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Quinaz T, Freire TF, Olmos A, Martins M, Ferreira FBN, de Moura MFSM, Zille A, Nguyễn Q, Xavier J, Dourado N. The Influence of Hydroxyapatite Crystals on the Viscoelastic Behavior of Poly(vinyl alcohol) Braid Systems. Biomimetics (Basel) 2024; 9:93. [PMID: 38392139 PMCID: PMC10886535 DOI: 10.3390/biomimetics9020093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Composites of poly(vinyl alcohol) (PVA) in the shape of braids, in combination with crystals of hydroxyapatite (HAp), were analyzed to perceive the influence of this bioceramic on both the quasi-static and viscoelastic behavior under tensile loading. Analyses involving energy-dispersive X-ray spectroscopy (EDS) and scanning electron microscopy (SEM) allowed us to conclude that the production of a homogeneous layer of HAp on the braiding surface and the calcium/phosphate atomic ratio were comparable to those of natural bone. The maximum degradation temperature established by thermogravimetric analysis (TGA) showed a modest decrease with the addition of HAp. By adding HAp to PVA braids, an increase in the glass transition temperature (Tg) is noticed, as demonstrated by dynamic mechanical analysis (DMA) and differential thermal analysis (DTA). The PVA/HAp composite braids' peaks were validated by Fourier transform infrared (FTIR) spectroscopy to be in good agreement with common PVA and HAp patterns. PVA/HAp braids, a solution often used in the textile industry, showed superior overall mechanical characteristics in monotonic tensile tests. Creep and relaxation testing showed that adding HAp to the eight and six-braided yarn architectures was beneficial. By exhibiting good mechanical performance and most likely increased biological qualities that accompany conventional care for bone applications in the fracture healing field, particularly multifragmentary ones, these arrangements can be applied as a fibrous fixation system.
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Affiliation(s)
- Tiago Quinaz
- CMEMS-UMinho, Departamento de Engenharia Mecânica, Campus de Azurém, Universidade do Minho, 4804-533 Guimarães, Portugal
| | - Tânia F Freire
- CMEMS-UMinho, Departamento de Engenharia Mecânica, Campus de Azurém, Universidade do Minho, 4804-533 Guimarães, Portugal
| | - Andrea Olmos
- CMEMS-UMinho, Departamento de Engenharia Mecânica, Campus de Azurém, Universidade do Minho, 4804-533 Guimarães, Portugal
| | - Marcos Martins
- INESC TEC, R. Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Fernando B N Ferreira
- 2C2T-Centro de Ciência e Tecnologia Têxtil, Departamento de Engenharia Têxtil, Campus de Azurém, Universidade do Minho, 4804-533 Guimarães, Portugal
| | - Marcelo F S M de Moura
- Departamento de Engenharia Mecânica, Faculdade de Engenharia da Universidade do Porto, 4200-464 Porto, Portugal
| | - Andrea Zille
- 2C2T-Centro de Ciência e Tecnologia Têxtil, Departamento de Engenharia Têxtil, Campus de Azurém, Universidade do Minho, 4804-533 Guimarães, Portugal
| | - Quyền Nguyễn
- 2C2T-Centro de Ciência e Tecnologia Têxtil, Departamento de Engenharia Têxtil, Campus de Azurém, Universidade do Minho, 4804-533 Guimarães, Portugal
| | - José Xavier
- UNIDEMI, Department of Mechanical and Industrial Engineering, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal
- LASI, Intelligent Systems Associate Laboratory, 4800-058 Guimarães, Portugal
| | - Nuno Dourado
- CMEMS-UMinho, Departamento de Engenharia Mecânica, Campus de Azurém, Universidade do Minho, 4804-533 Guimarães, Portugal
- LABBELS-Laboratório Associado, 4710-057 Braga, Portugal
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Cheng L, Wang G, Lu H, Li S, Xiong W, Wang J. Effect of Bushen Tiansui Decoction on Delayed Fracture Healing: A Systematic Review and Meta-analysis. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2023; 23:471-488. [PMID: 38037365 PMCID: PMC10696372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 12/02/2023]
Abstract
This review aimed to validate the therapeutic potential of Bushen Tiansui decoction (BSTSD), a traditional Chinese formulation, in treating delayed union of fractures. Comprehensive database searches identified randomized controlled trials up to September 13, 2022, assessing BSTSD's efficacy in delayed fracture healing. Outcomes were bone metabolism indexes and Harris hip scores. Quality and risk assessments were conducted using the Cochrane Collaboration's tools. Data were analyzed using RevMan software, with sensitivity analysis through Stata. BSTSD significantly improved bone GLA protein (SMD=1.76, P<0.00001) and alkaline phosphatase (SMD=1.31, P<0.00001). Additionally, Harris hip scores for pain, function, deformity, and motion showed marked improvement. BSTSD treatment also demonstrated enhanced clinical efficiency (RR=1.27, P<0.00001) with fewer complications. Sensitivity analyses indicated consistent results. BSTSD shows promise in treating delayed fracture unions, yet conclusions necessitate further high-quality research for validation.
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Affiliation(s)
- Ling Cheng
- Rehabilitation Medicine Department, Nanchang Hongdu Hospital of Traditional Chinese Medicine, China
| | - Gao Wang
- Orthopedics, Nanchang Hongdu Hospital of Traditional Chinese Medicine, China
| | - Hualong Lu
- Rehabilitation Medicine Department, Nanchang Hongdu Hospital of Traditional Chinese Medicine, China
| | - Song Li
- Rehabilitation Medicine Department, Nanchang Hongdu Hospital of Traditional Chinese Medicine, China
| | - Wei Xiong
- Rehabilitation Medicine Department, Nanchang Hongdu Hospital of Traditional Chinese Medicine, China
| | - Jun Wang
- General Surgery Department of Trauma Center, The First Hospital of Nanchang, China
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Chung HJ, Lee HB, Park KM, Jung TG, Kim SB, Lee BG, Kim WC, Lee JK. Feasibility of 3D-Printed Locking Compression Plates with Polyether Ether Ketone (PEEK) in Tibial Comminuted Diaphyseal Fractures. Polymers (Basel) 2023; 15:3057. [PMID: 37514445 PMCID: PMC10384545 DOI: 10.3390/polym15143057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
The applicability of a polyether ether ketone locking compression plate (PEEK LCP) fabricated using FDM (fused deposition modeling)-based 3D printing to treat actual patients was studied. Three different tests-bending, axial compression, and axial torsion-were conducted on tibial non-osteoporotic comminuted diaphyseal fracture samples fixed with the commercial titanium alloy LCP and 3D-printed PEEK LCP. Comparing the outcomes of these tests revealed that the commercial titanium alloy LCP underwent plastic deformation in the bending and axial torsion tests, though the LCP did not fail even when an external force greater than the maximum allowable load of the tibia fixture of the LCP was applied. Elastic deformation occurred in the 3D-printed PEEK LCP in the bending and axial torsion tests. However, deformation occurred even under a small external force, and its stiffness was 10% compared to commercial titanium alloy LCP. Thus, 3D-printed PEEK LCP can be applied to the fracture conditions in non-weight-bearing regions. The experimental results reveal detailed insights into the treatment of actual patients by considering the stiffness and high toughness of 3D-printed PEEK LCP.
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Affiliation(s)
- Hyung-Jin Chung
- Department of Orthopaedic Surgery, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, 20, Bodeum 7-ro, Sejong-si 30099, Republic of Korea
| | - Ho-Beom Lee
- School of Mechanical Engineering, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea
| | - Kwang-Min Park
- Medical Device Development Center, Osong Medical Innovation Foundation 123, Osongsaengmyeong-ro, Osong-eup, Heungdeok-gu, Cheonju-si 28160, Chungbuk, Republic of Korea
| | - Tae-Gon Jung
- Medical Device Development Center, Osong Medical Innovation Foundation 123, Osongsaengmyeong-ro, Osong-eup, Heungdeok-gu, Cheonju-si 28160, Chungbuk, Republic of Korea
| | - Sang-Bum Kim
- Department of Orthopaedic Surgery, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, 20, Bodeum 7-ro, Sejong-si 30099, Republic of Korea
| | - Byoung-Gu Lee
- Department of Orthopaedic Surgery, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, 20, Bodeum 7-ro, Sejong-si 30099, Republic of Korea
| | - Wan-Chin Kim
- Department of Mechanics-Material Convergence System Engineering, Hanbat National University, 125, Dongseo-daero, Yuseong-gu, Daejeon 34158, Republic of Korea
| | - Jeong-Kil Lee
- Department of Orthopaedic Surgery, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, 20, Bodeum 7-ro, Sejong-si 30099, Republic of Korea
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Giannoudis VP, Rodham P, Antypas A, Mofori N, Chloros G, Giannoudis PV. Patient perspective on the use of carbon fibre plates for extremity fracture fixation. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023:10.1007/s00590-023-03473-6. [PMID: 36656438 PMCID: PMC10368544 DOI: 10.1007/s00590-023-03473-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Carbon fibre-reinforced polyetheretherketone (CFR-PEEK) plates represent an exciting development within trauma and orthopaedic surgery, offering advantages including radiolucency, material properties similar to bone, and lack of localised tissue reaction. As more call for trials examining their use, there is no data available as to the acceptability of these implants to patients. This study aimed to therefore examine the acceptability of CFR-PEEK plates to patients undergoing fracture surgery. METHODS This was a prospective cross-sectional survey of patients undergoing surgery for a fracture of the ankle, distal femur, distal radius, or proximal humerus. Once a decision had been made to pursue operative fixation with a plate, patients were provided with descriptions of both CFR-PEEK and stainless steel and titanium metal implants alongside the current clinical evidence. All patients undertook a questionnaire examining their views as to the advantages and disadvantages of CFR-PEEK plates, and whether they would be happy to participate in a trial comparing both. RESULTS Ninety-nine patients were happy to participate (64 females, mean age 50). Eighty-seven patients reported that they would want a CFR-PEEK implant for their fracture, and 76 reported that they would be willing to participate in an RCT comparing their use. Commonly reported advantages included radiolucency, low weight and biocompatibility. Disadvantages reported included cost and concerns regarding durability. CONCLUSIONS This study demonstrates that CFR-PEEK implants would be acceptable to patients undergoing fracture surgery, with high numbers of patients stating that they would be willing to participate in a randomised study examining their use.
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Affiliation(s)
- Vasileios P Giannoudis
- LIMM Section Musculoskeletal Disease, Academic Department of Trauma and Orthopaedics, School of Medicine, Leeds General Infirmary, University of Leeds, Clarendon Wing, Level A, Clarendon Way, Leeds, LS1 3EX, UK
| | - Paul Rodham
- LIMM Section Musculoskeletal Disease, Academic Department of Trauma and Orthopaedics, School of Medicine, Leeds General Infirmary, University of Leeds, Clarendon Wing, Level A, Clarendon Way, Leeds, LS1 3EX, UK
| | - Antony Antypas
- Leeds General Infirmary, Health Education Yorkshire and Humber, Leeds, UK
| | | | | | - Peter V Giannoudis
- LIMM Section Musculoskeletal Disease, Academic Department of Trauma and Orthopaedics, School of Medicine, Leeds General Infirmary, University of Leeds, Clarendon Wing, Level A, Clarendon Way, Leeds, LS1 3EX, UK.
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Rajani AM, Rajani K, Mittal AR, Shah UA, Rajani KA, Rajani KA. Allograft Impaction and Supplementary Plating for the Management of Epi-Metaphyseal Enchondroma: A Rare Case Report. J Orthop Case Rep 2022; 12:6-9. [PMID: 36873325 PMCID: PMC9983407 DOI: 10.13107/jocr.2022.v12.i09.2992] [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: 06/02/2022] [Revised: 07/05/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Enchondroma is a common bone tumor; however, its location in the proximal epi-metaphyseal region of the tibia is a rare finding. Its management is complicated by the weight-bearing nature of the site and despite an array of available treatment modalities in the literature, there is no fixed consensus. Case Report Through this case, we report a 60-year-old female who was evaluated for bilateral knee osteoarthritis. On plain radiography, a lytic lesion was noted which on CT guided biopsy was confirmed to be an enchondroma of the right proximal tibia. The patient underwent extensive curettage, allograft impaction, and supplementary fixation by a poly ethyl ether ketone plate. Following a period of immobilization, she was able to walk full weight-bearing after 3 weeks of the surgery and carry out her daily activities at 2 months. At 1 year postoperatively, the patient achieved excellent clinical, radiological, and functional outcomes without any complications. Conclusion Management of an enchondroma in weight-bearing regions of long bones can pose multiple challenges. Timely diagnosis and management by thorough curettage, uncompromised allograft impaction, and supplementary fixation by a PEEK plate give excellent short-term and long-term results.
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Affiliation(s)
- Amyn M Rajani
- Department of Orthopaedic, OAKS Clinic, Mumbai, Maharashtra, India
| | - Kareena Rajani
- Department of Clinical Research, OAKS clinic, Mumbai, Maharashtra, India
| | - Anmol Rs Mittal
- Department of Orthopaedics, OAKS Clinic, Mumbai, Maharashtra, India
| | - Urvil A Shah
- Department of Orthopaedics, OAKS Clinic, Mumbai, Maharashtra, India
| | - Khushi A Rajani
- Department of Clinical Research, OAKS clinic, Mumbai, Maharashtra, India
| | - Kashish A Rajani
- Department of Clinical Research, OAKS clinic, Mumbai, Maharashtra, India
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Chen J, Cao G, Li L, Cai Q, Dunne N, Li X. Modification of polyether ether ketone for the repairing of bone defects. Biomed Mater 2022; 17. [PMID: 35395651 DOI: 10.1088/1748-605x/ac65cd] [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: 12/21/2021] [Accepted: 04/08/2022] [Indexed: 11/12/2022]
Abstract
Bone damage as a consequence of disease or trauma is a common global occurrence. For bone damage treatment - bone implant materials are necessary across three classifications of surgical intervention (i.e. fixation, repair, and replacement). Many types of bone implant materials have been developed to meet the requirements of bone repair. Among them, polyether ether ketone (PEEK) has been considered as one of the next generation of bone implant materials, owing to its advantages related to good biocompatibility, chemical stability, X-ray permeability, elastic modulus comparable to natural bone, as well as the ease of processing and modification. However, as PEEK is a naturally bioinert material, some modification is needed to improve its integration with adjacent bones after implantation. Therefore, it has become a very hot topic of biomaterials research and various strategies for the modification of PEEK including blending, 3D printing, coating, chemical modification and the introduction of bioactive and/or antibacterial substances have been proposed. In this systematic review, the recent advances in modification of PEEK and its application prospect as bone implants are summarized, and the remaining challenges are also discussed.
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Affiliation(s)
- Junfeng Chen
- Beihang University, 37 Xueyuan Rd, Haidian District, Beijing, Beijing, 100083, CHINA
| | - Guangxiu Cao
- Beihang University, 37 Xueyuan Rd, Haidian District, Beijing, Beijing, 100083, CHINA
| | - Linhao Li
- Beihang University, 37 Xueyuan Rd, Haidian District, Beijing, 100083, CHINA
| | - Qiang Cai
- Tsinghua University Department of Materials Science and Engineering, 30 shuangqing Rd, Haidian District, Beijing, Beijing, 100084, CHINA
| | - Nicholas Dunne
- School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin 9, Dublin, D09, IRELAND
| | - Xiaoming Li
- Biological Science and Medical Engineering, Beihang University, 37 Xueyuan Rd, Haidian District, Beijing, Beijing, 100083, CHINA
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Nanostructural interface and strength of polymer composite scaffolds applied to intervertebral bone. Colloids Surf A Physicochem Eng Asp 2021. [DOI: 10.1016/j.colsurfa.2021.127190] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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