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Tunkel J, Hoffmann F, Schmelcher Y, Kloss-Brandstätter A, Kämmerer PW. Allogeneic versus autogenous shell technique augmentation procedures: a prospective-observational clinical trial comparing surgical time and complication rates. Int J Implant Dent 2023; 9:52. [PMID: 38117445 PMCID: PMC10733239 DOI: 10.1186/s40729-023-00505-y] [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] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/04/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVES Autogenous and allogeneic blocks for shell augmentation of the jaw have shown comparable results. This observational clinical study aimed to compare both materials for shell augmentation concerning surgery time and intra- and postoperative complications. MATERIAL AND METHODS Bone augmentation with the shell technique using autogenous or allogenous bone was performed in 117 patients with segmental jaw atrophy. The primary study parameter was the surgical time, comparing both materials. Subsequently, intra- and postoperative complications were recorded. RESULTS Allogeneic (n = 60), autogenous (n = 52), or both materials (n = 5) were used. The use of allogeneic material led to a significantly shorter operation time (p < 0.001). A more experienced surgeon needed significantly less time than a less experienced surgeon (p < 0.001). An increasing number of bone shells (p < 0.001), an additional sinus floor elevation, and intraoperative complications also significantly increased the operation time (p = 0.001). Combining allogeneic and autogenous shells (p = 0.02) and simultaneous sinus floor elevation (p = 0.043) significantly impacted intraoperative complications. No correlations were found between the included variables for postoperative complications (all p > 0.05). In total, 229 implants were inserted after a healing time of 4-6 months, with a survival of 99.6% after a mean follow-up duration of 9 months. CONCLUSIONS Compared to the autogenous technique, allogeneic shell augmentation has a shorter surgical time and a similar rate of intra- and postoperative complications as autogenous bone. Together with its promising clinical results, this technique can be recommended.
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Affiliation(s)
- Jochen Tunkel
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Frederik Hoffmann
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Yannik Schmelcher
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Anita Kloss-Brandstätter
- Department of Engineering & IT, Carinthia University of Applied Sciences, Europastraße 4, 9524, Villach, Austria
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Ji SL, Zhao XD, Wang LM, Pang CG, Li WJ, Song KX, Ma RX, Li RF, Zhang JY, Hu YC. Comparison of demineralized bone matrix with different cycling crushing times in posterolateral fusion model of athymic rats. Cell Tissue Bank 2023; 24:747-758. [PMID: 37133795 DOI: 10.1007/s10561-023-10086-0] [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: 02/06/2023] [Accepted: 03/26/2023] [Indexed: 05/04/2023]
Abstract
Decalcified bone matrix (DBM) is a widely used alternative material for bone transplantation. In the DBM production process, an effective particle size and the highest utilization rate of raw materials can be achieved only through multiple high-speed circulating comminution. The rat posterolateral lumbar fusion model (PLF) is the most mature small animal model for the initial evaluation of the efficacy of graft materials for bone regeneration and spinal fusion. To evaluate the differences in the in vivo osteogenic effects of DBM pulverization through 1, 5, 9, and 14 high-speed cycles, sixty athymic rats were divided into six groups: single cycling crushing (CC1), 5 cycles of crushing (CC5), 9 cycles of crushing (CC9), 13 cycles of crushing (CC13), autogenous bone graft (ABG) and negative control (NC). Posterolateral lumbar fusion was performed. Six weeks after surgery, the bilateral lumbar fusion of athymic rats was evaluated through manual palpation, X-ray, micro-CT and histological sections. Rank data were tested by the rank-sum test, and nonparametric data were tested by the Kruskal‒Wallis H test. The manual palpation and X-ray results showed that the fusion rate did not significantly differ between the CC1, CC5, CC9, CC13 and ABG groups. However, cavities appeared in CC9 and CC13 on the micro-CT image. The bone mass (BV/TV) of CC1, CC5, CC9 and CC13 was better than that of the ABG group, while almost no osteogenesis was observed in the NC group. Histologically, there was no obvious difference between the four groups except that the CC9 group and CC13 group had more fibrous tissues in the new bone. In conclusion, DMB with different cycling crushing times has no obvious difference in fusion rate of PLF, but it is slightly better than the ABG group.
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Affiliation(s)
- Shao-Lin Ji
- Tianjin Medical University, Tianjin, China
- Shandong Provincial Third Hospital, Shandong University, Jinan, China
| | - Xiao-Dan Zhao
- Shandong Provincial Third Hospital, Shandong University, Jinan, China
| | - Li-Min Wang
- Beijing wonderful medical biomaterial Co., Ltd, Beijing, China
| | - Cheng-Gang Pang
- Department of Trauma, Zoucheng People's Hospital, Zoucheng, China
| | - Wen-Jing Li
- Beijing wonderful medical biomaterial Co., Ltd, Beijing, China
| | - Kun-Xiu Song
- Department of Hand Surgery, BinZhou medical university hospital, Binzhou, China
| | | | | | - Jing-Yu Zhang
- Department of Bone Tumor and Soft Tissue Oncology, Tianjin Hospital, 406 Jiefang Southern Road, Tianjin, 300211, China.
| | - Yong-Cheng Hu
- Department of Bone Tumor and Soft Tissue Oncology, Tianjin Hospital, 406 Jiefang Southern Road, Tianjin, 300211, China.
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Li S, Wang J, Ma R, Zhao C, Gao Z, Quan X, Zhang Q. Analysis of the efficacy of drilling decompression autologous bone marrow and allogeneic bone grafting in the treatment of HIV-positive patients with early osteonecrosis of the femoral head. BMC Musculoskelet Disord 2023; 24:902. [PMID: 37990216 PMCID: PMC10661564 DOI: 10.1186/s12891-023-07039-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE To investigate the efficacy of treating patients with HIV-positive osteonecrosis of the femoral head using drilled decompression autologous bone marrow and allogeneic bone grafting. METHODS 40 patients (44 hips) with early osteonecrosis of the femoral head treated by drilling decompression autologous bone marrow and allogeneic bone grafting since October 2015 were retrospectively analyzed, among which 20 patients (24 hips) were HIV-positive patients with early osteonecrosis of the femoral head, 16 males and 4 females, age 22-43 years, average 39.6 ± 10.18 years, and 20 patients (20 hips) in the same period HIV-negative early osteonecrosis of the femoral head patients, 13 males and 7 females, aged 48-78 years, mean 63.50 ± 7.94 years were negative controls. General information including ARCO stage, Harris score, VAS score, hematological indexes including CD4+ T lymphocyte count, and HIV viral load was recorded for all patients before surgery. All patients were operated on by drilling and decompression of the necrotic area, harvesting autologous iliac bone marrow with allogeneic bone, and bone grafting through the decompression channel. The patients were followed up regularly at 6, 12, and 24 months after surgery and annually thereafter, and the repair of the necrotic femoral head was observed by reviewing the frontal and lateral X-ray, CT or MRI of the hip joint, and the complications and functional recovery of the hip joint was counted and compared between the two groups. RESULTS All patients were followed up, and the ARCO stages in the HIV-positive group were stage I 2 hips, stage IIA 6 hips, stage IIB 8 hips, stage IIC 6 hips, and stage III 2 hips, with a follow-up time of 12 to 60 months and a mean of 24.6 months. In the negative control group, there were 3 hips in ARCO stage I, 7 hips in stage IIA, 5 hips in stage IIB, 3 hips in stage IIC, and 2 hips in stage III, and the follow-up time ranged from 13 to 62 months, with an average of 24.8 months. The Harris score and VAS score of the hip in both groups improved significantly at 6 months postoperatively compared with those before surgery (P < 0.001). The difference between the Harris score of the hip in the positive group at 24 months postoperatively compared with that at 6 months postoperatively was statistically significant, but the VAS score at 24 months postoperatively compared with that at 6 months postoperatively was not statistically significant. In the negative group, there was no statistically significant difference in the Harris score and VAS score of the hip at 24 months postoperatively compared with those at 6 months postoperatively. In the positive group, there was a trend of continuous increase in hip BMD from the beginning of the postoperative period (P < 0.001). There was no statistically significant difference between the negative group and the positive group at the 24 months postoperatively follow-up except for the Harris score, which was statistically significant (P < 0.001), and the VAS score, which was statistically insignificant. At the 24 months postoperatively follow-up, patients in both groups had good recovery of hip function, and no complications such as vascular and nerve injury and fracture occurred during the perioperative period and follow-up period, and no complications related to incisional infection and pulmonary infection occurred during hospitalization. CONCLUSION The treatment of early HIV-positive osteonecrosis of the femoral head patients with autologous bone marrow and allogeneic bone grafting by drilling and decompression to remove the tissue in the necrotic area of the femoral head can effectively stop the process of osteonecrosis of the femoral head and promoting femoral head repair in HIV-positive patients is a safe and effective method for treating HIV-positive patients with early osteonecrosis of the femoral head, and can effectively delay or postpone total hip replacement in patients.
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Affiliation(s)
- Shengtao Li
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing, 100015, China
| | - Jie Wang
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing, 100015, China
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Workers Stadium South Road, Chaoyang District, Beijing, 100020, China
| | - Rui Ma
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing, 100015, China
| | - Changsong Zhao
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing, 100015, China
| | - Zhengrong Gao
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing, 100015, China
| | - Xuemin Quan
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing, 100015, China
| | - Qiang Zhang
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing, 100015, China.
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Zhuo W, Huang F, Zhu W, Liu F, Liu J, Jin D. Analysis of risk factors for non-fusion of bone graft in anterior cervical discectomy and fusion: A clinical retrospective study. J Orthop Sci 2023:S0949-2658(23)00190-2. [PMID: 37500402 DOI: 10.1016/j.jos.2023.07.002] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 06/18/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Bone graft fusion is a major concern among surgeons after Anterior Cervical Discectomy and Fusion (ACDF) surgery as non-fusion may lead to further physical and drug therapies. METHODS The related risk elements of non-fusion of bone graft in ACDF surgery were retrospectively assessed. Patients receiving ACDF operation in our hospital from January 2015 to December 2019 were retrospectively analyzed. According to the criteria, 107 study subjects were recruited with a total of 164 surgical segments. The general information of patients, bone graft materials, imaging parameters, and clinical efficacy was recorded. T-test, chi-square test and binary logistic regression evaluation were employed to explore the risk factors of bone graft nonunion. RESULTS Low housefield unit (HU) value, diabetes, allogeneic bone, and hydroxyapatite (HA) artificial bone could be risk factors for bone graft fusion in ACDF surgery. Further multivariate analysis was performed and confirmed those related factors of bone graft non-fusion including low HU value (non-fusion rate: 32.53% [27/83], OR = 5.024, p = 0.025), diabetes (non-fusion rate: 53.33% [8/15], OR = 4.776, p = 0.031), allogeneic bone (18.57% [13/70], OR = 3.964, p = 0.046), and artificial bone (68.29% [28/41], OR = 50.550, p < 0.01). CONCLUSION By looking at bone graft fusion, selecting autologous iliac bone is an ideal selection to avoid non-fusion of bone graft in ACDF. Diabetes was more important predictor of bone graft nonunion than low HU value. Larger sample size and longer follow-up are required to further confirm these findings in the future.
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Affiliation(s)
- Wentao Zhuo
- Department of Spine Surgery, Section I, Maoming People's Hospital, Maoming City, Guangdong Province, 525000, China
| | - Fuming Huang
- Department of Trauma Orthopedics, Maoming People's Hospital, Maoming City, Guangdong Province, 525000, China
| | - Weijia Zhu
- Department of Surgery of Joint and Extremities Osteopathy, Maoming People's Hospital, Maoming City, Guangdong Province, 525000, China
| | - Fuqiang Liu
- Department of Spine Surgery, Section I, Maoming People's Hospital, Maoming City, Guangdong Province, 525000, China
| | - Jun Liu
- Department of Spine Surgery, Section I, Maoming People's Hospital, Maoming City, Guangdong Province, 525000, China
| | - Dadi Jin
- Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou City, Guangdong Province, 510000, China.
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Liu L, Yang F, Zong CC, Chen J. [Treatment of four-part proximal humerus fractures with depressed humeral head collapse using strut allograft with locking plates]. Zhongguo Gu Shang 2023; 36:116-9. [PMID: 36825409 DOI: 10.12200/j.issn.1003-0034.2023.02.004] [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] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To evaluate the clinical outcomes of allogeneic femoral head as strut allograft combined with proximal humeral internal locking system (PHILOS) in the treatment of proximal humeral Neer grade Ⅳ fracture with humeral head collapse. METHODS From January 2018 to November 2020, 18 patients with Neer grade Ⅳ fracture with humeral head collapse were treated with strut allograft with PHILOS, including 4 males and 14 females, aged from 55 to 78 years old, with an average of (68.11±7.20) years old. The operation time, intraoperative bleeding, postoperative drainage volume, fracture healing time, neck-shaft angle and the height of the humeral head, failure of internal fixation the shoulder function at the last follow-up was assessed using Neer's scoring system. RESULTS All 18 patients were followed up, and the duration ranged from 10 to 12 months, with an average of (11.08±0.65) months. The operation time was (66.44±5.06) min, the intraoperative bleeding volume was (206.67±36.14) ml, the postoperative drainage volume was (76.11±9.63) ml, and the fracture healing time was (17.28±3.92) weeks. At the last follow-up, the degree of loss of neck-shaft angle was (5.44±0.86) ° and the loss of the height of humeral head was (1.43±0.27) mm. All 18 patients had healing without complications such as fracture, withdrawal, penetration of internal fixation and necrosis of humeral head. According to Neer's evaluation standard, the total score was (89.61±5.60), 10 cases got an excellent result, 6 good, 2 fair. CONCLUSION Allogeneic femoral head combined with PHILOS is an appropriate treatment for the four-part proximal humerus fractures with humeral head collapse, exhibiting good clinic outcome.
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Affiliation(s)
- Lie Liu
- Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui, China
| | - Feng Yang
- Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui, China
| | - Cheng-Cheng Zong
- Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui, China
| | - Jing Chen
- Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui, China
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Zhang S, Zhang X, Li Y, Mao X, Liu R, Qi Y, Lee ES, Jiang HB. Clinical Reference Strategy for the Selection of Treatment Materials for Maxillofacial Bone Transplantation: A Systematic Review and Network Meta-Analysis. Tissue Eng Regen Med 2022; 19:437-450. [PMID: 35532735 PMCID: PMC9130380 DOI: 10.1007/s13770-022-00445-5] [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: 09/18/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 10/18/2022] Open
Abstract
Bone graft materials have mixed effects of bone repair in the field of oral maxillofacial surgery. The qualitative analyses performed by previous studies imply that autogenous odontogenic materials and autogenous bone have similar effects on bone repair in clinical jaw bone transplantation. This retrospective systematic assessment and network meta-analysis aimed to analyze the best effect of clinical application of autogenous odontogenic materials and autogenous, allogeneic, and xenogeneic bone grafts in bone defect repair. A systematic review was performed by searching the PubMed, Cochrane Library, and other journal databases using selected keywords and Medical Subject Headings search terms. 10 Papers (n = 466) that met the inclusion criteria were selected. The assessment of heterogeneity did not reveal any overall statistical difference or heterogeneity (P = 0.051 > 0.05), whereas the comparison between autogenous and allogeneic bone grafts revealed local heterogeneity (P = 0.071 < 0.1). Risk of bias revealed nine unclear studies and one high-risk study. The overall consistency was good (P = 0.065 > 0.05), and the local inconsistency test did not reveal any inconsistency. The publication bias was good. The confidence regarding the ranking of bone graft materials after GRADE classification was moderate. The effects on bone repair in the descending order were as follows: autogenous odontogenic materials, xenogeneic bone, autogenous bone, and allogeneic bone. This result indicates that the autogenous odontogenic materials displayed stronger effects on bone repair compared to other bone graft materials. Autogenous odontogenic materials have broad development prospects in oral maxillofacial surgery.
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Affiliation(s)
- Shuxin Zhang
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Xinyi Zhang
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Yanli Li
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Xuran Mao
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Rui Liu
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Yanxin Qi
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China
| | - Eui-Seok Lee
- Department of Oral and Maxillofacial Surgery, Graduate School of Clinical Dentistry, Korea University, Seoul, 08308, Korea.
| | - Heng Bo Jiang
- The CONVERSATIONALIST club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, Shandong, China.
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Wang Z, Li Z, Zhang X, Yu Y, Feng Q, Chen J, Xie W. A bone substitute composed of polymethyl-methacrylate bone cement and Bio-Gene allogeneic bone promotes osteoblast viability, adhesion and differentiation. Biomed Mater Eng 2021; 32:29-37. [PMID: 33427728 DOI: 10.3233/bme-201139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Increasing reports on new cement formulations that address the shortcomings of PMMA bone cements and various active components have been introduced to improve the biological activity of PMMA cement. OBJECTIVE Evaluating the biological properties of PMMA cements reinforced with Bio-Gene allogeneic bone. METHODS The MC3T3-E1 mouse osteoblast-like cells were utilized to determine the effects of Bio-Gene + PMMA on osteoblast viability, adhesion and differentiation. RESULTS The combination of allogeneic bone and PMMA increased the number of adherent live cells compared to both control group and PMMA or Bio-Gene group. Scanning electron microscopy observed that the number of cells adhered to Bio-Gene + PMMA was larger than Bio-Gene and PMMA group. Compared with the control and PMMA or Bio-Gene group, the level of ALP and the number of calcium nodules after osteoinduction was remarkably enhanced in Bio-Gene + PMMA group. Additionally, the combination of Bio-Gene and PMMA induced the protein expression of osteocalcin, osterix and collagen I. CONCLUSION The composition of PMMA and allogeneic bone could provide a more beneficial microenvironment for osteoblast proliferation, adhesion and differentiation. PMMA bone cement reinforced with Bio-Gene allogeneic bone may act as a novel bone substitute to improve the biological activity of PMMA cement.
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Affiliation(s)
- Zhikun Wang
- Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Department of Orthopedics, SSL Central Hospital of Dongguan City, Guangdong, China
| | - Zaixue Li
- Department of Orthopedics, SSL Central Hospital of Dongguan City, Guangdong, China
| | - Xiansen Zhang
- Department of Orthopedics, SSL Central Hospital of Dongguan City, Guangdong, China
| | - Yingfeng Yu
- Department of Orthopedics, SSL Central Hospital of Dongguan City, Guangdong, China
| | - Qingyu Feng
- Department of Orthopedics, SSL Central Hospital of Dongguan City, Guangdong, China
| | - Jianting Chen
- Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wenwei Xie
- Department of Orthopedics, SSL Central Hospital of Dongguan City, Guangdong, China
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Cai M, Xin Z, Kong W, Du Q, Ji W, Wu F, Li J, He J, Liao W. Clinical effect of a novel transpedicular reducer for reduction and bone grafting combined with pedicle screw fixation for thoracolumbar burst fractures. BMC Musculoskelet Disord 2021; 22:540. [PMID: 34126973 PMCID: PMC8204475 DOI: 10.1186/s12891-021-04423-1] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Short-segment transpedicular screw fixation is a common method for the treatment of thoracolumbar burst fractures (TBFs),but this technique has many problems. Therefore,the purpose of this article is to observe and evaluate the clinical efficacy of a novel transpedicular reducer that we designed for fractured vertebral body reduction and bone grafting in the treatment of TBFs. METHODS From July 2018 to November 2020, 70 cases of TBFs were included. Thirty-five patients were treated with the novel transpedicular reducer for reduction and bone grafting combined with pedicle screw fixation (observation group), and 35 patients were treated with short-segment transpedicular screw fixation (control group). Before the operation, after reduction, and 3 days, 3 months,and 12 months after the operation, the two groups were assessed, and compared with respect to the anterior and middle heights of the injured vertebrae, the ratios of the anterior and middle heights of the injured vertebral body to the respective heights of the adjacent uninjured vertebral bodies (AVBHr and MVBHr, respectively), and the Cobb angle of the patients. We compared the pain VAS score and quality of life GQOL-74 score at the last follow-up. Finally,we evaluated the distribution of bone grafts and bone healing 12 months after the operation. RESULTS The anterior height, middle height, AVBHr, MVBHr, and Cobb angle of the injured vertebral body in the observation after reduction, and 3 days, 3 months and 12 months post-operatively were compared with those of the injured vertebral body before operation. All of these parameters were improved, and the difference was statistically significant (p < 0.05). These parameters in the observation group at the above time points were significantly better than thoes in the control group at the corresponding time points (p < 0.05). The VAS scores at the last follow-up were significantly better than those of the control group (p < 0.05), but the GQOL-74 score differences were not statistically significant (p > 0.05). The observation group showed no obvious defects on CT at 12 months after the operation, and the bone healing was good. CONCLUSION The novel transpedicular reducer for reduction and bone grafting combined with pedicle screw fixation for TBFs has good clinical efficacy.
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Affiliation(s)
- Menghan Cai
- Department of Spinal Surgery, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563099, Guizhou, China
| | - Zhijun Xin
- Department of Spinal Surgery, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563099, Guizhou, China
| | - Weijun Kong
- Department of Spinal Surgery, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563099, Guizhou, China
| | - Qian Du
- Department of Spinal Surgery, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563099, Guizhou, China
| | - Wenjun Ji
- Department of Spinal Surgery, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563099, Guizhou, China
| | - Fujun Wu
- Department of Spinal Surgery, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563099, Guizhou, China
| | - Jin Li
- Department of Spinal Surgery, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563099, Guizhou, China
| | - Jialin He
- Department of Spinal Surgery, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563099, Guizhou, China
| | - Wenbo Liao
- Department of Spinal Surgery, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, 563099, Guizhou, China.
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Li Y, Yu Y, Hou TY, Zhang ZH, Xing JC, Lu HW, Zhou R, Cheng P, Xu JZ, Wu WJ, Luo F. Efficacy of Biocage in treating single-segment lumbar degenerative disease in patients with high risk of non-fusion: a prospective controlled study with at least 2 years' follow-up. J Int Med Res 2021; 48:300060520945500. [PMID: 32962480 PMCID: PMC7518008 DOI: 10.1177/0300060520945500] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective To evaluate the clinical efficacy of an allogeneic bone cage (Biocage; Beijing Datsing Bio-Tech Co., Ltd., Beijing, China) for treatment of single-segment lumbar degenerative disease in patients with a high risk of non-fusion. Methods From January 2013 to December 2016, 67 patients who underwent lumbar fusion were divided into the Biocage group (n = 33) and polyether ether ketone (PEEK) group (n = 34). The patients were followed up for 24 to 48 months. The mean intervertebral height of the fusion level, fusion rate, height of the intervertebral foramen, visual analog scale score, and Oswestry disability index were compared. Results The PEEK group had a lower fusion rate than the Biocage group (88.24% vs. 90.91%), although the difference was not statistically significant. During follow-up, the height of the intervertebral space was similar between the Biocage and PEEK groups (12.88 ± 0.45 and 12.84 ± 1.01 mm, respectively). The height of the intervertebral foramen was larger in the Biocage than PEEK group (20.67 ± 1.34 vs. 20.00 ± 2.05 mm). Good clinical efficacy was achieved in both groups. Conclusion The Biocage is efficient and safe for treatment of single-segment lumbar degenerative disease in patients with a high risk of non-fusion.
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Affiliation(s)
- Yang Li
- National & Regional Engineering Laboratory of Tissue Engineering, Department of Orthopedics, The First Affiliated Hospital to Army Medical University (Southwest Hospital), Chongqing, China
| | - Yang Yu
- Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tian-Yong Hou
- National & Regional Engineering Laboratory of Tissue Engineering, Department of Orthopedics, The First Affiliated Hospital to Army Medical University (Southwest Hospital), Chongqing, China
| | - Ze-Hua Zhang
- National & Regional Engineering Laboratory of Tissue Engineering, Department of Orthopedics, The First Affiliated Hospital to Army Medical University (Southwest Hospital), Chongqing, China
| | - Jun-Chao Xing
- National & Regional Engineering Laboratory of Tissue Engineering, Department of Orthopedics, The First Affiliated Hospital to Army Medical University (Southwest Hospital), Chongqing, China
| | - Hong-Wei Lu
- National & Regional Engineering Laboratory of Tissue Engineering, Department of Orthopedics, The First Affiliated Hospital to Army Medical University (Southwest Hospital), Chongqing, China
| | - Rui Zhou
- National & Regional Engineering Laboratory of Tissue Engineering, Department of Orthopedics, The First Affiliated Hospital to Army Medical University (Southwest Hospital), Chongqing, China
| | - Peng Cheng
- National & Regional Engineering Laboratory of Tissue Engineering, Department of Orthopedics, The First Affiliated Hospital to Army Medical University (Southwest Hospital), Chongqing, China
| | - Jian-Zhong Xu
- National & Regional Engineering Laboratory of Tissue Engineering, Department of Orthopedics, The First Affiliated Hospital to Army Medical University (Southwest Hospital), Chongqing, China
| | - Wen-Jie Wu
- National & Regional Engineering Laboratory of Tissue Engineering, Department of Orthopedics, The First Affiliated Hospital to Army Medical University (Southwest Hospital), Chongqing, China
| | - Fei Luo
- National & Regional Engineering Laboratory of Tissue Engineering, Department of Orthopedics, The First Affiliated Hospital to Army Medical University (Southwest Hospital), Chongqing, China
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Fölsch C, Sahm P, Ulloa CAF, Krombach GA, Kampschulte M, Rickert M, Pruss A, Jahnke A. Effect of synthetic bone replacement material of different size on shear stress resistance within impacted native and thermodisinfected cancellous bone: an in vitro femoral impaction bone grafting model. Cell Tissue Bank 2021; 22:651-664. [PMID: 33893901 PMCID: PMC8558171 DOI: 10.1007/s10561-021-09924-w] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 04/03/2021] [Indexed: 11/06/2022]
Abstract
Antibiotic carrier particles of variable size might influence mechanic properties within impacted thermodisinfected and native cancellous bone different. Herafill®G containing calciumsulfate and calciumcarbonate provides high local concentrations of gentamicin being important for revision surgery in infected joint replacements. Native and thermodisinfected cancellous bone derived from 6 to 7 months old piglets was used for in vitro impaction bone grafting and supplemented each with Herafill®G granules of two different sizes. Micromovement of implants related to shear force was measured in 29 specimens distributed in 6 groups. Thermodisinfected cancellous bone revealed a significant higher shear force resistance than native bone with a mean difference of 423.8 mdeg/Nm (p < 0.001) ranging within 95% confidence interval from 181.5 to 666.0 mdeg/Nm. Adding small granules to thermodisinfected bone did not reduce shear force resistance significantly since adding large granules to native bone improved it by 344.0 mdeg/Nm (p < 0.003). Shear force resistance was found higher at the distal region of the implant compared to a proximal point of measurement throughout all specimens. Less impaction impulses were necessary for thermodisinfected bone. Thermodisinfected cancellous bone might achieve a higher degree of impaction compared with native bone resulting in increased resistance against shear force since impaction was found increased distally. Supplementation of thermodisinfected bone with small granules of Herafill®G might be considered for application of local antibiotics. Large granules appeared more beneficial for supplementation of native bone. Heterogeneity of bone graft and technical aspects of the impaction procedure have to be considered regarding the reproducibility of femoral impaction bone grafting.
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Affiliation(s)
- C Fölsch
- Department of Orthopaedic Surgery, Justus-Liebig-University Medical School, Klinikstrasse 33, 35392, Gießen, Germany.
| | - P Sahm
- Laboratory of Biomechanics, Department of Orthopaedic Surgery, Justus-Liebig-University Medical School, Klinikstrasse 29, 35392, Giessen, Germany
| | - C A Fonseca Ulloa
- Laboratory of Biomechanics, Department of Orthopaedic Surgery, Justus-Liebig-University Medical School, Klinikstrasse 29, 35392, Giessen, Germany
| | - G A Krombach
- Department of Diagnostic and Interventional Radiology, Laboratory for Experimental Radiology, Justus-Liebig-University Medical School, Klinikstrasse 33, 35392, Giessen, Germany
| | - M Kampschulte
- Department of Diagnostic and Interventional Radiology, Laboratory for Experimental Radiology, Justus-Liebig-University Medical School, Klinikstrasse 33, 35392, Giessen, Germany
| | - M Rickert
- Department of Orthopaedic Surgery, Justus-Liebig-University Medical School, Klinikstrasse 33, 35392, Gießen, Germany
| | - A Pruss
- Institute of Transfusion Medicine, University Tissue Bank, Charité University Medical School, Charitéplatz 1, 10117, Berlin, Germany
| | - A Jahnke
- Laboratory of Biomechanics, Department of Orthopaedic Surgery, Justus-Liebig-University Medical School, Klinikstrasse 29, 35392, Giessen, Germany
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11
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Fölsch C, Dharma J, Fonseca Ulloa CA, Lips KS, Rickert M, Pruss A, Jahnke A. Influence of thermodisinfection on microstructure of human femoral heads: duration of heat exposition and compressive strength. Cell Tissue Bank 2020; 21:457-468. [PMID: 32314113 PMCID: PMC7452940 DOI: 10.1007/s10561-020-09832-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/30/2020] [Indexed: 11/25/2022]
Abstract
Allogeneic bone derived from living donors being necessary to match demand for bone transplantation and thermodisinfection of femoral heads is an established sterilization method. During the thermodisinfection the peripheral bone is exposed to maximum 86 °C for 94 min providing 82.5 °C within the center of the femoral head for at least 15 min. This study examined the compression force of the central and representative peripheral regions of native and thermodisinfected human femoral heads to observe wether different duration and intensity of heat exposure might alter mechanic behaviour. Slices from the equatorial region of human femoral heads were taken from each 14 native and thermodisinfected human femoral heads. The central area revealed a significantly higher compression force for native (p ≤ 0.001) and for thermodisinfected bone (p = 0.002 and p = 0.005) compared with peripheral regions since no relevant differences were found between the peripheral and intermediate areas themselves. A small reduction of compression force for thermodisinfected bone was shown since this did not appear significant due to the small number of specimens. The heat exposure did not alter the pre-existing anatomical changes of the microarchitecture of the native femoral heads from the center towards the peripheral regions. The heterogeneity of microstructure of the femoral head might be of interest concerning clinical applications of bone grafts since the difference between native and thermodisinfected bone appears moderate as shown previously. The different quantity of heat exposure did not reveal any significant influence on compression force which might enable thermodisinfection of preformed bone pieces for surgical indications.
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Affiliation(s)
- Christian Fölsch
- Department of Orthopaedic Surgery, Justus-Liebig-University Medical School, Klinikstrasse 33, 35392, Giessen, Germany.
| | - Julian Dharma
- Labarotory of Biomechanics, Department of Orthopaedic Surgery, Justus-Liebig-University Medical School, Klinikstrasse 29, 35392, Giessen, Germany
| | - Carlos Alfonso Fonseca Ulloa
- Labarotory of Biomechanics, Department of Orthopaedic Surgery, Justus-Liebig-University Medical School, Klinikstrasse 29, 35392, Giessen, Germany
| | - Katrin Susanne Lips
- Laboratory of Experimental Trauma Surgery, Justus-Liebig-University, Aulweg 128, 35392, Giessen, Germany
| | - Markus Rickert
- Department of Orthopaedic Surgery, Justus-Liebig-University Medical School, Klinikstrasse 33, 35392, Giessen, Germany
| | - Axel Pruss
- University Tissue Bank, Institute of Transfusion Medicine, Charité University Medical School, Charitéplatz 1, 10117, Berlin, Germany
| | - Alexander Jahnke
- Labarotory of Biomechanics, Department of Orthopaedic Surgery, Justus-Liebig-University Medical School, Klinikstrasse 29, 35392, Giessen, Germany
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Abstract
Background The objective of this study was to investigate the therapeutic effects of the application of fascial flap-wrapped allogeneic bone for repair of large segmental tibial defects in rabbits and provide a theoretical basis for treatment of large segmental defects in weight-bearing bones. Methods Forty-eight healthy adult New Zealand White (NZW) rabbits were randomized into two groups to establish 15-mm bone defects in the proximal tibia. Bone defects in test and control groups were repaired using allogeneic bone with and without a vascularized fascial flap from the rabbit proximal tibia, respectively. The differences in repair of bone defects between the two groups were assessed with postoperative X-ray examination, new bone quantity assessment, serum bone Gla protein (BGP) level, and biomechanical testing. Results The therapeutic effect in the test group was superior to that in the control group. Conclusions Fascial flap-wrapped allogeneic bone is superior to allogeneic bone alone, and is ideal for the treatment of large segmental bone defects.
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Affiliation(s)
- Honglei Dou
- Department of Orthopaedics, Yidu Central Hospital Affiliated to Weifang Medical University, Weifang, 261000, Shandong Province, China
| | - Guowei Wang
- Department of Orthopaedics, Yidu Central Hospital Affiliated to Weifang Medical University, Weifang, 261000, Shandong Province, China
| | - Na Xing
- Department of Orthopaedics, Yidu Central Hospital Affiliated to Weifang Medical University, Weifang, 261000, Shandong Province, China
| | - Lina Zhang
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, 266071, Shandong Province, China.
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