BACKGROUND: Stem cell is currently playing a major role in the treatment of number of incurable diseases via transplantation therapy. The objective of this study was to determine the osteogenic potential of allogenic and xenogenic bone-derived MSC seeded on a hydroxyapatite (HA/TCP) bioceramic construct in critical size bone defect (CSD) in rabbits. METHODS: A 15 mm long radial osteotomy was performed unilaterally in thirty-six rabbits divided equally in six groups. Bone defects were filled with bioscaffold seeded with autologous, allogenic, ovine, canine BMSCs and cell free bioscaffold block in groups A, B, C, D and E respectively. An empty defect served as the control group. RESULTS: The radiological, histological and SEM observations depicted better and early signs of new bone formation and bridging bone/implant interfaces in the animals of group A followed by B. Both xenogenous MSC-HA/TCP construct also accelerated the healing of critical sized bone defect. There was no sign of any inflammatory reaction in the xenogenic composite scaffold group of animals confirmed their well acceptance by the host body. CONCLUSION: In vivo experiments in rabbit CSD model confirmed that autogenous, allogenous and xenogenous BMSC seeded on bioscaffold promoted faster healing of critical size defects. Hence, we may suggest that BMSCs are suitable for bone formation in fracture healing and non-union.
Animals ; Durapatite ; Fracture Healing ; Mesenchymal Stromal Cells* ; Osteogenesis ; Osteotomy ; Rabbits ; Regeneration* ; Stem Cells

Introduction:The key important factor influencing the outcomes following rehabilitation is the surgical approach involved in Total Knee Replacement (TKR). Most studies have analysed the functional outcome in comparing the approaches on surgical perspective rather on post-operative therapeutic interventions. The current study was to analyse the effects of structured TKR rehabilitation programme on the quality of life and joint specific outcomes between two different surgical approaches. Materials and Methods: In this double-blind randomised controlled trial, participants were randomly allocated to one of two groups: Group 1- those who underwent medial parapatellar approach and Group 2- those who underwent mid-vastus approach. Both groups received three-phase structured rehabilitation protocol for 12 weeks. The outcome measures of SF-36, knee mobility, isometric knee musculature strength and six-minute walk distance were measured at baseline, on discharge and at review after three months. Results: The quality of life and joint specific outcome scores were better in mid-vastus approach than the popular medial parapatellar approach. The outcomes of knee flexion mobility (p=0.04), knee extension mobility (p=0.03), isometric muscle strength of quadriceps (p=0.001), isometric muscle strength of hamstrings (p=0.03), six-minute walk distance (p=0.001) and Physical Cumulative Scores (PCS) (p=0.03) were found to exhibit significant improvements at three months follow up. Conclusion: The mid-vastus approach was found to exhibit better improvements following structured rehabilitation care, in physical summary scores of quality of life and joint specific outcomes than medial parapatellar approach.

PURPOSE: The treatment and outcome of tibial stress fractures concomitant with knee osteoarthritis (OA) are complicated. The aim of this study was to evaluate the functional and radiological outcome of total knee arthroplasty with long tibial stem as a treatment for patients having knee OA and tibial stress fracture. METHODS: Patients who were diagnosed to have proximal tibia stress fracture along with knee OA at our institution between June 2013 and November 2018 were included in our study. All patients underwent total knee arthroplasty with long tibial stem. Preoperative and postoperative functional assessments were done according to range of movement of the knee joint, knee society score and knee injury and OA outcome score. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables. RESULTS: Twelve patients were included in the study. All patients were found to have stress fractures in the proximal half of tibia and extra-arthrosis. Four patients had non-union/delayed union, and 8 patients had acute fractures. The average preoperative range of movement was 88.1°, which improved to 116.3° at 3 months following surgery. It was found that the fracture has healed in all cases. Mean knee society score improved from 32.9 preoperatively to 89.3 at 1 year follow-up. Knee injury and OA outcome score improved from a mean score of 28.3 preoperatively to 81.1 at 1 year follow-up. CONCLUSION Stress fractures can occur in the proximal tibia in patients with knee OA. Total knee arthroplasty with tibial stem provides a suitable solution for both conditions. Additional plating or bone graft is unlikely to be required.
Humans ; Arthroplasty, Replacement, Knee/adverse effects* ; Osteoarthritis, Knee/surgery* ; Tibia/surgery* ; Fractures, Stress/surgery* ; Tibial Fractures ; Knee Joint ; Knee Injuries/surgery* ; Treatment Outcome