Papers by Keyword: Clinical

Abstract: Metallosis is an adverse event developed in relation with an orthopedic implant. It was brought into attention by metal on metal total hip arthroplasty. Lately, cases were diagnosed in total knee, total elbow, and spinal surgery. Metallic debris - released because of wear or corrosion - start an inflammatory response in a chronic condition. Beside local effects, systemic effects are also described; among them toxic effects, neurological and psychiatric, alteration in thyroid and heart function, skin rushes and discoloration. Diagnosis is helped by x-ray examination but is based on fluid aspiration with ions level determination and histological examination. Osteolysis phenomena induced by metallosis may compromise bone ingrowth and promote implant loosening; as result bone stock may be compromised. The cases we present have a particular development pattern; each of them was initiated as a result of atypical behavior of the implants. Two of them necessitated bone grafting in order to replace the reduced bone stock and all three required revision surgery. The cases emphasize the diagnosis methodology and the possible complications encountered during orthopedic implant surgery.

Abstract: A new biphasic calcium phosphate ceramic material Hydros™ has been developed. The main attractive feature of BCP ceramic is their ability to form a strong direct bond with the host bone resulting in a strong interface. Currently, granules are more and more used in moldable, injectable bone substitutes. However, the biological behaviour of the particles can be influenced not only by chemical composition and crystallinity, but also by several parameters as microporosity and nano-micro sized particles. The aim of the study was to assess, in animal experiment, the role played by an Hydrated Putty Bioceramics (Hydros™), based on specific combination of hydrophilic micro and macrosized BCP particles, to obtain high osteogenic Injectable Bone Substitute. No sign of clinical rejection was noticed. In muscular area, no fibrous encapsulation was observed, degradation of the smaller particles is observed by macrophages and giant cells. At 12 weeks, more of 75% of BCP was resorbed. The biocompatibility and safety in human orthopaedic applications (tibial plateau fracture) has been demonstrated.

Abstract: Fracture repair continues to be widely investigated, both within the clinical realm and at the fundamental research level. Clinical application of low intensity pulsed ultrasound (LIPUS) has shown great promise as an effective, minimally invasive treatment for accelerating fracture repair and has warranted further investigation into the cellular manifestation of applied ultrasound. Toward this end much has been learned about the response of osteoblasts to LIPUS stimulation. In vitro and in vivo evaluation of cellular response to LIPUS have revealed an increase in proliferation, protein synthesis, collagen synthesis, membrane permeability, integrin expression, and increased cytosolic calcium, to name a few, further clarifying its utility and overall impact on cellular behavior. Considerable effects of LIPUS on the cells of musculoskeletal soft tissue have been reported as well. The growing body of research in this area suggests that LIPUS may be a powerful tool in the development of novel approaches to musculoskeletal repair and regeneration. Regenerative engineering-based approaches to musculoskeletal healing and regeneration that incorporate polymeric scaffolds and stem cells may be combined with LIPUS to move beyond bone repair to large scale multicomponent tissue repair.

Abstract: Successful craniofacial reconstruction needs both a well-known and a reliable reconstruction material. However, there is often a lack of long-term knowledge of the tissue reactions and healing process in the human body. In this study, frontal sinus obliterations with bovine bone natural hydroxyapatite derivative (BHA), synthetic bioactive glass S53P4 (BAG) and hydroxyapatite cement (HAC) were investigated with clinical, histologic, scanning electron microscopic (SEM) and energy dispersive x-ray analysis (EDXA) 27, 12 and 3 years postoperatively. The aim was to determine the long-term clinical biocompatibility of the used materials. Histologic studies revealed bone formation with BHA particles and lamellar bone with BAG granule remnants in close contact to the new bone formation. In HAC reconstruction there was scattered fibroconnective tissue growth without new bone formation in the surface of HAC implantation. Neither foreign body reaction nor any abnormal findings were seen. SEM studies revealed a CaP layer on the surface of BAG granule remnants. In EDXA studies, composition profiles showed Ca-, P- and Si- rich layers on the BAG granule surface. No differences were found in CaO and P2O5 levels between BHA granules and HAC implantation and the surrounding bone. All investigated biomaterials were well tolerated in long-term applications.