【Abstract】 Objective To establ ish a animal model of osteonecrosis of femoral head in canine l ike human.Methods The thermal field of canine’s femoral head was three-dimensionally analyzed with fluent 6.2 software so that the best cryosurgery patent could be designed to maximize the osteonecrosis and minimize extra surgery trauma with the cryosurgery system invented by Shanghai Jiaotong University. Liquid nitrogen was pressurized to 0.5 MPa, poured into femoral head for 6.5 minutes, rewarming to 2 for 5 minutes and then repoured into it again for another 6.5 minutes. Ten three-foot canines were conducted as the animal models of osteonecrosis of femoral head according to the method above. At the end of followup,the results were reviewed by radiologic and pathologic check. Two dogs were conducted as control group. Results In the experimental group, one of the ten canines was testified to occur osteonecrosis of femoral head after one week pathologically, cell death and vessel breakage of cavitas medullaris in the femoral head was obvious under microscope; in other nine canines beingstill under follow-up, five with three-month follow-up at least progressed to the collapse of femoral head l ike human (Ficat III). In control group, no osteonecrosis was found. Conclusion Cryosurgery for osteonecrosis of the femoral head in three-foot canine model may become a method to establ ish the animal model of osteonecrosis of femoral head l ike human.
Objective To review the research and application progress of bioactive glass in bone repair. Methods The recently published literature concerning bioactive glass in bone repair was reviewed and summarized. Results Bioactive glass can classified different types, such as bioactive glass particulate, bioactive glass scaffold, bioactive glass coating, injectable bioactive glass cement, and bioactive glass delivery system. Bioactive glass has been well studied in the field of bone repair due to its excellent biological properties. Also, the remarkable progress has been made in various aspects. Conclusion Bioactive glass is a reliable material of bone repair and will play an even more important role in the future.
【Abstract】 Objective To measure the changes of bone mineral density and bone micro-architecture of thefemoral head that harvested from the three-foot bearing ethanol destroyed canine model for osteonecrosis of femoral head, and discuss the influences of local injection of ethanol and biomechanical loading to the structural properties of the femoral head. Methods Twenty-four Beagles were divided randomly into four-foot bearing canines and three-foot bearing canines. One fore-l imb was fixed randomly in three-foot bearing canines. Osteonecrosis was induced in all experimental animals by local injection of 5 mL pure ethanol into one side of the femoral head. The hind l imbs injected with NS were acted as control group, that of three-foot canines injected with ethanol were acted as three-foot canine group, and that of four-foot canines injected with ethanol were acted as four-foot canine group. The contralateral femoral head was injected into equal amount of NS. Animals were sacrificed at the time intervals of 1, 3, 6, and 12 weeks after the injection of ethanol. Quantitative microcomputedtomography was used to characterize changes in bone micro-architecture and bone mineral density of femoralhead. Results The clear three-dimensional model of trabecular bone of necrotic femoral head were obtained. There were no significant differences among 3 groups according to the time l ine by 1 week after ethanol injection(P gt; 0.05). At 3 weeks after injection of ethanol, in three-foot canine group and four-foot canine group, the volume of BMC, BMD, BVF, and BS/BV increased gradually as the distance to the drill ing canal increased. There were significant differences between 3 regions (P lt; 0.05). At 6 weeks, in three-foot canine group and four-foot canine group, the volume of BMC, BMD,BVF, and Tb.N of region I and II decreased significantly compared with region III (P lt; 0.05). At 12 weeks, there are no differences among 3 groups (P gt; 0.05). There were significant decreases in BMD values, BVF, BS/BV, Tb.N, Tb.Sp and Tb.Th after the injection of pure ethanol. And, the changes were more and more obvious by the time l ine. These changes were differentiable at 3 weeks after injection of ethanol, and became obvious at 6 weeks. These changes were more obvious at the part that near the injection canal. The changes in threefoot canine group were more obvious than that in four-foot canine group. Conclusion Resorption of necrotic compact bone trabecular may weaken the structural properties of the femoral head. Moreover, remodel ing and repairing process of necrotic bone trabecular may be hampered by constant biomechanical loading that presented in three-foot bearing canines, and thereby further weaken the structural properties of the femoral head. Biomechanical loading may be one of the critical reasons that lead to the collapse of femoral head.
Objective To establ ish an animal model of osteonecrosis of the femoral head (ONFH) l ike human. Methods Ten healthy adult three-leg Beagle male dogs weighing (16.0 ± 1.6) kg were conducted as the animal model of ONFH according to the schedule of cryosurgery designed in advance in which l iquid nitrogen, pressurized to 0.5 MPa, was poured into the femoral head for 16.5 minutes. After rewarmed to 0℃ for 10 minutes, the l iquid nitrogen was repoured into the femoral head for another 16.5 minutes. At the end of the follow-up, the results were reviewed by pathologic check. One dog was conducted as control group. Results The first boundary temperature of (—27.9 ± 4.3)℃ was higher than the second boundary temperature (— 31.3 ± 4.7)℃ by —3.4℃ , and there was significant difference (P lt; 0.01). The diameter of the femoral head of (17.7 ± 1.1) mm was l inearly (^ y= — 2.6 － 2.409 x) correlated to boundary temperature by Pearson analysis, and the R rate was —0.977 (Plt; 0.05). Four dogs in experimental group progressed to collapse of the femoral head l ike human in the 6th month after operation. The rate of the femoral head collapse rose to 44.4%. In the control group, osteonecrosis was never found. Conclusion Cryosurgcry for osteonecrosis of the femoral head in the three-leg canine model may become a method to establ ish an animal model of ONFH l ike human.
Objective As a bioactive material, the osteogenic activity of borate bioglass has been proved. To design a novel borate bioglass according to an improved formula and to investigate the effects of the borate bioglass on osteoblasts invitro for further research and potential cl inical appl ication. Methods The novel Na2O-K2O-MgO-CaO-P2O5-B2O3-SrO borate bioglass was prepared by melting process. The initial and secondary extracts were prepared according to ISO10993-12: 2007 respectively with different extract time of 0-24 hours and 24-48 hours. The osteoblasts (MC3T3-E1) of the 5th-15th passages from mouse were cocultured with the initial (initial extract group) and secondary (secondary extract group) extracts, respectively, to assess the effects of the borate bioglass on the cell prol iferation, protein synthesis, alkal ine phosphatase (ALP) activity, cell apoptosis, and cell migration; while α-MEM medium without addition of extract served as control group. Results The absorbance values at 450 nm were 0.356 0 ± 0.018 7, 0.331 0 ± 0.025 4, and 0.204 0 ± 0.013 8 in initial extract, secondary extract, and control groups, respectively, showing significant differences among 3 groups (P lt; 0.05). The total protein contents were (382.847 ± 9.521), (226.071 ± 5.847), and (220.248 ± 8.213) U in initial extract, secondary extract, and control groups, respectively; there were significant differences between initial extract group and control group, and between initial extract group and secondary group (P lt; 0.05), but there was no significant difference between secondary extract group and control group (P gt; 0.05). However, no significant difference was observed in the ALP activity [(0.013 01 ± 0.000 39), (0.012 93 ± 0.000 44), and (0.012 92 ± 0.000 35) U/ mg], apoptosis rate (7.03% ± 1.95%, 6.46% ± 2.88%, and 6.18% ± 2.21%), horizontal migration [(137.50 ± 11.43), (134.98 ± 10.50), (135.21 ± 8.66) μm], and transmembrane cell number [(10.92 ± 4.99), (10.07 ± 2.50), and (9.81 ± 2.64) cells/ field] among initial extract, secondary extract, and control groups (P gt; 0.05). Conclusion This novel borate bioglass has excellent cytocompatibil ity, which plays regulatory effects on the cell prol iferation, secretion, and migration.
Objective To study an optimal ratio of small intestinal submucosa (SIS) and (hydroxyapatite-tricalcium phosphate,HA-TCP,SIS/HA-TCP) compositions according to the effect of SIS/HA-TCP compositions with different ratios on repairing rabbit femoral condyle defect. Methods Thirty-six rabbits were made into bone defect models of 6 mm in diameter and 10 mm in depth in both sides of femoral condyles. Three different ratios of SIS/HA-TCP compositions (w/w: 1, 0.5, 0.25) were implanted into rabbit femoral condyle defect. After 2, 4, 8 and 12 weeks of operation, the repair effect wasobserved grossly. The histological evaluations were performed by histological scoring system and computer imaging analysis system. Results The amount of new bone formation in SIS/HA-TCP(0.5) group was more than that in SIS/HA-TCP(1) and SIS/HA-TCP(0.25) groups. Histological observation: In SIS/HA-TCP(1) group, few new bone formation was seen and bone defect was repaired in the 12th week. In SIS/HA-TCP(0.5) group, immature woven bone was found in the defect in the 2nd week; more immature woven bone appeared and formed trabeculae in the 4th week; the regenerated bone was vigorously growing into the interspaces of the implanted materials in the 8th week; the implanted materials was basically replaced by bony structure and the lamellar bone appeared in the 12thweek. The results of SIS/HA-TCP (0.25) group were similar to that of SIS/HA-TCP(0.5) group. The histological scoring was higher in SIS/HA-TCP(0.5) and SIS／HA-TCP(0.25) groups than that in SIS/HA-TCP(1) group (Plt;0.05) in the 2nd, 4th, 8th, and 12th weeks. The scoring was higher in SIS/HA-TCP(0.5) roup than that in SIS/HA-TCP(0.25) group in the 2nd and 12th weeks(P＜0.05). In new bone formation and the degradation of HA-TCP, SIS/HA-TCP(0.5) and SIS／HA-TCPC(0.25) groups were superior to SIS/HA-TCP(1) group(Plt;0.05), SIS/HA-TCP(0.5) group was superior to SIS/HA-TCP(0.25) group (Plt;0.05). Conclusion SIS/HA-TCP(0.5) has better effects of repairing bone defect and it can be used as a reference ratio in constructing bone scaffolds.
Objective To investigate the effect of various concentration of platelet-rich plasma (PRP) on osteogenic differentiation of rabbit skeletal muscle-derived stem cells (SMSCs) cultured in vitro. Methods Blood drawn from the central ear arteries of 9 one-year-old New Zealand white rabbits weighing 2.5-3.0 kg (male and female) was used to prepare PRP (Landesberg method). Full blood count and platelet count in PRP were tested. Soleus muscle of right hindl imb in rabbit was obtained and used to culture SMSCs in vitro. The cells at passage 3 were randomly divided into different groups: the experimental groups in which the cells were treated by conditioned culture media with various concentrations of autologousPRP (6.25%, 12.50%, 25.00%, 50.00%), and the control group in which the cells were treated with the media without PRP. At different time points after intervention, osteogenetic activity of the cells was detected by ALP staining observation, ALP activity detection was conducted, al izarin red staining for calcium nodules and immunofluorescence staining for osteocalcin were performed, and core binding factor α1 (Cbfα1) of osteogenic gene expression was tested by RT-PCR. Results The full blood PRP count and the platelet count in PRP was (3.06 ± 0.46) × 105/μL and (18.08 ± 2.10) × 105/μL, respectively. ALP staining: the cells in all the experimental groups were positive for the staining with many black sediment particles in cytoplasm; the cells in the control group were negative staining. ALP activity: all the experimental groups were higher than the control group (P lt; 0.05), the experimental group at 12.50% was superior to other experimental groups at each time point (P lt; 0.05). Al izarin red staining: at 14 days after culture, orange-red calcium nodules were evident in all the experimental groups; no orange-red calcium nodules were observed in the control group with a mineral ization rate of zero; there were significant difference between the experimental groups and the control group in terms of mineral ization rate (P lt; 0.05), the experimental group at 12.50% had a higher mineral ization rate than other experimental groups (P lt; 0.05). Immunofluorescence staining for osteocalcin: at 7 days after culture, the experimental groups were positive for the staining with yellow fluorescence in cytoplasm, and the result of the control group was negative. RT-PCR detection: no obvious changes of the gene expression were noted at 4, 12, and 24 hoursafter culture in the control group; the gene expression in all the experimental groups was significant superior to that of control group, especially at 12 hours, and the expression in the experimental group at 12.50% was the highest. Conclusion PRP can obviously promote the osteogenic differentiation of SMSCs cultured in vitro in a concentration-dependent manner, and the 12.50% is proved to be the ideal concentration.
To evaluate the cl inical results of less invasive stabil ization system (LISS) for femur supercondylar and intercondylar fractures. Methods From March 2004 to November 2005, 47 patients with 49 intercondylar and supercondylar fractures were treated. Of all the patients, there were 34 males and 13 females with an average of 39.7 years (range 19-56 years). The locations were left side in 21 cases and right side in 28 cases. Fracture was caused by traffic accident in 31 cases, fall ing in 8 cases, violence in 6 cases and others in 2 cases. Forty-nine fractures included 14 intercondylar fractures, 21supercondylar fractures and 14 intercondylar and supercondylar fractures; 32 closed fractures and 17 open fractures. According to the AO typing, there were 6 type 33-A1, 8 type 33-A2 , 10 type 33-A3, 7 type 33-C1, 3 type 33-C2 and 15 type 33-C3. The disease course was 30 minutes to 6 days. Articular surface reduction was first performed, then the LISS plate was inserted via two incisions and locking screws were used later. Results The average operation time was 126 minutes (range 48-248 minutes). The blood loss was 180 mL(range 60-1 200 mL). The average follow-up time was 18.6 months (range 12-23 months). There were 4 patients with AP angular deformity and 5 patients with lateral angular deformity (range 2-5°). External rotation deformity was presented in 2 patients. There were no plate breakage, screw loosen and fixation failure. Average bone union time was 5.6 months (range 3-8 months) without infection case. Six cases were treated with il iac bone transplantation for delayed union. Conclusion LISS is one kind of effective treatment to femoral intercondylar and supercondylar fractures.
ObjectiveTo assess the mid-term effecitveness of femoroacetabular impingement (FAI) treated by surgical hip dislocation.MethodsBetween April 2014 and August 2015, 15 patients (16 hips) with FAI were enrolled in the study and treated with surgical hip dislocation. There were 12 males and 3 females with an average age of 36.6 years (range, 22-59 years). Among them, 14 cases involved in unilateral hip and 1 in bilateral hips. The mean disease duration was 28 months (range, 4-120 months). Preoperative visual analogue scale (VAS) score and Harris hip score were 7.9±1.0 and 44.1±9.3, respectively.ResultsAll incisions healed by first intention. There was no main complication, such as vessel and nerve injuries and infection. All 15 patients were followed up 30-46 months (mean, 39.5 months). The VAS score was 2.5±1.6 at 3 months and 0.5±0.7 at last follow-up. The Harris score was 85.5±4.4 at 3 months and 95.6±3.9 at last follow-up. There were significant differences in two scores between pre- and post-operation and between 3 months and last follow-up (P<0.05). The satisfaction rate of hip function was 93.8% (15/16) at last follow-up. X-ray examination showed that there was no sign of impingment at the femoral head and neck and acetabulum forming site of the affected hip joint, and no complication such as loosening of internal fixator, nonunion of osteotomy, avascular necrosis of femoral head, and heterotopic ossification occurred during follow-up.ConclusionThe surgical hip dislocation is a safe and effective way to treat FAI in the mid-term follow-up, which can repair torn labrum and trim acetabulum and femoral neck.
ObjectiveTo review and evaluate the basic principles and advantages of orthopedic robot-assisted technology, research progress, clinical applications, and limitations in the field of traumatic orthopedics, especially in fracture reduction robots. Methods An extensive review of research literature on the principles of robot-assisted technology and fracture reduction robots was conducted to analyze the technical advantages and clinical efficacy and shortcomings, and to discuss the future development trends in this field. Results Orthopedic surgical robots can assist orthopedists in intuitive preoperative planning, precise intraoperative control, and minimally invasive operations. It greatly expands the ability of doctors to evaluate and treat orthopedic trauma. Trauma orthopedic surgery robot has achieved a breakthrough from basic research to clinical application, and the preliminary results show that the technology can significantly improve surgical precision and reduce surgical trauma. However, there are still problems such as insufficient evaluation of effectiveness, limited means of technology realization, and narrow clinical indications that need to be solved. ConclusionRobot-assisted technology has a broad application prospect in traumatic orthopedics, but the current development is still in the initial stage. It is necessary to strengthen the cooperative medical-industrial research, the construction of doctors’ communication platform, standardized training and data sharing in order to continuously promote the development of robot-assisted technology in traumatic orthopedics and better play its clinical application value.