The objective is to create a novel plastic bone filler material utilizing adhesive carriers and human bone-derived matrix particles, followed by pre-clinical testing in animal models to evaluate its safety and osteoinductive efficacy.
Decalcified bone matrix (DBM) was prepared from voluntarily donated human long bones by a process involving crushing, cleaning, and demineralization. Subsequently, the DBM was converted into bone matrix gelatin (BMG) using a warm bath technique. The BMG and DBM were combined to form the experimental group's plastic bone filler material, while DBM alone constituted the control group. Following preparation of the intermuscular space between the gluteus medius and gluteus maximus muscles in all fifteen healthy male thymus-free nude mice aged 6-9 weeks, experimental group materials were implanted. Evaluation of the ectopic osteogenic effect, utilizing HE staining, was conducted on animals sacrificed at 1, 4, and 6 weeks post-operation. Eight 9-month-old Japanese large-ear rabbits were chosen for the creation of 6-mm diameter defects at the condyles of each hind leg, with the left leg receiving experimental material and the right leg receiving control material. Micro-CT and HE staining were used to evaluate the results of bone defect repair in animals sacrificed at 12 and 26 weeks following the operation.
Observation of the ectopic osteogenesis experiment via HE staining demonstrated a considerable quantity of chondrocytes a week after the procedure, accompanied by the clear visualization of newly created cartilage tissue at the four- and six-week marks. Selleckchem Zimlovisertib HE staining, performed 12 weeks after the rabbit condyle bone filling surgery, indicated absorption of some materials and the presence of newly formed cartilage in both experimental and control groups. As revealed by micro-CT imaging, the experimental group's bone formation rate and area exceeded those of the control group. Bone morphometric parameters, measured 26 weeks post-operatively, exhibited significantly greater values in both groups compared to those assessed 12 weeks post-operatively.
This sentence, now re-fashioned, embodies a fresh perspective, its structure altered for a unique effect. Twelve weeks post-operation, the experimental group displayed statistically significant enhancements in bone mineral density and bone volume fraction relative to the control group.
There was no significant disparity in trabecular thickness measurements between the two groups.
The specified numerical value exceeds zero point zero zero five. tissue-based biomarker Following 26 weeks of postoperative monitoring, the experimental group's bone mineral density showed a statistically significant elevation relative to the control group.
With every breath we take, we experience the wonder of existence, a journey that constantly surprises and inspires. A comparative analysis of bone volume fraction and trabecular thickness revealed no substantial disparity between the two cohorts.
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This new plastic bone filler material is remarkably effective in bone repair, exhibiting both good biosafety and prominent osteoinductive activity.
Outstanding biosafety and potent osteoinductive properties define this new plastic bone filler material, making it an excellent choice for bone regeneration.
An examination of the efficacy of V-shaped calcaneal osteotomy, coupled with subtalar arthrodesis, in managing Stephens and calcaneal fracture malunions.
Clinical data for 24 patients presenting with severe calcaneal fracture malunion, who underwent combined calcaneal V-shaped osteotomy and subtalar arthrodesis treatment between January 2017 and December 2021, were retrospectively examined. Twenty males and four females, averaging 428 years of age (with a range from 33 to 60 years), were present. Despite conservative measures, calcaneal fracture treatment failed in 19 patients, and 5 further patients experienced surgical treatment failure. Fourteen cases of calcaneal fracture malunion, using Stephens' classification, were type A, and ten were categorized as type B. In the preoperative assessment, the Bohler angle of the calcaneus exhibited a range of 40 to 135 degrees, averaging 86 degrees, whereas the Gissane angle demonstrated a range of 100 to 152 degrees, averaging 119.3 degrees. The patient's experience spanned 6-14 months between the moment of injury and the surgical procedure, an average time of 97 months. The American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score, and the visual analogue scale (VAS) score, were used for evaluating the effectiveness both prior to the surgery and at the final follow-up visit. A record of the bone healing time was kept, and the healing process was observed. A series of measurements were performed to assess the talocalcaneal height, the inclination of the talus, the pitch angle, the width of the calcaneus, and the angle of hindfoot alignment.
The incision's cuticle edge exhibited necrosis in three cases, leading to recovery following antibiotic oral administration and dressing changes. First intention healing characterized the recovery of the remaining incisions. The 24 patients' follow-up spanned 12 to 23 months, establishing an average follow-up time of 171 months. The patients' recovered foot shapes allowed for a return to their prior shoe sizes without any indication of anterior ankle impingement. All patients experienced bone fusion, with recovery times spanning from 12 to 18 weeks, yielding an average healing period of 141 weeks. Finally, a follow-up examination revealed no adjacent joint degeneration in any of the patients. Five patients experienced mild foot pain while walking, but this discomfort did not substantially affect their daily routines or work obligations. No patient required revision surgery. The AOFAS ankle and hindfoot score post-surgery showed a considerable improvement over its value prior to the operation.
In 16 instances, the results were outstanding; in 4 cases, they were satisfactory; and in a further 4, they were unsatisfactory. The percentage of excellent and good outcomes was a remarkable 833%. After the surgical intervention, the VAS score, talocalcaneal height, talus inclination angle, pitch angle, calcaneal width, and hindfoot alignment angle exhibited considerable improvement.
0001).
A V-shaped osteotomy of the calcaneus, coupled with subtalar arthrodesis, proves effective in alleviating hindfoot discomfort, rectifying talocalcaneal height, restoring the talar inclination angle, and diminishing the likelihood of nonunion following subtalar arthrodesis procedures.
Subtalar arthrodesis, when combined with a calcaneal V-shaped osteotomy, can successfully alleviate hindfoot pain, rectify the talocalcaneal height, restore the talus inclination angle, and minimize the likelihood of nonunion following subtalar fusion.
Through a finite element approach, this research investigated the biomechanical distinctions between three innovative internal fixation strategies for bicondylar four-quadrant tibial plateau fractures, with the objective of pinpointing the fixation method that best adheres to mechanical principles.
Utilizing computed tomography (CT) image data from a healthy male volunteer's tibial plateau, a three-dimensional bicondylar four-quadrant fracture model of the tibial plateau, and three different experimental internal fixation methods, were established through finite element analysis software. Fixed with inverted L-shaped anatomic locking plates were the anterolateral tibial plateaus of the A, B, and C cohorts. Persistent viral infections Utilizing reconstruction plates, the anteromedial and posteromedial plateaus were fixed in a longitudinal orientation in group A. The posterolateral plateau was secured using an obliquely positioned reconstruction plate. For groups B and C, the medial proximal tibia was stabilized with a T-shaped plate, and the posteromedial plateau was longitudinally fixed with a reconstruction plate; conversely, the posterolateral plateau was secured obliquely using a reconstruction plate. In three distinct groups, a 1200-newton axial load simulated the walking gait of a 60-kg adult on the tibial plateau. The ensuing maximum displacement of the fracture and maximum Von-Mises stress within the tibia, implants, and fracture line were then calculated.
Stress concentration in the tibia, according to the finite element analysis for each group, was observed at the intersection of the fracture line and screw thread. The implant stress concentration was situated at the juncture of the screws and the fracture fragments. With an axial load of 1200 Newtons, the three groups displayed comparable maximum displacements of fracture fragments. Group A experienced the highest displacement (0.74 mm), and group B showed the lowest (0.65 mm). Among the implant groups, group C displayed the smallest maximum Von-Mises stress, measuring 9549 MPa, whereas group B exhibited the largest, reaching 17796 MPa. In group C, the tibia showed the smallest maximum Von-Mises stress, a modest 4335 MPa, in contrast to group B, which had the largest stress of 12050 MPa. Group A displayed the minimum Von-Mises fracture stress, a value of 4260 MPa, while the maximum Von-Mises stress, 12050 MPa, was found in group B.
For a bicondylar four-quadrant tibial plateau fracture, a medial tibial plateau-anchored T-plate provides a more robust supporting structure than two reconstruction plates affixed to the anteromedial and posteromedial plateaus, which should constitute the primary fixation. While playing a supporting role, the reconstruction plate exhibits a superior anti-glide effect when fixed longitudinally on the posteromedial plateau rather than obliquely on the posterolateral plateau, fostering a more stable biomechanical system.
For a bicondylar four-quadrant fracture of the tibial plateau, a T-shaped plate's fixation to the medial tibial plateau provides a more substantial supportive effect than employing two reconstruction plates in the anteromedial and posteromedial plateaus, which should serve as the predominant plate. The reconstruction plate, though secondary in its function, achieves anti-glide performance more efficiently when positioned longitudinally on the posteromedial plateau rather than obliquely on the posterolateral plateau. This contributes to a more consistent and reliable biomechanical structure.