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McMellen CJ, Sinkler MA, Calcei JG, Hobson TE, Karns MR, Voos JE. Management of Bone Loss and Tunnel Widening in Revision ACL Reconstruction. J Bone Joint Surg Am 2023; 105:1458-1471. [PMID: 37506198 DOI: 10.2106/jbjs.22.01321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
➤ Both mechanical and biological factors can contribute to bone loss and tunnel widening following primary anterior cruciate ligament (ACL) reconstruction.➤ Revision ACL surgery success is dependent on graft position, fixation, and biological incorporation.➤ Both 1-stage and 2-stage revision ACL reconstructions can be successful in correctly indicated patients.➤ Potential future solutions may involve the incorporation of biological agents to enhance revision ACL surgery, including the use of bone marrow aspirate concentrate, platelet-rich plasma, and bone morphogenetic protein-2.
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Affiliation(s)
- Christopher J McMellen
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Margaret A Sinkler
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Jacob G Calcei
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
- University Hospitals Drusinsky Sports Medicine Institute, Cleveland, Ohio
| | - Taylor E Hobson
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
- University Hospitals Drusinsky Sports Medicine Institute, Cleveland, Ohio
| | - Michael R Karns
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
- University Hospitals Drusinsky Sports Medicine Institute, Cleveland, Ohio
| | - James E Voos
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
- University Hospitals Drusinsky Sports Medicine Institute, Cleveland, Ohio
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2
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Gopinatth V, Casanova FJ, Knapik DM, Mameri ES, Jackson GR, Khan ZA, McCormick JR, Yanke AB, Cole BJ, Chahla J. Consistent Indications and Good Outcomes Despite High Variability in Techniques for Two-Stage Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review. Arthroscopy 2023; 39:2098-2111. [PMID: 36863622 DOI: 10.1016/j.arthro.2023.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/12/2022] [Accepted: 02/03/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE To systematically review the current literature regarding the indications, techniques, and outcomes after 2-stage revision anterior cruciate ligament reconstruction (ACLR). METHODS A literature search was performed using SCOPUS, PubMed, Medline, and the Cochrane Central Register for Controlled Trials according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta Analyses statement. Inclusion criteria was limited to Level I-IV human studies reporting on indications, surgical techniques, imaging, and/or clinical outcomes of 2-stage revision ACLR. RESULTS Thirteen studies with 355 patients treated with 2-stage revision ACLR were identified. The most commonly reported indications were tunnel malposition and tunnel widening, with knee instability being the most common symptomatic indication. Tunnel diameter threshold for 2-stage reconstruction ranged from 10 to 14 mm. The most common grafts used for primary ACLR were bone-patellar tendon-bone (BPTB) autograft, hamstring graft, and LARS (polyethylene terephthalate) synthetic graft. The time elapsed from primary ACLR to the first stage surgery ranged from 1.7 years to 9.7 years, whereas the time elapsed between the first and second stage ranged from 21 weeks to 13.6 months. Six different bone grafting options were reported, with the most common being iliac crest autograft, allograft bone dowels, and allograft bone chips. During definitive reconstruction, hamstring autograft and BPTB autograft were the most commonly used grafts. Studies reporting patient-reported outcome measures showed improvement from preoperative to postoperative levels in Lysholm, Tegner, and objective International Knee and Documentation Committee scores. CONCLUSIONS Tunnel malpositioning and widening remain the most common indications for 2-stage revision ACLR. Bone grafting is commonly reported using iliac crest autograft and allograft bone chips and dowels, whereas hamstring autograft and BPTB autograft were the most used grafts during the second-stage definitive reconstruction. Studies showed improvements from preoperative to postoperative levels in commonly used patient reported outcomes measures. LEVEL OF EVIDENCE Level IV, systematic review of Level I, III, and IV studies.
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Affiliation(s)
- Varun Gopinatth
- Saint Louis University School of Medicine, St. Louis, Missouri, U.S.A.; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Felipe J Casanova
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Derrick M Knapik
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Enzo S Mameri
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Garrett R Jackson
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Zeeshan A Khan
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | | | - Adam B Yanke
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Brian J Cole
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Jorge Chahla
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A..
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Elahi A, Duncan W, Li KC, Waddell JN, Coates D. Comparison of Low and High Temperature Sintering for Processing of Bovine Bone as Block Grafts for Oral Use: A Biological and Mechanical In Vitro Study. Bioengineering (Basel) 2023; 10:bioengineering10040473. [PMID: 37106660 PMCID: PMC10136185 DOI: 10.3390/bioengineering10040473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/07/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Large oral bone defects require grafting of bone blocks rather than granules to give physically robust, biocompatible and osteoconductive regeneration. Bovine bone is widely accepted as a source of clinically appropriate xenograft material. However, the manufacturing process often results in both reduced mechanical strength and biological compatibility. The aim of this study was to assess bovine bone blocks at different sintering temperatures and measure the effects on mechanical properties and biocompatibility. Bone blocks were divided into four groups; Group 1: Control (Untreated); Group 2: Initial boil for 6 h; Group 3: Boil 6 h followed by sintering at 550 °C for 6 h; Group 4: Boil 6 h followed by sintering at 1100 °C for 6 h. Samples were assessed for their purity, crystallinity, mechanical strength, surface morphology, chemical composition, biocompatibility and clinical handling properties. Statistical analysis was performed using one-way ANOVA and post-hoc Tukey's tests for normally distributed and Friedman test for abnormally distributed quantitative data from compression tests and PrestoBlue™ metabolic activity tests. The threshold for statistical significance was set at p < 0.05. The results showed that higher temperature sintering (Group 4) removed all organic material (0.02% organic components and 0.02% residual organic components remained) and increased crystallinity (95.33%) compared to Groups 1-3. All test groups (Group 2-4) showed decreased mechanical strength (MPa: 4.21 ± 1.97, 3.07 ± 1.21, 5.14 ± 1.86, respectively) compared with raw bone (Group 1) (MPa: 23.22 ± 5.24, p <0.05), with micro-cracks seen under SEM in Groups 3 and 4. Group 4 had the highest biocompatibility (p < 0.05) with osteoblasts as compared to Group 3 at all time points in vitro. Clinical handling tests indicated that Group 4 samples could better withstand drilling and screw placement but still demonstrated brittleness compared to Group 1. Hence, bovine bone blocks sintered at 1100 °C for 6 h resulted in highly pure bone with acceptable mechanical strength and clinical handling, suggesting it is a viable option as a block grafting material.
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Affiliation(s)
- Asrar Elahi
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, North Dunedin 9016, New Zealand
| | - Warwick Duncan
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, North Dunedin 9016, New Zealand
| | - Kai-Chun Li
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, North Dunedin 9016, New Zealand
| | - John Neil Waddell
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, North Dunedin 9016, New Zealand
| | - Dawn Coates
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, North Dunedin 9016, New Zealand
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Wolfson TS, Mannino B, Owens BD, Waterman BR, Alaia MJ. Tunnel Management in Revision Anterior Cruciate Ligament Reconstruction: Current Concepts. Am J Sports Med 2023; 51:545-556. [PMID: 34766840 DOI: 10.1177/03635465211045705] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Bone tunnel-related complications are frequently encountered during revision anterior cruciate ligament reconstruction (ACLR). Issues with tunnel positioning, enlargement, containment, and hardware interference may complicate surgery and compromise outcomes. As a result, several strategies have emerged to address these issues and optimize results. However, a systematic, unified approach to tunnel pathology in revision ACLR is lacking. The purpose of this review is to highlight the current state of the literature on bone tunnel complications and, although extensive literature on the subject is lacking, present an updated approach to the evaluation and management of tunnel-related issues in revision ACLR.
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Affiliation(s)
| | | | - Brett D Owens
- Brown University Alpert Medical School, East Providence, Rhode Island, USA
| | - Brian R Waterman
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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Salimon A, Statnik E, Kan Y, Yanushevich O, Tsarev V, Podporin M, Arutyunov S, Skripnichenko P, Galstyan M, Korsunsky A. Comparative study of biomaterial surface modification due to subcritical CO2 and autoclave disinfection treatments. J Supercrit Fluids 2022. [DOI: 10.1016/j.supflu.2022.105789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Uquillas JA, Spierings J, van der Lande A, Eren AD, Bertrand M, Yuan H, Yuan H, van Groningen B, Janssen R, Ito K, de Boer J, Foolen J. An off-the-shelf decellularized and sterilized human bone-ACL-bone allograft for anterior cruciate ligament reconstruction. J Mech Behav Biomed Mater 2022; 135:105452. [PMID: 36122497 DOI: 10.1016/j.jmbbm.2022.105452] [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: 07/07/2022] [Revised: 08/31/2022] [Accepted: 09/03/2022] [Indexed: 11/16/2022]
Abstract
Approximately 1% of active individuals participating in sports rupture their anterior cruciate ligaments (ACL) every year, which is currently reconstructed using tendon autografts. Upon reconstruction, clinical issues of concern are ACL graft rupture, persistent knee instability, limited return to sports, and early onset of osteoarthritis (OA). This happens because tendon autografts do not have the same compositional, structural, and mechanical properties as a native ACL. To overcome these problems, we propose to use decellularized bone-ACL-bone allografts in ACL reconstruction (ACLR) as a mechanically robust, biocompatible, and immunologically safe alternative to autografts. Here, a decellularization protocol combined with sterilization using supercritical carbon dioxide (scCO2) was used to thoroughly decellularize porcine and human ACLs attached to tibial and femoral bone blocks. The specimens were named ultrACLean and their compositional, structural, and mechanical properties were determined. Our results indicate that: 1) decellularization of ultrACLean allografts leads to the removal of nearly 97% of donor cells, 2) ultrACLean has mechanical properties which are not different to native ACL, 3) ultrACLean maintained similar collagen content and decreased GAG content compared to native ACL, and 4) ultrACLean is not cytotoxic to seeded tendon-derived cells in vitro. Results from an in vivo pilot experiment showed that ultrACLean is biocompatible and elicits a moderate immunological response. In summary, ultrACLean has proven to be a mechanically competent and biocompatible graft with the potential to be used in ACLR surgery.
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Affiliation(s)
- Jorge Alfredo Uquillas
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute of Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Janne Spierings
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute of Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Antonio van der Lande
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Aysegul Dede Eren
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute of Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Manon Bertrand
- Hightech Contract Manufacturing Medical, Nijmegen, the Netherlands
| | - Hao Yuan
- Huipin Yuan's Lab, Sichuan, China
| | | | - Bart van Groningen
- Department of Orthopaedic Surgery, Maxima Medical Centre Eindhoven/Veldhoven, the Netherlands
| | - Rob Janssen
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Department of Orthopaedic Surgery, Maxima Medical Centre Eindhoven/Veldhoven, the Netherlands; Health Innovations and Technology, Department of Paramedical Sciences, Fontys University of Applied Sciences, Eindhoven, the Netherlands
| | - Keita Ito
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Eindhoven MedTech Innovation Center, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Jan de Boer
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute of Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Jasper Foolen
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute of Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands.
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Büyükdoğan K, Laidlaw MS, Kew ME, Miller MD. Allograft Bone Dowels Show Better Incorporation in Femoral Versus Tibial Tunnels in 2-Stage Revision Anterior Cruciate Ligament Reconstruction: A Computed Tomography-Based Analysis. Arthroscopy 2021; 37:1920-1928. [PMID: 33581298 DOI: 10.1016/j.arthro.2021.01.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 01/18/2021] [Accepted: 01/25/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to quantitatively evaluate the radiographic outcomes of allograft dowels used in 2-stage revision anterior cruciate ligament reconstruction (ACLR) and to compare the incorporation rates of dowels placed in tibial and femoral tunnels. METHODS Prospective review of patients who underwent 2-stage revision ACLR with allograft bone dowels. Inclusion criteria were tibial/femoral tunnel diameter of ≥14 mm on preoperative computed tomography (CT) or overlapping of prior tunnels with planned tunnels. Second-stage timing was determined based on qualitative dowel integration on CT obtained at ∼3 months after the first stage. Quantitative analysis of incorporation rates was performed with the union ratio (UR) and occupying ratio (OR) on postoperative CT scans. RESULTS Twenty-one patients, with a mean (SD) age of 32.1 (11.4; range, 18-50) years, were included. Second-stage procedures were performed at a mean (SD) of 6.5 (2.1; range, 2.4-11.5) months after first-stage revision. All dowels showed no signs of degradation at the host bone/graft junction at the second-stage procedure. The mean (SD) diameter of the dowels placed in tibial tunnels was greater than those placed in femoral tunnels (16.1 [2.3] mm vs 12.4 [1.6] mm; P < .05). CT was obtained at a mean (SD) of 121 (28; range, 59-192) days after the first-stage surgery. There was no difference between the OR of femoral and tibial tunnels (mean [SD], 87.6% [4.8%] vs 85.7% [10.1%]; P = .484), but the UR was significantly higher in femoral tunnels (mean [SD], 83% [6.2%] vs 74% [10.5%], P = .005). The intraclass correlation coefficients of OR and UR measurements indicated good reliability. CONCLUSIONS Allograft bone dowels are a viable graft choice to replenish bone stock in the setting of a staged revision ACL reconstruction. Allograft dowels placed in femoral tunnels had a higher healing union ratio than tibial tunnel allografts and no evidence of degradation at the bone/graft junction, with no difference seen in occupying ratio. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Kadir Büyükdoğan
- Department of Orthopaedic Surgery, Koc University Hospital, Zeytinburnu/Istanbul, Turkey
| | | | - Michelle E Kew
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, U.S.A
| | - Mark D Miller
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, U.S.A..
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8
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Garcia-Mansilla I, Jones KJ, Kremen TJ. Hybrid Bone-Grafting Technique for Staged Revision Anterior Cruciate Ligament Reconstruction. JBJS Essent Surg Tech 2021; 11:ST-D-20-00055. [DOI: 10.2106/jbjs.st.20.00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Alekseev ES, Alentiev AY, Belova AS, Bogdan VI, Bogdan TV, Bystrova AV, Gafarova ER, Golubeva EN, Grebenik EA, Gromov OI, Davankov VA, Zlotin SG, Kiselev MG, Koklin AE, Kononevich YN, Lazhko AE, Lunin VV, Lyubimov SE, Martyanov ON, Mishanin II, Muzafarov AM, Nesterov NS, Nikolaev AY, Oparin RD, Parenago OO, Parenago OP, Pokusaeva YA, Ronova IA, Solovieva AB, Temnikov MN, Timashev PS, Turova OV, Filatova EV, Philippov AA, Chibiryaev AM, Shalygin AS. Supercritical fluids in chemistry. RUSSIAN CHEMICAL REVIEWS 2020. [DOI: 10.1070/rcr4932] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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10
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Gafarova ER, Grebenik EA, Lazhko AE, Frolova AA, Kuryanova AS, Kurkov AV, Bazhanov IA, Kapomba BS, Kosheleva NV, Novikov IA, Shekhter AB, Golubeva EN, Soloviova AB, Timashev PS. Evaluation of Supercritical CO 2-Assisted Protocols in a Model of Ovine Aortic Root Decellularization. Molecules 2020; 25:molecules25173923. [PMID: 32867356 PMCID: PMC7504408 DOI: 10.3390/molecules25173923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/26/2020] [Accepted: 08/26/2020] [Indexed: 01/03/2023] Open
Abstract
One of the leading trends in the modern tissue engineering is the development of new effective methods of decellularization aimed at the removal of cellular components from a donor tissue, reducing its immunogenicity and the risk of rejection. Supercritical CO2 (scCO2)-assisted processing has been proposed to improve the outcome of decellularization, reduce contamination and time costs. The resulting products can serve as personalized tools for tissue-engineering therapy of various somatic pathologies. However, the decellularization of heterogeneous 3D structures, such as the aortic root, requires optimization of the parameters, including preconditioning medium composition, the type of co-solvent, values of pressure and temperature inside the scCO2 reactor, etc. In our work, using an ovine aortic root model, we performed a comparative analysis of the effectiveness of decellularization approaches based on various combinations of these parameters. The protocols were based on the combinations of treatments in alkaline, ethanol or detergent solutions with scCO2-assisted processing at different modes. Histological analysis demonstrated favorable effects of the preconditioning in a detergent solution. Following processing in scCO2 medium provided a high decellularization degree, reduced cytotoxicity, and increased ultimate tensile strength and Young’s modulus of the aortic valve leaflets, while the integrity of the extracellular matrix was preserved.
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Affiliation(s)
- Elvira R. Gafarova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
- Correspondence: ; Tel.: +7-917-372-5217
| | - Ekaterina A. Grebenik
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Alexey E. Lazhko
- Kurnakov Institute of General and Inorganic Chemistry, Russian Academy of Sciences, 119991 Moscow, Russia;
| | - Anastasia A. Frolova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Anastasia S. Kuryanova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
- N. N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, 117977 Moscow, Russia;
| | - Alexandr V. Kurkov
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Ilya A. Bazhanov
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Byron S. Kapomba
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Nastasia V. Kosheleva
- FSBSI “Institute of General Pathology and Pathophysiology”, 125315 Moscow, Russia;
- Faculty of Biology, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Ivan A. Novikov
- Scientific Research Institute of Eye Diseases, 119021 Moscow, Russia;
| | - Anatoly B. Shekhter
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Elena N. Golubeva
- Faculty of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia;
| | - Anna B. Soloviova
- N. N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, 117977 Moscow, Russia;
| | - Peter S. Timashev
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
- N. N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, 117977 Moscow, Russia;
- Faculty of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia;
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Salem HS, Axibal DP, Wolcott ML, Vidal AF, McCarty EC, Bravman JT, Frank RM. Two-Stage Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review of Bone Graft Options for Tunnel Augmentation. Am J Sports Med 2020; 48:767-777. [PMID: 31116949 DOI: 10.1177/0363546519841583] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND No consensus is available regarding the optimal choice of bone graft material for bone tunnel augmentation in revision anterior cruciate ligament (ACL) surgery. PURPOSE To compare the outcomes of different bone graft materials for staged revision ACL reconstruction. STUDY DESIGN Systematic review. METHODS A systematic review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed. PubMed, EMBASE, and the Cochrane Library were queried through use of the terms anterior cruciate ligament and revision to identify all studies reporting outcomes of bone tunnel grafting in 2-stage revision ACL reconstruction. Data extracted included indications for 2-stage surgery, surgical technique, graft material, time between surgeries, rehabilitation protocols, physical examination findings, patient-reported outcomes, and radiographic and histologic findings. RESULTS The analysis included 7 studies with a total of 234 patients. The primary outcome in 2 studies was graft incorporation (mean follow-up, 8.8 months), whereas the other 5 studies reported clinical outcomes with follow-up mean ± SD of 4.2 ± 2.1 years. The indication for bone grafting and between-stage protocol varied among studies. Autograft was used in 4 studies: iliac crest bone autograft (ICBG, n = 3) and tibial bone autograft (TBA, n = 1). In 2 studies, the authors investigated the outcomes of allograft: allograft bone matrix (ABM) and allograft bone chips (AC). Finally, 1 study compared ICBG to a synthetic bone substitute. Radiographic evaluation of bone graft integration after the first stage was reported in 4 studies, with an average duration of 4.9 months. In 4 studies, the authors reported the time interval between first and second surgeries, with an average of 6.1 months for ICBG compared with 8.7 months for allogenic and synthetic grafts. Revision ACL graft failure rates were reported by 5 studies, including 1 study with ABM (6.1%), 1 study with AC (8.3%), 1 study with TBA (0%), and 2 studies with ICBG (0% and 2%). CONCLUSION The indications for staged ACL reconstruction and the rehabilitation protocol between stages need to be clearly established. The available data indicate that autograft for bone tunnel grafting in 2-stage ACL revision may be associated with a lower risk of revision ACL reconstruction graft failure compared with allograft bone.
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Affiliation(s)
- Hytham S Salem
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Derek P Axibal
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Armando F Vidal
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Eric C McCarty
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Rachel M Frank
- University of Colorado School of Medicine, Aurora, Colorado, USA
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Veryasova NN, Lazhko AE, Isaev DE, Grebenik EA, Timashev PS. Supercritical Carbon Dioxide—A Powerful Tool for Green Biomaterial Chemistry. RUSSIAN JOURNAL OF PHYSICAL CHEMISTRY B 2020. [DOI: 10.1134/s1990793119070236] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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Kim DH, Bae KC, Kim DW, Choi BC. Two-stage revision anterior cruciate ligament reconstruction. Knee Surg Relat Res 2019; 31:10. [PMID: 32660548 PMCID: PMC7219575 DOI: 10.1186/s43019-019-0010-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/22/2019] [Indexed: 12/13/2022] Open
Abstract
With the rising number of anterior cruciate ligament (ACL) reconstructions, revision ACL reconstructions are becoming increasingly common. A revision procedure may be performed to improved knee function, correct instability, and facilitate a return to normal activities. When performing a revision reconstruction, the surgeon decides between a single-stage or a two-stage revision. Two-stage revisions are rarely performed, but are particularly useful when addressing substantial tunnel-widening, active infection, and concomitant knee pathology (e.g., malalignment, other ligamentous injuries, meniscal or chondral lesions). Among these potential scenarios requiring a two-stage revision, tunnel-widening is the most common cause; the first stage involves graft removal, tunnel curettage, and bone grafting, followed by revision ACL reconstruction in the second stage. The purpose of this article is to review the preoperative planning, surgical considerations, rehabilitation, and outcomes of two-stage revision ACL reconstructions and summarize the recent literature outlining treatment results.
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Affiliation(s)
- Du-Han Kim
- Department of Orthopaedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, 1035 Dalgubul-ro, Dalseo-gu, Daegu, 42601, South Korea
| | - Ki-Cheor Bae
- Department of Orthopaedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, 1035 Dalgubul-ro, Dalseo-gu, Daegu, 42601, South Korea.
| | - Dong-Wan Kim
- Department of Orthopaedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, 1035 Dalgubul-ro, Dalseo-gu, Daegu, 42601, South Korea
| | - Byung-Chan Choi
- Department of Orthopaedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, 1035 Dalgubul-ro, Dalseo-gu, Daegu, 42601, South Korea
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You L, Weikang X, Lifeng Y, Changyan L, Yongliang L, Xiaohui W, Bin X. In vivo immunogenicity of bovine bone removed by a novel decellularization protocol based on supercritical carbon dioxide. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2018; 46:334-344. [PMID: 29726299 DOI: 10.1080/21691401.2018.1457044] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Trauma or infections associated critical bone defects lead to a huge economic burden in the healthcare system worldwide. Recent advances in tissue engineering have led to potential new strategies for the repair, replacement, and regeneration of bone defects, especially in biomaterials and decellularization protocols from xenogenic tissues. However, the complexity in bone structure and mechanical environment limits the synthesis of artificial bone with biomaterials. Thus, the purpose of our study is to develop a natural bone scaffold with great immunocompatibility. We combined decellularization techniques base on SC-CO2 to decellularize bovine bone. In order to study the immune response of mice to materials, the histology, spleen index, immune cells contents and in vitro proliferative performance, cytokine and immunoglobulin light chain expression of mice were characterized. Compared with the fresh bone group, the immune responses of decellularized group were significantly reduced. In conclusion, decellularization via this method can achieve a decellularized scaffold with great immunocompatibility. Our findings suggest the potential of using decellularized BB as a scaffold for bone bioengineering.
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Affiliation(s)
- Ling You
- a National Engineering Research Center for Human Tissue Restoration and Function Reconstruction , South China University of Technology , Guangzhou , Guangdong , China.,b National Engineering Laboratory for Regenerative Implantable Medical Devices , Grandhope Biotech Co., Ltd , Guangzhou , Guangdong , China
| | - Xu Weikang
- a National Engineering Research Center for Human Tissue Restoration and Function Reconstruction , South China University of Technology , Guangzhou , Guangdong , China
| | - Yang Lifeng
- c Guangdong Medical Devices Quality Surveillance and Test Institute , Guangzhou , Guangdong , China
| | - Liang Changyan
- d Department of Gynecology , Third Affiliated Hospital of Sun Yat-sen University , Guangzhou , China
| | - Lin Yongliang
- b National Engineering Laboratory for Regenerative Implantable Medical Devices , Grandhope Biotech Co., Ltd , Guangzhou , Guangdong , China
| | - Wei Xiaohui
- b National Engineering Laboratory for Regenerative Implantable Medical Devices , Grandhope Biotech Co., Ltd , Guangzhou , Guangdong , China
| | - Xu Bin
- b National Engineering Laboratory for Regenerative Implantable Medical Devices , Grandhope Biotech Co., Ltd , Guangzhou , Guangdong , China
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