Reconstruction Of Bone Defects Research Articles

Fibrous Dysplasia: From Historical Approaches to Modern Treatment Perspectives

Objective. This study aims to analyze scientific literature on fibrous dysplasia (FD) and highlight the state of diagnosis and treatment of orthopedic pathology in patients with various forms of FD. Materials and Methods. This article is based on a retrospective review of papers by various authors on the treatment of patients with FD. Articles were selected from scientific databases such as SCOPUS, Web of Science, and Google Scholar. The selected articles were reviewed in chronological order according to the topic of the study. Results and Discussion. The article provides a systematic analysis of treatment approaches for patients with FD at different stages of the development of science. Modern diagnostic and therapeutic approaches are also analyzed, with particular attention given to the molecular-genetic aspects of the disease’s etiology, particularly mutations in the GNAS gene, which underlie bone growth regulation disorders. Current treatment approaches, including the use of bisphosphonates and various types of surgical interventions, are discussed. Conclusions. A review of the scientific literature and analysis of historical aspects related to FD indicate both significant achievements of the orthopedic community in the diagnosis and treatment of FD, as well as significant challenges that will require further resolution. Changing views on the etiology and pathogenesis of the disease, as well as the identification of genetic mutations during early fetal development, have led to the recognition of FD as a stem cell disease. This provides new leverage for doctors and researchers to use stem cells in the treatment of patients with this pathology. Research on FD and the identification of this pathology as a result of stem cell disease has allowed scientists to explore new therapeutic approaches based on the use of mesenchymal stem cells (MSCs). MSCs can be used to correct bone tissue disorders since they can differentiate into osteoblasts and promote bone tissue remodeling. This opens the possibility for MSC transplantation or modification of their functioning to restore bone structures affected by FD. In our opinion, one promising area is the study of the osteogenic activity of MSCs from pathological sites, as this may help develop new regeneration strategies. There is a limited number of studies indicating the potential for bone defect reconstruction through the combination of MSCs and allomaterial.

Masquelet technique including a multiperforated non-vascularized fibula graft for the reconstruction of massive post-traumatic bone defects in military practice.

The management of extensive bone defects presents a significant challenge for military orthopedic surgeons, especially in the context of a high intensity conflict or when patients are fully treated in the field. The objective was to evaluate the induced membrane technique (IMT) including a multiperforated non-vascularized fibular graft (NVFG) for the reconstruction of massive bone defects performed in both the ideal conditions of military trauma centers and the austere environment of forward surgical units. A retrospective case study was conducted on patients who underwent the above procedure in various care settings between January 2019 and June 2023. Outcomes measured included the achievement of bone union, time to bone union, and the healing index (time to bone healing/length of reconstructed bone). Functional assessment was based on the Quick-DASH score and the lower extremity functional scale (LEFS). Nine patients with a mean age of 37 years were included: five were managed in a role 4 medical treatment facility (MTF) and four in a role 2 MTF. Five patients had an infected bone defect before IMT application. After debridement, the mean bone defect length was 14cm, and the mean bone defect volume was 190 cm3. The mean interval between stages was 15 weeks. The mean follow-up was 20 months. Bone union was achieved in 8/9 cases with a mean time of 8.1 months and a mean healing index of 0.58 month/cm. Only the patient with persistent humeral nonunion had a poor DASH-score. The mean LEFS was 68%. In this small cohort, IMT including a multiperforated NVFG enabled successful reconstruction of massive bone defects in the femur, tibia, and humerus, even in the austere environment of forward surgical units, provided that prior infection control had been achieved.

Consolidation of the Anteromedial Aspect of the Tibia Is Inferior to the Other Areas in the Reconstruction of Critical-Sized Bone Defect of the Tibial Shaft Using the Induced Membrane Technique: An Analysis of 111 Serial Computed Tomography of 37 Patients.

To compare the consolidation quality between the anteromedial aspect of regenerated bone (AMRB) and the other areas of regenerated bone (TORB) following the induced membrane technique (IMT) for managing critical-sized tibial shaft bone defects, and determine the factors affecting consolidation quality in the AMRB. Retrospective comparative study. Academic Level I trauma center. Included were patients who underwent IMT with only an intramedullary nail for tibial shaft segmental defects and serial computed tomography immediately, 6 months, and 1 year postoperatively. Comparison were made of regenerative bone volume, density, and corticalization between AMRB and TORB. This study enrolled 37 patients with a mean age of 47.7 years (range 20-79). Twenty-eight (75.7%) patients were men. Postoperatively, the AMRB exhibited significantly more negative volumetric change than TORB at 0-1 year (-20.01% ± 25.59% vs. -13.32% ± 22.48%, P = 0.028), less positive density change 0-6 months (+197.84 ± 107.95 vs. +290.14 ± 131.74 Hounsfield unit (HU), P < 0.001) and 0-1 year (+377.51 ± 150.71 HU vs. +455.48 ± 135.04 HU, P < 0.001), and lower corticalization rate in 1 year (49.77% ± 29.42% vs. 82.27 ± 19.73%, P < 0.001). Significant factors included fracture-related infection (FRI) ( P = 0.047 and P = 0.048 at 0-6 months and 0-1 year, respectively) and longer defect length ( P = 0.032 and P = 0.020) for the negative volumetric AMRB changes; older age ( P = 0.004 and P = 0.016) for the AMRB negative density changes; higher percentage of mixed recombinant human bone morphogenetic protein-2 in graft material ( P = 0.013 in 0-6 months) for the AMRB positive density change; FRI ( P = 0.024) for the inferior corticalization rate of the AMRB; FRI ( P = 0.026 in 0-1 year), longer defect length ( P = 0.017 in 0-6 months), and higher mixed demineralized bone matrix percentage ( P = 0.010 in 0-1 year) for the difference in density change between the AMRB and TORB; higher mixed demineralized bone matrix percentage ( P = 0.023) for the difference between the AMRB and TORB in corticalization rates. The tibial shaft's anteromedial aspects demonstrated significantly inferior consolidation after IMT, especially in terms of volume at 6 months, density at 6 months and 1 year, and corticalization at 1 year postoperatively. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

The results of the use of biological bone reconstruction in performing oncological revision knee replacement

Introduction. With an increase in revision surgeries for oncological knee prostheses replacement, one of the most significant challenges has been the need to address substantial intramedullary defects affecting the diaphysis and metaepiphyses in these patients. Our study is based on our experience with biological reconstruction methods used during such operations. We have developed both the methodology and necessary tools for its implementation, as well as conducted a comprehensive evaluation of its practical application results.Aim. To assess the effectiveness of using biological bone reconstruction techniques in oncologic revision knee arthroplasty.Materials and methods. A retrospective study included 57 patients who underwent revision total oncology knee arthroplasty with the use of biological reconstruction for intramedullary bone defects between 2017 and 2023, with a follow-up period of at least 12 months. Of these, 45 (78.9 %) were operated due to instability of the prosthetic components, while 12 (21.1 %) were treated in the second stage after spacer implantation due to infection.Distribution of patients by location of bone defect: 26 (45.5 %) had femoral bone defects, 4 (7 %) had tibial bone defects, and 27 (47.4 %) had combined lesions involving both bones. Among the participants, 59.6 % were female and 40.4 % were male. The median age was 48 years (Q1–Q3) 39.00–57.00; min 23 – max 72), and the median follow-up time was 48 months (Q1–Q3 28.00–60.00; min 12 – max 150). Median blood loss values were 900 ml (Q1–Q3 700.0–1100.0; min 400 – max 2200), operation duration was 220 minutes (Q1–Q3 190.0–240.0; min 140 – max 300), and patient weight was 85 kg (Q1–Q3 77.0–95.0; min 56 – max 180).We assessed complication risks, functional outcomes, and survival rates of the implants. All patients were divided into two groups: Group 1 (n = 37 or 64.9 %), operated before the introduction of new instruments, and Group 2 (n = 20 or 35.1%), operated after their introduction. Parameters such as operation duration and blood loss volume were compared between the groups.Results. Over the entire observation period from 2017 to 2024, three cases (5.3%) of complications were identified. Bone density assessment in the bone graft zone was performed via CT scan six months postoperatively, yielding a mean value of 690 HU (Q1–Q3 570.0 – 790.0; min 340 – max 980).Analysis of lower limb function dynamics according to the MSTS scale pre- and post-operation revealed statistically significant improvements (p &lt;0.001) (using Wilcoxon’s test).Five-year survival rate of knee prostheses after revision arthroplasty was 96 %.To analyze the effectiveness of introducing the newly developed instrumentation, we studied blood loss and operative times with and without its use. Using the instrumentation significantly reduced blood loss (p &lt;0.001) and operative time (p &lt;0.001) as determined by Mann-Whitney U-tests.Conclusion. The five-year survival rates for constructs in patients undergoing surgery with biological bone reconstruction are comparable to those observed after primary implantations of oncologic prostheses.

Exploring the optimal reconstruction strategy for Enneking III defects in pelvis bone tumors: a finite element analysis

BackgroundControversy exists regarding the reconstruction of bone defects in Enneking III. This study aimed to use the finite element analysis (FEA) method to clarify (1) the utility of reconstructing the pelvis Enneking III region and (2) the optimal approach for this reconstruction.MethodsFEA models were generated for three types of Enneking III defects in the pelvis, replacing all the defect areas in region III with a sizable solid box for topology optimization (TO). Based on the defect location and TO results, three reconstruction schemes were designed for each type of defect. We subsequently conducted simulations of static FEA under natural walking loads using ANSYS software (version 2022R1, Canonsburg, Pennsylvania, USA).ResultsCompared with Scheme A, reconstruction of the Enneking III region (Schemes B and C) led to a more uniform stress distribution and lower peak stress in the pelvis. Moreover, prostheses and screws exhibit decreased peak stress and deformation, with complex reconstruction schemes (C) outperforming simpler ones (B).ConclusionsThe FEA results suggest that reconstructing Enneking Zone III defects improves stress distribution and reduces peak stress in the pelvis compared to non-reconstruction, potentially enhancing stability and reducing fracture risks. Complex reconstruction schemes involving more contralateral pelvis regions demonstrate superior biomechanical performance. However, clinical decisions should be individualized, integrating biomechanical insights with comprehensive patient-specific factors.

Masquelet technique combined with concentrated growth factors for the reconstruction of rabbit mandibular marginal bone defect.

Both the Masquelet technique (MT) and concentrated growth factors (CGF) reduce early graft loss and improve bone regeneration. This study aims to explore the efficacy of combining MT with CGF for mandibular defect repair by characterizing the induced membrane and assessing in vivo osteogenesis. Three experimental groups were compared: negative control (NC), MT, and Masquelet combined with CGF (MTC). Four weeks after the first surgery, histopathology is used to identify the morphological structure of the induced membrane, evaluate the degree of vascularization, and the secretion levels of osteogenesis and angiogenesis-related growth factors. In vivo osteogenesis was assessed with a second autologous bone graft surgery 4 weeks later, and bone reconstruction was evaluated by micro-CT and histopathology. CGF significantly increased the induced membrane thickness, vascularization, and growth factor secretion levels. Quantitative micro-CT analysis showed that the bone volume fraction (BV/TV) at 4 weeks post-surgery was higher in the MTC group (23.30 ± 1.15%) compared to the MT group (16.50 ± 1.29%) and NC group (12.62 ± 1.23%) (P < 0.05). By 12 weeks, the difference in BV/TV between MTC (32.59 ± 0.11%) and MT (29.89 ± 0.49%) reduced, indicating consistent bone regeneration. Trabecular parameters were consistently higher in the MTC group, highlighting enhanced osteogenesis. Combining the Masquelet technique with CGF effectively reduces early bone graft absorption and promotes bone repair. These findings suggest potential benefits for oral and maxillofacial bone defect treatment, though further studies are needed to confirm long-term efficacy. Integrating Masquelet technique and CGF in mandibular reconstruction may improve clinical outcomes by enhancing bone regeneration and reducing graft failure.

Sticky Bone added to the Split Crest technique for implant placement in an atrophic mandible. Clinical Case

Placing an implant in an atrophic alveolar ridge is a challenge regarding the reconstruction of bone defects of one or two walls. A solidified bone graft trapped in a fibrin network prevents its dispersion even when subjected to movement or shaking. The Split Crest technique offers a practical way to expand the atrophic alveolar ridge. This allows the use of bone grafts without needing a second surgical site, which reduces the risk of edema, nerve injuries, and pain. A 50-year-old patient, systematically healthy, reported difficulty chewing, swallowing, and speech due to a poorly adapted prosthesis in the jaw, which caused dissatisfaction with the prosthetic treatment already performed. This case report aimed to describe the Sticky Bone procedure by adding an autologous atrophic jaw graft using the Split Crest technique, obtaining an average bone gain of 2.5mm, having good results after eight months postoperatively, there was no peri-implant marginal bone resorption.

Masquelet Inspired in Vivo Engineered Extracellular Matrix as Functional Periosteum for Bone Defect Repair and Reconstruction.

The Masquelet technique that combines a foreign body reaction (FBR)-induced vascularized tissue membrane with staged bone grafting for reconstruction of segmental bone defect has gained wide attention in Orthopedic surgery. The success of Masquelet hinges on its ability to promote formation of a "periosteum-like" FBR-induced membrane at the bone defect site. Inspired by Masquelet's technique, here a novel approach is devised to create periosteum mimetics from decellularized extracellular matrix (dECM), engineered in vivo through FBR, for reconstruction of segmental bone defects. The approach involved 3D printing of polylactic acid (PLA) template with desired pattern/architecture, followed by subcutaneous implantation of the template to form tissue, and depolymerization and decellularization to generate dECM with interconnected channels. The dECM matrices produces from the same mice (autologous) or from different mice (allogenic) are used as a functional periosteum for repair of structural bone allograft in a murine segmental bone defect model. This study shows that autologous dECM performed better than allogenic dECM, further permitting local delivery of low dose BMP-2 to enhance allograft incorporation. The success of this current approach can establish a new line of versatile, patient-specific, and periosteum-like autologous dECM for bone regeneration, offering personalized therapeutics to patients with impaired healing.

Analysis of the Effect of Human Type I Collagen-Derived Peptide on Bone Regenerative Capacity and Comparison with Various Collagen Materials In Vivo.

Background and Objectives: Autologous bone grafting is the first choice for reconstructive surgery in bone defects due to trauma or malignant tumors. However, there is an increasing demand for minimally invasive alternatives involving bone regeneration using artificial materials. Biomimetic materials that replicate the body's microscopic structure, such as Cellnest®, are gaining attention. Cellnest is a xeno-free recombinant peptide based on human type I collagen, containing a rich Arg-Gly-Asp (RGD) motif related to cell adhesion. The aim of this study was to compare the effects of Cellnest with existing collagen materials (Pelnac®, Integra®, Terudermis®) on bone regeneration and elucidate the underlying mechanisms. Materials and Methods: In vivo experiments involved a rat model of calvarial bone defects, in which Cellnest and other collagen materials were implanted into the defect area. Bone formation was assessed after 4 weeks using micro-computed tomography (micro-CT) and histological analysis. In vitro experiments included the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), adhesion, and migration assays, and a real-time polymerase chain reaction using rapidly expanding cells (RECs) to explore the mechanisms of Cellnest's bone regenerative capacity. Results: The micro-CT analysis showed that the regenerated bone area was significantly greater in the Cellnest group (72.3%) than in the Pelnac® (25.5%), Integra® (31.6%), and Terudermis® (38.3%) groups. The histological analysis confirmed similar trends, with Cellnest showing 42.2% bone regeneration, outperforming the other materials. The in vitro assays revealed that Cellnest promoted cell proliferation, adhesion, and migration. Gene expression analysis demonstrated that Cellnest significantly increased the levels of the bone formation markers ALP and COL1. Conclusions: Cellnest, a human type I collagen-like peptide rich in RGD motifs, enhances bone regeneration by promoting MSC adhesion and migration, and bone formation-related gene expression. The findings suggest its potential as an effective material for bone defect reconstruction.

Double-Barreled Vascularized Fibula Free Flap in Pediatric Tibial Bone Defect Reconstruction: A 20-Year Monocentric Experience.

Reconstructing large bone defects for lower limb salvage in the pediatric population remains challenging due to complex oncological or septic issues, limited surgical options, and lengthy procedures prone to complications. The vascularized double-barreled fibula free flap is pivotal for reconstructing large bones. In this article, we report our experience with this technique in the surgical management of pediatric tibial bone defects. We conducted a retrospective analysis of patients under 18 years of age who underwent tibial reconstruction using a double-barreled fibula free flap at our center between 2004 and 2023. Collected data included demographic information, operative details, time to bone consolidation and full weight-bearing, and functional outcomes using the Musculoskeletal Tumor Society (MSTS) score. Eight patients (5 females, 3 males) with a mean age of 12.5 years (range 5-17) were included. The average tibial defect length was 11.2 cm (range 7-14 cm), affecting the proximal tibia in 4 cases (50%), the middle third in 3 cases (37.5%), and the distal third in 1 case (12.5%). Reconstruction followed oncologic resection in 7 patients (87.5%) and addressed congenital pseudarthrosis in 1 patient (12.5%). One patient died of sarcoma. Six patients (75%) achieved full weight-bearing within a median of 7 months (range 6-16) and a bone consolidation at 9 months in median (range 6-18). One reconstruction (12.5%) failed due to septic pseudarthrosis leading to a below-knee amputation. The mean MSTS score was 81.65 (range 63.3-100). This study is the first to focus on pediatric tibial reconstructions using the double-barreled vascularized fibula free flap. It highlights the technique's reliability for reconstructing tibial defects, particularly in intermediate-sized cases (7-14 cm). This single-stage procedure minimizes stress fracture risk, enables earlier weight-bearing, and is an alternative to the Capanna technique without requiring an allograft.

Osteoclastogenesis markers in craniofacial bone defects after demineralized dentin material membrane implantation as guided bone regeneration.

this article aims to analyze the expression of TNF-α, RANKL, and osteoclast cells count after application of DDMM as GBR in mandibular bone defects. this is an experimental study with a post-test only control group design, which began with the randomization of 120 rats into five groups: K(-), without membrane implantation; K(+), PPCM; P1, DDMM; P2, DDMM + bone graft; P3, PPCM + bone graft. The expression of TNF-α, RANKL, and osteoclast cells count were observed, followed by analysis using a one-way ANOVA and post hoc Tukey HSD comparison test. there were significant differences in the expression of TNF-α, RANKL, and osteoclast cells count in all study groups (p=0.000). TNF-α showed a decreasing difference with the highest expression in the K(-) group on day 3 of 12.00±2.16. RANKL expression increased on day 14 and decreased on day 21 in all groups. The osteoclast cells count generally showed a critical period with the highest increase in the K(-) group on day 14 of 73.00±0.00. DDMM has the potential to be a superior membrane substitute compared to PPCM as GBR in alternative treatment for craniofacial bone defects reconstruction.

Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases

Abstract Background Treating infectious bone defects combined with large soft-tissue lesions poses significant clinical challenges. Herein, we introduced a modified two-stage treatment approach involving the implantation of 3D-printed prostheses and flap repair to treat large segmental infectious tibial bone defects. Method We conducted a retrospective study of 13 patients treated at our center between April 2018 and March 2022 for tibial infections owing to posttraumatic infection and chronic osteomyelitis combined with soft tissue defects. The average defect length was 14.0 cm (range, 5.7–22.9 cm). The flap area ranged from 14 × 5 to 15 × 8 + 25 × 15 cm. Sural neurocutaneous, lesser saphenous neurocutaneous, and local fasciocutaneous flaps were used to repair the skin defects. In the second stage, 3D-printed prostheses were designed and implanted. Union rate, complications, and functional outcomes were assessed at the final follow-up. Result The average follow-up period was 31.1 months (range, 17–47 months), with an average interval of 208.1 days (range, 139–359 days) between the two stages. According to our criteria, 7 of the 13 patients achieved radiographic healing without intervention. Two patients developed prosthesis-related complications and underwent revision surgery. Two patients experienced recurrent infections leading to prosthesis removal and debridement surgery, with the infection ultimately eradicated in one and the other undergoing amputation. Three patients experienced noninfectious flap-related complications, however, all eventually healed through surgical intervention. Conclusion The use of 3D-printed porous titanium prostheses combined with flap soft-tissue repair for the treatment of infectious tibial bone defects did not increase the rate of infection recurrence and provided good functional recovery, offering more options for the treatment of infectious bone defects.

Cancellous bone harvesting from the distal radius for reconstruction of bone defects in the hand

Extraction of cancellous bone from the distal radius for reconstructive procedures on the hand. All reconstructive procedures on the hand for which acorticocancellous and/or vascularized bone graft or alarge amount of cancellous bone is not required. Acute distal radius fracture, osteosynthesis material embedded in the distal radius, e.g., after palmar plate osteosynthesis of adistal radius fracture, tumor in the distal radius. Removal of cancellous bone from the distal radius radially from the dorsal radial tuberosity via asmall bone window at the base of the second extensor tendon compartment. Wound dressing on the distal radius, elevation of the arm above heart level until swelling has subsided, first dressing change on postoperative day1 or 2,depending on the primary procedure on the hand, dressing until wound healing is complete, removal of the skin sutures around postoperative day14. In 2023, cancellous bone was harvested from the distal radius of 17patients for reconstructive procedures on the hand (6mediocarpal partial arthrodeses, 3acute fractures, 5delayed bone healings, 1pseudarthrosis, 2bone tumors). In all cases, the available amount of radius cancellous bone was sufficient, resulting in satisfactory healing. All patients complained of short-term, slight discomfort at the donor site for the first few days after surgery, which resolved completely. There were no complications at the donor site on the distal radius.

Utilization of 3D-Printed Customized Uncemented Stem Prostheses for Revision of Aseptic Loosening in the Distal Femoral Cemented Prostheses: Case Series and Literature Review.

Aseptic loosening (AL) is a common mechanical complication following reconstruction of the distal femoral cemented prosthesis (DFCP), often resulting in severe bone loss, which complicates prosthesis revision. 3D-printed personalized implants represent an emerging solution for the reconstruction of complex bone defects. This study aimed to investigate the early therapeutic effects of using a 3D-printed, customized, uncemented stem prosthesis for revising aseptic AL in DFCP. From June 2021 to December 2022, a retrospective review was conducted on six consecutive patients who underwent revision surgery due to AL of the DFCP with a 3D-printed customized uncemented stem prosthesis. The study included four male and two female patients, with an average age of 58 ± 11 (range: 46-75) years. All six patients had previously undergone limb salvage surgery using a cemented megaprosthesis after tumor resection. Preoperative imaging evaluation was performed for all patients, and the personalized design of the prostheses was achieved through 3D printing based on CT imaging data. Regular clinical and radiographic follow-up was conducted postoperatively, with the main outcome measures being oncological outcomes, prosthesis survival, osseointegration, complications, and lower limb function. All patients successfully underwent surgery and were followed up for a mean duration of 30.33 ± 6.15 (range: 24-38) months. All patients were alive at the last follow-up, with no tumor recurrence or distant metastasis. No complications such as infection, loosening, or fracture of the prosthesis occurred. Osseointegration was satisfactory, with a mean MSTS score of 26 (range: 20-28) points. 3D-printed, customized, uncemented stem prosthesis exhibit immediate initial stability and reliable biocompatibility. Early clinical outcomes are satisfactory, making them an effective method for revision AL of DFCP.

Microstructural Analysis of the Human Scapula: Mandibular Bone Tissue Engineering Perspectives.

Mandibular bone defect reconstruction remains a significant challenge for surgeons worldwide. Among multiple biodegradable biopolymers, allogeneic bone scaffolds derived from human sources have been used as an alternative to autologous bone grafts, providing optimal conditions for cell recruitment, adhesion, and proliferation and demonstrating significant osteogenic properties. This study aims to investigate the bone microstructure of the human scapula as a source for allogeneic bone scaffold fabrication for mandibular tissue engineering purposes. We created color-coded anatomical maps of the scapula and the mandible, reflecting the best anatomical and geometrical match. In this pilot study, we hypothesized a microstructural similarity of these bone structures and evaluated the human scapula's bone tissue engineering potential for mandibular bone tissue engineering by focusing on the microstructural characteristics. Lyophilized human scapular and mandibular bioimplants were manufactured and sterilized. Experimental bone samples from the scapula's acromion, coracoid, and lateral border from the mandibular condyle, mandibular angle, and mental protuberance were harvested and analyzed using micro-CT and quantitative morphometric analysis. This pilot study demonstrates significant microstructural qualitative and quantitative intra-group differences in the scapular and mandibular experimental bone samples harvested from the various anatomical regions. The revealed microstructural similarity of the human scapular and mandibular bone samples, to a certain extent, supports the stated hypothesis and, thus, allows us to suggest the human scapula as an alternative off-the-shelf allogeneic scaffold for mandibular reconstruction and bone tissue engineering applications.

Antisolvent 3D Printing of Gene-Activated Scaffolds for Bone Regeneration.

The use of 3D-printed gene-activated bone grafts represents a highly promising approach in the fields of dentistry and orthopedics. Bioresorbable poly-lactic-co-glycolic acid (PLGA) scaffolds, infused with adenoviral constructs that carry osteoinductive factor genes, may provide an effective alternative to existing bone grafts for the reconstruction of extensive bone defects. This study aims to develop and investigate the properties of 3D scaffolds composed of PLGA and adenoviral constructs carrying the BMP2 gene (Ad-BMP2), both in vitro and in vivo. The elastic modulus of the disk-shaped PLGA scaffolds created using a specialized 3D printer was determined by compressive testing in both axial and radial directions. In vitro cytocompatibility was assessed using adipose-derived stem cells (ADSCs). The ability of Ad-BMP2 to transduce cells was evaluated. The osteoinductive and biocompatible properties of the scaffolds were also assessed in vivo. The Young's modulus of the 3D-printed PLGA scaffolds exhibited comparable values in both axial and radial compression directions, measuring 3.4 ± 0.7 MPa for axial and 3.17 ± 1.4 MPa for radial compression. The scaffolds promoted cell adhesion and had no cytotoxic effect on ADSCs. Ad-BMP2 successfully transduced the cells and induced osteogenic differentiation in vitro. In vivo studies demonstrated that the 3D-printed PLGA scaffolds had osteoinductive properties, promoting bone formation within the scaffold filaments as well as at the center of a critical calvarial bone defect.

Mandibular Bone Defect Reconstruction Using Autologous Bone Rings and Dental Implants after Peripheral Osteotomy for MRONJ stage II. Case Report and Literature Review.

Mandibular Bone Defect Reconstruction Using Autologous Bone Rings and Dental Implants after Peripheral Osteotomy for MRONJ stage II. Case Report and Literature Review.

Clinical efficacy on the reconstruction of bone defects using modular hemipelvic prosthesis in patients with pelvic tumors

ObjectiveTo evaluate the clinical efficacy of modular hemipelvic prosthesis replacement in the treatment of pelvic tumors and the relationship between postoperative functional recovery and the position deviation of the hip rotation center.MethodsA retrospective research was conducted involving 56 patients who underwent surgical resection of pelvic tumors followed by modular hemipelvic prosthesis reconstruction between 2010 and 2016. Comprehensive data encompassing preoperative conditions, intraoperative and postoperative follow-up information were systematically collected. Limb function was evaluated at 1, 3, 6, and 12 months postoperatively using the Musculoskeletal Tumor Society Scores (MSTS). The positional deviation of the hip joint’s rotational center was quantified. Statistical analyses were performed utilizing SPSS 26.0 software.ResultsAll surgical interventions were successful, with an average operation time of 268.82 ± 42.17 min and mean intraoperative blood loss of 1086.64 ± 538.28 ml. Postoperative complications were noted in 26.79% of patients, predominantly comprising incision-related issues. Hip dislocation was documented in 5.4% of cases, while seven patients experienced prosthesis loosening or fracture during follow-up. A statistically significant improvement in MSTS scores was observed, increasing from an average of 14.3 at 1 month to 21.1 at 12 months postoperatively. The recorded minor deviations in the position of the prosthetic hip joint’s rotational center did not exhibit a significant correlation with functional outcomes. The observed survival rates were 94.64%, 83.93%, 73.21%, and 48.21% at 1, 2, 3, and 5 years, respectively.ConclusionsThe modular hemipelvic prosthesis serves as an effective reconstructive solution for bone defects resulting from pelvic tumor resection, facilitating early functional rehabilitation. The prosthesis demonstrates commendable adaptability and mechanical properties, with a low incidence of complications such as hip dislocation and wound-related issues, thereby contributing to favorable functional recovery of the affected limb.

3D printed polyhydroxyalkanoate scaffold for bone defect reconstruction

3D printed polyhydroxyalkanoate scaffold for bone defect reconstruction

Viability Test of Osteoblast Cells After Application of Hydroxyapatite Nanoparticle from Unam Snail’s Shells In-vitro Examination

The bone defect reconstruction process can use hydroxyapatite is osteoconductive and can retain the original biocompatible shape to enhance hydroxyapatite with osteogenic proteins. To analyze the most appropriate concentration of hydroxyapatite nanoparticles using the MTT Assay method and to test the viability of osteoblast cells after being given hydroxyapatite nanoparticle (nHA) derived from unam snail shells. The fabrication of hydroxyapatite nanoparticles from unam snail shells using a mechanical-chemical combination method. Osteoblast cells are obtained from Calvaria rats after being cultured in DMEM. Viability tests of osteoblast cells were done using the MTT Assay method and repeated three times, and then results were measured using an Elisa reader. Viability of osteoblast cells in nHA 1,25 mg/ml (164,60 % ± 0,096), nHA 1,5 mg/ml (151,72 % ± 0,176), nHA 1,75 mg/ml (90,55 % ± 0,243), nHA 2 mg/ml (74,23 % ± 0,301) respectively. ANOVA test shows p &amp;lt; 0,05. IC50 value of hydroxyapatite nanoparticle from the unam snail’s shells to viability osteoblast cells is 2,23 mg/ml. Less concentration of hydroxyapatite nanoparticles tends to increase the viability of osteoblast cells. 1,75 mg/ml and below hydroxyapatite nanoparticles derived from unam snail shells are not toxic to osteoblast cells.