Objective To compare the curative effects of Orthofix extended external fixator versus Ilizarov external fixator in the treatment of bone defects following post-traumatic tibial osteomyelitis.Methods During the period from January,1996 through January,2015,129 patients were selected for a retrospective analysis.They were 106 males and 23 females,aged from 14 to 60 years (average,36.5 years).Orthofix extended external fixator was used in 43 of them and Ilizarov external fixator in 86.Bone transportation started 7 to 10 dlays after surgery at a speed of 1 mm/d and was completed in 4 turns.The 2 groups were compared in terms of mineralization time for the extended bone,hone lengthening length,fixation time,union indexes,Activity of Daily Living Scale (ADL),Self-Rating Anxiety Scale (SAS),knee range of motion (ROM) and complications.Results The patients were followed up for 13 to 216 months (average,96 months).Orthofix group and llizarov group were not significantly different in mineralization time for the extended bone,bone lengthening length,fixation time or union indexes (P ＞ 0.05).In Orthofix group and Ilizarov group respectively,there were 6 versus 73 patients with mildly limited self-living abilities and 37 versus 13 patients with little limited self-living abilities by ADL scores;there were 33 versus 16 cases of mild anxiety,8 versus 63 cases of moderate anxiety and 2 versus 7 cases of grave anxiety by SAS scores;there were 39 versus 10 cases of limited knee ROM of 15° to 30° and 4 versus 76 cases of limited knee ROM of 30° to 60°.There were significant differences between the 2 groups in the above indexes (P ＜ 0.05).The rate of complications in Orthofix treatment group(79.1％,34/43) was significantly lower than in Ilizarov group (88.4％,76/86) (P ＜ 0.05).Conclusions In the treatment of bone defects following post-traumatic tibial osteomyelitis,the curative effects of Orthofix extended external fixator are similar to those of Ilizarov external fixator.However,they may have different effects on the life and psychology of the patients in the long run.Therefore,specific therapeutic scheme should be decided in consideration of the advantages of the 2 treatments as well as the conditions of specific patients.

OBJECTIVETo explore the therapeutic effect of osteogenically induced adipose-derived stem cells (ADSCs) on vascular deprivation-induced osteonecrosis of the femoral head (ONFH) in rabbit model.

METHODSVascular deprivation-induced ONFH was established by intramuscular injection of methylpre- dnisolone, and vascular occlusion of the capital femoral epiphysis by electrocoagulation in adult New Zealand white rabbits. Eight weeks after the establishment of vascular deprivation-induced ONFH, animals were randomly divided into three equal groups. In Group A (control), no therapy was given. In Group B, core decompression was performed by drilling a hole (1.2 mm in diameter) from the outer cortex 2.5 cm distal to the proximal end of the greater trochanter. In Group C, 1 multiply 10(7) osteogenically induced ADSCs were resuspended in 0.5 ml PBS, and then injected directly into the femoral head. Femoral head specimens were obtained at postoperative 8 weeks. The bone formation and three-dimensional microstructure of the femoral head was evaluated by micro-computed tomography scans. Immunohistochemical analysis was performed to detect the expression of osteocalcin. Angiogenesis and repair of the femoral head were observed histologically.

RESULTSIn trabecular bone at the proximal femur region, the trabecular volume was higher in Group C (130.70 mm(3)+/-4.33 mm(3)) than that in Groups A (101.07 mm(3)+/-7.76 mm(3)) and B (107.89 mm(3)+/-8.68 mm(3), P less than 0.01). Bone volume was significantly increased in Group C (40.09 mm(3)+/-6.35 mm(3)) than in Groups A (29.65 mm(3)+/-4.61 mm(3)) and B (31.80 mm(3)+/-4.01 mm(3), P less than 0.01). The trabecular number was higher in Groups C (1.58+/-0.25) than other two groups (1.15+/-0.18, 1.16+/-0.21, P less than 0.01). Bone mineral density showed statistically significant difference between Groups C and A or B (375.38+/-23.06) mg HA/ccm, vs (313.73+/-19.30) mg HA/ccm and (316.09+/-16.45) mg HA/ccm, P less than 0.01). Histological examination indicated that there was more new bone formation in Group C than in other groups.

CONCLUSIONTreatment with autologous osteogeni-cally induced ADSCs transplantation results in an enhanced osteogenesis and microstructure of the vascular deprivation-induced osteonecrosis in rabbits.

Animals ; Femur Head ; Femur Head Necrosis ; Osteogenesis ; Rabbits ; Stem Cells ; X-Ray Microtomography