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At least 19 recordsLinked to original sources
PubMed2000

Experimental study of vascularized bone grafts: hypertrophy of the grafted bone.

The mechanism underlying hypertrophy of experimentally vascularized bone grafts was studied in 15-week-old rats. The segmental ulna was grafted to the tibial defect with an external fixator. In experiment 1, 24 rats were classified into four groups to evaluate conventional (non-vascularized), cuff (periosteum-encased, non-vascularized), and vascularized bone grafts, and vascularized segmental grafts with fracture. In experiment 2, 12 rats were classified into two groups according to the presence of mechanical loading. This involved vascularized bone grafts with external fixators, and vascularized bone grafts with external fixators removed after bone union. The bone dynamics of the grafts were investigated by several methods, including roentgenographic analysis, histologic studies, and fluorochrome labeling. In experiment 1, a slight bone formation was recognized in the conventional bone graft, while irregular bone formation with creeping substitution was observed in the cuff graft. The vascularized bone graft showed significant hypertrophy; hypertrophy of the vascularized bone with fracture was greater than that without fracture. In experiment 2, markedly circumferential bone formation was observed after removal of the external fixator, while slight new bone formation was observed during the late postoperative period in bone with an external fixator. These results suggest that hypertrophy can be promoted by artificial fracture of the grafted bone, and that mechanical loading is an important factor for remodeling of grafted bone.

Animals↗
PubMed1998

Studies of the healing of bone grafts, and the incorporation of titanium implants in grafted bone: an experimental animal model.

An insufficient quality and amount of bone often necessitate the clinical use of implants together with bone transplants. The present study describes an experimental animal model for the study of implants in bone grafts. Circular defects were made bilaterally in the tibia of 36 rabbits. The defects received either autologous cortical bone (control), demineralized bone matrix (DBM), plasma-augmented DBM or were left empty (without bone graft). In all defects a titanium implant was centrally placed and anchored in the opposite cortex. Evaluation with light microscopic morphometry showed that the insertion of a threaded titanium implant centrally in a cortical defect was followed by a spontaneous healing of the defect after 6 mon. After 6 wk, all implants in cortical grafts were well integrated with a significantly higher bone-to-implant contact than in the DBM and plasma-augmented groups. After 6 mon, all experimental groups had a mean bone area within the threads ranging between 69% and 80% and a mean bone-to-implant contact between 31% and 42%. The results from the present study indicate that the model allows comparative studies on the early formation, resorption and remodelling of bone around implants after modification of implant, graft and host properties.

Journal Article↗
PubMedDate not supplied

Ankle and subtalar fusion utilizing a tricortical bone graft, bone stimulator, and external fixator after avascular necrosis of the talus.

A unique ankle and subtalar fusion was performed on a patient with avascular necrosis of the talus. The body of the talus was removed and replaced with an autogenous tricortical bone graft. Healing was aided by the use of a bone stimulator and external fixator. The authors believe this fusion to be a more stable fusion than others used to treat avascular necrosis of the talus.

Adult↗
PubMed1999

Autogenous cultured bone graft--bone reconstruction using tissue engineering approach.

Maniatopoulos et al. reported the formation of calcified bone-like tissue when rat bone marrow cells were cultured in the presence of dexamethasone and beta-glycerophosphate. We have succeeded to construct the in vitro cultured bone on the porous framework of hydroxyapatite ceramics (HA). After 2 weeks of the culture, the construct showed the existence of mineralized collagen fibers on the surface of HA determined by Scanning Electron Microscopy. The construct also demonstrated high alkaline phosphatase (ALP) activity together with noticeable level of osteocalcin. The results indicate that the construct consisted of thin layer of bone matrix covered hydroxyapatite surface and abundant bone forming active osteoblasts. After the in vivo implantation of the construct, volume of the matrix increased and obvious bone tissue was detected by ordinal microscopy even one-week after implantation and its high osteogenic activity was maintained for a long term (one year). The in vivo bone is biologically active tissue evidenced by Northern blot analysis of the implanted construct which showed ALP and osteocalcin mRNA expression comparable to those of normal cancellous bone. These results demonstrate that the in vitro fabricated cultured bone/HA construct can possess new bone forming capability in in vivo situations. We have also succeeded to fabricate the construct using aged human marrow cells and the construct showed thick lamellar bone formation after the in vivo implantation. Based on these findings, we propose alternative approach for bone reconstruction surgery using the autogenous cultured bone/HA construct. Importantly, we can fabricate the implantable autogenous bone tissue derived from patient's marrow cells and the cells can be obtained by needle aspiration without damaging the patient's normal tissue.

Animals↗
PubMed1999

Bone repair techniques, bone graft, and bone graft substitutes.

This paper reviews the techniques and materials (bone graft and bone graft substitutes) that currently are used to treat nonunions and bone defects. The techniques reviewed are intramedullary nailing, plating, distraction osteogenesis, and electric stimulation. Bone graft and bone graft substitutes reviewed are as follows: vascularized bone transfers; autogenous bone graft; autogenous bone marrow; dimineralized bone matrix; growth factors; calcium sulphate; calcium phosphates; and allograft. The goal of management of fractures, nonunions, and segmental bony defects, is the return of function as quickly and completely as possible. Techniques and management strategies constantly are evolving to accomplish this goal. This paper reviews the history, indications, and limitations of bone repair techniques, methods of bone grafting, and materials available as bone graft substitutes.

Bone Plates↗
PubMed1991

Bone graft and bone graft substitutes: a review of current technology and applications.

The morbidity associated with autogenous bone graft harvest and the recent concern regarding the transmission of live virus through use of allografts, have been the impetus for research into a variety of materials that could take the place of these standard materials for bone grafting. The positive results reported with various ceramics and/or bone derivatives suggest the possibility of a material with osteoconductive and/or osteoinductive properties for use with or in place of bone graft. This review discusses a variety of bone graft and bone graft substitute materials. Among the osteoconductive materials outlined are the hydroxyapatite and tricalcium phosphate ceramics as well as some reportedly osteoactive polymers. While osteoconduction is a favorable quality, much interest has focussed on the use of osteoinductive or osteogenic materials such as demineralized bone matrix or bone derivatives, that is, BMP, osteogenin, etc. It is increasingly apparent that these materials require a carrier vehicle for optimal expression of osteoactivity. Therefore, the review finishes with a comparison of the various materials suggested for use as carriers.

Bone Transplantation↗
PubMed1990

Treatment of chronic osteomyelitis complicating nonunion and segmental defects of the tibia with open cancellous bone graft, posterolateral bone graft, and soft-tissue transfer.

Forty-two consecutive patients with chronic osteomyelitis complicating persistent tibial nonunion and chronic osteomyelitis complicating tibial fracture with segmental bone loss were treated from January 1979 through December 1986 using a protocol including either open cancellous bone grafting (Friedlaender-Papineau technique), posterolateral bone grafting (Harmon technique), or local or microvascular soft-tissue transfer before cancellous bone grafting. Each patient had undergone surgical debridement and intravenous antibiotic therapy before inclusion in this study. Patients were classified using a staging system which included consideration of anatomic location of the infection within the bone; extent of bone involvement; quality of soft-tissue envelope and vascular integrity; and generalized host status. The overall success rate for arresting the osteomyelitis and healing the nonunion was 62% (26/42). If the six patients who refused additional bone graft surgery, the one patient who represented poor patient selection, and the patient who refused ankle arthrodesis are eliminated, the success rate for healing of the nonunion and resolving the osteomyelitis in this difficult patient population is: open bone cell graft, 66% (12/18); soft-tissue transfer 87.5%, (7/8); and posterolateral bone grafting, 87.5% (7/8). Use of a standardized classification system allows comparison of treatment results. Adequate debridement is crucial in treating osteomyelitis complicating established long bone fractures and nonunions. Determining the extent of debridement has proven to be the single most difficult aspect technically. Patient selection and pretreatment education are crucial. Caring for these patients is not only labor intensive and demanding of personnel and hospital resources, but demanding of the patients as well.

Adolescent↗
PubMed1994

Ectomesenchymal mandibular symphysis bone graft: an improvement in alveolar cleft grafting?

Bone grafting the alveolar cleft in cleft lip and palate (CLP) patients is widely accepted. A traditional graft is the iliac crest. Other bone graft donor sites are briefly discussed. The ratio for an ectomesenchymal bone graft in alveolar cleft repair is explained. Aspects of the embryology, bone graft physiology, and reports on mandibular symphysis bone grafting are discussed.

Alveoloplasty↗
PubMed2005

Surgical technique for primary alveolar bone grafting.

Bone grafting of the alveolar cleft is an important component of the comprehensive care of the cleft lip and palate patient. Although debate exists regarding the optimal timing of the procedure, one approach is the placement of a rib graft in the alveolar cleft before eruption of the deciduous canine (primary alveolar bone graft). Since 1982, primary alveolar bone grafting has been performed at our institution in more than 300 patients. Because little is reported in the literature on primary alveolar bone grafting in general, an experienced surgical technique and protocol are lacking. Our surgical technique for rib graft harvest as well as alveolar bone graft placement in the infant cleft alveolus is described.

Alveolar Process↗
PubMed2002

Bone grafts.

Bone grafts are used in musculoskeletal surgery to restore structural integrity and enhance osteogenic potential. The demand for bone graft for skeletal reconstruction in bone tumor, revision arthroplasty, and trauma surgery, couple with recent advances in understanding and application of the biology of bone transplantation, has resulted in an exponential increase in the number of bone-grafting procedures performed over the last decade. It is estimated that 1.5 million bone-grafting procedures are currently performed worldwide each year, compared to a fraction of that number 20 years ago. Major developments also have resulted in the harvesting, storage, and use of bone grafts and production of graft derivatives, substitutes, and bone-inducing agents.

Bone Substitutes↗
PubMed1999

Bone grafts.

Bone grafting provides a method of enhancing bone healing in veterinary orthopedic patients. Specifically, autogenous cancellous bone graft provides the cellular components and matrix proteins that can accelerate bone healing, dramatically. Allografts provide immediate mechanical support for fracture repair and patient function, but these grafts do not create the osteogenic environment seen with the use of autogenous cancellous bone graft. Xenograft bone implants may also hold a place for use in fracture management. With the advent of recombinant bone-derived tissue growth factor technology, bone grafting may some day become a practiced technique of the past. For now, however, bone grafting still holds a strong place in orthopedic surgery when dealing with bone defects in animals.

Animals↗
PubMed1988

The history of bone grafts.

Bone autografts, allografts, and even vascularized bone grafts are currently used in nearly every orthopedic center throughout the world. The recent interest in bone graft surgery is because of the increased demand for bone grafts for skeletal reconstruction in limb salvage surgery for bone tumors and for reconstruction of failed arthroplasties. This reconstruction of large skeletal deficiencies presents a challenging problem to orthopedists; treatment of these defects has advanced significantly during the past two decades. Bone transplantation has been the subject of many experimental and clinical studies. This is a review of the history of different types of bone grafts used in the past and currently.

Bone Transplantation↗
PubMed1993

Septopal beads and autogenous bone grafting for bone defects in patients with chronic osteomyelitis.

Thirty-five patients with chronic osteomyelitis were treated with autogenous bone grafts for bone defects. Of 35 patients, two were lost to follow-up evaluation. There were 27 men and six women. The age range was from 18 to 62 years (median age, 29 years). The bones included 22 tibias, nine femurs, and two ulnas. The size of the bone defects ranged from 2.5 x 15 cm (median defect, 2.5 x 6 cm). The length of infection ranged from two to 540 months (median, 31 months). Twenty patients had nonunions and 19 patients required soft-tissue muscle transfers. Patients were treated with systemic antibiotics and/or gentamicin (Septopal) antibiotic beads. Twelve patients were treated with Septopal beads. The range of follow-up evaluation was 24 to 68 months (median, 47 months). Thirty-one of 33 patients had one bone-graft procedure and two patients required two. The time from initial debridement and infection control to bone graft for patients not requiring soft-tissue muscle flaps was one to six weeks (median time, four weeks). For patients requiring soft-tissue muscle transfer, the range was six to nine weeks (median, six weeks). The median time to bone-graft incorporation was six months. All fractures united. Complications included two refractures from auto accidents in the immediate postoperative period, one partial muscle loss, one skin-graft loss, four pin tract draining sites, and two antibiotic-related skin rashes. There was one recurrent infection, and the infection arrest rate was 97%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2005

[Expression of vascular endothelial growth factor in repairing bone defect with vascularized bone graft- reconstituted bone xenograft].

OBJECTIVE: To study efficiency of vascularized bone graft combining with reconstituted bone xenograft (RBX) in repairing bone defect and the expression of the vascular endothelial growth factor (VEGF) in serum. METHODS: From January 1998 to December 2002, 27 cases of bones defects were treated and randomly divided into 3 groups according to different repair materials: group A (the vascularized bone graft- RBX group, n=9), group B (the vascularized bone graft group, n=10) and group C(the RBX group, n=8). The bone defect repair, the bone healing time and the bone graft resorption were observed by radiograph after 3 months, 6 months and 12 months of operation, and the expression of VEGF in serum was assayed with lumino-enzyme immunoassay before operation and after operative 2 weeks, 4 weeks, 6 weeks and 8 weeks respectively. RESULTS: The X-ray films showed that the bone healing was achieved in 8 cases of group A, in 6 cases of group B and in 3 cases of group C after 3 months; in 1 case of group A, respectively in 3 cases of both group B and group C after 6 months. The bone graft resorption was observed in 1 case of group B and in 2 cases of group C after 12 months. The serum VEGF values after operative 2 weeks and 4 weeks were higher than those before operation in all of 3 groups (P<0. 05), and the VEGF values of groups A and B were higher than that group C(P<0. 05) after 4 weeks. There were no significant differences (P>0. 05) in serum VEGF level between postoperative 6, 8 weeks and pre-operation in 3 groups. CONCLUSION: The expression of serum VEGF obviously increase in the early period of bone transplanting, it is value of clinical evaluation of reparative efficiency of bone defect.

Adolescent↗
PubMed2001

The relationship between revascularisation and osteogenesis in fresh or demineralised bone grafts.

Bone formation generally depends on adequate blood flow. Failure of bone grafts has been attributed to delayed revascularisation of the graft. We compared the relationship between revascularisation and osteogenesis, evaluated as entrapment of (141)Ce-labelled microspheres and uptake of (85)Sr, respectively, in fresh or demineralised syngeneic bone grafts 3 weeks after heterotopic implantation in rats. Whereas a moderately high linear correlation between (85)Sr and (141)Ce radioactivity was found both in the (intact) host iliac bone (r = 0.75, p = 0.0001) and implanted fresh syngeneic grafts (r = 0.50, p = 0.001), no correlation could be demonstrated in demineralised grafts (r = 0.09, p = 0.6). The results may indicate differences in the mechanisms of vascularisation and osteogenesis in the grafts used fresh or after demineralization but are, at present, difficult to fully explain.

Animals↗