Concerting magnesium implant degradation facilitates local chemotherapy in tumor-associated bone defect

Effective management of malignant tumor-induced bone defects remains challenging due to severe systemic side effects,substantial tumor recurrence,and long-lasting bone reconstruction post tumor resection.Magnesium and its alloys have recently emerged in clinics as orthopedics implantable metals but mostly restricted to mechanical devices.Here,by deposition of calcium-based bilayer coating on the surface,a Mg-based composite implant platform is developed with tailored degradation characteristics,simultaneously integrated with chemotherapeutic(Taxol)loading capacity.The delicate modulation of Mg degradation occurring in aqueous environment is observed to play dual roles,not only in eliciting desirable osteoinductivity,but allows for modification of tumor microenvironment(TME)owing to the continuous release of degradation products.Specifically,the sustainable H2 evolution and Ca2+from the implant is distinguished to cooperate with local Taxol delivery to achieve superior antineoplastic activity through activating Cyt-c pathway to induce mitochondrial dysfunction,which in turn leads to significant tumor-growth inhibition in vivo.In addition,the local chemotherapeutic delivery of the implant minimizes toxicity and side effects,but markedly fosters osteogenesis and bone repair with appropriate structure degradation in rat femoral defect model.Taken together,a promising intraosseous administration strategy with biodegradable Mg-based implants to facilitate tumor-associated bone defect is proposed.

Kneadable dough-type hydrogel transforming from dynamic to rigid network to repair irregular bone defects

Irregular bone defects,characterized by unpredictable size,shape,and depth,pose a major challenge to clinical treatment.Although various bone grafts are available,none can fully meet the repair needs of the defective area.Here,this study fabricates a dough-type hydrogel(DR-Net),in which the first dynamic network is generated by coordination between thiol groups and silver ions,thereby possessing kneadability to adapt to various irregular bone defects.The second rigid covalent network is formed through photocrosslinking,maintaining the osteogenic space under external forces and achieving a better match with the bone regeneration process.In vitro,an irregular alveolar bone defect is established in the fresh porcine mandible,and the dough-type hydrogel exhibits outstanding shape adaptability,perfectly matching the morphology of the bone defect.After photocuring,the storage modulus of the hydrogel increases 8.6 times,from 3.7 kPa(before irradiation)to 32 kPa(after irradiation).Furthermore,this hydrogel enables effective loading of P24 peptide,which potently accelerates bone repair in Sprague–Dawley(SD)rats with critical calvarial defects.Overall,the dough-type hydrogel with kneadability,space-maintaining capability,and osteogenic activity exhibits exceptional potential for clinical translation in treating irregular bone defects.

Customized scaffolds for large bone defects using 3D‑printed modular blocks from 2D‑medical images

Additive manufacturing(AM)has revolutionized the design and manufacturing of patient-specific,three-dimensional(3D),complex porous structures known as scaffolds for tissue engineering applications.The use of advanced image acquisition techniques,image processing,and computer-aided design methods has enabled the precise design and additive manufacturing of anatomically correct and patient-specific implants and scaffolds.However,these sophisticated techniques can be timeconsuming,labor-intensive,and expensive.Moreover,the necessary imaging and manufacturing equipment may not be readily available when urgent treatment is needed for trauma patients.In this study,a novel design and AM methods are proposed for the development of modular and customizable scaffold blocks that can be adapted to fit the bone defect area of a patient.These modular scaffold blocks can be combined to quickly form any patient-specific scaffold directly from two-dimensional(2D)medical images when the surgeon lacks access to a 3D printer or cannot wait for lengthy 3D imaging,modeling,and 3D printing during surgery.The proposed method begins with developing a bone surface-modeling algorithm that reconstructs a model of the patient’s bone from 2D medical image measurements without the need for expensive 3D medical imaging or segmentation.This algorithm can generate both patient-specific and average bone models.Additionally,a biomimetic continuous path planning method is developed for the additive manufacturing of scaffolds,allowing porous scaffold blocks with the desired biomechanical properties to be manufactured directly from 2D data or images.The algorithms are implemented,and the designed scaffold blocks are 3D printed using an extrusion-based AM process.Guidelines and instructions are also provided to assist surgeons in assembling scaffold blocks for the self-repair of patient-specific large bone defects.

Clinical Efficacy of GBR Technique Combined with Temporary Bridgework-Guided Gingival Contouring in Treating Upper Anterior Tooth Loss with Labial Bone Defects

Objective:To investigate the clinical effect of the guided bone regeneration(GBR)technique combined with temporary bridgework-guided gingival contouring in treating upper anterior tooth loss with labial bone defects.Methods:From July 2023 to April 2024,80 patients with upper anterior tooth loss and labial bone defects were admitted to the hospital and selected as evaluation samples.They were divided into an observation group(n=40)and a control group(n=40)using a numerical table lottery scheme.The control group received treatment with the GBR technique,while the observation group received treatment with the GBR technique combined with temporary bridges to guide gingival contouring.The two groups were compared in terms of clinical red aesthetic scores(PES),labial alveolar bone density,labial bone wall thickness,gingival papillae,gingival margin levels,and patient satisfaction.Results:The PES scores of patients in the observation group were higher than those in the control group after surgery(P<0.05).The bone density of the labial alveolar bone and the thickness of the labial bone wall in the observation group were higher than those in the control group.The levels of gingival papillae and gingival margins were lower in the observation group after surgery(P<0.05).Additionally,patient satisfaction in the observation group was higher than in the control group(P<0.05).Conclusion:The GBR technique combined with temporary bridge-guided gingival contouring for treating upper anterior tooth loss with labial bone defects can improve the aesthetic effect of gingival soft tissue,increase alveolar bone density and the thickness of the labial bone wall,and enhance patient satisfaction.This approach is suitable for widespread application in healthcare institutions.

Artificial dermis combined with skin grafting for the treatment of hand skin and soft tissue defects and exposure of bone and tendon

BACKGROUND The recovery time of hand wounds is long,which can easily result in chronic and refractory wounds,making the wounds unable to be properly repaired.The treatment cycle is long,the cost is high,and it is prone to recurrence and disability.Double layer artificial dermis combined with autologous skin transplantation has been used to repair hypertrophic scars,deep burn wounds,exposed bone and tendon wounds,and post tumor wounds.AIM To investigate the therapeutic efficacy of autologous skin graft transplantation in conjunction with double-layer artificial dermis in treating finger skin wounds that are chronically refractory and soft tissue defects that expose bone and tendon.METHODS Sixty-eight chronic refractory patients with finger skin and soft tissue defects accompanied by bone and tendon exposure who were admitted from July 2021 to June 2022 were included in this study.The observation group was treated with double layer artificial dermis combined with autologous skin graft transplantation(n=49),while the control group was treated with pedicle skin flap transplantation(n=17).The treatment status of the two groups of patients was compared,including the time between surgeries and hospital stay.The survival rate of skin grafts/flaps and postoperative wound infections were evaluated using the Vancouver Scar Scale(VSS)for scar scoring at 6 mo after surgery,as well as the sensory injury grading method and two-point resolution test to assess the recovery of skin sensation at 6 mo.The satisfaction of the two groups of patients was also compared.RESULTS Wound healing time in the observation group was significantly longer than that in the control group(P<0.05,27.92±3.25 d vs 19.68±6.91 d);there was no significant difference in the survival rate of skin grafts/flaps between the two patient groups(P>0.05,95.1±5.0 vs 96.3±5.6).The interval between two surgeries(20.0±4.3 d)and hospital stay(21.0±10.1 d)in the observation group were both significantly shorter than those in the control group(27.5±9.3 d)and(28.4±17.7 d),respectively(P<0.05).In comparison to postoperative infection(23.5%)and subcutaneous hematoma(11.8%)in the control group,these were considerably lower at(10.2%)and(6.1%)in the observation group.When comparing the two patient groups at six months post-surgery,the excellent and good rate of sensory recovery(91.8%)was significantly higher in the observation group than in the control group(76.5%)(P<0.05).There was also no statistically significant difference in two point resolution(P>0.05).The VSS score in the observation group(2.91±1.36)was significantly lower than that in the control group(5.96±1.51),and group satisfaction was significantly higher(P<0.05,90.1±6.3 vs 76.3±5.2).CONCLUSION The combination of artificial dermis and autologous skin grafting for the treatment of hand tendon exposure wounds has a satisfactory therapeutic effect.It is a safe,effective,and easy to operate treatment method,which is worthy of clinical promotion.

Icariin accelerates bone regeneration by inducing osteogenesisangiogenesis coupling in rats with type 1 diabetes mellitus

BACKGROUND Icariin(ICA),a natural flavonoid compound monomer,has multiple pharmacological activities.However,its effect on bone defect in the context of type 1 diabetes mellitus(T1DM)has not yet been examined.AIM To explore the role and potential mechanism of ICA on bone defect in the context of T1DM.METHODS The effects of ICA on osteogenesis and angiogenesis were evaluated by alkaline phosphatase staining,alizarin red S staining,quantitative real-time polymerase chain reaction,Western blot,and immunofluorescence.Angiogenesis-related assays were conducted to investigate the relationship between osteogenesis and angiogenesis.A bone defect model was established in T1DM rats.The model rats were then treated with ICA or placebo and micron-scale computed tomography,histomorphometry,histology,and sequential fluorescent labeling were used to evaluate the effect of ICA on bone formation in the defect area.RESULTS ICA promoted bone marrow mesenchymal stem cell(BMSC)proliferation and osteogenic differentiation.The ICA treated-BMSCs showed higher expression levels of osteogenesis-related markers(alkaline phosphatase and osteocalcin)and angiogenesis-related markers(vascular endothelial growth factor A and platelet endothelial cell adhesion molecule 1)compared to the untreated group.ICA was also found to induce osteogenesis-angiogenesis coupling of BMSCs.In the bone defect model T1DM rats,ICA facilitated bone formation and CD31hiEMCNhi type H-positive capillary formation.Lastly,ICA effectively accelerated the rate of bone formation in the defect area.CONCLUSION ICA was able to accelerate bone regeneration in a T1DM rat model by inducing osteogenesis-angiogenesis coupling of BMSCs.

Masquelet technique in military practice:specificities and future directions for combat-related bone defect reconstruction

Because of its simplicity,reliability,and replicability,the Masquelet induced membrane technique(IMT)has become one of the preferred methods for critical bone defect reconstruction in extremities.Although it is now used worldwide,few studies have been published about IMT in military practice.Bone reconstruction is particularly challenging in this context of care due to extensive soft-tissue injury,early wound infection,and even delayed management in austere conditions.Based on our clinical expertise,recent research,and a literature analysis,this narrative review provides an overview of the IMT application to combat-related bone defects.It presents technical specificities and future developments aiming to optimize IMT outcomes,including for the management of massive multi-tissue defects or bone reconstruction performed in the field with limited resources.

Regenerative Medicine: A Review of Solutions in the Treatment of Skin Defects

The issue of skin defects is a major concern of almost every trauma surgeon after surgery. Despite numerous conventional methods and introduction of the reconstruction ladder, managing skin defects is still a challenge for the trauma surgeons. In recent years, parallel to the advances in the more conventional methods of skin repair, regenerative medicine has offered new and novel treatments. This article aims to explore these contemporary regenerative solutions as well as to review the conventional methods of treating skin defects.

Ilizarov technique for treatment of a giant aneurysmal bone cyst at the distal femur:A case report

BACKGROUND Aneurysmal bone cyst(ABC)is a benign cystic of unknown etiology,characterized by multiple chambers and a high recurrence rate.Current treatment options include vascular embolization,surgical excision,curettage with cavity filling,sclerosing agent injection into the cavity,radiotherapy,and systemic drug therapy.Among these,surgical excision and curettage are the preferred treatment modalities.However,when the cyst reaches a large size,extensive removal of diseased tissue during surgery can hinder bone healing.In our department,we treated a case of a large ABC at the distal end of the femur in a child using the Ilizarov technique.The tumor was completely excised,and reconstruction was achieved through autologous femoral bone transfer.The follow-up at two years post-surgery indicated good results without tumor recurrence,and the growth and development of the child were essentially unaffected.CASE SUMMARY An 11-year-old boy was presented with an accidental fracture of his right leg.Despite having been examined at other hospitals,he had not received treatment.Given the potential for significant bone defects and the difficulty of the surgery,our doctors opted to use the Ilizarov technique to minimize harm to the patient.Upon admission,the patient underwent a needle biopsy and complete tumor resection-the Ilizarov technique assisted in the transport and reconstruction of the autologous femoral bone.Postoperatively,the patient exhibited regular followups,during which bone transport was gradually performed,and the external fixation frame was removed on time.Follow-up X-rays of the right lower limb displayed no tumor recurrence,with a normal appearance.Bone formation at the cutting site was satisfactory,and the union of the bone ends indicated good healing.After two years of follow-up,the patient had essentially returned to normal.CONCLUSION We successfully applied the Ilizarov technique to treat ABC,reducing the financial burden of patients and the pain of multiple surgeries.In cases where significant bone defects occur,the Ilizarov technique has demonstrated satisfactory therapeutic outcomes.

Porocarcinoma in a palm reconstructed with a full thickness skin graft: A case report

BACKGROUND Porocarcinoma is a rare type of skin cancer that originates from sweat gland tumors.It is an aggressive malignant skin cancer that is difficult to diagnose clinically owing to its rarity and similarity to squamous cell carcinoma(SCC).CASE SUMMARY This case involved a 92-year-old woman,a farmer by profession,presented with an exophytic and verrucous mass on her left palm that had formed 2 years prior and caused chronic pain and frequent bleeding.Initially,the patient was diagnosed with SCC using a punch biopsy;however,a repeat biopsy with addi-tional immunohistochemical tests was performed for porocarcinoma.Ultimately,the patient was diagnosed with porocarcinoma and reconstruction was planned using a full-thickness skin graft.After treatment,the range of motion of the palm was preserved,and the aesthetic outcome was favorable.At 6 mo of follow-up,the patient was satisfied with the outcome.CONCLUSION Porocarcinoma is commonly misdiagnosed as SCC;therefore,clinicians should consider porocarcinomas when evaluating mass-like lesions on the hands.

Comparative study of chitosan/fibroin–hydroxyapatite and collagen membranes for guided bone regeneration in rat calvarial defects: micro-computed tomography analysis

This study aimed to utilize micro-computed tomography （micro-CT） analysis to compare new bone formation in rat calvarial defects using chitosan/fibroin-hydroxyapatite （CFB-HAP） or collagen （Bio-Gide） membranes. Fifty-four （54） rats were studied. A circular bony defect （8 mm diameter） was formed in the centre of the calvaria using a trephine bur. The CFB-HAP membrane was prepared by thermally induced phase separation. In the experimental group （n= 18）, the CFB-HAP membrane was used to cover the bony defect, and in the control group （n= 18）, a resorbable collagen membrane （Bio-Gide） was used. In the negative control group （n= 18）, no membrane was used. In each group, six animals were euthanized at 2, 4 and 8 weeks after surgery. The specimens were then analysed using micro-CT. There were significant differences in bone volume （BV） and bone mineral density （BMD） （P〈O.05） between the negative control group and the membrane groups. However, there were no significant differences between the CFB-HAP group and the collagen group. We concluded that the CFB-HAP membrane has significant potential as a guided bone regeneration （GBR） membrane.

Acellular allogeneic nerve grafting combined with bone marrow mesenchymal stem cell transplantation for the repair of long-segment sciatic nerve defects:biomechanics and validation of mathematical models

We hypothesized that a chemically extracted acellular allogeneic nerve graft used in combination with bone marrow mesenchymal stem cell transplantation would be an effective treatment for long-segment sciatic nerve defects.To test this,we established rabbit models of 30 mm sciatic nerve defects,and treated them using either an autograft or a chemically decellularized allogeneic nerve graft with or without simultaneous transplantation of bone marrow mesenchymal stem cells.We compared the tensile properties,electrophysiological function and morphology of the damaged nerve in each group.Sciatic nerves repaired by the allogeneic nerve graft combined with stem cell transplantation showed better recovery than those repaired by the acellular allogeneic nerve graft alone,and produced similar results to those observed with the autograft.These findings confirm that a chemically extracted acellular allogeneic nerve graft combined with transplantation of bone marrow mesenchymal stem cells is an effective method of repairing long-segment sciatic nerve defects.

Role of the Ilizarov non-free bone plasty in the management of long bone defects and nonunion: Problems solved and unsolved

BACKGROUND Ilizarov non-free bone plasty is a method of distraction osteogenesis using the Ilizarov apparatus for external fixation which originated in Russia and was disseminated across the world. It has been used in long bone defect and nonunion management along with free vascularized grafting and induced membrane technique. However, the shortcomings and problems of these methods still remain the issues which restrict their overall use.AIM To study the recent available literature on the role of Ilizarov non-free bone plasty in long bone defect and nonunion management, its problems and the solutions to these problems in order to achieve better treatment outcomes.METHODS Three databases(Pub Med, Scopus, and Web of Science) were searched for literature sources on distraction osteogenesis, free vascularized grafting and induced membrane technique used in long bone defect and nonunion treatment within a five-year period(2015-2019). Full-text clinical articles in the English language were selected for analysis only if they contained treatment results,complications and described large patient samples(not less than ten cases for congenital, post-tumor resection cases or rare conditions, and more than 20 cases for the rest). Case reports were excluded.RESULTS Fifty full-text articles and reviews on distraction osteogenesis were chosen.Thirty-five clinical studies containing large series of patients treated with this method and problems with its outcome were analyzed. It was found that distraction osteogenesis techniques provide treatment for segmental bone defects and nonunion of the lower extremity in many clinical situations, especially in complex problems. The Ilizarov techniques treat the triad of problems simultaneously(bone loss, soft-tissue loss and infection). Management of tibial defects mostly utilizes the Ilizarov circular fixator. Monolateral fixators are preferable in the femur. The use of a ring fixator is recommended in patients with an infected tibial bone gap of more than 6 cm. High rates of successful treatment were reported by the authors that ranged from 77% to 100% and depended on the pathology and the type of Ilizarov technique used. Hybrid fixation and autogenous grafting are the most applicable solutions to avoid after-frame regenerate fracture or deformity and docking site nonunion.CONCLUSION The role of Ilizarov non-free bone plasty has not lost its significance in the treatment of segmental bone defects despite the shortcomings and treatment problems encountered.

Real-time-guided bone regeneration around standardized critical size calvarial defects using bone marrow-derived mesenchymal stem cells and collagen membrane with and without using tricalcium phosphate: an in vivo microcomputed tomographic and histologic e

The aim of the present real time in vivo micro-computed tomography （pCT） and histologic experiment was to assess the efficacy of guided bone regeneration （GBR） around standardized calvarial critical size defects （CSD） using bone marrow-derived mesenchymal stem cells （BMSCs）, and collagen membrane （CM） with and without tricalcium phosphate （TCP） graft material. In the calvaria of nine female Sprague-Dawley rats, full-thickness CSD （diameter 4.6 mm） were created under general anesthesia. Treatment-wise, rats were divided into three groups. In group 1, CSD was covered with a resorbable CM; in group 2, BMSCs were filled in CSD and covered with CM; and in group 3, TCP soaked in BMSCs was placed in CSD and covered with CM. All defects were closed using resorbable sutures. Bone volume and bone mineral density of newly formed bone （NFB） and remaining TCP particles and rate of new bone formation was determined at baseline, 2, 4, 6, and 10 weeks using in vivo pCT. At the lOth week, the rats were killed and calvarial segments were assessed histologically. The results showed that the hardness of NFB was similar to that of the native bone in groups I and 2 as compared to the NFB in group 3. Likewise, values for the modulus of elasticity were also significantly higher in group 3 compared to groups 1 and 2. This suggests that TCP when used in combination with BMSCs and without CM was unable to form bone of significant strength that could possibly provide mechanical ＂lock＂ between the natural bone and NFB. The use of BMSCs as adjuncts to conventional GBR initiated new bone formation as early as 2 weeks of treatment compared to when GBR is attempted without adiunct BMSC therapy.

Management of Severe Femoral Bone Defect in Revision Total Hip Arthroplasty-A 236 Hip,6-14-year Follow-up Study

Summary： This study evaluated the clinical effect of impaction bone graft and distal press-fit fixation for the reconstruction of severe femoral bone defect in revision total hip arthroplasty. A total of 234 patients （involving 236 hips） with Paprosky III and 1V femoral bone defects were treated with the revision total hip arthroplasty from June 1998 to Aug. 2006. Impaction bone graft technique was used for 112 hips, with allogeneic freeze-dried bone as bone graft and SP II as prosthesis. With 124 hips, modular distal press-fit fixation and tapered femoral stem （MP stem） were employed. After the operation, the subjects were followed up on regular basis and results were assessed by using the Harris Hip Score （HHS） and 12-item Short Form Health Survey （SF-12）. Radiolucence, subsidence and loosening were observed and complications, including infection, fracture, dislocation etc. were recorded. A 6-14-year follow-up showed that prostheses failed, due to infection, in 4 patients of impaction bone graft group and that 6 patients in the press-fit fixation group experienced prosthesis failure, with the survival rates for the two techniques being 96.43% and 95.16%, respectively. One-way ANOVA showed that prosthesis survival was significantly associated with surgery-related complications （P〈0.05） and was not related to the type of the bone defects （P〉0.05）. The rate of complications bore significant association with the type of bone defects in the two groups （P〈0.05）. Our study showed that the two revision methods could achieve satisfactory mid-term and long-term results for the reconstruction of severe bone defects. It is of great significance for attaining high prosthesis survival rate to select suitable operation on the basis of the type of bone defect. Careful operative manipulation and post-operative rehabilitation aimed at reducing complications are also important.

Experimental study of natural hydroxyapatite/chitosan composite on reconstructing bone defects

Objective：To study the possibility of natural hydroxyapatite/chitosan composite on repairing bone defects. Methods：We developed a natural hydroxyapatite/chitosan composite that could be molded into any desired shape. The powder component consists of natural hydroxyapatite, which is epurated from bone of pigs. The liquid component consists of malic acid and chitosan. Operations were performed on the left tibias of 15 white rabbits to create two square bone defects. One of the defects was reconstructed with the composite, while the other was not repaired and used as a blank control. Three of the animals were killed at the end of 2 weeks, 4 weeks, 8 weeks, 12 weeks and 16 weeks respectively and implants were evaluated anatomically and histologically. Results：No apparent rejection reaction was found, except for a mild inflammatory infiltration observed 2 weeks after surgery. Fibrous tissue became thinner 2 -8 weeks after surgery and bony connections were detected 12 weeks after surgery. The new bone was the same as the recipient bone by the 16th postoperative week. Conclusion：The hydroxyapatite/chitosan composite has good biocompatibility and osteoconduction. It is a potential repairing material for clinical application.

Early therapeutic effect of platelet-rich fibrin combined with allogeneic bone marrow-derived stem cells on rats’ critical-sized mandibular defects

BACKGROUND Critically sized bone defects represent a significant challenge to orthopaedic surgeons worldwide.These defects generally result from severe trauma or resection of a whole large tumour.Autologous bone grafts are the current gold standard for the reconstruction of such defects.However,due to increased patient morbidity and the need for a second operative site,other lines of treatment should be introduced.To find alternative unconventional therapies to manage such defects,bone tissue engineering using a combination of suitable bioactive factors,cells,and biocompatible scaffolds offers a promising new approach for bone regeneration.AIM To evaluate the healing capacity of platelet-rich fibrin(PRF)membranes seeded with allogeneic mesenchymal bone marrow-derived stem cells(BMSCs)on critically sized mandibular defects in a rat model.METHODS Sixty-three Sprague Dawley rats were subjected to bilateral bone defects of critical size in the mandibles created by a 5-mm diameter trephine bur.Rats were allocated to three equal groups of 21 rats each.Group I bone defects were irrigated with normal saline and designed as negative controls.Defects of group II were grafted with PRF membranes and served as positive controls,while defects of group III were grafted with PRF membranes seeded with allogeneic BMSCs.Seven rats from each group were killed at 1,2 and 4 wk.The mandibles were dissected and prepared for routine haematoxylin and eosin(HE)staining,Masson's trichrome staining and CD68 immunohistochemical staining.RESULTS Four weeks postoperatively,the percentage area of newly formed bone was significantly higher in group III(0.88±0.02)than in groups I(0.02±0.00)and II(0.60±0.02).The amount of granulation tissue formation was lower in group III(0.12±0.02)than in groups I(0.20±0.02)and II(0.40±0.02).The number of inflammatory cells was lower in group III(0.29±0.03)than in groups I(4.82±0.08)and II(3.09±0.07).CONCLUSION Bone regenerative quality of critically sized mandibular bone defects in rats was better promoted by PRF membranes seeded with BMSCs than with PRF membranes alone.

ROLE OF TRANSFORMING GROWTH FACTOR β(TGF-β)IN REPAIRING OF BONE DEFECTS

TGF-β is a multifunctional cytokine that regulates many aspects of cellular function, including periosteal mesenchymal cell proliferation, differentiation. This experiment is to study its effects on bone defect repair. A rabbit radial bone defect model was used to evaluate the effect of TGF-β, which was extracted and purified from bovine blood platelets, on the healing of a large segmental osteoperiosteal defect. A 1. 5-centimeter segmental defect was created in the mid-upper part of the radial shaft of adult rabbits. The defect was filled with implant containing TGF-β that consisted of carrier and bovine TGF-β. Limbs served as controls received carrier alone. The defectswere examined radiographically and histologically at 4, 8,12 , 16 and 20 weeks after implantation. The results showed that in TGF-β implant group . the defect areas at 12 weeks post operation were bridged by uniform new bone and the cut ends of cortex could not be seen;while in control group, the defects remained clear. Only a small amount of new bone formed as a cap on the cut bone ends. In the experimental group, new lamellar and woven bone formed in continuity with the cut ends of the cortex. An early medullar canal appears to be forming and contained normal-appearancing marrow elements; while the control group displayed entirely fibrous tissue within the defect site. Remnants of the cancellous bone carrier were observed in the control specimen. These data demonstrate that exogenous TGF-β initiate osteogenesis and stimulate the bone defects repair in animal model.

3D Printing Hip Prostheses Offer Accurate Reconstruction,Stable Fixation,and Functional Recovery for Revision Total Hip Arthroplasty with Complex Acetabular Bone Defect

Complicated and large acetabular bone defects present the main challenges and difficulty in the revision of total hip arthroplasty(THA).This study aimed to explore the advantages of three-dimensional(3D)printing technology in the reconstruction of such acetabular bone defects.We retrospectively analyzed the prognosis of four severe bone defects around the acetabulum in three patients who were treated using 3D printing technology.Reconstruction of bone defect by conventional methods was difficult in these patients.In this endeavor,we used radiographic methods,related computer software such as Materialise's interactive medical image control system and Siemens NX software,and actual surgical experience to estimate defect volume,prosthesis stability,and installation accuracy,respectively.Moreover,a Harris hip score was obtained to evaluate limb function.It was found that bone defects could be adequately reconstructed using a 3D printing prosthesis,and its stability was reliable.The Harris hip score indicated a very good functional recovery in all three patients.In conclusion,3D printing technology had a good therapeutic effect on both complex and large bone defects in the revision of THA.It was able to achieve good curative effects in patients with large bone defects.

Autotransplantation of Teeth and the Reconstruction of Alveolar Bone Defects Using Artificial Bone: A Case Series

The aim of this study was to evaluate the outcome of autotransplantation or replantation of extracted teeth combining with reconstruction of alveolar bone defects in use of artificial bone grafting clinically and radiographically. This article presents a more useful and convenient method for repairing tooth and reconstruction of bone defecting with some interesting cases. Eleven patients (seven men and four women) in whom teeth with complete root formation were extracted and autotransplanted, the bone of receiving area was Insufficient. All transplanted teeth were stabilized with orthodontic wire and resin or 4-0 silk sutures;at the same time, artificial bone powder was filled. In 11 cases, the missing teeth were restored by autogenous teeth and the alveolar bone defect was restored by artificial bone, the improvement in the radiographic and clinical parameters strongly suggest that it may be a useful therapy to solve the problem of the missing teeth and alveolar bone insufficiency simultaneously. However, the risk of replacement root resorption remains.