Objective To introduce a method for fixation in periprosthetic fracture with locking compression plate (LCP). Methods Duringthe surgery, a long 12-hole LCP was placed to the lateral side of the femur. Six holes of the plate were placed proximal to the main fracture line to make sure that there could be enough cortex units for rigid fixation of proximal fragments. Locking screws used except for the most proximal hole where a 4.5 mm screw was used instead. Results The patient was pain free at the fracture site one week after the surgery,and was able to walk with a cane 3 months after the surgery. Bone union was evident radiographically 3 months after the surgery. There was no loose signs around the stem. Six months after the surgery, the patient recovered full function without pain. Conclusion In our experience from this case, LCP in treating periprosthetic fracture was easy and less time consuming, more over, extensive periosteal stripping could be avoided. LCP is a good choice in treating some periprosthetic fractures.
ObjectiveTo summarize the recent progress of the controlled releasing delivery of biological factors for cartilage repair. MethodsThe recently published 1iterature at home and abroad on the controlled releasing delivery of biological factors for cartilage repair was reviewed and summarized. ResultsVarious biological factors have been applied for repairing cartilage. For better cartilage repair effects, controlled releasing delivery of biological factors can be applied by means of combining biological factors with degradable biomaterials, or by micro- and nano-particles. Meanwhile, multiple biologic delivery and temporally controlled delivery are also inevitable choices. ConclusionAlthough lots of unsolved problems exist, the controlled releasing delivery of biological factors has been a research focus for cartilage repair because of the controllability and delicacy.
Objective To review the research progress of the seed cells, scaffolds, growth factors, and the prospects for clinical application of the intervertebral disc regeneration. Methods The recent literature concerning the regeneration strategies and tissue engineering for treatment of degenerative intervertebral disc disease was extensively reviewed and summarized. Results Seed cells based on mesenchymal stem cells (MSCs) and multiple-designed biomimetic scaffolds are the hot topic in the field of intervertebral disc regeneration. It needs to be further investigated how to effectively combine the interactions of seed cells, scaffolds, and growth factors and to play their regulation function. Conclusion The biological regeneration of intervertebral disc would have a very broad prospects for clinical application in future.
ObjectiveTo review the research progress of the co-culture system for constructing vascularized tissue engineered bone. MethodsThe recent literature concerning the co-culture system for constructing vascularized tissue engineered bone was reviewed, including the selection of osteogenic and endothelial lineages, the design and surface modification of scaffolds, the models and dimensions of the co-culture system, the mechanism, the culture conditions, and their application progress. ResultsThe construction of vascularized tissue engineered bone is the prerequisite for their survival and further clinical application in vivo. Mesenchymal stem cells (owning the excellent osteogenic potential) and endothelial progenitor cells (capable of directional differentiation into endothelial cell) are considered as attractive cell types for the co-culture system to construct vascularized tissue engineered bone. The culture conditions need to be further optimized. Furthermore, how to achieve the clinical goals of minimal invasion and autologous transplantation also need to be further studied. ConclusionThe strategy of the co-culture system for constructing vascularized tissue engineered bone would have a very broad prospects for clinical application in future.
OBJECTIVE To review the recent research progress of bone-marrow stromal stem cells (BMSCs) in the conditions of culture in vitro, chondrogenic differentiation, and the application in cartilage tissue engineering. METHODS: Recent original articles related to such aspects of BMSCs were reviewed extensively. RESULTS: BMSCs are easy to be isolated and cultivated. In the process of chondrogenesis of BMSCs, the special factors and interaction between cells are investigated extensively. BMSCs have been identified to form cartilage in vivo. One theory is the committed chondrocyte from BMSCs is only a transient stage. CONCLUSION: BMSCs are the alternative seeding cells for cartilage tissue engineering. The conditions promoting mature chondrocyte should be further investigated.
Urine-derived stem cells are a kind of cells with strong proliferative ability and multi-directional differentiation characteristics of mesenchymal stem cells isolated from urine. Urine-derived stem cells are derived from the kidney and express mesenchymal stem cell-specific antigens; experimental studies have shown that they can differentiate into a variety of cells such as adipocytes, chondrocytes, bone cells, nerve cells, etc., and have the function of promoting tissue repair. A review of the research progress of urinary stem cells is now available.
One of the most difficult problems on tendon surgery is adhesion formation during the process of tendon healing, which causes functional interference. This pathophysiologic pcocess is closely related to the ways of tendon nourishment and types of tendon healing. In order to understand whether the sutured tendon couldheal without blood circulation, the process and types of tendon healing in the synovial fluid were studied by in vivo culture modle. Flexor digitorum profundus (FDP) segments from the front paw of 50 New Zedland white rabbits were cut inthe middle and sutured with microsurgical technique, and then, preserved in thesynovial cavitied of both knees of the rabbits. After 1, 2, 4, 6 weeks, the specimens from the synovial cavities were studied by gross observation, light microscope, scanning and transmission electron microscope, and biochemical determination. The results showed that the tendon which was nourished by synovial fluid not only could survive, but also could heal. Healing of the tendon was completed by activation and proliferation of both peritendon cells and cells in the tendon.The healing could be devided into 3 periods: malnutrition period (less than 1 week), reparative period (2-4 week) and rebuilding period (more than 4 week).
ObjectiveTo explore the feasibility and short-term effectiveness of ankle arthrodesis by ankle osteotomy-tool. MethodsA retrospective analysis was made on the data of 38 patients with end-stage ankle arthritis undergoing ankle arthrodesis between February 2009 and March 2012. There were 24 males and 14 females, with an average age of 67 years (range, 40-85 years). The left ankle was involved in 18 cases and the right ankle in 20 cases. There were 20 cases of post-traumatic arthritis, 7 cases of avascular necrosis of talus, 5 cases of rheumatoid arthritis, 5 cases of primary osteoarthritis, and 1 case of post infective arthritis. The disease duration ranged 3.2-6.1 years (mean, 4.7 years). The ankle osteotomy-tool was used to remove the joint surfaces, and proximal humeral locking plate combined with compression screws were used for internal fixation. ResultsThe operation time was 40-90 minutes (mean, 60 minutes). The healing of incisions by first intention was obtained in the other cases except 1 case of superficial infection, which was cured after dressing change. Thirty-eight patients were followed up 10 to 36 months (mean, 23 months). The ankles in 4 patients started to swell repeatedly when they walked early after operation and the swelling subsided at 1 year after rehabilitation therapy. The X-ray films showed that bone fusion was obtained at 12 weeks after operation on average (range, 10-19 weeks). No internal fixation failure or malunion occurred. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was improved significantly from 43.11±17.49 at preoperation to 85.03±13.17 at last follow-up (t=14.412, P=0.000). The short-form 36 health survey scale (SF-36) showed that physical component summary score was increased significantly from preoperative 54.30±12.32 to postoperative 77.95±8.21 (t=7.723, P=0.000), and mental component summary score was significantly increased from preoperative 63.16±8.30 to postoperative 77.05±10.12 (t=2.523, P=0.021). According to the patients' satisfaction, 32 patients were very satisfied, 5 patients were satisfied, and 1 patient was not satisfied. The subjective satisfaction of patients was 97.37%. ConclusionAnkle arthrodesis by lateral malleolus osteotomy with ankle osteotomy-tool and internal fixation using proximal humeral locking plate and compression screws has the advantages of simple operation, less complications, rigid fixation, and high fusion rate. It may obtain a good short-term effectiveness.
OBJECTIVE: To sum up the clinical results of allogeneic humeral transplantation with vascular anastomosis, and evaluate the clinical significance. METHODS: From September to November 1979, 1 case with humeral shaft defect of 10 cm in length and 2 cases with tibia shaft defect of 12 cm in length were repaired by allogeneic humeral transplantation with vascular anastomosis. Azathiopurine and prednisone were applied for 3 months postoperatively. All cases were followed up for 20 years. RESULTS: Case 1 recovered well with good bone union and reconstruction after operation, and could work normally. In case 2, five chronic rejections were occurred during 3 years after operation, and recovered after treatment, the allograft bone was fractured after 2 years of operation, and unioned by autogeneous iliac bone transplantation. In case 3, the distal part of allograft bone was fractured after 46 months, and unioned by autogeneous iliac bone transplantation. The middle part of allograft bone was non-unioned after 20 years follow-up in case 3, but the patient could still work normally. CONCLUSION: The clinical results of allogeneic long bone transplantation can be improved by rational tissue matching test, application of effective immunosuppressive drugs in a certain period according to the principles of modern transplantation immunology.