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Valencia-Llano CH, Solano MA, Grande-Tovar CD. Nanocomposites of Chitosan/Graphene Oxide/Titanium Dioxide Nanoparticles/Blackberry Waste Extract as Potential Bone Substitutes. Polymers (Basel) 2021; 13:polym13223877. [PMID: 34833175 PMCID: PMC8618967 DOI: 10.3390/polym13223877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 12/28/2022] Open
Abstract
New technologies based on nanocomposites of biopolymers and nanoparticles inspired by the nature of bone structure have accelerated their application in regenerative medicine, thanks to the introduction of reinforcing properties. Our research incorporated chitosan (CS) covalently crosslinked with glutaraldehyde (GLA) beads with graphene oxide (GO) nanosheets, titanium dioxide nanoparticles (TiO2), and blackberry processing waste extract (BBE) and evaluated them as partial bone substitutes. Skullbone defects in biomodels filled with the scaffolds showed evidence through light microscopy, scanning electron microscopy, histological studies, soft tissue development with hair recovery, and absence of necrotic areas or aggressive infectious response of the immune system after 90 days of implantation. More interestingly, newly formed bone was evidenced by elemental analysis and Masson trichromacy analysis, which demonstrated a possible osteoinductive effect from the beads using the critical size defect experimental design in the biomodels. The results of this research are auspicious for the development of bone substitutes and evidence that the technologies for tissue regeneration, including chitosan nanocomposites, are beneficial for the adhesion and proliferation of bone cells.
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Affiliation(s)
| | - Moisés A. Solano
- Grupo de Investigación de Fotoquímica y Fotobiología, Facultad de Ciencias, Programa de Química, Universidad del Atlántico, Carrera 30 Número 8-49, Puerto Colombia 081008, Colombia;
| | - Carlos David Grande-Tovar
- Grupo de Investigación de Fotoquímica y Fotobiología, Facultad de Ciencias, Programa de Química, Universidad del Atlántico, Carrera 30 Número 8-49, Puerto Colombia 081008, Colombia;
- Correspondence: ; Tel.: +57-5-3599-484
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Daniels AH, Reid DBC, Durand WM, Line B, Passias P, Kim HJ, Protopsaltis T, LaFage V, Smith JS, Shaffrey C, Gupta M, Klineberg E, Schwab F, Burton D, Bess S, Ames C, Hart RA. Assessment of Patient Outcomes and Proximal Junctional Failure Rate of Patients with Adult Spinal Deformity Undergoing Caudal Extension of Previous Spinal Fusion. World Neurosurg 2020; 139:e449-e454. [PMID: 32305603 DOI: 10.1016/j.wneu.2020.04.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/03/2020] [Accepted: 04/04/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This case series examined patients undergoing caudal extension of prior fusion without alteration of the prior upper instrumented vertebra (UIV) to assess patient outcomes and rates of proximal junctional kyphosis (PJK)/proximal junctional failure (PJF). METHODS Patients eligible for 2-year minimum follow-up undergoing caudal extension of prior fusion with unchanged UIVs were identified. These patients were evaluated for PJK/PJF, and patient reported outcomes were recorded. RESULTS In total, 40 patients were included. Mean follow-up duration was 2.2 ± 0.3 years. Patients in this cohort had poor preoperative sagittal alignment (pelvic incidence minus lumbar lordosis [PI-LL] 26.7°, T1 pelvic angle [TPA] 29.0°, sagittal vertical axis [SVA] 93.4 mm) and achieved substantial sagittal correction (ΔSVA -62.2 mm, ΔPI-LL -19.8°, ΔTPA -11.1°) after caudal extension surgery. At final follow-up, there was a 0% rate of PJF among patients undergoing caudal extension of previous fusion without creation of a new UIV, but 27.5% of patients experienced PJK. Patients experienced significant improvement in both the Oswestry Disability Index and Scoliosis Research Society-22r total score at 2 years postoperatively (P < 0.05). In total, 7.5% (n = 3) of patients underwent further revision, at an average of 1.1 ± 0.54 years after the surgery with unaltered UIV. All 3 of these patients underwent revision for rod fracture with no revisions for PJK/PJF. CONCLUSIONS Patients undergoing caudal extension of previous fusions for sagittal alignment correction have high rates of clinical success, low revision surgery rates, and very low rates of PJF. Minimizing repetitive tissue trauma at the UIV may result in decreased PJF risk because the PJF rate in this cohort of patients with unaltered UIV is below historical PJF rates of patients undergoing sagittal balance correction.
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Affiliation(s)
- Alan H Daniels
- Department of Orthopedics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
| | - Daniel B C Reid
- Department of Orthopedics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Wesley M Durand
- Department of Orthopedics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Breton Line
- Department of Orthopedics, Denver International Spine Center, Presbyterian/St. Luke's, Rocky Mountain Hospital for Children, Denver, Colorado, USA
| | - Peter Passias
- Department of Orthopaedics, NYU Langone Medical Center, New York, New York, USA
| | - Han Jo Kim
- Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA
| | | | - Virginie LaFage
- Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA
| | - Justin S Smith
- Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA
| | | | - Munish Gupta
- Department of Orthopedics, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Eric Klineberg
- Department of Orthopedics, University of California, Davis, California, USA
| | - Frank Schwab
- Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA
| | - Doug Burton
- Department of Orthopedics, University of Kansas Hospital, Kansas City, Kansas, USA
| | - Shay Bess
- Department of Orthopedics, Denver International Spine Center, Presbyterian/St. Luke's, Rocky Mountain Hospital for Children, Denver, Colorado, USA
| | - Christopher Ames
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA
| | - Robert A Hart
- Department of Orthopedics, Swedish Medical Center, Seattle, Washington, USA
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Zhao CG, Qin J, Wang X, Xu G, Jia Y, Guan YC, Mou X, Yuan H. Clinical outcomes of treatment with cage-shaped demineralized bone plus local bone grafts vs. autogenous iliac crest bone grafts in instrumented single-level lumbar fusion: A retrospective cohort study. Exp Ther Med 2019; 19:393-399. [PMID: 31853316 DOI: 10.3892/etm.2019.8171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/03/2019] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to compare the clinical outcomes of cage-shaped demineralized bone plus local bone grafts (CDBLG) with those of autogenous iliac crest bone grafts (ICBG) implanted for the treatment of single-level lumbar intervertebral disc degenerative diseases. A total of 69 cases of degenerative spinal disorder treated between January 2011 and December 2013 were retrospectively analyzed. Of these, 44 were treated with CDBLG and 25 with autogenous ICBG. All fusions were instrumented single level. Fusion was assessed after 6, 12 and 24 months by X-ray and CT scans post-operatively. Clinical outcomes were determined during follow-up and assessments included the Oswestry Disability Index, Visual Analogue Scale for back and leg pain and the Short Form-36 general health survey physical component summary. The results indicated that the overall fusion rate at 24 months post-operatively was higher in the ICBG group compared with that in the CDBLG group, although not significantly (P>0.05). All other outcome measures were significantly improved in the two groups after the surgery (P<0.05), but no significant differences were observed between the two groups (P>0.05). Blood loss and mean duration of surgery in the CDBLG group were significantly lower compared with those in the ICBG group (P<0.05). In conclusion, CDBLG achieved a similar fusion rate and clinical outcome as ICBG but was associated with significantly reduced blood loss and mean duration of surgery. In conclusion, the present study provided CDBLG bone graft as an alternative option for single-level fusion.
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Affiliation(s)
- Chen-Guang Zhao
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Jie Qin
- Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Xin Wang
- Rehabilitation Center, Lintong Sanatorium of The PLA, Xi'an, Shaanxi 710060, P.R. China
| | - Gang Xu
- Orthopedic Center, General Hospital of Xinjiang Military Region, Urumqi, Xinjiang 830000, P.R. China
| | - Yong Jia
- Orthopedic Center, General Hospital of Xinjiang Military Region, Urumqi, Xinjiang 830000, P.R. China
| | - Yu-Cheng Guan
- Orthopedic Center, General Hospital of Xinjiang Military Region, Urumqi, Xinjiang 830000, P.R. China
| | - Xiang Mou
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Hua Yuan
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
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Samsonraj RM, Dudakovic A, Zan P, Pichurin O, Cool SM, van Wijnen AJ. A Versatile Protocol for Studying Calvarial Bone Defect Healing in a Mouse Model. Tissue Eng Part C Methods 2017; 23:686-693. [PMID: 28537529 DOI: 10.1089/ten.tec.2017.0205] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Animal models are vital tools for the preclinical development and testing of therapies aimed at providing solutions for several musculoskeletal disorders. For bone tissue engineering strategies addressing nonunion conditions, rodent models are particularly useful for studying bone healing in a controlled environment. The mouse calvarial defect model permits evaluation of drug, growth factor, or cell transplantation efficacy, together with offering the benefit of utilizing genetic models to study intramembranous bone formation within defect sites. In this study, we describe a detailed methodology for creating calvarial defects in mouse and present our results on bone morphogenetic protein-2-loaded fibrin scaffolds, thus advocating the utility of this functional orthotopic mouse model for the evaluation of therapeutic interventions (such as growth factors or cells) intended for successful bone regeneration therapies.
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Affiliation(s)
| | - Amel Dudakovic
- 1 Department of Orthopedic Surgery, Mayo Clinic , Rochester, Minnesota
| | - Pengfei Zan
- 1 Department of Orthopedic Surgery, Mayo Clinic , Rochester, Minnesota
| | - Oksana Pichurin
- 1 Department of Orthopedic Surgery, Mayo Clinic , Rochester, Minnesota
| | - Simon M Cool
- 2 Glycotherapeutics Group, Institute of Medical Biology , Agency for Science, Technology and Research (A*STAR), Singapore .,3 Department of Orthopaedic Surgery, National University of Singapore , Singapore
| | - Andre J van Wijnen
- 1 Department of Orthopedic Surgery, Mayo Clinic , Rochester, Minnesota.,4 Department of Biochemistry and Molecular Biology, Mayo Clinic , Rochester, Minnesota.,5 Department of Physiology and Biomedical Engineering, Mayo Clinic , Rochester, Minnesota
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