Despite its intrinsic ability to regenerate form and function after injury, bone tissue can be challenged by a multitude of pathological conditions. While innovative approaches have helped to unravel the cascades of bone healing, this knowledge has so far not improved the clinical outcomes of bone defect treatment. Recent findings have allowed us to gain in-depth knowledge about the physiological conditions and biological principles of bone regeneration. Now it is time to transfer the lessons learned from bone healing to the challenging scenarios in defects and employ innovative technologies to enable biomaterial-based strategies for bone defect healing. This review aims to provide an overview on endogenous cascades of bone material formation and how these are transferred to new perspectives in biomaterial-driven approaches in bone regeneration. Cite this article: T. Winkler, F. A. Sass, G. N. Duda, K. Schmidt-Bleek. A review of biomaterials in bone defect healing, remaining shortcomings and future opportunities for bone tissue engineering: The unsolved challenge.
The development and pre-clinical evaluation of
nano-texturised, biomimetic, surfaces of titanium (Ti) implants treated
with titanium dioxide (TiO2) nanotube arrays is reviewed. Cite this article:
Our aim in this study was to describe a continuing review of
11 total hip arthroplasties using 22.225 mm Alumina ceramic femoral
heads on a Charnley flanged femoral component, articulating against
a silane crosslinked polyethylene. Nine patients (11 THAs) were reviewed at a mean of 27.5 years
(26 to 28) post-operatively. Outcome was assessed using the d’Aubigne
and Postel, and Charnley scores and penetration was recorded on
radiographs. In addition, the oxidation of a 29-year-old shelf-aged
acetabular component was analysed.Aims
Patients and Methods
After an injury, the biological reattachment of tendon to bone is a challenge because healing takes place between a soft (tendon) and a hard (bone) tissue. Even after healing, the transition zone in the enthesis is not completely regenerated, making it susceptible to re-injury. In this study, we aimed to regenerate Achilles tendon entheses (ATEs) in wounded rats using a combination of kartogenin (KGN) and platelet-rich plasma (PRP). Wounds created in rat ATEs were given three different treatments: kartogenin platelet-rich plasma (KGN-PRP); PRP; or saline (control), followed by histological and immunochemical analyses, and mechanical testing of the rat ATEs after three months of healing.Objectives
Methods
We report the incidence of radiolucent lines (RLLs) using two
flanged acetabular components at total hip arthroplasty (THA) and
the effect of the Rim Cutter. We performed a retrospective review of 300 hips in 292 patients
who underwent primary cemented THA. A contemporary flanged acetabular
component was used with (group 1) and without (group 2) the use
of the Rim Cutter and the Rimfit acetabular component was used with
the Rim Cutter (group 3). RLLs and clinical outcomes were evaluated
immediately post-operatively and at five years post-operatively.Aims
Patients and Methods
This study aimed to evaluate the histological and mechanical features of tendon healing in a rabbit model with second-harmonic-generation (SHG) imaging and tensile testing. A total of eight male Japanese white rabbits were used for this study. The flexor digitorum tendons in their right leg were sharply transected, and then were repaired by intratendinous stitching. At four weeks post-operatively, the rabbits were killed and the flexor digitorum tendons in both right and left legs were excised and used as specimens for tendon healing (n = 8) and control (n = 8), respectively. Each specimen was examined by SHG imaging, followed by tensile testing, and the results of the two testing modalities were assessed for correlation.Objectives
Materials and Methods
The objective of this study was to determine if combining variations in mixing technique of antibiotic-impregnated polymethylmethacrylate (PMMA) cement with low frequency ultrasound (LFUS) improves antibiotic elution during the initial high phase (Phase I) and subsequent low phase (Phase II) while not diminishing mechanical strength. Three batches of vancomycin-loaded PMMA were prepared with different mixing techniques: a standard technique; a delayed technique; and a control without antibiotic. Daily elution samples were analysed using flow injection analysis (FIA). Beginning in Phase II, samples from each mix group were selected randomly to undergo either five, 15, 45, or 0 minutes of LFUS treatment. Elution amounts between LFUS treatments were analysed. Following Phase II, compression testing was done to quantify strength. Objectives
Methods
In the present study, we aimed to assess whether gelatin/β-tricalcium phosphate (β-TCP) composite porous scaffolds could be used as a local controlled release system for vancomycin. We also investigated the efficiency of the scaffolds in eliminating infections and repairing osteomyelitis defects in rabbits. The gelatin scaffolds containing differing amounts of of β-TCP (0%, 10%, 30% and 50%) were prepared for controlled release of vancomycin and were labelled G-TCP0, G-TCP1, G-TCP3 and G-TCP5, respectively. The Kirby-Bauer method was used to examine the release profile. Chronic osteomyelitis models of rabbits were established. After thorough debridement, the osteomyelitis defects were implanted with the scaffolds. Radiographs and histological examinations were carried out to investigate the efficiency of eliminating infections and repairing bone defects.Objective
Methods
The success of anterior cruciate ligament reconstruction (ACLR)
depends on osseointegration at the graft-tunnel interface and intra-articular
ligamentization. Our aim was to conduct a systematic review of clinical
and preclinical studies that evaluated biological augmentation of
graft healing in ACLR. In all, 1879 studies were identified across three databases.
Following assessment against strict criteria, 112 studies were included
(20 clinical studies; 92 animal studies). Aims
Materials and Methods
Fractures of the proximal femur are a common clinical problem, and a number of orthopaedic devices are available for the treatment of such fractures. The objective of this study was to assess the rotational stability, a common failure predictor, of three different rotational control design philosophies: a screw, a helical blade and a deployable crucifix. Devices were compared in terms of the mechanical work (W) required to rotate the implant by 6° in a bone substitute material. The substitute material used was Sawbones polyurethane foam of three different densities (0.08 g/cm3, 0.16 g/cm3 and 0.24 g/cm3). Each torsion test comprised a steady ramp of 1°/minute up to an angular displacement of 10°.Objectives
Methods
The objective of this five-year prospective, blinded, randomised
controlled trial (RCT) was to compare femoral head penetration into
a vitamin E diffused highly cross-linked polyethylene (HXLPE) liner
with penetration into a medium cross-linked polyethylene control
liner using radiostereometric analysis. Patients scheduled for total hip arthroplasty (THA) were randomised
to receive either the study E1 (32 patients) or the control ArComXL
polyethylene (35 patients). The median age (range) of the overall
cohort was 66 years (40 to 76).Aims
Patients and Methods
Vancomycin is commonly added to acrylic bone cement during revision
arthroplasty surgery. Proprietary cement preparations containing
vancomycin are available, but are significantly more expensive.
We investigated whether the elution of antibiotic from ‘home-made’
cement containing vancomycin was comparable with more expensive
commercially available vancomycin impregnated cement. A total of 18 cement discs containing either proprietary CopalG+V;
or ‘home-made’ CopalR+G with vancomycin added by hand, were made.
Each disc contained the same amount of antibiotic (0.5 g gentamycin,
2 g vancomycin) and was immersed in ammonium acetate buffer in a
sealed container. Fluid from each container was sampled at eight
time points over a two-week period. The concentrations of gentamicin
and vancomycin in the fluid were analysed using high performance
liquid chromatography mass spectrometry.Aims
Materials and Methods
The purpose of this study was to evaluate A total of 60 Sprague-Dawley rats (125 g to 149 g) were implanted
subcutaneously with SWCNT/PLAGA composites (10 mg SWCNT and 1gm
PLAGA 12 mm diameter two-dimensional disks), and at two, four, eight
and 12 weeks post-implantation were compared with control (Sham)
and PLAGA (five rats per group/point in time). Rats were observed
for signs of morbidity, overt toxicity, weight gain and food consumption,
while haematology, urinalysis and histopathology were completed
when the animals were killed.Objectives
Methods
The aim of this study was to compare the design of the generic
OptiStem XTR femoral stem with the established Exeter femoral stem. We obtained five boxed, as manufactured, implants of both designs
at random (ten in total). Two examiners were blinded to the implant
design and independently measured the mass, volume, trunnion surface
topography, trunnion roughness, trunnion cone angle, Caput-Collum-Diaphyseal
(CCD) angle, femoral offset, stem length, neck length, and the width
and roughness of the polished stem shaft using peer-reviewed methods.
We then compared the stems using these parameters.Aims
Materials and Methods
Polyethylene wear debris can cause osteolysis
and the failure of total hip arthroplasty. We present the five-year
wear rates of a highly cross-linked polyethylene (X3) bearing surface
when used in conjunction with a 36 mm ceramic femoral head. This was a prospective study of a cohort of 100 THAs in 93 patients.
Pain and activity scores were measured pre- and post-operatively.
Femoral head penetration was measured at two months, one year, two
years and at five years using validated edge-detecting software
(PolyWare Auto). At a mean of 5.08 years (3.93 to 6.01), 85 hips in 78 patients
were available for study. The mean age of these patients was 59.08
years (42 to 73, the mean age of males (n = 34) was 59.15 years,
and females (n = 44) was 59.02 years). All patients had significant
improvement in their functional scores (p <
0.001). The steady
state two-dimensional linear wear rate was 0.109 mm/year. The steady
state volumetric wear rate was 29.61 mm3/year. No significant
correlation was found between rate of wear and age (p = 0.34), acetabular
component size (p = 0.12) or clinical score (p = 0.74). Our study shows low steady state wear rates at five years in
X3 highly cross-linked polyethylene in conjunction with a 36 mm
ceramic femoral head. The linear wear rate was almost identical
to the osteolysis threshold of 0.1 mm/year recommended in the literature. Cite this article:
Bisphosphonates are widely used as first-line treatment for primary and secondary prevention of fragility fractures. Whilst they have proved effective in this role, there is growing concern over their long-term use, with much evidence linking bisphosphonate-related suppression of bone remodelling to an increased risk of atypical subtrochanteric fractures of the femur (AFFs). The objective of this article is to review this evidence, while presenting the current available strategies for the management of AFFs. We present an evaluation of current literature relating to the pathogenesis and treatment of AFFs in the context of bisphosphonate use.Objectives
Methods
Osteosynthesis of anterior pubic ramus fractures using one large-diameter screw can be challenging in terms of both surgical procedure and fixation stability. Small-fragment screws have the advantage of following the pelvic cortex and being more flexible. The aim of the present study was to biomechanically compare retrograde intramedullary fixation of the superior pubic ramus using either one large- or two small-diameter screws. A total of 12 human cadaveric hemipelvises were analysed in a matched pair study design. Bone mineral density of the specimens was 68 mgHA/cm3 (standard deviation (Objectives
Materials and Methods
