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.
Cell sheet technology refers to the preparation of cells into thin sheets, which retains a large amount of extracellular matrix, cell-cell junctions, and has a wide range of applications in the repair and regeneration of osteochondral tissues. This paper discusses the types, properties, and construction methods of stem cell sheets, and reviews the current research status of vascularization of stem cell sheets and their composite application with various cytokines and scaffolding materials for bone and cartilage repair, with the aim of exploring the direction of the further development of stem cell sheets in the field of bone and cartilage.
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 To review the application of urine derived stem cells (USCs) in regeneration of musculoskeletal system. Methods The original literature about USCs in the regeneration of musculoskeletal system was extensively reviewed and analyzed. Results The source of USCs is noninvasive and extensive. USCs express MSCs surface markers with stable proliferative and multi-directional differentiation capabilities, and are widely used in bone, skin, nerve, and other skeletal and muscle system regeneration fields and show a certain repair capacity. Conclusion USCs from non-invasive sources have a wide application prospect in the regeneration of musculoskeletal system, but the definite biological mechanism of its repair needs further study.
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.
ObjectiveTo systematically review the safety and efficacy of operative versus non-operative treatment for displaced midshaft clavicle fractures.MethodsDatabases including PubMed, The Cochrane Library, EMbase, MEDLINE(Ovid), CBM, CNKI and WanFang Data were searched to collect randomized controlled trials (RCTs) and cohort studies about operation versus non-operation for displaced midshaft clavicle fractures from inception to June 3rd, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by RevMan 5.2 software.ResultsA total of 14 RCTs and 5 prospective cohort studies involving 1 543 patients were included. The results of meta-analysis showed that operation was superior to non-operation in the Constant score (SMD=0.76, 95%CI 0.40 to 1.13, P<0.000 1), DASH score (SMD=–0.49, 95%CI –0.91 to 0.06,P=0.02), nonunion rate (RR=0.17, 95%CI 0.10 to 0.30, P<0.000 01), malunion (RR=0.20, 95%CI 0.12 to 0.33,P<0.000 01) and patients’ satisfaction rate (RR=1.39, 95%CI 1.13to 1.71,P=0.002), respectively.ConclusionCurrent evidence shows that operation could improve the function of the upper limbs, reduce nonunion and malunion, and improve the satisfaction of the patients with midshaft clavicle fractures. Due to the limited quality of the included studies, more large-scale, high-quality studies are required to verify the above conclusion.
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.
Objective To review the recent researches of basic fibroblast growth factor (bFGF) in tendon tissue engineering. Methods Recentoriginal related literature was extensively reviewed and analyzed. Results bFGF played an important role in establishing standard tendon tissue engineering cell lines, inducing the compound and analysis of extracellular matrix, enhancing interactions between cells and extracellular matrix and accelerating tissue engineering materials’ neovascularization. Conclusion The progresses in increasing endogenetic bFGF expression, controlling the release of exogenous bFGF and improving the bioutilization of bFGF has laid foundation for wider use of bFGF in tendon tissue engineering.
Titanium and its alloys have become one of the most widely used implant materials in orthopedics because of their excellent mechanical properties and biocompatibility. Implant-associated infection is the main reason of failure of orthopedic implant surgery. The anti-infection modification of implant surface has received more attention in the field of infection prevention and developed rapidly. This article focuses on the current research status of simple anti-infection surface modifications that make titanium implants possess anti-adhesion, bactericidal activity or antibacterial membrane activity, as well as the research progress of composite functional surface modifications that promote bone integration, osteogenesis or immunomodulatory effects on the basis of anti-infection, so as to provide references for the construction of orthopedic implants with composite functions.
ObjectiveTo evaluate the effect of early preoperative mobilization on the rehabilitation of the elderly patients with hip fractures after operation.MethodsThe clinical data of 16 elderly patients with hip fractures between February 2017 and April 2018 who met the selection criteria was retrospectively analyzed. There were 8 males and 8 females, with an average age of 80.3 years (range, 69-90 years). There were 8 cases of intertrochanteric fracture and 8 cases of femoral neck fracture. The preoperative American Society of Anesthesiologists (ASA) scored 2.94±0.43. There were 3 cases of cardiovascular and cerebrovascular diseases, 6 cases of essential hypertension, 5 cases of respiratory diseases, 3 cases of diabetes, and 2 cases of other system diseases. The time from injury to admission was 4 hours to 14 days with an average of 39.5 hours. On the day of admission or on the first day after admission, the patient started to exercise on the floor underwent analgesia treatment. And the patients were treated with closed reduction (9 cases) or artificial hip arthroplasty (7 cases). The time from admission to operation was 4 to 25 days, with an average of 7.4 days. At the time of admission, after the first ground movement before operation, on the second day after operation, and at last follow-up, the Barthel Index was used to assess the patients’ self-care ability, and Barthel effectiveness (BE) was calculated. The complications were observed and recorded during follow-up.ResultsAll 16 patients underwent operation successfully. The hospital stay was 8 to 24 days, with an average of 14.1 days. All patients were followed up 2.5-16.0 months with an average of 6.5 months. One patient developed postoperative pulmonary infection; the remaining patients had no surgical-related complications. No patient died during the follow-up. The Barthel Index scored 30.63±5.56 at admission, 53.13±9.50 after the first ground movement before operation, 60.63±6.09 on the second day after operation, and 96.25±4.84 at last follow-up. There were significant differences in Barthel Index scores between different time points (P<0.05). The BE was 0.23±0.06 after the first ground movement before operation, 0.30±0.04 on the second day after operation, and 0.66±0.06 at last follow-up. There were significant differences in BE between different time points (P<0.05).ConclusionFor elderly patients with hip fractures who have long waiting time before operation, early preoperative mobilization has a positive impact on patients’ activities of daily living.