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 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 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 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 recent advances in the application of graphene oxide (GO) for bone tissue engineering. Methods The latest literature at home and abroad on the GO used in the bone regeneration and repair was reviewed, including general properties of GO, degradation performance, biocompatibility, and application in bone tissue engineering. Results GO has an abundance of oxygen-containing functionalities, high surface area, and good biocompatibility. In addition, it can promote stem cell adhesion, proliferation, and differentiation. Moreover, GO has many advantages in the construction of new composite scaffolds and improvement of the performance of traditional scaffolds. Conclusion GO has been a hot topic in the field of bone tissue engineering due to its excellent physical and chemical properties. And many problems still need to be solved.
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).
Objective To review the recent research progress on shoulder arthroplasty, and to predict future research direction. Methods Recent l iterature concerned the shoulder arthroplasty was reviewed and analyzed in terms of appl iedanatomy, designs of prosthesis, patterns of prosthesis and fixation ways of prosthesis. Results The shoulder arthroplastyrepresented the treatments of choice for the patients with end-stage shoulder diseases and traumatic diseases. It could provide good and stable results in pain rel ief and functional outcomes. Conclusion There are still many controversies about the patterns of prosthesis, fixation ways and kinds of materials in cl inical practice. Currently, the main research is about the designs of the glenoid prosthesis and the cl inical practice in young patients.
Objective Based on images of pelvic CT three-dimensional reconstruction, to establish three-dimensional coordinate system of pelvis and investigate the three-axis displacement classification of pelvic fracture and its reduction principles. Methods Between June 2015 and May 2016, 21 cases of normal pelvic CT data were included in the study, and the mean pelvic three-dimensional model was established. The pelvic three-dimensional axis was established by defining the origin as the midpoint of the anterior superior iliac spine. Based on this coordinate system, a three-axis displacement classification of pelvic fracture were built. To assess the clinical guidance value of the three-axis classification, 55 cases (29 males and 26 females, aged 11-66 years with an average of 35.6 years) of pelvic fractures were analyzed by this classification, and replaced and fixed according to the principles of the reverse reduction. Results According to the theory of three-axis, pelvic fractures were divided into x-axis positive displacement/negative displacement, positive rotation/negative rotation; y-axis positive displacement/negative displacement, positive rotation/negative rotation; z-axis positive displacement/negative displacement, positive rotation/negative rotation. The average incision of included patients with pelvic fractures was 7.1 cm. The average reduction time was 12.2 minutes and the average radiation time was 55.3 s. The average time of screw implantation was 27.2 minutes. Postoperative pelvic X-ray films or three-dimensional CT showed all pelvic fracture was reducted well and the screw or plate was implanted correctly. The average intraoperative blood loss was 96.5 mL, the average operation time was 2.1 hours, and the average hospitalization time was 18.7 days. All patients were followed up 6-53 months (mean, 16.7 months). At last follow-up, according to Matta standard by pelvic radiography evaluation, there were excellent in 39 cases, good in 13 cases, and fair in 3 cases, the excellent and good rate was 94.55%. Conclusion Based on three-dimensional coordinate system, three-axis displacement classification of pelvic fracture can illustrate the displacement mode of patient simply and accurately, and can also guide the intraoperative reduction precisely.
ObjectiveTo investigate the effect of graphene oxide (GO)-carboxymethyl chitosan (CMC) hydrogel loaded with interleukin 4 (IL-4) and bone morphogenetic protein 2 (BMP-2) on macrophages M2 type differentiation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs).MethodsGO solution was mixed with CMC, then the phosphate buffered saline (PBS), IL-4, BMP-2, or IL-4+BMP-2 were added to prepare different GO-CMC hydrogel scaffolds with or without different cytokines under crosslinking agents. The characteristics of pure GO-CMC hydrogel were characterized by gross observation, scanning electron microscope (SEM), and Fourier transform infrared spectroscopy (FTIR), and the CMC hydrogel was used as control. The sustained release of GO-CMC hydrogels with different cytokines was also tested. Macrophages were isolated and cultured from female Sprague Dawley rats aged 4-5 weeks, and then cultured with GO-CMC hydrogels with and without different cytokines, respectively. CD206 immunofluorescence staining was used to detect the differentiation of macrophages after 24 hours. The 3rd generation of rats BMSCs were cultured with GO-CMC hydrogels with and without different cytokines respectively for osteogenic induction. The early osteogenesis was observed by alkaline phosphatase (ALP) staining after 10 days, and the late osteogenesis was observed by alizarin red staining after 21 days.ResultsGenerally, GO-CMC hydrogel was brown and translucent. SEM showed that the pore diameter and wall thickness of GO-CMC hydrogel were similar to that of CMC hydrogel, but the inner wall roughness increased. FTIR test showed that CMC polymerized to form hydrogel. In vitro, the sustained release experiments showed that the properties of GO-CMC hydrogels loaded with different cytokines were similar. CD206 immunofluorescence detection showed that GO-CMC hydrogels could induce macrophages differentiation into M2-type. ALP and alizarin red staining showed that GO-CMC hydrogels could induce BMSCs osteogenic differentiation, in which GO-CMC hydrogel loaded with IL-4+BMP-2 showed the most significant effect (P<0.05).ConclusionThe GO-CMC hydrogel loaded with IL-4 and BMP-2 can induce macrophages differentiation into M2-type and enhance the ability of BMSCs with osteogenic differentiation in vitro, which provide a new strategy for bone defect repair and immune regulation.
Objective To establish an effective model of myocardial infarction in black goat so as to provide a safe, convenient and credible model of myocardial infarction for treatment and research. Methods Sixteen black goats were made chronic myocardial infarction by ligation of far end of left anterior descending coronary artery through incision below xiphoidprocess. Electrocardiogram(ECG) and serum myocardial enzymes were investigated before and after occlusion. Echocardiographic measurements were performed, and left coronary artery angiography was performed with digital subtraction angiography (DSA) before infarction and 6 weeks after infarction. The myocardial ultrastructure were observed. Results All goats survived more than 6 weeks. ECG showed ambulatory change, ST-segment elevated half an hour after occlusion and pathologic Q waves 6 weeks after infarction, CK-MB significantly increased. Echocardiographic indexes showed significant decrease of maximal peak A, percent wall thickening(WHT) and ejecting fraction (EF), increase ofend-systolic volume (ESV), end-diastolic volume (EDV), and dilation of left ventricle. DSA showed block or decrease of perfusion of far end of left anterior descending coronary artery. Conclusion It is safe, convenient and credible to establish model of myocardial infarction by ligation of far end of left anterior descending coronary artery through incision below xiphoidprocess in black goat.