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Bone nonunion

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https://www.readbyqxmd.com/read/27923216/efficacy-of-a-cellular-bone-allograft-for-foot-and-ankle-arthrodesis-and-revision-nonunion-procedures
#1
Travis J Dekker, Peter White, Samuel B Adams
BACKGROUND: Bone graft substitutes are often required in patients at risk for nonunion, and therefore, an allograft that most closely mimics an autograft is highly sought after. This study explored the utility and efficacy of a cellular bone allograft used for foot and ankle arthrodesis and revision nonunion procedures in a patient population at risk for nonunion. METHODS: An institutional review board-approved retrospective review of consecutive patients who underwent arthrodesis and revision nonunion procedures with a cellular bone allograft was performed at a single academic institution...
October 23, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27920804/bone-healing-in-2016
#2
REVIEW
John A Buza, Thomas Einhorn
Delayed fracture healing and nonunion occurs in up to 5-10% of all fractures, and can present a challenging clinical scenario for the treating physician. Methods for the enhancement of skeletal repair may benefit patients that are at risk of, or have experienced, delayed healing or nonunion. These methods can be categorized into either physical stimulation therapies or biological therapies. Physical stimulation therapies include electrical stimulation, low-intensity pulsed ultrasonography, or extracorporeal shock wave therapy...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27903929/a-comparison-of-outcomes-of-particulated-juvenile-articular-cartilage-and-bone-marrow-aspirate-concentrate-for-articular-cartilage-lesions-of-the-talus
#3
Nathan S Lanham, John J Carroll, Minton T Cooper, Venkat Perumal, Joseph S Park
Background Articular cartilage lesions of the talus remain a challenging clinical problem because of the lack of natural regeneration and limited treatment options. Microfracture is often the first-line therapy, however lesions larger than 1.5 cm(2) have been shown to not do as well with this treatment method. Methods The objective of this retrospective study was to evaluate the outcomes of iliac crest bone marrow aspirate concentrate/collagen scaffold (ICBMA) and particulated juvenile articular cartilage (PJAC) for larger articular cartilage lesions of the talus...
November 30, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27891264/world-s-first-clinical-case-of-gene-activated-bone-substitute-application
#4
I Y Bozo, R V Deev, A Y Drobyshev, A A Isaev, I I Eremin
Treatment of patients with large bone defects is a complex clinical problem. We have initiated the first clinical study of a gene-activated bone substitute composed of the collagen-hydroxyapatite scaffold and plasmid DNA encoding vascular endothelial growth factor. The first patient with two nonunions of previously reconstructed mandible was enrolled into the study. Scar tissues were excised; bone defects (5-14 mm) between the mandibular fragments and nonvascularized rib-bone autograft were filled in with the gene-activated bone substitute...
2016: Case Reports in Dentistry
https://www.readbyqxmd.com/read/27890196/-nonunion-after-distal-radius-fracture-a-review
#5
P Liverneaux, S Facca, J J Hidalgo Diaz
Nonunion after distal radius fracture is rare, serious and unpredictable. The preferred treatment is resection of the nonunion zone followed by open reduction and internal fixation with autologous iliac crest bone graft. When the distal fragment is less than 5mm high, a dorsal plate that bridges the radiocarpal joint is recommended. In patients with low functional demands, radiocarpal fusion is a logical choice. The bone healing rate is 58% and could be improved by using a vascular graft. Bone healing is not synonymous with good clinical outcomes...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27881440/culturing-bone-marrow-cells-with-dexamethasone-and-ascorbic-acid-improves-osteogenic-cell-sheet-structure
#6
M Akahane, T Shimizu, T Kira, T Onishi, Y Uchihara, T Imamura, Y Tanaka
OBJECTIVES: To assess the structure and extracellular matrix molecule expression of osteogenic cell sheets created via culture in medium with both dexamethasone (Dex) and ascorbic acid phosphate (AscP) compared either Dex or AscP alone. METHODS: Osteogenic cell sheets were prepared by culturing rat bone marrow stromal cells in a minimal essential medium (MEM), MEM with AscP, MEM with Dex, and MEM with Dex and AscP (Dex/AscP). The cell number and messenger (m)RNA expression were assessed in vitro, and the appearance of the cell sheets was observed after mechanical retrieval using a scraper...
November 2016: Bone & Joint Research
https://www.readbyqxmd.com/read/27879570/bone-turnover-markers-as-a-new-predicting-factor-for-non-union-after-spinal-fusion-surgery
#7
Hiroyuki Inose, Tsuyoshi Yamada, Mieradili Mulati, Takashi Hirai, Shuta Ushio, Toshitaka Yoshii, Tsuyoshi Kato, Shigenori Kawabata, Atsushi Okawa
STUDY DESIGN: Retrospective observational study. OBJECTIVE: We investigated whether bone turnover markers could be a useful indicator for prediction of nonunion. SUMMARY OF BACKGROUND DATA: Nonunion is a major complication of lumbar spinal fusion surgery. However, the involvement of bone turnover in the process of bony union in spinal fusion surgery is poorly understood. METHODS: Of the 74 patients analyzed, 13 were diagnosed with nonunion...
November 22, 2016: Spine
https://www.readbyqxmd.com/read/27876350/a-solution-to-the-vessel-shortage-during-free-vascularized-fibular-grafting-for-reconstructing-infected-bone-defects-of-the-femur-bridging-with-vein-transplantation
#8
Ren Gao-Hong, Li Run-Guang, Jiang Gui-Yong, Chen Chao-Jie, Bao Zhi-Gang
PURPOSE: The present study aimed to evaluate the feasibility and clinical efficacy of bridging vein transplantation to deal with the vessel shortage during free vascularized fibular grafting for reconstructing infected bone defects of the femur. METHODS: Twelve patients (aged 15-58 years) with infected bone defects of the femur (between 6.0 and 18.0cm) were recruited in this study. Vacuum sealing drainage were applied after extensive debridement of the infected bone defects and irrigated with 0...
October 22, 2016: Injury
https://www.readbyqxmd.com/read/27871419/the-use-of-allostem-in-subtalar-fusions
#9
REVIEW
J Chris Coetzee, Mark S Myerson, John G Anderson
Subtalar arthrodesis is the mainstay for treatment of a variety of hindfoot problems associated with arthritis, however with an unpredictable if not high rate of nonunion. This article covers the use of adipose-derived stem cells as an adjunct or alternative to autologous or other bone grafting materials. Promising development and encouraging data exist with respect to the use of adipose-derived mesenchymal stem cells for bone arthrodesis, which is discussed in more detail in the article.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871418/efficacy-of-a-cellular-allogeneic-bone-graft-in-foot-and-ankle-arthrodesis-procedures
#10
REVIEW
Travis J Dekker, Peter White, Samuel B Adams
A cellular allogeneic bone graft can be used in patients at high risk for nonunion after arthrodesis surgery. This study explores the utility and efficacy of MAP3 in foot and ankle arthrodesis procedures. Map3 is a cellular allogeneic bone graft that contains osteogenic, osteoconductive, osteoinductive, and angiogenic properties. A total of 23 mostly high-risk patients were included in this study. The overall fusion rate was 83%. Univariate analysis demonstrated diabetic patients remain at risk of recurrent nonunion (P<...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871412/role-of-recombinant-human-bone-morphogenetic-protein-2-on-hindfoot-arthrodesis
#11
REVIEW
Jeremy Hreha, Ethan S Krell, Christopher Bibbo
Despite advances in understanding bone healing physiology and surgical techniques, delayed union and nonunion still occur after the treatment of hindfoot arthrodesis. There is increasing appeal of bone morphogenetic proteins (BMPs) owing to the innate osteoinductive abilities of BMPs. Effective treatment with BMPs has been shown in animal studies. Human clinical studies have also shown success. The only study investigating the use of recombinant human BMP (rhBMP)-2 in hindfoot arthrodesis found a significant increase in fusion rate...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871411/injectable-recombinant-human-platelet-derived-growth-factor-in-collagen-carrier-for-hindfoot-fusion
#12
REVIEW
Andrew Dodd, Timothy R Daniels
Arthrodesis of the hindfoot is a common procedure for degenerative joint disease and/or severe deformity. Nonunion is a common complication from this procedure, causing an increased burden to the patient and health care system, often resulting in the need for revision surgery. Recombinant human platelet-derived growth factor (rhPDGF) has been shown to be a safe and effective tool to enhance arthrodesis rates in hindfoot surgery while avoiding the potential morbidity of bone grafting. This article provides a review of the role of rhPDGF in hindfoot fusions, and the surgical technique for performing an rhPDGF enhanced double-arthrodesis through a medial approach...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871409/the-efficacy-of-platelet-derived-growth-factor-as-a-bone-stimulating-agent
#13
REVIEW
Ethan S Krell, Christopher W DiGiovanni
Nonunion remains the most impactful complication following ankle and hindfoot arthrodesis. Historically, surgeons have relied on autologous bone graft (ABG) to combat nonunion risk. Although effective, ABG remains limited in quantity, varies in quality, and can be associated with harvest site pain and morbidity. Use of alternative bone-stimulating agents, however, avoids harvesting an autograft, and provides a more predictable dose-response efficacy. This article highlights findings from basic science, animal, and human clinical research that led to the approval of Augment Bone Graft...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871407/the-role-of-orthobiologics-in-fracture-healing-and-arthrodesis
#14
REVIEW
Sheldon S Lin, Michael G Yeranosian
Nonunion after tibial shaft fracture and hindfoot arthrodesis remains a major problem. Known risk factors include advanced age, immunosuppression, smoking, and diabetes. Several factors must be considered in the fracture healing process. This review evaluates the efficacy of orthobiologics in improving union rates after fracture or arthrodesis. Use of compounds have shown increased cellular proliferation experimentally. Percutaneous autologous bone marrow has shown increased cellular proliferation. Matrix supplementation has shown significant improvements in bone healing...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27863947/the-effects-of-low-dose-radiotherapy-on-fresh-osteochondral-allografts-an-experimental-study-in-rabbits
#15
Uğur Gönç, Mehmet Çetinkaya, Mesut Atabek
OBJECTIVE: The aim of this study was to investigate the effects of low-dose fractionated radiotherapy on cartilage degeneration after distal femoral fresh massive osteochondral allograft transplantation. METHODS: Twenty-four New Zealand White rabbits were divided into three groups of 8 rabbits each. All rabbits underwent distal femoral medial condyle fresh massive osteochondral allograft transplantation from California rabbits. The group 1 underwent transplantation without any preliminary process...
November 15, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27852903/effects-of-teriparatide-compared-with-risedronate-on-recovery-after-pertrochanteric-hip-fracture-results-of-a-randomized-active-controlled-double-blind-clinical-trial-at-26-weeks
#16
Per Aspenberg, Jorge Malouf, Umberto Tarantino, Pedro A García-Hernández, Costantino Corradini, Søren Overgaard, Jan J Stepan, Lars Borris, Eric Lespessailles, Frede Frihagen, Kyriakos Papavasiliou, Helmut Petto, José Ramón Caeiro, Fernando Marin
BACKGROUND: Osteoporosis drugs might affect fracture-healing. We therefore studied the effects of teriparatide in comparison with risedronate on recovery after pertrochanteric hip fractures. METHODS: The study was a randomized, multicenter, active-controlled, 78-week trial comparing teriparatide (20 μg/day) with risedronate (35 mg/week) initiated within 2 weeks after fixation of a low-trauma pertrochanteric hip fracture (AO/OTA 31-A1 or 31-A2). The main inclusion criteria were a bone mineral density T-score of ≤-2...
November 16, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27848072/hamate-hook-nonunion-initially-mistaken-for-ulnar-nerve-compression-a%C3%A2-case-report-with-review-of-literature
#17
Mario Josipovic, Dorotea Bozic, Ivan Bohacek, Tomislav Smoljanovic, Ivan Bojanic
BACKGROUND: Hamate hook (HH) stress fractures are rare, often presenting with misleading symptoms and easily overlooked/misdiagnosed. These fractures occur frequently in individuals participating in sports activities involving racquets, bats, or clubs. Symptoms are non-specific and often mimic other clinical conditions, such as ulnar nerve entrapment or ulnar vessel thrombosis. CASE REPORT: A 17-year-old tennis player with no history of trauma presented with dominant hand weakness together with pain and paresthesia on the ulnar side, which exacerbated with tennis play...
November 15, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27847665/an-unusual-and-complicated-course-of-a-giant-cell-tumor-of-the-capitate-bone
#18
Ingo Schmidt
A 51-year-old female patient presented with a carpal giant cell tumor (GCT) of the right capitate bone. The lesion was initially misdiagnosed as having an osteomyelitis. First, the diagnosis of a benign GCT was confirmed by histological examination. Second, an intralesional curettage and packing of the cavity with cancellous iliac crest bone grafts combined with a fusion of the third carpometacarpal (CMC III) joint were carried out. Third, due to a secondary midcarpal osteoarthritis and a secondary scaphoid nonunion, the CMC III joint fusion plate was removed and the midcarpal joint completely excised...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27843272/open-intramedullary-nailing-for-segmental-long-bone-fractures-an-effective-alternative-in-a-resource-restricted-environment
#19
Olasunkanmi M Babalola, Gbadebo Hakeem Ibraheem, Bola A Ahmed, Ayokunle Olawepo, Samuel B Agaja, Adebowale Adeniyi
BACKGROUND: Closed, locked intramedullary nailing has been accepted as the gold standard in the care of femoral fractures, with reported union rates as high as 98-100%. Closed, locked intramedullary nailing often requires expensive equipment which is a challenge in developing countries. Segmental long bone fractures are often a result of high-energy trauma and hence often associated with a lot of injuries to the surrounding soft tissues. This consequently results in higher rates of delayed or nonunion...
July 2016: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/27836732/bone-fracture-nonunion-rate-decreases-with-increasing-age-a-prospective-inception-cohort-study
#20
Robert Zura, Mary Jo Braid-Forbes, Kyle Jeray, Samir Mehta, Thomas A Einhorn, J Tracy Watson, Gregory J Della Rocca, Kevin Forbes, R Grant Steen
BACKGROUND: Fracture nonunion risk is related to severity of injury and type of treatment, yet fracture healing is not fully explained by these factors alone. We hypothesize that patient demographic factors assessable by the clinician at fracture presentation can predict nonunion. METHODS: A prospective cohort study design was used to examine ~2.5 million Medicare patients nationwide. Patients making fracture claims in the 5% Medicare Standard Analytic Files in 2011 were analyzed; continuous enrollment for 12months after fracture was required to capture the ICD-9-CM nonunion diagnosis code (733...
November 9, 2016: Bone
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