1.Bottleneck and development trend of bone xenograft for the treatment of bone defect.
Bao-liang LI ; Lei LIU ; Wen-bo ZHAO ; Fu-jun LUAN ; Qin LI
China Journal of Orthopaedics and Traumatology 2015;28(12):1166-1170
Bone xenograft bone for the treatment of bone defect is one of the current research focus, which has advantages of extensive sources, low cost, simple preparation method. While the process of single bone xenograft bone in repairing bone defect is very long, and the clinical outcome is not satisfactory. The main problems focus on formation of bone and vascularization. Reconstituted bone xenograft combined with cells and xenogenic bone material could promote vascularization and bone fusion in vivo, thus achieve a clinical effect of autogenous bone in repairing bone defect.
Bone Transplantation
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methods
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Bone and Bones
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blood supply
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Humans
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Transplantation, Heterologous
2.Surgical Management of Bone Infection (14 Cases Treated by papineau's Method)
Ik Yull CHANG ; Yung Khee CHUNG ; Won Chang PARK ; Jung Han YOO
The Journal of the Korean Orthopaedic Association 1983;18(2):286-296
Papineau's technique represents an excellent method of dealing with serious bone infections with significant bone and soft tissue loss. The procedure is carried out in three stages: the 1st stage is the excision of infected bone and soft tissue, stabilization of the fracture site, the 2nd stage is the cancellous bone grafting, and the 3rd stage is the skin coverage. During the period from June 1980 to September 1982, our limited experience with 14 cases has been extremely satisfactory; 1. This method is applicable to traumatic osteomyelitis and some cases in which the infection has been blood borne. 2. Successful bone grafting in the presence of infection depends upon; a. complete sequestrectomy and removal of all infected tissue b. an adequate vascular bed for the graft c. no dead space d. sufficient immobilization.
Bone Transplantation
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Immobilization
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Methods
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Osteomyelitis
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Skin
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Transplants
3.Progress of vascularized bone grafting for the treatment of avascular osteonecrosis of the femoral head.
China Journal of Orthopaedics and Traumatology 2008;21(7):556-558
Avascular osteonecrosis of the femoral head is a common disease in orthopedic clinics. If the diagnosis can be made before collapse of the femoral head, the hip joint may probably be preserved by means of core decompression with or without bone grafting, osteotomies, as well as nonvascularized or vascularized bone grafting. Local pedicled bone grafts and free vascularized bone grafts can transfer the vascularized bone grafts into the necrotic area of the femoral head, which not only can replace necrotic bone with healthy bone, but also establish a new source of blood supply to the femoral head. The success rate in patients with different stages of osteonecrosis of femoral head was 80% at 5 years follow up. Free vascularized bone grafting for the treatment of avascular osteonecrosis of the femoral head can obtain a higher success rate.
Bone Transplantation
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methods
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Femur Head Necrosis
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surgery
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Fibula
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transplantation
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Humans
4.Experimental study on subcutaneous bone formation by marrow stromal osteoblast-cancellous bone matrix compound artificial bone.
Kai TAO ; Tianqiu MAO ; Fulin CHEN ; Weidong YANG ; Xiaoming GU ; Shujun CHEN
Chinese Journal of Stomatology 2002;37(1):18-20
OBJECTIVETo investigate the feasibility of using marrow stromal osteoblast (MSO) as bone derived cell and using cancellous bone matrix (CBM) as scaffold for bone tissue engineering, the subcutaneous osteogenesis of MSO-CBM compound artificial bone (MCCAB) was observed in the experiment.
METHODSThe marrow stromal cells of adult New Zealand rabbits cultivated and induced in vitro were used to form MCCAB by mixing, seeding and solidifying methods assisted by alginate. The MCCABs were auto-transplanted subcutaneously into the rabbits for 4 to 8 weeks. The alginate-cancellous bone matrix composites or the cancellous bone matrix alone were implanted as control. The effectiveness of bone formation was assessed by means of roentgenography, histology and computerized histomorphometry.
RESULTSThe osteogenesis of MCCABs was better than that of the alginate-cancellous bone matrix composites and of the cancellous bone matrixes. In the MCCABs, both intramembranous and cartilaginous osteogeneses were seen but the former was obvious. In the control, only slight cartilaginous osteogeneses were seen.
CONCLUSIONSThe osteogeneses of the MCCABs constructed by using tissue engineering method were obvious when transplanted subcutaneously. The MSO and CBM can be used as good bone-derived cell and scaffold material respectively for tissue-engineered bone construction.
Animals ; Bone Marrow Transplantation ; Bone Matrix ; transplantation ; Bone Transplantation ; methods ; Male ; Osteoblasts ; transplantation ; Osteogenesis ; Rabbits ; Tissue Engineering
6.Comparative study of onlay bone graft absorption of outer cortex from mandible and cranium.
Yan-Feng ZHAO ; Ping LU ; Xiao-Nan ZHOU ; Yun-Fei HAO ; Chang-Feng QU ; Hai-Feng LI ; Lai GUI
Chinese Journal of Plastic Surgery 2008;24(4):303-306
OBJECTIVETo investigate the value of application of mandibular outer cortex as bone graft by comparing its bone absorption with cranial outer cortex.
METHODS8 minitype grown-up pigs at the age of 8 - 12 months underwent surgery of taking out the same size (2.5 cm x 1.0 cm) of outer cortex from mandible and craninium. The volume of the outer cortex was measured by volume-displacement method. Then the outer cortex of mandible and cranium were onlay grafted to the each side of the pig snout, respectively. 12 weeks later, 2 pigs were randomly selected for histological examination. The other 6 pigs were killed 24 weeks after surgery for measurement of the bone graft volume and histologic examination.
RESULTSThe bone graft absorption rate was (41 +/- 5)% for mandibular outer cortex and (46 +/- 12)% for cranial outer cortex, showing no significant difference between them (P = 0.51). The histologic examination results also had no marked difference in the bony healing and reforming between the two graft.
CONCLUSIONSMandibular outer cortex is a good donor site for onlay bone graft in craniofacial region.
Animals ; Bone Plates ; Bone Regeneration ; Bone Transplantation ; methods ; Female ; Male ; Mandible ; transplantation ; Skull ; transplantation ; Swine ; Swine, Miniature
7.Selection of allografts for impaction bone grafting for bone defect reconstruction on the acetabular side.
Chinese Medical Journal 2010;123(21):3143-3147
OBJECTIVETo review the choices of allografts for bone defect reconstruction in acetabular revision surgery using the technique of impaction bone grafting.
DATA SOURCESThe data cited in this review were mainly obtained from articles listed in PubMed that were published from January 1993 to July 2009. The search terms were "impaction bone grafting", "particle size", "mechanical property" and "biological behavior".
STUDY SELECTIONArticles relevant to the choices of allografts and their results for bone defect reconstruction on the acetabular side were selected.
RESULTSDifferent choices of allografts, including the particle size, process of irradiation or fat reduction, composition and particle grade, are made to improve the survival rate of a prosthesis in acetabular revision surgery. This review, which compares both mechanical and biological factors, summarizes the experimental and clinical results for different techniques.
CONCLUSIONSFresh frozen cancellous allografts with particle sizes ranging from 7 to 10 mm are a favorable choice for reconstruction of bone defects of American Academy of Orthopedic Surgeons (AAOS) types II (cavitary defect) and III (combined cavitary and segmental defect) on the acetabular side. A fat-reducing procedure with saline or solvent/detergent is controversial. Adding autologous marrow into irradiated allografts, which provides reliable mechanical stability and biological safety, may be a substitute for fresh frozen allografts. Cortical bone can be a supplementary material in cases of insufficiency of cancellous allografts. Cartilage should be excluded from the graft material. Further research is required to demonstrate the best particle grade, and randomized controlled trials in clinical practice are required to obtain more information about the selection of allografts.
Acetabulum ; surgery ; Bone Transplantation ; methods ; Humans ; Reconstructive Surgical Procedures ; methods ; Transplantation, Homologous ; methods
9.Modified Masquelet technique in children.
Chinese Journal of Traumatology 2022;25(6):389-391
Masquelet technique is one of the modalities for the treatment of long bone defect. Using cancellous bone graft to fill the bone defect is always a concern in children due to the small size of their iliac crest and open growth plate. We reported a case of 13-year-old male who presented with gap non-union of middle third of tibia. We applied a modified Masquelet technique by using only the cortical fibular graft instead of cancellous bone to fill the space surrounded by induced membrane. Fibula was used as a nonvascularized strut graft and matched stick graft to achieve complete union. We concluded that nonvascularized fibula grafting is an easy and effective option to fill the bone defect in children in the second stage of Masquelet technique.
Male
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Child
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Humans
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Adolescent
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Fracture Healing
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Bone Transplantation/methods*
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Fibula/transplantation*
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Tibia/surgery*
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Ilium/transplantation*
10.Reconstruction of maxillary defects by distraction osteogenesis of zygoma and free fibula composite flap.
Xue-gang NIU ; Xiao-xian HAN ; Yong HAO
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2007;42(9):703-704
Adult
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Bone Transplantation
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Fibula
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transplantation
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Humans
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Male
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Maxilla
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surgery
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Osteogenesis, Distraction
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methods
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Surgical Flaps
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Zygoma
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transplantation