Osteochondral lesions of the talus are common injuries in the athletic patient. They present a challenging clinical problem as cartilage has a poor potential for healing. Current surgical treatments consist of reparat...Osteochondral lesions of the talus are common injuries in the athletic patient. They present a challenging clinical problem as cartilage has a poor potential for healing. Current surgical treatments consist of reparative(microfracture) or replacement(autologous osteochondral graft) strategies and demonstrate good clinical outcomes at the short and medium term follow-up. Radiological findings and second-look arthroscopy however, indicate possible poor cartilage repair with evidence of fibrous infill and fissuring of the regenerative tissue following microfracture. Longer-term follow-up echoes these findings as it demonstrates a decline in clinical outcome. The nature of the cartilage repair that occurs for an osteochondral graft to become integrated with the native surround tissue is also of concern. Studies have shown evidence of poor cartilage integration,with chondrocyte death at the periphery of the graft, possibly causing cyst formation due to synovial fluid ingress. Biological adjuncts, in the form of platelet-rich plasma(PRP) and bone marrow aspirate concentrate(BMAC), have been investigated with regard to their potential in improving cartilage repair in both in vitro and in vitro settings. The in vitro literature indicates that these biological adjuncts may increase chondrocyte proliferation as well as synthetic capability, while limiting the catabolic effects of an inflammatory joint environment. These findings have been extrapolated to in vitro animal models, with results showing that both PRP and BMAC improve cartilage repair. The basic science literature therefore establishes the proof of concept that biological adjuncts may improve cartilage repair when used in conjunction with reparative and replacement treatment strategies for osteochondral lesions of the talus.展开更多
Physiological repair of large-sized bone defects requires instructive scaffolds with appropriate mechanical properties,biocompatibility,biodegradability,vasculogenic ability and osteo-inductivity.The objective of this...Physiological repair of large-sized bone defects requires instructive scaffolds with appropriate mechanical properties,biocompatibility,biodegradability,vasculogenic ability and osteo-inductivity.The objective of this study was to fabricate in situ injectable hydrogels using platelet-rich plasma(PRP)-loaded gelatin methacrylate(GM)and employ them for the regeneration of large-sized bone defects.We performed various biological assays as well as assessed the mechanical properties of GM@PRP hydrogels alongside evaluating the release kinetics of growth factors(GFs)from hydrogels.The GM@PRP hydrogels manifested sufficient mechanical properties to support the filling of the tissue defects.For biofunction assay,the GM@PRP hydrogels significantly improved cell migration and angiogenesis.Especially,transcriptome RNA sequencing of human umbilical vein endothelial cells and bone marrow-derived stem cells were performed to delineate vascularization and biomineralization abilities of GM@PRP hydrogels.The GM@PRP hydrogels were subcutaneously implanted in rats for up to 4 weeks for preliminary biocompatibility followed by their transplantation into a tibial defect model for up to 8 weeks in rats.Tibial defects treated with GM@PRP hydrogels manifested significant bone regeneration as well as angiogenesis,biomineralization,and collagen deposition.Based on the biocompatibility and biological function of GM@PRP hydrogels,a new strategy is provided for the regenerative repair of large-size bone defects.展开更多
Background Platelet-rich plasma （PRP） is a kind of natural source of autologous growth factors, and has been used successfully in medical community. However, the effect of PRP in periodontal regeneration is not clea...Background Platelet-rich plasma （PRP） is a kind of natural source of autologous growth factors, and has been used successfully in medical community. However, the effect of PRP in periodontal regeneration is not clear yet. This study was designed to evaluate the effectiveness of PRP as an adjunct to bovine porous bone mineral （BPBM） graft in the treatment of human intrabony defects. Methods Seventeen intrabony defects in 10 periodontitis patients were randomly treated either with PRP and BPBM （test group, n=9） or with BPBM alone （control group, n=8）. Clinical parameters were evaluated including changes in probing depth, relative attachment level （measured by Florida Probe and a stent）, and bone probing level between baseline and 1 year postoperatively. Standardized periapical radiographs of each defect were taken at baseline, 2 weeks, and 1 year postoperatively, and analyzed by digital subtraction radiography （DSR）. Results Both treatment modalities resulted in significant attachment gain, reduction of probing depth, and bone probing level at 1-year post-surgery compared to baseline. The test group exhibited statistically significant improvement compared to the control sites in probing depth reduction： （4.78± 0.95） mm versus （3.48 ± 0.41） mm （P〈0.01）; clinical attachment gain： （4.52± 1.14） mm versus （2.85 ± 0.80） mm （P〈0.01）; bone probing reduction： （4.56±1.04） mm versus （2.88±0.79） turn （P〈0.01）; and defect bone fill： （73.41± 14.78）% versus （47.32± 11.47）% （P〈0.01）. DSR analysis of baseline and 1 year postoperatively also showed greater radiographic gains in alveolar bone mass in the test group than in the control group： gray increase （580±50） grays versus （220± 32） grays （P=0.0001）; area with increased gray were （5.21± 1.25） mm^2 versus （3.02± 1.22） mm^2 （P=0.0001）.Conclusions The treatment with a combination of PRP and BPBM led to a significantly favorable clinical improvement in periodontal intrabony defects compared to using BPBM alone. Further studies are necessary to assess the long-term effectiveness of PRP, and a larger sample size is needed.展开更多
文摘Osteochondral lesions of the talus are common injuries in the athletic patient. They present a challenging clinical problem as cartilage has a poor potential for healing. Current surgical treatments consist of reparative(microfracture) or replacement(autologous osteochondral graft) strategies and demonstrate good clinical outcomes at the short and medium term follow-up. Radiological findings and second-look arthroscopy however, indicate possible poor cartilage repair with evidence of fibrous infill and fissuring of the regenerative tissue following microfracture. Longer-term follow-up echoes these findings as it demonstrates a decline in clinical outcome. The nature of the cartilage repair that occurs for an osteochondral graft to become integrated with the native surround tissue is also of concern. Studies have shown evidence of poor cartilage integration,with chondrocyte death at the periphery of the graft, possibly causing cyst formation due to synovial fluid ingress. Biological adjuncts, in the form of platelet-rich plasma(PRP) and bone marrow aspirate concentrate(BMAC), have been investigated with regard to their potential in improving cartilage repair in both in vitro and in vitro settings. The in vitro literature indicates that these biological adjuncts may increase chondrocyte proliferation as well as synthetic capability, while limiting the catabolic effects of an inflammatory joint environment. These findings have been extrapolated to in vitro animal models, with results showing that both PRP and BMAC improve cartilage repair. The basic science literature therefore establishes the proof of concept that biological adjuncts may improve cartilage repair when used in conjunction with reparative and replacement treatment strategies for osteochondral lesions of the talus.
基金funded by Donghua University Postgraduate Innovation and Entrepreneurship Ability Training Program(yjssc2023002)supported by Science and Technology Commission of Shanghai Municipality,China(grant numbers 20S31900900 and 20DZ2254900)+1 种基金Sino German Science Foundation Research Exchange Center,China(M-0263)China Education Association for International Exchange(2022181).
文摘Physiological repair of large-sized bone defects requires instructive scaffolds with appropriate mechanical properties,biocompatibility,biodegradability,vasculogenic ability and osteo-inductivity.The objective of this study was to fabricate in situ injectable hydrogels using platelet-rich plasma(PRP)-loaded gelatin methacrylate(GM)and employ them for the regeneration of large-sized bone defects.We performed various biological assays as well as assessed the mechanical properties of GM@PRP hydrogels alongside evaluating the release kinetics of growth factors(GFs)from hydrogels.The GM@PRP hydrogels manifested sufficient mechanical properties to support the filling of the tissue defects.For biofunction assay,the GM@PRP hydrogels significantly improved cell migration and angiogenesis.Especially,transcriptome RNA sequencing of human umbilical vein endothelial cells and bone marrow-derived stem cells were performed to delineate vascularization and biomineralization abilities of GM@PRP hydrogels.The GM@PRP hydrogels were subcutaneously implanted in rats for up to 4 weeks for preliminary biocompatibility followed by their transplantation into a tibial defect model for up to 8 weeks in rats.Tibial defects treated with GM@PRP hydrogels manifested significant bone regeneration as well as angiogenesis,biomineralization,and collagen deposition.Based on the biocompatibility and biological function of GM@PRP hydrogels,a new strategy is provided for the regenerative repair of large-size bone defects.
文摘Background Platelet-rich plasma （PRP） is a kind of natural source of autologous growth factors, and has been used successfully in medical community. However, the effect of PRP in periodontal regeneration is not clear yet. This study was designed to evaluate the effectiveness of PRP as an adjunct to bovine porous bone mineral （BPBM） graft in the treatment of human intrabony defects. Methods Seventeen intrabony defects in 10 periodontitis patients were randomly treated either with PRP and BPBM （test group, n=9） or with BPBM alone （control group, n=8）. Clinical parameters were evaluated including changes in probing depth, relative attachment level （measured by Florida Probe and a stent）, and bone probing level between baseline and 1 year postoperatively. Standardized periapical radiographs of each defect were taken at baseline, 2 weeks, and 1 year postoperatively, and analyzed by digital subtraction radiography （DSR）. Results Both treatment modalities resulted in significant attachment gain, reduction of probing depth, and bone probing level at 1-year post-surgery compared to baseline. The test group exhibited statistically significant improvement compared to the control sites in probing depth reduction： （4.78± 0.95） mm versus （3.48 ± 0.41） mm （P〈0.01）; clinical attachment gain： （4.52± 1.14） mm versus （2.85 ± 0.80） mm （P〈0.01）; bone probing reduction： （4.56±1.04） mm versus （2.88±0.79） turn （P〈0.01）; and defect bone fill： （73.41± 14.78）% versus （47.32± 11.47）% （P〈0.01）. DSR analysis of baseline and 1 year postoperatively also showed greater radiographic gains in alveolar bone mass in the test group than in the control group： gray increase （580±50） grays versus （220± 32） grays （P=0.0001）; area with increased gray were （5.21± 1.25） mm^2 versus （3.02± 1.22） mm^2 （P=0.0001）.Conclusions The treatment with a combination of PRP and BPBM led to a significantly favorable clinical improvement in periodontal intrabony defects compared to using BPBM alone. Further studies are necessary to assess the long-term effectiveness of PRP, and a larger sample size is needed.
