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[Dural bone defects and encephalocele associated with chronic otitis media or its surgery].

OBJECTIVES: We investigated the incidence of dural bone defects and encephalocele following radical mastoidectomy or open cavity tympanoplasty. PATIENTS AND METHODS: We retrospectively evaluated 190 operations of 182 patients (97 males, 85 females; mean age 30.6 years; range 9 to 70 years) who underwent radical mastoidectomy (n=89) or open cavity tympanoplasty (n=101). Follow-up examinations included otomicroscopy. Patients with documented dural bone defects on examination or operation records were further evaluated by axial and coronal computed tomography scans of the temporal bone. Those with suspected encephalocele were studied by magnetic resonance imaging. RESULTS: Dural bone defects were detected in 17 patients perioperatively. Of these, 14 defects were associated with chronic otitis media. Three iatrogenic bone defects were induced during obliteration of lateral sinus thrombosis. The mastoid tegmen was the most common site of defects (41%) and the most common etiologic factor was cholesteatoma (84%). Encephalocele was detected in one patient in whom radical mastoidectomy with lateral sinus obliteration was performed due to lateral sinus thrombophlebitis. Encephalomalasia was found nearby the defect area in two patients. CONCLUSION: Dural bone defects associated with chronic otitis media are not rare, the most common cause being cholesteatoma. Repair of dural lacerations requires watertight closure to prevent the occurrence of encephalocele.

Adolescent↗
PubMed2002

[Experimental study on laryngeal cartilage defects repair with differently preserved allogeneic cartilages transplantation].

OBJECTIVE: To study the effect of laryngeal cartilage defect repair with differently preserved allogeneic cartilage grafts. METHODS: 16 New Zealand white rabbits were used and divided into two groups. A 6 mm x 3 mm x 1 mm whole thickness cartilage defect was made in each side of the thyroid cartilage of each rabbit. In group one, the tissue-cultured cartilage grafts, preserved in RPMI-1640 medium for 30 days, were implanted in the left defects and the 4% formaldehyde preserved cartilage grafts for 30 days were implanted in the right defects. Fresh autogenous and allogeneic grafts were seprately transplanted into the right and left thyroid cartilage defects of the other group. Thyroid cartilages were taken out at 7, 30, 180 and 360 days after implantation. Samples were observed by macroscopy and prepared for hematoxylin and eosin (H&E) staining and immunohistochemical examination. RESULTS: No marked changes in form and volume were found in the fresh allografts and RPMI-1640 cultured cartilage grafts. The same as the autogenous cartilages, the defects of thyroid cartilage were successfully repaired by the fresh allografts and RPMI-1640 cultured cartilages. Whereas 4% formaldehyde preserved cartilage grafts were completely absorbed and replaced by cicatricial tissues in the thyroid cartilage defects. Histological observation showed that severe inflammatory cellular infiltration in the formaldehyde preserved cartilages at 7 and 30 days. The cartilage matrixes were resorpted and the chondrocytes showed degenerative change. Finally they were replaced by fibrous connective tissue at 360 days. In the RPMI-1640 cultured and fresh allogeneic cartilages only a little inflammatory cellular infiltration was observed and the cartilage matrixes were almost normal from 7 to 360 days. CONCLUSION: It is clinically feasible to use allogeneic grafts stored in RPMI-1640 medium or fresh allogeneic cartilage grafts for repairing laryngeal cartilage defects.

Animals↗
PubMed2003

[Primary research of repairing large articular cartilage defect by tissue-engineering cartilage in rabbits].

OBJECTIVE: To investigate the feasibility of repairing the whole layer defects of tibial plateau by implanting tissue-engineering cartilage. METHODS: The chondrocytes of 2-week-old rabbits were cultured and transferred to the 3rd generation, and mixed with human placenta collagen-sponge. The whole layer defects of tibial plateau in adult rabbits were repaired by the tissue-engineering cartilage in the experimental group; the defects were left un-repaired in control group. The repair results of defects were observed after 4, 12 and 24 weeks. RESULTS: In experimental group, no obvious new cartilage formation was seen 4 weeks after operation; some new cartilage formation was found after 12 weeks. Histological observation showed that chondrocytes had irregular edge, honeycombing structure and that cartilage cavities formed around the chondrocytes. After 24 weeks, obvious new cartilage formation was found with smooth surface, and linked with the tissues around it, but the defect was not repaired completely; histological results showed that cartilage cavities formed and that cartilage matrix was stained positively for toluidine blue. In control group, the defect was not repaired. CONCLUSION: The tissue-engineering cartilage can repair the defects of the whole layer cartilage of tibial plateau in rabbits, it is feasible to repair the whole layer cartilage defects of tibial plateau by this method.

Animals↗
PubMed2003

[Repair of articular cartilage defect with homogeneous chondrocytes combined with pluronic].

OBJECTIVE: To investigate the possibility of repairing the cartilage cartilage defect with homogeneous chondrocytes combined with Pluronic. METHODS: Homogeneous cartilage chondrocytes of adult New Zealand rabbits were harvested and cultured in vitro, which were marked by 3H-TdR and mixed with Pluronic. The medial or lateral condyle defects were made (phi 4 mm, extending down to the calcified zone) in 20 rabbits. In the experimental group, the right defects were repaired by homogeneous chondrocytes combined with Pluronic; in the control group, the left defects were repaired by Pluronic only or were left un-repaired. The animals were sacrificed in the 4th, 8th and 16th weeks after operation respectively. The repair results were observed and the cell source of repair tissue was distinguished. RESULTS: In the experimental group, the cartilage defects were repaired by the cartilage-like tissue after 8 weeks of operation; the defects were completely filled with mature cartilage tissue, which integrated smoothly with articular cartilage 16 weeks later. In the control group, only a small amount fibrous tissues were seen on the surface of defects. Autoradiographic assessment showed that the repair cells came from the implants, but not from self-chondrocytes. CONCLUSION: It is a good way to repair articular cartilage defects with homograft of tissue engineering cartilage. It is a convenient method to mark with 3H-TdR to discriminate the resource of the repair cells.

Animals↗
PubMed2003

[Treatment of large bone defect of radius with vascularized tubulate periosteum graft and bone filling material in rabbits].

OBJECTIVE: To study the treatment efficacy of vascularized periosteum graft and bone filling material for long bone defect. METHODS: Forty young and forty adult rabbits were divided into four groups respectively according to the bone filling materials. A 3 cm long segment was removed from the middle part of the rabbit radius to make a bone defect model. The periosteum was reserved and restored to set up a vascularized tubulate periosteum graft. On the left side, autogenous bone graft, decalcified allograft, tricalcium phosphate, and hydroxyapatite were used to fill in the bone defect respectively; on the right side, no bone filling material was used as controls. The repairing effect of bone defect was evaluated by roentogenography, biomechanical, and histological methods. RESULTS: In young rabbits, bone defects on both sides healed in the 6th week after operation. The bending strength of radius in the tricalcium phosphate group and in the hydroxyapatite group were lower in the 12th week and there was significant difference when compared with autogenous bone graft group, decalcified allograft group and control group (P < 0.05). The repairing mechanism included intramembranous and endochondral ossification, and intramembranous ossification was prevalent. In the adult rabbits, the repairing rates of bone defect were 50% in the autogenous bone graft group, 40% in the decalcified allograft group, 30% in the tricalcium phosphate group and in the hydroxyapatite group and 42.5% in the control group, respectively. CONCLUSION: In young rabbits, large bone defect can be repaired with vascularized tubulate periosteum graft with or without the combining use of bone filling materials. The bone filling material which will be substituted slowly is disadvantageous to the recovery of bone strength. In adult rabbits, vascularized tubulate periosteum graft combined with bone filling materials can not repair the large bone defect effectively.

Animals↗
PubMed2003

[Repair of segmental bone defects in rhesus monkeys' radius with allogeneic tissue engineered bones].

OBJECTIVE: To construct tissue engineering bone with bio-derived materials and bone marrow stromal cells (MSCs), and to investigate the effect of allogeneic engineering bone implants on healing of segmental bone defects. METHODS: MSCs being aspirated aseptically from tibial tuberosities of young rhesus monkeys were induced into osteoblasts in vitro and then were cultured and marked with 5-bromo-2-deoxyuridine (BrdU). Tissue engineering bones were constructed with these labeled osteoblasts being seeded onto bio-derived materials made from fresh human bones which were treated physically and chemically, Then the constructs were implanted in 15 allogeneic monkeys to bridge 2.5 cm segmental bone defects of left radius as experimental groups, bio-derived materials only were implanted to bridge same size defects of right radius as control group. and, 2.5 cm segmental bone defects of both sides of radius were left empty in two rhesus monkeys as blank group. Every 3 monkeys were sacrificed in the 1st, 2nd, 3rd, 6th and 12th weeks postoperatively and both sides of the implants samples were examined macroscopically, histologicaly, and immunohistochemicaly. The two monkeys in blank group were sacrificed in the 12th week postoperatively. RESULTS: Apparent inflammatory reactions were seen around both sides of the implants samples in the 1st, 2nd, 3rd weeks, but it weakened in the 6th week and disappeared at the 12th week. The labeled osteoblasts existed at the 6th week but disappeared at the 12th week. The bone defects in experimental group were repaired and the new bone formed in multipoint way, and osteoid tissue, cartilage, woven bone and lamellar bone occurred earlier when compared with control group in which the bone defects were repaired in 'creep substitution' way. The bone defects in blank group remained same size at the 12th week. CONCLUSIONS: Engineering bones constructed with bio-derived materials and MSCs were capable of repairing segmental bone defects in allogeneic monkeys beyond 'creep substitution' way and making it healed earlier. Bio-derived materials being constituted with allogeneic MSCs may be a good option in construction of bone tissue engineering.

Animals↗
PubMed2004

Contained femoral defects: biomechanical analysis of pin augmentation in cement.

Although in the proximal tibia the need for pin augmentation of cemented giant cell tumor defects depends on whether the defect is contained, there is controversy regarding the role for pins in the distal femur. The current study investigated whether Steinmann pin augmentation offers biomechanical advantages in cement reconstruction of contained defects of the lateral femoral condyle. Twelve pairs of human femurs were used. They were tested either with the bone intact, with a standardized contained defect in the lateral condyle, with a defect repaired with cement alone, and with a defect repaired with pins in the cement. Intact specimens had significantly higher load to failure than specimens with a defect. In the repaired specimens there were no significant differences in stiffness, peak load to failure, and energy to failure between the specimens repaired with just cement or augmented with pins. This study did not show any significant biomechanical advantage of this configuration of Steinmann pin reinforcement in cement for contained defects of the lateral femoral condyle.

Biomechanical Phenomena↗
PubMed2004

[Impacts of birth defects on perinatal deaths in Chinese population].

OBJECTIVE: To examine the time trends of perinatal mortality and the frequency of birth defects occurring in perinatal deaths, and to provide a national perspective on the impacts of congenital anomalies on perinatal mortality from 1990 through 2001. METHODS: Data were from Chinese Birth Defects Monitoring network-a hospital-based congenital anomalies registry system. During 1990 - 2001, all live or still births with 28 weeks of gestation or more, born in monitoring units, were studied within 7 days after delivery. The proportion of perinatal deaths due to birth defects, which was defined as the number of perinatal deaths associated with congenital anomalies per 100 perinatal deaths, was calculated by birth area (urban versus rural), geographic-economic status (coast areas, inner land areas and remote areas), to evaluate the impacts of birth defects on perinatal mortality. RESULTS: Perinatal mortality declined from 22.85 per 1000 in 1990 to 13.26 per 1000 in 2001, which showed a significant downward trend. Similar trend was also observed in the rate of stillbirth and the ratio of early neonatal death. However, the proportion of perinatal deaths due to birth defects had an increasing trend although the perinatal birth defects-specific death rate was declining, especially during 1996 - 2001. This result was also seen in urban and rural area, in coast regions, in inner land regions and in remote regions of China. Higher rate of birth defects occurring in perinatal deaths was observed in urban area than in rural area. Significant difference of this rate was also found among different geographic-economic regions, with the highest one in inland regions. CONCLUSION: Birth defects were accounted for an increasing proportion of perinatal deaths in China, and had become one of the major causes of perinatal deaths.

China↗
PubMed2004

[History of registration of prenatally and postnatally diagnosed congenital defects in the Czech Republic].

OBJECTIVE: Analysis of incidence of birth defects in general and the proportion of individual types of birth defects within the framework of registration of inborn defects in the period of 1961-2000 in the Czech Republic. DESIGN: A retrospective analysis based on registered birth defects from the material of Institute of Care for Mother and Child and IHIS from the period of 1961-2000. METHODS: The authors compared the real frequency of birth defects in the eighties and nineties with expected frequency calculated on the basis of mean values from the sixties and seventies. RESULTS AND CONCLUSIONS: The results between the expected and estimated values of the overall frequency of birth defects are based on two reasons. First of all there are changes in registration as such--increased numbers of registered types of birth defects, prolonged period of reporting the inborn defects up to 15 years old children, decreased levels of foetus viability and other factors. There is also the change of frequency caused by all-population changes (eradication of some infections, vaccination rate in the population, improved nutrition of the population, year-around availability of vitamins), the development of diagnostic methods (ultrasonographic methods) and, especially, the role of prenatal screening and prenatal diagnostic methods in practice.

Congenital Abnormalities↗
PubMed2004

[Repairing porcine knee joint osteochondral defects at non-weight bearing area by autologous BMSC].

OBJECTIVE: To test the possibility of using bone marrow stromal cells (BMSC) and biodegradable polymers to repair articular osteochondral defects at non-weight bearing area of porcine knee joints. METHODS: Bone marrows were harvested from 18 hybrid pigs. BMSC were cultured and in vitro expanded and induced with dexamethasone (group A) or with dexamethasone and transforming growth factor-beta1 (TGF-beta1) (group B) respectively. Immunohistochemistry and RT-PCR were used to evaluate chondrogenic differentiation of induced cells. Part of BMSC of 2 animals were retrovirally-labeled with green fluorescent protein (GFP). After induction and label, cells were seeded on a construct of polyglycolic acid (PGA) and polylactic acid (PLA) and co-cultured for 1 week before implantation. Total 4 osteochondral defects (8 mm in diameter, 5 mm in depth) in each animal were created at the non-weight bearing areas of knee joints on both sides. The defects were repaired with dexamethasone induced BMSC-PGA/PLA construct in group A, with dexamethasone and TGF-beta1 induced BMSC-PGA/PLA construct in group B, with PGA/PLA construct alone (group C) or left untreated (group D) as controls. Animals were sacrificed at 3 months (n = 6) or 6 months (n = 10) post-repair. Gross observation, histology, glycosaminoglycan (GAG) quantification and biomechanical test were applied to analyze the results. The two animals with GFP-labeled cells were sacrificed at 7 months post-repair to observe with confocal microscope the distribution of GFP-labeled cells in repaired tissue. RESULTS: Stronger expression of type II collagen and aggrecan were observed in BMSCs induced with both dexamethasone and TGF-beta1. At both time points, Gross observation and histology showed that the defects in most of group A were repaired by engineered fibrocartilage and cancellous bone with an irregular surface, minority defects were repaired by engineered hyaline cartilage and cancellous bone. However, in most of group B, the defects were completely repaired by engineered hyaline cartilage and cancellous bone. No repair or only fibrous tissue were observed in groups C and D. Besides, the compressive moduli of repaired cartilage in groups A and B reached 30.37% and 43.82% of normal amount at 3 months and 62.69% and 80.27% at 6 months respectively, which was further supported by the high levels of GAG contents in engineered cartilage of group A (78.03% of normal contents) and group B (no statistical difference from normal contents). More importantly, confocal microscope revealed the presence of GFP-labeled cells in engineered cartilage lacuna and repaired underlying cancellous bone. CONCLUSION: The results demonstrated that implanted BMSC can differentiate into either chondrocytes or osteoblasts at different local environments and repair a complex articular defect with both engineered cartilage and bone. TGF-beta1 and dexamethasone in vitro induction can promote chondrogenic differentiation of BMSC and thus improve the results of repairing articular defects.

Animals↗
PubMed2004

[Effect of anti-infective reconstituted bone xenograft as primary bone grafting on repair of contaminated radius defect in canine].

OBJECTIVE: To investigate the effect of anti-infective reconstituted bone xenograft (ARBX) as primary grafting on repair of a segmental contaminated defect in canine radius. METHODS: The contaminated segmental defects of 1.5 cm were made in both radius of 8 canine and 1 ml of staphylococal suspension was injected into the defect region at a concentration of 5 x 10(6) CFU/ml. ARBX(experimental side) or RBX(control side) was implanted into the two sides of the defects respectively as primary grafting followed by internal fixation. The results were compared between the two grafting materials in repairing the contaminated segmental defect. RESULTS: In ARBX side, the defects were repaired completely in 5 cases and partially in 1 case, and there existed no osteomyelitis in all cases; while in RBX side, the defects were repaired partially in 1 case and were not repaired in 5 cases after 6 months of operation, and there existed osteomyelitis in all cases. CONCLUSION: Besides its strong osteoinductive and osteoconductive activity, ARBX is highly antibacterial and can be used as primary grafting in repairing contaminated segmental defects.

Animals↗
PubMed2004

[Repair of Achilles tendon defect by transplantation of iliotibial band with vascular anastomoses].

OBJECTIVE: To discuss a new operative procedure and the results of transplantation of iliotibial band with vascular anastomoses to repair Achilles tendon defect. METHODS: The origin, course, branches, distribution and anastomoses of the lateral superior genicular artery and blood supply of iliotibial band were observed on adult lower limbs perfused with red latax. From September 1999 to January 2003, 6 cases of Achilles tendon defects were treated with transplantation of the vascularized iliotibial band by use of microsurgical technique. The area of Achilles tendon defect was 6-11 cm. Six cases of Achilles tendon defects included 4 simple defects and 2 defects with skin defects. RESULTS: The lateral superior genicular artery originated from the popliteal artery and divided into the ascending branch and descending branch. The ascending branch gave off muscular branch and perforating rami of iliotibial band. The lateral superior genicular artery anatomosed the lateral uppermost genicular artery in the vastus lateralis muscle, and then formed the musculocutaneous perforating rami of iliotibial band. Six patients treated with transplantation of iliotibial band with vascular anastomoses were followed up 6-44 months. The results showed significant improvement in "heel test" and Thompson sign. No complication of ulcer on heel and rerupture of the Achilles tendon occurred. CONCLUSION: The vascularized iliotibial band is a good donor in reconstruction of Achille tendon defect.

Achilles Tendon↗
PubMed2005

A reentry study on the use of bovine porous bone mineral, GTR, and platelet-rich plasma in the regenerative treatment of intrabony defects in humans.

This study compared the clinical effectiveness of a combination therapy consisting of bovine porous bone mineral (BPBM), guided tissue regeneration (GTR), and platelet-rich plasma (PRP) in the regeneration of periodontal intrabony defects in humans. Twenty-eight paired intrabony defects were surgically treated using a split-mouth design. Defects were treated with BPBM, GTR, and PRP (experimental), or with open-flap debridement (control). Clinical parameters evaluated included changes in attachment level, pocket depth, and defect fill as revealed by reentry at 6 months. Preoperative pocket depths, attachment levels, and transoperative bone measurements were similar for the two groups. Postsurgical measurements taken at 6 months revealed that both treatment modalities significantly decreased pocket depth and increased clinical attachment and defect fill compared to baseline. The differences between the experimental and control groups were 2.22+/-0.39 mm on buccal and 2.12+/-0.34 mm on lingual sites for pocket depth, 3.05+/-0.51 mm on buccal and 2.88+/-0.46 mm on lingual sites for gain in clinical attachment, and 3.46+/-0.96 mm on buccal and 3.42+/-0.02 mm on lingual sites for defect fill. These differences between groups were statistically significant in favor of the experimental defects. The combined therapy was also clinically more effective than open-flap debridement. The superiority of the experimental group could not be attributed solely to the surgical intervention and was likely a result of the BPBM/GTR/ PRP application. Combining BPBM, GTR, and PRP was an effective modality of regenerative treatment for intrabony defects in patients with advanced periodontitis.

Adult↗
PubMed2005

[Experimental study on repairing segmental bone defects with three bio-bone derived materials].

OBJECTIVE: To evaluate the osteogenesis of three bio-bone derived materials in repairing segmental bone defects. METHODS: Sixty Japanese rabbits were made 10 mm radius segmental defects and divided into 5 groups (groups A, B, C, D and E, n=12). Composite fully deproteinised bone (CFDB, group A), partially deproteinised bone (PDPB, group B), partially decalcified bone (PDCB, group C), autogenous iliac bone graft (group D) and no implant (group E) were implanted into the radius segmental bone defects of rabbits. The specimens were examined after 4, 8, 12 and 24 weeks; the osteogenesis was evaluated through X-ray radiograph and undecalcified solid tissue histological examination. RESULTS: The border between the material and host's bone was distinct after 4 weeks and blurred after 8 weeks; the density of partial edge of the material was similar to that of radii after 12 weeks. The medullary cavity of bone reopened in group B; the density of most defect area was similar to that of the host bone and there was a few high density shadow in group C; the density of most defect area was higher than that of host bone in group A after 24 weeks. There was no significant difference in radiograph scoring between groups A, B and C after 4 weeks and 8 weeks (P>0.05); the scores of group B and C were higher than that of group A after 12 weeks (P<0.05); and the scores were arranged as follow: group D > group B > group C > group A after 24 weeks (P<0.05). Bone callus grew toward defect area and new bone adhered to the material after 4 weeks and 8 weeks; more new bone formed, and the materials were absorbed and degraded with time. The quantity of bone formation was more in group D than in group B and in group B than in group C and in group C than in group A after 24 weeks (P<0.05). CONCLUSION: PDPB had good osteogenesis in repairing the segmental bone defect, PDCB was inferior to it, both PDPB and PDCB are fit to repair segmental bone defect. Both of them were inferior to autogenous bone.

Animals↗
PubMed2005

[Combined use of autologous micro-morselized bone with bone morphogenetic protein and type I collagen graft in repairing rabbit bone defects].

OBJECTIVE: To study the effect of combined use of autologous micro-morselized bone with bone morphogenetic protein(BMP) and type I collagen graft on the treatment of segmental bone defects. METHODS: The bulk bone of rabbit iliac crest was ground into micro-morselized bone, which was combined with BMP and type I collagen. The model of 1.5 cm bone defect was established in the middle shaft of the radius. Fifty-six rabbits were assigned to four repairing methods: autologous micro-morselized bone graft with BMP and type I collagen, autologous micro-morselized bone graft with type I collagen, autologous micro-morselized bone graft alone, and control group. The defect-repairing capability of each group was assessed by radiographic, histological, bone densitometry and biomechanical studies. RESULTS: X-ray manifested that at the end of 8 weeks after operation, the bone defect treated with autologous micro-morselized bone graft with BMP and type I collagen was repaired completely, and at the end of 12 weeks after operation the bone defect treated with autologous micro-morselized bone and type I collagen was cured completely, but the bone defect treated with autologous micro-morselized alone was completely repaired. No healing was found in the control group. In the bone densitometry detection, the material with BMP exhibited the strongest defect-repairing capability in terms of amount increased and quality of the new bone at the end of 8 weeks and 12 weeks. The group with BMP has the best mechanical strength of all groups at the end of 12 weeks. CONCLUSION: Autologous micro-morselized bone graft with BMP/type I collagen and autologous micro-morselized bone graft with type I collagen prove to be effective in repairing segmental bone defects. The autologous micro-morselized bone combined BMP and type I collagen is an excellent bone repairing material considering the satisfactory osteogenesis, osteo-conduction, and osteo-induction seen in this method.

Animals↗
PubMed2005

The genetic contribution and relevance of knee cartilage defects: case-control and sib-pair studies.

OBJECTIVE: To describe the differences in knee cartilage defects between offspring of subjects with at least one parent with a total knee replacement for severe primary knee osteoarthritis (OA) and controls; and to estimate the heritability of knee cartilage defects in sib-pairs. METHODS: Population based, case-control study of 186 matched pairs (mean age 45 yrs, range 26-61) and sib-pair study of 128 subjects from 51 families (115 sib-pairs) within the case-control study. Knee cartilage defect scores (0-4) and prevalence (a cartilage defect score > or = 2) were assessed at the patellar, tibial, and femoral sites by processing images acquired using T1 weighted fat-saturated magnetic resonance imaging. Heritability was estimated using the SOLAR genetic analysis program. RESULTS: The prevalence of knee cartilage defects was surprisingly high (50% scored > or = 2 in any site). Compared to controls, offspring had higher knee cartilage defect scores and prevalence in tibiofemoral (4.39 vs 4.01, p = 0.003; 41% vs 28%, p = 0.009), patellar (1.32 vs 1.10, p = 0.031; 35% vs 26%, p = 0.075), and whole (5.71 vs 5.10, p = 0.002; 57% vs 42%, p = 0.007) compartments. These all became nonsignificant after adjustment for knee pain and radiographic OA. In the sib-pair component, knee cartilage defects had heritability for scores and prevalence, respectively, of 38% (p = 0.072) and 47% (p = 0.082) for tibiofemoral, 52% (p = 0.009) and 78% (p = 0.025) for patellar, and 43% (p = 0.038) and 68% (p = 0.072) for the whole compartments. These estimates became weaker at tibiofemoral and whole compartments after adjustment for bone size, knee pain, and radiographic OA. CONCLUSION: Knee cartilage defects are common, have a genetic component that is linked to the genetic contribution to knee pain and bone size, and may have a role in the genetic pathogenesis of knee OA.

Adult↗
PubMed2005

Evaluation of efficacy of enamel matrix derivative in the treatment of intrabony defects: a 24-month multicenter study.

The aim of this prospective multicenter controlled clinical study was to evaluate the efficacy of Emdogain (Biora), an enamel matrix derivative (EMD), when combined with surgical treatment of periodontal angular defects, as compared to surgery alone, for up to 24 months of follow-up. The study was performed at six Italian universities and 11 private practices. Patients with one-, two-, or three-wall angular defects were enrolled if intrabony defect depth (IBD) was 4 mm or more and probing pocket depth (PPD) was at least 6 mm. They were randomly allocated to either test or control groups. The test group was treated by the simplified papilla preservation (SPP) flap plus Emdogain after root conditioning with ethylenediaminetetraacetic acid. The control group was treated by SPP alone. Plaque Index, Gingival Index, PPD, and periodontal attachment level (PAL) at surgical sites were assessed at the presurgical examination (baseline). IBD was measured intraoperatively after debridement. IBD was also evaluated with a computer-aided technique, from periapical radiographs. Plaque Index, Gingival Index, PPD, PAL, and IBD were assessed at 12 and 24 months postsurgery. Data were further divided in two subgroups according to baseline IBD (6 mm or less and more than 6 mm). The differences between each follow-up and baseline, and between groups at each follow-up, for the above parameters were evaluated by standard statistical methods. One hundred fifty-three patients were recruited, accounting for 195 intrabony defects: 83 patients (108 defects) and 70 patients (87 defects) were allocated to the test and control groups, respectively. All parameters were improved at both 12 and 24 months, compared to baseline in both groups. In the test group, IBD, PPD, and PAL at 12 months were significantly better than these parameters in the control group. The test subgroup with IBD of more than 6 mm at baseline displayed a better outcome when compared to the 6 mm or less IBD subgroup. No significant adverse events related to the use of Emdogain were reported. The use of EMD as an adjunct to periodontal surgery in the treatment of angular defects significantly enhanced the rate and degree of periodontal regeneration. The control group also displayed significant tissue regeneration, but at a slower rate compared to the Emdogain group. The surgical procedure itself, with its goal of maximum preservation of the regenerative potential of periodontal tissues, proved to be effective in the treatment of periodontal angular defects. Pockets with IBD greater than 6 mm showed major improvement when treated with Emdogain.

Adult↗
PubMed2005

[Experimental study on repair of critical-sized cranial defect by tissue engineered bone].

OBJECTIVE: To evaluate repair of critical-sized cranial defect with tissue engineered bone fabricated by coral, bone mesenchymal stem cells (MSCs) and sustainedly released recombinant human bone morphogenetic protein 2 (rhBMP-2) by collagen. METHODS: Three scaffolds of rhBMP-2 + coral, collagen + rhBMP-2 + coral and MSCs+collagen+rhBMP-2+coral were fabricated. Forty New Zealand rabbits were made the models of critical-sized defects and divided into 5 groups according to different implants: group I, auto-ilium; group II, coral; group III, rhBMP-2+coral; group IV, collagen+rhBMP-2+coral; and group V , MSCs+collagen+rhBMP-2+coral. Repair of bone defect was evaluated after 8 and 16 weeks of implantation by gross observation, X-ray, HE staining and Masson's trichrome staining. RESULTS: Repair of bone defect in group V was similar to that in group I, and was better than that in group IV; and group III was worse. The gross appearance showed that defect region filled with bony tissue which had similar strength to adjacent bone and formed bone union with surrounding bone. The X-ray result displayed high radiopacity (80.45% +/- 2.52% in the 16th week). Histological observation showed new lamellar bone tissue and with few pore blank area. However, only transparent fibrous tissue filled the defect in group II. CONCLUSION: Collagen may be a suitable sustained release system for rhBMP-2. And MSCs may have important effect on enhancing repair of bone defect. Tissue engineered bone fabricated by MSCs+collagen+rhBMP-2+coral may be a useful material for bone defect repair.

Animals↗