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Savin G, Caillol S, Bethry A, Rondet E, Assor M, David G, Nottelet B. Collagen/polyester-polyurethane porous scaffolds for use in meniscal repair. Biomater Sci 2024; 12:2960-2977. [PMID: 38682257 DOI: 10.1039/d4bm00234b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Focusing on the regeneration of damaged knee meniscus, we propose a hybrid scaffold made of poly(ester-urethane) (PEU) and collagen that combines suitable mechanical properties with enhanced biological integration. To ensure biocompatibility and degradability, the degradable PEU was prepared from a poly(ε-caprolactone), L-lysine diisocyanate prepolymer (PCL di-NCO) and poly(lactic-co-glycolic acid) diol (PLGA). The resulting PEU (Mn = 52 000 g mol-1) was used to prepare porous scaffolds using the solvent casting (SC)/particle leaching (PL) method at an optimized salt/PEU weight ratio of 5 : 1. The morphology, pore size and porosity of the scaffolds were evaluated by SEM showing interconnected pores with a uniform size of around 170 μm. Mechanical properties were found to be close to those of the human meniscus (Ey ∼ 0.6 MPa at 37 °C). To enhance the biological properties, incorporation of collagen type 1 (Col) was then performed via soaking, injection or forced infiltration. The latter yielded the best results as shown by SEM-EDX and X-ray tomography analyses that confirmed the morphology and highlighted the efficient pore Col-coating with an average of 0.3 wt% Col in the scaffolds. Finally, in vitro L929 cell assays confirmed higher cell proliferation and an improved cellular affinity towards the proposed scaffolds compared to culture plates and a gold standard commercial meniscal implant.
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Affiliation(s)
- Gaëlle Savin
- IBMM, Univ Montpellier, CNRS, ENSCM, Montpellier, France.
- ICGM, Univ Montpellier, CNRS, ENSCM, Montpellier, France.
- Arthrocart Biotech, Marseille, France.
| | | | - Audrey Bethry
- IBMM, Univ Montpellier, CNRS, ENSCM, Montpellier, France.
| | - Eric Rondet
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de la Réunion, Montpellier, France.
| | | | - Ghislain David
- ICGM, Univ Montpellier, CNRS, ENSCM, Montpellier, France.
| | - Benjamin Nottelet
- IBMM, Univ Montpellier, CNRS, ENSCM, Montpellier, France.
- Department of Pharmacy, Nîmes University Hospital, 30900, Nimes, France
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2
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Bhatia A, Hanna J, Stuart T, Kasper KA, Clausen DM, Gutruf P. Wireless Battery-free and Fully Implantable Organ Interfaces. Chem Rev 2024; 124:2205-2280. [PMID: 38382030 DOI: 10.1021/acs.chemrev.3c00425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Advances in soft materials, miniaturized electronics, sensors, stimulators, radios, and battery-free power supplies are resulting in a new generation of fully implantable organ interfaces that leverage volumetric reduction and soft mechanics by eliminating electrochemical power storage. This device class offers the ability to provide high-fidelity readouts of physiological processes, enables stimulation, and allows control over organs to realize new therapeutic and diagnostic paradigms. Driven by seamless integration with connected infrastructure, these devices enable personalized digital medicine. Key to advances are carefully designed material, electrophysical, electrochemical, and electromagnetic systems that form implantables with mechanical properties closely matched to the target organ to deliver functionality that supports high-fidelity sensors and stimulators. The elimination of electrochemical power supplies enables control over device operation, anywhere from acute, to lifetimes matching the target subject with physical dimensions that supports imperceptible operation. This review provides a comprehensive overview of the basic building blocks of battery-free organ interfaces and related topics such as implantation, delivery, sterilization, and user acceptance. State of the art examples categorized by organ system and an outlook of interconnection and advanced strategies for computation leveraging the consistent power influx to elevate functionality of this device class over current battery-powered strategies is highlighted.
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Affiliation(s)
- Aman Bhatia
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Jessica Hanna
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Tucker Stuart
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Kevin Albert Kasper
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - David Marshall Clausen
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Philipp Gutruf
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
- Department of Electrical and Computer Engineering, The University of Arizona, Tucson, Arizona 85721, United States
- Bio5 Institute, The University of Arizona, Tucson, Arizona 85721, United States
- Neuroscience Graduate Interdisciplinary Program (GIDP), The University of Arizona, Tucson, Arizona 85721, United States
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3
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Hooijman EL, Radchenko V, Ling SW, Konijnenberg M, Brabander T, Koolen SLW, de Blois E. Implementing Ac-225 labelled radiopharmaceuticals: practical considerations and (pre-)clinical perspectives. EJNMMI Radiopharm Chem 2024; 9:9. [PMID: 38319526 PMCID: PMC10847084 DOI: 10.1186/s41181-024-00239-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/25/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND In the past years, there has been a notable increase in interest regarding targeted alpha therapy using Ac-225, driven by the observed promising clinical anti-tumor effects. As the production and technology has advanced, the availability of Ac-225 is expected to increase in the near future, making the treatment available to patients worldwide. MAIN BODY Ac-225 can be labelled to different biological vectors, whereby the success of developing a radiopharmaceutical depends heavily on the labelling conditions, purity of the radionuclide source, chelator, and type of quenchers used to avoid radiolysis. Multiple (methodological) challenges need to be overcome when working with Ac-225; as alpha-emission detection is time consuming and highly geometry dependent, a gamma co-emission is used, but has to be in equilibrium with the mother-nuclide. Because of the high impact of alpha emitters in vivo it is highly recommended to cross-calibrate the Ac-225 measurements for used quality control (QC) techniques (radio-TLC, HPLC, HP-Ge detector, and gamma counter). More strict health physics regulations apply, as Ac-225 has a high toxicity, thereby limiting practical handling and quantities used for QC analysis. CONCLUSION This overview focuses specifically on the practical and methodological challenges when working with Ac-225 labelled radiopharmaceuticals, and underlines the required infrastructure and (detection) methods for the (pre-)clinical application.
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Affiliation(s)
- Eline L Hooijman
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN, Rotterdam, The Netherlands
- Department of Hospital Pharmacy, Erasmus MC, 3015 CN, Rotterdam, The Netherlands
| | - Valery Radchenko
- Life Sciences Division, TRIUMF, Vancouver, BC, V6T 2A3, Canada
- Chemistry Department, University of British Columbia, Vancouver, BC, V6T 1Z1, Canada
| | - Sui Wai Ling
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN, Rotterdam, The Netherlands
| | - Mark Konijnenberg
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN, Rotterdam, The Netherlands
| | - Tessa Brabander
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN, Rotterdam, The Netherlands
| | - Stijn L W Koolen
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN, Rotterdam, The Netherlands
- Department of Hospital Pharmacy, Erasmus MC, 3015 CN, Rotterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 CN, Rotterdam, The Netherlands
| | - Erik de Blois
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN, Rotterdam, The Netherlands.
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Abd-Elaty DM, Ishak RAH, Osman R, Geneidi AS. Engineering a novel water-in-oil biocompatible microemulsion system for the ocular delivery of dexamethasone sodium phosphate in the treatment of acute uveitis. Int J Pharm 2024; 650:123704. [PMID: 38097148 DOI: 10.1016/j.ijpharm.2023.123704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/18/2023]
Abstract
Due to their unique characteristics, microemulsions (ME) represent one of the most promising delivery systems which can conquer poor ocular drug bioavailability providing long residence time. Development of a ME system, relying on the use of a safe and non-irritant surfactant combination derived from sustainable resources and which can consolidate the small ME droplets, is the goal of this work. Herein, we report the design and characterization of a novel biocompatible, eco-friendly ME system loaded with the hydrophilic dexamethasone sodium phosphate (DEXP) using a novel surfactant mixture composed of D-α-tocopherol polyethylene glycol succinate (TPGS) and Plantacare® (coco-Glycosides). Capryol™ PGMC and double-distilled water were used as the respective oil and aqueous phases and the MEs were prepared by the water titration method, suitable for scaling up. Optimization of ME formulae was conducted by varying Plantacare® grades, TPGS to Plantacare® mass ratios and drug loading. The formulae were characterized in terms of physical appearance, droplet size (PS), size distribution (PDI), zeta potential (ZP), and stability. The optimized DEXP-loaded ME formula attained acceptable PS, PDI, and ZP values of 43 ± 5 nm, 0.35 ± 0.07, -12 ± 4 mV, respectively. TEM images confirmed a small PS ≤ 100 nm. The in vivo safety of ME was proved by the Draize test. The ME formula prompted excellent mucoadhesion and transcorneal permeation. The confocal studies showed deep penetration into the rabbits' corneas. In vivo studies using endotoxin-induced uveitis showed high ocular efficacy and a significant reduction in inflammatory cells, including interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). The obtained results elect the novel engineered ME system as a promising tool for the ocular delivery of hydrophilic moieties in the management of various ophthalmic diseases.
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Affiliation(s)
- Dina M Abd-Elaty
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, 11566 Cairo, Egypt
| | - Rania A H Ishak
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, 11566 Cairo, Egypt.
| | - Rihab Osman
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, 11566 Cairo, Egypt
| | - Ahmed S Geneidi
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, 11566 Cairo, Egypt
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Shin M, Pelletier MH, Lovric V, Walsh WR, Martens PJ, Kruzic JJ, Gludovatz B. Effect of gamma irradiation and supercritical carbon dioxide sterilization with Novakill™ or ethanol on the fracture toughness of cortical bone. J Biomed Mater Res B Appl Biomater 2024; 112:e35356. [PMID: 38247241 DOI: 10.1002/jbm.b.35356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/15/2023] [Accepted: 11/11/2023] [Indexed: 01/23/2024]
Abstract
Sterilization of structural bone allografts is a critical process prior to their clinical use in large cortical bone defects. Gamma irradiation protocols are known to affect tissue integrity in a dose dependent manner. Alternative sterilization treatments, such as supercritical carbon dioxide (SCCO2 ), are gaining popularity due to advantages such as minimal exposure to denaturants, the lack of toxic residues, superior tissue penetration, and minor impacts on mechanical properties including strength and stiffness. The impact of SCCO2 on the fracture toughness of bone tissue, however, remains unknown. Here, we evaluate crack initiation and growth toughness after 2, 6, and 24 h SCCO2 -treatment using Novakill™ and ethanol as additives on ~11 samples per group obtained from a pair of femur diaphyses of a canine. All mechanical testing was performed at ambient air after 24 h soaking in Hanks' balanced salt solution (HBSS). Results show no statistically significant difference in the failure characteristics of the Novakill™-treated groups whereas crack growth toughness after 6 and 24 h of treatment with ethanol significantly increases by 37% (p = .010) and 34% (p = .038), respectively, compared to an untreated control group. In contrast, standard 25 kGy gamma irradiation causes significantly reduced crack growth resistance by 40% (p = .007) compared to untreated bone. FTIR vibrational spectroscopy, conducted after testing, reveals a consistent trend of statistically significant differences (p < .001) with fracture toughness. These trends align with variations in the ratios of enzymatic mature to immature crosslinks in the collagen structure, suggesting a potential association with fracture toughness. Additional Raman spectroscopy after testing shows a similar trend with statistically significant differences (p < .005), which further supports that collagen structural changes occur in the SCF-treated groups with ethanol after 6 and 24 h. Our work reveals the benefits of SCCO2 sterilization compared to gamma irradiation.
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Affiliation(s)
- Mihee Shin
- School of Mechanical and Manufacturing Engineering, University of New South Wales (UNSW Sydney), Sydney, New South Wales, Australia
| | - Matthew H Pelletier
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales (UNSW Sydney), Sydney, New South Wales, Australia
| | - Vedran Lovric
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales (UNSW Sydney), Sydney, New South Wales, Australia
| | - William R Walsh
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales (UNSW Sydney), Sydney, New South Wales, Australia
| | - Penny J Martens
- Graduate School of Biomedical Engineering, University of New South Wales (UNSW Sydney), Sydney, New South Wales, Australia
| | - Jamie J Kruzic
- School of Mechanical and Manufacturing Engineering, University of New South Wales (UNSW Sydney), Sydney, New South Wales, Australia
| | - Bernd Gludovatz
- School of Mechanical and Manufacturing Engineering, University of New South Wales (UNSW Sydney), Sydney, New South Wales, Australia
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Xiong L, Li H, Huang X, Jie S, Zhu W, Pan J, Wu X, Mao X. Both Acetabular and Femoral Reconstructions With Impaction Bone Grafting in Revision Total Hip Arthroplasty: Case Series and Literature Review. Arthroplast Today 2023; 24:101160. [PMID: 37927301 PMCID: PMC10622835 DOI: 10.1016/j.artd.2023.101160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/15/2023] [Indexed: 11/07/2023] Open
Abstract
Background Extensive bone loss on femur and acetabulum posed a big challenge to orthopedists in total hip revision surgeries. Impaction bone grafting (IBG) as a valuable bone preservation technique could effectively address this problem. Either IBG revision on the femoral or acetabular side was well studied, while its use on both sides in one operation was not. The aim of this study is to present the outcomes of IBG on both femoral and acetabular sides at first-time hip revision. Methods We retrospectively reviewed 8 patients (mean follow-up of 5.8 years) undergoing first-time revision with IBG on both acetabular and femoral sides at our institution. The Paprosky classification system was used to classify bone defects. Freeze-dried allografts and cemented prostheses were used in all patients. Postoperative complications and rerevision rates were reported. Results Five patients presented a Paprosky type IIC acetabular defect, 3 with a type IIIB, IIIA, and IIC defect, respectively. Three patients presented with a type IV femoral defect, 3 with a type IIIB defect, and 2 with a type II defect. Two patients developed complications, while one had an intraoperative femoral fracture and one had delayed wound healing. At the latest follow-up, no patient had rerevisions or operations related to the prosthesis. Conclusions IBG in combination with cemented prosthesis is a profitable biological reconstruction revision technique that could provide satisfying midterm outcomes. We first propose the use of blood clots mixed with bone grafts for potential bone incorporation enhancement, while its specific effects need to be verified in further studies.
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Affiliation(s)
- Liang Xiong
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hui Li
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xianzhe Huang
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Shuo Jie
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Weihong Zhu
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jiankang Pan
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaoxin Wu
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xinzhan Mao
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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7
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Ciszyński M, Dominiak S, Dominiak M, Gedrange T, Hadzik J. Allogenic Bone Graft in Dentistry: A Review of Current Trends and Developments. Int J Mol Sci 2023; 24:16598. [PMID: 38068918 PMCID: PMC10706024 DOI: 10.3390/ijms242316598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
In an effort to prepare non-autologous bone graft or biomaterial that would possess characteristics comparable to autologous bone, many different allogenic bone derivatives have been created. Although different existing processing methods aim to achieve the very same results, the specific parameters applied during different stages material preparation can result in significant differences in the material's mechanical and biological properties The properties, including osteoconductive, osteoinductive, and even osteogenic potential, can differ vastly depending on particular preparation and storage techniques used. Osteogenic properties, which have long been thought to be characteristic to autogenic bone grafts only, now seem to also be achievable in allogenic materials due to the possibility to seed the host's stem cells on a graft before its implantation. In this article, we aim to review the available literature on allogenic bone and its derivatives as well as the influence of different preparation methods on its performance.
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Affiliation(s)
| | | | | | | | - Jakub Hadzik
- Department of Dental Surgery, Faculty of Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
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Yuan X, Liu F, Zhou H, Liu B, Li G, Yan P, Li G, Luo X, Lyu X, Cheng J, Niu F. A simulation study on enhancing sterilization efficiency in medical plastics through gamma radiation optimization. Sci Rep 2023; 13:20289. [PMID: 37985894 PMCID: PMC10660597 DOI: 10.1038/s41598-023-47771-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/18/2023] [Indexed: 11/22/2023] Open
Abstract
Gamma radiation is progressively emerging as an effective method to enhance the sterilization efficiency of medical plastics including Polyvinyl chloride (PVC). The parameters of the radiation facility will affect the efficiency of radiation sterilization. To investigate these effects, we simulate the gamma radiation sterilization performance of PVC material sample using Monte Carlo Method. The simulation results indicated that compared with the sterilization time of 20-90 min from high-temperature steam sterilization of medical waste, by optimizing the parameters of the model radiation facility, the radiation sterilization time can be reduced to 6.61 min. The optimized model facility parameters are as follows: the gamma photon energy is 1.25 MeV, the model space is 300 × 300 × 300 cm3, the reflective layer material is concrete and its thickness is 8 cm, the PVC sample layer area is 100 × 100 cm2, the distance between the radiation source and the PVC sample layer is 150 cm, the energy deposition in the bottom layer of the PVC sample layer is 1.31315 × 10-6 MeV/g. This study offers a potentially feasible way for PVC sterilization, while also providing a crucial reference for the further promotion and application of radiation sterilization technology.
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Affiliation(s)
- Xin Yuan
- Beijing Key Laboratory of Passive Safety Technology for Nuclear Energy, School of Nuclear Science and Engineering, North China Electric Power University, Beijing, 102206, China
| | - Fang Liu
- Beijing Key Laboratory of Passive Safety Technology for Nuclear Energy, School of Nuclear Science and Engineering, North China Electric Power University, Beijing, 102206, China.
| | - Hongchi Zhou
- Beijing Key Laboratory of Passive Safety Technology for Nuclear Energy, School of Nuclear Science and Engineering, North China Electric Power University, Beijing, 102206, China
| | - Bin Liu
- Beijing Key Laboratory of Passive Safety Technology for Nuclear Energy, School of Nuclear Science and Engineering, North China Electric Power University, Beijing, 102206, China
| | - Guanda Li
- Beijing Key Laboratory of Passive Safety Technology for Nuclear Energy, School of Nuclear Science and Engineering, North China Electric Power University, Beijing, 102206, China
| | - Peiguang Yan
- Shenzhen Key Laboratory of Laser Engineering, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen, 518060, China
| | - Guoping Li
- The Institute of NBC Defense, Chinese PLA Army, Beijing, 102205, China
| | - Xiaoru Luo
- The Institute of NBC Defense, Chinese PLA Army, Beijing, 102205, China
| | - Xuefeng Lyu
- Beijing Key Laboratory of Passive Safety Technology for Nuclear Energy, School of Nuclear Science and Engineering, North China Electric Power University, Beijing, 102206, China
| | - Jinxing Cheng
- Institute of Nuclear and New Energy Technology, Tsinghua University, Beijing, 100084, China
| | - Fenglei Niu
- Beijing Key Laboratory of Passive Safety Technology for Nuclear Energy, School of Nuclear Science and Engineering, North China Electric Power University, Beijing, 102206, China
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Fischer M, Bortel E, Schoon J, Behnke E, Hesse B, Weitkamp T, Bekeschus S, Pichler M, Wassilew GI, Schulze F. Cold physical plasma treatment optimization for improved bone allograft processing. Front Bioeng Biotechnol 2023; 11:1264409. [PMID: 38026873 PMCID: PMC10661279 DOI: 10.3389/fbioe.2023.1264409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
In musculoskeletal surgery, the treatment of large bone defects is challenging and can require the use of bone graft substitutes to restore mechanical stability and promote host-mediated regeneration. The use of bone allografts is well-established in many bone regenerative procedures, but is associated with low rates of ingrowth due to pre-therapeutic graft processing. Cold physical plasma (CPP), a partially ionized gas that simultaneously generates reactive oxygen (O2) and nitrogen (N2) species, is suggested to be advantageous in biomedical implant processing. CPP is a promising tool in allograft processing for improving surface characteristics of bone allografts towards enhanced cellularization and osteoconduction. However, a preclinical assessment regarding the feasibility of pre-therapeutic processing of allogeneic bone grafts with CPP has not yet been performed. Thus, this pilot study aimed to analyze the bone morphology of CPP processed allografts using synchrotron radiation-based microcomputed tomography (SR-µCT) and to analyze the effects of CPP processing on human bone cell viability and function. The analyzes, including co-registration of pre- and post-treatment SR-µCT scans, revealed that the main bone morphological properties (total volume, mineralized volume, surface area, and porosity) remained unaffected by CPP treatment if compared to allografts not treated with CPP. Varying effects on cellular metabolic activity and alkaline phosphatase activity were found in response to different gas mixtures and treatment durations employed for CPP application. It was found that 3 min CPP treatment using a He + 0.1% N2 gas mixture led to the most favourable outcome regarding a significant increase in bone cell viability and alkaline phosphatase activity. This study highlights the promising potential of pre-therapeuthic bone allograft processing by CPP prior to intraoperative application and emphasizes the need for gas source and treatment time optimization for specific applications.
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Affiliation(s)
- Maximilian Fischer
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Janosch Schoon
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Einar Behnke
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Bernhard Hesse
- Xploraytion GmbH, Berlin, Germany
- ESRF: European Synchrotron Radiation Facility, Grenoble, France
| | | | - Sander Bekeschus
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany
| | - Monika Pichler
- Cells + Tissuebank Austria Gemeinnützige GmbH, Krems an der Donau, Austria
| | - Georgi I. Wassilew
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Frank Schulze
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
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Horie M, Fujita K, Endoh S, Sugino S, Maru J, Moriyama A, Ogura I. Contaminant microorganisms in the in vitro evaluation of cellular responses of cellulose nanofibers and their microbial inactivation using gamma irradiation. Toxicol Mech Methods 2023; 33:741-754. [PMID: 37496379 DOI: 10.1080/15376516.2023.2238061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 07/28/2023]
Abstract
Cellulose nanofibers (CNFs) are fibrous nanomaterials produced from plants. Since some nanomaterials are toxic, toxicity evaluation, including in vitro examinations using cultured cells, is essential for the effective use of CNFs. On the other hand, microorganisms in the environment can contaminate CNF suspensions. The contamination of CNF samples and the effects of contaminating microorganisms on in vitro examinations were investigated in this study. Microorganism contamination in CNF samples was examined, and microbial inactivation of CNF suspensions using gamma irradiation was evaluated. After gamma-ray irradiation at absorbed doses of 0.5, 1, 5, and 10 kGy, the cellular effects of CNF suspensions were examined using 6 types of cultured cell, HaCaT, A549, Caco-2, MeT-5A, THP-1, and NR8383 cells. CNF samples were contaminated with bacteria and CNF suspensions exhibited endotoxin activity. Gamma irradiation effectively inactivated the microorganisms contained in the CNF suspensions. When the absorbed dose was 10 kGy, the fiber length of CNF was shortened, but the effect on CNF was small at 1.0 kGy or less. CNF suspensions showed lipopolysaccharides (LPS)-like cellular responses and strongly induced interleukin-8, especially in macrophages. Absorbed doses of at least 10 kGy did not affect the LPS-like activity. In this study, it was shown that the CNF suspension may be contaminated with microorganisms. Gamma irradiation was effective for microbial inactivation of suspension for invitor toxicity evaluation of CNF. In vitro evaluation of CNFs requires attention to the effects of contaminants such as LPS.
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Affiliation(s)
- Masanori Horie
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Takamatsu, Kagawa, Japan
| | - Katsuhide Fujita
- Research Institute of Science for Safety and Sustainability, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Shigehisa Endoh
- Research Institute of Science for Safety and Sustainability, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Sakiko Sugino
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Takamatsu, Kagawa, Japan
| | - Junko Maru
- Research Institute of Science for Safety and Sustainability, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Akihiro Moriyama
- Research Institute of Science for Safety and Sustainability, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Isamu Ogura
- Research Institute of Science for Safety and Sustainability, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
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Prasannan D, Shindhe PS, Jadar PG, Killedar RS, Priyanka K. Efficacy of Jatyadi, Madhughrita and honey tulle in wound management: a three-arm randomized controlled clinical trial. J Ayurveda Integr Med 2023; 14:100719. [PMID: 37271064 PMCID: PMC10242641 DOI: 10.1016/j.jaim.2023.100719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Ayurveda underlines the significance of wounds and wound healing. Acharya Susruta has highlighted the need for shastiupakramas in the management of the wound. Even with a multitude of therapeutic concepts and formulations in Ayurveda, wound management has yet to gain acceptance. OBJECTIVE To evaluate the effect of Jatyadi tulle, Madhughrita tulle, and honey tulle in the management of Shuddhavrana (clean wound). MATERIALS AND METHODS A three-arm randomized, parallel group, active-controlled, open-label clinical trial. Randomization was done through online random number generator software to allocate 45 patients treatment into three groups. Trial groups were treated with Jatyadi tulle (JT), Madhughrita tulle (MG), and control group was treated with Honey tulle (HT) for 10 days, and assessment was done on the 5th and 10th day. The wound was assessed using the Bates Jensen wound assessment tool, and the efficacy of the dressing material was assessed using the Worcestershire tissue viability team dressing assessment form. The study outcomes were early wound healing and clinical cure. RESULTS Within-group results were assessed using the Wilcoxon matched pairs test, and between-group results were assessed by Kruskal-Wallis ANOVA and Mann-Whitney U test. Significant results were obtained within-group (p value < 0.05) from day 0 and at various time points. The results between groups were found to be comparable; JT and MG were found to be significant in ease of application, removal, and patient comfort. No adverse drug events were identified throughout the study. CONCLUSION JT and MG tulle have shown significant results in the management of shuddhavrana.
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Affiliation(s)
- Dhrushnu Prasannan
- Department of Shalyatantra, KAHER's Shri B M Kankanawadi Ayurveda Mahavidyalaya, Shahapur, Belagavi, Karnataka, India.
| | - Pradeep S Shindhe
- Department of Shalyatantra, KAHER's Shri B M Kankanawadi Ayurveda Mahavidyalaya, Shahapur, Belagavi, Karnataka, India
| | - Prashant G Jadar
- Department of Rasashastra and Bhaishajya kalpana, KAHER's Shri B M Kankanawadi Ayurveda Mahavidyalaya, Shahapur, Belagavi, Karnataka, India
| | - Ramesh S Killedar
- Department of Shalyatantra, KAHER's Shri B M Kankanawadi Ayurveda Mahavidyalaya, Shahapur, Belagavi, Karnataka, India
| | - Priyanka K
- Department of Shalyatantra, KAHER's Shri B M Kankanawadi Ayurveda Mahavidyalaya, Shahapur, Belagavi, Karnataka, India
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12
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Crocker DB, Hoffman I, Carter JL, Akkus O, Rimnac CM. Fatigue crack propagation and fracture toughness of cortical bone are radiation dose-dependent. J Orthop Res 2023; 41:823-833. [PMID: 35949192 PMCID: PMC9911555 DOI: 10.1002/jor.25424] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/08/2022] [Accepted: 08/09/2022] [Indexed: 02/04/2023]
Abstract
Cortical bone allograft sterilized with a standard γ-radiation dose of 25-35kGy has demonstrated reduced static and cyclic fracture resistance compared with unirradiated bone. To mitigate radiation damage, we recently observed a dose-dependent response of high-cycle fatigue behavior of human cortical bone from 0 to 25 kGy, with lower doses exhibiting logarithmically longer fatigue lives. The objectives of this study were as follows: (1) to determine whether fracture toughness, work-to-fracture, and fatigue crack propagation resistance of human cortical bone are also radiation dose-dependent, and (2) to determine the associations of radiation dose and a Raman biomarker for collagen disorder with fracture properties. Compact tension specimens were machined from two donor femoral pairs and allocated to four treatment groups: 0 (unirradiated control), 10, 17.5, and 25 kGy. Fracture toughness specimens were monotonically loaded to failure and the critical stress intensity factor (KC ) was determined. Work-to-fracture was calculated from the load versus displacement integral up to fracture. Fatigue crack propagation specimens were cyclically loaded under constant room-temperature irrigation and fatigue crack growth rate (da/dN) and cyclic stress intensity (∆K) were calculated. Fracture toughness, work-to-fracture, and fatigue crack propagation resistance decreased 18%, 33%, and 15-fold from 0 to 25 kGy, respectively (p < 0.05). Radiation dose was more predictive of fracture properties than collagen disorder. These findings support that quasi-static and fatigue fracture properties of cortical bone are radiation dose-dependent within this dose range. The structural alterations arising from irradiation that cause these losses in fracture resistance remain to be elucidated.
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Affiliation(s)
- Dylan B. Crocker
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH
| | - Isaac Hoffman
- Department of Materials Science and Engineering, Case Western Reserve University, Cleveland, OH
| | - Jennifer L.W. Carter
- Department of Materials Science and Engineering, Case Western Reserve University, Cleveland, OH
| | - Ozan Akkus
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, OH
| | - Clare M. Rimnac
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, OH
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13
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Sauer K, Zizak I, Forien JB, Rack A, Scoppola E, Zaslansky P. Primary radiation damage in bone evolves via collagen destruction by photoelectrons and secondary emission self-absorption. Nat Commun 2022; 13:7829. [PMID: 36539409 PMCID: PMC9768145 DOI: 10.1038/s41467-022-34247-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 10/18/2022] [Indexed: 12/24/2022] Open
Abstract
X-rays are invaluable for imaging and sterilization of bones, yet the resulting ionization and primary radiation damage mechanisms are poorly understood. Here we monitor in-situ collagen backbone degradation in dry bones using second-harmonic-generation and X-ray diffraction. Collagen breaks down by cascades of photon-electron excitations, enhanced by the presence of mineral nanoparticles. We observe protein disintegration with increasing exposure, detected as residual strain relaxation in pre-stressed apatite nanocrystals. Damage rapidly grows from the onset of irradiation, suggesting that there is no minimal 'safe' dose that bone collagen can sustain. Ionization of calcium and phosphorous in the nanocrystals yields fluorescence and high energy electrons giving rise to structural damage that spreads beyond regions directly illuminated by the incident radiation. Our findings highlight photoelectrons as major agents of damage to bone collagen with implications to all situations where bones are irradiated by hard X-rays and in particular for small-beam mineralized collagen fiber investigations.
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Affiliation(s)
- Katrein Sauer
- grid.6363.00000 0001 2218 4662Charité – Universitätsmedizin Berlin, Department for Operative, Preventive and Pediatric Dentistry, Aßmannshauser Straße 4-6, 14197 Berlin, Germany
| | - Ivo Zizak
- grid.424048.e0000 0001 1090 3682Helmholtz-Zentrum Berlin, Department for Structure and Dynamics of Energy Materials (SE-ASD), Albert-Einstein-Straße 15, 12489 Berlin, Germany
| | - Jean-Baptiste Forien
- grid.250008.f0000 0001 2160 9702Lawrence Livermore National Laboratory, Materials Science Division, 7000 East Ave, Livermore, CA 94550 USA
| | - Alexander Rack
- grid.5398.70000 0004 0641 6373ESRF - The European Synchrotron, Structure of Materials Group - ID19, CS 40220, F-38043, Grenoble, Cedex 9 France
| | - Ernesto Scoppola
- grid.461615.10000 0000 8925 2562Max Planck Institute of Colloids and Interfaces, Department of Biomaterials, Am Mühlenberg 1, 14476 Potsdam, Brandenburg Germany
| | - Paul Zaslansky
- grid.6363.00000 0001 2218 4662Charité – Universitätsmedizin Berlin, Department for Operative, Preventive and Pediatric Dentistry, Aßmannshauser Straße 4-6, 14197 Berlin, Germany
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14
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α-Calcium Sulfate Hemihydrate Bioceramic Prepared via Salt Solution Method to Enhance Bone Regenerative Efficiency. J IND ENG CHEM 2022. [DOI: 10.1016/j.jiec.2022.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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15
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Herczeg CK, Song J. Sterilization of Polymeric Implants: Challenges and Opportunities. ACS APPLIED BIO MATERIALS 2022; 5:5077-5088. [PMID: 36318175 PMCID: PMC9691608 DOI: 10.1021/acsabm.2c00793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Degradable and environmentally responsive polymers have been actively developed for drug delivery and regenerative medicine applications, yet inadequate consideration of their compatibility with terminal sterilization presents notable barriers to clinical translation. This Review discusses industry-established terminal sterilization methods and aseptic processing and contrasts them with innovative approaches aimed at preserving the integrity of polymeric implants. Regulatory guidelines, fiscal considerations, and potential pitfalls are discussed to encourage early integration of sterility regulatory considerations in material designs.
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Affiliation(s)
- Chloe K Herczeg
- Department of Orthopedics and Physical Rehabilitation, Department of Biochemistry and Molecular Biotechnology, UMass Chan Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, United States
| | - Jie Song
- Department of Orthopedics and Physical Rehabilitation, Department of Biochemistry and Molecular Biotechnology, UMass Chan Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, United States
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16
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Beheshtizadeh N, Gharibshahian M, Pazhouhnia Z, Rostami M, Zangi AR, Maleki R, Azar HK, Zalouli V, Rajavand H, Farzin A, Lotfibakhshaiesh N, Sefat F, Azami M, Webster TJ, Rezaei N. Commercialization and regulation of regenerative medicine products: Promises, advances and challenges. Biomed Pharmacother 2022; 153:113431. [DOI: 10.1016/j.biopha.2022.113431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/04/2022] [Accepted: 07/14/2022] [Indexed: 11/02/2022] Open
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17
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It's the Biology Orthopods! Heralding a Reconstructive Revolution Through Musculoskeletal Tissue Banks (MSTB) in India. Indian J Orthop 2022; 56:1533-1546. [PMID: 36052382 PMCID: PMC9385905 DOI: 10.1007/s43465-022-00661-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND A tissue bank is an establishment that aids in retrieval, processing, storage, and distribution of human tissue for transplantation. For many years, such banks have been dispensing tissue to orthopaedic surgeons, performing reconstructive surgeries. METHODOLOGY The retrieval, preparation, and delivery of musculoskeletal tissue used for transplantation is an intricate process involving varying practices among different musculoskeletal tissue banks. RESULTS Musculoskeletal allografts are used in various orthopaedic surgeries ranging from primary bone defects, trauma, and carcinoma to congenital disabilities. Every decade brings in paradigm shifts and new hope for treating challenging cases with the aid of newer devices and materials. CONCLUSION This review article outlines various technical, regulatory and quality enhancement steps involved in tissue banking. Also, it discusses the road ahead and the research avenues for developing novel allograft products with the synergy of tissue banks and clinicians. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s43465-022-00661-0.
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18
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Ina J, Vakharia A, Akkus O, Rimnac CM. The High-cycle Fatigue Life of Cortical Bone Allografts Is Radiation Sterilization Dose-dependent: An In Vitro Study. Clin Orthop Relat Res 2022; 480:1208-1219. [PMID: 35175232 PMCID: PMC9263473 DOI: 10.1097/corr.0000000000002146] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/28/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Structural cortical bone allografts are a reasonable treatment option for patients with large cortical bone defects caused by trauma, tumors, or complications of arthroplasty. Although structural cortical bone allografts provide the benefit of an osteoconductive material, they are susceptible to fatigue failure (fracture) and carry a risk of disease transmission. Radiation-sterilization at the recommended dose of 25 kGy decreases the risk of disease transmission. However, previous studies demonstrated that radiation sterilization at this dose can negatively impact the high cycle-fatigue life of cortical bone. Although the effects of higher doses of radiation on cortical bone allografts are well described, the effects of lower doses of radiation on a high-cycle fatigue life of cortical bone are poorly understood. QUESTIONS/PURPOSES (1) Does the cycle-fatigue life of human cortical allograft bone vary with gamma radiation dose levels of 0 (control), 10 kGy, 17.5 kGy, and 25 kGy? (2) What differences in Raman spectral biomarkers are observed following varying doses of gamma radiation exposure? METHODS The high-cycle fatigue behavior of human cortical bone specimens was examined at different radiation sterilization doses under physiologic stress levels (35 MPa) and in a 37° C phosphate-buffered saline bath using a custom-designed rotating-bending fatigue device. Six human femora from three donors were obtained for this study (two male, 63 and 61 years old, respectively, and one female, 48 years old). Test specimens were allocated among four treatment groups (0 kGy [control], 10 kGy, 17.5 kGy, and 25 kGy) based on donor and anatomic location of harvest site (both length and cross-sectional quadrant of femoral diaphysis) to ensure equal variation (n = 13 per group). Specimens underwent high-cycle fatigue testing to failure. The number of cycles to failure was recorded. Raman spectroscopy (a noninvasive vibrational spectroscopy used to qualitatively assess bone quality) was used to detect whether any changes in Raman spectral biomarkers occurred after varying doses of gamma radiation exposure. RESULTS There was a decrease in the log-transformed mean high-cycle fatigue life in specimens irradiated at 25 kGy (5.39 ± 0.32) compared with all other groups (0 kGy: 6.20 ± 0.50; 10k Gy: 6.35 ± 0.79; 17.5 kGy: 6.01 ± 0.53; p = 0.001). Specimens irradiated at 25 kGy were also more likely to exhibit a more brittle fracture surface pattern than specimens with more ductile fracture surface patterns irradiated at 0 kGy, 10 kGy, and 17.5 kGy (p = 0.04). The Raman biomarker for the ratio of the relative amount of disordered collagen to ordered collagen showed a decrease at the 10 kGy radiation level from 1.522 ± 0.025 preirradiation to 1.489 ± 0.024 postirradiation (p = 0.01); no other detectable changes in Raman biomarkers were observed. CONCLUSION The high-cycle fatigue life of cortical bone undergoes a nonlinear, dose-dependent decrease with an increase in gamma radiation sterilization in a clinically relevant dose range (0-25 kGy). Importantly, a notable drop-off in the high-cycle fatigue life of cortical bone appeared to occur between 17.5 kGy and 25 kGy, correlating to a sixfold decrease in mean cycles to failure. We speculate that the decrease in the Raman biomarker for disordered collagen at 10 kGy with no loss in high-cycle fatigue life may be caused by an increased amount of nonenzymatic crosslinking of the collagen backbone relative to collagen chain-scission (whereas the benefits of crosslinking may be outweighed by excess scission of the collagen backbone at higher radiation doses), but future studies will need to ascertain whether this in fact is the case. CLINICAL RELEVANCE Radiation sterilization at the industry standard of 25 kGy has a substantial negative impact on the high-cycle fatigue life of cortical bone. Given these findings, it is possible to provide a meaningful increase in the high-cycle fatigue life and improve the overall functional lifetime of cortical bone allografts by lowering the radiation-sterilization dose below 25 kGy. Future work on radiation-sterilization methods at these clinically relevant doses is warranted to aid in preserving the high cycle fatigue life of cortical bone allografts while maintaining sterility.
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Affiliation(s)
- Jason Ina
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Ajit Vakharia
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Ozan Akkus
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Clare M. Rimnac
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH, USA
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19
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Łabuś W, Kitala D, Klama-Baryła A, Szapski M, Kraut M, Smętek W, Glik J, Kucharzewski M, Rojczyk E, Utrata-Wesołek A, Trzebicka B, Szeluga U, Sobota M, Poloczek R, Kamiński A. Influence of electron beam irradiation on extracellular matrix of the human allogeneic skin grafts. J Biomed Mater Res B Appl Biomater 2021; 110:547-563. [PMID: 34478207 DOI: 10.1002/jbm.b.34934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/29/2021] [Accepted: 08/22/2021] [Indexed: 12/14/2022]
Abstract
The nonviable allogeneic human skin grafts might be considered as the most suitable skin substitutes in the treatment of extensive and deep burns. However, in accordance to biological security such grafts require the final sterilization prior to clinical application. The aim of the study was to verify the influence of electron beam irradiation of three selected doses: 18, 25, and 35 kGy on the extracellular matrix of human skin. Prior to sterilization, the microbiological tests were conducted and revealed contamination in all examined cases. Individual groups were subjected to single electron beam radiation sterilization at proposed doses and then subjected to microbiological tests again. The results of microbiological testing performed for all irradiation doses used were negative. Only in the control group was a growth of microorganisms observed. The FTIR spectrometry tests were conducted followed by the histological evaluation and mechanical tests. In addition, cost analysis of radiation sterilization of individual doses was performed. The results of spectroscopic analysis, mechanical tests, and histological staining showed no significant changes in composition and characteristics of tested tissues after their irradiation, in comparison to control samples. The cost analysis has shown that irradiation with 18 kGy is the most cost-effective and 35 kGy is the least favorable. However, according to biological risk reduction, the recommended sterilization dose is 35 kGy, despite the higher price compared to the other doses tested.
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Affiliation(s)
- Wojciech Łabuś
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland
| | - Diana Kitala
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland
| | | | - Michał Szapski
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland.,Gyncentrum, Laboratory of Molecular Biology and Virology, Katowice, Poland
| | - Małgorzata Kraut
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland
| | - Wojciech Smętek
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland.,Warsaw University of Technology, Warsaw, Poland
| | - Justyna Glik
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland.,Department of Chronic Wounds Healing Management Chronic Wound Care, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Marek Kucharzewski
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland.,Department of Descriptive and Topographic Anatomy, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Ewa Rojczyk
- Department of Descriptive and Topographic Anatomy, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | | | - Barbara Trzebicka
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, Zabrze, Poland
| | - Urszula Szeluga
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, Zabrze, Poland
| | - Michał Sobota
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, Zabrze, Poland
| | - Ryszard Poloczek
- Laboratory for Microscopic Examination "Diagno-Med", Siemianowice Slaskie, Poland
| | - Artur Kamiński
- Department of Transplantology and Central Tissue Bank, Medical University of Warsaw, Warszawa, Poland.,National Centre for Tissue and Cell Banking, Warszawa, Poland
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20
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Bargh S, Silindir-Gunay M, Ozer AY, Ekizoglu M, Kart D, Kutlu B, Nohutcu R. The effect of gamma and microwave radiation sterilization on periodontological grafts for microbiological evaluation. APMIS 2021; 129:587-597. [PMID: 34117658 DOI: 10.1111/apm.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 02/05/2021] [Accepted: 05/31/2021] [Indexed: 11/29/2022]
Abstract
Periodontological grafts are materials used in dentistry to regenerate lost gingival soft tissues or bone parts. In the case of direct contact with blood, the possibility of disease transmission from the source to the patient is high. This source can be an animal or a human. Therefore, the sterilization of grafts before implanting to the patient is of significant importance. The purpose of this study was to evaluate gamma radiation and microwave sterilization processes from microbiological and sterility perspectives and to compare the effectiveness of these two sterilization methods. Grafts were irradiated with 2, 4, 5, 10, 25 and 50 kGy doses of gamma radiation. Another group of same materials was irradiated by microwave for 1, 2, 3 and 4 min at 24,500 MHz and 900 W. Gamma radiation and microwave sterilization methods were evaluated as successful at minimum doses as 5 kGy and 3 min, respectively. Both gamma and microwave sterilization successfu lly sterilized periodontological grafts coded as PBG1, HBG1, HL1, PDG1, MBG3, MDG2 and PDG3. Moreover, microwave sterilization can be used as an alternative novel method to gamma radiation sterilization.
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Affiliation(s)
- Saharnaz Bargh
- Department of Radiopharmacy, Faculty of Pharmacy, Hacettepe, Ankara, Turkey
| | | | - A Yekta Ozer
- Department of Radiopharmacy, Faculty of Pharmacy, Hacettepe, Ankara, Turkey
| | - Melike Ekizoglu
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Hacettepe, Ankara, Turkey
| | - Didem Kart
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Hacettepe, Ankara, Turkey
| | - Burak Kutlu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Rahime Nohutcu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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21
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Dantas LR, Wollmann LC, Suss PH, Kraft L, Ribeiro VST, Tuon FF. Disinfection protocol for human musculoskeletal allografts in tissue banking using hydrogen peroxide 30. Cell Tissue Bank 2021; 22:643-649. [PMID: 34091815 DOI: 10.1007/s10561-021-09938-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
Musculoskeletal allografts are used in reconstructive procedures, however, the risk of contamination with potential pathogens is possible, and safe transplantation requires multiple processing considerations. Hydrogen peroxide (H2O2) has commonly been used in bone washing because it can remove donor cells and eliminate antigens, pathogens, or cytotoxic agents from the matrix. The aim of this study was to evaluate the quantitative activity of H2O2 in a model of bone contamination with a high bacterial load to define the bioburden reduction. Twelve bone disc models were artificially contaminated with Staphylococcus aureus. The bones were treated with a washing process composed by antibiotics, 30% hydrogen peroxide, and 70% alcohol. Tryptic Soy Agar plates were directly inoculated with 100µL of each step of the washing process and colonies were counted in CFU/mL. Scanning electron microscopy was used for bone structural analysis before and after the washing process. After antibiotics, there was a drop of less than 1 log for cancellous bone and almost 1 log for cortical bone. However, after H2O2, there as a drop of 3 logs for cortical (p = 0.007), and 2 logs for cancellous bone (p = 0.063). The use of alcohol did not change the bioburden following H2O2 in cancellous and cortical bone. Despite the important drop of bacterial load, H2O2 was not enough to completely eradicate bacterial with this model of bioburden. H2O2 is useful in decontamination, but antibiotics have little activity, and alcohol is useless. The process is useful in decontamination up to 3 logs of bioburden.
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Affiliation(s)
- Leticia Ramos Dantas
- Laboratory of Emerging Infectious Diseases, Escola de Medicina, Pontifícia Universidade Católica Do Paraná, Rua imaculada Conceição 1155, Curitiba, Paraná, 80215-901, Brazil
| | | | - Paula Hansen Suss
- Laboratory of Emerging Infectious Diseases, Escola de Medicina, Pontifícia Universidade Católica Do Paraná, Rua imaculada Conceição 1155, Curitiba, Paraná, 80215-901, Brazil
| | - Leticia Kraft
- Laboratory of Emerging Infectious Diseases, Escola de Medicina, Pontifícia Universidade Católica Do Paraná, Rua imaculada Conceição 1155, Curitiba, Paraná, 80215-901, Brazil
| | - Victoria Stadler Tasca Ribeiro
- Laboratory of Emerging Infectious Diseases, Escola de Medicina, Pontifícia Universidade Católica Do Paraná, Rua imaculada Conceição 1155, Curitiba, Paraná, 80215-901, Brazil
| | - Felipe Francisco Tuon
- Laboratory of Emerging Infectious Diseases, Escola de Medicina, Pontifícia Universidade Católica Do Paraná, Rua imaculada Conceição 1155, Curitiba, Paraná, 80215-901, Brazil.
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22
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Gomes AD, de Oliveira AAR, Houmard M, Nunes EHM. Gamma sterilization of collagen/hydroxyapatite composites: Validation and radiation effects. Appl Radiat Isot 2021; 174:109758. [PMID: 33962117 DOI: 10.1016/j.apradiso.2021.109758] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/06/2021] [Accepted: 04/26/2021] [Indexed: 11/30/2022]
Abstract
In this work, gamma sterilization was validated, and the impact of this sterilization process on collagen/hydroxyapatite (Col/HAp) composites was investigated. It has been already recognized that the improper sterilization of healthcare products may lead to infection and mortality/morbidity issues in patients. Gamma sterilization has emerged as a promising sterilization method because it shows advantages such as low cost, a small increase in temperature of irradiated materials, and no production of toxic residues. Moreover, gamma rays can reach the products even when contained in sealed packages. The dose of gamma radiation applied in this study ranged from 17.5 to 50 kGy. The studied samples were examined by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), thermogravimetry (TG), and differential scanning calorimetry (DSC). No apparent effect of gamma radiation on HAp was observed even when doses as high as 50 kGy were applied. On the other hand, Col was greatly affected by gamma radiation, displaying cross-linking and degradation after sterilization. These structural changes may alter Col's properties, which could, in turn, impact its medical use. As a consequence, it is strongly recommended that the irradiation dose used to sterilize the Col/HAp composites shall be kept as low as possible to mitigate the structural changes induced in Col. It was noticed that a radiation dose of 17.5 kGy was sufficient to sterilize the examined samples because a sterility assurance level (SAL) below 10-6 was detected. Although dramatic structural changes were observed in Col when this dose was applied, the sterilized samples showed no toxicity to human mesenchymal stem cells. Based on these results, we established a VDMax of 17.5 kGy for Col/HAp-based healthcare products.
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Affiliation(s)
- Anderson D Gomes
- JHS Biomaterials, Rua Ouro Branco 345, Novo Alvorada, Sabará, Minas Gerais, CEP, 34650-120, Brazil; Universidade Federal de Minas Gerais, Escola de Engenharia, Departamento de Engenharia Metalúrgica e de Materiais, Bloco 2, Sala 2233, Avenida Presidente Antônio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, CEP, 31270-901, Brazil.
| | - Agda A R de Oliveira
- JHS Biomaterials, Rua Ouro Branco 345, Novo Alvorada, Sabará, Minas Gerais, CEP, 34650-120, Brazil
| | - Manuel Houmard
- Universidade Federal de Minas Gerais, Escola de Engenharia, Departamento de Engenharia Química, Bloco 2, Sala 5212, Avenida Presidente Antônio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, CEP, 31270-901, Brazil
| | - Eduardo H M Nunes
- Universidade Federal de Minas Gerais, Escola de Engenharia, Departamento de Engenharia Metalúrgica e de Materiais, Bloco 2, Sala 2233, Avenida Presidente Antônio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, CEP, 31270-901, Brazil.
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23
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Ilyas I, Al-Mohrej OA. High Incidence of Irradiated Cortical Strut Allograft Resorption Following Revision of Femoral Stems. J Arthroplasty 2021; 36:1413-1419. [PMID: 33158636 DOI: 10.1016/j.arth.2020.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/06/2020] [Accepted: 10/14/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Despite the widespread use of revision total hip arthroplasties using cementless stems and cortical strut allografts, graft resorption has not been explicitly studied. METHODS Between 2010 and 2018, 40 femoral strut grafts were used in the revision of femoral stems of 36 patients (18 males and 18 females; average age, 51.9 ± 12.9 years). The mean follow-up was 78.9 ± 37.3 months. Failure was defined as revision surgery for any reason and subsidence of greater than 5 mm. RESULTS The survival rate of the stem without the need for revision at 5 years was 95% (mean graft survival time, 10.8 [95% CI, 9.414-12.234] years). Overall survival with graft resorption as the endpoint was 90% at 5 years (mean graft survival time, 8.8 [95% CI, 7.5-10.2] years). Survival with graft nonunion as the endpoint was 90% at 3 years (mean survival time, 11.7 [95% CI, 10.5-12.8] years). CONCLUSION The resorption rate increases proportionally to the follow-up duration and can be very severe in a high percentage of cases. Long-term multicenter studies are required to assess the effect of resorption on prosthesis longevity.
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Affiliation(s)
- Imran Ilyas
- Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Omar A Al-Mohrej
- Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
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24
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Ilays I, Alsakran SA, Fallatah AB, Alyateem M, Al-Mohrej OA. The contamination of allografts in multi-organ donors: a bone bank experience. Cell Tissue Bank 2021; 22:499-504. [PMID: 33420876 DOI: 10.1007/s10561-020-09899-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023]
Abstract
As a consequence of the preference for homologous tissues, bone banks are the primary source of bone and tendon grafts. However, the bacterial, viral, and fungal contamination of these grafts remains a considerable challenge in bone banks and often results in high rates of graft discarding and infections in patients. This study intended to investigate bacterial contamination in 509 bone grafts harvested from 110 multiorgan donors. Specimen collection included bone and soft tissue retrieved from culture-swabbing as well as bone and capsule for histopathology. Microbiological, histopathological, and radiographic analyses were carried out. Secondary sterilization was also conducted using cobalt 60 at the dose of 2.5 × 104 Gy. There were 106 multi-organ donors. Of the 506 grafts, there were 54 Hemi pelvis, 191 femur, 142 tibia, and 119 fibulae. The surface swab contamination rate for all the grafts retrieved was 16.6%, and bone culture from all the grafts was 6.1%. When we looked at the incidence of contamination according to the location than the surface swab contamination rate for hemipelvis was 18 (33.3%), femur 30 (15.7%), tibia 21(14.7%) and fibula 15 (12.6%). The bone cultures were hemipelvis 12 (22.2%) femur 8 (4.1%), tibia 5 (3.5%) and fibula 6 (5.04%). These findings suggest that separate harvesting of the grafts in reverse order may help prevent contamination. The study also recommends discarding all grafts contaminated even with low pathogenicity organisms. However, bioburden needs to be further investigated to be detected and reduced.
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Affiliation(s)
- Imran Ilays
- Bone Bank, Faisal Specialist Hospital and Research Centre, Riyadh, King, Saudi Arabia.,Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Centre, P.O. Box 3354 MBC 77, Riyadh, 11211, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Shuruq A Alsakran
- Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Centre, P.O. Box 3354 MBC 77, Riyadh, 11211, Saudi Arabia
| | - Abdulelah B Fallatah
- Bone Bank, Faisal Specialist Hospital and Research Centre, Riyadh, King, Saudi Arabia
| | - Mohammad Alyateem
- Bone Bank, Faisal Specialist Hospital and Research Centre, Riyadh, King, Saudi Arabia
| | - Omar A Al-Mohrej
- Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Centre, P.O. Box 3354 MBC 77, Riyadh, 11211, Saudi Arabia.
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25
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Grego T, Jurković L, Lyons DM, Kralj D, Maltar-Strmečki N. The influence of the saline and artificial saliva on gamma induced radical concentration in dental bone graft materials based on calcium sulfate studied by EPR spectroscopy. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2020.109138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Jeong K, Jung KJ, Bae J, Kim J, Seo J, Park CH, Kim S, Song IH. Laser sterilization of hydroxyapatite implants as an alternative to using radioactive facility. OPTIK 2020. [DOI: 10.1016/j.ijleo.2020.165200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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27
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Rahman N, Khan R, Hussain T, Ahmed N. Investigation of the mechanism of gamma irradiation effect on bovine bone. Cell Tissue Bank 2020; 21:249-256. [PMID: 32067198 DOI: 10.1007/s10561-020-09817-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/12/2020] [Indexed: 01/22/2023]
Abstract
Radiation sterilization is an effective method of bone sterilization prior to bone graft transplantation. Gamma irradiation affects the biological and mechanical properties of bone; depending on the dose of radiation. The effect of gamma irradiation on bone mechanical properties is an unwanted phenomenon. However the mechanism of the effect of irradiation on bone mechanical properties is not properly understood. In this research paper the mechanism of the effect of gamma irradiation on bovine bone is investigated using scanning electron microscopy, energy-dispersive X-rays spectroscopy and Fourier transform infrared spectroscopy techniques. Gamma irradiation affects the mineral and fiber composition of bovine bone. The mineral content of bone especially calcium, magnesium and phosphorus decrease with increasing dose of gamma radiation. At Nano-level gamma irradiation alter amide I, amide II and amide III collagen contents. High dose gamma irradiation induces collagen cross-linking reaction in bone and degrades bone properties.
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Affiliation(s)
- Noor Rahman
- International Islamic University Islamabad, Islamabad, Pakistan.
| | - Rafiullah Khan
- International Islamic University Islamabad, Islamabad, Pakistan
| | - Tanvir Hussain
- International Islamic University Islamabad, Islamabad, Pakistan
| | - Nabi Ahmed
- International Islamic University Islamabad, Islamabad, Pakistan
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28
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Calcium phosphate formation on TiO2 nanomaterials of different dimensionality. Colloids Surf A Physicochem Eng Asp 2020. [DOI: 10.1016/j.colsurfa.2020.124615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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29
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Bargh S, Silindir-Gunay M, Ozer AY, Palaska E, Karaarslan D, Ide S, Solpan D. Physicochemical evaluation of gamma and microwave irradiated dental grafts. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2019.108627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Ku JK, Kim BJ, Park JY, Lee JH, Yun PY, Kim YM, Um IW. Effects of gamma irradiation on the measurement of hepatitis B virus DNA in dentin harvested from chronically infected patients. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:314. [PMID: 32355758 PMCID: PMC7186722 DOI: 10.21037/atm.2020.03.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background The manufacturing of the demineralized dentin matrix (DDM) has been proven to extensively reduce the presence of human hepatitis B viral DNA (HBV DNA). This study measured and compared HBV DNA in fresh dentin to that in gamma radiation (GR)-sterilized dentin extracted from HBV-infected patients. The application of GR as a means of terminal sterilization is hypothesized to inactivate or eliminate HBV within the dentin matrix. Methods Dentin from 18 HBV-infected patients was collected and divided into three fragments. The first fragment was unaltered and used as the control group; the remaining two fragments were sterilized with gamma radiation doses of 15 or 25 kGy. DNA was extracted and purified from each fresh (control), and the GR-sterilized (experimental) dentin specimen and HBV DNA copy numbers were evaluated on the basis of the real-time polymerase chain reaction. The copy numbers were used to assess GR efficacy as a means of terminal sterilization for HBV inactivation or elimination. Results HBV DNA was detected in 66.67% of the fresh dentin specimens. The differences in HBV DNA levels between the fresh dentin and the GR-sterilized dentin were confirmed by the Wilcoxon signed-rank test for the doses of 15 and 25 kGy with P value of 0.012 and 0.010, respectively. Among the twelve HBV-DNA-positive fresh dentin samples, HBV DNA persisted in eleven after GR sterilization, yet the copy number was reduced to <10 (except for a single sample within each experimental group). Conclusions The results suggest that 15 and 25 kGy of GR significantly reduced the HBV DNA levels in the fresh dentin matrix. Expansion of the possible clinical applications of allogenic grafts with the irradiated DDM will require additional studies, including validation of viral load inactivation to prevent infectious transmission and examination of GR exposure effects on the osteoinductivity of the matrix.
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Affiliation(s)
- Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Hospital, Seongnam, Korea
| | - Bong-Ju Kim
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea
| | - Joo-Young Park
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea
| | - Jong-Ho Lee
- Clinical Trial Center, Seoul National University Dental Hospital, Seoul, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yu-Mi Kim
- R&D Institute, Korea Tooth Bank, Seoul, Korea
| | - In-Woong Um
- R&D Institute, Korea Tooth Bank, Seoul, Korea
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31
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Sun Y, Lovric V, Wang T, Oliver RA, Walsh WR. Effects of SCCO 2, Gamma Irradiation, and Sodium Dodecyl Sulfate Treatments on the Initial Properties of Tendon Allografts. Int J Mol Sci 2020; 21:ijms21051565. [PMID: 32106592 PMCID: PMC7084268 DOI: 10.3390/ijms21051565] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/07/2020] [Accepted: 02/15/2020] [Indexed: 01/05/2023] Open
Abstract
Sterile and decellularized allograft tendons are viable biomaterials used in reconstructive surgeries for dense connective tissue injuries. Established allograft processing techniques including gamma irradiation and sodium dodecyl sulfate (SDS) can affect tissue integrity. Supercritical carbon dioxide (SCCO2) represents a novel alternative that has the potential to decellularize and sterilize tendons with minimized exposure to denaturants, shortened treatment time, lack of toxic residues, and superior tissue penetration, and thus efficacy. This study attempted to develop a single-step hybrid decellularization and sterilization protocol for tendons that involved SCCO2 treatment with various chemical additives. The processed tendons were evaluated with mechanical testing, histology, scanning electron microscopy (SEM), and Fourier-transform infrared (FTIR) spectroscopy. Uniaxial mechanical testing showed that tendons treated with SCCO2 and additive NovaKillTM Gen2 and 0.1% SDS had significantly higher (p < 0.05) ultimate tensile stress (UTS) and Young's modulus compared to gamma-irradiated and standard-SDS-treated tendons. This was corroborated by the ultrastructural intactness of SCCO2-treated tendons as examined by SEM and FTIR spectroscopy, which was not preserved in gamma-irradiated and standard SDS-treated tendons. However, complete decellularization was not achieved by the experimented SCCO2-SDS protocols used in this study. The present study therefore serves as a concrete starting point for development of an SCCO2-based combined sterilization and decellularization protocol for allograft tendons, where additive choice is to be optimized.
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32
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Suhardi JV, Morgan DFA, Muratoglu OK, Oral E. Radioprotection and cross-linking of allograft bone in the presence of vitamin E. J Biomed Mater Res B Appl Biomater 2020; 108:2354-2367. [PMID: 31975566 DOI: 10.1002/jbm.b.34569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/11/2019] [Accepted: 01/06/2020] [Indexed: 11/08/2022]
Abstract
Bone allografts are the preferred method for bone augmentation in over 500,000 orthopedic surgical procedures in the US. Sterilization by ionizing radiation is the most effective method of minimizing the bioburden of bone allografts; however, radiation causes chain scission of collagen, resulting in the reduction of the allografts' mechanical strength. In this study, we doped bone allografts with vitamin E as radioprotectant using a novel two-step process to protect the collagen architecture against radiation damage and to preserve the mechanical strength of the construct. In addition, combining the radioprotectant with a cross-linking agent further minimized collagen degradation and further preserved the mechanical strength of the allografts. Both vitamin E and combined vitamin E/genipin-treated allograft were less cytotoxic to both osteoblasts and osteoclasts when compared to irradiated-only allografts. Host bone-allograft unionization was faster in a rat calvaria defect model with vitamin E-treated and combined vitamin E and genipin-treated allograft when compare to irradiated-only allografts. This method can enable the efficient and uniform radioprotective treatment of bone allograft of desired shapes for sterilization with improved mechanical strength and biointegration.
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Affiliation(s)
- Jeremy V Suhardi
- Harris Orthopedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medical Engineering and Medical Physics, Massachusetts Institute of Technology, Boston, Massachusetts.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
| | | | - Orhun K Muratoglu
- Harris Orthopedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
| | - Ebru Oral
- Harris Orthopedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
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33
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Thong FY, Mansor A, Ramalingam S, Yusof N. Does bone marrow aspirate help enhance the integration of gamma irradiated allograft bone? Cell Tissue Bank 2020; 21:107-117. [PMID: 31894432 DOI: 10.1007/s10561-019-09804-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022]
Abstract
Bone allografts donated by other individuals offer a viable alternative to autograft. Risks of disease transmission are overcome by sterilizing the bone; unfortunately sterilization methods generally affect bone functional properties including osteogenic potential and biomechanical integrity. This study aimed to determine any enhancement effect when gamma sterilised allografts was impregnated with autologous bone marrow in improving the rate and quality of integration in metaphyseal-tibial defects of rabbits. Almost all subjects showed 50% of the defect being covered by new bones by the third week and smaller residual defect size in the treated group at the fifth week. Hounsfield units at the defect site showed increasing healing in all samples, with the treated group having an apparent advantage although insignificant (p > 0.05). In the histopathological score evaluating healing over cortical and cancellous bone at the fracture site showed only slight variations between the groups (p > 0.05). Therefore no enhanced healing by the autologous bone marrow was observed when added to the bone allografts in treating the unicortical defects.
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Affiliation(s)
- Fu Yuen Thong
- Bone Bank, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Azura Mansor
- Bone Bank, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Saravana Ramalingam
- Bone Bank, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Norimah Yusof
- Bone Bank, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
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34
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Op 't Veld RC, Eerden M, Wagener FADTG, Kouwer PHJ, Jansen JA, Walboomers XF. Polyisocyanopeptide Hydrogels Are Effectively Sterilized Using Supercritical Carbon Dioxide. Tissue Eng Part C Methods 2019; 26:132-141. [PMID: 31847754 DOI: 10.1089/ten.tec.2019.0305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adequate sterilization procedures for soft biomaterials such as hydrogels are known to be challenging. These materials are delicate in structure, making them sensitive to harsh conditions and prone to damage. In this study, a suitable sterilization method for hydrogels composed of tri(ethylene glycol)-functionalized polyisocyanopeptides (PIC) was explored. These high biomimetic hydrogels are temperature and strain sensitive and have been presented as novel cell culturing matrices, wound dressings, and drug carriers. The methods that were investigated include autoclaving, γ-irradiation, ultraviolet (UV) light irradiation, and supercritical CO2 (scCO2) treatment. The results show that autoclaving and γ-irradiation have deleterious effects on the gelation behavior and mechanical characteristics of PIC. For γ-irradiation, cooling the gels on dry ice alleviated this negative impact, but not sufficiently enough to make the method viable. In contrast, UV light and scCO2 treatment do not affect the mechanical properties of the PIC gels. Studies with gels inoculated with 107 CFU/mL Gram-positive bacteria Staphylococcus aureus show that only scCO2 is capable of successfully sterilizing PIC hydrogels by achieving a 6-log reduction in bacterial load. It was concluded that, within the range of tested techniques, the sterilization of PIC is limited to scCO2.
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Affiliation(s)
- Roel C Op 't Veld
- Department of Dentistry-Biomaterials, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Dentistry-Orthodontics and Craniofacial Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Frank A D T G Wagener
- Department of Dentistry-Orthodontics and Craniofacial Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul H J Kouwer
- Department of Molecular Materials, Institute for Molecules and Materials, Radboud University, Nijmegen, The Netherlands
| | - John A Jansen
- Department of Dentistry-Biomaterials, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - X Frank Walboomers
- Department of Dentistry-Biomaterials, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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35
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Das P, Singh YP, Mandal BB, Nandi SK. Tissue-derived decellularized extracellular matrices toward cartilage repair and regeneration. Methods Cell Biol 2019; 157:185-221. [PMID: 32334715 DOI: 10.1016/bs.mcb.2019.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The inability of cartilage tissue to self-heal due to its avascular nature often leads to conditions such as osteoarthritis, traumatic rupture of cartilage, and osteochondrosis. The cartilage provides cushioning effects between the joints and avoids bone frictions. The extracellular matrix (ECM) of cartilage consists predominantly of collagens, elastin, proteoglycans and glycoproteins. A number of tissue engineered ECM derived biological scaffolds and matrices are available for cartilage regeneration. The decellularized tissues provide appropriate bioactive cues in the absence of cellular components, hence avoiding immunological issue. However, the decellularization process involves several cellular disruption techniques that may alter the ECM architecture affecting bioactivity. Therefore, development of cell-free cartilage biomaterials with unaltered ECM integrity and bioactivity is of paramount necessity by smart selection of modified techniques and agents. Herein, we described about various decellularization methods, agents, techniques, and their applications in tissue/cartilage decellularization. It also contemplates various difficulties and future perspectives to troubleshoot the existing obstructions in tissue-derived cartilage matrices and their applications.
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Affiliation(s)
- Piyali Das
- School of Bioscience and Engineering, Jadavpur University, Kolkata, West Bengal, India
| | - Yogendra Pratap Singh
- Biomaterial and Tissue Engineering Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India
| | - Biman B Mandal
- Biomaterial and Tissue Engineering Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India; Centre for Nanotechnology, Indian Institute of Technology Guwahati, Guwahati, Assam, India.
| | - Samit Kumar Nandi
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, West Bengal, India.
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36
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Kucko NW, Li W, García Martinez MA, Rehman IU, Ulset AST, Christensen BE, Leeuwenburgh SCG, Herber RP. Sterilization effects on the handling and degradation properties of calcium phosphate cements containing poly (D,L
-lactic-co-glycolic acid) porogens and carboxymethyl cellulose. J Biomed Mater Res B Appl Biomater 2019; 107:2216-2228. [DOI: 10.1002/jbm.b.34306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/07/2018] [Accepted: 12/19/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Nathan W. Kucko
- Department of Regenerative Biomaterials; Radboud University Medical Center; Philips van Leydenlaan 25, 6525 EX, Nijmegen The Netherlands
- CAM Bioceramics B.V.; Zernikedreef 6, 2333 CL, Leiden The Netherlands
| | - Wenliang Li
- Department of Regenerative Biomaterials; Radboud University Medical Center; Philips van Leydenlaan 25, 6525 EX, Nijmegen The Netherlands
| | - Marcela A. García Martinez
- Department of Materials Science and Engineering; The Kroto Research Institute, The University of Sheffield; North Campus, Broad Lane, S3 7HQ, Sheffield UK
| | - Ihtesham ur Rehman
- Department of Materials Science and Engineering; The Kroto Research Institute, The University of Sheffield; North Campus, Broad Lane, S3 7HQ, Sheffield UK
| | - Ann-Sissel Teialeret Ulset
- NOBIPOL, Department of Biotechnology and Food Science; Norwegian University of Science and Technology; Sem Saeland veg 6/8, NO-7491, Trondheim Norway
| | - Bjørn E. Christensen
- NOBIPOL, Department of Biotechnology and Food Science; Norwegian University of Science and Technology; Sem Saeland veg 6/8, NO-7491, Trondheim Norway
| | - Sander C. G. Leeuwenburgh
- Department of Regenerative Biomaterials; Radboud University Medical Center; Philips van Leydenlaan 25, 6525 EX, Nijmegen The Netherlands
| | - Ralf-Peter Herber
- CAM Bioceramics B.V.; Zernikedreef 6, 2333 CL, Leiden The Netherlands
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37
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da Costa RC, Pereira ED, Silva FM, de Jesus EO, Souza Jr. FG. Drug Micro-Carriers Based on Polymers and Their Sterilization. CHEMISTRY & CHEMICAL TECHNOLOGY 2018. [DOI: 10.23939/chcht12.04.473] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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38
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Wang S, Zhang C, Cai Y, Lin X. Autograft or Allograft? Irradiated or Not? A Contrast Between Autograft and Allograft in Anterior Cruciate Ligament Reconstruction: A Meta-analysis. Arthroscopy 2018; 34:3258-3265. [PMID: 30396800 DOI: 10.1016/j.arthro.2018.06.053] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 06/21/2018] [Accepted: 06/25/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the clinical outcomes and adverse events associated with irradiated and nonirradiated allografts in anterior cruciate ligament (ACL) reconstruction. METHODS PubMed, Web of Science, and EMBASE were searched for randomized controlled trials from January 1990 to March 2018 to compare autograft with allograft in ACL reconstruction. Both objective and subjective outcomes of the function and adverse events were meta-analyzed. Two comparisons were summarized: (1) autograft and nonirradiated allograft and (2) autograft and irradiated allograft. The bias risk was based on the Cochrane Handbook for Systematic Reviews of Interventions. The overall risk ratio or weighted mean difference was calculated using a fixed- or random-effects model. Heterogeneity between studies was evaluated by the Q and the I2 statistics. RESULTS Eleven trials were included in this review for meta-analysis. A total of 1,172 patients were involved (465 autograft and 461 nonirradiated allograft; 141 autograft and 138 irradiated allograft patients). The average follow-up varied from 2 to >10 years. The mean patient age varied from 22 to 32.8 years. The total failure rate was 2.5%. Our analyses demonstrated better clinical outcomes in autograft than irradiated allograft, which could be observed clearly through the International Knee Documentation Committee score (3.84; 95% confidence interval [CI], 1.93-5.76; P < .0001; I2 = 0%), Lysholm score (2.94; 95% CI, 0.66-5.22; P = .01; I2 = 0%), and Tegner score (0.14; 95% CI, -0.08 to 0.36; P = .22; I2 = 0%) with fewer adverse events 0.20 (95% CI, 0.11-0.39; P < .00001; I2 = 0%). There were no significant differences in autograft and nonirradiated allograft groups (P = .47, P = .27, P = .24, and P = .24, respectively). CONCLUSIONS Autograft offered greater advantages in functional outcomes and adverse events than irradiated allograft in ACL reconstruction; however, there were no significant differences between autograft and nonirradiated allograft in ACL reconstruction. LEVEL OF EVIDENCE Level II, meta-analysis of Level I and Level II studies.
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Affiliation(s)
- ShuaiYi Wang
- Center for Sport Medicine, First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, China
| | - Chi Zhang
- Center for Sport Medicine, First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, China
| | - YouZhi Cai
- Center for Sport Medicine, First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, China
| | - XiangJin Lin
- Center for Sport Medicine, First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, China.
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39
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Rahman N, Khan R, Badshah S. Effect of x-rays and gamma radiations on the bone mechanical properties: literature review. Cell Tissue Bank 2018; 19:457-472. [PMID: 30426337 DOI: 10.1007/s10561-018-9736-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/30/2018] [Indexed: 12/21/2022]
Abstract
The bone auto grafting, isografting, allografting and xenografting are used for defective bone replacement or treatment in almost all living species. The X-ray and Gamma (electromagnetic radiation) sterilization performed on the donor bone graft to prevent toxicity or migration of virus/bacterial infections from donors to reciver. Conversely, X-ray and Gamma radiation deteriorates the bone mechanical properties and bone become more susceptible to fracture. Fracture toughness as well as other mechanical properties of bone change with these radiations. In this literature review the effect of the X-rays and Gamma radiation on bone mechanical properties are discussed. All relevant literature was reviewed. After reviewing the literature only the research relating to the effect of X-rays and Gamma radiations on bone mechanical properties are included. Literature studies showed significant effect of the X-rays and Gamma radiations on the mechanical properties of the bones. In some studies the differences exists on the doses of radiations which were discussed in this study. The high energetic electromagnetic radiation (X-rays and Gamma radiations) changed/modify the collagen network of the bone, which reduced the mechanical properties of bone; however these changes depend on the radiation dose.
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Affiliation(s)
- Noor Rahman
- Department of Mechanical Engineering, Faculty of Engineering and Technology, International Islamic University, Islamabad, H-10, Pakistan.
| | - Rafiullah Khan
- Department of Mechanical Engineering, Faculty of Engineering and Technology, International Islamic University, Islamabad, H-10, Pakistan
| | - Saeed Badshah
- Department of Mechanical Engineering, Faculty of Engineering and Technology, International Islamic University, Islamabad, H-10, Pakistan
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40
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Low-energy electron-beam treatment as alternative for on-site sterilization of highly functionalized medical products – A feasibility study. Radiat Phys Chem Oxf Engl 1993 2018. [DOI: 10.1016/j.radphyschem.2018.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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41
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Is Structural Allograft Superior to Synthetic Graft Substitute in Anterior Cervical Discectomy and Fusion? Clin Spine Surg 2018; 31:274-277. [PMID: 29608448 DOI: 10.1097/bsd.0000000000000637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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42
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Cingolani A, Casalini T, Caimi S, Klaue A, Sponchioni M, Rossi F, Perale G. A Methodologic Approach for the Selection of Bio-Resorbable Polymers in the Development of Medical Devices: The Case of Poly(l-lactide- co-ε-caprolactone). Polymers (Basel) 2018; 10:E851. [PMID: 30960776 PMCID: PMC6403915 DOI: 10.3390/polym10080851] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 07/23/2018] [Accepted: 07/31/2018] [Indexed: 11/16/2022] Open
Abstract
In the last decades bioresorbable and biodegradable polymers have gained a very good reputation both in research and in industry thanks to their unique characteristics. They are able to ensure high performance and biocompatibility, at the same time avoiding post-healing surgical interventions for device removal. In the medical device industry, it is widely known that product formulation and manufacturing need to follow specific procedures in order to ensure both the proper mechanical properties and desired degradation profile. Moreover, the sterilization method is crucial and its impact on physical properties is generally underestimated. In this work we focused our attention on the effect of different terminal sterilization methods on two commercially available poly(l-lactide-co-ε-caprolactone) with equivalent chemical composition (70% PLA and 30% PCL) and relatively similar initial molecular weights, but different chain arrangements and crystallinity. Results obtained show that crystallinity plays a key role in helping preserve the narrow distribution of chains and, as a consequence, defined physical properties. These statements can be used as guidelines for a better choice of the most adequate biodegradable polymers in the production of resorbable medical devices.
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Affiliation(s)
- Alberto Cingolani
- Institute for Chemical and Bioengineering, Department of Chemistry and Applied Bioscience ETH Zurich, Vladimir-Prelog-Weg 1-5/10, 8093 Zürich, Switzerland.
- Industrie Biomediche Insubri SA (IBI), Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland.
| | - Tommaso Casalini
- Institute for Chemical and Bioengineering, Department of Chemistry and Applied Bioscience ETH Zurich, Vladimir-Prelog-Weg 1-5/10, 8093 Zürich, Switzerland.
- Biomaterials Laboratory, Institute for Mechanical Engineering and Materials Technology, SUPSI-University of Applied Sciences and Arts of Southern Switzerland, Via Cantonale 2C, Galleria 2, 6928 Manno, Switzerland.
| | - Stefano Caimi
- Institute for Chemical and Bioengineering, Department of Chemistry and Applied Bioscience ETH Zurich, Vladimir-Prelog-Weg 1-5/10, 8093 Zürich, Switzerland.
| | - Antoine Klaue
- Institute for Chemical and Bioengineering, Department of Chemistry and Applied Bioscience ETH Zurich, Vladimir-Prelog-Weg 1-5/10, 8093 Zürich, Switzerland.
| | - Mattia Sponchioni
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, 20100 Milan, Italy.
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, 20100 Milan, Italy.
| | - Giuseppe Perale
- Industrie Biomediche Insubri SA (IBI), Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland.
- Biomaterials Laboratory, Institute for Mechanical Engineering and Materials Technology, SUPSI-University of Applied Sciences and Arts of Southern Switzerland, Via Cantonale 2C, Galleria 2, 6928 Manno, Switzerland.
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43
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Kowalczewski CJ, Saul JM. Biomaterials for the Delivery of Growth Factors and Other Therapeutic Agents in Tissue Engineering Approaches to Bone Regeneration. Front Pharmacol 2018; 9:513. [PMID: 29896102 PMCID: PMC5986909 DOI: 10.3389/fphar.2018.00513] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/27/2018] [Indexed: 12/14/2022] Open
Abstract
Bone fracture followed by delayed or non-union typically requires bone graft intervention. Autologous bone grafts remain the clinical "gold standard". Recently, synthetic bone grafts such as Medtronic's Infuse Bone Graft have opened the possibility to pharmacological and tissue engineering strategies to bone repair following fracture. This clinically-available strategy uses an absorbable collagen sponge as a carrier material for recombinant human bone morphogenetic protein 2 (rhBMP-2) and a similar strategy has been employed by Stryker with BMP-7, also known as osteogenic protein-1 (OP-1). A key advantage to this approach is its "off-the-shelf" nature, but there are clear drawbacks to these products such as edema, inflammation, and ectopic bone growth. While there are clinical challenges associated with a lack of controlled release of rhBMP-2 and OP-1, these are among the first clinical examples to wed understanding of biological principles with biochemical production of proteins and pharmacological principles to promote tissue regeneration (known as regenerative pharmacology). After considering the clinical challenges with such synthetic bone grafts, this review considers the various biomaterial carriers under investigation to promote bone regeneration. This is followed by a survey of the literature where various pharmacological approaches and molecular targets are considered as future strategies to promote more rapid and mature bone regeneration. From the review, it should be clear that pharmacological understanding is a key aspect to developing these strategies.
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Affiliation(s)
| | - Justin M Saul
- Department of Chemical, Paper and Biomedical Engineering, Miami University, Oxford, OH, United States
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Smith RA, Chua R, Carnachan SM, Tan CL, Sims IM, Hinkley SF, Nurcombe V, Cool SM. Retention of the Structure and Function of Heparan Sulfate Biomaterials After Gamma Irradiation. Tissue Eng Part A 2018; 24:729-739. [DOI: 10.1089/ten.tea.2017.0263] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Raymond A.A. Smith
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - R.J.E. Chua
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - Susan M. Carnachan
- The Ferrier Research Institute, Victoria University of Wellington, Lower Hutt, New Zealand
| | - Clarissa L.L. Tan
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - Ian M. Sims
- The Ferrier Research Institute, Victoria University of Wellington, Lower Hutt, New Zealand
| | - Simon F.R. Hinkley
- The Ferrier Research Institute, Victoria University of Wellington, Lower Hutt, New Zealand
| | - Victor Nurcombe
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University-Imperial College London, Singapore
| | - Simon M. Cool
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
- Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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45
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Selcan Turker N, Yekta Özer A, Kutlu B, Nohutcu R, Colak S, Ekizoglu M, Özalp M. The Effect of Different Sterilization Methods on Polypropylene Syringes. J Med Device 2018. [DOI: 10.1115/1.4039434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This presents the influence of gamma irradiation on Pharmacopeia specifications, mechanical and flow parameters of polypropylene (PP) syringes. There has been significant progress in the terminal sterilization of single-use, disposable medical devices with gamma radiation sterilization due to the growing awareness of toxic residues during the ethylene oxide (EtO) sterilization. PP is a widely used polymer for the production of syringes because of its excellent mechanical and thermal properties and has expanded continuously over the last decade. Although 25 kGy was generally recommended for the gamma radiation sterilization of medical products, this radiation dose is high enough to produce substantial damage. Electron spin resonance (ESR) characteristics of irradiated syringes were also studied at normal (25 °C, 60% relative humidity) and accelerated (40 °C, 75% relative humidity) stability test conditions. It was found that the chemical and radiolytic changes and sterility assurance levels (SAL) after gamma radiation sterilization were different in PP syringes. It was shown that for two commercial syringes, E1 and E3, a SAL of 10−4 could be attained with only 10 kGy, with there being less detrimental radiation effects on E1. The differences in the radiosensitivity of the propylene syringes could be due to the different formulations and manufacturing processes. The results indicated that a commercial syringe, identified as E1 could be safely sterilized with gamma irradiation as the radicals decay over a period of days under normal conditions and quenched much faster under stability conditions. Furthermore, ESR technique could be used successfully in monitoring the radiosterilization of this material. Additionally, the confirmation and validation of the SAL doses which are below 25 kGy, will decrease the time and cost of the sterilization with less damaging effects of ionizing irradiation.
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Affiliation(s)
- N. Selcan Turker
- Department of Radiopharmacy, Faculty of Pharmacy, Hacettepe University, Sıhhiye 06100, Ankara, Turkey
- Harvard Medical School, MGH Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02129
| | - A. Yekta Özer
- Department of Radiopharmacy, Faculty of Pharmacy, Hacettepe University, Sıhhiye 06100, Ankara, Turkey e-mail:
| | - Burak Kutlu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sıhhiye 06100, Ankara, Turkey
| | - Rahime Nohutcu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sıhhiye 06100, Ankara, Turkey
| | - Seyda Colak
- Department of Physics Engineering, Faculty of Engineering, Hacettepe University, Sıhhiye 06100, Ankara, Turkey
| | - Melike Ekizoglu
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Hacettepe University, Sıhhiye 06100, Ankara, Turkey
| | - Meral Özalp
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Hacettepe University, Sıhhiye 06100, Ankara, Turkey
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46
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Attia T, Tupy J, Asker D, Hatton B, Grynpas M, Willett T. The effect of ribose pre-treatment of cortical bone on γ-irradiation sterilization effectiveness. Cell Tissue Bank 2017; 18:555-560. [PMID: 29032461 DOI: 10.1007/s10561-017-9662-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/05/2017] [Indexed: 11/30/2022]
Abstract
Reconstruction of large skeletal defects is a significant and challenging issue. Tissue banks often use γ-irradiation (15-35 kGy) to sterilize bone allografts, which, however, drastically impairs the post-yield mechanical properties. In previous studies, we reported the development of a method that protects human bone collagen connectivity through ribose crosslinking while still undergoing γ-irradiation. Given these promising results, the next step was to determine if the presence of ribose within the bone tissue would interfere with the effectiveness of the γ-irradiation sterilization against bacteria. This study had two stages. The aim of the first stage was to assess the protective effect of ribose in solution using a Bacillus pumilus spore strip model. The aim of the second stage was to assess the protective effect of ribose (R) on spores within a human cortical bone model in comparison to conventionally irradiated bone (I). Treatment of B. pumilus spore strips with ribose in solution led to temperature-dependent effects on spore viability versus spore strips treated with PBS alone. Ribose solution at 60 °C led to a notable two logs decrease in spore count relative to PBS at 60 °C. In the human bone model, the number of spores in the I and R groups were greatly decreased in comparison to the non-irradiated N group. No spore colonies were detected in the R group (n = 4) whereas two of the four plates of group I formed colonies. This study provides evidence that the method of pre-treating bone with ribose crosslinking prior to irradiation sterilization, while improving irradiation sterilized bone allograft quality, also may improve the effectiveness of the sterilization process.
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Affiliation(s)
- Tarik Attia
- Musculoskeletal Research Laboratory, Mount Sinai Hospital - Lunenfeld Tanenbaum Research Institute, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Jindra Tupy
- Musculoskeletal Research Laboratory, Mount Sinai Hospital - Lunenfeld Tanenbaum Research Institute, Toronto, ON, Canada
| | - Dalal Asker
- Materials Science and Engineering, University of Toronto, Toronto, ON, Canada.,Alexandria University, Alexandria, Egypt
| | - Benjamin Hatton
- Materials Science and Engineering, University of Toronto, Toronto, ON, Canada
| | - Marc Grynpas
- Musculoskeletal Research Laboratory, Mount Sinai Hospital - Lunenfeld Tanenbaum Research Institute, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Thomas Willett
- Biomedical Engineering Program, Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada.
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47
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Pierannunzii L, Zagra L. Bone grafts, bone graft extenders, substitutes and enhancers for acetabular reconstruction in revision total hip arthroplasty. EFORT Open Rev 2017; 1:431-439. [PMID: 28461922 PMCID: PMC5367522 DOI: 10.1302/2058-5241.160025] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Acetabular bone loss is a relevant concern for surgeons dealing with a failed total hip arthroplasty. Since the femoral head is no longer available, allografts represent the first choice for most reconstructive solutions, either as a structural buttress or impacted bone chips. Even though fresh-frozen bone is firmly recommended for structural grafts, freeze-dried and/or irradiated bone may be used alternatively for impaction grafting. Indeed, there are some papers on freeze-dried or irradiated bone impaction grafting, but their number is limited, as is the number of cases. Xenografts do not represent a viable option based on the poor available evidence but bioactive bioceramics such as hydroxyapatite and biphasic calcium phosphates are suitable bone graft extenders or even substitutes for acetabular impaction grafting. Bone-marrow-derived mesenchymal stem cells and demineralised bone matrix seem to act as reliable bone graft enhancers, i.e. adjuvant therapies able to improve the biological performance of standard bone grafts or substitutes. Among these therapies, platelet-rich plasma and bone morphogenetic proteins need to be investigated further before any recommendations can be made.
Cite this article: EFORT Open Rev 2016;1:431-439. DOI:10.1302/2058-5241.160025
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Affiliation(s)
| | - Luigi Zagra
- IRCCS Galeazzi Orthopedic Institute, Milan, Italy
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48
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Sedlacek O, Kucka J, Monnery BD, Slouf M, Vetrik M, Hoogenboom R, Hruby M. The effect of ionizing radiation on biocompatible polymers: From sterilization to radiolysis and hydrogel formation. Polym Degrad Stab 2017. [DOI: 10.1016/j.polymdegradstab.2017.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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49
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Kawecki M, Łabuś W, Klama-Baryla A, Kitala D, Kraut M, Glik J, Misiuga M, Nowak M, Bielecki T, Kasperczyk A. A review of decellurization methods caused by an urgent need for quality control of cell-free extracellular matrix' scaffolds and their role in regenerative medicine. J Biomed Mater Res B Appl Biomater 2017; 106:909-923. [DOI: 10.1002/jbm.b.33865] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/12/2016] [Accepted: 01/26/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Marek Kawecki
- Dr Stanislaw Sakiel Centre for Burns Treatment in Siemianowice Slaskie; Poland
- University of Technology and Humanities in Bielsko-Biała; Department of Health Science in Bielsko-Biała; Poland
| | - Wojciech Łabuś
- Dr Stanislaw Sakiel Centre for Burns Treatment in Siemianowice Slaskie; Poland
| | | | - Diana Kitala
- Dr Stanislaw Sakiel Centre for Burns Treatment in Siemianowice Slaskie; Poland
| | - Malgorzata Kraut
- Dr Stanislaw Sakiel Centre for Burns Treatment in Siemianowice Slaskie; Poland
| | - Justyna Glik
- Dr Stanislaw Sakiel Centre for Burns Treatment in Siemianowice Slaskie; Poland
- The Medical University of Silesia in Katowice; Unit for Chronic Wound Treatment Organization, Nursery Division; School of Healthcare in Zabrze Poland
| | - Marcelina Misiuga
- Dr Stanislaw Sakiel Centre for Burns Treatment in Siemianowice Slaskie; Poland
| | - Mariusz Nowak
- Dr Stanislaw Sakiel Centre for Burns Treatment in Siemianowice Slaskie; Poland
| | - Tomasz Bielecki
- Saint Barbara's Clinical Hospital number 5 in Sosnowiec; Clinical Department of Orthopaedics, Trauma; Oncologic and Reconstructive Surgery Poland
| | - Aleksandra Kasperczyk
- Medical University of Silesia in Katowice; Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze
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50
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Motlagh MF, Bayat M, Naji S. Bone Allograft: An Option for Total Mandibular Reconstruction. Craniomaxillofac Trauma Reconstr 2016; 10:306-313. [PMID: 29114352 DOI: 10.1055/s-0036-1593474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 07/04/2016] [Indexed: 10/20/2022] Open
Abstract
Total mandibular reconstruction is one of the most challenging modalities in maxillofacial surgery. In this article, we try to introduce a method of total mandible reconstruction. We report a 25-year-old male patient with complete involvement of the mandible by Langerhans cell tumor. The patient underwent total mandibulectomy and reconstruction with bone allograft harvested from a donor who had died the day before. The patient has good functional and aesthetic results in a long time. It seems that bone allograft can be a good alternative to other methods in total mandibular reconstruction.
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Affiliation(s)
| | - Mohamad Bayat
- Department of Oral and Maxillofacial, Tehran University of Medical Science, Tehran, Iran
| | - Siamak Naji
- Department of Pathology, Urmia University of Medical Sciences Ringgold Standard Institution, Urmia, Iran
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