1
|
Wang X, Liu H, Wang B, Wu T, He J, Yan L, Ding C. Early Outcomes of Bone Autografting in the Bilateral Atlantoaxial Joints Applied in Posterior Fusion Surgery. Orthop Surg 2024; 16:559-567. [PMID: 38214016 PMCID: PMC10925506 DOI: 10.1111/os.13997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE Cable-dragged reduction and cantilever beam internal fixation can provide promising results in the treatment of atlantoaxial dislocation or instability. However, bilateral atlantoaxial joints bone autografting has not been conducted in this technique. We aim to evaluate the safety and effectiveness of bilateral atlantoaxial joints bone autografting in posterior cable-dragged reduction and cantilever-beam internal fixation. METHODS In this retrospective study, we included 14 patients with a minimum 24-month follow-up from December 2019 to September 2020. The granular bone harvested from the iliac crest was packed into the bilateral atlantoaxial joints of 14 patients in posterior cable-dragged reduction and cantilever-beam internal fixation. X-ray imaging and cervical computed tomography (CT) were performed during follow-up. The time required for bone fusion was recorded. The clinical outcomes were evaluated using the JOA scores, NDI, and VAS scores. Mann-Whitney U test, the chi-squared test, or the Fisher exact test were used to compare the two groups regarding patient characteristics, clinical outcomes, bone fusion rates, and cervical sagittal alignment. RESULTS The operations were successfully performed in all patients without any intraoperative complications. The mean operation time was (169.64 ± 20.91) minutes, and the intraoperative blood loss was (130.71 ± 33.62) mL. All patients received satisfactory reductions and firm bony fusion at the final follow-up. The fusion rates were 64.29% in the atlantoaxial joints and 21.43% in post bone graft area at 3 months postoperatively, and a significant difference was observed (p = 0.022). Besides, the cervical sagittal alignment in all patients was well maintained in the last follow-up compared to preoperatively. Importantly, a complete bony fusion in the atlantoaxial joints was observed in all patients. Moreover, the JOA, NDI, and VAS scores had improved significantly at the last follow-up. CONCLUSION Bone autografting of the bilateral atlantoaxial joints is a safe and effective technique to increase bone fusion rates, shorten bone fusion time, and reduce complication rates when the cable-dragged reduction and cantilever beam internal fixation approach is used. Therefore, it is a cost-effective surgical procedure for treating patients with atlantoaxial dislocation or instability.
Collapse
Affiliation(s)
- Xing‐jin Wang
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Hao Liu
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Bei‐yu Wang
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Ting‐kui Wu
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Jun‐bo He
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Lu Yan
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Chen Ding
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| |
Collapse
|
2
|
Bohner M, Maazouz Y, Ginebra MP, Habibovic P, Schoenecker JG, Seeherman H, van den Beucken JJ, Witte F. Sustained local ionic homeostatic imbalance caused by calcification modulates inflammation to trigger heterotopic ossification. Acta Biomater 2022; 145:1-24. [PMID: 35398267 DOI: 10.1016/j.actbio.2022.03.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 12/15/2022]
Abstract
Heterotopic ossification (HO) is a condition triggered by an injury leading to the formation of mature lamellar bone in extraskeletal soft tissues. Despite being a frequent complication of orthopedic and trauma surgery, brain and spinal injury, the etiology of HO is poorly understood. The aim of this study is to evaluate the hypothesis that a sustained local ionic homeostatic imbalance (SLIHI) created by mineral formation during tissue calcification modulates inflammation to trigger HO. This evaluation also considers the role SLIHI could play for the design of cell-free, drug-free osteoinductive bone graft substitutes. The evaluation contains five main sections. The first section defines relevant concepts in the context of HO and provides a summary of proposed causes of HO. The second section starts with a detailed analysis of the occurrence and involvement of calcification in HO. It is followed by an explanation of the causes of calcification and its consequences. This allows to speculate on the potential chemical modulators of inflammation and triggers of HO. The end of this second section is devoted to in vitro mineralization tests used to predict the ectopic potential of materials. The third section reviews the biological cascade of events occurring during pathological and material-induced HO, and attempts to propose a quantitative timeline of HO formation. The fourth section looks at potential ways to control HO formation, either acting on SLIHI or on inflammation. Chemical, physical, and drug-based approaches are considered. Finally, the evaluation finishes with a critical assessment of the definition of osteoinduction. STATEMENT OF SIGNIFICANCE: The ability to regenerate bone in a spatially controlled and reproducible manner is an essential prerequisite for the treatment of large bone defects. As such, understanding the mechanism leading to heterotopic ossification (HO), a condition triggered by an injury leading to the formation of mature lamellar bone in extraskeletal soft tissues, would be very useful. Unfortunately, the mechanism(s) behind HO is(are) poorly understood. The present study reviews the literature on HO and based on it, proposes that HO can be caused by a combination of inflammation and calcification. This mechanism helps to better understand current strategies to prevent and treat HO. It also shows new opportunities to improve the treatment of bone defects in orthopedic and dental procedures.
Collapse
|
3
|
Abstract
Background The goal of cranioplasty is to achieve a lifelong, stable and structural reconstruction of the cranium covered by a healthy skin and scalp flap. We present two cases of large frontal bone defect following a accident. Cases We describe the utilization of autogenous local split calvarial graft and titanium mesh for the reconstruction of the post trauma frontal bone defect. Conclusion Cranioplasty using split calvarial bone grafting for restoring large cranial defects resulting from a trauma is a useful technique, and allows the surgeon to reconstruct a moderate to large cranial defect without rifting the inner cortical plate.
Collapse
Affiliation(s)
- Shimels Megersa Gema
- Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran.,Department of Oral and Maxillofacial Surgery, college of public health and medical sciences, Jimma University
| | - Mehrnoush Momeni
- Oral and Maxillofacial Surgery at Sina Hospital, Tehran University of Medical Sciences, (TUMS), Tehran, Iran
| | - Amir Ali Badri
- Oral and Maxillofacial Surgery at Sina Hospital, Tehran University of Medical Sciences, (TUMS), Tehran, Iran
| |
Collapse
|
4
|
Brauner E, De Angelis F, Jamshir S, Mezi S, Tiroli RC, Pompa G, Quarato A, Di Carlo S. Aesthetic satisfaction in lip and palate clefts: a comparative study between secondary and tertiary bone grafting. Clin Ter 2018; 169:e62-e66. [PMID: 29595867 DOI: 10.7417/t.2018.2055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Lip and palate cleft represent one of the most frequently occurring congenital deformity, which includes dental anomalies, such as variation in tooth number and position. In case of hypodontia implant-prosthetic rehabilitation offers significant advantages in terms of function, aesthetics and quality of life and bone graft is usually needed. Secondary bone grafting, generally performed in the mixed dentition phase (years 8-11) seems to be the most successful method to allow for rehabilitation. It's often necessary to perform a tertiary bone grafting in adult age in order to achieve better bone quantity and quality before implant placement. Aim of this retrospective study was to evaluate the aesthetic perception that patients had of themselves comparing dental implants placed in tertiary grafted alveolar cleft sites with a previous secondary grafting to only secondary grafting. Between 2009 and 2012, fourteen alveolar cleft were treated with implant rehabilitation and eleven of them received tertiary bone grafting six months prior to implant placement. All patients were questioned to give a score from 1 to 10 their aesthetic satisfaction of their smile before and after implant rehabilitation and during pre-surgery provisional rehabilitation. At the end of their prosthesis rehabilitation patients who received tertiary bone grafting resulted more satisfied than those who had secondary bone grafting only (9.5 vs 8).
Collapse
Affiliation(s)
- E Brauner
- Department of Oral And Maxillo-Facial Sciences, Sapienza University of Rome
| | - F De Angelis
- Department of Oral And Maxillo-Facial Sciences, Sapienza University of Rome
| | - S Jamshir
- Department of Oral And Maxillo-Facial Sciences, Sapienza University of Rome
| | - S Mezi
- Dipartimento di Scienze radiologiche oncologiche ed anatomopatologiche, Rome
| | | | - G Pompa
- Department of Oral And Maxillo-Facial Sciences, Sapienza University of Rome
| | | | - S Di Carlo
- Department of Oral And Maxillo-Facial Sciences, Sapienza University of Rome
| |
Collapse
|
5
|
Garbin Junior EA, de Lima VN, Momesso GAC, Mello-Neto JM, Érnica NM, Magro Filho O. Potential of autogenous or fresh-frozen allogeneic bone block grafts for bone remodelling: a histological, histometrical, and immunohistochemical analysis in rabbits. Br J Oral Maxillofac Surg 2017; 55:589-593. [PMID: 28404212 DOI: 10.1016/j.bjoms.2017.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 03/12/2017] [Indexed: 12/22/2022]
Abstract
Our aim was to compare the wound healing of autogenous bone grafts with that of fresh-frozen allogeneic block bone in rabbits. We used 25 animals. One was killed before the experiment to provide the allogeneic bone, and the remainder were killed at four time points (n=6 in each group). On histometrical analysis there was a significant difference between the two groups only at 45days and between 15 and 45days in the intergroup analysis. However, there was significantly more revascularisation (p<0.05), resorption (p<0.05), and bony replacement (p<0.05) in the autogenous group in the immunohistochemical analysis. In later periods, the autogenous bone was replaced by newly-formed bone in all samples, whereas it was always possible to find regions of devitalised bone in the fresh-frozen allogeneic bone grafts. Autogenous grafts were completely replaced whereas, in the fresh- frozen allogeneic grafts, we found acellular tissue that had been incorporated into the receptor bed interface during the later evaluation times.
Collapse
Affiliation(s)
- E A Garbin Junior
- UNESP-Univ Estadual Paulista, Araçatuba Dental School, Surgery and Integrated Clinic Department, Araçatuba, SP, Brazil
| | - V N de Lima
- UNESP-Univ Estadual Paulista, Araçatuba Dental School, Surgery and Integrated Clinic Department, Araçatuba, SP, Brazil.
| | - G A C Momesso
- UNESP-Univ Estadual Paulista, Araçatuba Dental School, Surgery and Integrated Clinic Department, Araçatuba, SP, Brazil
| | - J M Mello-Neto
- UNESP-Univ Estadual Paulista, Araçatuba Dental School, Surgery and Integrated Clinic Department, Araçatuba, SP, Brazil
| | - N M Érnica
- School of Dentistry, West Parana State University-UNIOESTE, Cascavel, PR, Brazil
| | - O Magro Filho
- UNESP-Univ Estadual Paulista, Araçatuba Dental School, Surgery and Integrated Clinic Department, Araçatuba, SP, Brazil
| |
Collapse
|
6
|
Abstract
Introduction: Uni-compartmental knee arthritis may be treated with several surgical options including uni-compartmental knee arthroplasty, total knee arthroplasty and high tibial osteotomy. Non-union is a well-established and common complication that may arise from the latter option and few reports have shown successful treatment of persistent non-union of high tibial osteotomy. Case Presentation: We present a case of persistent non-union after high tibial osteotomy treated with autologous iliac crest bone grafting and revision plating. At 1 year post-operative interval, successful union was achieved after revision internal fixation. In addition, a good functional outcome was achieved. Conclusion: In this patient with persistent non-union following high tibial osteotomy, the aim of revision was to restore alignment and effect bone healing while preserving adequate tibial bone stock. Revision plating with autologous bone grafting is a good surgical strategy in the treatment ofpersistent non-union with hardware failure.
Collapse
Affiliation(s)
- Tan Shi Ming
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
| | - Wong Merng Koon
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
| |
Collapse
|
7
|
Vahid Farahmandi M, Abbasian M, Safdari F, Emami Moghaddam Tehrani M. Midterm results of treating femoral head osteonecrosis with autogenous corticocancellous bone grafting. Trauma Mon 2014; 19:e17092. [PMID: 25717446 PMCID: PMC4310157 DOI: 10.5812/traumamon.17092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 07/14/2014] [Accepted: 08/28/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Appropriate treatment of osteonecrosis of femoral head (ONFH) remains challenging. OBJECTIVES Here, we report the results of treating these patients with auto-corticocancellous bone graft from iliac crest to overcome the need for early total hip arthroplasty (THA). PATIENTS AND METHODS There were 132 hips (96 patients) with ONFH. Association Research Circulation Osseous (ARCO) type II and III underwent auto-corticocancellous bone grafting from the iliac crest in the current prospective study. Before the operation and in the final postoperative visit, the pain intensity using visual analogue scale (VAS), range of hip motions and Harris hip score (HHS) were determined and compared. Patients were followed for 48.5 ± 17.9 months. RESULTS The shape of head and the joint space were preserved in 120 hips (90.9%). There were 12 hips in which the disease progressed to grade IV and resulted in THA in 10 of them. The pain intensity significantly decreased (6.3 ± 4.1 vs. 1.4 ± 2) and HHS (35.8 ± 15.3 vs. 79.5 ± 16.2) and range of motion (ROM) significantly improved after the operation (P < 0.001). CONCLUSIONS Necrotic bone removal and filling the femoral head cavity with auto-corticocancellous bone graft from iliac crest is an effective femoral head preserving method in treating patients with precollapse stages of ONFH and preventing the need for early THA, especially in young active populations.
Collapse
Affiliation(s)
- Manouchehr Vahid Farahmandi
- Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mohammadreza Abbasian
- Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Farshad Safdari
- Bone Joint and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Emami Moghaddam Tehrani
- Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Mohammad Emami Moghaddam Tehrani, Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Shahid Madani St, Tehran, IR Iran. Tel: +98-2173432338, E-mail:
| |
Collapse
|
8
|
Bertrand B, Philandrianos C, Apostolou N, Casanova D, Bardot J. [Technical note: iliac crest bone graft harvesting in children]. ANN CHIR PLAST ESTH 2014; 59:215-8. [PMID: 24512894 DOI: 10.1016/j.anplas.2013.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 12/27/2013] [Indexed: 11/19/2022]
Abstract
Harvesting iliac crest bone in children is special because of the presence of a thick cartilage. Constant pressure on the internal iliac fossa, ascends the skin, and moves the abdominal muscles away from the iliac crest. A single incision is then used for cutaneous and subcutaneous dissection. An internal piece of cartilage is then removed and the iliac muscle retracted in order to harvest cortical and spongy bone from the internal side of the iliac crest. That pièce of cartilage is then sutured at its initial place. During the harvesting, the surgeon needs to be careful to preserve the lateral femoral cutaneous nerve.
Collapse
Affiliation(s)
- B Bertrand
- Service de chirurgie plastique, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 05, France.
| | - C Philandrianos
- Service de chirurgie plastique, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 05, France
| | - N Apostolou
- Service de chirurgie infantile traumatologique et orthopédique du Pr. Mazda, hôpital Robert-Debré, 48, boulevard Serrurier, 75019 Paris, France
| | - D Casanova
- Service de chirurgie plastique, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 05, France
| | - J Bardot
- Service de chirurgie plastique, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 05, France
| |
Collapse
|
9
|
Shen JZ, Yao JF, Lin DS, Lian KJ, Ding ZQ, Lin B, Guo ZM, Zhang MH, Li Q, Li L, Qi P. Hollow-bone-graft dynamic hip screw can fix and promote bone union after femoral neck fracture: an experimental research. Int J Med Sci 2012; 9:916-22. [PMID: 23236261 PMCID: PMC3520017 DOI: 10.7150/ijms.4567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 08/05/2012] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise. OBJECTIVE To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS) and standard dynamic hip screws (DHS) in an animal model. DESIGN Testing of specifically designed fixation devices in a pig animal model. INTERVENTIONS/METHODS We designed Hb-DHS and DHS devices appropriate to the femoral neck and head of experimental animals and used them in eight pigs (4-month-old, male or female, 30-40 kg/each). Under anesthesia, we induced medium neck type, Garden III type femoral neck fractures in each pig with fracture gaps of 0.5 mm and then fixed each left femur with Hb-DHS and each right femur with DHS. We assessed the animals radiographically and by postmortem visual appraisal of evidence of bone healing 8 and 16 weeks postoperatively. RESULTS There were significant differences in radiographic and general findings between the Hb-DHS and DHS groups at weeks 8 and 16 postoperatively. We found statistically significant differences between the Hb-DHS and DHS groups in bone healing scores, trabecular bone volume percentage and bone mineral density as assessed on plain radiographs and computed tomography images (P < 0.05). There were also significant differences between the Hb-DHS and DHS groups in postmortem visually assessed indicators of bone healing at both 8 and 16 weeks postoperatively. CONCLUSIONS The Hb-DHS device promotes femoral neck bone union, stimulates trabecular bone formation, increases BMD and has advantages over DHS for internal fixation of femoral neck fractures. This animal experiment will contribute to developing optimal treatment for femoral neck fractures in young adults.
Collapse
Affiliation(s)
- Jia-Zuo Shen
- Department of Orthopaedic Surgery, Affiliated Dongnan Hospital of Xiamen University, Orthopaedic Trauma Center of the 175th Hospital of PLA, Zhangzhou, Fujian 363000, PR China
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|