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Huang S, Wen J, Zhang Y, Bai X, Cui ZK. Choosing the right animal model for osteomyelitis research: Considerations and challenges. J Orthop Translat 2023; 43:47-65. [PMID: 38094261 PMCID: PMC10716383 DOI: 10.1016/j.jot.2023.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/27/2023] [Accepted: 10/09/2023] [Indexed: 03/22/2024] Open
Abstract
Osteomyelitis is a debilitating bone disorder characterized by an inflammatory process involving the bone marrow, bone cortex, periosteum, and surrounding soft tissue, which can ultimately result in bone destruction. The etiology of osteomyelitis can be infectious, caused by various microorganisms, or noninfectious, such as chronic nonbacterial osteomyelitis (CNO) and chronic recurrent multifocal osteomyelitis (CRMO). Researchers have turned to animal models to study the pathophysiology of osteomyelitis. However, selecting an appropriate animal model that accurately recapitulates the human pathology of osteomyelitis while controlling for multiple variables that influence different clinical presentations remains a significant challenge. In this review, we present an overview of various animal models used in osteomyelitis research, including rodent, rabbit, avian/chicken, porcine, minipig, canine, sheep, and goat models. We discuss the characteristics of each animal model and the corresponding clinical scenarios that can provide a basic rationale for experimental selection. This review highlights the importance of selecting an appropriate animal model for osteomyelitis research to improve the accuracy of the results and facilitate the development of novel treatment and management strategies.
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Affiliation(s)
| | | | - Yiqing Zhang
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Xiaochun Bai
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Zhong-Kai Cui
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
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2
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Choi Y, Yang YH, Kwon YH. Reliability of Goldberg Scoring System in the Radiographic Evaluation of Bony Union after Bone Grafting. Clin Orthop Surg 2021; 13:549-557. [PMID: 34868505 PMCID: PMC8609213 DOI: 10.4055/cios19152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 06/22/2020] [Accepted: 01/12/2021] [Indexed: 11/17/2022] Open
Abstract
Background Evaluation of bony union after bone grafting is very important in orthopedic surgery. The aim of this study was to verify inter- and intraobserver reliability of the Goldberg scoring system for radiographic evaluation of bony union after bone grafting in various situations of animal models. Methods Twenty-seven male C57/BL6 mice, which lack the ability to synthesize galactose-alpha-1,3-galactose (GalT KO mice), and 9 C57/BL6 mice carrying a wild-type gene were used as animal models. We divided the mice into four groups. In group 1, syngenic bone grafting and intramedullary fixation were performed (9 wild type C57BL/6 mice). In group 2, allogenic bone grafting was performed (9 GalT KO mice). In group 3, an alpha-galactosidase-treated porcine xenograft was transplanted into the femur to reduce the antigenicity (9 GalT KO mice). In group 4, a non-treated porcine xenobone grafting was performed (9 GalT KO mice). The level of radiographic bony union (Goldberg method) was assessed by three orthopedic surgeons. Intra- and interobserver reliability for radiographic evaluation was assessed. Results In the Goldberg scoring system, most of the radiographic measurements showed substantial to almost perfect intraobserver reliability. The total score showed substantial intraobserver reliability. The kappa coefficient (κ) of the first examiner was 0.603, the κ of the second examiner was 0.790, and the κ of the third examiner was 0.758. The scoring system showed substantial interobserver reliability. The κ of the first session was 0.641 and the κ of the second session was 0.649. Conclusions The Goldberg scoring system is a reliable tool for radiographic evaluation of bony union after bone grafting.
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Affiliation(s)
- Young Choi
- Department of Orthopaedic Surgery, Kosin University College of Medicine, Busan, Korea
| | - Young Hoon Yang
- Department of Orthopaedic Surgery, Kosin University College of Medicine, Busan, Korea
| | - Young-Ho Kwon
- Department of Orthopaedic Surgery, Kosin University College of Medicine, Busan, Korea
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3
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Wang F, Liu Y, Qiu X, Fei H, Liu W, Yuan K. Effect of Anti-Infective Reconstituted Bone Xenograft Combined with External Fixator on Serum CRP and PCT Levels and Prognosis of Patients with Bone Infection after Lower Extremity Long Bone Trauma. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:5979514. [PMID: 34504538 PMCID: PMC8423557 DOI: 10.1155/2021/5979514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/18/2021] [Indexed: 11/24/2022]
Abstract
Bone infection is one of the common complications of orthopedic surgery. After bone trauma occurs in the human body, the infection of Staphylococcus aureus and Gram-negative bacteria into the fracture area can lead to double infection of the soft tissue and bone tissue at the fracture site, leading to a variety of complications, mostly in the lower extremities. Bone infection easily causes bone destruction, bone nonunion, and bone defect, seriously affecting the quality of life of patients. The traditional treatment method of bone infection is to control the infection first and then repair the bone graft, but this method has a long course, poor efficacy, and high disability rate. In this study, anti-infective reconstituted bone xenograft (ARBX) combined with external fixation was used to treat patients with posttraumatic bone infections of the long bones of the lower extremities, to explore its efficacy, and to analyze its effects on serum CRP, PCT levels, and prognosis. Our results showed that ARBX combined with the external fixator had a good effect on the treatment of patients with bone infection after lower extremity long bone trauma, which could effectively enhance the repair and functional recovery of the limb bone, significantly alleviate the infection degree of patients, reduce the inflammatory response of the body, and have a good prognosis.
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Affiliation(s)
- Fei Wang
- The First People's Hospital of Nantong, The Second Affiliated Hospital of Nantong University, Teaching Hospital Affiliated to Kangda College of Nanjing Medical University, Nantong 226001, Jiangsu, China
| | - Yang Liu
- The First People's Hospital of Nantong, The Second Affiliated Hospital of Nantong University, Teaching Hospital Affiliated to Kangda College of Nanjing Medical University, Nantong 226001, Jiangsu, China
| | - Xiaofeng Qiu
- The First People's Hospital of Nantong, The Second Affiliated Hospital of Nantong University, Teaching Hospital Affiliated to Kangda College of Nanjing Medical University, Nantong 226001, Jiangsu, China
| | - Hao Fei
- The First People's Hospital of Nantong, The Second Affiliated Hospital of Nantong University, Teaching Hospital Affiliated to Kangda College of Nanjing Medical University, Nantong 226001, Jiangsu, China
| | - Wei Liu
- The First People's Hospital of Nantong, The Second Affiliated Hospital of Nantong University, Teaching Hospital Affiliated to Kangda College of Nanjing Medical University, Nantong 226001, Jiangsu, China
| | - Kun Yuan
- The First People's Hospital of Nantong, The Second Affiliated Hospital of Nantong University, Teaching Hospital Affiliated to Kangda College of Nanjing Medical University, Nantong 226001, Jiangsu, China
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Stogov MV, Smolentsev DV, Kireeva EA. Bone Xenografts in Trauma and Orthopaedics (Analytical Review). TRAUMATOLOGY AND ORTHOPEDICS OF RUSSIA 2019. [DOI: 10.21823/2311-2905-2020-26-1-181-189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Purpose of the analytical review — to evaluate the application experience of bone xenografts in trauma and orthopaedics surgery. Methods. Data search was performed in the electronic databases of PubMed and eLIBRARY with depth of 20 years. Results. The authors identified 13 papers which described the application experience of bone xenografts in trauma surgery and orthopaedics. The highest efficiency (from 92 to 100%) was reported for cases of xenografts use to replace defects in intraarticular fractures and revision arthroplasty. Unsatisfactory outcomes were related to cases with no integration and graft rejection. The least efficiency (from 41,9 to 46,1%) was reported in reconstructive foot surgery. No effect of bone xenografts was observed for replacement of defects in cases of pseudoarthrosis. The most frequent complication was graft material infection. The summarized literature data provided the calculated share of complications following xenograft use of 7,53% (18 out of 239 cases, CI 5-95%, 4,53-11,21). Two areas were identified for improvement of technical and biological properties of bone xenografts: 1. Modification of original xeno-matrix (enhancement of purification technique, alteration of structure of chemical composition of the bone matrix); 2. Augmentation of matrix volume by additional elements (biologically active agents, stem cells). It’s noted that demand for xenografts in traumatology and orthopaedics can increase after refining and expanding the indications for clinical use. Conclusion. Bone xenografts used in the modern trauma surgery and orthopaedics to replace bone defects in revision arthroplasty as well as in certain fracture types. Such material is relatively safe and its ability to be modified allows to improve its biological properties.
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Wei P, Jing W, Yuan Z, Huang Y, Guan B, Zhang W, Zhang X, Mao J, Cai Q, Chen D, Yang X. Vancomycin- and Strontium-Loaded Microspheres with Multifunctional Activities against Bacteria, in Angiogenesis, and in Osteogenesis for Enhancing Infected Bone Regeneration. ACS APPLIED MATERIALS & INTERFACES 2019; 11:30596-30609. [PMID: 31373193 DOI: 10.1021/acsami.9b10219] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Biomaterials that have capacities to simultaneously induce bone regeneration and kill bacteria are in demand because bone defects face risks of severe infection in clinical therapy. To meet the demand, multifunctional biodegradable microspheres are fabricated, which contain vancomycin to provide antibacterial activity and strontium-doped apatite to provide osteocompatibility. Moreover, the strontium component shows activity in promoting angiogenesis, which further favors osteogenesis. For producing the microspheres, vancomycin is loaded into mesoporous silica and embedded in polylactide-based microspheres via the double emulsion technique and the strontium-doped apatite is deposited onto the microspheres via biomineralization in strontium-containing simulated body fluid. Sustained release behaviors of both vancomycin and Sr2+ ions are achieved. The microspheres exhibit strong antibacterial effect against Staphylococcus aureus, while demonstrating excellent cell/tissue compatibility. Studies of differentiation confirm that the introduction of strontium element strengthens the angiogenic and osteogenic expressions of mesenchymal stromal cells. Subcutaneous injection of the microspheres into rabbit's back confirms their effectiveness in inducing neovascularization and ectopic osteogenesis. Finally, an infected rabbit femoral condyle defect model is created with S. aureus infection and the multifunctional microspheres are injected, which display significant antibacterial activity in vivo and achieve efficient new bone formation in comparison with biomineralized microspheres without vancomycin loading. The vancomycin- and strontium-loaded microspheres, being biomineralized, injectable, and biodegradable, are attractive because of their flexibility in integrating multiple functions into one design, whose potentials in treating infected bone defects are highly expected.
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Affiliation(s)
- Pengfei Wei
- State Key Laboratory of Organic-Inorganic Composites, Beijing Laboratory of Biomedical Materials , Beijing University of Chemical Technology , Beijing 100029 , P. R. China
| | - Wei Jing
- State Key Laboratory of Organic-Inorganic Composites, Beijing Laboratory of Biomedical Materials , Beijing University of Chemical Technology , Beijing 100029 , P. R. China
| | - Zuoying Yuan
- State Key Laboratory of Organic-Inorganic Composites, Beijing Laboratory of Biomedical Materials , Beijing University of Chemical Technology , Beijing 100029 , P. R. China
| | - Yiqian Huang
- State Key Laboratory of Organic-Inorganic Composites, Beijing Laboratory of Biomedical Materials , Beijing University of Chemical Technology , Beijing 100029 , P. R. China
| | - Binbin Guan
- Department of Stomatology , Tianjin Medical University General Hospital , Tianjin 300052 , P. R. China
| | - Wenxin Zhang
- Department of Endodontics, School and Hospital of Stomatology , Tianjin Medical University , Tianjin 300070 , P. R. China
| | - Xu Zhang
- Department of Endodontics, School and Hospital of Stomatology , Tianjin Medical University , Tianjin 300070 , P. R. China
| | | | - Qing Cai
- State Key Laboratory of Organic-Inorganic Composites, Beijing Laboratory of Biomedical Materials , Beijing University of Chemical Technology , Beijing 100029 , P. R. China
| | | | - Xiaoping Yang
- State Key Laboratory of Organic-Inorganic Composites, Beijing Laboratory of Biomedical Materials , Beijing University of Chemical Technology , Beijing 100029 , P. R. China
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Pang L, Dai C, Bi L, Guo Z, Fan J. Biosafety and Antibacterial Ability of Graphene and Graphene Oxide In Vitro and In Vivo. NANOSCALE RESEARCH LETTERS 2017; 12:564. [PMID: 29027140 PMCID: PMC5639822 DOI: 10.1186/s11671-017-2317-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/17/2017] [Indexed: 05/07/2023]
Abstract
In recent years, graphene (G) and graphene oxide (GO) nanoparticles have begun to be applied in surgical implant surface modification. However, biosafety and antibacterial ability of G and GO are still unclear. In this study, the biosafety of G and GO in vitro was evaluated by co-culture with bone marrow mesenchymal stem cells (BMSCs) and biosafety in vivo was observed by implanting materials into mice muscle tissue. Biosafety results showed that 10 μg/ml was the safety critical concentration for G and GO. When the concentration was more than 10 μg/ml, the cytotoxicity of G and GO showed a dose-dependent manner.Antibacterial results showed that G presented the antibacterial ability with the concentration equal to and more than 100 μg/ml; GO presented the antibacterial ability with the concentration equal to and more than 50 μg/ml. The antibacterial effect of G and GO were in a dose-dependent manner in vitro.The GO or G concentration between 50 and 100 μg/ml may be the better range to keep the balance of cytotoxicity and antibacterial ability. Our study reveals that G and GO have potential to be used in clinic with good biosafety and antibacterial properties in a certain concentration range.
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Affiliation(s)
- Long Pang
- The 3rd Orthopedic Department of General Hospital, Ningxia Medical University, Ningxia, 750004 China
| | - Chunqiu Dai
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Changle road, Xi’an, 710032 China
- The Fifth Camp of the First Cadet Brigade, Fourth Military Medical University, Xi’an, 710032 People’s Republic of China
| | - Long Bi
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Changle road, Xi’an, 710032 China
| | - Zhongshang Guo
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Changle road, Xi’an, 710032 China
- Hanzhong Central Hospital, No. 22 Kangfu road, Hanzhong, 723099 China
| | - Junjun Fan
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Changle road, Xi’an, 710032 China
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Yang Y, Yang S, Wang Y, Yu Z, Ao H, Zhang H, Qin L, Guillaume O, Eglin D, Richards RG, Tang T. Anti-infective efficacy, cytocompatibility and biocompatibility of a 3D-printed osteoconductive composite scaffold functionalized with quaternized chitosan. Acta Biomater 2016; 46:112-128. [PMID: 27686039 DOI: 10.1016/j.actbio.2016.09.035] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 09/01/2016] [Accepted: 09/24/2016] [Indexed: 12/15/2022]
Abstract
Contaminated or infected bone defects remain serious challenges in clinical trauma and orthopaedics, and a bone substitute with both osteoconductivity and antibacterial properties represents an improvement for treatment strategy. In this study, quaternized chitosan (hydroxypropyltrimethyl ammonium chloride chitosan, HACC) was grafted to 3D-printed scaffolds composed of polylactide-co-glycolide (PLGA) and hydroxyapatite (HA), in order to design bone engineering scaffolds endowed with antibacterial and osteoconductive properties. We found that both the PLGA/HA/HACC and PLGA/HACC composite scaffolds decreased bacterial adhesion and biofilm formation under in vitro and in vivo conditions. Additionally, ATP leakage assay indicated that immobilizing HACC on the scaffolds could effectively disrupt microbial membranes. Using human bone marrow-derived mesenchymal stem cells (hBMSCs), we demonstrated that HA incorporated scaffolds, including PLGA/HA and PLGA/HA/HACC, favoured cell attachment, proliferation, spreading and osteogenic differentiation compared to HA-free PLGA or PLGA/HACC scaffolds. Finally, an in vivo biocompatibility assay conducted on rats, showed that HA incorporated scaffolds (including PLGA/HA and PLGA/HA/HACC scaffolds) exhibited good neovascularization and tissue integration. Taken together, our findings support the approach for developing porous PLGA/HA/HACC composite scaffold with potential clinical application in the treatment of infected bone. STATEMENT OF SIGNIFICANCE Although plenty of conductive scaffold biomaterials have been exploited to improve bone regeneration under infection, potential tissue toxicity under high concentration and antibiotic-resistance are their main deficiencies. This study indicated that HACC-grafted PLGA/HA composite scaffold prepared using an innovative 3D-printing technique and covalent grafting strategy showed significantly enhanced antibacterial activities, especially against the antibiotic-resistant strains, together with good osteogenic activity and biocompatibility. Therefore, it provides an effective porous composite scaffold to combat the infected bone defect in clinic with decreased risks of bacterial resistance and open a feasible strategy for the modification of scaffold interfaces involved in the bone regeneration and anti-infection.
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8
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Scaffold-based anti-infection strategies in bone repair. Ann Biomed Eng 2014; 43:515-28. [PMID: 25476163 DOI: 10.1007/s10439-014-1205-3] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/26/2014] [Indexed: 12/14/2022]
Abstract
Bone fractures and non-union defects often require surgical intervention where biomaterials are used to correct the defect, and approximately 10% of these procedures are compromised by bacterial infection. Currently, treatment options are limited to sustained, high doses of antibiotics and surgical debridement of affected tissue, leaving a significant, unmet need for the development of therapies to combat device-associated biofilm and infections. Engineering implants to prevent infection is a desirable material characteristic. Tissue engineered scaffolds for bone repair provide a means to both regenerate bone and serve as a base for adding antimicrobial agents. Incorporating anti-infection properties into regenerative medicine therapies could improve clinical outcomes and reduce the morbidity and mortality associated with biomaterial implant-associated infections. This review focuses on current animal models and technologies available to assess bone repair in the context of infection, antimicrobial agents to fight infection, the current state of antimicrobial scaffolds, and future directions in the field.
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HUANG JIANGUO, PANG LONG, CHEN ZHIRONG, TAN XIPENG. Dual-delivery of vancomycin and icariin from an injectable calcium phosphate cement-release system for controlling infection and improving bone healing. Mol Med Rep 2013; 8:1221-7. [DOI: 10.3892/mmr.2013.1624] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 07/23/2013] [Indexed: 11/06/2022] Open
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Wang DX, He Y, Bi L, Qu ZH, Zou JW, Pan Z, Fan JJ, Chen L, Dong X, Liu XN, Pei GX, Ding JD. Enhancing the bioactivity of Poly(lactic-co-glycolic acid) scaffold with a nano-hydroxyapatite coating for the treatment of segmental bone defect in a rabbit model. Int J Nanomedicine 2013; 8:1855-65. [PMID: 23690683 PMCID: PMC3656818 DOI: 10.2147/ijn.s43706] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Poly(lactic-co-glycolic acid) (PLGA) is excellent as a scaffolding matrix due to feasibility of processing and tunable biodegradability, yet the virgin scaffolds lack osteoconduction and osteoinduction. In this study, nano-hydroxyapatite (nHA) was coated on the interior surfaces of PLGA scaffolds in order to facilitate in vivo bone defect restoration using biomimetic ceramics while keeping the polyester skeleton of the scaffolds. METHODS PLGA porous scaffolds were prepared and surface modification was carried out by incubation in modified simulated body fluids. The nHA coated PLGA scaffolds were compared to the virgin PLGA scaffolds both in vitro and in vivo. Viability and proliferation rate of bone marrow stromal cells of rabbits were examined. The constructs of scaffolds and autogenous bone marrow stromal cells were implanted into the segmental bone defect in the rabbit model, and the bone regeneration effects were observed. RESULTS In contrast to the relative smooth pore surface of the virgin PLGA scaffold, a biomimetic hierarchical nanostructure was found on the surface of the interior pores of the nHA coated PLGA scaffolds by scanning electron microscopy. Both the viability and proliferation rate of the cells seeded in nHA coated PLGA scaffolds were higher than those in PLGA scaffolds. For bone defect repairing, the radius defects had, after 12 weeks implantation of nHA coated PLGA scaffolds, completely recuperated with significantly better bone formation than in the group of virgin PLGA scaffolds, as shown by X-ray, Micro-computerized tomography and histological examinations. CONCLUSION nHA coating on the interior pore surfaces can significantly improve the bioactivity of PLGA porous scaffolds.
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Affiliation(s)
- De-Xin Wang
- Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
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Cao Z, Hou S, Sun D, Wang X, Tang J. Osteochondral regeneration by a bilayered construct in a cell-free or cell-based approach. Biotechnol Lett 2012; 34:1151-7. [PMID: 22361963 DOI: 10.1007/s10529-012-0884-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 02/15/2012] [Indexed: 11/26/2022]
Abstract
A bilayered construct with or without adipose-derived stem cells (ASCs) was applied to repair full-thickness defects in the patellar groove of 18 rabbits. Non-treated and treated defects were divided into three groups: a control group (n = 12), a cell-free group (n = 12) and a cell-based group (n = 12). Histological appearance and grading were evaluated at 8 and 12 weeks. At 12 weeks, osteochondral-like tissues completely filled in the defects and integrated with host tissues in the cell-based group. The semi-quantitative score of the cell-based group (4.2 ± 1.2), which is a total score ranging from 0 (best) to 20 (worst), was significantly better than that of the other two groups (cell-free: 13.8 ± 2.5; control: 10.3 ± 2.4). This finding indicated that the bilayered constructs combined with ASCs could be an effective way to enhance osteochondral regeneration.
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Affiliation(s)
- Zheng Cao
- Departments of Orthopaedics, The First Affiliated Hospital of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
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12
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Zhang W, Pan W, Zhang M, Wei Y. In vivo evaluation of two types of bioactive scaffold used for tendon-bone interface healing in the reconstruction of anterior cruciate ligament. Biotechnol Lett 2010; 33:837-44. [PMID: 21136138 DOI: 10.1007/s10529-010-0490-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Accepted: 11/26/2010] [Indexed: 02/02/2023]
Abstract
Fibrin glue combined with bone morphogenetic protein (BMP) and recombined bone xenograft (RBX), were compared to evaluate their effect on the tendon-bone interface healing. The interface of fibrin glue-BMP developed new cartilage but the new bone was thinner whereas the interface of RBX had large areas of chondrocyte-like cells, bone formation and an immature neo-enthesis structure. At 12 weeks, bone mineral density of RBX group (152 ± 52 cm(3)) and fibrin glue-BMP group (109 ± 13 cm(3)) was calculated by micro-computed tomography. The ultimate load of fibrin glue-BMP group (60 ± 18 and 51 ± 14 N) and RBX group (65 ± 21 and 57 ± 15 N) was shown by biomechanics at 6 and 12 weeks. RBX thus has an advantage on accelerating tendon-bone interface healing.
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Affiliation(s)
- Weibin Zhang
- Department of Orthopaedics, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China
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13
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Xing Ma, Yunyu Hu, Rong Lv, Jun Wang, Xiaoming Wu, Yongnian Yan. Multilevel Posterior Lumbar Interlaminar Fusion in Rabbits Using Bovine Bone Protein Extract Delivered by a RP-synthesized 3D Biopolymer Construct. J BIOACT COMPAT POL 2010. [DOI: 10.1177/0883911510377556] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Rapid prototyping (RP)-based highly porous poly(DL-lactic-co-glycolic acid)/tricalcium phosphate (PLGA/TCP(RP)) scaffolds were fabricated. PLGA/TCP constructs (PLGA/TCP(TS)) were also made via thermally induced phase separation with solvent casting and by particulate leaching approach. Both scaffolds were loaded with bovine bone protein extract (BBPE). Sixty-four New Zealand white rabbits were randomized into four groups (groups of A, B, C, and D) and unilaterally underwent posterior lumbar interlaminar fusion at L2—L4 level. Spinal fusions were systematically evaluated. In groups of A (PLGA/TCP (RP)/BBPE constructs) and C (autogenous iliac bone grafts), good bone fusions occurred in vivo. Histological analyses indicated that endochondral ossification played an essential role in initiation of bone fusions in group A, whereas in group B (PLGA/TCP(TS)/BBPE constructs), few bone fusions were observed. In group D (PLGA/TCP(RP) scaffolds alone), the scaffolds were biocompatible and biodegradable; however, no newly formed bone mass or bone fusion was found. Twelve weeks after surgery, the fusion was significantly higher in groups of A and C compared with groups B and D (p<0.01). The PLGA/ TCP(RP)/BBPE biomaterials have potential as grafting substitutes for bone healing and spinal fusion.
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Affiliation(s)
- Xing Ma
- Department of Orthopaedics, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an 710061, PR China,
| | - Yunyu Hu
- Institute of Orthopaedic Surgery & Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032 PR China
| | - Rong Lv
- Institute of Orthopaedic Surgery & Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032 PR China
| | - Jun Wang
- Institute of Orthopaedic Surgery & Department of Orthopaedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032 PR China
| | - Xiaoming Wu
- Department of Biomedical Engineering, The Fourth Military Medical University, Xi'an 710032, PR China
| | - Yongnian Yan
- Key Laboratory for Advanced Materials Processing Technology Ministry of Education & Center of Organ Manufacturing Department of Mechanical Engineering, Tsinghua University Beijing 100084, PR China
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Ma X, Wu X, Hu Y, Xiong Z, Lv R, Wang J, Li D, Yan Y. Intervertebral Spinal Fusion Using a RP-based PLGA/TCP/bBMP Biomimetic Grafting Material. J BIOACT COMPAT POL 2009. [DOI: 10.1177/0883911509103830] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Three-dimensional highly porous poly(DL-lactic-co-glycolic acid)/tricalcium phosphate (PLGA/TCP) scaffolds were synthesized via a rapid prototyping (RP) technique. Bovine bone morphogenetic protein (bBMP) was loaded into the biopolymer scaffolds (PLGA/TCP/bBMP). Both the PLGA/TCP scaffolds and the PLGA/TCP/bBMP composites were evaluated by scanning electron microscopy. Lumbar intervertebral body fusion at L2~3 and L4~5 levels were performed on 15 goats using one of the following graft materials: RP synthesized PLGA/TCP scaffolds (group A), PLGA/TCP/bBMP composites (group B), and autogenous iliac bone graft (group C). All animals were sacrificed 24 weeks after surgery and the spine fusions evaluated by manual palpation tests, histological analyses, and radiography. In group A, the histological analyses showed that the PLGA/TCP scaffolds were biocompatible and biodegradable; however, no new bone was found. In group B, highly cellular bone marrow between the new trabecular bone was present in the fusion mass. In group C, there was a lesser amount of new bone. Twenty-four weeks after surgery, the fusion rate of lumbar intervertebral body fusion in group A, B, and C was 10% (1/10), 80% (8/10), and 50% (5/10), respectively. The fusion rate was significantly higher in group B compared with groups of A and C (p<0.01). Based on these results, extracted bBMP can be loaded in vitro into RP-based highly porous structural PLGA/TCP scaffolds to fabricate new graft composites that appear to be more effective for intervertebral spinal fusions. This biomimetic artificial grafting material holds promise as a tool for spine surgery.
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Affiliation(s)
- Xing Ma
- Department of Orthopaedics, The First Affiliated Hospital of Medical School Xi'an Jiaotong University, Xi'an 710061, PR China
- Institute of Orthopaedic Surgery & Department of Orthopaedics Xijing Hospital, The Fourth Military Medical University Xi'an 710032, PR China
| | - Xiaoming Wu
- Department of Biomedical Engineering, The Fourth Military Medical University, Xi'an 710032, PR China
| | - Yunyu Hu
- Institute of Orthopaedic Surgery & Department of Orthopaedics Xijing Hospital, The Fourth Military Medical University Xi'an 710032, PR China
| | - Zhuo Xiong
- Department of Mechanical Engineering, Tsinghua University Beijing 100084, PR China
| | - Rong Lv
- Institute of Orthopaedic Surgery & Department of Orthopaedics Xijing Hospital, The Fourth Military Medical University Xi'an 710032, PR China
| | - Jun Wang
- Institute of Orthopaedic Surgery & Department of Orthopaedics Xijing Hospital, The Fourth Military Medical University Xi'an 710032, PR China
| | - Dan Li
- Institute of Orthopaedic Surgery & Department of Orthopaedics Xijing Hospital, The Fourth Military Medical University Xi'an 710032, PR China
| | - Yongnian Yan
- Department of Mechanical Engineering, Tsinghua University Beijing 100084, PR China
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15
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Pan W, Hu Y, Wei Y, Bi L, Li D, Wang J, Lv R, Li J, Cao Z. Recombined bone xenografts enhance tendon graft osteointegration of anterior cruciate ligament reconstruction. INTERNATIONAL ORTHOPAEDICS 2009; 33:1761-8. [PMID: 19184009 DOI: 10.1007/s00264-008-0715-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Revised: 11/24/2008] [Accepted: 11/24/2008] [Indexed: 10/21/2022]
Abstract
The objective of the study was to discover whether recombined bone xenograft (RBX), a porous solid material, could augment healing of the tendon-to-bone interface after anterior cruciate ligament (ACL) reconstruction. ACL reconstruction was performed bilaterally in 25 skeletally mature rabbits using long digital extensor tendon grafts. RBX was implanted into the treated knee, with the contralateral knee serving as control. Three rabbits were killed at postoperative weeks two, six and 12 for routine histology. The remaining 16 rabbits were killed at weeks six and 12, and their femur-graft-tibia complexes were harvested for mechanical testing. The treatment and control groups produced different histological findings at the interface between the tendon and bone. In the treatment group, large areas of chondrocyte-like cells were noted around the tendon-bone interface two weeks after the operation. At six weeks, more abundant bone formation was observed around the tendon. At 12 weeks, an immature neoenthesis structure was seen. In biomechanical evaluation six and 12 weeks after the operation, the ultimate strength of tendon in the bone tunnel was significantly higher in the treatment group than in the control group. RBX can augment the osteointegration of tendon to bone after ACL reconstruction.
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Affiliation(s)
- Weimin Pan
- Institute of Orthopaedics and Traumatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, People's Republic of China
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16
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Calhoun JH, Murray CK, Manring MM. Multidrug-resistant organisms in military wounds from Iraq and Afghanistan. Clin Orthop Relat Res 2008; 466:1356-62. [PMID: 18347888 PMCID: PMC2384049 DOI: 10.1007/s11999-008-0212-9] [Citation(s) in RCA: 135] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2007] [Accepted: 02/26/2008] [Indexed: 01/31/2023]
Abstract
Mortality from battlefield wounds has historically declined, thanks to better surgical management, faster transport of casualties, and improved antibiotics. Today, one of the major challenges facing U.S. military caregivers is the presence of multidrug-resistant organisms in orthopaedic extremity wounds. The most frequently identified resistant strains of bacteria are Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter calcoaceticus-baumannii complex. Overuse of broad-spectrum antibiotics may be an important factor in building resistant strains. Acinetobacter infections appear to hospital-acquired and not from an initial colonization of the injury. More research is required to give military physicians the tools they require to reduce the infection rate and defeat multidrug-resistant organisms.
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Affiliation(s)
- Jason H Calhoun
- Department of Orthopaedic Surgery, University of Missouri, MC213, DC053.00, One Hospital Drive, Columbia, MO 65212, USA.
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