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Chuang EY, Lin YC, Huang YM, Chen CH, Yeh YY, Rethi L, Chou YJ, Jheng PR, Lai JM, Chiang CJ, Wong CC. Biofunctionalized hydrogel composed of genipin-crosslinked gelatin/hyaluronic acid incorporated with lyophilized platelet-rich fibrin for segmental bone defect repair. Carbohydr Polym 2024; 339:122174. [PMID: 38823938 DOI: 10.1016/j.carbpol.2024.122174] [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: 03/01/2024] [Revised: 04/07/2024] [Accepted: 04/16/2024] [Indexed: 06/03/2024]
Abstract
Segmental bone defects can arise from trauma, infection, metabolic bone disorders, or tumor removal. Hydrogels have gained attention in the field of bone regeneration due to their unique hydrophilic properties and the ability to customize their physical and chemical characteristics to serve as scaffolds and carriers for growth factors. However, the limited mechanical strength of hydrogels and the rapid release of active substances have hindered their clinical utility and therapeutic effectiveness. With ongoing advancements in material science, the development of injectable and biofunctionalized hydrogels holds great promise for addressing the challenges associated with segmental bone defects. In this study, we incorporated lyophilized platelet-rich fibrin (LPRF), which contains a multitude of growth factors, into a genipin-crosslinked gelatin/hyaluronic acid (GLT/HA-0.5 % GP) hydrogel to create an injectable and biofunctionalized composite material. Our findings demonstrate that this biofunctionalized hydrogel possesses optimal attributes for bone tissue engineering. Furthermore, results obtained from rabbit model with segmental tibial bone defects, indicate that the treatment with this biofunctionalized hydrogel resulted in increased new bone formation, as confirmed by imaging and histological analysis. From a translational perspective, this biofunctionalized hydrogel provides innovative and bioinspired capabilities that have the potential to enhance bone repair and regeneration in future clinical applications.
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Affiliation(s)
- Er-Yuan Chuang
- Graduate Institute of Biomedical Materials and Tissue Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan; Cell Physiology and Molecular Image Research Center, Taipei Medical University-Wan Fang Hospital, Taipei 11696, Taiwan; Precision Medicine and Translational Cancer Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Yi-Cheng Lin
- Department of Orthopedics, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yu-Min Huang
- Department of Orthopedics, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Chih-Hwa Chen
- Graduate Institute of Biomedical Materials and Tissue Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan; Department of Orthopedics, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan; Taipei Medical University Research Center of Biomedical Devices Prototyping Production, Taipei 11031, Taiwan; School of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan; School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Yen Yeh
- Department of Orthopedics, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan
| | - Lekha Rethi
- Department of Orthopedics, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan
| | - Yu-Jen Chou
- Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 10607, Taiwan
| | - Pei-Ru Jheng
- Graduate Institute of Biomedical Materials and Tissue Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan
| | - Jen-Ming Lai
- Department of Orthopedic Surgery, Woodlands Health, 768024, Singapore
| | - Chang-Jung Chiang
- Department of Orthopedics, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; Taipei Medical University Research Center of Biomedical Devices Prototyping Production, Taipei 11031, Taiwan
| | - Chin-Chean Wong
- Department of Orthopedics, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; Taipei Medical University Research Center of Biomedical Devices Prototyping Production, Taipei 11031, Taiwan; International PhD Program for Cell Therapy and Regenerative Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
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Mahdi S, Stoner R, Wyatt J, De'Ath H, Perkins Z. Prevalence of chronic pain after severe lower limb injury (SLLI): A systematic review and meta-analysis. Injury 2024; 55:111495. [PMID: 38490051 DOI: 10.1016/j.injury.2024.111495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 03/08/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Globally, severe lower limb injuries (SLLIs) are the predominant cause of long-term injury related disability and poor functional outcomes. Chronic pain is a major source of this morbidity, but the magnitude of the contribution is not clearly understood. The aim of this systematic review and meta-analysis was to determine the prevalence of chronic pain following SLLIs in civilian and military patients. METHOD This systematic review was prospectively registered with The International Prospective Register of Systematic Reviews (PROSPERO) with study ID CRD42022313615. A systematic literature search (Medline, Embase, Ovid, and Web of Science) was performed to identify original studies that reported chronic pain outcomes for adults who underwent surgical treatment for SLLIs in a civilian or military setting. Risk of bias in included studies was assessed using the ROBINS-E tool, and quality assessment was reported at study level using the Newcastle-Ottawa Scale, and at outcome-level using the GRADE framework. Absolute (proportional) and relative (odds ratio) outcome measures were calculated and pooled using a random effects model. RESULTS Forty-three studies reporting the outcomes of 5601 patients were included. Estimated overall prevalence of pain was 63 % (CI 55-70 %). The prevalence of chronic pain in amputees (64 % (CI 55-73 %)) was similar to those who underwent limb salvage (56 % (CI 44-67 %)). The prevalence of chronic pain in civilian populations was 70 % (CI 63-77 %) compared to military populations (51 % (CI 35-66 %)). In amputees, the prevalence of residual limb pain was similar to phantom limb pain (OR 1.06 [0.64-1.78], p = 0.81, I2 = 92 %). CONCLUSION Most people who sustain a SLLI will suffer from chronic pain. Healthcare systems must continue to research interventions that can reduce the incidence and severity of long-term pain and ensure adequate resources are allocated for this common and debilitating complication.
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Affiliation(s)
- Shareef Mahdi
- Centre for Trauma Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom.
| | - Rebecca Stoner
- Centre for Trauma Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
| | | | - Henry De'Ath
- Centre for Trauma Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
| | - Zane Perkins
- Centre for Trauma Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
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Zhou Z, Liu J, Xiong T, Liu Y, Tuan RS, Li ZA. Engineering Innervated Musculoskeletal Tissues for Regenerative Orthopedics and Disease Modeling. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2310614. [PMID: 38200684 DOI: 10.1002/smll.202310614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/28/2023] [Indexed: 01/12/2024]
Abstract
Musculoskeletal (MSK) disorders significantly burden patients and society, resulting in high healthcare costs and productivity loss. These disorders are the leading cause of physical disability, and their prevalence is expected to increase as sedentary lifestyles become common and the global population of the elderly increases. Proper innervation is critical to maintaining MSK function, and nerve damage or dysfunction underlies various MSK disorders, underscoring the potential of restoring nerve function in MSK disorder treatment. However, most MSK tissue engineering strategies have overlooked the significance of innervation. This review first expounds upon innervation in the MSK system and its importance in maintaining MSK homeostasis and functions. This will be followed by strategies for engineering MSK tissues that induce post-implantation in situ innervation or are pre-innervated. Subsequently, research progress in modeling MSK disorders using innervated MSK organoids and organs-on-chips (OoCs) is analyzed. Finally, the future development of engineering innervated MSK tissues to treat MSK disorders and recapitulate disease mechanisms is discussed. This review provides valuable insights into the underlying principles, engineering methods, and applications of innervated MSK tissues, paving the way for the development of targeted, efficacious therapies for various MSK conditions.
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Affiliation(s)
- Zhilong Zhou
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P. R. China
| | - Jun Liu
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P. R. China
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Shatin, NT, Hong Kong SAR, P. R. China
| | - Tiandi Xiong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P. R. China
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Shatin, NT, Hong Kong SAR, P. R. China
| | - Yuwei Liu
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P. R. China
- Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518000, P. R. China
| | - Rocky S Tuan
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Shatin, NT, Hong Kong SAR, P. R. China
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P. R. China
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P. R. China
| | - Zhong Alan Li
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P. R. China
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Shatin, NT, Hong Kong SAR, P. R. China
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P. R. China
- Key Laboratory of Regenerative Medicine, Ministry of Education, School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P. R. China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, Guangdong, 518057, P. R. China
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Hoveidaei AH, Sadat-Shojai M, Mosalamiaghili S, Salarikia SR, Roghani-Shahraki H, Ghaderpanah R, Ersi MH, Conway JD. Nano-hydroxyapatite structures for bone regenerative medicine: Cell-material interaction. Bone 2024; 179:116956. [PMID: 37951520 DOI: 10.1016/j.bone.2023.116956] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/04/2023] [Accepted: 11/05/2023] [Indexed: 11/14/2023]
Abstract
Bone tissue engineering holds great promise for the regeneration of damaged or severe bone defects. However, several challenges hinder its translation into clinical practice. To address these challenges, interdisciplinary efforts and advances in biomaterials, cell biology, and bioengineering are required. In recent years, nano-hydroxyapatite (nHA)-based scaffolds have emerged as a promising approach for the development of bone regenerative agents. The unique similarity of nHA with minerals found in natural bones promotes remineralization and stimulates bone growth, which are crucial factors for efficient bone regeneration. Moreover, nHA exhibits desirable properties, such as strong chemical interactions with bone and facilitation of tissue growth, without inducing inflammation or toxicity. It also promotes osteoblast survival, adhesion, and proliferation, as well as increasing alkaline phosphatase activity, osteogenic differentiation, and bone-specific gene expression. However, it is important to note that the effect of nHA on osteoblast behavior is dose-dependent, with cytotoxic effects observed at higher doses. Additionally, the particle size of nHA plays a crucial role, with smaller particles having a more significant impact. Therefore, in this review, we highlighted the potential of nHA for improving bone regeneration processes and summarized the available data on bone cell response to nHA-based scaffolds. In addition, an attempt is made to portray the current status of bone tissue engineering using nHA/polymer hybrids and some recent scientific research in the field.
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Affiliation(s)
- Amir Human Hoveidaei
- International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA
| | - Mehdi Sadat-Shojai
- Department of Chemistry, College of Sciences, Shiraz University, Shiraz, Iran
| | - Seyedarad Mosalamiaghili
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Rezvan Ghaderpanah
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hamed Ersi
- Evidence Based Medicine Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; Clinical Research Development Center of Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Janet D Conway
- International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA.
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Papareddy P, Selle M, Partouche N, Legros V, Rieu B, Olinder J, Ryden C, Bartakova E, Holub M, Jung K, Pottecher J, Herwald H. Identifying biomarkers deciphering sepsis from trauma-induced sterile inflammation and trauma-induced sepsis. Front Immunol 2024; 14:1310271. [PMID: 38283341 PMCID: PMC10820703 DOI: 10.3389/fimmu.2023.1310271] [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: 10/09/2023] [Accepted: 12/22/2023] [Indexed: 01/30/2024] Open
Abstract
Objective The purpose of this study was to identify a panel of biomarkers for distinguishing early stage sepsis patients from non-infected trauma patients. Background Accurate differentiation between trauma-induced sterile inflammation and real infective sepsis poses a complex life-threatening medical challenge because of their common symptoms albeit diverging clinical implications, namely different therapies. The timely and accurate identification of sepsis in trauma patients is therefore vital to ensure prompt and tailored medical interventions (provision of adequate antimicrobial agents and if possible eradication of infective foci) that can ultimately lead to improved therapeutic management and patient outcome. The adequate withholding of antimicrobials in trauma patients without sepsis is also important in aspects of both patient and environmental perspective. Methods In this proof-of-concept study, we employed advanced technologies, including Matrix-Assisted Laser Desorption/Ionization (MALDI) and multiplex antibody arrays (MAA) to identify a panel of biomarkers distinguishing actual sepsis from trauma-induced sterile inflammation. Results By comparing patient groups (controls, infected and non-infected trauma and septic shock patients under mechanical ventilation) at different time points, we uncovered distinct protein patterns associated with early trauma-induced sterile inflammation on the one hand and sepsis on the other hand. SYT13 and IL1F10 emerged as potential early sepsis biomarkers, while reduced levels of A2M were indicative of both trauma-induced inflammation and sepsis conditions. Additionally, higher levels of TREM1 were associated at a later stage in trauma patients. Furthermore, enrichment analyses revealed differences in the inflammatory response between trauma-induced inflammation and sepsis, with proteins related to complement and coagulation cascades being elevated whereas proteins relevant to focal adhesion were diminished in sepsis. Conclusions Our findings, therefore, suggest that a combination of biomarkers is needed for the development of novel diagnostic approaches deciphering trauma-induced sterile inflammation from actual infective sepsis.
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Affiliation(s)
- Praveen Papareddy
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Michael Selle
- Genomics and Bioinformatics of Infectious Diseases, Institute for Animal Genomics, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Nicolas Partouche
- Hôpitaux Universitaires de Strasbourg, Service d’Anesthésie-Réanimation & Médecine Péri-opératoire - Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Vincent Legros
- Département d’Anesthésie-Réanimation et Médecine Peri-Operatoire, Centre Hospitalier et Universitaire (CHU) de Reims, Université de Reims Champagne-Ardenne, Reims, France
| | - Benjamin Rieu
- Réanimation Médico-Chirurgicale, Trauma Center, Pôle Médecine Péri-Opératoire, Centre Hospitalier et Universitaire (CHU) de Clermont-Ferrand, Clermont Ferrand, France
| | - Jon Olinder
- Division of Infection Medicine, Helsingborg Hospital and Department of Clinical Sciences Helsingborg, Lund University, Helsingborg, Sweden
| | - Cecilia Ryden
- Division of Infection Medicine, Helsingborg Hospital and Department of Clinical Sciences Helsingborg, Lund University, Helsingborg, Sweden
| | - Eva Bartakova
- Department of Infectious Diseases, First Faculty of Medicine, Charles University and Military University Hospital Prague, Prague, Czechia
| | - Michal Holub
- Department of Infectious Diseases, First Faculty of Medicine, Charles University and Military University Hospital Prague, Prague, Czechia
| | - Klaus Jung
- Genomics and Bioinformatics of Infectious Diseases, Institute for Animal Genomics, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Julien Pottecher
- Hôpitaux Universitaires de Strasbourg, Service d’Anesthésie-Réanimation & Médecine Péri-opératoire - Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Heiko Herwald
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
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Chen J. Current advances in anisotropic structures for enhanced osteogenesis. Colloids Surf B Biointerfaces 2023; 231:113566. [PMID: 37797464 DOI: 10.1016/j.colsurfb.2023.113566] [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: 08/26/2023] [Revised: 09/20/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023]
Abstract
Bone defects are a challenge to healthcare systems, as the aging population experiences an increase in bone defects. Despite the development of biomaterials for bone fillers and scaffolds, there is still an unmet need for a bone-mimetic material. Cortical bone is highly anisotropic and displays a biological liquid crystalline (LC) arrangement, giving it exceptional mechanical properties and a distinctive microenvironment. However, the biofunctions, cell-tissue interactions, and molecular mechanisms of cortical bone anisotropic structure are not well understood. Incorporating anisotropic structures in bone-facilitated scaffolds has been recognised as essential for better outcomes. Various approaches have been used to create anisotropic micro/nanostructures, but biomimetic bone anisotropic structures are still in the early stages of development. Most scaffolds lack features at the nanoscale, and there is no comprehensive evaluation of molecular mechanisms or characterisation of calcium secretion. This manuscript provides a review of the latest development of anisotropic designs for osteogenesis and discusses current findings on cell-anisotropic structure interactions. It also emphasises the need for further research. Filling knowledge gaps will enable the fabrication of scaffolds for improved and more controllable bone regeneration.
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Affiliation(s)
- Jishizhan Chen
- UCL Mechanical Engineering, University College London, WC1E 7JE, UK.
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Zhang Y, Xu H, Wang J, Fan X, Tian F, Wang Z, Lu B, Wu W, Liu Y, Ai Y, Wang X, Zhu L, Jia S, Hao D. Incorporation of synthetic water-soluble curcumin polymeric drug within calcium phosphate cements for bone defect repairing. Mater Today Bio 2023; 20:100630. [PMID: 37114092 PMCID: PMC10127129 DOI: 10.1016/j.mtbio.2023.100630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Modified macroporous structures and active osteogenic substances are necessary to overcome the limited bone regeneration capacity and low degradability of self-curing calcium phosphate cement (CPC). Curcumin (CUR), which possesses strong osteogenic activity and poor aqueous solubility/bioavailability, esterifies the side chains in hyaluronic acid (HA) to form a water-soluble CUR-HA macromolecule. In this study, we incorporated the CUR-HA and glucose microparticles (GMPs) into the CPC powder to fabricate the CUR-HA/GMP/CPC composite, which not only retained the good injectability and mechanical strength of bone cements, but also significantly increased the cement porosity and sustained release property of CUR-HA in vitro. CUR-HA incorporation greatly improved the differentiation ability of bone marrow mesenchymal stem cells (BMSCs) to osteoblasts by activating the RUNX family transcription factor 2/fibroblast growth factor 18 (RUNX2/FGF18) signaling pathway, increasing the expression of osteocalcin and enhancing the alkaline phosphatase activity. In addition, in vivo implantation of CUR-HA/GMP/CPC into femoral condyle defects dramatically accelerated the degradation rate of cement and boosted local vascularization and osteopontin protein expression, and consequently promoted rapid bone regeneration. Therefore, macroporous CPC based composite cement with CUR-HA shows a remarkable ability to repair bone defects and is a promising translational application of modified CPC in clinical practice.
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Affiliation(s)
- Ying Zhang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
| | - Hailiang Xu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
| | - Jing Wang
- Science and Technology on Thermostructural Composite Materials Laboratory, Northwestern Polytechnical University, Xi'an, China
| | - Xiaochen Fan
- Department of Chinese Medicine and Rehabilitation, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Fang Tian
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
| | - Zhiyuan Wang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
| | - Botao Lu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
| | - Weidong Wu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
| | - Youjun Liu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
| | - Yixiang Ai
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
| | - Xiaohui Wang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
| | - Lei Zhu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
- Corresponding author. Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China; Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China.
| | - Shuaijun Jia
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
- Corresponding author. Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China; Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China.
| | - Dingjun Hao
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China
- Corresponding author. Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China; Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, China.
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de Ridder VA, Whiting PS, Balogh ZJ, Mir HR, Schultz BJ, Routt M“C. Pelvic ring injuries: recent advances in diagnosis and treatment. OTA Int 2023; 6:e261. [PMID: 37533441 PMCID: PMC10392441 DOI: 10.1097/oi9.0000000000000261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/30/2022] [Indexed: 08/04/2023]
Abstract
Pelvic ring injuries typically occur from high-energy trauma and are often associated with multisystem injuries. Prompt diagnosis of pelvic ring injuries is essential, and timely initial management is critical in the early resuscitation of polytraumatized patients. Definitive management of pelvic ring injuries continues to be a topic of much debate in the trauma community. Recent studies continue to inform our understanding of static and dynamic pelvic ring stability. Furthermore, literature investigating radiographic and clinical outcomes after nonoperative and operative management will help guide trauma surgeons select the most appropriate treatment of patients with these injuries.
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Affiliation(s)
| | - Paul S. Whiting
- Department of Orthopedics and Rehabilitation, University of Wisconsin Hospital and Clinics, Madison, WI
| | - Zsolt J. Balogh
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, New South Wales, Australia
| | - Hassan R. Mir
- Director of Orthopedic Trauma Research, Florida Orthopedic Institute, Tampa FL; and
| | - Blake J. Schultz
- University of Texas Health Science Center at Houston, Houston TX
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Halvachizadeh S, Martin DP, Pfeifer R, Jukema GN, Gueorguiev B, Pape HC, Berk T. Which non-infection related risk factors are associated with impaired proximal femur fracture healing in patients under the age of 70 years? BMC Musculoskelet Disord 2023; 24:405. [PMID: 37210475 DOI: 10.1186/s12891-023-06539-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 05/16/2023] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND/PURPOSE Impaired healing is a feared complication with devastating outcomes for each patient. Most studies focus on geriatric fracture fixation and assess well known risk factors such as infections. However, risk factors, others than infections, and impaired healing of proximal femur fractures in non-geriatric adults are marginally assessed. Therefore, this study aimed to identify non-infection related risk factors for impaired fracture healing of proximal femur fractures in non-geriatric trauma patients. METHODS This study included non-geriatric patients (aged 69 years and younger) who were treated between 2013 and 2020 at one academic Level 1 trauma center due to a proximal femur fracture (PFF). Patients were stratified according to AO/OTA classification. Delayed union was defined as failed callus formation on 3 out of 4 cortices after 3 to 6 months. Nonunion was defined as lack of callus-formation after 6 months, material breakage, or requirement of revision surgery. Patient follow up was 12 months. RESULTS This study included 150 patients. Delayed union was observed in 32 (21.3%) patients and nonunion with subsequent revision surgery occurred in 14 (9.3%). With an increasing fracture classification (31 A1 up to 31 A3 type fractures), there was a significantly higher rate of delayed union. Additionally, open reduction and internal fixation (ORIF) (OR 6.17, (95% CI 1.54 to 24.70, p ≤ 0.01)) and diabetes mellitus type II (DM) (OR 5.74, (95% CI 1.39 to 23.72, p = 0.016)), were independent risk factors for delayed union. The rate of nonunion was independent of fracture morphology, patient's characteristics or comorbidities. CONCLUSION Increasing fracture complexity, ORIF and diabetes were found to be associated with delayed union of intertrochanteric femur fractures in non-geriatric patients. However, these factors were not associated with the development of nonunion.
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Affiliation(s)
- Sascha Halvachizadeh
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
- Harald-Tscherne Laboratory for Orthopedic and Trauma Research, University of Zurich, Sternwartstrasse 14, 8091, Zurich, Switzerland
| | - David Paul Martin
- Department of Orthopedics and Rehabilitation, University of Wisconsin, 1685 Highland Ave, Madison, WI, 53705, USA
| | - Roman Pfeifer
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
- Harald-Tscherne Laboratory for Orthopedic and Trauma Research, University of Zurich, Sternwartstrasse 14, 8091, Zurich, Switzerland
| | - Gerrolt Nico Jukema
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
- Harald-Tscherne Laboratory for Orthopedic and Trauma Research, University of Zurich, Sternwartstrasse 14, 8091, Zurich, Switzerland
| | - Boyko Gueorguiev
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos, Switzerland
| | - Hans-Christoph Pape
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
- Harald-Tscherne Laboratory for Orthopedic and Trauma Research, University of Zurich, Sternwartstrasse 14, 8091, Zurich, Switzerland
| | - Till Berk
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
- Harald-Tscherne Laboratory for Orthopedic and Trauma Research, University of Zurich, Sternwartstrasse 14, 8091, Zurich, Switzerland.
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10
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Conceição C, Completo A, Soares dos Santos MP. Ultrasensitive capacitive sensing system for smart medical devices with ability to monitor fracture healing stages. J R Soc Interface 2023; 20:20220818. [PMCID: PMC9943881 DOI: 10.1098/rsif.2022.0818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Bone fractures are a global public health problem. A sustained increase in the number of incident cases has been observed in the last few decades, as well as the number of prevalent cases and the number of years lived with disability. Current monitoring techniques are based on imaging techniques, which are highly subjective, radioactive, expensive and unable to provide daily monitoring of fracture healing stages. The development of reliable, non-invasive and non-subjective technologies is mandatory to minimize non-union risks. Delayed healing and non-union conditions require timely medical intervention, such that preventive procedures and shortened treatment periods can be carried out. This work proposes the development of an ultrasensitive capacitive sensing system for smart implantable fixation implants with ability to effectively monitor the evolution of bone fractures. Both in vitro experimental tests and numerical simulations highlight that networks of co-surface capacitive systems are able: (i) to detect four different bone healing phases, capacitance decrease patterns occurring as the healing process progresses and (ii) to monitor the callus evolution in multiple target regions. These are very promising results that highlight the potential of capacitive technologies to minimize the individual and social burdens related to fracture management, mainly when delayed healing or non-union conditions occur.
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Affiliation(s)
- Cassandra Conceição
- Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal
| | - António Completo
- Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal,TEMA—Centre for Mechanical Technology and Automation, 3810-193 Aveiro, Portugal,LASI—Intelligent Systems Associate Laboratory, Portugal
| | - Marco P. Soares dos Santos
- Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal,TEMA—Centre for Mechanical Technology and Automation, 3810-193 Aveiro, Portugal,LASI—Intelligent Systems Associate Laboratory, Portugal
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11
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Rougier G, Maistriaux L, Fievé L, Xhema D, Evrard R, Manon J, Olszewski R, Szmytka F, Thurieau N, Boisson J, Kadlub N, Gianello P, Behets C, Lengelé B. Decellularized vascularized bone grafts: A preliminary in vitro porcine model for bioengineered transplantable bone shafts. Front Bioeng Biotechnol 2023; 10:1003861. [PMID: 36743653 PMCID: PMC9890275 DOI: 10.3389/fbioe.2022.1003861] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/09/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction: Durable reconstruction of critical size bone defects is still a surgical challenge despite the availability of numerous autologous and substitute bone options. In this paper, we have investigated the possibility of creating a living bone allograft, using the perfusion/decellularization/recellularization (PDR) technique, which was applied to an original model of vascularized porcine bone graft. Materials and Methods: 11 porcine bone forelimbs, including radius and ulna, were harvested along with their vasculature including the interosseous artery and then decellularized using a sequential detergent perfusion protocol. Cellular clearance, vasculature, extracellular matrix (ECM), and preservation of biomechanical properties were evaluated. The cytocompatibility and in vitro osteoinductive potential of acellular extracellular matrix were studied by static seeding of NIH-3T3 cells and porcine adipose mesenchymal stem cells (pAMSC), respectively. Results: The vascularized bone grafts were successfully decellularized, with an excellent preservation of the 3D morphology and ECM microarchitecture. Measurements of DNA and ECM components revealed complete cellular clearance and preservation of ECM's major proteins. Bone mineral density (BMD) acquisitions revealed a slight, yet non-significant, decrease after decellularization, while biomechanical testing was unmodified. Cone beam computed tomography (CBCT) acquisitions after vascular injection of barium sulphate confirmed the preservation of the vascular network throughout the whole graft. The non-toxicity of the scaffold was proven by the very low amount of residual sodium dodecyl sulfate (SDS) in the ECM and confirmed by the high live/dead ratio of fibroblasts seeded on periosteum and bone ECM-grafts after 3, 7, and 16 days of culture. Moreover, cell proliferation tests showed a significant multiplication of seeded cell populations at the same endpoints. Lastly, the differentiation study using pAMSC confirmed the ECM graft's potential to promote osteogenic differentiation. An osteoid-like deposition occurred when pAMSC were cultured on bone ECM in both proliferative and osteogenic differentiation media. Conclusion: Fully decellularized bone grafts can be obtained by perfusion decellularization, thereby preserving ECM architecture and their vascular network, while promoting cell growth and differentiation. These vascularized decellularized bone shaft allografts thus present a true potential for future in vivo reimplantation. Therefore, they may offer new perspectives for repairing large bone defects and for bone tissue engineering.
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Affiliation(s)
- Guillaume Rougier
- Pole of Morphology (MORF)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium,Department of Oncological and Cervicofacial Reconstructive Surgery, Otorhinolaryngology, Maxillofacial Surgery—Institut Curie, Paris, France
| | - Louis Maistriaux
- Pole of Morphology (MORF)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium,Pole of Experimental Surgery and Transplantation (CHEX)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium,*Correspondence: Louis Maistriaux,
| | - Lies Fievé
- Pole of Morphology (MORF)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium
| | - Daela Xhema
- Pole of Experimental Surgery and Transplantation (CHEX)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium
| | - Robin Evrard
- Pole of Experimental Surgery and Transplantation (CHEX)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium,Neuromusculoskeletal Lab (NMSK)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium
| | - Julie Manon
- Pole of Morphology (MORF)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium,Neuromusculoskeletal Lab (NMSK)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium
| | - Raphael Olszewski
- Neuromusculoskeletal Lab (NMSK)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium,Department of Maxillofacial Surgery and Stomatology—Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Fabien Szmytka
- IMSIA, ENSTA Paris, Institut Polytechnique de Paris, Palaiseau, France
| | - Nicolas Thurieau
- IMSIA, ENSTA Paris, Institut Polytechnique de Paris, Palaiseau, France
| | - Jean Boisson
- IMSIA, ENSTA Paris, Institut Polytechnique de Paris, Palaiseau, France
| | - Natacha Kadlub
- IMSIA, ENSTA Paris, Institut Polytechnique de Paris, Palaiseau, France,Department of Maxillofacial and Reconstructive Surgery—Necker Enfants Malades, Paris, France
| | - Pierre Gianello
- Pole of Experimental Surgery and Transplantation (CHEX)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium
| | - Catherine Behets
- Pole of Morphology (MORF)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium
| | - Benoît Lengelé
- Pole of Morphology (MORF)—Institute of Experimental and Clinical Research (IREC)—UCLouvain, Brussels, Belgium,Department of Plastic and Reconstructive Surgery—Cliniques Universitaires Saint-Luc, Brussels, Belgium
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12
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Decellularized vascularized bone grafts as therapeutic solution for bone reconstruction: A mechanical evaluation. PLoS One 2023; 18:e0280193. [PMID: 36638107 PMCID: PMC9838862 DOI: 10.1371/journal.pone.0280193] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/22/2022] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Large bone defects are challenging for surgeons. Available reimplanted bone substitutes can't properly restore optimal function along and long term osteointegration of the bone graft. Bone substitute based on the perfusion-decellularization technique seem to be interesting in order to overcome these limitations. We present here an evaluation of the biomechanics of the bones thus obtained. MATERIAL AND METHODS Two decellularization protocols were chosen for this study. One using Sodium Dodecyl Sulfate (SDS) (D1) and one using NaOH and H2O2 (D2). The decellularization was performed on porcine forearms. We then carried out compression, three-point bending, indentation and screw pull-out tests on each sample. Once these tests were completed, we compared the results obtained between the different decellularization protocols and with samples left native. RESULTS The difference in the means was similar between the tests performed on bones decellularized with the SDS protocol and native bones for pull-out test: +1.4% (CI95% [-10.5%- 12.4%]) of mean differences when comparing Native vs D1, compression -14.9% (CI95% [-42.7%- 12.5%]), 3-point bending -5.7% (CI95% [-22.5%- 11.1%]) and indentation -10.8% (CI95% [-19.5%- 4.6%]). Bones decellularized with the NaOH protocol showed different results from those obtained with the SDS protocol or native bones during the pull-out screw +40.7% (CI95% [24.3%- 57%]) for Native vs D2 protocol and 3-point bending tests +39.2% (CI95% [13.7%- 64.6%]) for Native vs D2 protocol. The other tests, compression and indentation, gave similar results for all our samples. CONCLUSION Vascularized decellularized grafts seem to be an interesting means for bone reconstruction. Our study shows that the decellularization method affects the mechanical results of our specimens. Some methods seem to limit these alterations and could be used in the future for bone decellularization.
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13
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Yu F, Li F, Yu P, Zhou B, Ye L. Identification and characterization of NFATc1+ skeletal stem cells in bone regeneration. Cell Rep 2022; 41:111599. [DOI: 10.1016/j.celrep.2022.111599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/06/2022] [Accepted: 10/13/2022] [Indexed: 11/09/2022] Open
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Xing Y, Zhong X, Chen Z, Liu Q. Optimized osteogenesis of biological hydroxyapatite-based bone grafting materials by ion doping and osteoimmunomodulation. Biomed Mater Eng 2022; 34:195-213. [DOI: 10.3233/bme-221437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Biological hydroxyapatite (BHA)-based bone grafting materials have been widely used for bone regeneration in implant surgery. Much effort has been made in the improvement of their osteogenic property as it remains unsatisfactory for clinical use. Osteoimmunomodulation plays a significant role in bone regeneration, which is highly related to active inorganic ions. Therefore, attempts have been made to obtain osteoimmunomodulatory BHA-based bone grafting materials with optimized osteogenic property by ion doping. OBJECTIVE: To summarize and discuss the active inorganic ions doped into BHA and their effects on BHA-based bone grafting materials. METHOD: A literature search was performed in databases including Google Scholar, Web of Science and PubMed, with the elementary keywords of “ion doped” and “biological hydroxyapatite”, as well as several supplementary keywords. All document types were included in this search. The searching period and language were not limited and kept updated to 2022. RESULTS: A total of 32 articles were finally included, of which 32 discussed the physiochemical properties of BHA-based biomaterials, while 12 investigated their biological features in vitro, and only three examined their biological performance in vivo. Various ions were doped into BHA, including fluoride, zinc, magnesium and lithium. Such ions improved the biological performance of BHA-based biomaterials, which was attributed to their osteoimmunomodulatory effect. CONCLUSION: The doping of active inorganic ions is a reliable strategy to endow BHA-based biomaterials with osteoimmunomodulatory property and promote bone regeneration. Further studies are still in need to explore more ions and their effects in the crosstalk between the skeletal and immune systems.
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Affiliation(s)
| | | | | | - Quan Liu
- , Sun Yat-sen University, , China
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15
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Differences in characteristics between patients ≥ 65 and < 65 years of age with orthopaedic injuries after severe trauma. Scand J Trauma Resusc Emerg Med 2022; 30:51. [PMID: 36153545 PMCID: PMC9509558 DOI: 10.1186/s13049-022-01038-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Aim
Many trauma patients have associated orthopaedic injuries at admission. The existing literature regarding orthopaedic trauma often focuses on single injuries, but there is a paucity of information that gives an overview of this group of patients. Our aim was to describe the differences in characteristics between polytrauma patients ≥ 65 and < 65 years of age suffering orthopaedic injuries.
Methods
Patients registered in the Norwegian Trauma Registry (NTR) with an injury severity score (ISS) > 15 and orthopaedic injuries, who were admitted to Haukeland University Hospital in 2016–2018, were included. Data retrieved from the patients’ hospital records and NTR were analysed. The patients were divided into two groups based on age.
Results
The study comprised 175 patients, of which 128 (73%) and 47 (27%) were aged < 65 (Group 1) and ≥ 65 years (Group 2), respectively. The ISS and the new injury severity score (NISS) were similar in both groups. The dominating injury mechanism was traffic-related and thoracic injury was the most common location of main injury in both groups. The groups suffered a similar number of orthopaedic injuries. A significantly higher proportion of Group 1 underwent operative treatment for their orthopaedic injuries than in Group 2 (74% vs. 53%). The mortality in Group 2 was significantly higher than that in Group 1 (15% vs. 3%). In Group 2 most deaths were related to traffic injuries (71%). High energy falls and traffic-related incidents caused the same number of deaths in Group 1. In Group 1 abdominal injuries resulted in most deaths, while head injuries was the primary reason for deaths in Group 2.
Conclusions
Although the ISS and NISS were similar, mortality was significantly higher among patients aged ≥ 65 years compared to patients < 65 years of age. The younger age group underwent more frequently surgery for orthopaedic injuries than the elderly. There may be multiple reasons for this difference, but our study does not have sufficient data to draw any conclusions. Future studies may provide a deeper understanding of what causes treatment variation between age groups, which would hopefully help to further develop strategies to improve outcome for the elderly polytrauma patient.
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16
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Briggs GD, Gelzinnis S, Meakes S, King KL, Balogh ZJ. NOT ALL CELL-FREE MITOCHONDRIAL DNA IS EQUAL IN TRAUMA PATIENTS. Shock 2022; 58:231-235. [PMID: 36125357 PMCID: PMC9512242 DOI: 10.1097/shk.0000000000001969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/20/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022]
Abstract
ABSTRACT Mitochondrial DNA (mtDNA) acts as a proinflammatory damage-associated molecular pattern that stimulates innate immune activation via Toll-like receptor 9, similarly to bacterial DNA. A number of clinical studies have measured elevated cell-free mtDNA in the plasma of trauma patients, thought to originate from tissue injury and inflammatory processes; however, the magnitude of this increase, the absolute concentration, and the association with poor outcomes varies considerably across studies. Measurements of cell-free mtDNA in healthy individuals have shown that the majority of "cell-free" mtDNA (>95%) can be centrifuged/filtered from plasma in the size range of 0.45 to 5 μm, suggesting that there are larger forms of mtDNA-containing complexes in the plasma that could be considered cell-free. Whether this is true for trauma patients (and other relevant disease states) and the clinical relevance of the larger forms of mtDNA is unknown. These findings from healthy individuals also suggest that the centrifugation speeds used to generate cell-free plasma (which are rarely consistent among studies) could result in mixed populations of cell-free mtDNA that could confound associations with outcomes. We demonstrate in this study of 25 major trauma patients that the majority of the cell-free mtDNA in trauma patient plasma (>95%) is removed after centrifugation at 16,000g. Despite the larger forms of mtDNA being predominant, they do not correlate with outcomes or expected parameters such as injury/shock severity, multiple organ failure, and markers of inflammation, whereas low-molecular-weight cell-free mtDNA correlates strongly with these variables.
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Affiliation(s)
- Gabrielle D. Briggs
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Scott Gelzinnis
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Department of Traumatology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Simone Meakes
- Department of Traumatology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Kate L. King
- Department of Traumatology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Zsolt J. Balogh
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Department of Traumatology, John Hunter Hospital, Newcastle, New South Wales, Australia
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17
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Lin SJ, Huang CC. Strontium Peroxide-Loaded Composite Scaffolds Capable of Generating Oxygen and Modulating Behaviors of Osteoblasts and Osteoclasts. Int J Mol Sci 2022; 23:ijms23116322. [PMID: 35683001 PMCID: PMC9181728 DOI: 10.3390/ijms23116322] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 11/24/2022] Open
Abstract
The reconstruction of bone defects remains challenging. The utilization of bone autografts, although quite promising, is limited by several drawbacks, especially substantial donor site complications. Recently, strontium (Sr), a bioactive trace element with excellent osteoinductive, osteoconductive, and pro-angiogenic properties, has emerged as a potential therapeutic agent for bone repair. Herein, a strontium peroxide (SrO2)-loaded poly(lactic-co-glycolic acid) (PLGA)-gelatin scaffold system was developed as an implantable bone substitute. Gelatin sponges serve as porous osteoconductive scaffolds, while PLGA not only reinforces the mechanical strength of the gelatin but also controls the rate of water infiltration. The encapsulated SrO2 can release Sr2+ in a sustained manner upon exposure to water, thus effectively stimulating the proliferation of osteoblasts and suppressing the formation of osteoclasts. Moreover, SrO2 can generate hydrogen peroxide and subsequent oxygen molecules to increase local oxygen tension, an essential niche factor for osteogenesis. Collectively, the developed SrO2-loaded composite scaffold shows promise as a multifunctional bioactive bone graft for bone tissue engineering.
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18
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Nash KE, Ong KG, Guldberg RE. Implantable biosensors for musculoskeletal health. Connect Tissue Res 2022; 63:228-242. [PMID: 35172654 PMCID: PMC8977250 DOI: 10.1080/03008207.2022.2041002] [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] [Indexed: 02/03/2023]
Abstract
PURPOSE A healthy musculoskeletal system requires complex functional integration of bone, muscle, cartilage, and connective tissues responsible for bodily support, motion, and the protection of vital organs. Conditions or injuries to musculoskeeltal tissues can devastate an individual's quality of life. Some conditions that are particularly disabling include severe bone and muscle injuries to the extremities and amputations resulting from unmanageable musculoskeletal conditions or injuries. Monitoring and managing musculoskeletal health is intricate because of the complex mechanobiology of these interconnected tissues. METHODS For this article, we reviewed literature on implantable biosensors related to clinical data of the musculoskeletal system, therapeutics for complex bone injuries, and osseointegrated prosthetics as example applications. RESULTS As a result, a brief summary of biosensors technologies is provided along with review of noteworthy biosensors and future developments needed to fully realize the translational benefit of biosensors for musculoskeletal health. CONCLUSIONS Novel implantable biosensors capable of tracking biophysical parameters in vivo are highly relevant to musculoskeletal health because of their ability to collect clinical data relevant to medical decisions, complex trauma treatment, and the performance of osseointegrated prostheses.
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Affiliation(s)
- Kylie E. Nash
- Phil and Penny Knight Campus for Accelerating Scientific Impact Department of Bioengineering, University of Oregon, Eugene, OR 97403
| | - Keat Ghee Ong
- Phil and Penny Knight Campus for Accelerating Scientific Impact Department of Bioengineering, University of Oregon, Eugene, OR 97403
| | - Robert E. Guldberg
- Phil and Penny Knight Campus for Accelerating Scientific Impact Department of Bioengineering, University of Oregon, Eugene, OR 97403,Corresponding Author: Robert E. Guldberg, Ph.D., 3231 University of Oregon, Eugene OR, 97403,
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19
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Xu C, Chang Y, Xu Y, Wu P, Mu C, Nie A, Qu Y, Duan D, Guo X, Liu Z, Wang J, Luo Z. Silicon-Phosphorus-Nanosheets-Integrated 3D-Printable Hydrogel as a Bioactive and Biodegradable Scaffold for Vascularized Bone Regeneration. Adv Healthc Mater 2022; 11:e2101911. [PMID: 34865322 DOI: 10.1002/adhm.202101911] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/17/2021] [Indexed: 12/18/2022]
Abstract
Natural bone is a highly vascularized tissue that relies on the vasculature for blood and nutrients supply to maintain skeletal integrity. Bioactive nanomaterials with the capability of improving vascularized bone regeneration are highly demanded for bone tissue engineering. In this work, 2D silicon phosphorus (SiP) is explored as a new kind of bioactive and biodegradable nanomaterial with excellent angiogenesis and osteogenesis, and a 3D printed biohybrid hydrogel of GelMA-PEGDA incorporated with photocrosslinkable SiP-nanosheet (GelMA-PEGDA/SiPAC) is developed to apply on bone tissue engineering. Findings show that the GelMA-PEGDA/SiPAC possessess excellent biocompatibility and biodegradability, and can sustainably release Si and P elements. Compared with the biohybrid hydrogel scaffolds incorporated with black phosphorus nanosheets, the GelMA-PEGDA/SiPAC can further enhance the osteogenesis of mesenchymal stem cells, and tubular networking of human umbilical vascular endothelial cells. In a rat calvarial bone defect model, the superior angiogenesis and osteogenesis induced by GelMA-PEGDA/SiPAC have been confirmed in vivo. The current strategy paves a new way to design a multifunctional SiP nanocomposite scaffold on mediating the osteogenesis and angiogenesis in one system, and provides a bioactive and biodegradable alternative nanomaterial for tissue engineering and regenerative medicine.
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Affiliation(s)
- Chao Xu
- College of Life Science and Technology Huazhong University of Science and Technology Wuhan 430074 China
| | - Yukai Chang
- Center for High Pressure Science State Key Laboratory of Metastable Materials Science and Technology Yanshan University Qinhuangdao 066004 China
| | - Yan Xu
- Department of Orthopaedics Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China
| | - Ping Wu
- College of Life Science and Technology Huazhong University of Science and Technology Wuhan 430074 China
| | - Congpu Mu
- Center for High Pressure Science State Key Laboratory of Metastable Materials Science and Technology Yanshan University Qinhuangdao 066004 China
| | - Anmin Nie
- Center for High Pressure Science State Key Laboratory of Metastable Materials Science and Technology Yanshan University Qinhuangdao 066004 China
| | - Yanzhen Qu
- Department of Orthopaedics Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China
| | - Deyu Duan
- Department of Orthopaedics Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China
| | - Xiaodong Guo
- Department of Orthopaedics Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China
| | - Zhongyuan Liu
- Center for High Pressure Science State Key Laboratory of Metastable Materials Science and Technology Yanshan University Qinhuangdao 066004 China
| | - Jianglin Wang
- College of Life Science and Technology Huazhong University of Science and Technology Wuhan 430074 China
| | - Zhiqiang Luo
- College of Life Science and Technology Huazhong University of Science and Technology Wuhan 430074 China
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20
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Sun Y, Liu X, Zhu Y, Han Y, Shen J, Bao B, Gao T, Lin J, Huang T, Xu J, Chai Y, Zheng X. Tunable and Controlled Release of Cobalt Ions from Metal-Organic Framework Hydrogel Nanocomposites Enhances Bone Regeneration. ACS APPLIED MATERIALS & INTERFACES 2021; 13:59051-59066. [PMID: 34846853 DOI: 10.1021/acsami.1c16300] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cobalt (Co) ions, which can mimic hypoxia to promote angiogenesis, exhibit great potential for bone repair. However, a key point for the use of Co ions is that their release profile should be controllable and, more importantly, suitable for the bone regeneration process. Here, 2-ethylimidazole (eIm) was introduced into zeolitic imidazolate framework-67 (ZIF-67) to slow down Co-ion release and fabricate eIm-doped ZIF-67 (eIm/ZIF-67), which was combined into gelatin methacrylate (GelMA) to obtain an in situ photo-cross-linking nanocomposite hydrogel as a tunable Co-ion controlled release system. A tunable and controlled release of Co ions from the nanocomposite hydrogel was achieved by variation of linker composition, and GelMA with 75% eIm/ZIF-67 (with 75% eIm in the precursor solutions) could maintain a 21-day sustained release of Co ions, which is matched with early-stage angiogenesis during the bone formation process. Our in vitro study also showed that the GelMA@eIm/ZIF-67 hydrogel could reduce cytotoxicity and effectively promote the angiogenic activity of human umbilical vein endothelial cells (HUVECs) and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Moreover, an in vivo rat calvarial defect model demonstrated that the GelMA@eIm/ZIF-67 hydrogel exhibited remarkably enhanced bone formation and neovascularization abilities and had good biocompatibility as shown in organ histopathological examinations. Therefore, this novel nanocomposite hydrogel has strong therapeutic potential as a desirable Co-ion controlled release system and a powerful proangiogenic/osteogenic agent for the treatment of bone defects.
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Affiliation(s)
- Yi Sun
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
| | - Xuanzhe Liu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
| | - Yu Zhu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
| | - Yue Han
- School of Chemistry and Molecular Engineering, East China University of Science and Technology, Meilong Road 130, Shanghai 200237, P. R. China
| | - Junjie Shen
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
| | - Bingbo Bao
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
| | - Tao Gao
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
| | - Junqing Lin
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
| | - Tengli Huang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
| | - Jia Xu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
| | - Yimin Chai
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
| | - Xianyou Zheng
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai 200233, P. R. China
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Köhli P, Otto E, Jahn D, Reisener MJ, Appelt J, Rahmani A, Taheri N, Keller J, Pumberger M, Tsitsilonis S. Future Perspectives in Spinal Cord Repair: Brain as Saviour? TSCI with Concurrent TBI: Pathophysiological Interaction and Impact on MSC Treatment. Cells 2021; 10:2955. [PMID: 34831179 PMCID: PMC8616497 DOI: 10.3390/cells10112955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/08/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022] Open
Abstract
Traumatic spinal cord injury (TSCI), commonly caused by high energy trauma in young active patients, is frequently accompanied by traumatic brain injury (TBI). Although combined trauma results in inferior clinical outcomes and a higher mortality rate, the understanding of the pathophysiological interaction of co-occurring TSCI and TBI remains limited. This review provides a detailed overview of the local and systemic alterations due to TSCI and TBI, which severely affect the autonomic and sensory nervous system, immune response, the blood-brain and spinal cord barrier, local perfusion, endocrine homeostasis, posttraumatic metabolism, and circadian rhythm. Because currently developed mesenchymal stem cell (MSC)-based therapeutic strategies for TSCI provide only mild benefit, this review raises awareness of the impact of TSCI-TBI interaction on TSCI pathophysiology and MSC treatment. Therefore, we propose that unravelling the underlying pathophysiology of TSCI with concomitant TBI will reveal promising pharmacological targets and therapeutic strategies for regenerative therapies, further improving MSC therapy.
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Affiliation(s)
- Paul Köhli
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Ellen Otto
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Denise Jahn
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Marie-Jacqueline Reisener
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
| | - Jessika Appelt
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Adibeh Rahmani
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Nima Taheri
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
| | - Johannes Keller
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany;
- University Hospital Hamburg-Eppendorf, Department of Trauma Surgery and Orthopaedics, Martinistraße 52, 20246 Hamburg, Germany
| | - Matthias Pumberger
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany;
| | - Serafeim Tsitsilonis
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; (P.K.); (E.O.); (D.J.); (M.-J.R.); (J.A.); (A.R.); (N.T.)
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany;
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Thurairajah K, Briggs GD, Balogh ZJ. Stem cell therapy for fracture non-union: The current evidence from human studies. J Orthop Surg (Hong Kong) 2021; 29:23094990211036545. [PMID: 34396805 DOI: 10.1177/23094990211036545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Non-union is a taxing complication of fracture management for both the patient and their surgeon. Modern fracture fixation techniques have been developed to optimise the biomechanical environment for fracture healing but do not guarantee union. Patient biology has a critical role in achieving union and stem cell therapy has potential for improving fracture healing at a cellular level to treat or avoid non-union. This article reviews the current understanding of non-union, concepts in bone healing and the current literature on the application of stem cells in non-union.
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Affiliation(s)
- Kabilan Thurairajah
- Department of Traumatology, 37024John Hunter Hospital and University of Newcastle, Newcastle, Australia
| | - Gabrielle D Briggs
- School of Medicine and Public Health, 5982University of Newcastle, Newcastle, Australia
| | - Zsolt J Balogh
- Department of Traumatology, 37024John Hunter Hospital and University of Newcastle, Newcastle, Australia
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23
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Jiang S, Wang M, He J. A review of biomimetic scaffolds for bone regeneration: Toward a cell-free strategy. Bioeng Transl Med 2021; 6:e10206. [PMID: 34027093 PMCID: PMC8126827 DOI: 10.1002/btm2.10206] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 11/05/2020] [Accepted: 11/12/2020] [Indexed: 12/20/2022] Open
Abstract
In clinical terms, bone grafting currently involves the application of autogenous, allogeneic, or xenogeneic bone grafts, as well as natural or artificially synthesized materials, such as polymers, bioceramics, and other composites. Many of these are associated with limitations. The ideal scaffold for bone tissue engineering should provide mechanical support while promoting osteogenesis, osteoconduction, and even osteoinduction. There are various structural complications and engineering difficulties to be considered. Here, we describe the biomimetic possibilities of the modification of natural or synthetic materials through physical and chemical design to facilitate bone tissue repair. This review summarizes recent progresses in the strategies for constructing biomimetic scaffolds, including ion-functionalized scaffolds, decellularized extracellular matrix scaffolds, and micro- and nano-scale biomimetic scaffold structures, as well as reactive scaffolds induced by physical factors, and other acellular scaffolds. The fabrication techniques for these scaffolds, along with current strategies in clinical bone repair, are described. The developments in each category are discussed in terms of the connection between the scaffold materials and tissue repair, as well as the interactions with endogenous cells. As the advances in bone tissue engineering move toward application in the clinical setting, the demonstration of the therapeutic efficacy of these novel scaffold designs is critical.
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Affiliation(s)
- Sijing Jiang
- Department of Plastic SurgeryFirst Affiliated Hospital of Anhui Medical University, Anhui Medical UniversityHefeiChina
| | - Mohan Wang
- Stomatologic Hospital & College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChina
| | - Jiacai He
- Stomatologic Hospital & College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChina
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Early myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs. Sci Rep 2021; 11:8503. [PMID: 33875675 PMCID: PMC8055677 DOI: 10.1038/s41598-021-86151-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 10/01/2020] [Indexed: 12/27/2022] Open
Abstract
Musculoskeletal injuries are the most common reason for surgery in severely injured patients. In addition to direct cardiac damage after physical trauma, there is rising evidence that trauma induces secondary cardiac structural and functional damage. Previous research associates hip fractures with the appearance of coronary heart disease: As 25% of elderly patients developed a major adverse cardiac event after hip fracture. 20 male pigs underwent femur fracture with operative stabilization via nailing (unreamed, reamed, RIA I and a new RIA II; each group n = 5). Blood samples were collected 6 h after trauma and the concentration of troponin I and heart-type fatty acid binding protein (HFABP) as biomarkers for EMD were measured. At baseline and 6 h after trauma, transesophageal ECHO (TOE) was performed; and invasive arterial and left ventricular blood pressure were measured to evaluate the cardiac function after femur fracture. A systemic elevation of troponin I and HFABP indicate an early myocardial damage after femur fracture in pigs. Furthermore, various changes in systolic (ejection fraction and cardiac output) and diastolic (left ventricular end-diastolic pressure, mitral valve deceleration time and E/A ratio) parameters illustrate the functional impairment of the heart. These findings were accompanied by the development of valvular dysfunction (pulmonary and tricuspid valve). To the best of our knowledge, we described for the first time the development of functional impairment of the heart in the context of EMD after long bone fracture in pigs. Next to troponin and HFABP elevation, alterations in the systolic and diastolic function occurred and were accompanied by pulmonary and tricuspid valvular insufficiency. Regarding EMD, none of the fracture stabilization techniques (unreamed nailing, reaming, RIA I and RIA II) was superior.
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Implications of positive urine toxicology screening in trauma patients. Injury 2021; 52:478-480. [PMID: 33610312 DOI: 10.1016/j.injury.2021.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/16/2020] [Accepted: 02/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Pain management in trauma patients can be difficult due to their varied injuries and presence or absence of illicit substances in their systems. Additionally, trauma patients have variable lengths of stay. Limiting length of stay to what is medically necessary and preventing long-term dependence on narcotic medications are important in trauma patient care. METHODS We performed a retrospective review of 385 consecutive trauma activations at a Level II trauma center with urine toxicology screens from 2015. Main outcome measures recorded were urine toxicology results, average daily morphine milligram equivalents (MME), length of stay (LOS), injury severity score (ISS). We also recorded patient demographic information. Statistical analysis compared outcomes and demographics between trauma patients with positive urine toxicology screens to those with negative screens. Significance was set at p < 0.05. RESULTS Positive urine toxicology screens were present in 230/385 (59.7%) patients. The median (interquartile range (IQR)) daily MME usage in the positive urine toxicology group was 25.2 (12.0-48.6) versus 12.4 (2.5-27.5) for those with a negative drug screen (p < 0.001). Median LOS was 3 (1-6) days versus 2 (1-4) days for the positive and negative groups, respectively (p = 0.004). There were no differences in age, gender distribution, or ISS between the two groups. Subgroup analysis showed urine toxicology positive for opiates, benzodiazepines, and tetrahydrocannabinol (THC) were associated with increased daily MME. Benzodiazepines and amphetamines were associated with increased LOS. CONCLUSION This study identifies a positive toxicology screening as a risk factor for increased narcotic demands and longer length of stay in trauma patients. These findings may assist in developing treatment plans and setting expectations in this population. This information can also lead to proactive interventions aimed at minimizing narcotic use and shortening LOS in this population.
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Charbonnier B, Hadida M, Marchat D. Additive manufacturing pertaining to bone: Hopes, reality and future challenges for clinical applications. Acta Biomater 2021; 121:1-28. [PMID: 33271354 DOI: 10.1016/j.actbio.2020.11.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/06/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022]
Abstract
For the past 20 years, the democratization of additive manufacturing (AM) technologies has made many of us dream of: low cost, waste-free, and on-demand production of functional parts; fully customized tools; designs limited by imagination only, etc. As every patient is unique, the potential of AM for the medical field is thought to be considerable: AM would allow the division of dedicated patient-specific healthcare solutions entirely adapted to the patients' clinical needs. Pertinently, this review offers an extensive overview of bone-related clinical applications of AM and ongoing research trends, from 3D anatomical models for patient and student education to ephemeral structures supporting and promoting bone regeneration. Today, AM has undoubtably improved patient care and should facilitate many more improvements in the near future. However, despite extensive research, AM-based strategies for bone regeneration remain the only bone-related field without compelling clinical proof of concept to date. This may be due to a lack of understanding of the biological mechanisms guiding and promoting bone formation and due to the traditional top-down strategies devised to solve clinical issues. Indeed, the integrated holistic approach recommended for the design of regenerative systems (i.e., fixation systems and scaffolds) has remained at the conceptual state. Challenged by these issues, a slower but incremental research dynamic has occurred for the last few years, and recent progress suggests notable improvement in the years to come, with in view the development of safe, robust and standardized patient-specific clinical solutions for the regeneration of large bone defects.
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27
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Hydroxyapatite Based Materials for Bone Tissue Engineering: A Brief and Comprehensive Introduction. CRYSTALS 2021. [DOI: 10.3390/cryst11020149] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hydroxyapatite (HA) is widely used in bone tissue engineering for its bioactivity and biocompatibility, and a growing number of researchers are exploring ways to improve the physical properties and biological functions of hydroxyapatite. Up to now, HA has been used as inorganic building blocks for tissue engineering or as nanofillers to blend with polymers, furthermore, various methods such as ion doping or surface modification have been also reported to prepare functionalized HA. In this review, we try to give a brief and comprehensive introduction about HA-based materials, including ion-doped HA, HA/polymer composites and surface modified HA and their applications in bone tissue engineering. In addition, the prospective of HA is also discussed. This review may be helpful for researchers to get a general understanding about the development of hydroxyapatite based materials.
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28
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Chakka JL, Acri T, Laird NZ, Zhong L, Shin K, Elangovan S, Salem AK. Polydopamine functionalized VEGF gene-activated 3D printed scaffolds for bone regeneration. RSC Adv 2021; 11:13282-13291. [PMID: 35423856 PMCID: PMC8697638 DOI: 10.1039/d1ra01193f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 03/27/2021] [Indexed: 12/20/2022] Open
Abstract
Bone is a highly vascularized organ and the formation of new blood vessels is essential to regenerate large critical bone defects.
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Affiliation(s)
- Jaidev L. Chakka
- Department of Pharmaceutics and Experimental Therapeutics
- College of Pharmacy
- University of Iowa
- Iowa City
- USA
| | - Timothy Acri
- Department of Pharmaceutics and Experimental Therapeutics
- College of Pharmacy
- University of Iowa
- Iowa City
- USA
| | - Noah Z. Laird
- Department of Pharmaceutics and Experimental Therapeutics
- College of Pharmacy
- University of Iowa
- Iowa City
- USA
| | - Ling Zhong
- Department of Experimental Research
- Sun Yat-sen University
- Guangzhou
- PR China
| | - Kyungsup Shin
- Department of Orthodontics
- College of Dentistry and Dental Clinics
- University of Iowa
- Iowa City
- USA
| | - Satheesh Elangovan
- Department of Periodontics
- College of Dentistry and Dental Clinics
- University of Iowa
- Iowa City
- USA
| | - Aliasger K. Salem
- Department of Pharmaceutics and Experimental Therapeutics
- College of Pharmacy
- University of Iowa
- Iowa City
- USA
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Hongo T, Naito H, Fujiwara T, Inaba M, Fujisaki N, Nakao A. Incidence and related factors of hypoxia associated with elderly femoral neck fractures in the emergency department setting. Acute Med Surg 2020; 7:e618. [PMID: 33364038 PMCID: PMC7750023 DOI: 10.1002/ams2.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/01/2020] [Accepted: 11/29/2020] [Indexed: 11/17/2022] Open
Abstract
Aim Femoral neck fractures in elderly patients needing oxygen therapy are often encountered in the emergency department. This single‐center, retrospective, observational study aimed to examine the frequency, cause, and factors related to hypoxia in elderly patients with femoral neck fractures. Methods We analyzed data from 241 patients admitted to Okayama Saiseikai General Hospital (Okayama, Japan) from April 2016 to March 2019. Hypoxia was defined as PaO2 / FiO2 ratio under 300. The independent factors for hypoxia were determined by multiple logistic regression analysis. Results There were 194 patients who met the study inclusion criteria, 148 in the non‐hypoxia group and 46 in the hypoxia group. The hypoxia group included patients with pneumonia (n = 3), chronic obstructive pulmonary disease (n = 2), pulmonary edema (n = 1), and pulmonary embolization (n = 1). The cause of hypoxia was undetermined in 39 cases. However, occult fat embolism syndrome was suspected in 29 of these 39 cases based on Gurd and Wilson criteria after considering clinical examination results. Barthel indexes were significantly lower in the hypoxia group on discharge. Age (adjusted odds ratio [OR] 1.07; 95% confidence interval [CI], 1.00–1.14; P = 0.038), D‐dimer (adjusted OR 1.02; 95% CI, 1.00–1.03; P = 0.005), and transtricuspid pressure gradient (adjusted OR 1.03; 95% CI, 1.00–1.07; P = 0.015) were independently associated with the hypoxia. Conclusion We found that hypoxia, including undetermined hypoxia, was commonly encountered in the emergency department. Hypoxia in elderly patients with femoral neck fractures was associated with age, D‐dimer, and transtricuspid pressure gradient and needs further investigation.
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Affiliation(s)
- Takashi Hongo
- Emergency Department Okayama Saiseikai General Hospital Okayama Japan.,Department of Emergency Critical Care, and Disaster Medicine Dentistry, and Pharmaceutical Sciences Okayama University Graduate School of Medicine Okayama Japan
| | - Hiromichi Naito
- Department of Emergency Critical Care, and Disaster Medicine Dentistry, and Pharmaceutical Sciences Okayama University Graduate School of Medicine Okayama Japan
| | | | - Mototaka Inaba
- Department of Emergency Critical Care, and Disaster Medicine Dentistry, and Pharmaceutical Sciences Okayama University Graduate School of Medicine Okayama Japan
| | - Noritomo Fujisaki
- Department of Emergency Critical Care, and Disaster Medicine Dentistry, and Pharmaceutical Sciences Okayama University Graduate School of Medicine Okayama Japan
| | - Atsunori Nakao
- Department of Emergency Critical Care, and Disaster Medicine Dentistry, and Pharmaceutical Sciences Okayama University Graduate School of Medicine Okayama Japan
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Liu H, Du Y, Yang G, Hu X, Wang L, Liu B, Wang J, Zhang S. Delivering Proangiogenic Factors from 3D-Printed Polycaprolactone Scaffolds for Vascularized Bone Regeneration. Adv Healthc Mater 2020; 9:e2000727. [PMID: 32743958 DOI: 10.1002/adhm.202000727] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/10/2020] [Indexed: 01/04/2023]
Abstract
Natural bone is a highly vascularized tissue that relies on the vasculature for blood and nutrients supply to maintain skeletal integrity. Inadequacy of neovascularization may compromise the tissue ingrowth to the implanted scaffolds, and eventually results in failure for the repair. To tackle this issue and enhance self-vascularized bone regeneration, herein a 3D biomimetic selective lasersintering (SLS) derived scaffold, with an angiogenic growth factor immobilized on its surface, that can be released in a controlled manner is proposed. To this end, a porous polycaprolactone/hydroxyapatite (PCL/HA) scaffold is prepared via the SLS technique, which is further modified with vascular endothelial growth factor (VEGF) by coprecipitation with apatite. The resultant scaffold (PCL/HA/VEGF) has an excellent cytocompatibility, and subcutaneous implantation experiment shows that the VEGF-loaded scaffold significantly enhances the blood vessel formation compared with the VEGF-free control. It is further demonstrated that the PCL/HA/VEGF scaffold is able to enhance the in vivo bone regeneration in a rat cranial defect model. Taken together, the current study provides not only a feasible and promising scaffold candidate to enhance the vascularized bone regeneration, but also a general strategy to overcome the inadequate vascularization issue for the repair of other tissue and organs.
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Affiliation(s)
- Haoming Liu
- Advanced Biomaterials and Tissue Engineering Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Yingying Du
- Advanced Biomaterials and Tissue Engineering Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Gaojie Yang
- Advanced Biomaterials and Tissue Engineering Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Xixi Hu
- Advanced Biomaterials and Tissue Engineering Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Lin Wang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Bin Liu
- Center for Medical Device Evaluation, National Medical Products Administration, Beijing, 100037, China
| | - Jianglin Wang
- Advanced Biomaterials and Tissue Engineering Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Shengmin Zhang
- Advanced Biomaterials and Tissue Engineering Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China
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Complementary and synergistic effects on osteogenic and angiogenic properties of copper-incorporated silicocarnotite bioceramic: In vitro and in vivo studies. Biomaterials 2020; 268:120553. [PMID: 33253963 DOI: 10.1016/j.biomaterials.2020.120553] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 10/26/2020] [Accepted: 11/18/2020] [Indexed: 01/09/2023]
Abstract
Promoting bone regeneration to treat bone defects is a challenging problem in orthopedics, and developing novel biomaterials with both osteogenic and angiogenic activities is sought as a feasible solution. Here, copper-silicocarnotite [Cu-Ca5(PO4)2SiO4, Cu-CPS] was designed and fabricated. In this study, the Cu-CPS ceramics demonstrated better mechanical, osteogenic, and angiogenic properties in vitro and in vivo than pure CPS one. Particularly, CPS with 1.0 wt% CuO (1.0Cu-CPS) exhibited the best performance. Additionally, hydroxyapatite with 1.0 wt% CuO (1.0Cu-HA) was used to explore the respective effects of copper and silicon (Si). According to the in vitro results, it indicated that Cu enhanced the osteogenic activity of CPS ceramics although Si played a dominate role in the osteogenic process. Moreover, Cu could promote an early stage of angiogenesis, and the complementary effect of Si and Cu was found in the late phase. Furthermore, the in vivo results illustrated that the synergistic effect of Cu and Si improved bone and vessel regeneration during the degradation of Cu-CPS scaffolds (P < 0.05). Therefore, Cu-CPS ceramics could improve osteogenesis and angiogenesis through the simultaneous effects of Cu and Si, thus, offering a promising treatment option in orthopedic application for bone tissue regeneration.
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Kobayashi M, Chijimatsu R, Yoshikawa H, Yoshida K. Extracorporeal shock wave therapy accelerates endochondral ossification and fracture healing in a rat femur delayed-union model. Biochem Biophys Res Commun 2020; 530:632-637. [PMID: 32762942 DOI: 10.1016/j.bbrc.2020.07.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/12/2020] [Indexed: 11/30/2022]
Abstract
Extracorporeal shock wave therapy (ESWT) has been demonstrated to accelerate bone healing; however, the mechanism underlying ESWT-induced bone regeneration has not been fully elucidated. This study aimed to examine the effects of ESWT and the process of fracture healing. A rat model of femur delayed-union was established by cauterizing the periosteum. ESWT treatment at the fracture site was performed 2 weeks after the operation and the site was radiographically and histologically evaluated at weeks 4, 6, and 8. The bone union rate and radiographic score of the ESWT group were significantly higher than those of the control group at 8 weeks. Histological evaluation revealed enhanced endochondral ossification at the fracture site. The effects of ESWT on ATDC5 cells were examined in vitro. ESWT promoted chondrogenic differentiation without inhibiting the proliferation of ATDC5 cells. ESWT may induce significant bone healing by promoting endochondral ossification at the fracture site.
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Affiliation(s)
- Masato Kobayashi
- Osaka University, Graduate School of Medicine, Department of Orthopaedic Surgery, 2-2, Yamadaoka, Suita, Osaka, Japan
| | - Ryota Chijimatsu
- The University of Tokyo, Bone and Cartilage Regenerative Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hideki Yoshikawa
- Osaka University, Graduate School of Medicine, Department of Orthopaedic Surgery, 2-2, Yamadaoka, Suita, Osaka, Japan
| | - Kiyoshi Yoshida
- Osaka University, Graduate School of Medicine, Department of Orthopaedic Surgery, 2-2, Yamadaoka, Suita, Osaka, Japan.
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Wang W, Liu Y, Yang C, Jia W, Qi X, Liu C, Li X. Delivery of Salvianolic Acid B for Efficient Osteogenesis and Angiogenesis from Silk Fibroin Combined with Graphene Oxide. ACS Biomater Sci Eng 2020; 6:3539-3549. [PMID: 33463186 DOI: 10.1021/acsbiomaterials.0c00558] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The efficiency of drugs often hinges on drug carriers. To effectively transport therapeutic plant molecules, drug delivery carriers should be able to carry large doses of therapeutic drugs, enable their sustained release, and maintain their biological activity. Here, graphene oxide (GO) is demonstrated to be a valid carrier for delivering therapeutic plant molecules. Salvianolic acid B (SB), which contains a large number of hydroxyl groups, bound to the carboxyl groups of GO by self-assembly. Silk fibroin (SF) substrates were combined with functionalized GO through the freeze-drying method. SF/GO scaffolds could be loaded with large doses of SB, maintain the biological activity of SB while continuously releasing SB, and significantly promote the osteogenic differentiation of rat bone marrow mesenchymal stem cells (rBMSCs). SF/GO/SB also dramatically enhanced endothelial cell (EA-hy9.26) migration and tubulogenesis in vitro. Eight weeks after implantation of SF/GO/SB scaffolds in a rat cranial defect model, the defect area showed more new bone and angiogenesis than that following SF and SF/GO scaffold implantation. Therefore, GO is an effective sustained-release carrier for therapeutic plant molecules, such as SB, which can repair bone defects by promoting osteogenic differentiation and angiogenesis.
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Affiliation(s)
- Wei Wang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yang Liu
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai 200237, China
| | - Chao Yang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Weitao Jia
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Xin Qi
- Department of Orthopedic Surgery, Shanghai General Hospital, Shanghai 200080, China
| | - Changsheng Liu
- Engineering Research Center for Biomedical Materials of Ministry of Education, East China University of Science and Technology, Shanghai 200237, China
| | - Xiaolin Li
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
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Pottecher J, Noll E, Borel M, Audibert G, Gette S, Meyer C, Gaertner E, Legros V, Carapito R, Uring-Lambert B, Sauleau E, Land WG, Bahram S, Meyer A, Geny B, Diemunsch P. Protocol for TRAUMADORNASE: a prospective, randomized, multicentre, double-blinded, placebo-controlled clinical trial of aerosolized dornase alfa to reduce the incidence of moderate-to-severe hypoxaemia in ventilated trauma patients. Trials 2020; 21:274. [PMID: 32183886 PMCID: PMC7079402 DOI: 10.1186/s13063-020-4141-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 02/04/2020] [Indexed: 01/01/2023] Open
Abstract
Background Acute respiratory distress syndrome continues to drive significant morbidity and mortality after severe trauma. The incidence of trauma-induced, moderate-to-severe hypoxaemia, according to the Berlin definition, could be as high as 45%. Its pathophysiology includes the release of damage-associated molecular patterns (DAMPs), which propagate tissue injuries by triggering neutrophil extracellular traps (NETs). NETs include a DNA backbone coated with cytoplasmic proteins, which drive pulmonary cytotoxic effects. The structure of NETs and many DAMPs includes double-stranded DNA, which prevents their neutralization by plasma. Dornase alfa is a US Food and Drug Administration-approved recombinant DNase, which cleaves extracellular DNA and may therefore break up the backbone of NETs and DAMPs. Aerosolized dornase alfa was shown to reduce trauma-induced lung injury in experimental models and to improve arterial oxygenation in ventilated patients. Methods TRAUMADORNASE will be an institution-led, multicentre, double-blinded, placebo-controlled randomized trial in ventilated trauma patients. The primary trial objective is to demonstrate a reduction in the incidence of moderate-to-severe hypoxaemia in severe trauma patients during the first 7 days from 45% to 30% by providing aerosolized dornase alfa as compared to placebo. The secondary objectives are to demonstrate an improvement in lung function and a reduction in morbidity and mortality. Randomization of 250 patients per treatment arm will be carried out through a secure, web-based system. Statistical analyses will include a descriptive step and an inferential step using fully Bayesian techniques. The study was approved by both the Agence Nationale de la Sécurité du Médicament et des Produits de Santé (ANSM, on 5 October 2018) and a National Institutional Review Board (CPP, on 6 November 2018). Participant recruitment began in March 2019. Results will be published in international peer-reviewed medical journals. Discussion If early administration of inhaled dornase alfa actually reduces the incidence of moderate-to-severe hypoxaemia in patients with severe trauma, this new therapeutic strategy may be easily implemented in many clinical trauma care settings. This treatment may facilitate ventilator weaning, reduce the burden of trauma-induced lung inflammation and facilitate recovery and rehabilitation in severe trauma patients. Trial registration ClinicalTrials.gov, NCT03368092. Registered on 11 December 2017.
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Affiliation(s)
- Julien Pottecher
- Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Service d'Anesthésie-Réanimation Chirurgicale, 1 Avenue Molière, 67098, Strasbourg, France. .,Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), EA3072, 4 Rue Kirschleger, 67085, Strasbourg, France. .,Fédération Hospitalo-Universitaire OMICARE, Centre de Recherche d'Immunologie et d'Hématologie, 4 rue Kirschleger, 67085, Strasbourg Cedex, France.
| | - Eric Noll
- Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Service d'Anesthésie-Réanimation Chirurgicale, 1 Avenue Molière, 67098, Strasbourg, France.,Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), EA3072, 4 Rue Kirschleger, 67085, Strasbourg, France.,Fédération Hospitalo-Universitaire OMICARE, Centre de Recherche d'Immunologie et d'Hématologie, 4 rue Kirschleger, 67085, Strasbourg Cedex, France
| | - Marie Borel
- Sorbonne Universités, UPMC Université Paris 06, INSERM UMR_S 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Département d'Anesthésie Réanimation, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Gérard Audibert
- CHRU Nancy, Hôpital Central, Service d'Anesthésie-Réanimation, 29 Avenue de Lattre de Tassigny, 54000, Nancy, France
| | - Sébastien Gette
- CHR Metz-Thionville-Site de Mercy, Service de Réanimation Polyvalente, 1 Allée du Château, 57350, Ars-Laquenexy, France
| | - Christian Meyer
- Groupe Hospitalier de la Région de Mulhouse et Sud Alsace (GHRMSA), Pôle d'Anesthésie-Réanimation, 20 rue du Dr Laennec, 68051, Mulhouse Cedex 1, France
| | - Elisabeth Gaertner
- Hôpital Louis Pasteur, Service d'Anesthésie-Réanimation Pôle 2, 39 Avenue de la Liberté, 68024, Colmar Cedex, France
| | - Vincent Legros
- CHU de Reims, Hôpital Maison Blanche, Réanimation Chirurgicale et Traumatologique, SAMU 51, 45 rue Cognacq-Jay, 51092, Reims, France
| | - Raphaël Carapito
- Fédération Hospitalo-Universitaire OMICARE, Centre de Recherche d'Immunologie et d'Hématologie, 4 rue Kirschleger, 67085, Strasbourg Cedex, France.,Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Laboratoire Central d'Immunologie, 1 Place de l'Hôpital, 67091, Strasbourg Cedex, France.,Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Laboratoire d'ImmunoRhumatologie Moléculaire, INSERM UMR_S 1109, 4 rue Kirschleger, 67085, Strasbourg Cedex, France
| | - Béatrice Uring-Lambert
- Fédération Hospitalo-Universitaire OMICARE, Centre de Recherche d'Immunologie et d'Hématologie, 4 rue Kirschleger, 67085, Strasbourg Cedex, France.,Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Laboratoire Central d'Immunologie, 1 Place de l'Hôpital, 67091, Strasbourg Cedex, France.,Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Laboratoire d'ImmunoRhumatologie Moléculaire, INSERM UMR_S 1109, 4 rue Kirschleger, 67085, Strasbourg Cedex, France
| | - Erik Sauleau
- Hôpitaux Universitaires de Strasbourg, Hôpital Civil, Pôle Santé Publique, Groupe Méthode en Recherche Clinique (GMRC), 1 Place de l'Hôpital, 67091, Strasbourg Cedex, France
| | - Walter G Land
- Fédération Hospitalo-Universitaire OMICARE, Centre de Recherche d'Immunologie et d'Hématologie, 4 rue Kirschleger, 67085, Strasbourg Cedex, France.,Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Laboratoire d'ImmunoRhumatologie Moléculaire, INSERM UMR_S 1109, 4 rue Kirschleger, 67085, Strasbourg Cedex, France
| | - Seiamak Bahram
- Fédération Hospitalo-Universitaire OMICARE, Centre de Recherche d'Immunologie et d'Hématologie, 4 rue Kirschleger, 67085, Strasbourg Cedex, France.,Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Laboratoire Central d'Immunologie, 1 Place de l'Hôpital, 67091, Strasbourg Cedex, France.,Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Laboratoire d'ImmunoRhumatologie Moléculaire, INSERM UMR_S 1109, 4 rue Kirschleger, 67085, Strasbourg Cedex, France
| | - Alain Meyer
- Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), EA3072, 4 Rue Kirschleger, 67085, Strasbourg, France.,Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Service de Physiologie et d'Explorations Fonctionnelles, 1 Place de l'Hôpital, 67091, Strasbourg Cedex, France
| | - Bernard Geny
- Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), EA3072, 4 Rue Kirschleger, 67085, Strasbourg, France.,Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Service de Physiologie et d'Explorations Fonctionnelles, 1 Place de l'Hôpital, 67091, Strasbourg Cedex, France
| | - Pierre Diemunsch
- Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Service d'Anesthésie-Réanimation Chirurgicale, 1 Avenue Molière, 67098, Strasbourg, France.,Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), EA3072, 4 Rue Kirschleger, 67085, Strasbourg, France.,Fédération Hospitalo-Universitaire OMICARE, Centre de Recherche d'Immunologie et d'Hématologie, 4 rue Kirschleger, 67085, Strasbourg Cedex, France
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Liu H, Du Y, St-Pierre JP, Bergholt MS, Autefage H, Wang J, Cai M, Yang G, Stevens MM, Zhang S. Bioenergetic-active materials enhance tissue regeneration by modulating cellular metabolic state. SCIENCE ADVANCES 2020; 6:eaay7608. [PMID: 32232154 PMCID: PMC7096169 DOI: 10.1126/sciadv.aay7608] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/03/2020] [Indexed: 05/02/2023]
Abstract
Cellular bioenergetics (CBE) plays a critical role in tissue regeneration. Physiologically, an enhanced metabolic state facilitates anabolic biosynthesis and mitosis to accelerate regeneration. However, the development of approaches to reprogram CBE, toward the treatment of substantial tissue injuries, has been limited thus far. Here, we show that induced repair in a rabbit model of weight-bearing bone defects is greatly enhanced using a bioenergetic-active material (BAM) scaffold compared to commercialized poly(lactic acid) and calcium phosphate ceramic scaffolds. This material was composed of energy-active units that can be released in a sustained degradation-mediated fashion once implanted. By establishing an intramitochondrial metabolic bypass, the internalized energy-active units significantly elevate mitochondrial membrane potential (ΔΨm) to supply increased bioenergetic levels and accelerate bone formation. The ready-to-use material developed here represents a highly efficient and easy-to-implement therapeutic approach toward tissue regeneration, with promise for bench-to-bedside translation.
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Affiliation(s)
- Haoming Liu
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
- Advanced Biomaterials and Tissue Engineering Centre, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Yingying Du
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
- Advanced Biomaterials and Tissue Engineering Centre, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Jean-Philippe St-Pierre
- Department of Materials, Imperial College London, London SW7 2AZ, UK
- Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
| | - Mads S. Bergholt
- Department of Materials, Imperial College London, London SW7 2AZ, UK
- Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
| | - Hélène Autefage
- Department of Materials, Imperial College London, London SW7 2AZ, UK
- Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
- Division of Biomaterials, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Jianglin Wang
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
- Advanced Biomaterials and Tissue Engineering Centre, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Mingle Cai
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
- Advanced Biomaterials and Tissue Engineering Centre, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Gaojie Yang
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
- Advanced Biomaterials and Tissue Engineering Centre, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Molly M. Stevens
- Department of Materials, Imperial College London, London SW7 2AZ, UK
- Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
- Corresponding author. (M.M.S.); (S.Z.)
| | - Shengmin Zhang
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
- Advanced Biomaterials and Tissue Engineering Centre, Huazhong University of Science and Technology, Wuhan 430074, China
- Corresponding author. (M.M.S.); (S.Z.)
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Sparks DS, Saifzadeh S, Savi FM, Dlaska CE, Berner A, Henkel J, Reichert JC, Wullschleger M, Ren J, Cipitria A, McGovern JA, Steck R, Wagels M, Woodruff MA, Schuetz MA, Hutmacher DW. A preclinical large-animal model for the assessment of critical-size load-bearing bone defect reconstruction. Nat Protoc 2020; 15:877-924. [PMID: 32060491 DOI: 10.1038/s41596-019-0271-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 11/11/2019] [Indexed: 12/31/2022]
Abstract
Critical-size bone defects, which require large-volume tissue reconstruction, remain a clinical challenge. Bone engineering has the potential to provide new treatment concepts, yet clinical translation requires anatomically and physiologically relevant preclinical models. The ovine critical-size long-bone defect model has been validated in numerous studies as a preclinical tool for evaluating both conventional and novel bone-engineering concepts. With sufficient training and experience in large-animal studies, it is a technically feasible procedure with a high level of reproducibility when appropriate preoperative and postoperative management protocols are followed. The model can be established by following a procedure that includes the following stages: (i) preoperative planning and preparation, (ii) the surgical approach, (iii) postoperative management, and (iv) postmortem analysis. Using this model, full results for peer-reviewed publication can be attained within 2 years. In this protocol, we comprehensively describe how to establish proficiency using the preclinical model for the evaluation of a range of bone defect reconstruction options.
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Affiliation(s)
- David S Sparks
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Department of Plastic & Reconswrapping a sterile Coban wrap around the limb distallytructive Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, Queensland, Australia
| | - Siamak Saifzadeh
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Medical Engineering Research Facility, Queensland UCoban wrap only comes non-sterile. Sterilize Coban wrap before use.niversity of Technology, Chermside, Queensland, Australia
| | - Flavia Medeiros Savi
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,ARC Centre for Additive Biomanufactthe mounting resin base cement. Use it only in a laboratory fume cabinet and withuring, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Constantin E Dlaska
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Queensland, Australia
| | - Arne Berner
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Department of Trauma Surgery, University Hospital of Regensburg, Regensburg, Germany
| | - Jan Henkel
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Johannes C Reichert
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, König-Ludwig-Haus, Julius-Maximilians-University, Würzburg, Germany.,Department of Orthopaedic and Trauma Surgery, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany
| | - Martin Wullschleger
- Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Queensland, Australia.,Griffith University, School of Medicine, Southport, Queensland, Australia
| | - Jiongyu Ren
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Amaia Cipitria
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Potsdam, Germany
| | - Jacqui A McGovern
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Roland Steck
- Medical Engineering Research Facility, Queensland UCoban wrap only comes non-sterile. Sterilize Coban wrap before use.niversity of Technology, Chermside, Queensland, Australia
| | - Michael Wagels
- Department of Plastic & Reconswrapping a sterile Coban wrap around the limb distallytructive Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, Queensland, Australia.,Australian Centre for Complex Integrated Surgical Solutions (ACCISS), Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Maria Ann Woodruff
- ARC Centre for Additive Biomanufactthe mounting resin base cement. Use it only in a laboratory fume cabinet and withuring, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Biofabrication and Tissue Morphology Group, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Michael A Schuetz
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Queensland, Australia
| | - Dietmar W Hutmacher
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia. .,ARC Centre for Additive Biomanufactthe mounting resin base cement. Use it only in a laboratory fume cabinet and withuring, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
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37
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Laparoscopy and resection with primary anastomosis for perforated diverticulitis: challenging old dogmas. Updates Surg 2020; 72:21-28. [DOI: 10.1007/s13304-020-00708-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/16/2020] [Indexed: 01/25/2023]
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Horst K, Greven J, Lüken H, Zhi Q, Pfeifer R, Simon TP, Relja B, Marzi I, Pape HC, Hildebrand F. Trauma Severity and Its Impact on Local Inflammation in Extremity Injury-Insights From a Combined Trauma Model in Pigs. Front Immunol 2020; 10:3028. [PMID: 31993054 PMCID: PMC6964795 DOI: 10.3389/fimmu.2019.03028] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 12/10/2019] [Indexed: 01/06/2023] Open
Abstract
Background: Extremity fracture is frequently seen in multiple traumatized patients. Local post-traumatic inflammatory reactions as well as local and systemic interactions have been described in previous studies. However, trauma severity and its impact on the local immunologic reaction remains unclear. Therefore, fracture-associated local inflammation was investigated in a porcine model of isolated and combined trauma to gain information about the early inflammatory stages. Material and Methods: Polytrauma (PT) consisted of lung contusion, liver laceration, femur fracture, and controlled hemorrhage. Monotrauma (MT) consisted of femur fracture only. The fracture was operatively stabilized and animals were monitored under ICU-standard for 72 h. Blood, fracture hematoma (FH) as well as muscle samples were collected throughout the experimental period. Levels of local and systemic pro- and anti-inflammatory as well as angiogenetic cytokines were measured by ELISA. Results: Both groups showed a significant decrease in pro-inflammatory IL-6 in FH over time. However, concentrations in MT were significantly higher than in PT. The IL-8 concentrations initially decreased in FH, but recovered by the end of the observation period. These dynamics were only statistically significant in MT. Furthermore, concentrations measured in muscle tissue showed inverse kinetics compared to those in FH. The IL-10 did not present statistical resilient dynamics over time, although a slight increase in FH was seen by the end of the observation time in the MT group. Conclusions: Time-dependent dynamics of the local inflammatory response were observed. Trauma severity showed a significant impact, with lower values in pro- as well as angiogenetic mediators. Fracture repair could be altered by these trauma-related changes of the local immunologic milieu, which might serve as a possible explanation for the higher rates of delayed or non-union bone repair in polytraumatised patients.
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Affiliation(s)
- Klemens Horst
- Department of Orthopedic Trauma, University Hospital Aachen, Aachen, Germany.,Orthopedic Trauma Research Laboratory, University Hospital Aachen, Aachen, Germany
| | - Johannes Greven
- Department of Orthopedic Trauma, University Hospital Aachen, Aachen, Germany.,Orthopedic Trauma Research Laboratory, University Hospital Aachen, Aachen, Germany
| | - Hannah Lüken
- Department of Orthopedic Trauma, University Hospital Aachen, Aachen, Germany
| | - Qiao Zhi
- Orthopedic Trauma Research Laboratory, University Hospital Aachen, Aachen, Germany
| | - Roman Pfeifer
- Department of Orthopaedic Trauma Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Tim P Simon
- Department of Intensive Care and Intermediate Care, RWTH Aachen University, Aachen, Germany
| | - Borna Relja
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany.,Experimental Radiology, Department of Radiology and Nuclear Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Ingo Marzi
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - Hans-Christoph Pape
- Department of Orthopaedic Trauma Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Frank Hildebrand
- Department of Orthopedic Trauma, University Hospital Aachen, Aachen, Germany
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Is Systemic Inflammatory Response Syndrome Relevant to Pulmonary Complications and Mortality in Multiply Injured Children? J Pediatr Orthop 2020; 40:1-7. [PMID: 31815855 DOI: 10.1097/bpo.0000000000001085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Systemic inflammatory response syndrome (SIRS) is a well-recognized phenomenon in adult trauma populations. The "initial hit" of the traumatic event is often coupled with a systemic immune response characterized by changes in vital signs and laboratory indicators. A "second hit" from surgery during this time frame often results in acute lung injury, along with deterioration of the patient's clinical condition. We hypothesized that children and adolescents would experience SIRS physiology, but would not experience adult respiratory distress syndrome (ARDS) or "second hit" related death to the extent seen in the adult populations. METHODS We queried the trauma database of our level 1 pediatric trauma center from January 2005 to December 2015 for patients with injury severity scores of >16. We used the electronic medical record to track SIRS criteria in patients days 1 to 4 posttrauma. Trends were examined in patients with an orthopaedic injury (OI) and with no orthopaedic injury. Patients were further subcategorized and analyzed by age group based on the convention for definition of pediatric SIRS. Patients in the orthopaedic cohort were further examined for pulmonary complications and death. Logistic regression was used to identify risk factors for SIRS physiology in the first 4 days of hospitalization. RESULTS 81.4% (OI) and 69.1% no orthopaedic injury reached the threshold for SIRS within their first 4 days of hospitalization. Nine patients died in the hospital. Only 3 OI patients developed the criteria for ARDS, and only 3 patients with orthopaedic injuries died, 2 died within 24 hours of presentation and 1 within 48 hours, all had severe brain trauma. Increasing age groups showed increasing proportion of patients with SIRS. Increasing injury severity score and increasing age were independent predictors of SIRS during days 1 to 4. DISCUSSION SIRS seems to be as common in children as the reported rates for adults, and the proportion of SIRS in children increases with increasing age and injury severity. The high mortality rate and rate of ARDS observed in adults was not observed in our cohort. The presence or absence of major orthopaedic injuries was not a significant predictor. The SIRS response in polytraumatized children is poorly understood. The clinical phenomenon of acute lung injury/ARDS is observed less often in children, but the exact mechanism by which this occurs is unknown. LEVEL OF EVIDENCE Level III-case control.
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40
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The Surgical Burden of Musculoskeletal Conditions and Injuries. World J Surg 2019; 44:1007-1008. [PMID: 31820056 DOI: 10.1007/s00268-019-05304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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41
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Pottecher J, Meyer A, Wenceslau CF, Timmermans K, Hauser CJ, Land WG. Editorial: Trauma-Induced, DAMP-Mediated Remote Organ Injury, and Immunosuppression in the Acutely Ill Patient. Front Immunol 2019; 10:1971. [PMID: 31481961 PMCID: PMC6710339 DOI: 10.3389/fimmu.2019.01971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/05/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Julien Pottecher
- Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Strasbourg, France
- Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), FRU 6702, EA3072, Strasbourg, France
| | - Alain Meyer
- Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Service de Physiologie et d'Explorations Fonctionnelles - Hôpital de Hautepierre, Centre de Référence National des Maladies Auto-immunes Rares, Service de Rhumatologie, Strasbourg, France
- Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), FRU 6702, EA3072, Strasbourg, France
| | - Camilla Ferreira Wenceslau
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
| | - Kim Timmermans
- Radboud University Medical Center, Radboudumc Health Academy, Nijmegen, Netherlands
| | - Carl Jeffrey Hauser
- Acute Care Surgery and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Walter Gottlieb Land
- Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), FRU 6702, Laboratoire d'Excellence Transplantex, Unité INSERM UMR_S1109, Immuno-Rhumatologie Moléculaire, Strasbourg, France
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López Gualdrón CI, Bravo Ibarra ER, Murillo Bohórquez AP, Garnica Bohórquez I. Present and future for technologies to develop patient-specific medical devices: a systematic review approach. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2019; 12:253-273. [PMID: 31496840 PMCID: PMC6689557 DOI: 10.2147/mder.s215947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/08/2019] [Indexed: 01/25/2023] Open
Abstract
The main purpose of this investigation was to systematically review the literature regarding case studies on patient-specific implants and devices, with the goal of analyzing the process of developing custom-made medical devices. A content analysis was performed to identify design processes and methodologies implemented to develop devices such as implants adapted to bone geometries. Reverse engineering, computer-aided design, simulation of assets, and rapid prototyping technologies were selected according to their interoperability in a process framework for developing new products. Finally, results from the case studies and process stages identified in the consulted research were analyzed. These results showed a relationship between the scope and complexity of the process and the stage of technology integration of the patient-specific device development. The analyzed case studies were characterized by technical, scientific, and multidisciplinary components to achieve research goals. Likewise, integration of technologies using patient-specific technologies is needed for product development that converges into designing devices, such as implants, biomodels, and cutting drilling guides.
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Affiliation(s)
| | - Edna-Rocío Bravo Ibarra
- Industrial and Business Studies School, Universidad Industrial de Santander, Bucaramanga, Colombia
| | | | - Israel Garnica Bohórquez
- Industrial and Business Studies School, Universidad Industrial de Santander, Bucaramanga, Colombia
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Li C, Wang Q, Gu X, Kang Y, Zhang Y, Hu Y, Li T, Jin H, Deng G, Wang Q. Porous Se@SiO 2 nanocomposite promotes migration and osteogenic differentiation of rat bone marrow mesenchymal stem cell to accelerate bone fracture healing in a rat model. Int J Nanomedicine 2019; 14:3845-3860. [PMID: 31213805 PMCID: PMC6539174 DOI: 10.2147/ijn.s202741] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/14/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Delay or failure of bone union is a significant clinical challenge all over the world, and it has been reported that bone marrow mesenchymal stem cells (BMSCs) offer a promising approach to accelerate bone fracture healing. Se can modulate the proliferation and differentiation of BMSCs. Se-treatment enhances the osteoblastic differentiation of BMSCs and inhibiting the differentiation and formation of mature osteoclasts. The purpose of this study was to assess the effects of porous Se@SiO2 nanocomposite on bone regeneration and the underlying biological mechanisms. Methods: We oxidized Se2- to develop Se quantum dots, then we used the Se quantum dots to form a solid Se@SiO2 nanocomposite which was then coated with polyvinylpyrrolidone (PVP) and etched in hot water to synthesize porous Se@SiO2 nanocomposite. We used XRD pattern to assess the phase structure of the solid Se@SiO2 nanocomposite. The morphology of porous Se@SiO2 nanocomposite were evaluated by scanning electron microscope (SEM) and the biocompatibility of porous Se@SiO2 nanocomposite were investigated by cell counting kit-8 (CCK-8) assays. Then, a release assay was also performed. We used a Transwell assay to determine cell mobility in response to the porous Se@SiO2 nanocomposite. For in vitro experiments, BMSCs were divided into four groups to detect reactive oxygen species (ROS) generation, cell apoptosis, alkaline phosphatase activity, calcium deposition, gene activation and protein expression. For in vivo experiments, femur fracture model of rats was constructed to assess the osteogenic effects of porous Se@SiO2 nanocomposite. Results: In vitro, intervention with porous Se@SiO2 nanocomposite can promote migration and osteogenic differentiation of BMSCs, and protect BMSCs against H2O2-induced inhibition of osteogenic differentiation. In vivo, we demonstrated that the porous Se@SiO2 nanocomposite accelerated bone fracture healing using a rat femur fracture model. Conclusion: Porous Se@SiO2 nanocomposite promotes migration and osteogenesis differentiation of rat BMSCs and accelerates bone fracture healing, and porous Se@SiO2 nanocomposite may provide clinic benefit for bone tissue engineering.
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Affiliation(s)
- Chunlin Li
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201620, People's Republic of China
| | - Qi Wang
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201620, People's Republic of China.,Trauma Center, Shanghai General Hospital of Nanjing Medical University, Shanghai 200080, People's Republic of China
| | - Xiaohua Gu
- Department of Orthopedics, Shanghai Seventh People's Hospital, Shanghai, 200137, People's Republic of China
| | - Yingjie Kang
- Department of Radiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, People's Republic of China
| | - Yongxing Zhang
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201620, People's Republic of China
| | - Yangyang Hu
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201620, People's Republic of China
| | - Taixi Li
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201620, People's Republic of China
| | - Hansong Jin
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201620, People's Republic of China
| | - Guoying Deng
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201620, People's Republic of China
| | - Qiugen Wang
- Trauma Center, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201620, People's Republic of China
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Chen Y, Zheng Z, Zhou R, Zhang H, Chen C, Xiong Z, Liu K, Wang X. Developing a Strontium-Releasing Graphene Oxide-/Collagen-Based Organic-Inorganic Nanobiocomposite for Large Bone Defect Regeneration via MAPK Signaling Pathway. ACS APPLIED MATERIALS & INTERFACES 2019; 11:15986-15997. [PMID: 30945836 DOI: 10.1021/acsami.8b22606] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Significant efforts have been dedicated to fabricating favorable biomaterial-based bone substitutes for the repair of large bone defects. However, the development of bone biomaterials with suitable physiochemical and osteoinductive properties remains a challenge. Here, novel strontium-graphene oxide (Sr-GO) nanocomposites that allow long-term release of Sr ions are fabricated, which are used to reinforce collagen (Col) scaffolds through covalent cross-linking. The prepared Sr-GO-Col scaffold demonstrates significantly high water retention rates and excellent mechanical properties compared with unmodified Col scaffolds. The Sr-GO-modified Col scaffolds display a strong effect on adipose-derived stem cells by facilitating cell adhesion and osteogenic differentiation and by promoting the secretion of angiogenic factors to stimulate the in vitro tube formation of endothelial cells. Additionally, the secretion of angiogenic VEGF and osteogenic BMP-2 proteins is increased, which may be attributed to the synergistic effects of GO and Sr on the activation of the MAPK signaling pathway. The Sr-GO-Col constructs were then transplanted into rat critical-size calvarial bone defects, which showed the best bone regeneration and angiogenesis outcome at 12 weeks. Moreover, histological staining results show that the Sr-GO-Col group achieved complete defect bridging with the newly formed bone tissue and the residual Sr-GO nanoparticles are phagocytosed and degraded by multinucleated giant cells. These findings reveal that the incorporation of inorganic Sr-GO nanocomposites into biocompatible Col scaffolds is a viable strategy for fabricating favorable substitutes that enhance the regeneration of large bone defects.
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Affiliation(s)
- Yahong Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital , Shanghai Jiao Tong University School of Medicine , 639 Zhizaoju Road , Shanghai 200011 , P. R. China
| | | | - Renpeng Zhou
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital , Shanghai Jiao Tong University School of Medicine , 639 Zhizaoju Road , Shanghai 200011 , P. R. China
| | - Huizhong Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital , Shanghai Jiao Tong University School of Medicine , 639 Zhizaoju Road , Shanghai 200011 , P. R. China
| | - Chuhsin Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital , Shanghai Jiao Tong University School of Medicine , 639 Zhizaoju Road , Shanghai 200011 , P. R. China
| | - Zhezhen Xiong
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital , Shanghai Jiao Tong University School of Medicine , 639 Zhizaoju Road , Shanghai 200011 , P. R. China
| | - Kai Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital , Shanghai Jiao Tong University School of Medicine , 639 Zhizaoju Road , Shanghai 200011 , P. R. China
| | - Xiansong Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital , Shanghai Jiao Tong University School of Medicine , 639 Zhizaoju Road , Shanghai 200011 , P. R. China
- Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, National Tissue Engineering Center of China , Shanghai Jiao Tong University School of Medicine , Shanghai 200011 , P. R. China
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Yadav V, Suri HS, Vijayvargiya M, Agashe V, Shetty V. "Floating knee," an Uncommon Injury: Analysis of 12 Cases. Rev Bras Ortop 2019; 54:53-59. [PMID: 31363243 PMCID: PMC6424807 DOI: 10.1016/j.rboe.2017.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 09/05/2017] [Indexed: 11/17/2022] Open
Abstract
Objective Floating knee injuries are complex injuries and are usually caused by high-velocity trauma. These injuries are often associated with life treating injuries, which should take precedent over extremity injuries. The authors reviewed the outcomes of floating knee injuries managed in this institute from 2003 to 2015. Method A retrospective study was conducted of all patients with floating knee injuries from2003 to 2015. Twelve patients were included in the study. Data related to fracture type, associated injuries, treatment modalities, and complications were noted. Functional assessment was performed using the modified Karlstrom and Olerud criteria after complete bony union. Result The mechanism of injury was motor vehicle accident in all patients. The mean follow up was four years. The mean age of patients was 34.75 year. The mean union time was 6.5 months in femurs and 6.7 month in tibias. The complications were knee stiffness, delayed union, and infection. According to modified Karlstrom criteria, there were three - excellent, five - good, three - fair, and one poor result. Conclusion Floating knee injuries are severe injuries and are usually associated with multi-organ injuries. Early detection and appropriate management of associated injuries, early fixation of fractures, and postoperative rehabilitation are needed for good outcome. Complications are frequent, in the form of delayed union, knee stiffness, and infection.
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Affiliation(s)
- Vishal Yadav
- Departmento de Ortopedia, P.D. Hinduja National Hospital, Mumbai, Maharashtra, India
| | - Harpreet Singh Suri
- Departmento de Ortopedia, P.D. Hinduja National Hospital, Mumbai, Maharashtra, India
| | - Mayank Vijayvargiya
- Departmento de Ortopedia, P.D. Hinduja National Hospital, Mumbai, Maharashtra, India
| | - Vikas Agashe
- Departmento de Ortopedia, P.D. Hinduja National Hospital, Mumbai, Maharashtra, India
| | - Vivek Shetty
- Departmento de Ortopedia, P.D. Hinduja National Hospital, Mumbai, Maharashtra, India
- Address for correspondence Vivek Shetty Department of Orthopedics, P.D. Hinduja National HospitalMumbaiIndia
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Ma Y, Zhou Y, Wu F, Ji W, Zhang J, Wang X. The Bidirectional Interactions Between Inflammation and Coagulation in Fracture Hematoma. TISSUE ENGINEERING PART B-REVIEWS 2018; 25:46-54. [PMID: 30129875 DOI: 10.1089/ten.teb.2018.0157] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
IMPACT STATEMENT The review leads to better understanding of the interrelation between inflammation mediators and coagulation factors in the early fracture hematoma, and their influences on hematoma formation in the beginning of fracture healing. Furthermore, development of therapies aimed at simultaneous modulation of both coagulation factors and inflammation factors that affect hematoma structure, rather than specific factors, may be most promising.
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Affiliation(s)
- Yaping Ma
- 1 Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,2 Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center (JCMR-ZMU & URMC), Zunyi Medical University, Zunyi, China
| | - Yinghong Zhou
- 3 Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Fujun Wu
- 1 Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Wenjun Ji
- 1 Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jun Zhang
- 1 Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xin Wang
- 1 Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,2 Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center (JCMR-ZMU & URMC), Zunyi Medical University, Zunyi, China.,3 Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Brady J, Hardy BM, Yoshino O, Buxton A, Quail A, Balogh ZJ. The effect of haemorrhagic shock and resuscitation on fracture healing in a rabbit model: an animal study. Bone Joint J 2018; 100-B:1234-1240. [PMID: 30168758 PMCID: PMC6333172 DOI: 10.1302/0301-620x.100b9.bjj-2017-1531.r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Aims Little is known about the effect of haemorrhagic shock and resuscitation
on fracture healing. This study used a rabbit model with a femoral
osteotomy and fixation to examine this relationship. Materials and Methods A total of 18 male New Zealand white rabbits underwent femoral
osteotomy with intramedullary fixation with ‘shock’ (n = 9) and
control (n = 9) groups. Shock was induced in the study group by
removal of 35% of the total blood volume 45 minutes before resuscitation
with blood and crystalloid. Fracture healing was monitored for eight weeks
using serum markers of healing and radiographs. Results Four animals were excluded due to postoperative complications.
The serum concentration of osteocalcin was significantly elevated
in the shock group postoperatively (p < 0.0001). There were otherwise
no differences with regard to serum markers of bone healing. The
callus index was consistently increased in the shock group on anteroposterior
(p = 0.0069) and lateral (p = 0.0165) radiographs from three weeks
postoperatively. The control group showed an earlier decrease of
callus index. Radiographic scores were significantly greater in
the control group (p = 0.0025). Conclusion In a rabbit femoral osteotomy model with intramedullary fixation,
haemorrhagic shock and resuscitation produced larger callus but
with evidence of delayed remodelling. Cite this article: Bone Joint J 2018;100-B:1234–40.
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Affiliation(s)
- J Brady
- Lismore Base Hospital, Lismore, Australia
| | - B M Hardy
- John Hunter Hospital, New Lambton Heights, Australia
| | - O Yoshino
- Austin Hospital, Melbourne, Australia
| | - A Buxton
- University of Newcastle, Newcastle, Australia
| | - A Quail
- School of Medicine and Public Health, University of Newcastle, Australia
| | - Z J Balogh
- University of Newcastle, Newcastle, Australia and Orthopaedic Surgeon, John Hunter Hospital, New Lambton Heights, Australia
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Wang L, Zhu LX, Wang Z, Lou AJ, Yang YX, Guo Y, Liu S, Zhang C, Zhang Z, Hu HS, Yang B, Zhang P, Ouyang HW, Zhang ZY. Development of a centrally vascularized tissue engineering bone graft with the unique core-shell composite structure for large femoral bone defect treatment. Biomaterials 2018; 175:44-60. [PMID: 29800757 DOI: 10.1016/j.biomaterials.2018.05.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/10/2018] [Accepted: 05/12/2018] [Indexed: 01/09/2023]
Abstract
Great effort has been spent to promote the vascularization of tissue engineering bone grafts (TEBG) for improved therapeutic outcome. However, the thorough vascularization especially in the central region still remained as a major challenge for the clinical translation of TEBG. Here, we developed a new strategy to construct a centrally vascularized TEBG (CV-TEBG) with unique core-shell composite structure, which is consisted of an angiogenic core and an osteogenic shell. The in vivo evaluation in rabbit critical sized femoral defect was conducted to meticulously compare CV-TEBG to other TEBG designs (TEBG with osteogenic shell alone, or angiogenic core alone or angiogenic core+shell). Microfil-enhanced micro-CT analysis has been shown that CV-TEBG could outperform TEBG with pure osteogenic or angiogenic component for neo-vascularization. CV-TEBG achieved a much higher and more homogenous vascularization throughout the whole scaffold (1.52-38.91 folds, p < 0.01), and generated a unique burrito-like vascular network structure to perfuse both the central and peripheral regions of TEBG, indicating a potential synergistic effect between the osteogenic shell and angiogenic core in CV-TEBG to enhance neo-vascularization. Moreover, CV-TEBG has generated more new bone tissue than other groups (1.99-83.50 folds, p < 0.01), achieved successful bridging defect with the formation of both cortical bone like tissue externally and cancellous bone like tissue internally, and restored approximately 80% of the stiffness of the defected femur (benchmarked to the intact femur). It has been further observed that different bone regeneration patterns occurred in different TEBG implants and closely related to their vascularization patterns, revealing the potential profound influence of vascularization patterns on the osteogenesis pattern during defect healing.
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Affiliation(s)
- Le Wang
- Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China; Translational Research Centre of Regenerative Medicine and 3D Printing Technologies, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China.
| | - Li-Xin Zhu
- Department of Orthopaedic Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510282, China
| | - Zhao Wang
- Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China; Translational Research Centre of Regenerative Medicine and 3D Printing Technologies, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China
| | - Ai-Ju Lou
- Translational Research Centre of Regenerative Medicine and 3D Printing Technologies, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China; Department of Rheumatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China
| | - Yi-Xi Yang
- Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China; Translational Research Centre of Regenerative Medicine and 3D Printing Technologies, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China
| | - Yuan Guo
- Translational Research Centre of Regenerative Medicine and 3D Printing Technologies, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China
| | - Song Liu
- Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China; Translational Research Centre of Regenerative Medicine and 3D Printing Technologies, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China
| | - Chi Zhang
- Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China; Translational Research Centre of Regenerative Medicine and 3D Printing Technologies, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China
| | - Zheng Zhang
- Department of Cardiology, The General Hospital of the PLA Rocket Force, Beijing 100088, China
| | - Han-Sheng Hu
- Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China
| | - Bo Yang
- Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China
| | - Ping Zhang
- Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China
| | - Hong-Wei Ouyang
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University-University of Edinburgh Institute, Zhejiang University, Hangzhou, Zhejiang 310058, China; China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310058, China
| | - Zhi-Yong Zhang
- Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China; Translational Research Centre of Regenerative Medicine and 3D Printing Technologies, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, China; China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, 310058, China.
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Karipott SS, Nelson BD, Guldberg RE, Ong KG. Clinical potential of implantable wireless sensors for orthopedic treatments. Expert Rev Med Devices 2018; 15:255-264. [PMID: 29558820 DOI: 10.1080/17434440.2018.1454310] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Implantable wireless sensors have been used for real-time monitoring of chemicals and physical conditions of bones, tendons and muscles to diagnose and study orthopedic diseases and injuries. Due to the importance of these sensors in orthopedic care, a critical review, which not only analyzes the underlying technologies but also their clinical implementations and challenges, will provide a landscape view on their current state and their future clinical role. AREAS COVERED By conducting an extensive literature search and following the leaders of orthopedic implantable wireless sensors, this review covers the battery-powered and battery-free wireless implantable sensor technologies, and describes their implementation for hips, knees, spine, and shoulder stress/strain monitoring. Their advantages, limitations, and clinical challenges are also described. EXPERT COMMENTARY Currently, implantable wireless sensors are mostly limited for scientific investigations and demonstrative experiments. Although rapid advancement in sensors and wireless technologies will push the reliability and practicality of these sensors for clinical realization, regulatory constraints and financial viability in medical device industry may curtail their continuous adoption for clinical orthopedic applications. In the next five years, these sensors are expected to gain increased interest from researchers, but wide clinical adoption is still unlikely.
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Affiliation(s)
| | - Bradley D Nelson
- a Biomedical Engineering , Michigan Technological University , Houghton , MI , USA
| | - Robert E Guldberg
- b George W. Woodruff School of Mechanical Engineering , Georgia Institute of Technology , Atlanta , GA , USA
| | - Keat Ghee Ong
- a Biomedical Engineering , Michigan Technological University , Houghton , MI , USA
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Perozziello A, Gauss T, Diop A, Frank-Soltysiak M, Rufat P, Raux M, Hamada S, Riou B. La codification PMSI identifie mal les traumatismes graves. Rev Epidemiol Sante Publique 2018; 66:43-52. [DOI: 10.1016/j.respe.2017.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 10/04/2017] [Accepted: 10/17/2017] [Indexed: 11/25/2022] Open
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