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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  5. Three-Dimensional Evaluation of Mandibular Bone Regenerated By Bone Transport Distraction Osteogenesis

    OpenAIRE

    Kontogiorgos, Elias; Elsalanty, Mohammed E.; Zapata, Uriel; Zakhary, Ibrahim; Nagy, William W; Dechow, Paul C.; Opperman, Lynne A.

    2011-01-01

    The purpose of this study was to evaluate the structure and material properties of native mandibular bone and those of early regenerate bone, produced by bone transport distraction osteogenesis. Ten adult foxhounds were divided into two groups of five animals each. In all animals, a 3- to 4-cm defect was created on one side of the mandible. A bone transport reconstruction plate, consisting of a reconstruction plate with an attached intraoral transport unit, was utilized to stabilize the mandi...

  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. 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...

  8. Tissue engineering of bone: the reconstructive surgeon's point of view

    OpenAIRE

    Kneser, U; Schaefer, D. J.; Polykandriotis, E; Horch, R E

    2007-01-01

    Bone defects represent a medical and socioeconomic challenge. Different types of biomaterials are applied for reconstructive indications and receive rising interest. However, autologous bone grafts are still considered as the gold standard for reconstruction of extended bone defects. The generation of bioartificial bone tissues may help to overcome the problems related to donor site morbidity and size limitations. Tissue engineering is, according to its historic definition, an “interdisciplin...

  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. Maxillary Tuberosity Reconstruction with Transport Distraction Osteogenesis

    OpenAIRE

    F. Ugurlu; Basel, B.; B. Cem Sener; A. Sertgöz

    2012-01-01

    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 × 3 cm cyst was discovered in the left maxillary m...

  11. Prefabricated flaps for bone reconstructive surgery

    NARCIS (Netherlands)

    Hartman, E.H.M.

    2004-01-01

    Tissue engineering of bone could help minimise donor site defects of conventional bone flaps like the fibula, iliac crest, radius and scapula. First a review is given on the literature of donor site morbidity of these flaps. Then the use of MRI is investigated for longitudinal study of ectopic bone

  12. Reconstruction of saddle nose deformity with calvarial bone graft

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of calvarial bone in the reconstruction of saddle nose deformity. Methods: The cross-sectional study was conducted at the Plastic Surgery Unit of Imam Reza Hospital, Tabriz University of Medical Sciences, Iran, from July 2004 to October 2009. It comprised 19 patients who underwent saddle nose deformity reconstruction with calvarial bone graft. All patients were operated upon under general anaesthesia. They were followed up periodically. Results: The patients followed up for 25 to 61 months for an average period of 39.2+-4.3 months. In 14 (74%) patients the result of the surgical intervention was excellent, while in 5 (26%) it was acceptable. All patients were satisfied and there was not displacement, absorption, distortion or infection of the graft. Conclusion: Calvarial bone graft is a viable option for the reconstruction of saddle nose deformity, especially in severe cases. (author)

  13. Bioactive Ca-P scaffolds used for bone reconstruction

    Institute of Scientific and Technical Information of China (English)

    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.

  14. 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.

  15. 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.

  16. 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...... (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....

  17. Complications of massive allograft reconstruction for bone tumors

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    Abolhasan Borjian

    2006-11-01

    Full Text Available BACKGROUND: Since the evolution of multi-drug chemotherapy and radiotherapy and new sophisticated surgical techniques, limb salvage and reconstruction, rather than amputation, has become the preferred treatment for patients with bone tumors. One option is allograft replacement. Although allograft has several advantages, it is not without complications. This study was performed to observe these complications in a group of patients treated with allograft replacement for bone tumor resection. The purpose was to gain an overview of the factors predisposing to these complications to minimize their occurrence. METHODS: This retrospective study was performed on patients with benign aggressive and malignant bone tumors undergoing limb reconstruction with allograft between 1997 and 2005 in Al-Zahra and Kashani Hospitals in Isfahan, Iran. Data was collected from patient files, clinical notes, radiographs and a recent physical examination. Complications including local recurrence, fracture of allograft, fixation failure, nonunion, infection, skin necrosis and neurological damage were recorded. RESULTS: Sixty patients including 39 males and 21 females were studied. The mean age of patients was 23 ± 11.7 years. The mean follow-up interval was 28.1 ± 12.4 months (mean ± SD. Complications were allograft fracture in 20%, local recurrence in 16%, fixation failure in 11%, nonunion in 6%, infection in 6%, skin necrosis in 6%, and peroneal nerve palsy in 1% of cases. Most local recurrences (60% were those with a mal-performed biopsy. Most allograft fractures occurred when a short plate was used. CONCLUSIONS: Allograft replacement for bone tumors remains a valid option. To avoid complications, biopsy should be done by a trained surgeon in bone oncology. A long plate is recommended for fixation. Sterility and graft processing must be optimal. Autogenous bone graft must be added at host-allograft junction. KEY WORDS: Bone tumors, bone allograft, limb

  18. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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. PMID:27274452

  1. Patellar tendon ossification after anterior cruciate ligament reconstruction using bone – patellar tendon – bone autograft

    OpenAIRE

    Camillieri, Gianluca; Di Sanzo, Vincenzo; Ferretti, Matteo; Calderaro, Cosma; Calvisi, Vittorio

    2013-01-01

    Background Among the various complications described in literature, the patellar tendon ossification is an uncommon occurrence in anterior cruciate ligament (ACL) reconstruction using bone – patellar tendon – bone graft (BPTB). The heterotopic ossification is linked to knee traumatism, intramedullary nailing of the tibia and after partial patellectomy, but only two cases of this event linked to ACL surgery have been reported in literature. Case presentation We present a case of a 42-year-old ...

  2. Bone reconstruction of large defects using bone marrow derived autologous stem cells.

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    Lucarelli, Enrico; Donati, Davide; Cenacchi, Annarita; Fornasari, Pier Maria

    2004-04-01

    Bone is a tissue that has the ability to heal itself when fractured. Occasionally, a critical defect can be formed when part of the bone is lost or excised, in this case the bone fails to heal and requires bone reconstruction to prevent a non-union defect. Autogenous cancellous bone is the current gold standard treatment in bone loss. Because the amount of autogenous cancellous bone that can be harvested is limited, the expanding need for bone reconstruction is paired by the growth of interest in the discipline of tissue engineering. Labs worldwide are working to provide the right carrier and the right set of cells that, once retransplanted, will ensure bone repair. Several investigators have focused their attention on a subset of autologous non-hematopoietic stem/progenitor cells contained in the adult bone marrow stroma, referred to as stromal stem cells (SSC), as the appropriate cells to be transplanted. The use of autologous cells is facilitated by less stringent ethical and regulatory issues and does not require the patient to be immunologically suppressed. In pre-clinical and clinical protocols of critical defects in which SSC are employed, two approaches are mainly used: in the first, SSC are derived from bone marrow and directly introduced at the lesion site, in the second, SSC are derived from several sites and are expanded ex vivo before being implanted. Both approaches, equally correct in principle, will have to demonstrate, with definitive evidence of their efficacy, their capability of solving a critical clinical problem such as non-union. In this report we outline the difficulties of working with SSC. PMID:15062758

  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. Craniofacial reconstruction by transport distraction osteogenesis: corticotomy versus osteotomy--an experimental study.

    Science.gov (United States)

    Kramer, Franz-Josef; Mueller, Michal; Rahmstorf, Meike; Swennen, Gwen; Dempf, Rupert; Schierle, Hannes

    2004-07-01

    Transport osteogenesis is a modified technique of callus distraction appropriate for the reconstruction of extended osseous defects of long or flat bones. The aim of this study was to determine the regenerative potential of this technique related to the degree of mobilization of the transport segment. In 10 adult sheep, critically sized defects of the calvaria were treated by gradual movement of a transport segment consisting of calvarial bone. The transport segments were either corticotomized (n = 5) or osteotomized (n = 5). The latency period was 5 days; the rate of distraction was 1 mm/d, extended for approximately 40 days. The consolidation period was 28 days. Specimens were investigated by conventional radiography, computed tomography scans, immunofluorescence, and histological examination. In both groups, transport osteogenesis resulted in a complete closure of the defect. The volume and thickness of newly formed bone at the defect site did not differ significantly between the groups, nor did the extent of vascularization. Bone formation and remodeling occurred during the entire period of distraction and consolidation. Osteotomized transport segments became smaller during distraction, whereas the volume of corticotomized segments remained relatively constant. In conclusion, transport osteogenesis resulted in reliable closure of extended skull defects in adult organisms; corticotomy and osteotomy of the transport segment led to a similar extent of bone formation. PMID:15213530

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

    Science.gov (United States)

    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.

  6. [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.

  7. [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 < 0.05) and 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. PMID:22476418

  8. 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

  9. 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.

  10. Efficacy of PRP in the Reconstruction of Mandibular Segmental Defects Using Iliac Bone Grafts

    OpenAIRE

    Magesh, D. P. Uma; Kumaravelu, C.; Maheshwari, G. Uma

    2012-01-01

    This retrospective study was conducted to evaluate the role of platelet-rich plasma (PRP) in the reconstruction of segmental mandibular defects using iliac bone grafts. Thirteen patients underwent reconstruction of post-resection segmental defects of the mandible using titanium reconstruction plates, cortico cancellous iliac bone graft. The patients were randomly separated into two groups. One group of the patients received a PRP graft in addition to the iliac bone graft. Post-operative dimen...

  11. 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....

  12. 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.

  13. 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. PMID:25650097

  14. 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.

  15. A comparative study of calcium sulfate artificial bone graft versus allograft in the reconstruction of bone defect after tumor curettage

    Institute of Scientific and Technical Information of China (English)

    Yang Yongkun; Niu Xiaohui; Zhang Qing; Hao Lin; Ding Yi; Xu Hairong

    2014-01-01

    Background Cavity reconstruction after benign bone tumor removal is varied and controversial.AIIograft is widely used but is associated with complications.New bone substitutes,such as calcium sulfate artificial bone,have been introduced for bone tumor operation.However,the bone healing response of artificial bone has not been compared with allograft bone.We therefore compared calcium sulfate grafts (study group) with bone allografts (control group) for the treatment of benign bone tumors.Methods We retrospectively reviewed 50 patients who underwent calcium sulfate reconstruction and 50 patients who underwent allograft cancellous bone reconstruction.The two groups were well matched.The mean follow-up time of the study group was 19.9 (12-55) months.We investigated bone healing response,complications,and factors affecting bone healing.Results At the last follow-up,84% (42/50) of cases in the study group and 62% (31/50) of cases in the control group had achieved clinical healing (P=0.013).The initial healing rate showed no significant difference between the two groups (100% vs.96%,P=0.153).The mean healing times for calcium sulfate and allograft bone were 9.6 (3-42) months and 13.8 (3-36) months,respectively (P <0.01).Complications in the study group were minor and resolved.Implant volume was a significant factor affecting bone healing.Conclusion The calcium sulfate bone substitute showed a satisfactory healing outcome and safety profile in reconstruction of bone defects after benign bone tumor curettage,especially in smaller cavities.

  16. Exposed tibial bone after burns: Flap reconstruction versus dermal substitute.

    Science.gov (United States)

    Verbelen, Jozef; Hoeksema, Henk; Pirayesh, Ali; Van Landuyt, Koenraad; Monstrey, Stan

    2016-03-01

    A 44 years old male patient had suffered extensive 3rd degree burns on both legs, undergoing thorough surgical debridement, resulting in both tibias being exposed. Approximately 5 months after the incident he was referred to the Department of Plastic and Reconstructive Surgery of the University Hospital Gent, Belgium, to undergo flap reconstruction. Free flap surgery was performed twice on both lower legs but failed on all four occasions. In between flap surgery, a dermal substitute (Integra(®)) was applied, attempting to cover the exposed tibias with a layer of soft tissue, but also without success. In order to promote the development of granulation tissue over the exposed bone, small holes were drilled in both tibias with removal of the outer layer of the anterior cortex causing the bone to bleed and subsequently negative pressure wound therapy (NPWT) was applied. The limited granulation tissue resulting from this procedure was then covered with a dermal substitute (Glyaderm(®)), consisting of acellular human dermis with an average thickness of 0.25mm. This dermal substitute was combined with a NPWT-dressing, and then served as an extracellular matrix (ECM), guiding the distribution of granulation tissue over the remaining areas of exposed tibial bone. Four days after initial application of Glyaderm(®) combined with NPWT both tibias were almost completely covered with a thin coating of soft tissue. In order to increase the thickness of this soft tissue cover two additional layers of Glyaderm(®) were applied at intervals of approximately 1 week. One week after the last Glyaderm(®) application both wounds were autografted. The combination of an acellular dermal substitute (Glyaderm(®)) with negative pressure wound therapy and skin grafting proved to be an efficient technique to cover a wider area of exposed tibial bone in a patient who was not a candidate for free flap surgery. An overview is also provided of newer and simpler techniques for coverage of

  17. 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.

  18. 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.

  19. 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.

  20. 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. PMID:25844596

  1. 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

  2. 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.

  3. Development of a biointegrated mandibular reconstruction device consisting of bone compatible titanium fiber mesh scaffold.

    Science.gov (United States)

    Hirota, Makoto; Shima, Takaki; Sato, Itaru; Ozawa, Tomomichi; Iwai, Toshinori; Ametani, Akihiro; Sato, Mitsunobu; Noishiki, Yasuharu; Ogawa, Takahiro; Hayakawa, Tohru; Tohnai, Iwai

    2016-01-01

    Coating biomaterials with a thin hydroxyapatite (HA) was proven effective in enhancing bone compatibility. Segmental bone defects are considered as the most difficult defect to repair in bone regeneration therapy. We developed submicron-thin HA-coated titanium fiber mesh scaffolds to reconstruct immediately loaded segmental mandibular defects and evaluated their bone compatibility in vitro and in vivo. Human osteoblasts attachment, proliferation, and osteocalcin expression in non- and HA-coated scaffolds were evaluated. A 10-mm long segmental bone defect in a rabbit mandibular bone was reconstructed with non- or HA-coated scaffolds, which were removed at 9 and 21 weeks, to evaluate the mechanical strength of the bone-scaffold connection and the bone formation around the scaffold. Expression of osteocalcin was greater in HA-coated scaffolds. In vivo bone formation in HA-coated scaffolds was greater than that in non-coated scaffolds at 21 weeks. Newly formed bone in HA-coated scaffolds mostly restored bone continuity. Scanning electron microscopy identified strong integration of the bone and HA-coated scaffolds. The mechanical strength of the bone-scaffold connection was 3-fold greater in HA-coated scaffolds than that in non-coated scaffolds. These results suggest that a thin HA-coated titanium fiber mesh scaffold is a bone-compatible mandibular reconstruction device in immediately loaded segmental defects.

  4. Management of complex long bone nonunions using limb reconstruction system

    Directory of Open Access Journals (Sweden)

    Hiranya Kumar Seenappa

    2013-01-01

    Full Text Available Background: Management of complex nonunions is difficult due to the presence of infection, deformities, shortening and multiple surgeries in the past. Complex nonunions are traditionally managed by Ilizarov fixation. The disadvantages of Ilizarov are poor patient compliance, inconvenience of the frame and difficult frame construction. We conducted a study on 30 long bone complex nonunions treated by the limb reconstruction system (LRS. Materials and Methods: Between April 2009 and September 2012, we treated 30 cases of complex nonunion of long bone with the LRS. 28 were male and 2 females. Average shortening was 5.06 cm and 14 cases presented with infected implants. Initially we managed with implant removal, radical debridement followed by fixation with the LRS. In 16 cases, corticotomy and lengthening was done. The average duration of treatment was 9.68 months. We compressed the fracture site at the rate of 0.25 mm per day for 1-2 weeks and distracted the corticotomy at the rate of 1 mm/day till lengthening was achieved. Result: The union occurred in 89.28% cases and eradication of infection in 91.66% cases. Average lengthening done was 4.57 cm. We had 79% excellent, 11% good and 10% poor bony result and fnctional result was excellent in 40% cases, good in 50% and failure in 10% cases using ASAMI scoring system. Conclusion: LRS is an alternative to the Ilizarov fixation in their management of complex nonunion of long bones. It is less cumbersome to the patient and more surgeon and patient friendly.

  5. 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

  6. 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.

  7. 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.

  8. Biomechanical testing of implant free wedge shaped bone block fixation for bone patellar tendon bone anterior cruciate ligament reconstruction in a bovine model

    Directory of Open Access Journals (Sweden)

    Willis-Owen Charles A

    2010-09-01

    Full Text Available Abstract Background The use of an interference fit wedged bone plug to provide fixation in the tibial tunnel when using bone-patellar tendon-bone autograft for anterior cruciate ligament reconstruction offers many theoretic advantages including the potential to offer a more economical and biological alternative to screw fixation. This technique has not been subjected to biomechanical testing. We hypothesised that a wedged bone plug fixation technique provides equivalent tensile load to failure as titanium interference screw fixation. Methods In a controlled laboratory setting, anterior cruciate ligament reconstruction was performed in 36 bovine knees using bone-patella-bone autograft. In 20 knees tibial fixation relied upon a standard cuboid bone block and interference screw. In eight knees a wedge shaped bone block with an 11 mm by 10 mm base without a screw was used. In a further eight knees a similar wedge with a 13 mm by 10 mm base was used. Each specimen used a standard 10 mm tibial tunnel. The reconstructions were tested biomechanically in a physiological environment using an Instron machine to compare ultimate failure loads and modes of failure. Results Statistical analysis revealed no significant difference between wedge fixation and screw fixation (p = 0.16, or between individual groups (interference screw versus 11 mm versus 13 mm wedge fixation (P = 0.35. Conclusions Tibial tunnel fixation using an impacted wedge shaped bone block in anterior cruciate ligament reconstruction has comparable ultimate tensile strength to titanium interference screw fixation.

  9. 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. PMID:24626785

  10. Histological Observation of Regions around Bone Tunnels after Compression of the Bone Tunnel Wall in Ligament Reconstruction

    International Nuclear Information System (INIS)

    The objectives of this study were to investigate the time-course of influence of compression of bone tunnel wall in ligament reconstruction on tissue around the bone tunnel and to histologically examine the mechanism of preventing the complication of bone tunnel dilation, using rabbit tibia. A model in which the femoral origin of the extensor digitorum longus tendon was cut and inserted into a bone tunnel made proximal to the tibia was prepared in the bilateral hind legs of 20 Japanese white rabbits. In each animal, a tunnel was made using a drill only in the right leg, while an undersized bone tunnel was made by drilling and then dilated by compression using a dilator to the same tunnel size as that in the right leg. Animals were sacrificed at 0, 2, 4, 8 and 12 weeks after surgery (4 animals at each time point). Observation of bone tunnels by X-ray radiography showed osteosclerosis in the 2- and 4-week dilation groups. Osteosclerosis appeared as white lines around the bone tunnel on X-ray radiography. This suggests that dilation promotes callus formation in the bone tunnel wall and prevents the complication of bone tunnel enlargement after ligament reconstruction

  11. Free Bone Plug Quadriceps Tendon Harvest and Suspensory Button Attachment for Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Todor, Adrian; Caterev, Sergiu; Nistor, Dan Viorel; Khallouki, Youssef

    2016-06-01

    The most commonly used autografts for anterior cruciate ligament reconstruction are the bone-patellar tendon-bone and hamstring tendons. Each has its advantages and limitations. The bone-patellar tendon-bone autograft can lead to more donor-site morbidity, and the hamstring autograft can be unpredictable in size. The quadriceps tendon, with or without a bone block, has been described as an alternative graft source and has been used especially in revision cases, but in recent years, it has attracted attention even for primary cases. We report a technique for harvesting a free bone quadriceps tendon graft and attaching an extracortical button for femoral fixation for anterior cruciate ligament reconstruction. PMID:27656375

  12. Onlay Rib Bone Graft in Elevation of Reconstructed Auricle: 17 Years of Experience

    Directory of Open Access Journals (Sweden)

    Taehoon Kim

    2013-05-01

    Full Text Available Background  A cartilage wedge block and covering flap are standard procedures for firmelevation of the ear in microtia correction. However, using costal cartilage for elevation ofthe reconstructed auricle can be insufficient, and the fixed cartilage wedge block may beabsorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and usesup fascia, a potential source of reconstruction material. Therefore, we propose an innovativemethod using autologous onlay rib bone graftfor auricular elevation ofmicrotia.Methods  From February 1995 to August 2012, 77 patients received a first stage operationwith a rib cartilage framework graft. In the second stage operation, a small full thickness ofrib bone was harvested through the previous donor scar. The bihalved rib bone was insertedinto the subperiosteal pocket beneath the cartilage framework.Results  The follow-up time ranged from 1 month to 17 years, with a mean of 3 years. Allof the patients sustained the elevation of their ears very well during the follow-up period.Donorsite problems, exceptfor hypertrophic scars,were not observed. Surgery-related complications,specifically skin necrosis, infection, or hematoma, occurred in 4 cases.Conclusions  Onlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate materialthan cartilage, due to the bone-to-bone contact between thebone graft and the temporal bone. Postoperative minor correction of the elevation degree isstraightforward and the skin graft survives better. Therefore, reconstructed auricle elevationusing onlay rib bone graftis a useful and valuablemethod.

  13. Bioactive glass-polymer composite for experimental bone reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Aho, A.J.; Tirri, T.; Strandberg, N.; Jaakkola, T.; Naerhi, T.; Kukkonen, J. [Turku Univ. (Finland). Biomaterials Project of Turku; Seppaelae, J.; Rich, J. [Helsinki Univ. of Technology, Espoo (Finland). Dept. of Chemical Engineering

    2001-07-01

    Thermoplastic composite of bioactive glass (S53P4) and copolymer of lactones (Glepron) can be used as liquid, injectable or paste like form, as solid plugs or thin membranes for filling bone defects. This bone substitute is bioactive, osteoconductive and biocompatible resulting in bone bonding contacts between glass granules and bone in defects on the distal femur and ulna of experimental animals. Properties of the material can be adjusted by polymer chemistry. (orig.)

  14. 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.

  15. 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.

  16. 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. PMID:27656381

  17. Retrospective Reconstructions of Active Bone Marrow Dose-Volume Histograms

    Energy Technology Data Exchange (ETDEWEB)

    Veres, Cristina; Allodji, Rodrigue S.; Llanas, Damien; Vu Bezin, Jérémi [Radiation Epidemiology Group, Center for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale, UMR 1018, Villejuif (France); Institut Gustave Roussy, Villejuif (France); University Paris-Sud XI, Villejuif (France); Chavaudra, Jean; Mège, Jean Pierre; Lefkopoulos, Dimitri [Institut Gustave Roussy, Villejuif (France); Quiniou, Eric [Institut National de la Santé et de la Recherche Médicale UMR 759, Orsay (France); Deutsh, Eric [Institut Gustave Roussy, Villejuif (France); Institut National de la Santé et de la Recherche Médicale, UMR 1030, Villejuif (France); Vathaire, Florent de [Radiation Epidemiology Group, Center for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale, UMR 1018, Villejuif (France); Institut Gustave Roussy, Villejuif (France); University Paris-Sud XI, Villejuif (France); Diallo, Ibrahima, E-mail: ibrahim.diallo@gustaveroussy.fr [Radiation Epidemiology Group, Center for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale, UMR 1018, Villejuif (France); Institut Gustave Roussy, Villejuif (France); University Paris-Sud XI, Villejuif (France)

    2014-12-01

    Purpose: To present a method for calculating dose-volume histograms (DVH's) to the active bone marrow (ABM) of patients who had undergone radiation therapy (RT) and subsequently developed leukemia. Methods and Materials: The study focuses on 15 patients treated between 1961 and 1996. Whole-body RT planning computed tomographic (CT) data were not available. We therefore generated representative whole-body CTs similar to patient anatomy. In addition, we developed a method enabling us to obtain information on the density distribution of ABM all over the skeleton. Dose could then be calculated in a series of points distributed all over the skeleton in such a way that their local density reflected age-specific data for ABM distribution. Dose to particular regions and dose-volume histograms of the entire ABM were estimated for all patients. Results: Depending on patient age, the total number of dose calculation points generated ranged from 1,190,970 to 4,108,524. The average dose to ABM ranged from 0.3 to 16.4 Gy. Dose-volume histograms analysis showed that the median doses (D{sub 50%}) ranged from 0.06 to 12.8 Gy. We also evaluated the inhomogeneity of individual patient ABM dose distribution according to clinical situation. It was evident that the coefficient of variation of the dose for the whole ABM ranged from 1.0 to 5.7, which means that the standard deviation could be more than 5 times higher than the mean. Conclusions: For patients with available long-term follow-up data, our method provides reconstruction of dose-volume data comparable to detailed dose calculations, which have become standard in modern CT-based 3-dimensional RT planning. Our strategy of using dose-volume histograms offers new perspectives to retrospective epidemiological studies.

  18. Muscle strength after ACL reconstruction with bone tendon-bone patellar autograft tested by Cybex II dynamometer

    OpenAIRE

    Gogus, Abdullah; Taser, Omer; Eralp, Levent

    2004-01-01

    The Cybex II dynamometer is a device which offers isokinetic testing of different body joints and muscle groups, allowing precise, reproducible control of joint range of motion in keeping with specific rehabilitation goals. This system collects torque, work and power data, thus it can be used to identify and quantify functional musculoskeletal deficits. 25 patients with chronic anterolateral knee instability have been treated with ACL reconstruction using bone-tendon-bone patellar autograft a...

  19. Massive Bone Loss from Fungal Infection after Anterior Cruciate Ligament Arthroscopic Reconstruction

    OpenAIRE

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

    2009-01-01

    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 th...

  20. Reconstruction of mandibular defects with autogenous bone grafts: a review of 30 cases

    International Nuclear Information System (INIS)

    Multitudes of options are available for reconstruction of functional and cosmetic defects of the mandible, caused by various ailments. At the present time, autogenous bone grafting is the gold standard by which all other techniques of reconstruction of the mandible can be judged. The purpose of this study was to evaluate the outcome of different osseous reconstruction options using autogenous bone grafts for mandibular reconstruction. Methods: This Interventional study was conducted at Department of Oral and Maxillofacial Surgery, King Edward Medical University/Mayo Hospital Lahore, from January 2008 to July 2009 including one year follow-up. The study was carried out on thirty patients having bony mandibular defects. They were reconstructed with the autogenous bone grafts from different graft donor sites. On post-operative visits they were evaluated for outcome variables. Results: Success rate of autogenous bone grafts in this study was 90%. Only 10% of the cases showed poor results regarding infection, resorption and graft failure. Conclusion: Autogenous bone grafts, non-vascularized or vascularized, are a reliable treatment modality for the reconstruction of the bony mandibular defects with predictable functional and aesthetic outcome. (author)

  1. USE OF CORTICAL STRUCTURAL HOMOLOGOUS BONE GRAFT IN FEMORAL RECONSTRUCTIVE SURGERY

    Science.gov (United States)

    Roos, Milton Valdomiro; Roos, Bruno Dutra; Giora, Taís Stedile Busin; Taglietti, Thiago Martins

    2015-01-01

    To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. Methods: A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical structural homologous bone graft and cemented implants, between June 1999 and February 2008. Of these, 21 fulfilled all the criteria required for this study. The patients underwent pre and postoperative clinical assessments using the Harris Hip Score. Preoperative, immediate postoperative and late postoperative radiographs were also evaluated, with comparisons of fracture consolidation, radiographic signs of graft consolidation, changes to the bone stock and femoral bone quality, and femoral alignment. Results: Nine patients (42.9%) underwent femoral reconstruction following mechanical failure of total hip arthroplasty and 12 cases (57.1%) underwent femoral reconstruction following periprosthetic fracture. Regarding the postoperative clinical classification, the results were considered satisfactory in 85.7% of the cases and unsatisfactory in 14.3%. Radiographic signs of graft consolidation were seen in all cases. There was an increase in bone stock in 90.5% of the hip reconstructions, as measured by the cortical index. Furthermore, the changes to femoral bone quality were considered good in 66.7% of the cases. Conclusion: The use of cortical structural homologous bone grafts for both femoral reconstructive surgery on total hip arthroplasty and periprosthetic fractures is a good treatment option for selected cases, enabling satisfactory clinical and radiographic results. PMID:27026955

  2. Regions of ilium and fibula providing clinically usable bone for mandible reconstruction: "A different approach to bone comparison".

    Science.gov (United States)

    Ghassemi, Alireza; Schreiber, Lovorka; Prescher, Andreas; Modabber, Ali; Nanhekhan, Lloyd

    2016-09-01

    A variety of donor sites are available for mandibular reconstruction. We present here a different way of comparing two commonly-used bone flaps. The lengths of the usable parts in a total of 241 coxal bones, 91 mandibles and 60 fibulas were measured. The mandible was measured from condyle-to-condyle and the harvestable bone length (HBL) and usable (UBL) bone lengths in fibula and ilium were also measured. The bone thickness (BT) in 60 iliac crests was measured in two parallel lines from the anterior superior iliac spine (ASIS) along the iliac crest. The mandible was 32.17 mm shorter in females than in males. The total ilium UBL was 171.12 mm in females and 178.80 mm in males. The mean HBL of the fibula was 22.6 mm shorter in females than in males. However, in some fibulas in both females and males, only 4.2% and 21.1% of the HBL respectively could be used if the ultimate goal was to insert dental implants. We found significant correlations between BT and gender in both fibula and ilium (P≤ 0.05). The ilium offers constant BT throughout the usable bone area with a similar bone length to the fibula. In contrast, the fibula showed variable bone dimensions, so not all of it is clinically usable. This should especially be considered in females when a mandibular reconstruction is planned with the goal of occlusal rehabilitation. Clin. Anat. 29:773-778, 2016. © 2016 Wiley Periodicals, Inc. PMID:27124383

  3. Effect of Low-Dose MDCT and Iterative Reconstruction on Trabecular Bone Microstructure Assessment.

    Science.gov (United States)

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

    2016-01-01

    We investigated the effects of low-dose multi detector computed tomography (MDCT) in combination with statistical iterative reconstruction algorithms on trabecular bone microstructure parameters. Twelve donated vertebrae were scanned with the routine radiation exposure used in our department (standard-dose) and a low-dose protocol. Reconstructions were performed with filtered backprojection (FBP) and maximum-likelihood based statistical iterative reconstruction (SIR). Trabecular bone microstructure parameters were assessed and statistically compared for each reconstruction. Moreover, fracture loads of the vertebrae were biomechanically determined and correlated to the assessed microstructure parameters. Trabecular bone microstructure parameters based on low-dose MDCT and SIR significantly correlated with vertebral bone strength. There was no significant difference between microstructure parameters calculated on low-dose SIR and standard-dose FBP images. However, the results revealed a strong dependency on the regularization strength applied during SIR. It was observed that stronger regularization might corrupt the microstructure analysis, because the trabecular structure is a very small detail that might get lost during the regularization process. As a consequence, the introduction of SIR for trabecular bone microstructure analysis requires a specific optimization of the regularization parameters. Moreover, in comparison to other approaches, superior noise-resolution trade-offs can be found with the proposed methods.

  4. USE OF CORTICAL STRUCTURAL HOMOLOGOUS BONE GRAFT IN FEMORAL RECONSTRUCTIVE SURGERY

    OpenAIRE

    Roos, Milton Valdomiro; Roos, Bruno Dutra; Giora, Taís Stedile Busin; Taglietti, Thiago Martins

    2015-01-01

    To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. Methods: A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical...

  5. 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.

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

    International Nuclear Information System (INIS)

    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

  7. 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.

  8. 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.

  9. 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.

  10. The use of lyophilised bovine bone xenograft in mandibular reconstructive surgery - an animal experimental surgery

    International Nuclear Information System (INIS)

    The aim of this study is to look at the effectiveness of using lyophillised bovine bone xenograft in mandibular reconstructive surgery. Six adult merino sheep underwent bilateral marginal block resection of the mandible under general anaesthesia. The defect on the right body of mandible was left alone while the similar mandibulectomy defect on the left body of mandible was reconstructed using a cortico-cancellous block of radiosterilised lyophillised bovine bone xenograft which was procured from a calve femur. The bone xenograft was fixed and immobilized using titanium mini plates and screws. All the sheep returned to the controlled grazing ground on the 7th. Postoperative day. One sheep was sacrificed every month and the mandible was retrieved for postmortem gross and microscopical histological examination. Clinical results showed no evidence of tissue rejection in the mandible of the sheep and all the wounds healed well. All sheep showed no problem with normal eating habits. Histological examination showed resorption of the xenograft very early at one month postoperative and xenograft resorption together with new host bone deposition started at 2 months postoperative and maximise at 6 months postoperative. There is also evidence showing that the cancellous portion resorp more than the cortical portion of the xenograft. In conclusion, cortico-cancellous blocks of bovine bone xenograft may be use in mandibular reconstructive surgery giving esthetically acceptable, functional, biocompatible and overall clinically predictable results

  11. 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.

  12. 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.

  13. 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.

  14. 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. PMID:19190972

  15. Virtopsy -- noninvasive detection of occult bone lesions in postmortem MRI: additional information for traffic accident reconstruction.

    Science.gov (United States)

    Buck, Ursula; Christe, Andreas; Naether, Silvio; Ross, Steffen; Thali, Michael J

    2009-05-01

    In traffic accidents with pedestrians, cyclists or motorcyclists, patterned impact injuries as well as marks on clothes can be matched to the injury-causing vehicle structure in order to reconstruct the accident and identify the vehicle which has hit the person. Therefore, the differentiation of the primary impact injuries from other injuries is of great importance. Impact injuries can be identified on the external injuries of the skin, the injured subcutaneous and fat tissue, as well as the fractured bones. Another sign of impact is a bone bruise. The bone bruise, or occult bone lesion, means a bleeding in the subcortical bone marrow, which is presumed to be the result of micro-fractures of the medullar trabeculae. The aim of this study was to prove that bleeding in the subcortical bone marrow of the deceased can be detected using the postmortem noninvasive magnetic resonance imaging. This is demonstrated in five accident cases, four involving pedestrians and one a cyclist, where bone bruises were detected in different bones as a sign of impact occurring in the same location as the external and soft tissue impact injuries. PMID:19034476

  16. CT scans and 3D reconstructions of Florida manatee (Trichechus manatus latirostris) heads and ear bones.

    Science.gov (United States)

    Chapla, Marie E; Nowacek, Douglas P; Rommel, Sentiel A; Sadler, Valerie M

    2007-06-01

    The auditory anatomy of the Florida manatee (Trichechus manatus latirostris) was investigated using computerized tomography (CT), three-dimensional reconstructions, and traditional dissection of heads removed during necropsy. The densities (kg/m3) of the soft tissues of the head were measured directly using the displacement method and those of the soft tissues and bone were calculated from CT measurements (Hounsfield units). The manatee's fatty tissue was significantly less dense than the other soft tissues within the head (p<0.05). The squamosal bone was significantly less dense than the other bones of the head (p<0.05). Measurements of the ear bones (tympanic, periotic, malleus, incus, and stapes) collected during dissection revealed that the ossicular chain was overly massive for the mass of the tympanoperiotic complex. PMID:17420106

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. Imaging of vascularized fibular grafts in large bone reconstruction in skeletally immature patients

    International Nuclear Information System (INIS)

    Objective. To describe the imaging findings of vascularized fibular grafts (VFG) in large bone reconstruction in children and teenagers. Design and patients. Fifteen patients aged from 4 to 19 years underwent VFG for bone reconstruction for primary tumors involving bone in 13 cases and for chronic osteomyelitis in 2 cases. Lesions were located in the femur (6 cases), the tibia (6 cases), the humerus, the distal fibula and the ilium. Radiographic follow-up was performed in all patients, radionuclide studies in 12 patients and MRI in 8. Results. Plain films showed a lamellated periosteal reaction on the VFG within 3 weeks following the procedure in all cases. Fusion of VFG and host bone occurred during the first 3 months. Radionuclide uptake of the VFG was seen in all cases but one. MRI showed cortical thickening and conservation of the high signal intensity of fatty marrow on T1-weighted sequences, and periosteal enhancement on dynamic post-contrast studies in all but one of the patients. Conclusion. Radionuclide studies and MRI show the periosteal enhancement and assess the viability of the VFG satisfactorily. However, we feel that plain films may be sufficient to ascertain this viability. (orig.). With 4 figs., 1 tab

  2. Imaging of vascularized fibular grafts in large bone reconstruction in skeletally immature patients

    Energy Technology Data Exchange (ETDEWEB)

    Panuel, M. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France)]|[Department of Radiology, CHU Nord, 13 - Marseille (France)]|[Anthropology Department, Universite de la Mediterranee, Marseille (France); Petit, P. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Jouve, J.L. [Department of Pediatric Orthopedics, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Portier, F. [Department of Radiology, CHU Nord, 13 - Marseille (France); Legre, R. [Department of Plastic Surgery, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Bourliere, B. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Devred, P. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France)

    1997-07-07

    Objective. To describe the imaging findings of vascularized fibular grafts (VFG) in large bone reconstruction in children and teenagers. Design and patients. Fifteen patients aged from 4 to 19 years underwent VFG for bone reconstruction for primary tumors involving bone in 13 cases and for chronic osteomyelitis in 2 cases. Lesions were located in the femur (6 cases), the tibia (6 cases), the humerus, the distal fibula and the ilium. Radiographic follow-up was performed in all patients, radionuclide studies in 12 patients and MRI in 8. Results. Plain films showed a lamellated periosteal reaction on the VFG within 3 weeks following the procedure in all cases. Fusion of VFG and host bone occurred during the first 3 months. Radionuclide uptake of the VFG was seen in all cases but one. MRI showed cortical thickening and conservation of the high signal intensity of fatty marrow on T1-weighted sequences, and periosteal enhancement on dynamic post-contrast studies in all but one of the patients. Conclusion. Radionuclide studies and MRI show the periosteal enhancement and assess the viability of the VFG satisfactorily. However, we feel that plain films may be sufficient to ascertain this viability. (orig.). With 4 figs., 1 tab.

  3. 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.

  4. Experimental study of natural hydroxyapatite/chitosan composite on reconstructing bone defects

    Institute of Scientific and Technical Information of China (English)

    Hua Yuan; Ning Chen; XiaoyingLü; Buzhong Zheng

    2008-01-01

    Objective:To study the possibility of natural hydroxyapatite/chitosan composite on repairing bone defects. Methods:We developed a natural hydroxyapatite/chitosan composite that could be molded into any desired shape. The powder component consists of natural hydroxyapatite, which is epurated from bone of pigs. The liquid component consists of malic acid and chitosan. Operations were performed on the left tibias of 15 white rabbits to create two square bone defects. One of the defects was reconstructed with the composite, while the other was not repaired and used as a blank control. Three of the animals were killed at the end of 2 weeks, 4 weeks, 8 weeks, 12 weeks and 16 weeks respectively and implants were evaluated anatomically and histologically. Results:No apparent rejection reaction was found, except for a mild inflammatory infiltration observed 2 weeks after surgery. Fibrous tissue became thinner 2 -8 weeks after surgery and bony connections were detected 12 weeks after surgery. The new bone was the same as the recipient bone by the 16th postoperative week. Conclusion:The hydroxyapatite/chitosan composite has good biocompatibility and osteoconduction. It is a potential repairing material for clinical application.

  5. Optimal transport by omni-potential flow and cosmological reconstruction

    CERN Document Server

    Frisch, Uriel; Villone, Barbara; Zheligovsky, Vladislav

    2011-01-01

    One of the simplest models used in studying the dynamics of large-scale structure in cosmology, known as the Zeldovich approximation, is equivalent to the three-dimensional inviscid Burgers equation for potential flow. For smooth initial data and sufficiently short times it has the property that the mapping of the positions of fluid particles at any time $t_1$ to their positions at any time $t_2\\ge t_1$ is the gradient of a convex potential, a property we call omni-potentiality. Are there other flows with this property, that are not straightforward generalizations of Zeldovich flows? This is answered in the affirmative in both two and three dimensions. How general are such flows? Using a WKB technique we show that in two dimensions, for sufficiently short times, there are omni-potential flows with arbitrary smooth initial velocity. Mappings with a convex potential are known to be associated with the quadratic-cost optimal transport problem. This has important implications for the problem of reconstructing the...

  6. Enhancement of tendon-to-bone healing after anterior cruciate ligament reconstruction using bone marrow-derived mesenchymal stem cells genetically modified with bFGF/BMP2

    Science.gov (United States)

    Chen, Biao; Li, Bin; Qi, Yong-Jian; Ni, Qu-Bo; Pan, Zheng-Qi; Wang, Hui; Chen, Liao-Bin

    2016-01-01

    Many strategies, including various growth factors and gene transfer, have been used to augment healing after anterior cruciate ligament (ACL) reconstruction. The biological environment regulated by the growth factors during the stage of tendon-bone healing was considered important in controlling the integrating process. The purpose of this study was to evaluate the effects of bone marrow-derived mesenchymal stem cells (BMSCs) genetically modified with bone morphogenetic protein 2 (BMP2) and basic fibroblast growth factor (bFGF) on healing after ACL reconstruction. BMSCs were infected with an adenoviral vector encoding BMP2 (AdBMP2) or bFGF (AdbFGF). Then, the infected BMSCs were surgically implanted into the tendon-bone interface. At 12 weeks postoperatively, the formation of abundant cartilage-like cells, smaller tibial bone tunnel and significantly higher ultimate load and stiffness levels, through histological analysis, micro-computed tomography and biomechanical testing, were observed. In addition, the AdBMP2-plus-AdbFGF group had the smallest bone tunnel and the best mechanical properties among all the groups. The addition of BMP2 or bFGF by gene transfer resulted in better cellularity, new bone formation and higher mechanical property, which contributed to the healing process after ACL reconstruction. Furthermore, the co-application of these two genes was more powerful and efficient than either single gene therapy. PMID:27173013

  7. Enhancement of tendon-to-bone healing after anterior cruciate ligament reconstruction using bone marrow-derived mesenchymal stem cells genetically modified with bFGF/BMP2.

    Science.gov (United States)

    Chen, Biao; Li, Bin; Qi, Yong-Jian; Ni, Qu-Bo; Pan, Zheng-Qi; Wang, Hui; Chen, Liao-Bin

    2016-01-01

    Many strategies, including various growth factors and gene transfer, have been used to augment healing after anterior cruciate ligament (ACL) reconstruction. The biological environment regulated by the growth factors during the stage of tendon-bone healing was considered important in controlling the integrating process. The purpose of this study was to evaluate the effects of bone marrow-derived mesenchymal stem cells (BMSCs) genetically modified with bone morphogenetic protein 2 (BMP2) and basic fibroblast growth factor (bFGF) on healing after ACL reconstruction. BMSCs were infected with an adenoviral vector encoding BMP2 (AdBMP2) or bFGF (AdbFGF). Then, the infected BMSCs were surgically implanted into the tendon-bone interface. At 12 weeks postoperatively, the formation of abundant cartilage-like cells, smaller tibial bone tunnel and significantly higher ultimate load and stiffness levels, through histological analysis, micro-computed tomography and biomechanical testing, were observed. In addition, the AdBMP2-plus-AdbFGF group had the smallest bone tunnel and the best mechanical properties among all the groups. The addition of BMP2 or bFGF by gene transfer resulted in better cellularity, new bone formation and higher mechanical property, which contributed to the healing process after ACL reconstruction. Furthermore, the co-application of these two genes was more powerful and efficient than either single gene therapy. PMID:27173013

  8. 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.

  9. 3D RECONSTRUCTION OF PHALANGEAL AND METACARPAL BONES OF MALE JUDO PLAYERS AND SEDENTARY MEN BY MDCT IMAGES

    Directory of Open Access Journals (Sweden)

    Ibrahim Kalayci

    2008-12-01

    Full Text Available This study has been performed to reveal hand bone peculiarities of elite male judoists by comparing their phalangeal and metacarpal bones with those of sedentary men on the basis of biometric ratio of the bones by means of three-dimensional (3D reconstruction of multidetector computed tomography (MDCT images. For this purpose, the axial images of the right and left hands of 8 elite male judo players (mean age: 22.0 ± 2.9 years, mean weight: 64.0 ± 4.9 kg and 8 sedentary men (mean age: 26.0 ± 2.8 years, mean weight: 69.0 ± 3.6 kg were obtained from MDCT. After semi-automatic segmentation and manual editing, the tracings of bone surfaces were stacked and overlaid to be reconstructed as the 3D images by the 3D program. All biometrical measurements of the reconstructed images of the bones were automatically calculated by this program to analyze statistically. This study showed that the differences between biometric ratios of judoist and sedentary men's hand bones were significant contrary to null hypothesis which was established as there is no difference between biometric hand bone ratios of these men of both groups. Therefore null hypothesis was rejected. Author suggests that intense clutching actions practised in judo sports can most probably lead to some hand bone proliferations. 3D reconstructed results belonging to the judo players and sedentary men help orthopaedists to diagnose pathological formations related to hand bones of judoists and may be used for anatomical education in medicine faculties, respectively. We hope that the results from the biometric and reconstructive techniques carried out in this work will contribute to the present knowledge on judoist and shed light on the future studies on sports medicine related to skeletal structure of other sportsmen

  10. Synthesis and characterization of a nanostructured matrix hydroxyapatite ceramic bone reconstruction

    International Nuclear Information System (INIS)

    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

  11. 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

  12. 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.

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

    International Nuclear Information System (INIS)

    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 mm3, and the surface area of the bone is 7913.42 mm2. The volume of the cortical is approximately 1988.62 mm3 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

  14. 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.

  15. 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.

  16. Surgical Guides (Patient-Specific Instruments for Pediatric Tibial Bone Sarcoma Resection and Allograft Reconstruction

    Directory of Open Access Journals (Sweden)

    Laura Bellanova

    2013-01-01

    Full Text Available To achieve local control of malignant pediatric bone tumors and to provide satisfactory oncological results, adequate resection margins are mandatory. The local recurrence rate is directly related to inappropriate excision margins. The present study describes a method for decreasing the resection margin width and ensuring that the margins are adequate. This method was developed in the tibia, which is a common site for the most frequent primary bone sarcomas in children. Magnetic resonance imaging (MRI and computerized tomography (CT were used for preoperative planning to define the cutting planes for the tumors: each tumor was segmented on MRI, and the volume of the tumor was coregistered with CT. After preoperative planning, a surgical guide (patient-specific instrument that was fitted to a unique position on the tibia was manufactured by rapid prototyping. A second instrument was manufactured to adjust the bone allograft to fit the resection gap accurately. Pathologic evaluation of the resected specimens showed tumor-free resection margins in all four cases. The technologies described in this paper may improve the surgical accuracy and patient safety in surgical oncology. In addition, these techniques may decrease operating time and allow for reconstruction with a well-matched allograft to obtain stable osteosynthesis.

  17. Hybrid technique of cortical bone trajectory and pedicle screwing for minimally invasive spine reconstruction surgery : A technical note

    OpenAIRE

    Takata, Yoichiro; Matsuura, Tetsuya; Higashino, Kosaku; Sakai, Toshinori; Mishiro, Takuya; Suzue, Naoto; Kosaka, Hirofumi; Hamada, Daisuke; Goto, Tomohiro; Nishisho, Toshihiko; Goda, Yuichiro; Sato, Ryosuke(Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Oho, Tsukuba, 305-0801, Japan); Tsutsui, Takahiko; Tonogai, Ichiro; Tezuka, Fumitake

    2014-01-01

    The pedicle screw (PS) system is widely used for spinal reconstruction. Recently, screw insertion using the cortical bone trajectory (CBT) technique has been reported to provide increased holding strength of the vertebra, even in an osteoporotic spine. CBT is also beneficial due to its low invasiveness. We have been performing hybrid reconstruction with CBT at the cranial level and PS at the caudal level based on the concept of minimal invasiveness. We applied this hybrid technique to 6 cases...

  18. The Influence of Peracetic Acid Sterilization on Tendon Bone Healing of Soft-Tissue Allografts in ACL Reconstruction

    OpenAIRE

    Böhm, Tassilo

    2010-01-01

    Allogenic tissue has become an important graft option for the reconstruction of the anterior cruciate ligament. Recent reports of disease transmission following ACL reconstruction with fresh-frozen non-sterilized allografts have highlighted the need for new sterilization techniques that do not impair the mechanical or biological properties as it was shown for most of the current sterilization techniques. Peracetic acid (PAA) has been successfully used to sterilize bone allografts without thes...

  19. Limb reconstruction with decellularized, non-demineralized bone in a young leporine model

    International Nuclear Information System (INIS)

    Limb salvage from a variety of pathological processes in children is often limited by the unavailability of optimal allograft bone, or an appropriate structural bone substitute. In this study, we sought to examine a practical alternative for pediatric limb repair, based on decellularized, non-demineralized bone grafts, and to determine whether controlled recellularization prior to implantation has any impact on outcome. Growing New Zealand rabbits (n = 12) with a complete, critical-size defect on the left tibiofibula were equally divided into two groups. One group received a decellularized, non-demineralized leporine tibiofibula graft. The other group received an equivalent graft seeded with mesenchymal stem cells labeled with green fluorescent protein (GFP), at a fixed density. Animals were euthanized at comparable time points 3–8 weeks post-implantation. Statistical analysis was by the Student t-test and Fisher’s exact test (P < 0.05). There was no significant difference in the rate of non-union between the two groups, including on 3D micro-CT. Incorporated grafts achieved adequate axial bending rigidity, torsional rigidity, union yield and flexural strength, with no significant differences or unequal variances between the groups. Correspondingly, there were no significant differences in extracellular calcium levels, or alkaline phosphatase activity. Histology confirmed the presence of neobone in both groups, with GFP-positive cells in the recellularized grafts. It was shown that osseous grafts derived from decellularized, non-demineralized bone undergo adequate remodeling in vivo after the repair of critical-size limb defects in a growing leporine model, irrespective of subsequent recellularization. This methodology may become a practical alternative for pediatric limb reconstruction. (paper)

  20. 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 (Pdistraction osteogenesis.

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

    Directory of Open Access Journals (Sweden)

    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

  2. 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.

  3. Fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted femoral fractures in dogs: 35 cases (1987-1997)

    International Nuclear Information System (INIS)

    To compare fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted (> 4 fragments) femoral fractures in dogs. Retrospective study. 35 dogs with highly comminuted fractures of the femur. Medical records of all dogs included in this study were reviewed. Dogs had been treated with fragment reconstruction and bone plate application (n = 20) or major fragment alignment and bridging plate fixation (15). Postoperative and follow-up radiographs were evaluated. Operating and hospitalization times, bone alignment, bone healing, and complications were considered. There were no differences in hospitalization times, limb alignment, and complications between dogs with fractures treated with fragment reconstruction and dogs with fractures treated with bridging plate fixation. Dogs with fractures treated with bridging plate fixation had shorter operative times and faster times to radiographic evidence of bone healing. Bridging plate fixation is quicker to perform and results in faster healing than fragment reconstruction and bone plate fixation when used to treat comminuted femoral fractures

  4. Three-Dimensional Upper Lip and Nostril Sill Changes After Cleft Alveolus Reconstruction Using Autologous Bone Grafting Versus Recombinant Human Bone Morphogenetic Protein-2.

    Science.gov (United States)

    Raposo-Amaral, Cassio Eduardo; Denadai, Rafael; Alonso, Nivaldo

    2016-06-01

    Cleft alveolus in patients with unilateral complete cleft lip and palate has been alternatively reconstructed with recombinant human bone morphogenetic protein (rhBMP)-2. However, its effects on upper lip and nostril sill anatomy are not known. Thus, the objective of this investigation was to assess and compare upper lip and nostril sill changes after cleft alveolus reconstruction with autologous bone from the iliac crest region and rhBMP-2. Patients were randomly allocated into 2 groups. In group 1, autologous bone from the iliac crest region was used to fill the cleft alveolus (n = 4), and in group 2, rhBMP-2 was used to fill the cleft alveolus (n = 8). Preoperatively and at one after the surgery, computerized tomography (CT) was performed. Reformatted CT imaging was used to perform cephalometric linear measurements of the upper lip and nostril sill regions. Inter- and intragroup data of the pre and postoperative reformatted CT measurements of the upper lip and nostril sill regions did not show differences (P >0.05) in cutaneous upper lip height and projection, nostril sill elevation, and subnasale projection. There were no significant upper lip and nostril sill anatomical changes after cleft alveolus reconstruction using autologous bone grafting and rhBMP-2. PMID:27244210

  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. PMID:27137437

  7. 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.

  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. Concomitant reconstruction of mandibular basal and alveolar bone with a free fibular flap.

    Science.gov (United States)

    Lee, J H; Kim, M J; Choi, W S; Yoon, P Y; Ahn, K M; Myung, H; Hwang, S J; Seo, B M; Choi, J Y; Choung, P H; Kim, S M

    2004-03-01

    Repair of long-span mandibular defects with a free fibular flap is now a routine procedure. However, the bone height of the neo-mandible after reconstruction with a fibular flap is about half that of the dentulous mandible. When a fibular graft is placed only at the inferior border of the mandible, the resulting vertical discrepancy between the graft segment and the occlusal plane can adversely affect implant mechanics or denture stability and retention. To overcome these problems, we developed a technique for two-strut type mandibular reconstruction. A vascularized fibular segment is used to reconstruct the inferior basal portion of the neo-mandible, while a non-vascularized residual fibular segment is used to simulate the superior alveolar portion. We used this technique in 22 patients. Graft survival, graft resorption, and the ability to place implants were assessed as compared with those after the conventional one-strut type technique. The fibular segment grafted to the alveolar region was removed in one patient with intraoral wound dehiscence and in two with postoperative infection. All vascularized fibular flaps were successful. The resorption rate was 13.6+/-7.2% for non-vascularized segments and 3.0+/-3.7% for vascularized segments. Dental implants were placed in five of our 22 patients. The crown:fixture length ratio was improved to 1:1.7, as compared with a ratio of 1:1.21 with use of a conventional fibular flap. We conclude that our technique is very easy and safe and provides substantially improved lower-lip and cheek support and implant-prosthetic mechanics than conventional procedures for the repair of long-span mandibular defects. PMID:15050071

  10. 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

  11. 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.

  12. Image reconstruction in diffuse optical tomography using the coupled radiative transport-diffusion model

    International Nuclear Information System (INIS)

    The coupled radiative transport-diffusion model can be used as light transport model in situations in which the diffusion equation is not a valid approximation everywhere in the domain. In the coupled model, light propagation is modelled with the radiative transport equation in sub-domains in which the approximations of the diffusion equation are not valid, such as within low-scattering regions, and the diffusion approximation is used elsewhere in the domain. In this paper, an image reconstruction method for diffuse optical tomography based on using the coupled radiative transport-diffusion model is developed. In the approach, absorption and scattering distributions are estimated by minimising a regularised least-squares error between the measured data and solution of the coupled model. The approach is tested with simulations. Reconstructions from different cases including domains with low-scattering regions are shown. The results show that the coupled radiative transport-diffusion model can be utilised in image reconstruction problem of diffuse optical tomography and that it produces as good quality reconstructions as the full radiative transport equation also in the presence of low-scattering regions.

  13. 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

  14. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  16. X-ray micro-diffraction analysis of reconstructed bone at Zr prosthetic surface with sub-micrometre spatial resolution

    International Nuclear Information System (INIS)

    The purpose of the present investigation is to demonstrate the power of the x-ray micro-diffraction technique in biological studies. In particular the reported experiment concerns the study of the interface between a Zr prosthetic device implanted in a rat femur and the newly-formed bone, with a spatial resolution of 0.5 μm. The obtained results give interesting information on the Zr deformation and on the crystallographic phase, the grain size and the orientation of the new bone. Moreover the study reveals a marked difference in the structure of the reconstructed bone with respect to the native bone, which cannot be appreciated with other techniques. (note)

  17. Biomechanical competence of six different bone screws for reconstructive surgery in three different transplants: Fibular, iliac crest, scapular and artificial bone.

    Science.gov (United States)

    Pietsch, Arnold P; Raith, Stefan; Ode, Jan-Eric; Teichmann, Jan; Lethaus, Bernd; Möhlhenrich, Stephan C; Hölzle, Frank; Duda, Georg N; Steiner, Timm

    2016-06-01

    The goal of this study was to determine a combination of screw and transplantation type that offers optimal primary stability for reconstructive surgery. Fibular, iliac crest, and scapular transplants were tested along with artificial bone substrate. Six different kinds of bone screws (Medartis(©)) were compared, each type utilized with one of six specimens from human transplants (n = 6). Controlled screw-in-tests were performed and the required torque was protocolled. Subsequently, pull-out-tests were executed to determine the retention forces. The artificial bone substitute material showed significantly higher retention forces than real bone samples. The self-drilling screws achieved the significantly highest retention values in the synthetic bone substitute material. Cancellous screws achieved the highest retention in the fibular transplants, while self-drilling and cancellous screws demonstrated better retention than cortical screws in the iliac crest. In the scapular graft, no significant differences were found between the screw types. In comparison to the human transplant types, the cortical screws showed the significantly highest values in the fibula and the lowest values in the iliac crest. The best retention was found in the combination of cancellous screws with fibular graft (514.8 N + -252.3 N). For the flat bones (i.e., scapular and illiac crest) we recommend the cancellous screws. PMID:27107477

  18. 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

  19. 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.

  20. 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

  1. 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. PMID:25603924

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Osteointegration of soft tissue grafts within the bone tunnels in anterior cruciate ligament reconstruction can be enhanced

    OpenAIRE

    Kuang, GM; Yau, WP; Lu, WW; Chiu, KY

    2010-01-01

    Anterior cruciate ligament reconstruction with a soft tissue autograft (hamstring autograft) has grown in popularity in the last 10 years. However, the issues of a relatively long healing time and an inferior histological healing result in terms of Sharpey-like fibers connection in soft tissue grafts are still unsolved. To obtain a promising outcome in the long run, prompt osteointegration of the tendon graft within the bone tunnel is essential. In recent decades, numerous methods have been r...

  7. Reconstruction of advanced bone defect associated with severely compromised maxillary anterior teeth in aggressive periodontitis: a case report

    OpenAIRE

    Kamil, Wisam; Al Bayati, Lina; Hussin, Akbar S.; Hassan, Haszelini

    2015-01-01

    Introduction Aggressive periodontitis is characterized by a rapid rate of attachment loss and bone resorption. Regenerative therapy offers reconstruction of the periodontium; however, certain advanced cases with a questionable prognosis might remain a challenge. We report a successful intervention outcome of a challenging case in the aesthetic zone of a patient with aggressive periodontitis. Case presentation A 34-year-old systemically healthy Malay woman was referred to the Periodontics Spec...

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. Long-term bone tissue reaction to polyethylene oxide/polybutylene terephthalate copolymer (Polyactive) in metacarpophalangeal joint reconstruction.

    Science.gov (United States)

    Waris, Eero; Ashammakhi, Nureddin; Lehtimäki, Mauri; Tulamo, Riitta-Mari; Törmälä, Pertti; Kellomäki, Minna; Konttinen, Yrjö T

    2008-06-01

    The poly-L/D-lactide 96/4 joint scaffolds are used to engineer fibrous tissue joints in situ for the reconstruction of metacarpophalangeal joints. In this experimental study, a supplementary elastomeric stem made of Polyactive 1000PEO70PBT30 (a segmented block copolymer of polyethylene oxide and polybutylene terephtalate with 70/30 PEO/PBT ratio) was used to anchor the joint scaffold in the arthroplasty space. Eleven resected fifth metacarpophalangeal joints of minipig were reconstructed and evaluated radiologically and histologically for 3 years. Plain joint scaffold and Swanson silicone implant arthroplasties (11 of each) in metacarpophalangeal joints of minipig served as controls. Altogether fore limbs of eighteen minipigs were operated for the study. Deleterious tissue reaction with dramatic signs of osteolysis and inflammatory foreign-body reaction was observed around the Polyactive stems. The mean maximum diameter of the osteolytic stem cavity was statistically wider when compared to the mean maximum diameter of Swanson implant group during the first postoperative year. Numerous osteoclasts were found at the margins of the osteolytic areas. No direct bone contact could be seen. At 1 year osteoblastic regeneration and formation of new trabecular bone followed. Finally the foreign-body reaction settled, but the adjoining bones were at this stage highly sclerotic and composed of coarse trabeculae. In contrary to previous in vivo studies suggesting biocompatibility, osteoconductivity and capability to bond to bone, Polyactive 1000PEO70PBT30 stem in this setting caused massive osteolytic lesions and foreign-body reactions. PMID:18336902

  13. 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.

  14. Surface reconstructions and transport of epitaxial PtLuSb (001) thin films grown by MBE

    Science.gov (United States)

    Patel, Sahil J.; Logan, John A.; Harrington, Sean D.; Schultz, Brian D.; Palmstrøm, Chris J.

    2016-02-01

    This work presents the surface reconstructions and transport properties of the topological insulator PtLuSb grown on Al0.1In0.9Sb/GaAs (001). Two stable surface reconstructions, (1×3) and c(2×2), were observed on PtLuSb (001) surfaces. Antimony-dimerization was determined to be the nature of the (1×3) surface reconstruction as evidenced by chemical binding energy shifts in the antimony 4d core-level for surface bonding components. The two surface reconstructions were studied as a function of Sb4 overpressure and substrate temperature to create a reconstruction phase diagram. From this reconstruction phase diagram, a growth window from 320 °C to 380 °C using an antimony overpressure was identified. Within this window, the highest quality films were grown at a growth temperature of 380 °C. These films exhibited lower p-type carrier concentrations as well as relatively high hole mobilities.

  15. 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.

  16. 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

  17. Bone grafting and one-stage revision of THR - biological reconstruction and effective antimicrobial treatment using antibiotic impregnated allograft bone.

    Science.gov (United States)

    Winkler, Heinz

    2012-01-01

    Infection of a total hip replacement (THR) is considered one of the most serious complications in orthopaedic surgery. Problems derive from the presence of biofilms with inherent resistance to usual antibiotic treatment and bone defects resulting from infection induced osteolysis. Discussions on the choice of treatment mainly focus on the chance of eradicating the infection in either one or more stages. The advantages of only one operation with regard to patients' satisfaction, functional results and economical burden are evident. However, the fear of re-infection usually leads surgeons to multiple stage procedures, mostly using antibiotic loaded spacers in the interval. Spacers have no effect on biofilms and are associated with a high rate of complications such as breakage or dislocation. Cemented revisions show several disadvantages like reduction of biomechanical properties through added antibiotics, inferior long term results, difficulties of removal in case of recurrence etc. Uncemented implants appear more advantageous but are at risk of becoming colonised by remaining biofilm fragments. To overcome this risk higher local concentrations of antibiotics are needed. Allograft bone may be impregnated with high loads of antibiotics using special incubation techniques, resulting in an antibiotic bone compound (ABC). ABC provides local concentrations exceeding those of cement by more than a 100-fold and efficient release is prolonged for several weeks. At the same time it is likely to restore bone stock, which is usually compromised after removal of an infected endoprosthesis. Based on these considerations new protocols for one-stage exchange of infected THR have been established. Bone voids may be filled with ABC, uncemented implants may be fixed in original healthy bone. Recent studies indicate an overall success rate of more than 90% with one operation, without any adverse side effects. Incorporation of allografts appears as after grafting with unimpregnated bone

  18. Experience of using vascularized bone grafts in reconstructive surgery of the upper limbs

    Science.gov (United States)

    Atamanov, E. A.; Keosyan, V. T.; Bryukhanov, A. V.; Tsaregorodtseva, E. M.; Danilov, A. V.

    2015-11-01

    The article describes the results of treatment patients with defects and diseases of bone tissue using bone grafting with vascularized bone grafts from different areas of the body. The results of treatment of 27 patients with bone tissue defects of the upper extremities are demonstrated. 16 of patients had scaphoid nonunion. 2 cases of nonunion were reported: one scaphoid nonunion due to unstable osteosynthesis and one lunate fragmentation nonunion in patient with late stage Kienbock`s disease. Vascularized bone graft from distal radius was used in both cases. We had two cases of delayed union at 18 months in surgical treatment of scaphoid. 2 patients had metacarpal bone defect, 1 patient with radius bone defect, 2 patients with SLAC (scapholunate advanced collapse), 2 patients with bone defect of the humerus, 1 patient with bone defect of the ulna. In all cases we used vascularized bone crafts from various anatomical areas. We achieved union in all other cases. The study shows high efficiency of upper extremity bone defect replacement methods.

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

    OpenAIRE

    Degen, Ryan M; Giles, Joshua W.; Harm W Boons; Litchfield, Robert B.; Johnson, James A.; Athwal, George S.

    2013-01-01

    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 (...

  20. 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).

  1. 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

  2. A meta-analysis of hamstring autografts versus bone-patellar tendon-bone autografts for reconstruction of the anterior cruciate ligament.

    Science.gov (United States)

    Li, ShuZhen; Su, Wei; Zhao, Jinmin; Xu, Yinglong; Bo, Zhandong; Ding, Xiaofei; Wei, Qingjun

    2011-10-01

    The objective of this study was to evaluate the effectiveness of hamstring (HT) autografts versus bone-patellar tendon-bone (BPTB) autografts for reconstruction of the anterior cruciate ligament (ACL). We searched the Cochrane Library, MEDLINE, EMBASE and the Chinese Biomedicine Database (CBM) for published randomised clinical trials (RCTs) relevant to ACL reconstruction comparing HT and BPTB autografts. Data analyses were performed with Cochrane Collaboration's RevMan 5.0. A total of 23 reports of 19 randomised controlled trials (RCTs) (1643 patients) met the inclusion criteria. Outcomes favouring BPTB autografts were found in terms of KT-1000 arithmometer values, negative rates of Lachman tests and negative rates of Pivot tests. Outcome measures that favoured HT autografts included anterior knee pain, kneeling pain and extension loss. There was no statistical difference of postoperative graft failure. Overall, postoperative complications of the knee joint were lower for HT autografts than for BPTB autografts, and BPTB autografts were superior to HT autografts in resuming stability of the knee joint, but four-strand HT combined with application of the modern endobutton HT graft-fixation technique could increase knee-joint stability. PMID:20850327

  3. Tratamento da falha óssea parcial pelo transporte ósseo parietal Partial bone defect treatment using parietal bone transportation

    Directory of Open Access Journals (Sweden)

    Fabio Lucas Rodrigues

    2005-01-01

    Full Text Available OBJETIVO: Descrever a técnica de transporte ósseo parietal para tratamento de falha óssea parcial, e descrever o resultado clínico e radiográfico de uma série de pacientes tratados por esta técnica. CASUÍSTICA E MÉTODO: tratamos nove pacientes portadores de lesão óssea parcial, sendo seis localizada na tíbia e três no fêmur. Todos apresentavam lesão infectada, acompanhada de pseudo-artrose. O procedimento iniciou-se com estabilização do segmento ósseo com fixador externo, seguido de corticotomia parietal, em osso sadio adjacente à falha, para criar o fragmento que foi transportado. Este fragmento foi transfixado por fios olivados, que conectados às hastes sulcadas permitiam o transporte ósseo. Em dois pacientes os fragmentos utilizados eram de osso adjacente (fíbula, transportados para a tíbia em direção da tíbia. A latência, velocidade e ritmo de distração foram os preconizados por Ilizarov. RESULTADOS: a infecção e a pseudo-artrose foram curadas em todos os casos, com preenchimento da falha óssea. As complicações encontradas foram infecção nos orifícios dos fios na pele e regenerado hipotrófico. CONCLUSÃO: o tratamento da falha óssea parcial pelo transporte ósseo parietal determinou solução do processo infeccioso, com consolidação da pseudo-artrose e preenchimento da falha óssea.OBJECTIVE: This study describes the bone transportation technique for partial bone defect, and shows clinical and radiological results of a series of patients treated by using this method. MATERIAL AND METHODS: Nine patients with partial bone defect were treated (six tibia and three femur. Every patient had infection and nonunion. The initial procedure was to stabilize the bone, followed by a partial corticotomy on the healthy bone adjacent to the defect, in order to create a fragment to be distracted. This fragment was fixed by olive wires, which were conected to the thread rod. We used fibula transport for tibial lateral

  4. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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

    , and the defect site was primed with a LD musculocutaneous flap wrapped around the reconstruction plate to bring in vascularized tissue and optimize healing conditions for a subsequent particulate iliac free bone graft reconstruction. The management of defect closure was successful in all 15 patients. Twelve......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....... The aim of this study is to present an alternative method of mandibular segmental reconstruction employing a latissimus dorsi (LD) flap and subsequent particulate iliac free bone graft reconstruction. In 15 patients with ORN, a mandibular segmental defect was bridged with a reconstruction plate...

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  9. 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.

  10. 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.

  11. 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 ...

  12. 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

  13. 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

  14. 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.

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

    International Nuclear Information System (INIS)

    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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Bone grafts and dental implants in the reconstruction of the severely atrophied, edentulous maxilla

    OpenAIRE

    Johansson, Björn

    2001-01-01

    In two prospective, clinical studies the stability of implants and prosthetic constructions were evaluated after three years of loading. In the first study, the implant and the bridge stability of 39 patients with 1-stage bone grafts, were compared to a reference-group of 37 patients who did not need bone grafts. In the second study, 40 patients were randomised to have either 1-stage sinus inlay bloc grafts or 2-stage sinus inlay particulated grafts. Implant success in Paper 1, was 75.3% in...

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

    International Nuclear Information System (INIS)

    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

  2. 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

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

    International Nuclear Information System (INIS)

    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

  4. 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.

  5. 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.

  6. 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。

  7. 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....

  8. 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.

  9. 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

  10. Evaluation of iterative reconstruction method and attenuation correction on brain dopamine transporter SPECT using anthropomorphic striatal phantom

    OpenAIRE

    Akira Maebatake; Ayaka Imamura; Yui Kodera; Yasuo Yamashita; Kazuhiko Himuro; Shingo Baba; Kenta Miwa; Masayuki Sasaki

    2016-01-01

    Objective(s): The aim of this study was to determine the optimal reconstruction parameters for iterative reconstruction in different devices and collimators for dopamine transporter (DaT) single-photon emission computed tomography (SPECT). The results were compared between filtered back projection (FBP) and different attenuation correction (AC) methods.Methods: An anthropomorphic striatal phantom was filled with 123I solutions at different striatum-to-background radioactivity ratios. Data wer...

  11. Outcome of revision total knee arthroplasty with the use of trabecular metal cone for reconstruction of severe bone loss at the proximal tibia

    DEFF Research Database (Denmark)

    Jensen, Claus L; Olsen, Nikolaj Winther; Schrøder, Henrik M;

    2014-01-01

    BACKGROUND: The relative effectiveness of different methods for reconstructing large bone loss at the proximal tibia in revision total knee arthroplasty (rTKA) has not been established. The aim of this study was to evaluate the clinical and radiological outcome after the use of trabecular metal...

  12. 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

  13. 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

  14. 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. PMID:25434288

  15. Bone

    International Nuclear Information System (INIS)

    Bone scanning provides information on the extent of primary bone tumors, on possible metastatic disease, on the presence of osteomyelitis prior to observation of roentgenographic changes so that earlier therapy is possible, on the presence of collagen diseases, on the presence of fractures not disclosed by x-ray films, and on the evaluation of aseptic necrosis. However, the total effect and contribution of bone scanning to the diagnosis, treatment, and ultimate prognosis of pediatric skeletal diseases is, as yet, unknown. (auth)

  16. 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.

  17. 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

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

    OpenAIRE

    Gaurav Gupta; Sohail Ahmad; Mohd. Zahid; Khan, A H.; M K A Sherwani; Abdul Qayyum Khan

    2016-01-01

    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...

  19. 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.

  20. 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.

  1. Reconstruction of Frontal Bone With Custom-Made Prosthesis Using Rapid Prototyping.

    Science.gov (United States)

    Florentino, Vinícius Gabriel Barros; Mendonça, Diego Santiago de; Bezerra, Ariel Valente; Silva, Leonardo de Freitas; Pontes, Rafael Figueirêdo; Melo, Carlos Vinícius Mota de; Mello, Manoel de Jesus Rodrigues; de Aguiar, Andréa Silvia Walter

    2016-06-01

    Frontal bone fracture treatment is still an issue of research in craniofacial surgery and neurosurgery. The aims of the treatment are to reduce the complication risks and to keep the aesthetic of the face. Before the management of this fracture type, it is necessary to consider the permanence or not of the frontal sinus function. Rapid prototyping has been an aid tool on planning and simulation of the surgical procedure, improving the diagnostic quality and the implant manufacture, beyond reducing the operative time. Among the used materials on treatment of these fractures, titanium mesh shows large versatility and ease of handling. Poly(methyl methacrylate) has been used in defects of partial thickness or irregularities on cranial surface. The aim of this study is to report a case of a patient presenting sequelae of large fracture of anterior wall of frontal bone, treated by a titanium mesh associated with the customized poly(methyl methacrylate) implant from the rapid prototyping. It could be concluded that the use of this technique showed itself effective on patient treatment, and rapid prototyping demonstrated being a valuable tool showing predictable and satisfactory results. PMID:27285896

  2. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    International Nuclear Information System (INIS)

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  3. Regional Atmospheric Transport Code for Hanford Emission Tracking (RATCHET). Hanford Environmental Dose Reconstruction Project

    Energy Technology Data Exchange (ETDEWEB)

    Ramsdell, J.V. Jr.; Simonen, C.A.; Burk, K.W.

    1994-02-01

    The purpose of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate radiation doses that individuals may have received from operations at the Hanford Site since 1944. This report deals specifically with the atmospheric transport model, Regional Atmospheric Transport Code for Hanford Emission Tracking (RATCHET). RATCHET is a major rework of the MESOILT2 model used in the first phase of the HEDR Project; only the bookkeeping framework escaped major changes. Changes to the code include (1) significant changes in the representation of atmospheric processes and (2) incorporation of Monte Carlo methods for representing uncertainty in input data, model parameters, and coefficients. To a large extent, the revisions to the model are based on recommendations of a peer working group that met in March 1991. Technical bases for other portions of the atmospheric transport model are addressed in two other documents. This report has three major sections: a description of the model, a user`s guide, and a programmer`s guide. These sections discuss RATCHET from three different perspectives. The first provides a technical description of the code with emphasis on details such as the representation of the model domain, the data required by the model, and the equations used to make the model calculations. The technical description is followed by a user`s guide to the model with emphasis on running the code. The user`s guide contains information about the model input and output. The third section is a programmer`s guide to the code. It discusses the hardware and software required to run the code. The programmer`s guide also discusses program structure and each of the program elements.

  4. Bone graft revascularization strategies

    NARCIS (Netherlands)

    W.F. Willems

    2014-01-01

    Reconstruction of avascular necrotic bone by pedicled bone grafting is a well-known treatment with little basic research supporting its application. A new canine model was used to simulate carpal bone avascular necrosis. Pedicled bone grafting proved to increase bone remodeling and bone blood flow,

  5. 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.

  6. 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

  7. A novel silk–TCP–PEEK construct for anterior cruciate ligament reconstruction: an off-the shelf alternative to a bone–tendon–bone autograft

    International Nuclear Information System (INIS)

    Bone–tendon–bone autograft represents a gold-standard for anterior cruciate ligament (ACL) reconstruction but at the cost of a secondary surgical site that can be accompanied by functional impairment and discomfort. Although numerous in vitro and in vivo studies have investigated tissue engineering alternatives to autografting, the achievement of a functional histological transition between soft and hard tissue has remained elusive. To bridge this gap we developed and tested a novel multiphase scaffold of silk, tricalcium phosphate (TCP) and polyether ether ketone for ACL reconstruction. We present in vitro biomechanical tests demonstrating that the construct recapitulates native ACL function under typical physiological loads. A pilot in vivo experiment in two pigs with a three-month follow-up showed a robust histological transition between regenerated fibrous tissue and the margins of the bone tunnel, with histological features similar to the native ACL to bone insertion. These histological observations suggest that the construct was stably anchored until TCP incorporation to the host tissues. On the strength of these preliminary results, we conclude that the described approach may offer a promising alternative to autograft for ACL reconstruction. This study thus provides proof for a concept that warrants further development. (paper)

  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. 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. PMID:26836869

  10. Evaluation of Short Term Outcomes of Transportal Femoral Cross Pin Fixation in Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Zehir, Sinan; Şahin, Ercan; Çalbıyık, Murat; Kalem, Mahmut; İpek, Deniz; Songür, Murat

    2014-01-01

    Objectives: Many fixation techniques are currently in use for femoral side graft fixation at ACL reconstruction surgery. Short term success following ACL reconstruction highly depends on fixation strength of the graft. In this study we report short term results of anterior cruciate ligament reconstruction using double hamstring tendon autograft using double cross pin for femoral tunnel fixation. Methods: Between years 2009 and 2013, 51 male adult anterior cruciate ligament injury cases treate...

  11. 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.

  12. 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.

  13. Biomechanical characteristics of regenerated cortical bone in the canine mandible

    OpenAIRE

    Zapata, Uriel; Opperman, Lynne A.; Kontogiorgos, Elias; Elsalanty, Mohammed E.; Dechow, Paul C.

    2011-01-01

    To test the mechanical properties of regenerate cortical bone created using Mandibular Bone Transport (MBT) distraction, five adult male American foxhound dogs underwent unilateral distraction of the mandible with a novel MBT device placed to linearly repair a 30-35 mm bone defect. The animals were sacrificed 12 weeks after the beginning of the consolidation period. Fourteen cylindrical specimens were taken from the inner (lingual) and outer (buccal) plates of the reconstructed mandible and 2...

  14. 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.

  15. 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

  16. 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

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

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    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.

  18. Experimental study on mechanical and biomechanical reconstruction of bone defect of long bone near joint%长骨近关节端骨缺损的力学和生物力学结构重建

    Institute of Scientific and Technical Information of China (English)

    胡春明; 张伟; 苏云; 王成学; 徐莘香; 卢宝顺

    2005-01-01

    reconstruction methods.DESIGN: A completely randomized experiment with self-control and mutual control.SETTING: Laboratory for Experimental Animals, First Hospital of Jilin University.MATERIALS: Twelve healthy adult hybrid dogs, 5 males and 7 females weighing 12 to 18 kg, were recruited.METHODS: The bone defects near joints were established in upper femoral condyle in the 12 dogs, which were reconstructed by 3 operation styles: only filling with bone cement, filling with bone cement + autogenous ilium bone graft, and filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate. There was one dog in each method. The specimens were harvested at the end of weeks 3, 6, 12and 24, respectively, after operation. One week before specimens were harvested the fluorescent labeling was prepared; we conducted vascular perfusion of disulphine blue before the animals were executed.MAIN OUTCOME MEASURES: A series of examinations were carried out, including X-ray film, biomechanical test, intravascular perfusion and tetracycline fluorescent labeling. The bone healing, blood supply recovery and biomechanics were observed in the three groups.RESULTS: The 12 dogs all entered the result analysis. ① Results of Xray examination: Two cases of fracture occurred in experimental side at 6and 12 weeks in group Ⅰ; one case of fracture occurred in experimental side at 6 weeks in group Ⅱ. No fracture happened in group Ⅲ. ② Bone stiffness assayed with biomechanics: It decreased in experimental side as compared to control side by 67% and 70% in group Ⅰ; 66%, 76% and 46% in group Ⅱ; and 8% in group Ⅲ. ③ Specimen observation after operation: Bone formation, callus, and blood supply recovery were significantly better in group Ⅲ than in groups Ⅰ and Ⅱ at all stages.CONCLUSION: The third operation, filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate, is an ideal method of bone reconstruction. It can

  19. [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.

  20. Bolt from the Blue: A Large Foreign Body in the Maxillary Antrum Necessitating Delayed Primary Reconstruction with Split Cranial Bone Graft.

    Science.gov (United States)

    Sharma, Ramesh K; Vemula, Guru Karna; John, Jerry R

    2016-09-01

    We report an unusual case of a large metallic foreign body embedded in the maxillary antrum leading to extensive bony destruction of the mid-face following a road side accident in a 12-year-old boy. There was extensive bony loss that necessitated reconstruction for both aesthetic and functional reasons. The same was accomplished by using split cranial bone graft in a delayed primary manner after a gap of 7 days following initial debridement. There was primary healing with good aesthetic and functional results. PMID:27516840

  1. 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.

  2. 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

  3. Uso do transporte ósseo no tratamento de perda óssea segmentar extensa da tíbia: estudo experimental em cães Use of bone transport to treat tibial large segmental defects: experimental study in dogs

    Directory of Open Access Journals (Sweden)

    S.C. Rahal

    2005-02-01

    Full Text Available Avaliou-se a técnica de transporte ósseo realizada com fixador externo de Ilizarov no tratamento de defeito ósseo segmentar extenso promovido na tíbia de sete cães. Após aplicação de montagem constituída de um semi-anel proximal, um anel médio e outro distal, ligados entre si por meio de hastes rosqueadas, foi excisado um segmento da diáfise média distal da tíbia e fíbula direitas de 30% do comprimento ósseo. A reconstrução do defeito foi realizada por transporte de um segmento ósseo obtido por osteotomia subperiosteal da parte proximal da tíbia, entre o semi-anel proximal e o anel médio. O período de latência foi de seis dias e o ritmo do transporte foi de 0,5mm a cada 12 horas. Na área de acoplamento foi aplicada compressão. O fixador permaneceu em fase neutra por 14 semanas e, após a remoção do aparelho, os animais foram observados por mais quatro semanas. O resultado funcional foi considerado excelente em um animal, bom em um, satisfatório em três e deficiente nos outros dois. O transporte ósseo permitiu a reparação de falhas ósseas segmentares extensas, porém pode apresentar dificuldades no direcionamento do segmento ósseo transportado e de sua consolidação na área de acoplagem.The aim of this study was to evaluate the bone transport technique using the Ilizarov external fixator for the treatment of the extensive segmental bone defect induced in the tibia of seven dogs. An Ilizarov frame assembled with one proximal half-ring, one middle ring and one distal ring, all connected to each other, was used. Thirty percent of the tibia and fibula were removed in the medium and distal parts of the diaphyses, between the medium and distal rings. The bone defect was reconstructed by bone transport using a bone segment developed by proximal subperiosteal osteotomy of the tibia between the half-ring and the middle ring. Bone transport started seven days after surgery (0.5mm every 12 hours. Compression was applied in

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

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    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%.

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

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    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.

  6. 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.

  7. Reconstruction of (131)I radioactive contamination in Ukraine caused by the Chernobyl accident using atmospheric transport modelling.

    Science.gov (United States)

    Talerko, Nikolai

    2005-01-01

    The evaluation of (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 (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 (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 (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 (131)I soil contamination obtained from the (129)I measurements. PMID:16024139

  8. 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.

  9. Long Term Behavior of Pedicled Vascularized Fibular Grafts in Reconstruction of Middle and Distal Tibia after Resection of Malignant Bone Tumors

    International Nuclear Information System (INIS)

    Objectives: The aim of this study was to evaluate the long term behavior of pedicled vascualrized fibula graft in reconstruction of middle and distal tibia defects following malignant tumor resection with particular emphasis on success in limb salvage and the specific late related complications. Patients and Methods: Between 1997 and 2006, 16 patients having malignant bone tumors of the middle tibia (10 cases) and distal tibia (6 cases) were candidate for wide resection of their tumors and reconstruction of the bony defect by ipsilateral vascularized pedicled fibular graft based on the peroneal vessels. There were 9 males and 7 females with a mean age of 13 years at time of surgery (range 11-23 years). Mean follow up period was 52 months (range 32 -110 months). Fixation was done by cast in 14 cases and by plate and screws in 2 patients. According to the Enneking staging system (1), 9 patients had stage IIB and 7 had stage IIA. Bony union and hypertrophy were assessed radio graphically on regular basis. Hypertrophy was estimated in a percentage. Functional limb results were also reported according to MSTS functional scores [2]. Results: The mean length of bony gap bridged was 14 cm (range of 11.0-16.0 cm) and the mean length of fibula harvested was 15.5 cm (range 12-17 cm). Ninety seven percent of patients (15 cases) healed primarily at a mean time of 4.8 months (range 3.5-6 months). Hypertrophy was evident in all patients and ranged from 60 to 210% (mean 91%). Increase in size of the hypertrophied fibula beyond the recipient bone was noticed in three cases (18.7%) and we relate this to weight-bearing forces and not to the size of the recipient bone. The mean time of the fibula to double its size (10 cases) was 21 months (range 18-31 months). Young patients developed full hypertrophy earlier than older patients. Complication rate was low. One patient had non union at the proximal end of the fibulotibial junction and two patients had stress fracture of the fibula

  10. 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.

  11. Modeling fluorescence recovery after photobleaching in loaded bone: potential applications in measuring fluid and solute transport in the osteocytic lacunar-canalicular system.

    Science.gov (United States)

    Zhou, Xiaozhou; Novotny, John E; Wang, Liyun

    2008-12-01

    Solute transport through the bone lacunar-canalicular system is essential for osteocyte viability and function, and it can be measured using fluorescence recovery after photobleaching (FRAP). The mathematical model developed here aims to analyze solute transport during FRAP in mechanically loaded bone. Combining both whole bone-level poroelasticity and cellular-level solute transport, we found that load-induced solute transport during FRAP is characterized by an exponential recovery rate, which is determined by the dimensionless Strouhal (St) number that characterizes the oscillation effects over the mean flows, and that significant transport occurs only for St values below a threshold, when the solute stroke displacement exceeds the distance between the source and sink (the canalicular length). This threshold mechanism explains the general flow behaviors such as increasing transport with increasing magnitude and decreasing frequency. Mechanical loading is predicted to enhance transport of all tracers relative to diffusion, with the greatest enhancement for medium-sized tracers and less enhancement for small and large tracers. This study provides guidelines for future FRAP experiments, based on which the model can be used to quantify bone permeability, solute-matrix interaction, and flow velocities. These studies should provide insights into bone adaptation and metabolism, and help to treat various bone diseases and conditions. PMID:18810639

  12. 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)

  13. Bone transportion by composite external fixator on refractory chronic osteomyelitis of femur%组合式外固定架骨搬运术治疗难治性股骨慢性骨髓炎疗效评价

    Institute of Scientific and Technical Information of China (English)

    海国栋; 张春雷

    2014-01-01

    Objective To evaluate the clinical effect of bone transport by composite external fixator on chronic osteomyelitis of femur. Methods Thirteen patients with bone defect of femur after chronic osteomyelitis were treated by bone transport with composite external fixator. The mean length of the bone defect was 8. 7 cm. Results All patients were followed up for 21-32 months. The bone lengthening area grew well,the length of callus distraction was 6. 8~14. 5 cm,and the mean radiographic con-solidation index was 19. 7 d/cm. According to the Paley’s criteria,the healing effect of 10 cases was excellent,and that of the rest 3 cases was good. The functional recovery of 9 cases was excellent,and that of the rest 4 cases was good. Conclusion Bone trans-port by composite external fixator is a reliable method in the reconstruction of bone defect caused by chronic osteomyelitis.%目的:评价应用组合式外固定架骨搬运术治疗股骨慢性骨髓炎的临床疗效。方法应用组合式外固定架骨搬运技术治疗13例股骨慢性骨髓炎清除后骨缺损,平均骨缺损长度8.7 cm。结果随访21~32个月,骨缺损接触并全部愈合,骨延长区骨生长满意,切口一期愈合,窦道和骨外露消失。骨延长6.8~14.5 cm,平均外固定指数19.7 d/cm。依据Paley 的评定标准进行骨愈合评定,优为11例,良为2例;功能评定优为9例,良为4例。结论组合式外固定架骨搬运术是治疗难治性股骨慢性骨髓炎可靠方法。

  14. 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.

  15. Arthroscopic reconstruction of the posterior cruciate ligament. MR studies for bone tunnel positioning and comparison with physical findings

    International Nuclear Information System (INIS)

    The success of arthroscopic cruciate ligament construction depends on several factors., such as patient selection, current surgical execution and postoperative rehabilitation. Technical considerations include graft choice, positioning, fixations, intercondylar notch enlargement, and new ligament tensioning. Graft acceptance is effected by all these factors. Tunnel position is of great importance both for bio mechanical reasons and optimal function of the new ligament, and to avoid stress, friction, abnormal strain, and/or damage to the reconstructed ligament. Many orthopedic and radiographic literature studies discuss the exact site of anterior cruciate ligament insertion for the best possible anatomical reconstruction, In contrast, the debate over the insertional area and anatomical landmarks is open for the posterior cruciate ligament (PCL), because of the difficult execution of this type of reconstruction and the smaller number of candidate

  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. Evaluation of Iterative Reconstruction Method and Attenuation Correction in Brain Dopamine Transporter SPECT Using an Anthropomorphic Striatal Phantom

    Science.gov (United States)

    Maebatake, Akira; Imamura, Ayaka; Kodera, Yui; Yamashita, Yasuo; Himuro, Kazuhiko; Baba, Shingo; Miwa, Kenta; Sasaki, Masayuki

    2016-01-01

    Objective(s): The aim of this study was to determine the optimal reconstruction parameters for iterative reconstruction in different devices and collimators for dopamine transporter (DaT) single-photon emission computed tomography (SPECT). The results were compared between filtered back projection (FBP) and different attenuation correction (AC) methods. Methods: An anthropomorphic striatal phantom was filled with 123I solutions at different striatum-to-background radioactivity ratios. Data were acquired using two SPECT/CT devices, equipped with a low-to-medium-energy general-purpose collimator (cameras A-1 and B-1) and a low-energy high-resolution (LEHR) collimator (cameras A-2 and B-2). The SPECT images were once reconstructed by FBP using Chang’s AC and once by ordered subset expectation maximization (OSEM) using both CTAC and Chang’s AC; moreover, scatter correction was performed. OSEM on cameras A-1 and A-2 included resolution recovery (RR). The images were analyzed, using the specific binding ratio (SBR). Regions of interest for the background were placed on both frontal and occipital regions. Results: The optimal number of iterations and subsets was 10i10s on camera A-1, 10i5s on camera A-2, and 7i6s on cameras B-1 and B-2. The optimal full width at half maximum of the Gaussian filter was 2.5 times the pixel size. In the comparison between FBP and OSEM, the quality was superior on OSEM-reconstructed images, although edge artifacts were observed in cameras A-1 and A-2. The SBR recovery of OSEM was higher than that of FBP on cameras A-1 and A-2, while no significant difference was detected on cameras B-1 and B-2. Good linearity of SBR was observed in all cameras. In the comparison between Chang’s AC and CTAC, a significant correlation was observed on all cameras. The difference in the background region influenced SBR differently in Chang’s AC and CTAC on cameras A-1 and B-1. Conclusion: Iterative reconstruction improved image quality on all cameras

  18. 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.

  19. 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。

  20. Hydroxyapatite-doped polycaprolactone nanofiber membrane improves tendon–bone interface healing for anterior cruciate ligament reconstruction

    OpenAIRE

    Han F; Zhang P; Sun YY; Lin C.; Zhao P; Chen JW

    2015-01-01

    Fei Han,1,* Peng Zhang,2,* Yaying Sun,2 Chao Lin,1 Peng Zhao,1 Jiwu Chen2 1Shanghai East Hospital, The Institute for Biomedical Engineering and Nanoscience, Tongji University School of Medicine, Tongji University, 2Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Hamstring tendon autograft is a routine graft for anterior cruciate ligament (ACL) reconstruction. However,...

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. Effectiveness and limitations of reconstruction of the medial patellofemoral ligament using a titanium interference screw in single patellar and femoral bone tunnels

    Directory of Open Access Journals (Sweden)

    Nobuyuki Kumahashi

    2014-01-01

    Full Text Available No standard surgical procedure for medial patellofemoral ligament (MPFL reconstruction exists. The purpose of this study was to evaluate the clinical effectiveness and limitation of the reconstructions of the MPFL in single patellar and femoral bone tunnels. The methods used a hamstring tendon and titanium interference screws in patients with recurrent patellar dislocation. Nineteen knees in 17 patients were studied. Subjects underwent MPFL reconstruction with or without lateral release using interference screws in single patellar and femoral tunnels. Patients were evaluated using preoperative and postoperative physical and radiographic examinations, including apprehension testing, assessment of tilting and congruence angles, medial and lateral shift ratios under stress X-ray imaging, and Kujala and Lysholm scores. Average follow-up was 22 months (12–71 months. None experienced recurrent postoperative episodes of dislocation or subluxation. By the final follow-up, patellar apprehension had disappeared in all patients except for one with generalized joint laxity. In addition, patients showed significant improvement in the following areas: tilting angle (from 14.4 ± 5.6° to 6.4 ± 4.6°, p < 0.0001, congruence angle (0.5 ± 16° to −9.2 ± 6.9°, p < 0.001, lateral shift ratio (23.8 ± 11.3% to 11.6 ± 13.4%, p < 0.001, Kujala score (74.0 ± 7.8 points to 95.7 ± 4.4 points, p < 0.0001, and Lysholm score (71.0 ± 10 points to 95.5 ± 5.3 points, p < 0.0001. MPFL reconstruction methods, using titanium interference screws in single patellar and femoral tunnels provide acceptable short-term results for the treatment of recurrent patellar dislocations.

  7. 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.

  8. 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

  9. 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.

  10. Autologous transplantation of CD34(+) bone marrow derived mononuclear cells in management of non-reconstructable critical lower limb ischemia.

    Science.gov (United States)

    Ismail, Ahmed M; Abdou, Said M; Aty, Hassan Abdel; Kamhawy, Adel H; Elhinedy, Mohammed; Elwageh, Mohammed; Taha, Atef; Ezzat, Amal; Salem, Hoda A; Youssif, Said; Salem, Mohamed L

    2016-08-01

    Patients with a decrease in limb perfusion with a potential threat to limb viability manifested by ischemic rest pain, ischemic ulcers, and/or gangrene are considered to have critical limb ischemia (CLI). Because of this generally poor outcome, there is a strong need for attempting any procedure to save the affected limb. The aim of this work is to evaluate the possibility to use stem cell therapy as a treatment option for patients with chronic critical lower limb ischemia with no distal run off. This study includes 20 patients with chronic critical lower limb ischemia with no distal run off who are unsuitable for vascular or endovascular option. These patients underwent stem cell therapy (SCT) by autologous transplantation of bone marrow derived mononuclear cells. 55 % of patients treated with SCT showed improvement of the rest pain after the first month, 60 % continued improvement of the rest pain after 6 months, 75 % after 1 year and 80 % after 2 years and continued without any deterioration till the third year. Limb salvage rate after STC was 80 % after the first year till the end of the second and third years. SCT can result in angiogenesis in patients with no-option CLI, providing a foundation for the application of this therapy to leg ischemia. PMID:25511801

  11. Engineered allogeneic chondrocyte pellet for reconstruction of fibrocartilage zone at bone-tendon junction--a preliminary histological observation.

    Science.gov (United States)

    Wong, Margaret W N; Qin, Lin; Tai, Jenny K O; Lee, Simon K M; Leung, K S; Chan, K M

    2004-08-15

    This study examined histologically the potential of using allogeneic cultured chondrocyte pellet (CCP) in enhancing bone-tendon junction (BTJ) healing using a rabbit partial patellectomy model. Chondrocytes isolated from the cartilaginous ribs of 6-week-old New Zealand white rabbits were cultured for 14 days to form CCP. Partial patellectomy was performed on 30 18-week-old rabbits. After removal of the distal third patella, the BTJ gap was repaired surgically with or without CCP interposition. Four samples of patella-patellar tendon complexes (PPTC) for each group were harvested each at 8, 12, and 16 weeks; and two additional PPTC for each group were harvested at 2, 4, and 6 weeks for early observation of fibrocartilage zone regeneration, histologically. Results showed that CCP interposition demonstrated earlier structural integration at the BTJ after 8, 12, and 16 weeks of healing, and formation of a fibrocartilage zone like structure, compared with control specimens. In addition, no immune rejection was observed in CCP experimental group. The results suggested that CCP had a stimulatory effect on BTJ healing. This bioengineering approach might have potential clinical application in treatment of difficult BTJ healing. However, systemic histomorphometric, immunological tests, and biomechanical evaluations are needed before any clinical trials. PMID:15264320

  12. 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.

  13. The effect of CT dose on glenohumeral joint congruency measurements using 3D reconstructed patient-specific bone models

    International Nuclear Information System (INIS)

    The study of joint congruency at the glenohumeral joint of the shoulder using computed tomography (CT) and three-dimensional (3D) reconstructions of joint surfaces is an area of significant clinical interest. However, ionizing radiation delivered to patients during CT examinations is much higher than other types of radiological imaging. The shoulder represents a significant challenge for this modality as it is adjacent to the thyroid gland and breast tissue. The objective of this study was to determine the optimal CT scanning techniques that would minimize radiation dose while accurately quantifying joint congruency of the shoulder. The results suggest that only one-tenth of the standard applied total current (mA) and a pitch ratio of 1.375:1 was necessary to produce joint congruency values consistent with that of the higher dose scans. Using the CT scanning techniques examined in this study, the effective dose applied to the shoulder to quantify joint congruency was reduced by 88.9% compared to standard clinical CT imaging techniques.

  14. The effect of CT dose on glenohumeral joint congruency measurements using 3D reconstructed patient-specific bone models

    Energy Technology Data Exchange (ETDEWEB)

    Lalone, Emily A; Fox, Anne-Marie V; Jenkyn, Thomas R; King, Graham J W; Johnson, James A; Peters, Terry M [Biomedical Engineering, University of Western Ontario, London (Canada); Kedgley, Angela E [Wolf Orthopaedic Biomechanics Lab, Fowler Kennedy Sports Medicine Clinic, London (Canada); Athwal, George S, E-mail: tpeters@robarts.ca [Hand and Upper Limb Centre, St. Joseph' s Hospital, London, Canada (CT Scanning Location) (Canada)

    2011-10-21

    The study of joint congruency at the glenohumeral joint of the shoulder using computed tomography (CT) and three-dimensional (3D) reconstructions of joint surfaces is an area of significant clinical interest. However, ionizing radiation delivered to patients during CT examinations is much higher than other types of radiological imaging. The shoulder represents a significant challenge for this modality as it is adjacent to the thyroid gland and breast tissue. The objective of this study was to determine the optimal CT scanning techniques that would minimize radiation dose while accurately quantifying joint congruency of the shoulder. The results suggest that only one-tenth of the standard applied total current (mA) and a pitch ratio of 1.375:1 was necessary to produce joint congruency values consistent with that of the higher dose scans. Using the CT scanning techniques examined in this study, the effective dose applied to the shoulder to quantify joint congruency was reduced by 88.9% compared to standard clinical CT imaging techniques.

  15. Ilizarov技术联合骨搬移治疗胫骨骨缺损的护理%Nursing technique on treatment of tibial bone defect by combined Ilizarov technology and bone transport

    Institute of Scientific and Technical Information of China (English)

    周晓霞; 吴件姿; 甘春红; 周柳晓; 潘红英

    2016-01-01

    目的:探讨Ilizarov技术联合骨搬移治疗胫骨骨缺损的护理要点。方法对应用Ilizarov技术联合骨搬移治疗胫骨骨缺损12例患者护理进行回顾性分析和总结。结果12例患者均获随访,随访时间5~24个月,平均骨愈合时间(9.4±2.6)个月,平均外固定拆除时间(10.6±2.6)个月。1例钉道少许感染,给去除痂皮,局部用75%乙醇棉签清洗干净并保持干燥,2 d后好转;1例搬移骨段与远端骨段之间骨不连给再次植骨;2例肢体疼痛,延缓骨搬移后好转。无一例患者因护理不当出现并发症。结论应用Ilizarov技术联合骨搬移治疗胫骨骨缺损具有创伤小、骨愈合快、双下肢等长、膝关节活动良好的优点,而加强术后并发症观察和护理,做好心理护理、骨搬移期护理、功能锻炼、出院指导,是确保手术疗效,提高患者满意度的有力保障。%Objective To explore key points of nursing in treatment of tibial bone defect by united Ilizarov technology and bone transport. Methods A total of 12 patients treated tibial bone defect with combined Ilizarov technology and bone transport were retrospectively analyzed and summarized. Results All 12 patients were followed up for 5 to 24 months. Their average bone healing time was (9. 4 ± 2. 6) months, and average external fixation removal time was (10. 6 ± 2. 6) months. In one case, a little infection happened to the nail trail; after removal of crusts, the local part was cleaned with 75% alcohol cotton swab and kept dry, then the infection became better 2 days later. In another case, nonunion happened between the bone transport segment and the distal segment, so bone graft was done again. 2 cases of limb pain became better after delaying bone transport. No patients had complications due to nursing care. Conclusions Application of Ilizarov technique combined with bone transport on the treatment of tibial bone defect has advantages like small trauma, quick bone

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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

  2. [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.

  3. [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. PMID:16998521

  4. 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

  5. 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.

  6. ''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.)

  7. Acromioclavicular Joint Reconstruction.

    Science.gov (United States)

    Scillia, Anthony J; Cain, E Lyle

    2015-12-01

    Our technique for acromioclavicular joint reconstruction provides a variation on coracoclavicular ligament reconstruction to also include acromioclavicular ligament reconstruction. An oblique acromial tunnel is drilled, and the medial limb of the gracilis graft, after being crossed and passed beneath the coracoid and through the clavicle, is passed through this acromial tunnel and sutured to the trapezoid graft limb after appropriate tensioning. Tenodesis screws are not placed in the bone tunnels to avoid graft fraying, and initial forces on the graft are offloaded with braided absorbable sutures passed around the clavicle. PMID:27284528

  8. 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

  9. 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...

  10. 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

  11. Impacted cancellous autograft for reconstructing bone defects of tibiul plateau in totul knee arthroplasty%自体打压植骨修复膝关节置换术中胫骨平台骨缺损

    Institute of Scientific and Technical Information of China (English)

    蔡谞; 李众利; 王岩; 王继芳; 周勇刚; 董纪元; 陈继营; 魏民; 王志刚; 刘玉杰

    2008-01-01

    . The average depth of the dish-like bone defect left after bone cutting was g. 78 mm and the defect occupied averagely 31.5% of the total section area. The sclerotic bone layer was removed to the depth of the cancellous bone by saw blade or reamer, which made the defect to be contained. Small holes were drilled in the contained bone defect.Fragments 5-8 mm in diameter were made from the cancellous bone osteomized from the femur and tibia were impacted into the bone defect. The defect was finally covered by a bone slice to make a fiat tibial section allowing the tibia prosthesis to be firmly seated on it by routine technique. Follow-up was conducted for 32.2 months on average. Results The tibial deformity was repaired effectively and reliable support for the prosthesis at the tibia side was provided. Subsequent X ray films showed that no bone defect was seen under the prosthesis and the position of the prosthesis was fine. No autograft resorption and complete radiolucency between the graft and the tibial host bone appeared during the follow-up. The average KSS score raised from 45. 6 preoperatively up to 94.5 postoperatively. Conclusion In comparison with other techniques, the impacted autografting technique more effectively reconstructs the bone defects of tibial plateau in TKA. The cancellous bone obtained from the bony end can be used fully, thus over-cutting can beavoided and the mechanical characteristics of the knee joint would not be disturbed.

  12. 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

  13. Achilles tendon graft matches with bone tunnel of different sizes for anterior cruciate ligament reconstruction%跟腱移植物与不同大小骨隧道匹配重建前交叉韧带★

    Institute of Scientific and Technical Information of China (English)

    杨晓; 王跃; 吕波

    2013-01-01

    BACKGROUND:Anterior cruciate ligament is the important anatomic structure to maintain the knee joint stability. The tendon bone healing and clinical functional recovery after anterior cruciate ligament have attracted more attention. OBJECTIVE:To observe the healing of graft tendon and surrounding bone with histological method through the same diameter grafts matching with the bone tunnel of different sizes in the anterior cruciate ligament reconstruction surgery, and to detect the functional recovery with biomechanics. METHODS:Middle 1/3 of canine autologous tendon was selected as the anterior cruciate ligament graft, and then trimmed into the same diameter of 4 mm. Sixteen adult mongrel canine were randomly divided into four groups. The anterior cruciate ligament was resected completely, and the tibial and femoral tunnels were prepared on the end sites of tibia and femur with the diameters of 5, 4.5, 4 and 3.5 mm, then implanted into the tendon in prepared and linked into the bone tunnel. At 6 weeks after reconstruction, the experimental canine were sacrificed under general anesthesia to col ect the tissue and organs in the surgical area. Then the hematoxylin-eosin staining, biomechanical testing and statistical analysis were performed. RESULTS AND CONCLUSION:At 6 weeks after anterior cruciate ligament reconstruction, anatomical observation showed that there were no significant differences in growth of grafts and bone tunnels between groups;hematoxylin-eosin staining showed sharpey-like fibronectin could be seen in the tendon bone healing surface, and the col agen fibers in the 3.5 mm bone tunnel group were more compact and regular than those in the other groups;the biomechanical testing results in the 3.5 mm bone tunnel group were better than those in the other groups. The results indicate that during anterior cruciate ligament reconstruction, decreasing the diameter of bone tunnel that matched with grafts in order to make the tendon and the bone tunnel closely

  14. Bone tumor

    Science.gov (United States)

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

  15. Use of extended curettage with osteotomy and fenestration followed by reconstruction with conservation of muscle insertion in the treatment of Enneking stage II locally aggressive bone tumor of the proximal extremities: resection and treatment of bone tumors

    Science.gov (United States)

    2013-01-01

    Background The purpose of this study was to investigate the clinical efficacy of extended resection with osteotomy, fenestration and conservation of muscle (tendon) insertion in the treatment of bone tumors. Methods A total of 15 patients with locally aggressive bone tumors (Enneking stage II) in the adjacent muscle (tendon) insertion of the proximal extremity were enrolled in the present study (mean age of 29 years). Extended curettage of lesions with osteotomy, fenestration and/or conservation of muscle (tendon) insertion and internal fixation with a bone graft or bone cement was performed at stage I. Postsurgical brace protection was used for 4 to 12 weeks and the patients were periodically followed-up by X-ray and functional assessment. Recurrence, postsurgical Enneking score and outcome rating were assessed. Results Treated cases included 15 patients aged 29 ±7.75 years (range, 18 to 42) with a male to female ratio of 8:7. Six had a femoral tumor and nine had a humeral tumor. These tumors comprised three chondroblastomas, five giant-cell tumors and seven aneurysmal bone cysts. Follow-up for 48 ±12.95 months (range, 25 to 72) revealed that 13 of 15 (87%) patients exhibited no recurrence. Local recurrence was observed in a patient with an aneurysmal bone cyst (nine months) and one with a giant-cell tumor (12 months). Mean Enneking scores were 27 ±4.07 (range, 18 to 29). Except for the patient with the recurrent giant-cell tumor, all patients reported good (13%, 2 out of 15) or very good (80%, 12 out of 15) outcomes. Very good outcomes were reported in 92% of patients (12 out of 13) without recurrence. Conclusions The procedures used in this study achieved high clinical efficacy, complete lesion removal, reduced recurrence and good restoration of joint function in patients with primary locally aggressive Enneking stage II bone tumors of the proximal extremities. PMID:23497479

  16. 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

  17. Uso de enxerto ósseo homólogo estrutural cortical em cirurgias de reconstrução femoral Use of cortical structural homologous bone graft in femoral reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Milton Valdomiro Roos

    2010-01-01

    periprotéticas é uma boa opção de tratamento em casos selecionados, permitindo resultados clínicos e radiográficos satisfatórios.OBJECTIVE: To perform a clinical and radiographic assessment of patients submitted to cortical structural homologous bone graftsurgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. METHODS: A retrospective study with 27 patients submitted to surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases and periprosthetic fractures (15 cases, using cortical structural homologous bone graft and cemented implants, in the period of June 1999 to February 2008 was performed. Of these, 21 fulfilled the criteria required for this study. Patients were submitted to a pre and postoperative clinical assessment according to Harris Hip Score. Pre-operative, immediate and late postoperative radiographs were also evaluated by comparing fracture consolidation, radiographic signs of graft integration, changes in bone stock and femoral bone quality, as well as femoral alignment. RESULTS: Nine patients (42.9% were submitted to femoral reconstruction following mechanical failure of total hip arthroplasty. The other 12 cases (57.1%, were submitted to femoral reconstruction following periprosthetic fracture. Results were considered satisfactory in 85.7% and unsatisfactory in 14.3% of cases. Radiographic signs of graft integration to the host's bone were seen in all cases. There was an increase of bone stock in 90.5% of hip reconstructions, according to cortical index measurement. Furthermore, changes in femoral bone quality were considered good in 66.7% of cases. CONCLUSION: The use of cortical structural homologous bone grafts for both femoral reconstructive surgeries of total hip arthroplasty and periprosthetic fractures is a good treatment option for selected cases, allowing for satisfactory clinical and radiographic results.

  18. 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)

  19. 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.

  20. Study on Technology of Reconstruction to Drop and Pull Transport Vehicle%甩挂运输车辆的改造技术

    Institute of Scientific and Technical Information of China (English)

    王琦

    2015-01-01

    In order to automatically separate the tractor and semi‐trailer ,using hydraulic transmission the tractor saddle was transformed into that can automatic rising‐lowering .Using pneumatic drive mode ,landing gear‐leg of semi‐trailer was changed into foldable pneumatic leg .This technological reconstruction prepared for the company transform transport operation mode ,car‐ry out drop and pull transport that the ratios one over two of the tractor and semi‐trailer .%为实现牵引车和半挂车自动分离,采用液压传动方式将牵引车的鞍座改造为自动升降的鞍座,采用气压传动的技术方法将半挂车支腿改造为可折叠的气动支腿,从而改变运输组织模式,实现主车与挂车1∶2配比的甩挂运输方式。

  1. Bone Biopsy

    Science.gov (United States)

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

  2. Bone Diseases

    Science.gov (United States)

    ... avoid smoking and drinking too much alcohol. Bone diseases can make bones easy to break. Different kinds ... break Osteogenesis imperfecta makes your bones brittle Paget's disease of bone makes them weak Bones can also ...

  3. Treatment of open tibial fracture with bone defect caused by high velocity missiles: A case report

    Directory of Open Access Journals (Sweden)

    Golubović Zoran

    2013-01-01

    Full Text Available Introduction .Tibia fracture caused by high velocity missiles is mostly comminuted and followed by bone defect which makes their healing process extremely difficult and prone to numerous complications. Case Outline. A 34-year-old male was wounded at close range by a semi-automatic gun missile. He was wounded in the distal area of the left tibia and suffered a massive defect of the bone and soft tissue. After the primary treatment of the wound, the fracture was stabilized with an external fixator type Mitkovic, with convergent orientation of the pins. The wound in the medial region of the tibia was closed with the secondary stitch, whereas the wound in the lateral area was closed with the skin transplant after Thiersch. Due to massive bone defect in the area of the rifle-missile wound six months after injury, a medical team placed a reconstructive external skeletal fixator type Mitkovic and performed corticotomy in the proximal metaphyseal area of the tibia. By the method of bone transport (distractive osteogenesis, the bone defect of the tibia was replaced. After the fracture healing seven months from the secondary surgery, the fixator was removed and the patient was referred to physical therapy. Conclusion. Surgical treatment of wounds, external fixation, performing necessary debridement, adequate antibiotic treatment and soft and bone tissue reconstruction are essential in achieving good results in patients with the open tibial fracture with bone defect caused by high velocity missiles. Reconstruction of bone defect can be successfully treated by reconstructive external fixator Mitkovic. [Projekat Ministarstva nauke Republike Srbije, br. III 41017 i br. III 41004

  4. 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.

  5. 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

  6. Unfavourable results in thumb reconstruction

    Directory of Open Access Journals (Sweden)

    Samir M Kumta

    2013-01-01

    Full Text Available The history of thumb reconstruction parallels the history of hand surgery. The attributes that make the thumb unique, and that the reconstructive surgeon must assess and try to restore when reconstructing a thumb, are: Position, stability, strength, length, motion, sensibility and appearance. Deficiency in any of these attributes can reduce the utility of the reconstructed thumb. A detailed assessment of the patient and his requirements needs to be performed before embarking on a thumb reconstruction. Most unsatisfactory results can be attributed to wrong choice of procedure. Component defects of the thumb are commonly treated by tissue from adjacent fingers, hand or forearm. With refinements in microsurgery, the foot has become a major source of tissue for component replacement in the thumb. Bone lengthening, osteoplastic reconstruction, pollicisation, and toe to hand transfers are the commonest methods of thumb reconstruction. Unfavourable results can be classified as functional and aesthetic. Some are common to all types of procedures. However each type of reconstruction has its own unique set of problems. Meticulous planning and execution is essential to give an aesthetic and functionally useful thumb. Secondary surgeries like tendon transfers, bone grafting, debulking, arthrodesis, may be required to correct deficiencies in the reconstruction. Attention needs to be paid to the donor site as well.

  7. A novel intramedullary callus distraction system for the treatment of femoral bone defects.

    Science.gov (United States)

    Horas, Konstantin; Schnettler, Reinhard; Maier, Gerrit; Horas, Uwe

    2016-08-01

    An intramedullary device has some advantages over external fixation in callus distraction for bone defect reconstruction. There are difficulties controlling motorized intramedullary devices and monitoring the distraction rate which may lead to poor results. The aim of this study was to design a fully implantable and non-motorized simple distraction nail for the treatment of bone defects. The fully implantable device comprises a tube-in-tube system and a wire pulling mechanism for callus distraction. For the treatment of femoral bone defects, a traction wire, attached to the device at one end, is fixed to the tibial tubercle at its other end. Flexion of the knee joint over a predetermined angle generates a traction force on the wire triggering bone segment transport. This callus distraction system was implanted into the femur of four human cadavers (total 8 femora), and bone segment transport was conducted over 60-mm defects with radiographic monitoring. All bone segments were transported reliably to the docking site. From these preliminary results, we conclude that this callus distraction system offers an alternative to the current intramedullary systems for the treatment of bone defects. PMID:27221258

  8. Long-term functional outcome of mandibular reconstruction with stainless steel AO reconstruction plates

    NARCIS (Netherlands)

    van Minnen, B; Nauta, JM; Vermey, A; Bos, RRM; Roodenburg, JLN

    2002-01-01

    Mandibular continuity defects are usually reconstructed with bone grafts. However, factors associated with the tumour and the patient can still be reasons to choose reconstruction plates. The aim of this study was to find out the results of mandibular reconstructions with stainless steel AO reconstr

  9. 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

  10. 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.

  11. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... be more useful in identifying bone and joint injuries (e.g., meniscal and ligament tears in the knee, rotator cuff and labrum tears in the shoulder) and in imaging of the spine (because both the bones and the spinal cord can ... suspected spine injury or other complicated injuries, 3-D reconstructed CT ...

  12. 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.

  13. 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.

  14. Intermittent negative pressure affects tendon-bone healing after anterior cruciate ligament reconstruction%间歇性负压干预前交叉韧带重建后的腱-骨愈合

    Institute of Scientific and Technical Information of China (English)

    孙正明; 凌鸣; 冯伟楼; 董向辉; 刘时璋; 易智

    2013-01-01

    背景:间歇性负压被证实可以促进软组织修复及骨愈合,但其对交叉韧带重建后腱-骨愈合的影响尚未见报道。  目的:观察间歇性负压对兔前交叉韧带重建后腱-骨愈合及肌腱移植物生物力学的影响。  方法:取24只新西兰大白兔制备自体半腱肌前交叉韧带重建模型,随机取一侧后腿作为负压侧,负压侧关节通过引流管接微型负压吸引器,并维持低强度、间歇性负压;对侧后腿作为对照,接普通引流管。5d后两侧同时拔除吸引管。造模后6周,取关节液检测白细胞介素1β的表达水平;取股骨-韧带-胫骨复合体行肌腱移植物拉力测定和腱-骨界面组织学观察。  结果与结论:1只兔关节感染,最终23只兔进入结果分析。拉力测定结果显示,负压组完全断裂所需拉力显著大于对照组(P OBJECTIVE:To research the effect of intermittent negative pressure on tendon-bone healing after anterior cruciate ligament reconstruction and on the biomechanics of tendon grafts. METHODS:A total of 24 New Zealand white rabbits were randomly selected to establish the models of anterior cruciate ligament reconstruction of autogenous semitendinosus. The hind leg of one side was selected randomly as the negative pressure group, and the joint of the negative pressure side was connected with the micro-negative pressure aspirator through drainage tube and maintained a low-intensity and intermittent negative pressure;the contralateral hind leg was as the control and connected with ordinary drainage tube. Drainage tubes of both sides were removed at the same time after 5 days. At 6 weeks after modeling, the joint fluid was drawn to detect the expression levels of interleukin-1β;femur-ligament-tibia complex was used for tension measurement of tendon graft, and histological observation of tendon-bone interface. RESULTS AND CONCLUSION:One rabbit had joint infection, and final y 23

  15. Bone Grafts

    Science.gov (United States)

    ... repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some types of fractures or cancers. Once your body accepts the bone ...

  16. 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.

  17. 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

  18. Definitive Management of Open Tibia Fractures Using Limb Reconstruction System

    Science.gov (United States)

    Patil, Mahantesh Yellangouda; Gupta, Srinath Myadam; Agarwal, Saumya; Chandarana, Vishal

    2016-01-01

    Introduction Open fractures are treated as surgical emergency and early administration of intravenous antibiotic coupled with early irrigation and debridement decreases the infection rate dramatically. Limb Reconstruction System (LRS) is a unilateral rail system which consists of Shanz pins, rail rods and sliding clamps. It is specifically designed to enable the surgeon to perform simple and effective surgery as it offers rigid fixation of fracture fragments, allowing early weight bearing and reduces economic burden. Aim To determine the efficacy of Limb Reconstruction System for treatment of compound tibia fractures. Materials and Methods A prospective study was carried out where in 54 cases out of 412 compound tibia fractures having Modified Gustilo Anderson Type IIIA and IIIB with a mean age of 42±5 years were treated using LRS over a period of 26 months. Limb reconstruction system was used in acute docking mode or with corticotomy and bone transport was done depending upon the bone loss. The soft tissue condition was assessed and split thickness skin grafting and flap repairs were done as per the need. Clinical and radiological assessment was done at every follow-up. Bony and functional assessment was done by Association for the Study and Application of the Methods of Illizarov (ASAMI) criteria. Results Among 54 patients, bony results as per ASAMI score were excellent in 36, good in 14, fair in 2 and poor in 2 patients. Functional results were excellent in 43, good in 7, fair in 4 patients. The average fracture union time was 8 months. Post-surgery patient satisfaction was excellent since fixation allowed weight bearing immediately. Average hospital stay was 7 days and financial burden was reduced by 40% as compared to multi staged surgery. The average time of return to work was 20 days. Conclusion LRS is an easy, simple and definitive surgical procedure that allows immediate full weight bearing walking. It reduces hospital stay, is cost effective with

  19. 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

  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. A new double bone-double bundle patellar tendon-bone graft model: A calf model study

    OpenAIRE

    Öztürk, Hayati; Öztemur, Zekeriya; Bulut, Okay; Tezeren, Seyfi Gündüz

    2011-01-01

    AbstractThe aim of this study is to improve a new graft model for anatomic double bundle Anterior Crucial Ligament reconstruction (ACL). The aim of ACL reconstruction is to reproduce the functions of the native ACL. An anatomic double bundle ACL reconstruction utilizes two separate grafts to replace the Anterior Medial (AM) and Posterior Lateral (PL) bundles of the ACL. Bone-Patellar Tendon-Bone (BPTB) Graft was harvested from calf knee. Patellar tendon and distal bone were split as longitudi...

  2. Bone marrow mesenchymal stem cells/collagen/chitosan combined with bone transport for tibial defect repair:study protocol for a randomized controlled trial%骨髓间充质细胞复合胶原-壳聚糖材料联合骨搬移修复胫骨缺损:随机对照实验方案

    Institute of Scientific and Technical Information of China (English)

    朴成哲; 刘军; 刘新; 马勇; 蔡振存; 时丹

    2015-01-01

    BACKGROUND:Bone marrow mesenchymal stem cels play an osteogenic role under the assistance of scaffold materials. The scaffold cannot only deliver the cels to the bone defect area, but also act as a new bone growth framework. Colagen-chitosan composite is one of ideal scaffold materials in bone tissue engineering, which has osteoinductive ability and better osteogenic ability than conventional scaffolds. Bone transport technology has been widely used in the clinical repair of long bone defects, but it has some deficiencies, such as slow osteogenesis, long time for external fixation and nonunion. How to further accelerate bone formation and reduce complications has become the current problem to be solved. Here, it is hypothesized that bone marrow mesenchymal stem cels/ colagen/chitosan composite scaffold can increase the therapeutic effect of bone transport in the repair of tibial bone defects. METHODS/DESIGN:This study is a randomized controled animal experiment, includingin vitro andin vivo tests.In vitro test: Bone marrow mesenchymal stem cels are isolated from the bone marrow of New Zealand rabbits aged 1-2 months, and passaged to the third generation. Then, cel suspension is added onto the colagen-chitosan scaffold to construct the bone marrow mesenchymal stem cels/colagen/chitosan composite scaffold.In vivo test: Twenty-four New Zealand rabbits at 3-4 months are selected and randomly assigned to receive bone transport, scaffold implantation, bone transport+scaffold implantation, respectively. The primary outcome measures are the growth of implant materials and bone defect interface, X-ray detection of bone defect repair, hematoxylin-eosin staining and scanning electron microscope observation of bone formation in the bone defect region, immunohistochemical detection of type I colage expression in the osteogenic region, scanning electron microscope observation of interface bonding between implant materials and host bone, ultrastructure and bone formation

  3. Clinical study of prosthetic gingival reconstruction in vertical bone defect patients%垂直骨量不足时种植修复体的牙龈补偿处理及其效果研究

    Institute of Scientific and Technical Information of China (English)

    邸萍; 林野; 李健慧; 邱立新; 崔宏燕

    2011-01-01

    目的 探讨和评估垂直骨量不足的种植修复患者采用牙龈色材料进行牙龈补偿修复的临床效果、技术要点及应用价值.方法 2002年2月至2011年1月采用牙龈瓷或牙龈色树脂对北京大学口腔医学院·口腔医院口腔种植中心垂直骨量不足患者31例(男性22例、女性9例)的种植修复体进行了牙龈补偿修复处理.31例中牙列缺失12例、牙列缺损19例,共有152件种植体支持固定修复体.对种植体存留率、修复体质量及美学、软组织变化、牙龈状态等进行观察和评价.患者追踪3~108个月,平均31.5个月.结果 本研究观察期内152枚种植体存留率100%,修复体总体评估可接受率96.8%.结论 具有适应证的垂直骨量不足患者种植修复时牙龈补偿处理方法临床可行、无外科创伤、美观效果可接受、患者满意度高.%Objective To evaluate the preliminary clinical results of prosthetic gingival reconstruction in vertical bone defect patients.Methods The study included 31 partial or edentulous patients (male 22,female 9) with 152 implants supporting fixed prostheses from February 2002 to January 2011 in Peking University School and Hospital of Stomatology.The implant-supported fixed prostheses with artificial gingival material to compensate for vertical defect were delivery after implant healing period.At time of prostheses delivery,a panoramic radiograph was taken.The results were evaluated according to California Dental Association by two prosthodontists.Clinical observation included survival of the implants,integrity of the restoration,complication of prosthesis and degree of satisfaction of the patients.Results A total of 152 implants supported fixed prostheses with artificial gingival materials to compensate vertical bone defect were delivered.No implants lost,and the survival rate was 100% during the follow-up period.The sore of acceptance of prosthesis was 96.8%.All patients were satisfied with

  4. Evidence-Based ACL Reconstruction.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2015-01-01

    There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACL) reconstruction. The purpose of this article is to answer the following questions: 1) Bone-patellar tendon-bone reconstruction (BPTB-R) or hamstrimg reconstruction (H-R); 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-analyses focused 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. PMID:25692162

  5. 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...

  6. 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

  7. Metaphyseal bone loss in revision knee arthroplasty.

    Science.gov (United States)

    Ponzio, Danielle Y; Austin, Matthew S

    2015-12-01

    The etiology of bone loss encountered during revision total knee arthroplasty (TKA) is often multifactorial and can include stress shielding, osteolysis, osteonecrosis, infection, mechanical loss due to a grossly loose implant, and iatrogenic loss at the time of implant resection. Selection of the reconstructive technique(s) to manage bone deficiency is determined by the location and magnitude of bone loss, ligament integrity, surgeon experience, and patient factors including the potential for additional revision, functional demand, and comorbidities. Smaller, contained defects are reliably managed with bone graft, cement augmented with screw fixation, or modular augments. Large metaphyseal defects require more extensive reconstruction such as impaction bone grafting with or without mesh augmentation, prosthetic augmentation, use of bulk structural allografts, or use of metaphyseal cones or sleeves. While each technique has advantages and disadvantages, the most optimal method for reconstruction of large metaphyseal bone defects during revision TKA is not clearly established. PMID:26362647

  8. 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

  9. 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.

  10. 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.

  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. Biology and augmentation of tendon-bone insertion repair

    OpenAIRE

    Lui PPY; Zhang P; KM, Chan; Qin L

    2010-01-01

    Abstract Surgical reattachment of tendon and bone such as in rotator cuff repair, patellar-patella tendon repair and anterior cruciate ligament (ACL) reconstruction often fails due to the failure of regeneration of the specialized tissue ("enthesis") which connects tendon to bone. Tendon-to-bone healing taking place between inhomogenous tissues is a slow process compared to healing within homogenous tissue, such as tendon to tendon or bone to bone healing. Therefore special attention must be ...

  13. 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

  14. 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.

  15. 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.

  16. 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...

  17. Fracture of the patella after the anterior cruciate ligament reconstruction

    OpenAIRE

    Milović Milan; Bojat Veselin; Kovačev Nemanja; Rašović Predrag; Milankov Miroslav

    2012-01-01

    Introduction. Fracture of the patella, after harvesting the central third of the patellar tendon for a bone-tendon-bone autograft, is a rare complication. Material and Methods. We made 1714 reconstructions of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and 7 patients had fracture of the patella (0.42%). The fracture was immediately recognized in the patients with vertical non-displaced patellar fracture and the broken screw osteosynthesis was ca...

  18. Laryngopharyngeal reconstruction

    OpenAIRE

    Kazi, Rehan A

    2006-01-01

    There is a high incidence of hypopharyngeal cancer is our country due to the habits of tobacco and alcohol. Moreover these cases are often detected in the late stages thereby making the issue of reconstruction very tedious and unpredictable. There are a number of options for laryngopharyngeal reconstruction available now including the use of microvascular flaps depending upon the patient’s fitness, motivation, technical expertise, size and extent of the defect. This article reviews the differ...

  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. 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.

  1. 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 ...

  2. “Basket weave technique” for medial patellofemoral ligament reconstruction: Clinical outcome of a prospective study

    Directory of Open Access Journals (Sweden)

    Pranjal S Kodkani

    2016-01-01

    Conclusion: This new method of MPFL reconstruction gives excellent results. It avoids complications related to bone tunneling and implants. It is a safe, effective, reliable and reproducible technique.

  3. 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

  4. Laryngeal reconstruction by complex hyoid bone flap after frontal partial laryngectomy%复合舌骨瓣悬吊修复额侧部分喉缺损的临床研究

    Institute of Scientific and Technical Information of China (English)

    欧阳电; 杨安奎; 张诠; 陈文宽; 宋明; 李浩; 刘巍巍; 刘学奎; 陈艳峰

    2013-01-01

    Objective To describe a new flap technique,the combined hyoid bone and thyrohyoid membrane flap,for laryngeal reconstruction after tumor resection,and to evaluate clinical outcome.Methods Six patients requiring frontal partial laryngectomy for cancer were enrolled between September 2008 and August 2012.Results Nasogastric feeding was given in the first 24 hours after surgery.The median times of swallowing batter,drinking water and removal of the nasogastric tubes were 2.6,5.5 and 6.3 days respectively.All patients had good respiratory function,no dyspnea or dysphagia postoperatively.Voice quality was satisfactory.There were no deaths.The median of survival time was 29.5 months,ranging from 14 to 47 months.Only one case subsequently underwent total laryngectomy due to disease recurrence in the paraglottic space,no evidence of tumor recurrence in other cases.Conclusions The combined musclepedicle hyoid bone and thyrohyoid membrane flap is a reliable for one-stage repair of laryngotracheal defects and voice quality,swallowing function and ventilation after the procedure were favorable.%目的 报道用复合舌骨瓣悬吊修复额侧部分喉缺损,并且探讨术后喉功能和肿瘤预后情况.方法 分析2008年9月至2012年8月中山大学肿瘤防治中心头颈科运用该技术治疗6例患者的临床资料.结果 患者均在术后24 h内进行鼻饲营养,进食糊状物、喝水和拔出鼻饲营养管的中位数时间分别是2.6,5.5和6.3d.未发生误吸和吸人性肺炎等严重不良事件.发声效果还是令人满意的.呼吸功能良好,无喉狭窄发生.第2例患者术后8个月声门旁间隙复发因而进行了喉全切除,其余病例均无瘤生存至今.中位生存时间是29.5个月(14 ~ 47个月).结论 复合舌骨瓣悬吊术可以一期修复额侧喉软骨和喉黏膜缺损,可以重建喉的吞咽、呼吸和发音功能.

  5. 二处截骨骨搬运治疗胫骨干大段感染性骨缺损合并软组织缺损的再认识%Bifocal corticotomy and bone transport for large segmental defects of the infected tibia and soft tissue

    Institute of Scientific and Technical Information of China (English)

    徐永清; 朱跃良; 范新宇; 林玮; 何晓清; 李阳; 王毅

    2015-01-01

    .After debridement,the tibia was fixated with Ilizarov external fixator.Bifocal corticotomy was performed on the proximal and distal tibial metaphyses simultaneously.The transporting speeds for proximal and distal tibial segment were 1 mm/d and 0.6 mm/d initially,and lowered to 0.5 ~ 0.6 mm/d later until the 2 bone segments connected.The bone transport lasted for 40 to 150 days,averaging 69.6 days.Results The patients were followed up for 12 to 72 months (average,26.6 months).The soft tissue wound healed uneventfully and the bone defects were reconstructed.Of the 25 cases,22 obtained primary bone union.Nonunion of the bone segments occurred in one,wound infection and osteogenesis imperfect in bone lengthening area occurred in one,and cut and pull-out of K-wires in the osteoporotic tibial ends occurred in one.These complications were treated accordingly before bone union was achieved.The other complications were also treated accordingly,including serious pin tract infection in 2 cases,re-fracture after removal of the external fixator in one,and shift of the tibial alignment in 2 cases.Conclusions Bifocal corticotomy can decrease bone transport time for large segmental defects of the tibia and soft tissue.During the long treatment period,a surgeon must pay much attention to the technical details and management of complications.

  6. Low Bone Density

    Science.gov (United States)

    ... Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your bone density ... people with normal bone density. Detecting Low Bone Density A bone density test will determine whether you ...

  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. 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.

  10. Bone Cancer

    Science.gov (United States)

    ... cancer. Surgery is often the main treatment for bone cancer. Other treatments may include amputation, chemotherapy, and radiation therapy. Because bone cancer can come back after treatment, regular follow-up visits are important. NIH: National ...

  11. 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

  12. Project Reconstruct.

    Science.gov (United States)

    Helisek, Harriet; Pratt, Donald

    1994-01-01

    Presents a project in which students monitor their use of trash, input and analyze information via a database and computerized graphs, and "reconstruct" extinct or endangered animals from recyclable materials. The activity was done with second-grade students over a period of three to four weeks. (PR)

  13. Vaginal reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Lesavoy, M.A.

    1985-05-01

    Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients.

  14. Vaginal reconstruction

    International Nuclear Information System (INIS)

    Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients

  15. 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.

  16. 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. PMID:27054380

  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. CT-based three-dimensional reconstruction navigation technique assisted pedicle screw placement in lumbar and sacral bone%腰骶骨椎弓根螺钉置入内固定:CT三维重建虚拟导航的辅助

    Institute of Scientific and Technical Information of China (English)

    陈晓明; 陈前芬; 肖增明; 宗少晖

    2015-01-01

      结果与结论:共置入腰骶椎椎弓根螺钉1088枚,其中1068枚螺钉位置为Ⅰ级,置钉准确率达98.2%。152例获得随访,随访时间12个月,无内固定物移位、断裂等并发症。术前CT三维重建虚拟导航技术能为腰骶骨椎弓根螺钉内固定提供三维立体的解剖信息,制定最优置钉计划,使置钉更加精确安全,从而提高整体的修复质量。%BACKGROUND:Pedicle screw fixation techniques have been widely used in the treatment of lumbar and sacral disease, such as trauma, deformity, tumor and degeneration. How to improve the accuracy of screw placement is a hot topic. CT-based three-dimensional reconstruction navigation technique provides real-time, multi-perspective, three-dimensional visualization of lumbar and sacral anatomy, and surgeons can perform the pedicle screw insertion procedures confidently with increase of accuracy and safety. OBJECTIVE:To study the clinical value of CT-based three-dimensional reconstruction navigation technique in the application of lumbar and sacral pedicle screw placement. METHODS:A total of 203 patients with lumbar and sacral diseases, including lumbar fracture, lumbar spondylolysis and lumbar spinal stenosis, were recruited from Department of Spine&Osteopathy, the First Affiliated Hospital of Guangxi Medical University between July 2008 and November 2014. Patients received pedicle screw placement in lumbar and sacral bone under the guidance of CT-based three-dimensional reconstruction navigation. Postoperative X-ray films and three-dimensional CT scan of lumbar bone were routinely examined in each patient. The accuracy of pedicle screw insertion was evaluated with postoperative CT scan according to Andrew classification. RESULTS AND CONCLUSION:A total of 1 088 screws were inserted in the lumbar and sacral bone. The accuracy of pedicle screw insertion was rated as grade I in 1 068 screws (98.2%) according to postoperative CT scan. 152 cases were fol owed

  19. 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

  20. 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

  1. Finite element analysis of total hip replacement with structural bone graft for acetabulum reconstruction in dysplasia of hip%成人髋臼发育不良伴骨关节炎行髋臼结构性植骨重建关节置换术的力学分析

    Institute of Scientific and Technical Information of China (English)

    许杰; 马若凡; 蔡志清; 李登

    2014-01-01

    Objective To study the stress distribution in the acetabular cup-bone interface affected by the structural bone graft for the acetabulum reconstruction during the total hip replacement (THR) in treating the dysplasia of hip by using the three dimensional (3D) finite element analysis. Methods The acetabulumm of the hip with dysplasia was scanned by CT.The computer simulation technology was used to reconstruct the three-dimensional (3D) model of the pelvic from CT scan picture in order to observe the dysplasia of the hip.The structural bone graft for reconstruction of the acetabulum reconstruction in THR was simulated.Then the pelvis and acetabular cup models were meshed.The mechanical analysis tool was used to analyze the 3D model, and the stress data in the acetabular cup-bone interface was achieved.After the statistical analysis of the experimental results, the structural bone graft affecting the stress distribution in the acetabular cup-bone interface was observed.Results The structural bone graft augmented the deficient acetabulum and improved the bone-bed inclusion of the cup during THR in treating the dysplasia of the hip, which leaded to greater contact area and smaller stress per unit area. The structural autograft which covered the anterior-lateral part of the cup bore greater stress.Conclusion The acetabular reconstruction with the structural bone graft improves the bone-bed inclusion of the cup during THR in treating the dysplasia of the hip.The stress deconcentration due to the larger contact area could benefit the stability of the cup.The coverage of the cup by the graft should not be too much, otherwise, the great stress on the structural bone graft would increase the risk of loosening.%目的:利用三维有限元力学分析方法,研究髋关节发育不良患者髋臼外上缘结构性植骨重建髋臼、增加臼杯假体包容对髋臼假体-骨界面间的应力分布情况的影响。方法选取髋关节发育不良患者的骨盆为

  2. Radio Reconstructions

    OpenAIRE

    Bulley, James; Jones, Daniel

    2013-01-01

    Radio Reconstructions is a sound installation which use indeterminate radio broadcasts as its raw material. Each piece is structured by a notated score, which controls its rhythm, dynamics and melodic contour over time. The audio elements used to enact this score are selected in real-time from unknown radio transmissions, by an autonomous software system which is continuously scanning the radio waves in search of similar fragments of audio. Using a technique known as audio mosaicing, hund...

  3. 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

  4. 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

  5. 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.

  6. [Bone diseases].

    Science.gov (United States)

    Uebelhart, Brigitte; Rizzoli, René

    2016-01-13

    Calcium intake shows a small impact on bone mineral density and fracture risk. Denosumab is a more potent inhibitor of bone resorption than zoledronate. Abaloparatide, PTHrP analog, increases bone mineral density and decreases fracture incidence. Teriparatide could be delivered via a transdermic device. Romosozumab and odanacatib improve calculated bone strength. Sequential or combined treatments with denosumab and teriparatide could be of interest, but not denosumab followed by teriparatide. Fibrous dysplasia, Paget disease and hypophosphatasia are updated, as well as atypical femoral fracture and osteonecrosis of the jaw. PMID:26946704

  7. 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.

  8. 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.

  9. 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

  10. 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

  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

    OpenAIRE

    Bilbao, A.; Cobo, R.; 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 ...

  12. Tracheal reconstructions.

    Science.gov (United States)

    Srikrishna, S V; Shekar, P S; Shetty, N

    1998-12-01

    Surgical reconstruction of the trachea is a relatively complex procedure. We had 20 cases of tracheal stenosis. We have a modest experience of 16 tracheal reconstructions for acquired tracheal stenosis. Two patients underwent laser treatment while another two died before any intervention. The majority of these cases were a result of prolonged ventilation (14 cases), following organophosphorous poisoning (11 cases), Guillain-Barré syndrome, bullet injury, fat embolism and surprisingly only one tumor, a case of mucoepidermoid carcinoma, who had a very unusual presentation. There were 12 males and 4 females in this series, age ranging from 12-35 years. The duration of ventilation ranged from 1-21 days and the interval from decannulation to development of stridor was between 5-34 days. Six of them were approached by the cervical route, 5 by thoracotomy and cervical approach, 2 via median sternotomy and 3 by thoracotomy alone. Five of them required an additional laryngeal drop and 1 required pericardiotomy and release of pulmonary veins to gain additional length. The excised segments of trachea measured 3 to 5 cms in length. All were end to end anastomosis with interrupted Vicryl sutures. We have had no experience with stents or prosthetic tubes. Three patients developed anastomotic leaks which were controlled conservatively. Almost all of them required postoperative tracheo-bronchial suctioning with fibreoptic bronchoscope. We had one death in this series due to sepsis. PMID:9914459

  13. 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

  14. 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.

  15. A novel 3D template for mandible and maxilla reconstruction: Rapid prototyping using stereolithography

    OpenAIRE

    Samir Kumta; Monica Kumta; Leena Jain; Shrirang Purohit; Rani Ummul

    2015-01-01

    Introduction: Replication of the exact three-dimensional (3D) structure of the maxilla and mandible is now a priority whilst attempting reconstruction of these bones to attain a complete functional and aesthetic rehabilitation. We hereby present the process of rapid prototyping using stereolithography to produce templates for modelling bone grafts and implants for maxilla/mandible reconstructions, its applications in tumour/trauma, and outcomes for primary and secondary reconstruction. Materi...

  16. Talking Bones.

    Science.gov (United States)

    Johnson, Jaclyn; Kassing, Sharon

    2002-01-01

    Describes cooperation with the Saint Louis Zoo to provide opportunities for elementary school students to learn about bones, how animals move, what they eat, and how much they grow. Uses biofacts which include bones, skulls, and other parts to make the laboratory a hands-on experience for students. (YDS)

  17. Bone Markers

    Science.gov (United States)

    ... bone turnover: C-telopeptide (C-terminal telopeptide of type 1 collagen (CTx)) – a marker for bone resorption. It is ... resorption include: N-telopeptide (N-terminal telopeptide of type 1 collagen (NTx)) – a peptide fragment from the amino terminal ...

  18. Bone metabolism during pregnancy.

    Science.gov (United States)

    Salles, Jean Pierre

    2016-06-01

    During pregnancy, mineral concentrations, of calcium and phosphorus in particular, are maintained at a high level in fetal blood so that the developing skeleton may accrete adequate mineral content. The placenta actively transports minerals for this purpose. Maternal intestinal absorption increases in order to meet the fetal demand for calcium, which is only partly dependent on calcitriol. Mineral regulation is essentially dependent on parathyroid hormone (PTH) and PTH-related protein (PTHrP). The calcium-sensing receptor (CaSR) regulates PTH and PTHrP production. If calcium intake is insufficient, the maternal skeleton will undergo resorption due to PTHrP. After birth, a switch from fetal to neonatal homeostasis occurs through increase in PTH and calcitriol, and developmental adaptation of the kidneys and intestines with bone turnover contributing additional mineral to the circulation. Calcium absorption becomes progressively active and dependent on calcitriol. The postnatal skeleton can transiently present with osteoposis but adequate mineral diet usually allows full restoration. Cases of primary osteoporosis must be identified. Loss of trabecular mineral content occurs during lactation in order to provide calcium to the newborn. This programmed bone loss is dependent on a "brain-breast-bone" circuit. The physiological bone resorption during reproduction does not normally cause fractures or persistent osteoporosis. Women who experience fracture are likely to have other causes of bone loss. PMID:27157104

  19. Bone in vivo: Surface mapping technique

    CERN Document Server

    Fan, Yifang; Lin, Zhiyu; Lv, Changsheng

    2010-01-01

    Bone surface mapping technique is proposed on the bases of two kinds of uniqueness of bone in vivo, (i) magnitude of the principal moments of inertia, (ii) the direction cosines of principal axes of inertia relative to inertia reference frame. We choose the principal axes of inertia as the bone coordinate system axes. The geographical marks such as the prime meridian of the bone in vivo are defined and methods such as tomographic reconstruction and boundary development are employed so that the surface of bone in vivo can be mapped. Experimental results show that the surface mapping technique can both reflect the shape and help study the surface changes of bone in vivo. The prospect of such research into the surface shape and changing laws of organ, tissue or cell will be promising.

  20. 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....... The weak response at the distal forearm during antiresorptive treatment has restricted the use of bone densitometry at this region. We describe a new model for bone densitometry at the distal forearm, by which the response obtained is comparable to the response in other regions where bone densitometry...... is much more expensive and technically complicated. By computerized iteration of single X-ray absorptiometry forearm scans we defined a region with 65% trabecular bone. The region was analyzed in randomized, double-masked, placebo- controlled trials: a 2-year trial with alendronate (n = 69), a 1-year...

  1. Biofabrication of bone tissue: approaches, challenges and translation for bone regeneration.

    Science.gov (United States)

    Tang, Daniel; Tare, Rahul S; Yang, Liang-Yo; Williams, David F; Ou, Keng-Liang; Oreffo, Richard O C

    2016-03-01

    The rising incidence of bone disorders has resulted in the need for more effective therapies to meet this demand, exacerbated by an increasing ageing population. Bone tissue engineering is seen as a means of developing alternatives to conventional bone grafts for repairing or reconstructing bone defects by combining biomaterials, cells and signalling factors. However, skeletal tissue engineering has not yet achieved full translation into clinical practice as a consequence of several challenges. The use of additive manufacturing techniques for bone biofabrication is seen as a potential solution, with its inherent capability for reproducibility, accuracy and customisation of scaffolds as well as cell and signalling factor delivery. This review highlights the current research in bone biofabrication, the necessary factors for successful bone biofabrication, in addition to the current limitations affecting biofabrication, some of which are a consequence of the limitations of the additive manufacturing technology itself. PMID:26803405

  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. Sodium-dependent phosphate transporters in osteoclast differentiation and function

    OpenAIRE

    Giuseppe Albano; Matthias Moor; Silvia Dolder; Mark Siegrist; Wagner, Carsten A.; Jürg Biber; Nati Hernando; Willy Hofstetter; Olivier Bonny; Fuster, Daniel G

    2015-01-01

    Osteoclasts are multinucleated bone degrading cells. Phosphate is an important constituent of mineralized bone and released in significant quantities during bone resorption. Molecular contributors to phosphate transport during the resorptive activity of osteoclasts have been controversially discussed. This study aimed at deciphering the role of sodium-dependent phosphate transporters during osteoclast differentiation and bone resorption. Our studies reveal RANKL-induced differential expressio...

  4. 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

    International Nuclear Information System (INIS)

    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. (paper)

  5. 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.

  6. 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

  7. A quantification strategy for missing bone mass in case of osteolytic bone lesions

    Energy Technology Data Exchange (ETDEWEB)

    Fränzle, Andrea, E-mail: a.fraenzle@dkfz.de; Giske, Kristina [Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Bretschi, Maren; Bäuerle, Tobias [Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Hillengass, Jens [Department of Internal Medicine V, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Bendl, Rolf [Medical Informatics, Heilbronn University, Max-Planck-Strasse 39, 74081 Heilbronn, Germany and Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)

    2013-12-15

    ratiov{sub r}/v{sub m} of the reconstructed bone volume v{sub r} and the healthy model bone volume v{sub m} is 1.07, which indicates a good reconstruction of the modified bone. Conclusions: The qualitative and quantitative comparison of manual and semi-automated segmentation results have shown that comparing a modified bone structure with a healthy model can be used to identify and measure missing bone mass in a reproducible way.

  8. Effect of negative pressure on vascularization of tendon-bone interface after reconstruction of anterior cruciate ligament in rabbits%负压对兔前交叉韧带重建术后腱-骨界面血管化影响的研究

    Institute of Scientific and Technical Information of China (English)

    孙正明; 凌鸣; 冯伟楼; 董向辉; 刘时璋; 易智

    2013-01-01

    Objective To explore the effect of intermittent negative pressure on vascularization of tendon-bone interface after reconstruction of anterior cruciate ligament in rabbits.Methods One side of hind legs in 24 New Zealand white rabbits were randomly chosen as negative pressure group,and its contralateral hind leg was chosen as control.The anterior cruciate ligament model was reconstructed with autogenous semitendinosus of rabbit.Joint at the negative pressure side was placed with drainage tube connecting the micro-negative pressure aspirator for maintaining a low-intensity,intermittent negative pressure.Control side was placed with ordinary drainage tube.Drainage tubes of both sides were removed at 5 d after operation.After 6 weeks,femur-ligament-tibia complex was obtained to determine tendon graft tension,observe the blood vessels of the tendon-bone interface and detect the expression of VEGF.Results Twenty-three rabbits were included in the study,and one rabbit was excluded because of joint infections.Rally measurement results showed that the maximum load breakage of tendon graft was significantly greater in negative pressure group than that in control group (P < 0.05).Histological studies of tendon-bone interface found that the number of blood vessels was significantly more in negative pressure group than that in control group (P < 0.01).Immunohistochemistry showed that expression of VEGF was higher in negative pressure group than that in control group (P < 0.01).Conclusion Intermittent negative pressure may promote tendon-bone healing by increasing the vascularization of the tendon-bone interface after reconstruction of anterior cruciate ligament in rabbits.%目的 研究间歇性负压对兔前交叉韧带(anterior cruciate ligament,ACL)重建后腱-骨血管化的影响.方法 24只新西兰大白兔,随机取负压侧后腿,对侧后腿为对照.采用兔自体半腱肌重建前交叉韧带模型,负压侧关节通过引流管接微型负压吸引器,

  9. 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

  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. Your Bones

    Science.gov (United States)

    ... a fall! If you play sports like football, soccer, lacrosse, or ice hockey, always wear all the ... to strengthen your bones is through exercise like running, jumping, dancing, and playing sports. Take these steps ...

  12. 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.

  13. 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

  14. Estudo biomecânico da fixação transcortical ou transesponjosa do enxerto de tendão patelar com pinos bioabsorvíveis na reconstrução do LCA em ovinos Biomechanical study of transcortical or transtrabecular bone fixation of patellar tendon graft with bioabsorbable pins in ACL reconstruction in sheep

    Directory of Open Access Journals (Sweden)

    Mauro Batista Albano

    2012-02-01

    Full Text Available OBJETIVO: Determinar a resistência inicial de fixação do sistema RigidFix® e comparar com o método tradicional de fixação que utiliza parafusos de interferência metálicos. Avaliar a resistência da fixação com o sistema RigidFix® ao se modificar o posicionamento rotacional do bloco ósseo no interior do túnel femoral. MÉTODOS: 40 espécimes de joelhos (soldras de ovinos, foram submetidos à reconstrução do ligamento cruzado anterior (LCAutilizando enxerto osso-tendão-osso. Em 20 espécimes utilizou-se o método RigidFix®, este grupo foi subdividido em dois, 10 joelhos foram utilizados para fixação através da esponjosa e 10 para fixação cruzando a tábua óssea cortical. Nos 20 espécimes restantes fixou-se o enxerto com parafusos de interferência metálico de 9mm. RESULTADOS: A comparação do método RigidFix® com o método de fixação com parafuso de interferência metálico não mostrou diferenças estatisticamente significativas ao se considerar carga máxima e rigidez, também não houve diferenças estatisticamente significativas ao se modificar o posicionamento rotacional do bloco ósseo no interior do túnel femoral. Para estas avaliações considerou-se o p OBJECTIVE: to determine the initial resistance of fixation using the Rigid Fix® system, and compare it with traditional fixation methods using metal interference screws; and to evaluate the resistance of the fixation with the rigid fix system when the rotational position of the bone block is altered in the interior of the femoral tunnel. METHODS: forty ovine knee specimens (stifle joints were submitted to anterior cruciate ligament reconstruction (ACL using a bone-tendon-bone graft. In twenty specimens, the RigidFix® method was used; this group was subdivided into two groups: ten knees used for fixation with trabecular bone screw, and ten for fixation passing through the layer of cortical bone. In the twenty remaining specimens, the graft was fixed with 9

  15. 丹红注射液促进兔重建前交叉韧带早期腱-骨愈合实验研究%The effects on tendon-bone healing by use of Dan-Hong injection in rabbit ACL reconstruction model

    Institute of Scientific and Technical Information of China (English)

    蔡明; 周振宇; 曹毅; 刘培超; 刘宇博

    2014-01-01

    目的:通过建立兔前交叉韧带重建模型,分别对实验标本进行组织学及生物力学研究,为临床上丹红注射液是否能影响腱-骨愈合提供参考。方法:成年新西兰兔20只,膝关节40个,随机分为丹红注射液组(观察组)及空白对照组,每组10只。所有动物均行自体跟腱移植重建双侧前交叉韧带。观察组腱-骨界面注射丹红注射液,对照组注射生理盐水。在术后第4周、8周时处死观察组和对照组各5只兔子。每个时间段处死的兔子中,观察组5只兔子共10个膝关节中,取5个作组织学观察,剩余的5个作抗拉力生物力学测试。结果:组织学观察发现:术后4周观察组可见成纤维细胞明显增生,以及少量排列有序的胶原纤维,同时腱骨界面可见少量的新血管生成,成软骨细胞增生,肌腱和骨隧道间间隙减小。对照组骨隧道和肌腱间有新生肉芽组织和少量成纤维细胞增生,腱骨界面可见少量的胶原纤维,但排列疏松且不规则。术后8周观察组骨隧道和移植肌腱间可见较多且排列整齐胶原纤维,腱骨界面更成熟,并可见类似垂直胶原纤维。对照组腱骨界面可见大量成纤维细胞,胶原纤维较多排列仍不规则,腱骨界面可见少量骨组织生成,两组界面形态学分布差异有统计学意义(P<0.05)。术后4周观察组腱骨界面的抗拉脱强度高于空白组,差异有统计学意义(P<0.05)。结论:前交叉韧带重建术后应用丹红注射液处理,腱骨界面成熟成纤维细胞及Sharpey样纤维更早出现,观察组肌腱移植物的生物力学特性优于对照组,丹红注射液能促进肌腱移植物在骨隧道中的早期愈合。%Objective:To observe whether Dan-Hong injection can affect clinical tendon-bone healing, the rabbit anterior cruciate ligament reconstruction model was built and the animal experiments about

  16. 64排螺旋CT三维重建技术在颌骨埋伏阻生牙定位中的应用价值%Application Value of Three-dimensional Reconstruction Technique of 64-slice Spiral CT in Diagnosis of Impacted Teeth within Jaw Bone

    Institute of Scientific and Technical Information of China (English)

    谢友扬; 潘功茂; 施君; 孟庆乐; 夏云宝

    2012-01-01

    目的:探讨64排螺旋CT三维重建技术对颔骨内埋伏阻生牙的定位及临床应用价值.方法:对33例临床疑似埋伏阻生牙患者行64排螺旋CT容积扫描,利用GEAW4.4工作站对数据进行多平面重组(MPR)、容积再现技术(VRT)重组图像.结果:33例阻生牙患者中,切牙8颗,侧切牙5颗,尖牙11颗,第三磨牙5颗,多生牙9颗.结论:64排螺旋CT三维重建能准确显示颔骨内埋伏阻生牙及多生牙的数量、位置、形态及萌出方向,为临床提供可靠的指导信息.%Objective To discuss the value of three-diniensiona)(3D) reconstruction technique of 64-slice spiral CT in the diagnosis of impacted teeth within the jaw bone, Methods Thirty-three suspected eases of impacted teeth were examined by 64-slice CT volume scan. The acquired data were processed by multi-planar reconstruction(MPR), volume rendering technique(VRT) using GEAW4.4 workstation. Results Impacted teeth consisted of 8 centra! incisors, 5 lateral incisors, 11 canine teeth, 5 cranters and 9 accessory teeth were detected from all the 33 patients. Conclusion The 3D reconstruction technique of 64-slice spiral CT could display the details of impacted teeth, including the shape, location and eruption orientation. It can provide valuable information for diagnosis.[Chinese Medical Equipment Journal.2012,33(5):76-77

  17. 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. PMID:24755526

  18. 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.

  19. 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

  20. 后交叉韧带重建中股骨侧"锐角效应"的相关研究及骨道技术的评价%Correlative study of femur "acute angle" in reconstruction of posterior cruciate ligament with hamstring tendons and evaluation of bone tunnel technique

    Institute of Scientific and Technical Information of China (English)

    闫昌葆; 陈百成; 赵宝辉; 孙然; 刘虎; 李嘉

    2009-01-01

    [Objective]To explore the "acute angle" of femur,and evaluate the bone tunnel technique in posterior cruciate ligament reconstruction. [Method] Using the porcine flexor digilorum tendon as graft, the author reconstructed posterior cruciate ligament. The bone tunnel was established wilh the angle of 80°,90°and 100°comparison the tunnel and intercondylar fossa of femur side wall,and press sensitive film was set between the edge of tunnel and graft. The pressure between was used to represent abrasion. The bigger the pressure was, the larger the abrasion was. The difference of pressure between bone tunnel technique group and the control group was compared. [ResultJThe pressure of angle 100°was lowest(3. 55 ±0. 21 MPa). And the pressure of burnishing group(3.29 ±0.19 MPa)was lower than that of the control group(3.55 ±0.21 MPa). [Conclusion]The bone tunnel technique can reduce the femoral; "acute angle" of femur in posterior cruciate ligament reconstruction.%[目的]探讨后交叉韧带重建中股骨侧的"锐角效应"以及对骨道技术进行评价.[方法]应用猪的屈趾肌腱作为移植物重建后交叉韧带,分别建立与股骨髁间窝侧壁呈80°、90°、100°夹角的骨道,以及对骨道边缘进行打磨处理.在骨道边缘与移植物之间放置压敏片计算得压强值来表示磨损作用的大小,压强值越大表示磨损作用越大.通过比较应用骨道技术重建PCL组与对照组的压强值来说明这种减小"锐角效应"的方法是否可行.[结果]应用骨道技术重建后交叉韧带各组中移植物与股骨髁间窝侧壁夹角为100°时压强最小[(3.55±0.21)MPa],并且对骨道边缘进行打磨后压强值[(3.29±0.19)MPa]明显低于对照组[(3.55±0.21)MPa].[结论]应用骨道技术可以有效减小后交叉韧带重建中股骨侧的"锐角效应".

  1. Effect of changing the position of the transported bone on early vascularization after distraction osteoporosis%牵张成骨后移动骨段移位对早期血管生成的影响

    Institute of Scientific and Technical Information of China (English)

    孙明; 律娜; 张令达; 黄代营; 陈松龄

    2011-01-01

    To assess the effects of 1 -step changing the buccal position of the transported bone after distraction on early vascularization. Methods Total of 8 adult mongrel dogs were procured. The bilaterally mandible premolar canine were extracted. After 1 month, the complete osteotomy was performed and the devices were placed. The gradual distraction was started after 1 week latency at the rate of 1 mm once a day, total 6 mm height was achieved. 1 -step changing the buccal position of the transported bone was performed in the day after the vertical distraction period in one side of the animals, and the other side as the controlled side. All animals were killed after a 7-day consolidation period. The vascular system was stained post mortem carbon ink perfusion to assess possible damages, and analyzed the ratio of vascular squre in computer. Results All animals tolerated the procedures well. After vertical distraction, the tested side could be moved 3 mm in buccal direction. Vascular damage was not detected, and there was no statistical difference in the ratio of vascular squre with analysis the histological section in computer. Conclusion In some extent, 1 -step changing the buccal position of the transported bone after distraction can mold the regenerate bone to correct the axial displacement, without endangering early vascularization.%目的 研究牙槽骨垂直牵张成骨后移动骨段一步颊向移位较大距离对早期血管生成的影响.方法 杂种犬8只,拔除双侧下颌前磨牙1个月后,骨切开放置牵张器,间歇7 d后以1 mm/d速度牵张,垂直牵张高度为6 mm.垂直牵张完成后,每只犬的随机一侧作为实验侧,于牵张结束后第2天一步将移动骨段颊向移位3 mm,另一侧作为对照侧不改变移动骨段的颊向位置.完成垂直牵张后7 d处死动物并行墨汁灌注,图像分析血管面积比率.结果 实验动物均能顺利完成实验,实验侧移动骨段在垂直牵张后可较容易颊向移位3 mm,实

  2. Regulation of ATP-binding cassette transporters and cholesterol efflux by glucose in primary human monocytes and murine bone marrow-derived macrophages

    Science.gov (United States)

    Individuals with type 2 diabetes mellitus are at increased risk of developing atherosclerosis. This may be partially attributable to suppression of macrophage ATP-binding cassette (ABC) transporter mediated cholesterol efflux by sustained elevated blood glucose concentrations. Two models were used...

  3. 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.

  4. 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 ...

  5. Cemented total hip arthroplasty with impacted morcellized bone-grafts to restore acetabular bone defects in congenital hip dysplasia.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Melenhorst, J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2001-01-01

    We evaluated the results of 27 acetabular reconstructions in 21 patients with secondary osteoarthritis resulting from congenital dysplasia of the hip in which the acetabular bone defects were restored with impacted morcellized bone-grafts in combination with a cemented cup. At an average follow-up o

  6. The effects of BMP-2 gene medication on the reconstruction of osteolytic bone defect around implant%假体周围骨溶解性骨缺损的转骨形态发生蛋白-2基因治疗

    Institute of Scientific and Technical Information of China (English)

    严孟宁; 戴尅戎; 汤亭亭

    2008-01-01

    目的 模拟假体周围骨溶解环境,观察骨形态发生蛋白-2(BMP-2)基因治疗假体周围骨溶解性骨缺损的效果.方法 成年雄性Beagle犬6条,于股骨外髁造成假体周围3mm骨缺损区.1条动物的左侧缺损区植入1ml平均直径1μm的钛合金颗粒混悬液,右侧植入1ml磷酸盐缓冲液(PBS),观察造模结果;其他5条动物双侧植入1ml钛合金颗粒混悬液,于术后2个月取出假体,植入转BMP-2基因冻干骨或单纯冻干骨,二次术后3个月取材,行组织学、组织形态计量学观察植骨愈合替代及界面骨整合情况.结果 颗粒造模术后2个月可见典型的骨溶解界膜组织形成.翻修术后3个月,冻干骨组见较多植骨残余,假体-骨界面基本为软组织界膜,假体骨接触率(BIC)为(1.38±1.22)%;基因治疗组见少量植骨残余,假体-骨界面有点状骨接触,BIC为(12.96±1.61)%,两组差异有统计学意义(P<0.01).结论 采用BMP-2基因治疗可提高假体周围骨溶解性骨缺损的界面骨整合.%Objective With the osteolystic model,the simulating revision was done to investigate the effects of BMP-2 gene therapy on the reconstruction of periprosthetic bone defect.Methods A 3 mm bone defect around Ti alloy implant was created in both femoral lateral condyla of 6 adult Beagle dogs.One animal was left as a model to evaluate the effects of particles on the defect,with 1 ml Ti alloy particles averaged diameter of 1μm implanted on the left bone defect and 1 ml PBS on the right.Ten defects of the other 5 animals were implanted 1 ml Ti alloy particle and the revisions were done 2 months postoperatively.With the impaction grafting technique,two defects of each animal were reconstructed with freeze-dried allograft (FDB group),freeze-dried allograft loading autogenous bone marrow stromal cells transfected by Adv-BMP2 gene (gene group) respectively.The allograft healing and osseointegration of bone-implant interface were evaluated by histological

  7. 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

    International Nuclear Information System (INIS)

    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.)

  8. 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.)

  9. 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...

  10. 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...

  11. 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.

  12. Custom facial reconstruction for osteosarcoma of the jaw.

    Science.gov (United States)

    Lazarides, Alexander; Erdmann, Detlev; Powers, David; Eward, William

    2014-11-01

    Osteosarcoma accounts for most primary bone cancers in children and young adults. High-grade lesions are typically managed with a combination of chemotherapy and wide-margin surgical excision. Although this malignancy typically affects the metaphyseal region of long bones, it also can be seen in the axial skeleton. Of axial locations, tumors in the head and neck can be particularly troubling to treat. Segmental bone loss after resection of malignant mandibular tumors continues to present important challenges to the reconstructive surgeon. Recent advancements in 3-dimensional modeling have facilitated custom templates for patient-specific reconstructions. This report describes the case of a young woman with osteosarcoma of the mandible undergoing customized template composite facial reconstruction using a vascularized osteoseptocutaneous fibula flap. PMID:25438280

  13. What Is Bone?

    Science.gov (United States)

    ... by your browser. Home Bone Basics What Is Bone? Publication available in: PDF (57 KB) Related Resources ... Men, and Osteoporosis Osteoporosis Prevention For Your Information Bone Remodeling Throughout life, bone is constantly renewed through ...

  14. 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. ...

  15. Facts about Broken Bones

    Science.gov (United States)

    ... White House Lunch Recipes The Facts About Broken Bones KidsHealth > For Kids > The Facts About Broken Bones ... through the skin . continue What Happens When a Bone Breaks? It hurts to break a bone! It's ...

  16. 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 ...

  17. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... is sent to a lab for examination. Bone biopsy may also be done under general anesthesia to ... remove the bone can be done if the biopsy exam shows that there is an abnormal growth ...

  18. 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.

  19. 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

  20. 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.

  1. 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

  2. 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.

  3. Mandibular reconstruction with composite microvascular tissue transfer

    International Nuclear Information System (INIS)

    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

  4. Cranial reconstruction with prefabricated 3D implant after a gunshot injury: A case report

    Directory of Open Access Journals (Sweden)

    Malivuković Ana

    2016-01-01

    Full Text Available Introduction. Complex defects of skull bones with different etiology, still present the challenge in reconstructive surgery. The goldstandard for cranioplasty is the autologous calvarial bone graft removed during surgery which cannot be always applied, especially in gunshot wounds for sometimes complete bone destruction. Autologous reconstruction with split calvarial, rib bones or iliac bone graft is also possible. Materials routinely used for reconstructions like titanium mesh, polymethyl metacrylate (PMMA, and other have numerous disadvantages and limitations. Case report. We presented a patient with gunshot injury to the head with residual large bone defect in the frontal region, with involvement of the skull base, and open frontal sinus. After conservative treatment, six months after the injury, reconstruction of the residual bone defect was performed. The chosen material was computerdesigned PEEK-OPTIMA® implant, manufactured on the basis of MSCT scan. This material has not been used in this region so far. The postoperative and follow-up period of the next 12 months passed without surgical complications, neurological deficit, with satisfactory functional and aesthetic results. Conclusion. Implanted bone replacement was designed and manufactured precisely according to the skull defect, and we found it suitable for the treatment of complex defects of the cranium. Early results are in favor of this cranioplasty method over standardized materials. Therefore, this material is expected to become a method of choice for reconstructive surgery of bony defects of the face and skull especially in complex cases.

  5. 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.

  6. Patella fracture following anterior cruciate ligament reconstruction: A case report

    OpenAIRE

    Milankov Miroslav; Kecojević Vaso; Ninković Srđan; Gajdobranski Đorđe R.

    2003-01-01

    Introduction The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL) rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002), 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. Case report An 18-year-old female patie...

  7. ACL Reconstruction With Autografts Weighing Performance Considerations and Postoperative Care.

    Science.gov (United States)

    Grant, John A; Mohtadi, Nicholas G

    2003-04-01

    Anterior cruciate ligament (ACL) reconstruction is the treatment of choice for patients who experience episodes of instability and a decreased quality of life after ACL rupture. The bone-patellar tendon-bone and hamstring autografts are the current standards for ACL reconstruction. Primary care physicians, especially sports medicine clinicians, are the first-line providers of nonoperative care for patients who have ACL injuries. Care providers need to know the biologic and biomechanic properties of these grafts, clinical indications for each graft, and rehabilitation considerations to appropriately counsel their patients. PMID:20086463

  8. Hanford Environmental Dose Reconstruction Project

    International Nuclear Information System (INIS)

    The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. 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, Washington, and Idaho, 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 humans (dose estimates): Source terms, environmental transport, environmental monitoring data, demography, food consumption, and agriculture, and environmental pathways and dose estimates. Progress is discussed

  9. 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

  10. Esthetic Craniofacial Bony and Skull Base Reconstruction Using Flap Wrapping Technique.

    Science.gov (United States)

    Yano, Tomoyuki; Suesada, Nobuko; Usami, Satoshi

    2016-07-01

    For a safe and esthetic skull base reconstruction combined with repair of craniofacial bone defects, the authors introduce the flap wrapping technique in this study. This technique consists of skull base reconstruction using the vastus lateralis muscle of an anterolateral thigh (ALT) free flap, and structural craniofacial bony reconstruction using an autologous calvarial bone graft. The key to this technique is that all of the grafted autologous bone is wrapped with the vascularized fascia of the ALT free flap to protect the grafted bone from infection and exposure. Two anterior skull base tumors combined with craniofacial bony defects were included in this study. The subjects were a man and a woman, aged 18 and 64. Both patients had preoperative proton beam therapy. First, the skull base defect was filled with vastus lateralis muscle, and then structural reconstruction was performed with an autologous bone graft and a fabricated inner layer of calvarial bone, and then the grafted bone was completely wrapped in the vascularized fascia of the ALT free flap. By applying this technique, there was no intracranial infection or grafted bone exposure in these 2 patients postoperatively, even though both patients had preoperative proton beam therapy. Additionally, the vascularized fascia wrapped bone graft could provide a natural contour and prevent collapse of the craniofacial region, and this gives patients a better facial appearance even though they have had skull base surgery. PMID:27300454

  11. 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

  12. 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.

  13. 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.

  14. Breast Reconstruction After Mastectomy

    Science.gov (United States)

    ... reconstruction with or without radiotherapy. Current Opinion in Obstetrics and Gynecology 2011;23(1):44–50. [PubMed Abstract] Barry M, Kell MR. Radiotherapy and breast reconstruction: a meta-analysis. Breast ...

  15. Tibial Tunnel Cyst Formation after Anterior Cruciate Ligament Reconstruction Using a Non-Bioabsorbable Interference Screw.

    Science.gov (United States)

    Joshi, Yogesh V; Bhaskar, Deepu; Phaltankar, Padmanabh M; Charalambous, Charalambos P

    2015-12-01

    Tibial cyst formation following the use of bioabsorbable interference screws in anterior cruciate ligament (ACL) reconstruction is well-described; however, cyst formation after the use of metallic interference screws is not well-documented. We describe a case of osteolytic lesion of the proximal tibia presenting to us 20 years after ACL reconstruction using an autologous bone-tendon-bone graft. The original graft fixation technique was interference fixation with a metal screw in the tibial and femoral tunnels. A two-stage revision reconstruction of the ACL was undertaken with curettage and bone grafting of the tibial lesion in the first stage and reconstruction using a four-strand hamstring tendon in the second stage. The patient recovered satisfactorily with complete healing of the cyst and returned to pre-injury level of activities. We have reviewed case reports and case series that describe the aetiology of intra-osseous cyst formation following ACL reconstruction. PMID:26673117

  16. 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.

  17. Effects of administration rhBMP-2/rhVEGF165 on tendon-bone healing after anterior cruciate ligament reconstruction in rabbits%rhBMP-2联合rhVEGF165对兔前交叉韧带重建后腱-骨愈合的影响

    Institute of Scientific and Technical Information of China (English)

    周平; 赵其纯; 尚希福; 王姚斐; 李旭; 纪小枫; 凌晓冬; 朱亚林

    2013-01-01

    目的 探讨局部联合应用重组人骨形态发生蛋白(rhBMP)-2和重组人血管内皮生长因子165 (rhVEGF165) 对兔前叉韧带重建后腱-骨早期愈合的影响.方法 78只健康成年雄性新西兰大白兔,随机分为VB、B、V、F及正常组,前4组建立双膝自体半腱肌前交叉韧带重建模型,正常组未行手术.VB组腱-骨界面注入以纤维蛋白胶(FG)为载体的rhBMP-2/rhVEGF165混合物;B组注入rhBMP-2和FG混合物;V组注入rhVEGF165和FG混合物;F组单纯注入FG.术后第2、4、8周,每组随机抽取6只兔子,右膝标本行组织学观察,左膝标本行生物力学测试.结果 术后第2周:VB组腱-骨连接紧密,成纤维细胞大量增生;B组连接紧密,可见少量软骨细胞;V、F组连接疏松,主要为纤维血管组织构成.术后第4周:VB组腱-骨界面初步形成四层结构;V、B、F组则主要由成熟的成纤维细胞构成,腱-骨连接紧密,骨隧道壁出现一定量成骨反应;术后第8周:VB组四层结构更明显,可见潮线;B组骨隧道壁侧成骨反应进步加强;V、F组腱-骨界面宽度进步变窄,成纤维细胞数目明显减少.直至术后第4、8周,VB组平均最大载负荷及刚度才较V、B、F组大(P<0.05),均低于正常组;同时V、B组生物力学性能优于F组(P<0.05).结论 rhBMP-2联合rhVEGF165对兔前交叉韧带重建术后腱-骨早期愈合具有促进作用,且联合效应强于各自单独效应.%Objective To explore effects of local administration rhBMP-2/rhVEGF165 on tendon-bone ealy healing after anterior cruciate ligament reconsctruction in rabbits. Methods Seventy eight male New Zealand white rabbits were randomly divided into Group VB,B,V,F and normal group. Bilateral anterior cruciate ligaments of each animal were removed and reconstructed with autogenetic tendon of semitendinosus muscles while normal group did not receive any operation. The fibrin glue ( FG ) containing rhBMP-2/rhVEGF165 was injected into tendon-bone interface

  18. 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.

  19. 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.

  20. 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.

  1. 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. PMID:17899003

  2. 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. PMID:11770503

  3. 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

  4. 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

  5. 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

  6. 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.

  7. 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.

  8. 骨移植重建肩关节后脱位合并肱骨头前内侧骨缺损的临床疗效分析%The clinical outcome of anatomical reconstruction with bone graft for humeral head impression fractures after posterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    徐德兴; 陈昌礼; 陈硕

    2012-01-01

    目的 自体或异体骨移植方法解剖重建肩关节后脱位伴有前内侧骨缺损,恢复肱骨头关节面形态,为肩关节后脱位的诊治提供一种有效、可靠方法.方法 6例患者纳入本次研究,患者平均年龄46.3(35~65)岁,所有患者肩关节后脱位伴有25%~45%肱骨头关节面前内侧骨缺损,2例患者伴有小结节撕脱性骨折,1例患者小结节联合外科颈骨折.6例患者中5例发生肩关节脱位延迟诊断,延迟诊断时间平均71.2(36~105)d.所有患者均采用自体或异体骨移植来解剖修复肱骨头前内侧骨缺损,恢复肱骨头关节面形态.结果 所有患者术后随访16.8(6~30)个月,优秀5例,良好1例,Constant评分平均为84.8(76~90)分,随访时无复发性肩关节脱位、移植骨塌陷以及肩关节不稳表现.结论 采用自体/异体骨移植、重建肱骨头形态是一种有效、可靠方法,能够恢复良好肩关节功能及稳定性.%There had an anatomical reconstruction with bone autograft/allograft for humeral head impression fractures after posterior shoulder dislocation . It provide a valid and good method for the diagnosis and treatment of posterior shoulder dislocation. Methods Six patients with an average age of 46. 3years (35 ~ 65 ) at time of surgery were included. All patients had a 25% ~45% anteromedial humeral head articular surface defect associated with five missed locked posterior shoulder dislocation. Two patients had an less tuberosity fracture,one patient had an additional less tuberosity and surgical neck fracture . For five patients the time span between the injury and the diagnosis is 71. 2 days,ranged between 36 and 105 days, all patients used an anatomical repair with bone autograft/allograft for humeral head impression fractures after posterior shoulder dislocation. Results At a mean time follow-up of 16. S months (6 to 30) , the result was found to be excellent for five patients and good for one patient with a mean

  9. Osteoclasts prefer aged bone

    DEFF Research Database (Denmark)

    Henriksen, K; Leeming, Diana Julie; Byrjalsen, I;

    2007-01-01

    We investigated whether the age of the bones endogenously exerts control over the bone resorption ability of the osteoclasts, and found that osteoclasts preferentially develop and resorb bone on aged bone. These findings indicate that the bone matrix itself plays a role in targeted remodeling...

  10. 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

  11. Hanford Environmental Dose Reconstruction Project

    International Nuclear Information System (INIS)

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that 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 project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from released to impact on humans (dose estimates): source terms; environmental transport; environmental monitoring data; demographics, agriculture, food habits; and, environmental pathways and dose estimates

  12. Pectoralis major rib osteomyo cutaneous flap in primary mandibular reconstruction in floor of the mouth cancer

    OpenAIRE

    MISHRA, R.C.; Sahoo, M.

    1997-01-01

    We report pectoralis major rib osteo myocutaneous flap in reconstruction of cancer floor of the mouth in 8 cases. We have discussed it's advantages in country like ours over the micro vascular graft. The rib (Vascularised bone graft) incorporated in this flap gives ideal support for mandibular arch reconstruction.

  13. Analysis of the grafts selection and clinical effect in the reconstruction of nasal bone and cartilage%鼻部骨、软骨结构重建充填物的选择及其疗效分析

    Institute of Scientific and Technical Information of China (English)

    代娓; 翟立杰

    2011-01-01

    [ Objective] To observe the effect of autologous septal cartilage and allogenic costal cartilage in rhinoplasty. [ Method ] Dorsal onlay grafting was performed in 51 patients with autologous septal cartilage and allogenic costal cartilage from 2006 to 2010. Twelve patients were suffered from saddle nose malformation, 3 patients had nose pyramidal asymmetry malformation, 27 patients got irregular asymmetry nose malformation, and 9 patients were troubled from depression in the juncture of nasal osseous pyramid and cartilage pyramid after a nasal septum operation. [ Result] All cases were followed up from 6 months to 46 months. Forty -six cases of them obtained cosmetic effect, with 90.20% (46/51) as satisfaction rate. [ Conclusion] Autogenous septal cartilage and allogenic costal cartilage are safe and effective grafts for the reconstructive nasal surgery, with the advantages of good histocompatibility. It is easy to get material, with fewer complications and better long - term results.%[目的]探讨自体鼻中隔软骨和同种异体肋软骨移植在鼻整形手术中的应用效果.[方法]回顾性分析2006年1月~2010年12月采用自体鼻中隔软骨和同种异体肋软骨作为充填物矫正鼻背凹槽畸形5l例患者的临床资料及手术疗效.其中,鞍鼻12例,骨鼻锥不对称3例,不规则性歪鼻27例,鼻中隔术后骨鼻锥与软骨鼻锥交界处凹陷9例.采用鼻中隔软骨片或压碎的网状软骨末充填移植43例;同种异体肋软骨充填移植8例.[结果]本组5l例术后随访6~46个月,外形满意46例,满意率90.20%(46/51).[结论]自体鼻中隔软骨和同种异体肋软骨因其具有良好的组织相容性、取材方便、并发症少、远期效果较好等优点,是鼻重建手术较好的移植材料.

  14. Bone mineralization pathways during the rapid growth of embryonic chicken long bones.

    Science.gov (United States)

    Kerschnitzki, Michael; Akiva, Anat; Ben Shoham, Adi; Asscher, Yotam; Wagermaier, Wolfgang; Fratzl, Peter; Addadi, Lia; Weiner, Steve

    2016-07-01

    The uptake and transport of ions from the environment to the site of bone formation is only partially understood and, for the most part, based on disparate observations in different animals. Here we study different aspects of the biomineralization pathways in one system, the rapidly forming long bones of the chicken embryo. We mainly used cryo-fixation and cryo-electron imaging to preserve the often unstable mineral phases in the tissues. We show the presence of surprisingly large amounts of mineral particles located inside membrane-delineated vesicles in the bone forming tissue between the blood vessels and the forming bone surface. Some of these particles are also located inside mitochondrial networks. The surfaces of the forming bones in the extracellular space contain abundant aggregates of amorphous calcium phosphate particles, but these are not enveloped by vesicle membranes. In the bone resorbing region, osteoclasts also contain many particles in both mitochondrial networks and within vesicles. Some of these particles are present also between cells. These observations, together with the previously reported observation that CaP mineral particles inside membranes are present in blood vessels, leads us to the conclusion that important components of the bone mineralization pathways in rapidly forming chicken bone are dense phase mineral particles bound within membranes. It remains to be determined whether these mineral particles are transported to the site of bone formation in the solid state, fluid state or dissolve and re-precipitate. PMID:27108185

  15. Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan); M.J.N. Niggebrugge (Marnix); J.A.N. Verhaar (Jan)

    2009-01-01

    textabstractThe aim of the study was to investigate whether use of short bone blocks is safe in anterior cruciate ligament (ACL) reconstruction. Our hypothesis was that the smaller 10-mm-length bone blocks will fail at lower loads than 20-mm-bone blocks. Ten paired human cadaver knees were randomly

  16. Human maxillary sinus floor elevation as a model for bone regeneration enabling the application of one-step surgical procedures

    NARCIS (Netherlands)

    E. Farre-Guasch; H.J. Prins; J.R. Overman; C.M. ten Bruggenkate; E.A.J.M. Schulten; M.N. Helder; J. Klein-Nulend

    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

  17. 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

  18. Bone marrow aspiration

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003658.htm Bone marrow aspiration To use the sharing features on this page, please enable JavaScript. Bone marrow is the soft tissue inside bones that helps ...

  19. Bone marrow biopsy

    Science.gov (United States)

    Biopsy - bone marrow ... A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may be taken from the pelvic or breast bone. Sometimes, other areas are used. Marrow is removed ...

  20. 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

  1. 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

  2. Effect of allograft compound vertebra on vertebral reconstruction in rabbits

    Institute of Scientific and Technical Information of China (English)

    ZHOU Pang-hu; LIU Shi-qing; MING Jiang-hua

    2007-01-01

    Objective: To study the effect of allograft compound vertebra on vertebral reconstruction in rabbits so as to provide biomechanical direction for manufacturing and selecting vertebral reconstruction materials.Methods: Twenty-five healthy New Zealand white rabbits were divided randomly into three groups: normal group ( Group A, n = 5), iliac bone graft group ( Group B,n = 10) and allograft compound vertebra group ( Group C,n = 10). After C4 was resected, iliac bone implantation and allograft bone cage transplantation were fulfilled in Group B and Group C, respectively. Every 5 rabbits from Group B and Group C were selected to test the biomechanical strength and biological activity one and two months postoperatively.Results: No significant statistical difference was found between Group A and Group C one and two months postoperatively (P > 0.05). The biomechanical strength of Group B was much weaker than that of Group A and Group C one month postoperatively ( P < 0.05 ), but at two months postoperatively, no statistical difference was found among the three groups. The biological activity and vertebral moulding ability of Group C were better than those of Group B at one and two months postoperatively.Conclusions: Compound vertebra, which is made up of allograft cortical bone cage and autogenous cancellous bone, shows instantaneous and permanent biomechanical stability and biological activity, therefore, it is an ideal material for vertebral reconstruction.

  3. Anorexia Nervosa and Bone

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure and reduced bone strength, all of which contribute to increased fracture risk., Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising addition concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, hormonal alterations secondary to nutritional factors...

  4. Predictors of bone loss in revision total knee arthroplasty.

    Science.gov (United States)

    Bloomfield, Michael R; Klika, Alison K; Lee, Ho H; Joyce, David M; Mehta, Priyesh; Barsoum, Wael K

    2010-03-01

    Revision total knee arthroplasty (RTKA) requires preoperative planning to enable the reconstruction of bony deficiencies. The objective of this project was to identify predictors of bone loss management at RTKA based on the preoperative failure mode and patient demographics known preoperatively. We retrospectively reviewed 245 consecutive RTKA procedures in which the same revision knee system was utilized. Patient demographic and treatment data were recorded, and locations of bone loss were identified based on the reconstructive management. We identified significant predictors for use of femoral augments at all four positions. Several predictors significantly predisposed to use of a thick (>19 mm) polyethylene; however, no predictors of tibial augments were significant. Although the reconstruction of bone loss is primarily based on the intraoperative assessment, these findings may provide additional information to help the surgeon prepare for difficult revision procedures. PMID:20812582

  5. [Regulation of bone homeostasis by glucose].

    Science.gov (United States)

    Fukasawa, Kazuya; Hinoi, Eiichi

    2016-08-01

    Synthesis of type Ⅰ collagen, a major component of the bone matrix, precedes the expression of Runt-related transcription factor 2(Runx2), a master regulator in osteoblast differentiation. Thus, a direct link between osteoblast differentiation and bone formation is seemingly absent, and how these are maintained in a coordinated matter remains unclear. It was recently demonstrated that osteoblasts depend on glucose, which glucose transporter type 1(GLUT1)takes up as an energy source, and it was found that glucose uptake promotes osteoblast differentiation and bone formation via AMP-activated protein kinase. It was also shown that Runx2 upregulates GLUT1 expression, and this Runx2-GLUT1 feedforward regulation integrates and coordinates osteoblast differentiation and bone formation throughout life. These previous findings revealed that the energy metabolism balance in osteoblasts integrates the differentiation and function of osteoblasts, and re-emphasized the importance of crosstalk between bone and sugar metabolism. PMID:27461500

  6. 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 .

  7. Quantification of osteolytic bone lesions in a preclinical rat trial

    Science.gov (United States)

    Fränzle, Andrea; Bretschi, Maren; Bäuerle, Tobias; Giske, Kristina; Hillengass, Jens; Bendl, Rolf

    2013-10-01

    In breast cancer, most of the patients who died, have developed bone metastasis as disease progression. Bone metastases in case of breast cancer are mainly bone destructive (osteolytic). To understand pathogenesis and to analyse response to different treatments, animal models, in our case rats, are examined. For assessment of treatment response to bone remodelling therapies exact segmentations of osteolytic lesions are needed. Manual segmentations are not only time-consuming but lack in reproducibility. Computerized segmentation tools are essential. In this paper we present an approach for the computerized quantification of osteolytic lesion volumes using a comparison to a healthy reference model. The presented qualitative and quantitative evaluation of the reconstructed bone volumes show, that the automatically segmented lesion volumes complete missing bone in a reasonable way.

  8. Bone marrow transplant - discharge

    Science.gov (United States)

    Transplant - bone marrow - discharge; Stem cell transplant - discharge; Hematopoietic stem cell transplant - discharge; Reduced intensity; Non-myeloablative transplant - discharge; Mini transplant - discharge; Allogenic bone marrow transplant - discharge; ...

  9. 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.)

  10. Layer-by-layer paper-stacking nanofibrous membranes to deliver adipose-derived stem cells for bone regeneration.

    Science.gov (United States)

    Wan, Wenbing; Zhang, Shiwen; Ge, Liangpeng; Li, Qingtao; Fang, Xingxing; Yuan, Quan; Zhong, Wen; Ouyang, Jun; Xing, Malcolm

    2015-01-01

    Bone tissue engineering through seeding of stem cells in three-dimensional scaffolds has greatly improved bone regeneration technology, which historically has been a constant challenge. In this study, we researched the use of adipose-derived stem cell (ADSC)-laden layer-by-layer paper-stacking polycaprolactone/gelatin electrospinning nanofibrous membranes for bone regeneration. Using this novel paper-stacking method makes oxygen distribution, nutrition, and waste transportation work more efficiently. ADSCs can also secrete multiple growth factors required for osteogenesis. After the characterization of ADSC surface markers CD29, CD90, and CD49d using flow cytometry, we seeded ADSCs on the membranes and found cells differentiated, with significant expression of the osteogenic-related proteins osteopontin, osteocalcin, and osteoprotegerin. During 4 weeks in vitro, the ADSCs cultured on the paper-stacking membranes in the osteogenic medium exhibited the highest osteogenic-related gene expressions. In vivo, the paper-stacking scaffolds were implanted into the rat calvarial defects (5 mm diameter, one defect per parietal bone) for 12 weeks. Investigating with microcomputer tomography, the ADSC-laden paper-stacking membranes showed the most significant bone reconstruction, and from a morphological perspective, this group occupied 90% of the surface area of the defect, produced the highest bone regeneration volume, and showed the highest bone mineral density of 823.06 mg/cm(3). From hematoxylin and eosin and Masson staining, the new bone tissue was most evident in the ADSC-laden scaffold group. Using quantitative polymerase chain reaction analysis from collected tissues, we found that the ADSC-laden paper-stacking membrane group presented the highest osteogenic-related gene expressions of osteocalcin, osteopontin, osteoprotegerin, bone sialoprotein, runt-related transcription factor 2, and osterix (two to three times higher than the control group, and 1.5 times higher

  11. 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...

  12. Characterization and simulation of fate and transport of selected volatile organic compounds in the vicinities of the Hadnot Point Industrial Area and landfill: Chapter A Supplement 6 in Analyses and historical reconstruction of groundwater flow, contaminant fate and transport, and distribution of drinking water within the service areas of the Hadnot Point and Holcomb Boulevard Water Treatment Plants and vicinities, U.S. Marine Corps Base Camp Lejeune, North Carolina

    Science.gov (United States)

    Jones, L. Elliott; Suárez-Soto, René J.; Anderson, Barbara A.; Maslia, Morris L.

    2013-01-01

    This supplement of Chapter A (Supplement 6) describes the reconstruction (i.e. simulation) of historical concentrations of tetrachloroethylene (PCE), trichloroethylene (TCE), and benzene3 in production wells supplying water to the Hadnot Base (USMCB) Camp Lejeune, North Carolina (Figure S6.1). A fate and transport model (i.e., MT3DMS [Zheng and Wang 1999]) was used to simulate contaminant migration from source locations through the groundwater system and to estimate mean contaminant concentrations in water withdrawn from water-supply wells in the vicinity of the Hadnot Point Industrial Area (HPIA) and the Hadnot Point landfill (HPLF) area.4 The reconstructed contaminant concentrations were subsequently input into a flow-weighted, materials mass balance (mixing) model (Masters 1998) to estimate monthly mean concentrations of the contaminant in finished water 5 at the HPWTP (Maslia et al. 2013). The calibrated fate and transport models described herein were based on and used groundwater velocities derived from groundwater-flow models that are described in Suárez-Soto et al. (2013). Information data pertinent to historical operations of water-supply wells are described in Sautner et al. (2013) and Telci et al. (2013).

  13. 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.

  14. Re-construction

    OpenAIRE

    Bernadette Marie Devilat

    2013-01-01

    Re-construct: to build again. The necessary reconstruction process after an earthquake can be seen as an opportunity to improve previous conditions. All damaged buildings undergo a renovation process in which every piece is carefully returned to its original place. The photograph shows roof reconstruction work in San Pedro de Alcántara, a heritage area in the central valley of Chile, which was particularly affected by the 2010 earthquake. 

  15. Temperature reconstruction analysis

    CERN Document Server

    Scafetta, N; Grigolini, P; Roberts, J; Scafetta, Nicola; Imholt, Tim; Grigolini, Paolo; Roberts, Jim

    2002-01-01

    This paper presents a wavelet multiresolution analysis of a time series dataset to study the correlation between the real temperature data and three temperature model reconstructions at different scales. We show that the Mann et.al. model reconstructs the temperature better at all temporal resolutions. We show and discuss the wavelet multiresolution analysis of the Mann's temperature reconstruction for the period from 1400 to 2000 A.D.E.

  16. Flexor pulley reconstruction.

    Science.gov (United States)

    Dy, Christopher J; Daluiski, Aaron

    2013-05-01

    Flexor pulley reconstruction is a challenging surgery. Injuries often occur after traumatic lacerations or forceful extension applied to an acutely flexed finger. Surgical treatment is reserved for patients with multiple closed pulley ruptures, persistent pain, or dysfunction after attempted nonoperative management of a single pulley rupture, or during concurrent or staged flexor tendon repair or reconstruction. If the pulley cannot be repaired primarily, pulley reconstruction can be performed using graft woven into remnant pulley rim or looping graft around the phalanx. Regardless of the reconstructive technique, the surgeon should emulate the length, tension, and glide of the native pulley. PMID:23660059

  17. 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

  18. Bioengineered periosteal progenitor cell sheets to enhance tendon-bone healing in a bone tunnel

    Directory of Open Access Journals (Sweden)

    Chih-Hsiang Chang

    2012-12-01

    Full Text Available Background: Tendon-bone tunnel healing is crucial for long term success in anterior cruciate liga­ment (ACL reconstruction. The periosteum contains osteochondral progenitor cells that can differenti­ate into osteoblasts and chondroblasts during tendon-bone healing. We developed a scaf­fold-free method using polymerized fibrin-coated dishes to make functional periosteal progenitor cell (PPC sheets. Bioengineered PPC sheets for enhancing tendon-bone healing were evaluated in an extra-articular bone tunnel model in rabbit. Methods: PPC derived from rabbit tibia periosteum, cultivated on polymerized fi­brin-coated dishes and harvested as PPC sheet. A confocal microscopy assay was used to evaluate the morphology of PPC sheets. PPC sheets as a periosteum to wrap around hamstring tendon grafts were pulled into a 3-mm diameter bone tunnel of tibia, and compared with a tendon graft without PPC sheets treatment. Rabbits were sacrificed at 4 and 8 weeks postoperatively for biochemical as­say and histological assay to demonstrate the enhancement of PPC sheets in tendon-bone healing. Results: PPC spread deposit on fibrin on the dish surface with continuous monolayer PPC was ob­served. Histological staining revealed that PPC sheets enhance collagen and glycosaminoglycans deposi­tion with fibrocartilage formation in the tendon-bone junction at 4 weeks. Collagen fiber with fibrocartilage formation at tendon-bone junction was also found at 8 weeks. Matured fibrocartilage and dense collagen fiber were formed at the tendon-bone interface at 8 weeks by Masson trichrome and Safranin-O staining Conclusions: Periosteal progenitor cell monolayer maintains the differentiated capacity and osteochon­dral potential in order to promote fibrocartilage formation in tendon-bone junction. Bioengi­neered PPC sheets can offer a new feasible therapeutic strategy of a novel approach to en­hance tendon-bone junction healing.

  19. 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 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.

  20. 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

  1. Biology and augmentation of tendon-bone insertion repair

    Directory of Open Access Journals (Sweden)

    Lui PPY

    2010-08-01

    Full Text Available Abstract Surgical reattachment of tendon and bone such as in rotator cuff repair, patellar-patella tendon repair and anterior cruciate ligament (ACL reconstruction often fails due to the failure of regeneration of the specialized tissue ("enthesis" which connects tendon to bone. Tendon-to-bone healing taking place between inhomogenous tissues is a slow process compared to healing within homogenous tissue, such as tendon to tendon or bone to bone healing. Therefore special attention must be paid to augment tendon to bone insertion (TBI healing. Apart from surgical fixation, biological and biophysical interventions have been studied aiming at regeneration of TBI healing complex, especially the regeneration of interpositioned fibrocartilage and new bone at the healing junction. This paper described the biology and the factors influencing TBI healing using patella-patellar tendon (PPT healing and tendon graft to bone tunnel healing in ACL reconstruction as examples. Recent development in the improvement of TBI healing and directions for future studies were also reviewed and discussed.

  2. Resection followed by vascularized bone autograft in patients with possible recurrence of malignant bone tumors after conservative treatment

    International Nuclear Information System (INIS)

    In conservative treatment of malignant bone tumors, assessment of the local condition is difficult. The radiological changes seen in the irradiated tumor and the frequent occurrence of pathological fractures at this site may give rise to the fear that the tumor has relapsed. Resection of the whole of the involved bone is the best way to assure adequate local control but the extent of the bone defect and the bad local conditions secondary to irradiation make reconstruction hazardous. In two patients (one with Ewing's sarcoma of the femur and one with osteogenic sarcoma of the humerus) the authors used a free, vascularized fibular graft for the reconstruction having obtained consolidation of the limb after resection of the irradiated tumor, with preservation of its function. The encouraging results obtained have suggested a conservative attitude as primary treatment of specific malignant bone tumors

  3. 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.

  4. Multiple Delayed Scalp Reconstruction for Complicated Cranial Defects.

    Science.gov (United States)

    Sakamoto, Yoshiaki; Arnaud, Eric

    2016-08-01

    In cases of skull trauma, emergency surgery for cranial decompression typically involves the shortest approach, with the incision lying directly on or immediately near the bony defect. Subsequent reconstructive plastic surgery for the skull is difficult in such cases because incisions taken on the previous scar overlying the bony defect are prone to dehiscence and infection. Herein, we describe a technique for creating a well-vascularized delayed skin flap via multistaged operation before the actual skull reconstruction. Four patients (age range, 10-25 y) were prepared for skull reconstruction using this technique. Flap elevation was performed in 3 stages, with adequate time intervals (4 wk between each stage) to allow for adequate delay. Dissection under the galea aponeurotica was performed only after initial flap elevation allowing for adequate vascularization. Skull reconstruction was then performed using custom-made implants. The patients were followed up for 6 to 12 months. No complications, including infections, exposure of the artificial bone, or flap necrosis, were observed. All the patients were satisfied with the cosmetic results. Despite the multiple stages required, we consider that our technique of using a delayed, well-vascularized bipedicled skin flap can be successfully used in the skull reconstruction of patients in whom the initial scar lies close to the bone defect. We recommend scalp incision be shifted outside of the foreseen bony flap to limit infectious risks during primary or subsequent cranial reconstruction. PMID:27622104

  5. A neural network technique for remeshing of bone microstructure.

    Science.gov (United States)

    Fischer, Anath; Holdstein, Yaron

    2012-01-01

    Today, there is major interest within the biomedical community in developing accurate noninvasive means for the evaluation of bone microstructure and bone quality. Recent improvements in 3D imaging technology, among them development of micro-CT and micro-MRI scanners, allow in-vivo 3D high-resolution scanning and reconstruction of large specimens or even whole bone models. Thus, the tendency today is to evaluate bone features using 3D assessment techniques rather than traditional 2D methods. For this purpose, high-quality meshing methods are required. However, the 3D meshes produced from current commercial systems usually are of low quality with respect to analysis and rapid prototyping. 3D model reconstruction of bone is difficult due to the complexity of bone microstructure. The small bone features lead to a great deal of neighborhood ambiguity near each vertex. The relatively new neural network method for mesh reconstruction has the potential to create or remesh 3D models accurately and quickly. A neural network (NN), which resembles an artificial intelligence (AI) algorithm, is a set of interconnected neurons, where each neuron is capable of making an autonomous arithmetic calculation. Moreover, each neuron is affected by its surrounding neurons through the structure of the network. This paper proposes an extension of the growing neural gas (GNN) neural network technique for remeshing a triangular manifold mesh that represents bone microstructure. This method has the advantage of reconstructing the surface of a genus-n freeform object without a priori knowledge regarding the original object, its topology, or its shape. PMID:22692609

  6. A comparative MRI analysis of tibial tunnel after anterior cruciate ligament reconstruction with bone-patellar-bone from autograft and allograft%自体与同种异体骨-髌腱-骨重建前交叉韧带术后胫骨骨隧道演变过程的MRI对比研究

    Institute of Scientific and Technical Information of China (English)

    向芳友; 杨柳; 郭林; 陈光兴; 陈伟; 文亚名; 唐康来

    2005-01-01

    目的利用MRI比较自体与同种异体骨-髌腱-骨(bone-patellar tendon-bone,B-PT-B)重建前交叉韧带(anterior cruciate ligament,ACL)术后胫骨骨隧道的变化过程.方法将50例B-PT-B重建ACL患者,分成A、B两组,A组为自体组20例,B组为同种异体组30例.分别于术后1、6周、3~4、5~6、7~8、9~10、12~13、15~16、18~19、21~22个月进行磁共振(magnetic resonance image,MRI)检查,采用胫骨骨隧道斜轴状位扫描技术,扫描序列包括:T1WI、T2WI、GE-T1WI、GE-STIR.动态观察骨隧道内的MRI信号变化,并比较术后6周、3~4、5~6个月骨隧道扩大情况.结果术后6周骨隧道扩大增幅最为显著(P<0.05).术后3个时间段上比较两组骨隧道扩大程度均无显著性差异(P>0.05).MRI动态观察发现,A组术后5~8个月,移植物与骨隧道之间已发生骨性愈合;而B组将延迟到术后7~13个月.结论MRI是准确评价骨隧道的一种无创手段;同种异体B-PT-B在胫骨骨隧道内的愈合相对延迟;自体组与同种异体组术后胫骨骨隧道扩大的程度基本相当.

  7. Bone Adaptation and Regeneration - New Developments

    Science.gov (United States)

    Klein-Nulend, Jenneke; Bacabac, Rommel Gaud

    Bone is a dynamic tissue that is constantly renewed and adapts to its local loading environment. Mechanical loading results in adaptive changes in bone size and shape that strengthen bone structure. The mechanisms for adaptation involve a multistep process called mechanotransduction, which is the ability of resident bone cells to perceive and translate mechanical energy into a cascade of structural and biochemical changes within the cells. The transduction of a mechanical signal to a biochemical response involves pathways within the cell membrane and cytoskeleton of the osteocytes, the professional mechansensor cells of bone. During the last decade the role of mechanosensitive osteocytes in bone metabolism and turnover, and the lacuno-canalicular porosity as the structure that mediates mechanosensing, is likely to reveal a new paradigm for understanding the bone formation response to mechanical loading, and the bone resorption response to disuse. Strain-derived fluid flow of interstitial fluid through the lacuno-canalicular porosity seems to mechanically activate the osteocytes, as well as ensures transport of cell signaling molecules, nutrients and waste products. Cell-cell signaling from the osteocyte sensor cells to the effector cells (osteoblasts or osteoclasts), and the effector cell response - either bone formation or resorption, allow an explanation of local bone gain and loss as well as remodeling in response to fatigue damage as processes supervised by mechanosensitive osteocytes. The osteogenic activity of cultured bone cells has been quantitatively correlated with varying stress stimulations highlighting the importance of the rate of loading. Theoretically a possible mechanism for the stress response by osteocytes is due to strain amplification at the pericellular matrix. Single cell studies on molecular responses of osteocytes provide insight on local architectural alignment in bone during remodeling. Alignment seems to occur as a result of the

  8. Bone grafting: An overview

    Directory of Open Access Journals (Sweden)

    D. O. Joshi

    2010-08-01

    Full Text Available Bone grafting is the process by which bone is transferred from a source (donor to site (recipient. Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of

  9. Autogenous tendon double bone-tunnel reconstruction technique to repair the posterolateral rotating instability of the elbow%自体肌腱双骨隧道重建技术修复肘关节后外侧旋转不稳定

    Institute of Scientific and Technical Information of China (English)

    刘大海; 李开南; 母建松; 兰海

    2016-01-01

    Background The concept of posterolateral rotatory instability (PLRI)of the elbow was proposed in 1991 by O′Driscoll for the first time.The pathogenic mechanism of PLRI is injury to the radial collateral ligament complex at the elbow,among which the lateral ulnar collateral ligament (LUCL) plays a major role. However, because most physicians know little about the elbow dysfunction caused by such ligament inj ury,missed or delayed diagnosis often prevents timely and effective treatment,leading to seriously impact on the quality of life of patients.Surgical treatment is often very effective,but surgical approaches vary a lot.Rhyou et al established a horizontal bone tunnel cross the humerus for passing through the tendon,but this approach doesn′t allow attachment of the upper end of this ligament on the lateral condyle of the humerus. Sanchez-Sotelo et al. established bone tunnel on ulna and humerus perpendicular to the ligament,and passed longer tendon through the tunnel at an"8"shape,which was immobilized by suture knot.This procedure requires that the tendon have to be a long and thin one while problems such as tendon breakage and suture slippage often happen.The way Dehlinger et al.established the bone tunnel was similar to the present study,i.e.,after passing the bone tunnel;the tendon was only fixed to the bone marrow with suture. This method also has the disadvantage of poor stability and delayed functional exercise.This study used autologous tendon and established humerus and ulna double bone tunnel for ligament reconstruction in 16 patients and the treatment effect is reported below.Methods From January 2008 to December 2013,orthopedics division of our hospital admitted and diagnosed 16 cases of elbow LUCL tear with PLRI patients,of which 11 males and 5 females,aged 19-43 years old,average age of 28.8 years old,7 cases of fresh injuries and 9 cases of old injuries,4 cases of simple ulnar coronoid process fracture,3 cases of elbow dislocation,5 cases of

  10. Bone scan in rheumatology

    International Nuclear Information System (INIS)

    In this chapter a revision is made concerning different uses of bone scan in rheumatic diseases. These include reflex sympathetic dystrophy, osteomyelitis, spondyloarthropaties, metabolic bone diseases, avascular bone necrosis and bone injuries due to sports. There is as well some comments concerning pediatric pathology and orthopedics. (authors). 19 refs., 9 figs

  11. Bone Marrow Transplantation

    Science.gov (United States)

    Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains immature cells, called stem cells. The ... platelets, which help the blood to clot. A bone marrow transplant is a procedure that replaces a ...

  12. Bone grafts in dentistry

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar

    2013-01-01

    Full Text Available Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation.

  13. In vivo bioreactors for mandibular reconstruction.

    Science.gov (United States)

    Tatara, A M; Wong, M E; Mikos, A G

    2014-12-01

    Large mandibular defects are difficult to reconstruct with good functional and aesthetic outcomes because of the complex geometry of craniofacial bone. While the current gold standard is free tissue flap transfer, this treatment is limited in fidelity by the shape of the harvested tissue and can result in significant donor site morbidity. To address these problems, in vivo bioreactors have been explored as an approach to generate autologous prefabricated tissue flaps. These bioreactors are implanted in an ectopic site in the body, where ossified tissue grows into the bioreactor in predefined geometries and local vessels are recruited to vascularize the developing construct. The prefabricated flap can then be harvested with vessels and transferred to a mandibular defect for optimal reconstruction. The objective of this review article is to introduce the concept of the in vivo bioreactor, describe important preclinical models in the field, summarize the human cases that have been reported through this strategy, and offer future directions for this exciting approach.

  14. Peri-Implant Tissue Findings in Bone Grafted Oral Cancer Patients Compared to non Bone Grafted Patients without Oral Cancer

    OpenAIRE

    Jan Wolff; Hideki Agata; George K. Sándor; Suvi Haimi

    2011-01-01

    ABSTRACT Objectives The aim of this study was to compare microbiological, histological, and mechanical findings from tissues around osseointergrated dental implants in patients who had undergone tumour resection and subsequent bone grafting with non bone grafted patients without a history of oral cancer and to develop an effective tool for the monitoring of the peri-implant tissues. A third aim was to assess and compare the masticatory function of the two patient groups after reconstruction w...

  15. 一期前路病灶清除植骨重建钛板内固定术治疗腰骶段脊柱结核%Clinical efficacy of one-stage anterior debridement, bone graft and reconstruction titanium plate internal fixation in treating lumbosacral spinal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    夏曦; 唐绍锋; 曹志武; 王辉; 姚女兆; 王文军

    2016-01-01

    Objective To evaluate clinical outcomes following one-stage anterior radical debridement, interbody fusion, and reconstruction titanium plate internal fixation for the treatment of lumbosacral spinal tuberculosis.Methods The clinical data of 30 patients(17 males and 13 females,aged range from 27 to 65 years, mean 37. 5 years) with tuberculosis of the lumbosacral segments(including L5 -S1 ) who were treated with anterior radical debridement, autologous iliac bone graft,and internal fixation with reconstruction titanium plate at Department of Spinal Surgery of the First Affiliated Hospital of University of South China from August 2011 to August 2014 were retrospectively reviewed. All patients routinely received antitubercular drugs for 2 to 3 weeks before operation. Operation was performed when the general condition improved. All patients were systematically and routinely treated with antituberculous drug for 12-18 months after operation. The preoperative, 3 months after operation, last follow up erythrocyte sedimentation rate ( ESR) , C reactive protein( CRP) , visual analog scale ( VAS) , as well as Oswestry disability index ( ODI) were analyzed.Results Thirty patients were followed up for 12-36 months,mean 18 months.At last follow-up, no lower limb radiation pain and tuberculosis recurrence were found in all cases. The VAS scores were significantly decreased from 7. 8 ± 1. 7 at preoperation to 1. 7 ± 0. 6 at 3 months after operation, and 1.5±0.5 at last follow-up(all P values0.05).Conclusions Based on systemic and routine antituberculosis treatment,the surgical treatment of lumbosacral spinal tuberculosis with one-stage anterior debridement, bone graft and reconstruction titanium plate internal fixation have a direct and safe access to lesions of lumbosacral tuberculosis, and eradicate tuberculosis kitchen, reconstruct spinal stability and achieve good clinical outcome.%目的:探讨一期前路结核病灶清除植骨重建钛板内固定治疗腰骶段脊

  16. Image Reconstruction. Chapter 13

    International Nuclear Information System (INIS)

    This chapter discusses how 2‑D or 3‑D images of tracer distribution can be reconstructed from a series of so-called projection images acquired with a gamma camera or a positron emission tomography (PET) system [13.1]. This is often called an ‘inverse problem’. The reconstruction is the inverse of the acquisition. The reconstruction is called an inverse problem because making software to compute the true tracer distribution from the acquired data turns out to be more difficult than the ‘forward’ direction, i.e. making software to simulate the acquisition. There are basically two approaches to image reconstruction: analytical reconstruction and iterative reconstruction. The analytical approach is based on mathematical inversion, yielding efficient, non-iterative reconstruction algorithms. In the iterative approach, the reconstruction problem is reduced to computing a finite number of image values from a finite number of measurements. That simplification enables the use of iterative instead of mathematical inversion. Iterative inversion tends to require more computer power, but it can cope with more complex (and hopefully more accurate) models of the acquisition process

  17. Bone Health and Osteoporosis.

    Science.gov (United States)

    Lupsa, Beatrice C; Insogna, Karl

    2015-09-01

    Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue leading to decreased bone strength and an increased risk of low-energy fractures. Central dual-energy X-ray absorptiometry measurements are the gold standard for determining bone mineral density. Bone loss is an inevitable consequence of the decrease in estrogen levels during and following menopause, but additional risk factors for bone loss can also contribute to osteoporosis in older women. A well-balanced diet, exercise, and smoking cessation are key to maintaining bone health as women age. Pharmacologic agents should be recommended in patients at high risk for fracture.

  18. Clinical evaluation of bone- patellar tendon- bone grafts for anterior cruciate ligament injury

    International Nuclear Information System (INIS)

    One thousand and thirty-eight cases of Anterior Cruciate Ligament (ACL) rupture were treated between January 2002 and November 2010. Eight hundred sixty-six cases (83.9%) were observed for at least six months. All cases were reconstructed with a bone to tendon to bone (BTB) graft from the patella. Much effort was made to return the patient to a competitive sports activity level within one year. The age at suffering from the initial injury ranged from 9 to 74 years old with a mean of 24.7 years old. There were 493 female (50.7%) and 427 male (49.3%) cases. The injured side was right in 408 cases and left in 458 cases. The mean postoperative observation period was 449.2 days. The number of patients who felt 80% or more certain that they could return to competitive sports activities was 538 (61.9%). From the MRI findings, continuity of the reconstructed graft was observed in 793 cases (98.5%). Arthroscopy after reconstruction was performed in 775 cases (89.5%). The reconstructed ACL was observed to be covered with an adequate synovium in 629 cases (81.2%). The medial meniscus and lateral meniscus showed no changes in 657 cases (84.8%) and 666 cases (85.9%) respectively. Reconstructions performed less than two weeks after injury showed no significant differences in terms of Range Of Motion (ROM), arthroscopic findings, or the number of patients who could return to competitive sports activities. Statistically significantly more patients who underwent their reconstruction at an age over forty experienced a loss motion of five degree in extension or ten degree in flexion and resumed a lower level of sports activities. Patients who underwent the reconstruction could return to exercises for muscle strengthening and ROMs within 2 weeks. Patients over forty years old who underwent their reconstruction could prevent their menisci from fraying, tearing, or undergoing osteoarthritic changes. (author)

  19. BONE IN OSTEOPETROSIS

    Directory of Open Access Journals (Sweden)

    Ramkumar

    2014-04-01

    Full Text Available Osteopetrosis, a generalized developmental bone disease due to genetic disturbances, characterized by failure of bone re sorption and continuous bone formation making the bone hard, dense and brittle. Bones of intramembranous ossification and enchondrial ossification are affected genetically and symmetrically. During the process of disease the excess bone formation obliterates the cranial foramina and presses the optic, auditory and facial nerves resulting in defective vision, impaired hearing and facial paralysis. The bone formation in osteopetrosis affects bone marrow function leading to severe anemia and deficient of blood cells. The bone devoid of blood supply due to compression of blood vessels by excess formation of bone are prone to osteomyelitic changes with suppuration and pathological fracture if exposed to infection. Though the condition is chronic progressive, it produces changes leading to fatal condition, it should be studied thoroughly by everyone and hence this article presents a classical case of osteopetrosis with detailed description and discussion for the benefit of readers

  20. Bone wax as a cause of a foreign body granuloma in a cranial defect: a case report.

    Science.gov (United States)

    Wolvius, E B; van der Wal, K G H

    2003-12-01

    Bone wax was used to stop bleeding of the diploic vessels after harvesting cranial bone for reconstruction of an orbital floor defect. After five months a fistula in the overlying skin of the donor site appeared and was eventually surgically explored. Remnants of bone wax and surrounding inflammatory tissue were removed and the fistula was excised. Histological examination revealed a foreign body granuloma. The use of bone wax and possible alternative local haemostatic agents and their complications are discussed.

  1. Bone grafting versus distraction osteogenesis in pre-implant surgery. Literature review

    Directory of Open Access Journals (Sweden)

    Fotios TZERMPOS

    2013-08-01

    Full Text Available Nowadays there is an increasing demand for implant-supported prosthetic rehabilitation of the edentulous ridges. However problems occur regarding adequate bone support for implants. Loss of alveolar bone may be gradual due to age resorption or due to previous local pathology. Alveolar bone augmentation may be achieved by using a variety of different techniques.The aim of the present paper is to compare two methods for bone augmentation: distraction osteogenesis and bone grafting. Advantages and disadvantages of each one are presented and discussed together with their ability to reconstruct the deficient edentulous ridges with ultimate purpose the placement of implants upported prostheses.

  2. Bone cysts: unicameral and aneurysmal bone cyst.

    Science.gov (United States)

    Mascard, E; Gomez-Brouchet, A; Lambot, K

    2015-02-01

    Simple and aneurysmal bone cysts are benign lytic bone lesions, usually encountered in children and adolescents. Simple bone cyst is a cystic, fluid-filled lesion, which may be unicameral (UBC) or partially separated. UBC can involve all bones, but usually the long bone metaphysis and otherwise primarily the proximal humerus and proximal femur. The classic aneurysmal bone cyst (ABC) is an expansive and hemorrhagic tumor, usually showing characteristic translocation. About 30% of ABCs are secondary, without translocation; they occur in reaction to another, usually benign, bone lesion. ABCs are metaphyseal, excentric, bulging, fluid-filled and multicameral, and may develop in all bones of the skeleton. On MRI, the fluid level is evocative. It is mandatory to distinguish ABC from UBC, as prognosis and treatment are different. UBCs resolve spontaneously between adolescence and adulthood; the main concern is the risk of pathologic fracture. Treatment in non-threatening forms consists in intracystic injection of methylprednisolone. When there is a risk of fracture, especially of the femoral neck, surgery with curettage, filling with bone substitute or graft and osteosynthesis may be required. ABCs are potentially more aggressive, with a risk of bone destruction. Diagnosis must systematically be confirmed by biopsy, identifying soft-tissue parts, as telangiectatic sarcoma can mimic ABC. Intra-lesional sclerotherapy with alcohol is an effective treatment. In spinal ABC and in aggressive lesions with a risk of fracture, surgical treatment should be preferred, possibly after preoperative embolization. The risk of malignant transformation is very low, except in case of radiation therapy.

  3. Surgical simulation and evaluation in anterior cruciate ligament reconstruction with image-free navigation

    Institute of Scientific and Technical Information of China (English)

    Wang Tianmiao; Hu Yan; Liu Wenyong; Sun Lei; Wang Junchen; Feng Hua; Hu Lei

    2009-01-01

    A surgical simulation and evaluation method in the anterior cruciate ligament (ACL) reconstruction with image-free navigation was presented. Firstly, video tracking module, bone surface reconstruction module and virtual simulation module of this system were discussed. Secondly, the coordinate relations of several surgery objects (including surgical instrument, anatomical, camera and screen) in the surgical environment, the tracking based on MicronTracker with two cameras and the bone surface real-time reconstruction based on the Delaunay algorithm were introduced in detail. Finally, experiments of anisometry measurement and virtual simulation on two plastics were carried out to verify the validity of the proposed method. The anisometry value of reconstructed ACL was 8.970039mm. The effectiveness of ACL reconstruction has been proved by preliminary evaluation trials.

  4. Reconstruction of tissue-engineered bone using adipose-derived stem cells and Bio-oss scaffold for the treatment of peri-implantitis%脂肪干细胞与Bio-oss支架构建组织工程骨治疗种植体周围骨缺损

    Institute of Scientific and Technical Information of China (English)

    姜全春; 赵秀兰

    2013-01-01

    BACKGROUND: Current treatments of peri-implantitis include surgery, laser therapy, ultrasonic scaling, local medication or their combination. However, there have been no ideal therapeutic effects achieved. OBJECTIVE: To investigate the feasibility of treating peri-implantitis using tissue-engineered bone reconstructed by bone morphogenetic protein-modified adipose-derived stem cells and Bio-oss scaffold. METHODS: A computer-based online retrieval of Pubmed database was performed to search papers published during January 1988 to December 2011 using the key words “adipose-derived stem cells, tissue engineering” in English. Simultaneously, related papers published during January 2005 to December 2011 in CNKI were retrieved using the key words “adipose-derived stem cells, tissue engineering” in Chinese. A total of 56 papers were retrieved. RESULTS AND CONCLUSION: According to the characteristics and advantages of regenerative tissues in tissue engineering, a three-dimensional environment was established using adipose-derived stem cells as ideal seed cells, bone morphogenetic protein 2 as an ideal cytokine and Bio-oss biomaterial. The multiporous structure of Bio-oss biomaterial facilitates the migration of adipose-derived stem cells. After compounded by adipose-derived stem cells, bone morphogenetic protein 2 promotes osteogenic differentiation of adipose-derived stem cells, leading to new bone formation by deposition of calcium salt and achieving the purpose of treating peri-implantitis.%  背景:目前治疗种植体周围炎的方法主要有手术治疗、激光治疗、超声洁治加局部用药单独或联合治疗等,但并未完全达到理想的治疗效果。目的:探讨由骨形态发生蛋白修饰的脂肪干细胞与 Bio-oss 支架构建组织工程骨治疗种植体周围炎性骨缺损的可行性。方法:应用计算机检索1988年1月至2011年12月Pubmed数据库相关文章,检索词为“adipose-derived stem cel s

  5. Is alveolar cleft reconstruction still controversial? (Review of literature

    Directory of Open Access Journals (Sweden)

    Sameh A. Seifeldin

    2016-01-01

    Full Text Available Cleft lip and palate (CL/P is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to provide a bony bridge at the cleft site that allows maxillary arch continuity, oronasal fistula repair, eruption of the permanent dentition into the newly formed bone, enhances nasal symmetry through providing alar base support, orthodontic movement and placement of osseointegrated implants when indicated. Other goals include improving speech, improvement of periodontal conditions, establishing better oral hygiene, and limiting growth disturbances. In order to rehabilitate oral function in CL/P patients alveolar bone grafting is necessary. Secondary bone grafting is the most widely accepted method for treating alveolar clefts. Autogenous bone graft is the primary source for reconstructing alveolar cleft defects and is currently the preferred grafting material.

  6. Relation between in vitro and in vivo osteogenic potential of cultured human bone marrow stromal cells

    NARCIS (Netherlands)

    Mendes, SC; Tibbe, JM; Veenhof, M; Both, S; Oner, FC; van Blitterswijk, CA; de Bruijn, Joost D.

    2004-01-01

    The use of cell therapies in bone reconstruction has been the subject of extensive research. It is known that human bone marrow stromal cell (HBMSC) cultures contain a population of progenitor cells capable of differentiation towards the osteogenic lineage. In the present study, the correlation betw

  7. Secondary bone grafting for alveolar cleft in children with cleft lip or cleft lip and palate

    NARCIS (Netherlands)

    J. Guo; C. Li; Q. Zhang; G. Wu; S.A. Deacon; J. Chen; H. Hu; S. Zou; Q. Ye

    2011-01-01

    BACKGROUND: Secondary alveolar bone grafting has been widely used to reconstruct alveolar cleft. However, there is still some controversy. OBJECTIVES: To compare the effectiveness and safety of different secondary bone grafting methods. SEARCH STRATEGY: The final electronic and handsearches were car

  8. Bone replacement following dental trauma prior to implant surgery - present status

    NARCIS (Netherlands)

    Hallman, Mats; Mordenfeld, Arne; Strandkvist, Tomas

    2009-01-01

    Dento-alveolar trauma often leads to a need for reconstruction of the alveolar crest before an implant can be placed. Although autogenous bone grafts is considered the 'gold standard', this may be associated with patient morbidity and graft resorption. Consequently, the use of bone substitutes has i

  9. Revision Anterior Cruciate Ligament Reconstruction in Military Personnel.

    Science.gov (United States)

    Balazs, George C; Grimm, Patrick D; Donohue, Michael A; Keblish, David J; Rue, John-Paul

    2016-08-01

    This study aims to report the clinical and functional outcomes of revision anterior cruciate ligament (ACL) reconstruction in a young, active duty military population. Patients undergoing revision ACL reconstruction were enrolled in an institutional clinical database and followed prospectively. The primary outcomes were patients' scores on a timed run, as compared with recorded scores before reinjury. Secondary outcomes included scores on the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the International Knee Documentation Committee subjective (IKDC subjective), the Short Form - 36 health survey (SF-36) version 2, the Single Assessment Numeric Evaluation (SANE), and the Tegner activity scale. A total of 13 patients were identified who met the inclusion criteria and had complete follow-up. The mean age at revision ACL reconstruction was 20.5 years (range, 19-22 years), and mean follow-up was 40.2 months (range, 13-66 months). All patients underwent a single stage revision ACL reconstruction with ipsilateral bone-patellar tendon-bone autograft, ipsilateral hamstring autograft, or bone-tendon-bone allograft. Mean physical readiness test (PRT) score at final follow-up was not statistically different than documented preinjury PRT score (77.9 vs. 85.5, p > 0.05), nor was the mean run time (7:12 vs. 6:43/mile, p > 0.05). Significant improvements exceeding published minimal clinically important differences were seen in SANE score, SF-36 physical component summary score, KOOS sports and recreation, KOOS quality of life, WOMAC pain score, and WOMAC function score. Patients undergoing revision ACL reconstruction at our facility show good recovery of baseline physical performance as measured by the semiannual PRT and timed run test, and significant improvements in patient-reported outcome scores. Level of Evidence Level IV, case series. PMID:26524090

  10. Reconstructing Step by Step

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    On May 22,10 days after the Wenchuan earthquake in Sichuan Province,the State Council formed the Post-earthquake Reconstruction Planning Group,deciding to work out a general recon- struction plan within a period of three months. Sichuan was the worst-hit area of China,so reconstruction work there will have a direct influence on how plans proceed in other areas.On July 18,Beijing Review reporter Feng Jianhua interviewed Wang Guangsi,Vice Director of the Sichuan Development and Reform Commission,about Sichuan’s reconstruction plan.

  11. Massive acetabular bone loss: Limits of trabecular metal cages

    Directory of Open Access Journals (Sweden)

    Villanueva-Martínez Manuel

    2011-01-01

    Full Text Available Massive acetabular bone loss (more than 50% of the acetabular area can result in insufficient native bone for stable fixation and long-term bone ingrowth of conventional porous cups. The development of trabecular metal cages with osteoconductive properties may allow a more biological and versatile approach that will help restore bone loss, thus reducing the frequency of implant failure in the short-to-medium term. We report a case of massive bone loss affecting the dome of the acetabulum and the ilium, which was treated with a trabecular metal cage and particulate allograft. Although the trabecular metal components had no intrinsic stability, they did enhance osseointegration and incorporation of a non-impacted particulate graft, thus preventing failure of the reconstruction. The minimum 50% contact area between the native bone and the cup required for osseointegration with the use of porous cups may not hold for new trabecular metal cups, thus reducing the need for antiprotrusio cages. The osteoconductive properties of trabecular metal enhanced allograft incorportation and iliac bone rebuilding without the need to fill the defect with multiple wedges nor protect the reconstruction with an antiprotrusio cage.

  12. Tendon gradient mineralization for tendon to bone interface integration.

    Science.gov (United States)

    Qu, Jin; Thoreson, Andrew R; Chen, Qingshan; An, Kai-Nan; Amadio, Peter C; Zhao, Chunfeng

    2013-11-01

    Tendon-to-bone integration is a great challenge for tendon or ligament reconstruction regardless of use of autograft or allograft tendons. We mineralized the tendon, thus transforming the tendon-to-bone into a "bone-to-bone" interface for healing. Sixty dog flexor digitorum profundus (FDP) tendons were divided randomly into five groups: (1) normal FDP tendon, (2) CaP (non-extraction and mineralization without fetuin), (3) CaPEXT (Extraction by Na2 HPO4 and mineralization without fetuin), (4) CaPFetuin (non-extraction and mineralization with fetuin), and (5) CaPEXTFetuin (extraction and mineralization with fetuin). The calcium and phosphate content significantly increased in tendons treated with combination of extraction and fetuin compared to the other treatments. Histology also revealed a dense mineral deposition throughout the tendon outer layers and penetrated into the tendon to a depth of 200 µm in a graded manner. Compressive moduli were significantly lower in the four mineralized groups compared with normal control group. No significant differences in maximum failure strength or stiffness were found in the suture pull-out test among all groups. Mineralization of tendon alters the interface from tendon to bone into mineralized tendon to bone, which may facilitate tendon-to-bone junction healing following tendon or ligament reconstruction.

  13. Fat Grafting to the Breast, a Simple Procedure for a Very Complex Reconstruction.

    Science.gov (United States)

    Claro, Francisco; Pereira, Fernando Linhares; Pinto-Neto, Aarão M

    2016-01-01

    Usually, complicated reconstructions demand complex procedures. However, we report an unpublished situation where lipofilling was the only effective procedure for breast reconstruction, once 4 previous procedures, including 2 microvascular free flaps, had failed. The reported case describes a woman without subcutaneous tissue in the left breast topography, with radiation sequelae resulting in a fibrotic, hyperchromic, unexpandable skin that was tethered to her costal bone and pleura. The 4 previous attempts of breast reconstruction resulted in unavailable nearby recipient vessels, and this situation appointed breast lipofilling as the most feasible procedure. This report shows the power of breast lipofilling, a simple procedure that can be used even for the more complex reconstructions.

  14. MDR1基因转染的骨髓单个核细胞对放疗后造血功能重建的研究%Investigation of post-radiotherapeutic hematopoietic reconstruction mediated by multidrug resistance gene 1 transfected bone marrow mononuclear cells

    Institute of Scientific and Technical Information of China (English)

    孔祥如; 王珊; 李圆; 张秀亚; 王江波

    2009-01-01

    目的 研究BALB/c小鼠放射治疗后经尾静脉回输携带多药耐药MDR1基因的骨髓单个核细胞(bone marrow mononuclear cells,BM-MNCs)对造血功能重建的影响.方法 BAB/c近交系小鼠32只,随机分为4组:正常对照组、空白对照组、阴性对照组和实验组.正常对照组不做任何处理,其他3组首先接受1.5Gy60Co-γ射线全身照射,空白对照组尾静脉回输等量生理盐水,阴性对照组经尾静脉回输未转染MDR1基因BM-MNCs,实验组回输已转染MDR1基因BM-MNCs.动态观察各组外周血变化.结果 同种异体回输后第七天,阴性对照组和实验组与空白对照组比较均表现为白细胞恢复提前.实验组7、10、14 d白细胞计数分别为(2.9±0.3)×109/L、(3.2±0.2)×109/L、(4.2±0.3)×109/L,阴性对照组为(2.7±0.2)×109/L、(2.8±0.2)×109/L、(3.5±0.3)×109/L,实验组与阴性对照组比较,白细胞数量增加,差异有统计学意义(t=2.21、3.53、4.73,P<0.05),14 d后差异无统计学意义(t=0.79,P>0.05).结论 同种异体携MDR1基因的骨髓单个核细胞移植,能在早期显著提高外周血白细胞数量,利于骨髓造血微环境恢复,加快辐射损伤后骨髓早期造血功能重建.%Objective To investigate the post-radiotherapeutic hematopoietic reconstruction mediated by multidrug resistance gene 1 (MDR1) transfected bone marrow mononuclear cells (BM-MNCs).Methods Thirty-two BALB/c mice were randomly divided into four groups (n=8/group):normal group,blank control group,negative control group and transfection group.Mice in the blank control group,negative group and transduced group accepted 1.5Gy60Co-γ radiotherapy.After radiotherapy,normal BM-MNCs were given to mice in the blank control group;normal saline was given to mice in the negative control group by tail vein injection:MDR1 tramfected BM-MNCs were given to mice in the transduced group by tail vein injection.The following peripherals blood changes in each group were observed and

  15. Application of MSCT multimodal 3D reconstruction in the assessment of temporal bone structures and cochlear ;implantation%MSCT 多模态三维重建观测颞骨结构及对人工耳蜗手术的指导意义

    Institute of Scientific and Technical Information of China (English)

    王一红; 李瑞玉; 陈彩龙; 王晓燕; 林美福; 周硕

    2015-01-01

    Objective To investigate the application and value of MSCT multimodal three-dimensional (3D)recon-struction in cochlear implantation.Methods ① The membranous structures with 3D imaging of cochlea,vestibular, semicircular canal and temporal bone transparent imaging were constructed with a double threshold reconstruction tech-nique,where the anatomical relationship between ossicles,inner ear and temporal bone were displayed.② The facial nerve reconstruction displayed the path of the facial nerve.The ultrastructure showed the facial nerve,facial nerve re-cess,posterior wall of the external auditory canal and the structure of chorda tympani nerve and neighboring structures.③ The distance between promontory plane vertical segment of the facial nerve and chorda tympani nerve was measured. Results Of the 83 patients recruited in this study,11 had inner ear malformation.Of them,2 had Mondini malforma-tion,2 had semicircular canal malformation,2 had common cavity malformation,1 had internal auditory canal stenosis, and 4 had enlarged vestibular aqueduct.The distance between normal structure of cape plane vertical segment of the fa-cial nerve and chorda tympani nerve was 0.27 ±0.057 cm at the left-side and 0.28 ±0.068 cm at the right-side.An in-tact structure of the implanted electrodes was clearly showed in 5 patients in the post-operative examination.Conclusion The 3D multimodal reconstruction technique is useful in providing ultrastructure imaging of the middle and inner ear, which is important for surgeons in pre-and post-operative evaluations of the success and potential risk factors for per-forming cochlear implantation.%目的:探讨采用 MSCT 影像三维多模态重建技术在人工耳蜗植入术术前评估、术后复查中的应用价值。方法①应用双阈值重建技术显示耳蜗、前庭、半规管的膜性立体结构及听小骨,颞骨透明成像,逐一融合显示听小骨、内耳与颞骨的关系;②面神经曲面重建显示

  16. [Materials for reconstruction of the middle ear].

    Science.gov (United States)

    Geyer, G

    1999-02-01

    To rehabilitate most cases of conductive hearing loss closure of ear drum perforations and rebuilding of the ossicular chain can be performed. Due to the great number of biocompatible bone substitute materials available it is occasionally difficult for the surgeon to choose the most favorable substitute. Autogenous structures (ossicles, cortical bone, cartilage) and allogenous tissues (ossicles, cortical bone, cartilage, dentin) are possible bone replacement materials. Xenogenic tissue is currently not used in middle ear surgery. Ionomer cement is a hybrid material for replacement of bone but does not fit direct classification of the various classes of alloplastic materials in current use: that is, metals (gold, steel wire, platinum, titanium), plastics (polyethylene, polytetrafluorethylene) and ceramics (ceramic oxide, carbon, calcium-phosphate ceramic, vitreous ceramic). For restoration of the sound conductive apparatus preference is given to autogenous ossicles because cortical bone is resorbed and cartilage weakens over time. Most surgeons do not use allogenous tissue, because of the possible transmission of such infectious disease as immunodeficiency syndrome or Creutzfeldt-Jakob disease. Only dentin deserves special attention as a possible bone substitute in the middle ear because its form can be preserved during sterilization. Based on the observations available to date, it becomes apparent that titanium implants hold greater promise than gold. Form-stable synthetic materials are not generally recommended due to foreign body reactions which have been confirmed by many investigators. Ceramic materials (e.g. ceramic oxide, carbon, calcium-phosphate ceramic, glass ceramic) are well tolerated in the middle ear and have also proved to be useful over time. Hybrid bone substitute ionomer cement is easily workable and well integrated, showing a good functional outcome. For many years good results in otosclerosis surgery have been achieved with a prosthesis made of

  17. Treatment of severe bone deficiency in acetabular revision surgery using a reinforcement device and bone grafting

    Institute of Scientific and Technical Information of China (English)

    ZHAI Ji-liang; LIN Jin; JIN Jin; QIAN Wen-wei; WENG Xi-sheng

    2011-01-01

    Background Severe acetabular bone deficiency is a major challenge in acetabular revision surgery. Most cases require reconstruction of the acetabulum with bone grafting and a reinforcement device. The purpose of this study was to evaluate the results of this procedure for severe acetabular bone deficiency in acetabular revision surgery.Methods This study involved 12 patients (2 males and 10 females) with severe acetabular bone defects who underwent implantation of a reinforcement device (ring or cage) and bone grafting between February 2003 and October 2008. Using the Paprosky classification, 2 cases were Paprosky ⅡC, 6 were ⅢA, and 4 were ⅢB. The mean age at the time of surgery was 63.0 years (range, 46-78 years). During revision surgery, a reinforcement ring was implanted in 6patients, and a cage in 6 patients. The clinical and radiographic results were evaluated retrospectively. The mean duration of follow-up was 37 months (range, 9-71 months).Results The average Harris Hip Score improved from 35.2 preoperatively to 82.9 at the time of the final follow-up visit.The results were excellent in 8 hips (66.7%), good in 2 (16.7%), and fair in 2 (16.7%). Osteolysis was found in 1 case, but did not worsen. Three patients had yellow wound effusion, with healing after administration of dressing changes,debridement, and antibiotics. Dislocation occurred in a 62-year-old woman. Closed reduction was performed, and dislocation did not recur. There was no evidence of intraoperative acetabular fracture, nerve injury, ectopic ossification,aseptic loosening, or infection.Conclusion Reconstruction with a reinforcement device and bone grafting is an effective approach to the treatment of acetabular bone deficiency in acetabular revision surgery, given proper indications and technique.

  18. PROXIMAL RADIUS RECONSTRUCTION BY METATARSAL OSTEOCHONDRAL AUTO GRAFT

    Directory of Open Access Journals (Sweden)

    Kammar

    2015-04-01

    Full Text Available 17 Year Old student, Pavan presents with swelling since 8 months. Swelling was diffuse over forearm. Tenderness was present. No local rise of temperature. Range of m ovement at elbow was restricted and painful terminally. No distal neurovascular deficits. X - ray reveale d it to be an a neurysmal bone cyst of proximal right radius. FNAC showed Aneurysmal bone cyst for which curettage and bone grafting was done. Post 6 months tumour recurred with a swelling around upper third of right fo rearm. FNAC and J - needle biopsy showed it to be a neurysmal bone cyst. MRI showed ABC of proximal radius without soft tissue involvement. Excision of proximal third of radius with reconstruction by 3 rd metatarsal and augmented with fib ular graft and stabili zed with dynamic c ompression plate and screws . Tumour specimen was sent for h istopathology a t 2 weeks p ost operatively patient had good range of movements. At present patient has full range of flexion , extension , supination & pronation . He is able to carry out his ADL. In the literature proximal radius