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The Journal of Bone & Joint Surgery British Volume
Vol. 93-B, Issue 9 | Pages 1259 - 1264
1 Sep 2011
Wähnert D Windolf M Brianza S Rothstock S Radtke R Brighenti V Schwieger K

We investigated the static and cyclical strength of parallel and angulated locking plate screws using rigid polyurethane foam (0.32 g/cm3) and bovine cancellous bone blocks. Custom-made stainless steel plates with two conically threaded screw holes with different angulations (parallel, 10° and 20° divergent) and 5 mm self-tapping locking screws underwent pull-out and cyclical pull and bending tests. The bovine cancellous blocks were only subjected to static pull-out testing. We also performed finite element analysis for the static pull-out test of the parallel and 20° configurations. In both the foam model and the bovine cancellous bone we found the significantly highest pull-out force for the parallel constructs. In the finite element analysis there was a 47% more damage in the 20° divergent constructs than in the parallel configuration. Under cyclical loading, the mean number of cycles to failure was significantly higher for the parallel group, followed by the 10° and 20° divergent configurations.

In our laboratory setting we clearly showed the biomechanical disadvantage of a diverging locking screw angle under static and cyclical loading.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 272 - 273
1 May 2009
D’Amelio P Grimaldi A Di Bella S Brianza S Tamone C Pescarmona G Isaia G
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Aims: Compelling evidences suggest that increased production of osteoclastogenic cytokines by activated T cells plays a relevant role in the bone loss induced by estrogen (E) deficiency in the mouse. However, little information is available on the role of T cells in post-menopausal bone loss in humans.

Methods: To investigate this issue we have assessed the production of cytokines involved in osteoclasts (OCs) formation (RANKL, TNFα and OPG), in vitro Ocs formation in pre and postmenopausal women, the latter with or without osteoporosis. We also evaluate OC precursors in peripheral blood and the ability of peripheral blood mononuclear cells to produce TNFα in both basal and stimulated condition by flow cytometry in these subjects.

Results: Our data demonstrate that E enhances the production of the pro-osteoclastogenetic cytokines TNF alpha and RANKL and increases the number of circulating OCs precursors. Furthermore we show that T cells and monocytes from women with osteoporosis exhibit a higher production of TNF α then those from the other two groups.

Conclusions: Our findings suggest that E deficiency stimulates OCs formation both by increasing the production of TNF and RANKL and increasing the number of OCs precursors. Women with postmenopausal osteoporosis have a higher T cells activity than healthy postmenopausal subjects, T cells thus contribute to the bone loss induced by E deficiency in humans as they do in the mouse.