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Bone & Joint Research
Vol. 6, Issue 5 | Pages 331 - 336
1 May 2017
Yamauchi R Itabashi T Wada K Tanaka T Kumagai G Ishibashi Y

Objectives

Ultraviolet (UV) light-mediated photofunctionalisation is known to improve osseointegration of pure titanium (Ti). However, histological examination of titanium alloy (Ti6Al4V), which is frequently applied in orthopaedic and dental surgery, has not yet been performed. This study examined the osseointegration of photofunctionalised Ti6Al4V implants.

Methods

Ti and Ti6Al4V implants were treated with UV light, and the chemical composition and contact angle on the surfaces were evaluated to confirm photofunctionalisation. The implants were inserted into femurs in rats, and the rats were killed two or four weeks after the surgery. For histomorphometric analysis, both the bone–implant contact (BIC) ratio and the bone volume (BV) ratio were calculated from histological analysis and microcomputed tomography data.


Bone & Joint Research
Vol. 6, Issue 2 | Pages 108 - 112
1 Feb 2017
Itabashi T Narita K Ono A Wada K Tanaka T Kumagai G Yamauchi R Nakane A Ishibashi Y

Objectives

The surface of pure titanium (Ti) shows decreased histocompatibility over time; this phenomenon is known as biological ageing. UV irradiation enables the reversal of biological ageing through photofunctionalisation, a physicochemical alteration of the titanium surface. Ti implants are sterilised by UV irradiation in dental surgery. However, orthopaedic biomaterials are usually composed of the alloy Ti6Al4V, for which the antibacterial effects of UV irradiation are unconfirmed. Here we evaluated the bactericidal and antimicrobial effects of treating Ti and Ti6Al4V with UV irradiation of a lower and briefer dose than previously reported, for applications in implant surgery.

Materials and Methods

Ti and Ti6Al4V disks were prepared. To evaluate the bactericidal effect of UV irradiation, Staphylococcus aureus 834 suspension was seeded onto the disks, which were then exposed to UV light for 15 minutes at a dose of 9 J/cm2. To evaluate the antimicrobial activity of UV irradiation, bacterial suspensions were seeded onto the disks 0, 0.5, one, six, 24 and 48 hours, and three and seven days after UV irradiation as described above. In both experiments, the bacteria were then harvested, cultured, and the number of colonies were counted.


Bone & Joint Research
Vol. 1, Issue 10 | Pages 238 - 244
1 Oct 2012
Naraoka T Ishibashi Y Tsuda E Yamamoto Y Kusumi T Kakizaki I Toh S

Objectives

This study aimed to investigate time-dependent gene expression of injured human anterior cruciate ligament (ACL), and to evaluate the histological changes of the ACL remnant in terms of cellular characterisation.

Methods

Injured human ACL tissues were harvested from 105 patients undergoing primary ACL reconstruction and divided into four phases based on the period from injury to surgery. Phase I was < three weeks, phase II was three to eight weeks, phase III was eight to 20 weeks, and phase IV was ≥ 21 weeks. Gene expressions of these tissues were analysed in each phase by quantitative real-time polymerase chain reaction using selected markers (collagen types 1 and 3, biglycan, decorin, α-smooth muscle actin, IL-6, TGF-β1, MMP-1, MMP-2 and TIMP-1). Immunohistochemical staining was also performed using primary antibodies against CD68, CD55, Stat3 and phosphorylated-Stat3 (P-Stat3).


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 109 - 110
1 Mar 2006
Tsuda E Ishibashi Y Tazawa K Sato H Toh S
Full Access

Purpose: Since the pathomechanism of patellofemoral malalignment is complex, multifactorial and varies individually, the ideal treatment has been a matter of controversy. The purpose of this study was to demonstrate the clinical outcome and radiographic changes of knees with patellofemoral malalignment treated with Fulkerson osteotomy after a minimum follow-up of 24 months.

Materials and Methods: Sixty knees in 40 patients (32 female and 8 male) were examined with a mean of 55 20 (25 97) months after having undergone medialization of the tibial tubercle using Fulkerson osteotomy for patel-lofemoral malalignment. Mean age at surgery was 20 7 (12 42) years. Prior surgery of medial retinacular plication in 4 knees and lateral retinacular release in 1 knee had been performed. During surgery, amount of tibial tubercle transfer was determined by examining the patellar tracking over full range of knee motion. After Fulkerson osteotomy, proximal realignment procedures were added depending on arthroscopic appearance of the patellofemoral adaptation. The clinical outcome was evaluated using Fulkersons knee instability scale. The radiographic parameters including congruence angle, lateral patellofemoral angle, tilting angle and lateral shift ratio were measured in Merchant view.

Results: Mean distance of medial transfer of tibial tubercle was 12.8 3.1 (8 22) mm. Lateral retinacular release in 54 knees and adductor magnus tenodesis (Avikainen procedure) in 2 knees were simultaneously performed combined with Fulkerson osteotomy. All radiographic parameters at the final follow-up were significantly improved compared to the preoperative values (p < 0.05 in a paired t-test), that is, from 23.0 14.6 to 0.4 13.7 degrees in congruence angle, from −6.3 9.0 to 0.4 6.9 degrees in lateral patellofemoral angle, from 25.1 11.5 to 16.3 5.6 degrees in tilting angle and from 35 24 to 17 9% in lateral shift ratio. Mean score in Fulkersons knee instability scale was 96 5 points at the final follow-up. All knees except 3 were ranked as excellent, very good or good. Two knees with moderate osteoarthritis of the patellofemoral joint were ranked as fair. One knee that had postoperative recurrence of patellar subluxation underwent a revision surgery with Avikainen procedure.

Discussion: In the clinical study with a minimum 2-year follow-up, Fulkerson tibial tubercle osteotomy provided excellent or good overall outcome in 93% of patients in combination with proximal realignment surgeries. Although all radiographic parameters were significantly improved, it was found that the lateral shift of the patella was more effectively corrected compared to the lateral tilt. It was suggested that reconstruction of the medial patellofemoral structures might be more suitable than Fulkerson osteotomy for some knees characterized by significant lateral tilt.