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Reduction of Broach Rotation for Versys Fibermetal Tapered Stem during the Femoral Canal Shaping.

Youngbae PARK ; Deuk Soo HWANG ; Kyeongbin LIM ; Yong San YOON

Journal of Korean Orthopaedic Research Society.2007;10(2):83-89.

PURPOSE: Inaccurate femoral canal shaping can result in post-operative complications in hip arthroplasty. We addressed the amount of broach rotation during shaping of the femoral canal and compared it with respect to newly designed broaches which were modified to minimize the rotation. MATERIALS AND METHOD: we designed the broaches that had canal guide which restricts the broach motion such that it is always aligned with the femoral axis while the broach machines the metaphyseal bone. Conventional broaches and the modified broach applied to 5 pair of fresh-frozen cadaver femurs and its spatial motion was measured with motion tracker. Rotations in coronal, saggital and frontal plane during the final 10 mm of broach advance were measured. RESULTS: 2.4..of axial rotation was occurred during final 10 mm advance of broach in the conventional method, which was the largest component of the rotation. Rotation of the broach during machining was decreased to 37% (p=0.075) and 25% (p=0.042) in the sagittal plane and coronal plane, respectively, by proposed method. CONCLUSION: The canal guide in the proposed method significantly reduced the rotation of the broach without any extra incision or measurement devices, resulting in increased accuracy in the femoral canal shaping.
Arthroplasty ; Axis, Cervical Vertebra ; Cadaver ; Femur ; Hip

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The Change of Stress Distribution according to Fixation Devices and Osteotomy Methods in High Tibial Osteotomy.

Se Hyun CHO ; Sung Hwan AN ; Hyung Bin PARK ; Soon Taek JEONG ; Sun Chul HWANG

Journal of Korean Orthopaedic Research Society.2007;10(2):76-82.

PURPOSE: To evaluate the necessity of lateral translation and the primary stability of the fixation devices in a closed wedge high tibial osteotomy. MATERIALS AND METHODS: The authors studied four pairs of high tibial osteotomy: Pair I, lateral translation with blade plate fixation; Pair II, lateral translation with staple fixation; Pair III, no translation with blade plate fixation; Pair IV, no translation with staple fixation. Four models of bovine tibia were taken and analyzed for stress distribution at the osteotomy site under axial loading. After axial loading, information recorded in pressure sensitive film was transformed to image file. After, by using image analysis software, the mean stress value and maximum stress value was calculated. RESULTS: The mean stress calculated at each osteotomy site is as follows; 3.89 MPa in the first pair; 4.55 MPa in the second pair; 4.62 MPa in the third pair; and 4.67 MPa in the fourth pair. In Group I, stress value was distributed evenly. But in group II, III, IV, the stress was concentrated at posteromedial area of the osteotomy site. CONCLUSION: The primary in the high tibial osteotomy was dependent more on the rigid fixation than on the continuity of the medial cortex. The pairs on which blade plate fixation was used more stable than the pairs on which staple fixation was used regardless of lateral translation.
Osteotomy* ; Tibia

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Cross-talk between Integrin and SMAD Signal Pathway in Articular Chondrocyte.

Soo Bong HAHN ; Min Sung PARK ; Yun Hee KIM ; Jin Woo LEE

Journal of Korean Orthopaedic Research Society.2007;10(2):65-75.

PURPOSE: Identifying the signal cross-talk between integrin signaling cascade and TGF-beta 1 signaling cascade in articular chondrocytes. MATERIALS AND METHODS: To analyze integrin or TGF-beta 1 mediated signaling pathways from extracellular stimuli, type II collagen was coated on the cell culture plate and TGF-beta 1 was added to cell culture media. Chondrocytes were cultured in the conditioned media with each or both stimuli. Altered activation of signaling proteins detected with western blot technique. RESULTS: More rapid attachment of cells was observed in the type II collagen coated group than non-coated group. The phosphorylated SMAD 2 and 3 were expressed in the type II collagen coated group and synergistically up-regulated phosphorylation in the co-treated group. The phosphorylated FAK at tyrosine 925 was activated by TGF-beta 1 treatment and synergistically up-regulated by both stimuli. But there was no meaningfully changed phosphorylation of extracellular signal regulated protein kinase (ERK) 1/2 and p38, as known downstream molecules of FAK cascade. CONCLUSION: This result means that SMAD 2, SMAD 3 and tyrosine 925 of FAK are involved in this signal cross-talking in articular chondrocytes.
Blotting, Western ; Cell Culture Techniques ; Chondrocytes* ; Collagen Type II ; Culture Media, Conditioned ; Phosphorylation ; Protein Kinases ; Signal Transduction* ; Transforming Growth Factor beta ; Tyrosine

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The Effect of Human Joint Fluid in the Surviviorship and Proliferation of Bone-Marrow Derived Progenitor Cell.

Kyu Bum SEO ; Dong Kee JUNG ; Sang Rim KIM ; Kwang Bok LEE

Journal of Korean Orthopaedic Research Society.2007;10(2):56-64.

PURPOSE: To investigate the effect of human joint fluid media on the survival and proliferation of bone marrow derived precusor cell, and to provide the basic data of the intraarticular injection with scaffold-free progenitor cell in advanced degenerative osteoarthritis (OA). MATERIALS AND METHODS: We obtained the joint fluid and bone marrow from 15 patients who had total knee arthroplasty due to degenerative OA, and isolated the mesenchymal progenitor cells (MPCs) from bone marrow by washing and ten times subculture. We devided the control and experiment groups according to the addition of joint fluid at various ratios (1/100, 1/10, 1, 10, 100, 1000 microliter), and statistically analyzed the numbers of mesenchymal progenitor cell proliferated according to the culture period. RESULTS: The experiments using joint fluid without centrifuge showed the increase of MPCs as the culture poriod was extended and was independent to the existence of fetal bovine serum, the dose dependent pattern in the increase of MPCs in proportion to the dose of joint fluid, and statistically significant increase MPCs in 10, 100, 1000 microliter of serum contained groups, 1000 microliter of serum-free groups (p=0.039, p=0.017, p=0.077, p=0.004). The experiments using joint fluid with centrifuge showed the increase of MPCs as the culture period was extended and was independent of fetal bovine serum, and the dose dependent pattern in the increase of MPCs in proportion to the dose of joint fluid, and statistically significant increase MPCs in 1000 microliter of both serum contained and serum-free groups (p=0.006, p=0.024). CONCLUSION: MSCs not only can survive, but also proliferate in human joint fluid. The rate of proliferaton is increased faster by the adding of joint fluid than only using common media in cell culture. And the experiment shows the dose dependent pattern in the increase of MPCs in proportion to the dose of joint fluid.
Arthroplasty ; Bone Marrow ; Cell Culture Techniques ; Humans* ; Injections, Intra-Articular ; Joints* ; Knee ; Mesenchymal Stromal Cells ; Osteoarthritis ; Stem Cells*

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The Effect of a Fibirn-Collagen Sponge Scaffold on Osteogenic Differentiation of Rabbit Mesenchymal Stem Cells.

Young Chang KIM ; Young Il YANG ; Ji Yeon SEO ; Jung Han KIM ; Sang Woo KIM ; Seung Suk SEO

Journal of Korean Orthopaedic Research Society.2007;10(2):45-55.

PURPOSE: To investigate whether collagen sponge with or without fibrin reinforcement can be used as a biocompatible scaffold for in vitro osteogenic differentiation of bone marrow-derived mesenchymal stem cells of rabbit (rBMSC). MATERIALS AND METHODS: rBMSC were isolated and expanded from the femur of New Zealand White rabbit. The nucleated cells were separated from red blood cells by Percoll(R) -gradient centrifuge. The porous collagen sponge with pore size 150~250 mm (Collacote(R), Sulzer Dental Inc. Carlsbad, CA) was used. rBMSC were seeded at a density of 2x10(5)/cm2 on two types of scaffold. In this study, type I scaffold consisted of collagen sponge without fibrin, while type II scaffold consisted of collagen sponge with fibrin. Fibrin composition used in this experiment was 0.5% fibrinogen and 0.5 unit/ml thrombin solution (Tisseel kit(R), Baxter AG, Vienna, Austria). After rBMSC seeded into scaffold, cells were induced into osteogenic differentiation by dexamethasone, -glycerol phosphate, and ascorbic acid. The contraction rate of the scaffold and pore size were measured by photoplanimetric method. Cell-mediated contraction rate was calculated by after normalization by DNA content in scaffold. The alkaline phosphatase activity and calcium content were measured by colorimetric method. The degree of mineralization and cellular distribution within the scaffold were analyzed by histomorphologic method. RESULTS: The contraction rate of scaffold was similar during the first 3 days in culture. The type II scaffold was contracted less than 20 % and type I scaffolds was contracted more than 20 %. After 7 days in culture, the type I scaffold was markedly decreased in size than type II scaffold (p<0.05). Type II scaffold showed more resistance to cell-mediated contraction than type I scaffold (p<0.05). The pore size of scaffold was markedly decreased on 14 days after culture in type I scaffold, but structure and size of pore in type II scaffold were well preserved. The degree of osteogenic differentiation of rBMSC did not showed any difference in both types of scaffold biochemically. However, cells were more evenly distributed and mineral intensity was more increased in type II scaffold than those of type I scaffold. CONCLUSION: The fibrin reinforcement into collagen sponges could prevent cell-mediated contraction of scaffold and could support in vitro osteogenic differentiation of rBMSC.
Alkaline Phosphatase ; Ascorbic Acid ; Calcium ; Collagen ; Dexamethasone ; DNA ; Erythrocytes ; Femur ; Fibrin ; Fibrinogen ; Mesenchymal Stromal Cells* ; New Zealand ; Porifera* ; Thrombin

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Optimal Orientation of the Femoral Tunnel in Reconstruction of Posterior Cruciate Ligament.

Byoung Hyun MIN ; Keun Soo SOHN ; Shin Young KANG

Journal of Korean Orthopaedic Research Society.2000;3(1):43-49.

PURPOSE: We investigated the optimal orientation of femoral tunnel in PCL reconstruction. MATERIALS AND METHODS: Five cadaver knees were used for this study. We made the tibial tunnel at the center of foot-print of posterior cruciate ligament, at an angle of 45o to the long axis of the tibia using the Kirschner wire. The femoral tunnel was made 11mm posterior to the articular cartilage margin of medial femoral condyle. The orientation of the femoral tunnel was made on the expolated line between two points, namely the placement of the femoral tunnel on lateral wall of medial femoral condyle and the opening of the tibial tunnel in full extension of knee. We measured the angles between the tunnel and wire on roentgenogram which passed through the femoral and tibial tunnel. RESULT: On the anteroposterior view, the angle of the graft to the long axis of the femur became acute during flexion. The angle of the graft to the long axis of the femur on the coronal plane changed from 12.6o to 154.9o with flexion from 0o to 105o. The angle of the graft to the long axis of the femur on sagittal plane changed from 137.0o to 45.1o with flexion from 0o to 105o. These results suggest that optimal graft-tunnel divergence (GTD) is obtained when the angle of graft to the long axis of the femur are 83.8o on the coronal plane and about 91o on the sagittal plane. CONCLUSION: To obtain optimal orientation of the femoral tunnel, the opening of the femoral tunnel should be located as near as possible to the margin of the articular cartilage of the medial femoral condyle.
Axis, Cervical Vertebra ; Cadaver ; Cartilage, Articular ; Femur ; Knee ; Posterior Cruciate Ligament* ; Tibia ; Transplants

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The Effect of Fluid Flow Induced Shear Stress on the Prostaglandin E2 and Nitric Oxide Production of Osteoblast.

Jun Weon CHOI ; Choon Sung LEE ; Jae Suk CHANG ; Soo Sung PARK ; Ki Dae KWON ; Jung Hwa KIM

Journal of Korean Orthopaedic Research Society.2000;3(1):36-42.

It has been generally known that bone tissue responds to the mechanical stress with an adaptative change in the mass and the structure. Recently, the signal transduction pathways involved in fluid flow have been reported, and several mechanotransduction products were suggested. This study was designed to verify the prostaglandin E2(PGE2) and nitric oxide(NO) involving as the biomechanical transducing material of the osteoblast to the fluid flow stimuli. We have checked changes in PGE2 and NO production after applying fluid flow-induced shearing stress to the primary high-density monolayer cultures of chicken fetus osteoblasts. PGE2 and nitrite which is the stable end-product of nitric oxide oxidationas are measured spectrophotometrically, the former using enzyme immunoassay system and the latter using Griess reaction. As a result, PGE2 and NO production by osteoblast was increased after applying the fluid flow-induced shear stress: PGE2 production was increased accumulatively in response to the duration of stress. There were no significant changes in NO production after 6 hours of the stress, but production of NO was markedly increased only after 24 hours. From the above findings, it was confirmed that osteoblast increased the production of PGE2 and NO in respond to the fluid flow-induced shearing stress and that PGE2 production is an earlier response to mechanical stimuli than the production of NO.
Bone and Bones ; Chickens ; Dinoprostone* ; Fetus ; Immunoenzyme Techniques ; Nitric Oxide* ; Osteoblasts* ; Signal Transduction ; Stress, Mechanical

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Effects of human serum and TGF-beta on proliferation and redifferentiation of human articular chondrocytes.

Byoung Hyun MIN ; Jeong Im WOO ; Kyeung Sook CHOI ; Jeong Mo LEE ; So Ra PARK

Journal of Korean Orthopaedic Research Society.2000;3(1):25-35.

In monolayer culture, articular chondrocytes are well known to proliferate and dedifferentiate by seum and transforming growth factor-beta(TGF-beta). These dedifferentiated cells regain the ability to express type II collagen in alginate bead culture. In this study, the effects of human serum and TGF-beta on the proliferation and phenotypical change of human chondrocytes were examined in both monolayer and alginate bead culture. Proliferation was measured by 3H-thymidine incorporation and cell counting, chondrocytic phenotype by Western blot analysis of type II collagen expression, and proteoglycan synthesis by dimethylmethylene blue assay. Both human serum and TGF-beta synergistically increased the proliferation of chondrocytes in monolayer culture. Human serum had effect to maintain the type II collagen expression, even with enhanced level, in monolayer culture and showed redifferentiation in alginate culture, similar to fetal bovine serum control. TGF-beta enhanced the production of proteoglycan in monolayer culture. In conclusion, the present study demonstrated that human serum and TGF-beta could be used as potent additives to increase chondrocyte proliferation and maintain its phenotype.
Blotting, Western ; Cell Count ; Chondrocytes* ; Collagen Type II ; Humans* ; Phenotype ; Proteoglycans ; Transforming Growth Factor beta*

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The effects of sonication on human osteoarthritis cartilage in ex vivo tissue culture.

Byoung Hyun MIN ; Jeong Im WOO ; Hong Sik CHO ; Jae Young RHO ; Jeong Mo LEE ; So Ra PARK

Journal of Korean Orthopaedic Research Society.2000;3(1):14-24.

This study was initiated to investigate the effect of ultrasound(US) stimulation on therapeutic effects on human osteoarthritic cartilage repair. Cartilage explants from human osteoarthritic knee were sonicated for 10 minutes every day using continuous wave at frequency 1 MHz US signals with spatial and temporal average intensities of 0, 40, 200, 500 and 700mW/cm2. One group of explants was exposed to sham ultrasound as a control. After 1 week of culture, the intensity-dependent effects of US on DNA, proteoglycan (PG) and collagen synthesis were measured by 3H-thymidine, 35S-sulfate, 3H-proline incorporation, respectively. The expression of PG and type II collagen released into medium were measured by DMB (dimethylmethylene blue) method and western blot analysis. Safranin O/fast green and immunohistochemical staining with anti-collagen type II antibody were performed using the serial sections of cartilage explants. The histochemical examination showed that the expression of PG at the pericellular area in the deep layer increased continuously up to 700mW/cm2. In contrast, the depth of the superficial layer significantly decreased after treatment of sonication at 500 and 700mW/cm2. The expression of PG and type II collagen assessed by the isotope incorporation was significantly enhanced to the level up to 140%, 120% respectively, although US had no stimulatory effect on cell proliferation. These results suggest that optimum intensity of US for the effective expression of extracellular matrix in osteoarthritic cartilage may be around 200mW/cm2. In conclusion, our study suggests the possibilities that sonication may be therapeutically utilized for the repair of human osteoarthritic cartilage.
Blotting, Western ; Cartilage* ; Cell Proliferation ; Collagen ; Collagen Type II ; DNA ; Extracellular Matrix ; Humans* ; Knee ; Osteoarthritis* ; Proteoglycans ; Sonication* ; Ultrasonography

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Influence of synovial Joint Fluid of Rheumatic and Osteoarthritic on Chondrocyte in vitro.

Jin Hyung SUNG ; Jae Duk RYU ; Young Hun KIM ; Kyu Sik JUNG ; Weon Yoo KIM ; Hee Ju HWANG ; Jin Young KIM

Journal of Korean Orthopaedic Research Society.2000;3(1):5-13.

PURPOSE: Earlier work suggested that two cytokines inhibit synthesis of type II collagen and of aggrecans by chondrocytes and they depress chondrocyte proliferation, but there was little report how the chondrocyte is modulated by culture conditions such as the joint fluids of the rheumatoid arthritis and that of the osteoarthritis. The purpose of this investigation was to determine whether RA(rheumatic arthritis) or OA(Osteoarthritis) joint fluid influence proliferation and differentiation in cultured human articular chondrocytes. MATERIALS AND METHODS: Human chondrocytes were cultured in a standard media (DMEM and 10% FBS), RA and OA joint fluid were added to media at the concentration of 20, 40 and 60% respectively for 1, 3 and 6days. 3H-thymidine and 3H-uridine uptake of cultured chondrocytes were measured as indicators of cell proliferation. Synthesis of human collagen type I, II was estimated by the RT-PCR procedures. RESULTS: 3H-thymidine uptake of the chondrocyte cultured in RA SF(synovial fluid) medium at 2 and 4 days; its uptake in the group treated by RA SF 20%, 40%, 60% increased more significantly than that in control group (P<0.05). 3H-thyrnidine uptake of the chondrocyte cultured in OA SF medium at 2 days; its uptake of the group treated in OA SF 60%(P<0.05), but there was no significant difference of its uptake between in the control group & the group treated in OA SF 20%, 40% (P<0.05). 3H-thymidine uptake of the chondrocyte cultured in OA SF medium at 4 days; there was no significant difference of its uptake between control group & OASF treated group(P>0.05). 3H-uridine uptake of the chondrocyte cultured in RA SF medium at 2 and 4 days; its uptake of the group treated by RA SF 20%, 40%, 60% increased more significantly than that of control group (P<0.05). 3H-uridine uptake of the chondrocyte cultured in OA SF medium at 2 days; its uptake of the group treated by OA SF 20%, 40%, 60% increased more significantly than that of control group (P<0.05). 3H-uridine uptake of the chondrocyte cultured in OA SF medium at 4 days; its uptake of the group treated by OA SF 20%, 60% increased more significantly than that of control group (P<0.05), but there was no significant difference of its uptake between control group & OA SF 40% treated group(P>0.05). Human type I collagen mRNA expressions of the chondrocyte markedly increased in RA and OA SF mixed groups. Human type II collagen mRNA expressions of the chondrocyte were reduced in RA and OA SF mixed groups, especially RA SF 60% mixed groups. CONCLUSION: RA and OA SF increased the proliferation of the articular chondrocyte, but its decreased the differentiation of the chondrocyte. RA and OA SF may change the phenotype of the articular chondrocyte and this phenomenon was more outstanding in RA SF.
Aggrecans ; Arthritis, Rheumatoid ; Cell Proliferation ; Chondrocytes* ; Collagen Type I ; Collagen Type II ; Cytokines ; Humans ; Joints* ; Osteoarthritis ; Phenotype ; RNA, Messenger

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