogenous human cultured bone/ceramic grafts may be useful to reconstruct bone in the clinical setting. (orig.)

  9. Epiphyseal preservation and reconstruction with inactivated bone in distal femur for metaphyseal osteosarcoma in children%保留骨骺灭活再植术治疗儿童股骨远端骨肉瘤及术后肢体功能恢复特征

    Institute of Scientific and Technical Information of China (English)

    于秀淳; 刘晓平; 周银; 付志厚; 宋若先; 孙海宁; 徐明

    2007-01-01

    和肢体长度的保持.%BACKGROUND: Limb salvage operations with preservation of the epiphysis (LSPPE) had been used clinically in order to overcome discrepancy of affected limb and poorer limb function, but more post-operation complications existed, including infection, grafting bone resorption, fracture and internal fixation cinch.OBJECTIVE: To study the clinical related matters of inactivated bone replantation with preservation of the epiphysis in children limb salvage with osteosarcoma.DESIGN: Clinical observation regularly.SETTING: General Hospital of Jinan Military Area Command of Chinese PLA.MATERIALS: Eleven patients corresponded selected standard and accepted treatment from January 1999 to January distal metastasis was found with lung X-ray check and CT scanning, the patient would be excluded this study. There were 5 males, 6 females, and the mean age of (8±2) years old (4-11 years). The disease history was 1-6 months.FO) were adopted. After 2 weeks of chemotherapy, the operations of inactivated bone replantation with preservation of the epiphysis were performed. The operation was performed under epidural or general anesthesia. The patient lied on operating table. The knee anteriomedialis incision was adopted. Firstly, femur periosteum was opened beyond proximal end 2-3 cm from tumor, subperiosteum stripping was done to the proximal femur, descend femur with wire saw, separated and disconnected aboral periosteum, blunt dissecting femur aboral blood vessel and nerves to the popliteal fossa,deligating blood vessel around the tumor. Attachment of gastroenemius was cut off. Epiphyseal plate was identified carefully. According to pre-operation MR, the distal femur descend level was determined and the femur was descend with electro-saw. It was determined with cytology that no tumor cell existed in descend level, and reconstruction of bone de-fect with inactivated tumor-bone shell with 95% alcohol and bone cement containing ADR (20 g bone cement: 10 mg ADR), the diaphysis was fixed by intramedullary

  10. 基于逆向工程和快速成型技术的髋骨三维实体模型个性化重建%Reconstruction of personalized three-dimensional entity model of hip bone based on reverse engineering and rapid prototyping technology

    Institute of Scientific and Technical Information of China (English)

    唐通鸣; 邓佳文; 张政; 黄明宇; 倪红军

    2015-01-01

    BACKGROUND:Hip’s anatomy structure is complex, and the traditional two-dimensional imaging, such as X-ray film or CT scan, is susceptible to image overlap and other soft tissue. As a result, there are some limitations in the diagnosis of hip disease. The digital model is built based on reverse engineering and rapid prototyping. It is comprehensive, intuitive and accurate of the stereo configuration of the hip and the spatial relations of other parts’ anatomical structures. This study has a broad application prospect. OBJECTIVE:To reconstruct the personalized three-dimensional entity model of the hip bone with computer aided technology. METHODS: The human hips were scanned with a portable three-dimensional laser scanner, and then the point cloud data of the hips were gotten. The point cloud was processed and the three-dimensional model reconstruction was carried out by using the engineering software Geomagic and the computer aided software CimatronE. Three-dimensional print of hip was completed and the model was gotten, which was consistent with the geometry of hip bone, through the rapid prototyping machine. RESULTS AND CONCLUSION:A model with good geometric similarity and biomechanical characteristics was built by digital modeling method based on reverse engineering and rapid prototyping. This way of digital modeling provided the basis for digital manufacturing of artificial hip, virtual assembly, stress analysis and surgical simulation.%背景:髋骨解剖结构复杂,传统的X射线片及CT扫描等二维影像检查易受到影像重叠、软组织等的干扰,在髋骨的诊断中具有一定的局限性。通过基于逆向工程技术的数字化建模能全面、直观、精确地显示髋骨立体形态和各部位解剖结构的空间关系,在骨骼研究中有着广阔的应用前景。目的:利用计算机辅助技术重建个性化的髋骨三维实体模型。方法:使用手持式三维激光扫描仪对人体髋骨表面进行扫

  11. Reconstruction of facial defects after combat wounding using vascularized pedicled galeal and parietal bony grafts

    Directory of Open Access Journals (Sweden)

    Jović Nebojša

    2002-01-01

    Full Text Available Combat wounds are basically extensive and destructive. Such injuries cause defects of soft and bone structures of the face and neck. During primary surgical management of maxillofacial combat wounds the principle of minimal bone and soft tissue debridement was respected. Definitive reconstruction of the defect was performed after two or three months, when infection was cured and adjacent tissues were restituted. Each combat wound leaves behind fibrous changes in surrounding tissues. Success of the reconstructive procedures is more certain if flaps with its own blood supply are used, either arterial or vascularized grafts from the other parts of body (by microvascular technique. This paper presents our experiences with galeal flap in reconstruction of facial soft tissue defects, as well as galea, together with external table of parietal bone in reconstruction of soft and bony tissues of maxillofacial region in 15 patients.

  12. First experiences with simultaneous skeletal and soft tissue reconstruction of noma-related facial defects.

    Science.gov (United States)

    Giessler, Goetz A; Borsche, André; Lim, Paul K; Schmidt, Andreas B; Cornelius, C-Peter

    2012-02-01

    Noma victims suffer from a three-dimensional facial soft-tissue loss. Some may also develop complex viscerocranial defects, due to acute osteitis, chronic exposure, or arrested skeletal growth. Reconstruction has mainly focused on soft tissue so far, whereas skeletal restoration was mostly avoided. After successful microvascular soft tissue free flap reconstruction, we now included skeletal restoration and mandibular ankylosis release into the initial step of complex noma surgery. One free rib graft and parascapular flap, one microvascular osteomyocutaneous flap from the subscapular system, and two sequential chimeric free flaps including vascularized bone were used as the initial steps for facial reconstruction. Ankylosis release could spare the temporomandibular joint. Complex noma reconstruction should include skeletal restoration. Avascular bone is acceptable in cases with complete vascularized graft coverage. Microsurgical chimeric flaps are preferable as they can reduce the number and complexity of secondary operations and provide viable, infection-resistant bone supporting facial growth.

  13. Post-traumatic Vertebral Compression Fracture Treated with Minimally Invasive Biologic Vertebral Augmentation for Reconstruction.

    Science.gov (United States)

    Chiu, John C; Maziad, Ali M

    2011-12-01

    In the United States, there is a high incidence of motor vehicle and sports injuries among the active population causing symptomatic post-traumatic vertebral compression fracture. At our institution, 28 cases of painful post-traumatic vertebral compression fractures (PPT-VCFs) were successfully treated with percutaneous vertebral augmentation (VA) for stabilization and reconstruction with intravertebral polyethylene mesh sac (OptiMesh®, Spineology, Inc., Stillwater, MN) and biological morcelized bone graft. The surgical approach provides an efficacious and controlled minimally invasive delivery mechanism to stabilize and reconstruct VCFs, as well as avoiding serious complications from Polymethylmethacrylate (PMMA) of vertebroplasty and kyphoplasty. The construct for biological bone graft/vertebral augmentation is osteoconductive and osteoinductive, and is used to create biologic vertebral stabilization and reconstruction. The adjacent vertebra integrity is protected by the construct with similar elasticity and physical characteristics of the biologic morcelized bone, more matched to that of adjacent bone than PMMA. The surgical techniques are described herein.

  14. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;

    2012-01-01

    We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during...... reconstruction approaches other than implants should be seriously considered among women who have received radiation therapy....

  15. Microtomography with sandwich detectors for small-animal bone imaging

    Science.gov (United States)

    Kim, S. H.; Kim, D. W.; Kim, D.; Youn, H.; Cho, S.; Kim, H. K.

    2016-10-01

    An x-ray radiographic system consisting of two detectors in tandem, or a sandwich detector, can produce dual-energy image from a single-shot exposure. Subtraction of two images obtained from the two detectors can produce a sharper image through an unsharp masking effect if the two images are formed at different spatial resolutions. This is indeed possible by incorporating different thicknesses of x-ray conversion layers in the detectors. In this study, we have developed a microtomography system with a sandwich detector in pursuit of high-resolution bone-enhanced small-animal imaging. The results show that the bone-enhanced images reconstructed from the dual-energy projection data provide higher visibility of bone details than the conventionally reconstructed images. The microtomography with the single-shot dual-energy sandwich detector will be useful for the high-resolution bone-enhanced small-animal imaging.

  16. Sclerostin antibody stimulates bone regeneration after experimental periodontitis.

    Science.gov (United States)

    Taut, Andrei D; Jin, Qiming; Chung, Jong-Hyuk; Galindo-Moreno, Pablo; Yi, Erica S; Sugai, James V; Ke, Hua Z; Liu, Min; Giannobile, William V

    2013-11-01

    The reconstruction of large osseous defects due to periodontitis is a challenge in regenerative therapy. Sclerostin, secreted by osteocytes, is a key physiological inhibitor of osteogenesis. Pharmacologic inhibition of sclerostin using sclerostin-neutralizing monoclonal antibody (Scl-Ab) thus increases bone formation, bone mass and bone strength in models of osteopenia and fracture repair. This study assessed the therapeutic potential of Scl-Ab to stimulate alveolar bone regeneration following experimental periodontitis (EP). Ligature-induced EP was induced in rats to generate localized alveolar bone defects. Following 4 weeks of disease induction, Scl-Ab (+EP) or vehicle (+/- EP) were systemically delivered, twice weekly for up to 6 wks to determine the ability of Scl-Ab to regenerate bone around tooth-supporting osseous defects. 3 and 6 wks after the initiation of Scl-Ab or vehicle treatment, femur and maxillary jawbones were harvested for histology, histomorphometry, and micro-computed tomography (micro-CT) of linear alveolar bone loss (ABL) and volumetric measures of bone support, including bone volume fraction (BVF) and tissue mineral density (TMD). Serum was analyzed to examine bone turnover markers during disease and regenerative therapy. Vehicle + EP animals exhibited maxillary bone loss (BVF, TMD and ABL) at ligature removal and thereafter. 6 weeks of Scl-Ab significantly improved maxillary bone healing, as measured by BVF, TMD and ABL, when compared to vehicle + EP. After 6 weeks of treatment, BVF and TMD values in the Scl-Ab + EP group were similar to those of healthy controls. Serum analysis demonstrated higher levels of bone formation markers osteocalcin and PINP in Scl-Ab treatment groups. Scl-Ab restored alveolar bone mass following experimental periodontitis. These findings warrant further exploration of Scl-Ab therapy in this and other oral bone defect disease scenarios.

  17. Regenerate augmentation with bone marrow concentrate after traumatic bone loss

    Directory of Open Access Journals (Sweden)

    Jan Gessmann

    2012-03-01

    Full Text Available Distraction osteogenesis after post-traumatic segmental bone loss of the tibia is a complex and time-consuming procedure that is often complicated due to prolonged consolidation or complete insufficiency of the regenerate. The aim of this feasibility study was to investigate the potential of bone marrow aspiration concentrate (BMAC for percutaneous regenerate augmentation to accelerate bony consolidation of the regenerate. Eight patients (age 22-64 with an average posttraumatic bone defect of 82.4 mm and concomitant risk factors (nicotine abuse, soft-tissue defects, obesity and/or circulatory disorders were treated with a modified Ilizarov external frame using an intramedullary cable transportation system. At the end of the distraction phase, each patient was treated with a percutaneously injection of autologous BMAC into the centre of the regenerate. The concentration factor was analyse