Field Of Orthopedics Research Articles

FeMnCSi alloy for degradable pin implants: Surface and in vitro characterization

Biodegradable metals such iron-based materials, are studied as temporary implants in the orthopedic field due to their adequate mechanical properties, non-toxic degradation products, and the possibility of avoiding a second surgical intervention to remove the device. One strategy to overcome the slow degradation rate of pure Fe is the addition of alloying elements. The aim of this work is to characterize the in vitro behavior of a new FeMnCSi alloy (Fe 26.5Mn 0.5C 1.14Si 0.03P 0.01S), and compare it with the performance of pure iron in simulated body fluid. The alloy performance was characterized in terms of chemical composition, microstructure, hemocompatibility and electrochemical responseIt has been found that FeMnCSi alloy presented a marked and progressive degradation in simulated body fluid after 14 days of immersion, significantly larger than pure Fe. The presence of phosphate-based compounds was confirmed on the surface of the alloy after 1 day of immersion while only after 14 days of immersion was detected on Fe. Additionally, the FeMnCSi alloy demonstrates improved blood compatibility compared to pure iron, indicating its suitability for applications in irrigated areas such as bones.

Study on the Antibacterial Activity and Bone Inductivity of Nanosilver/PLGA-Coated TI-CU Implants.

Implants are widely used in the field of orthopedics and dental sciences. Titanium (TI) and its alloys have become the most widely used implant materials, but implant-associated infection remains a common and serious complication after implant surgery. In addition, titanium exhibits biological inertness, which prevents implants and bone tissue from binding strongly and may cause implants to loosen and fall out. Therefore, preventing implant infection and improving their bone induction ability are important goals. To study the antibacterial activity and bone induction ability of titanium-copper alloy implants coated with nanosilver/poly (lactic-co-glycolic acid) (NSPTICU) and provide a new approach for inhibiting implant-associated infection and promoting bone integration. We first examined the in vitro osteogenic ability of NSPTICU implants by studying the proliferation and differentiation of MC3T3-E1 cells. Furthermore, the ability of NSPTICU implants to induce osteogenic activity in SD rats was studied by micro-computed tomography (micro-CT), hematoxylin-eosin (HE) staining, masson staining, immunohistochemistry and van gieson (VG) staining. The antibacterial activity of NSPTICU in vitro was studied with gram-positive Staphylococcus aureus (Sa) and gram-negative Escherichia coli (E. coli) bacteria. Sa was used as the test bacterium, and the antibacterial ability of NSPTICU implanted in rats was studied by gross view specimen collection, bacterial colony counting, HE staining and Giemsa staining. Alizarin red staining, alkaline phosphatase (ALP) staining, quantitative real-time polymerase chain reaction (qRT-PCR) and western blot analysis showed that NSPTICU promoted the osteogenic differentiation of MC3T3-E1 cells. The in vitro antimicrobial results showed that the NSPTICU implants exhibited better antibacterial properties. Animal experiments showed that NSPTICU can inhibit inflammation and promote the repair of bone defects. NSPTICU has excellent antibacterial and bone induction ability, and has broad application prospects in the treatment of bone defects related to orthopedics and dental sciences.

Technological Advancements in e-Healthcare: A Comprehensive Assessment in orthopaedics-patient relationship management

Healthcare has witnessed a profound transformation over recent decades, one catalysed by the relentless march of technology. As the healthcare landscape evolves, the integration of technological innovations has become increasingly ubiquitous, revolutionising traditional care delivery models, and introducing novel paradigms. Amidst this advanced landscape, a particular focal point emerges, centred on the symbiotic relationship between technology and healthcare, embodied by the burgeoning field of e-healthcare.Within the broader expanse of healthcare, orthopaedics represents a significant frontier where the confluence of technological advancement and patient care has garnered attention. Orthopaedic practice, by its nature, often necessitates precision, innovation, and multidisciplinary collaboration. From diagnostic imaging modalities that offer unparalleled insights into musculoskeletal structures to wearable devices that empower patients to engage actively in their recovery, technology within the orthopaedic field catalysed a change.The main objective of this paper is to conduct a comprehensive assessment, shedding light on the state of the art in technological advancements within e-healthcare, with orthopaedics as our focal domain. At the heart of our research is a central concern: the orthopaedic-patient relationship. The importance of this relationship cannot be underestimated, as it is the foundation on which healthcare is provided. Our aim, therefore, is twofold: to elucidate the extent to which technology influences the orthopaedics-patient relationship and to uncover novel avenues through which this pivotal relationship can be fortified and optimised.The impetus behind this assessment is rooted in the dual importance of technological innovation and the orthopaedics-patient relationship. As orthopaedic practitioners increasingly harness technology and platforms, the potential for improved patient care, more informed decision-making, and enhanced outcomes beckons. However, these opportunities come hand in hand with challenges, including ethical and privacy concerns and the imperative to ensure that technology augments rather than diminishes the patient-physician bond. In this context, our assessment aims to contribute to the ongoing discourse of technology integration into healthcare, highlighting the unique dynamics that play within orthopaedic practice.

Research on Characterization and Biocompatibility of 3D Printed Ti-6Al-4V Pelvic Prosthesis

The treatment of bone defects caused by fractures or bone tissue lesions has always been a difficult problem in the field of orthopedics. Implantation of high-performance titanium alloy prosthesis is an effective method to treat bone defects. 3D printing technology can produce low-modulus titanium alloy implants with porous structures, providing a better solution to the above problems. This technology is convenient to design and has a huge advantage in making orthopedic implants. The article used electron beam melting in 3D printing technology to create two samples of Ti-6Al-4V prosthesis, including solid structural pelvic prosthesis and porous structural pelvic prosthesis. The mechanical properties of the prosthesis showed that the yield and tensile strengths of the rod tensile specimen were 894 MPa and 956 MPa, respectively, and the compressive modulus and compressive strength of the porous pelvic prosthesis were 55 GPa and 65.2 MPa, respectively. The results of the L929 cytotoxicity assay and the MC3T3-E1 cell adhesion assay demonstrated good biocompatibility of the prosthetic samples. New Zealand white rabbits were used to prepare the femoral joint cavity defect models and two pelvic prostheses were implanted. A microscopic CT scan 4 weeks after implantation showed that the bone defect caused by the drill had healed and that the porous structure of the pelvic prosthesis formed a new trabecular structure within the hole. In conclusion, the 3D printed Ti-6Al-4V pelvic prosthesis has excellent mechanical properties, biocompatibility, and the ability to promote new bone growth.

Virtual reality use in pediatric patients for orthopedic clinical procedures: A randomized prospective trial of efficacy.

Distraction therapy use such as virtual reality is novel in the pediatric orthopedic field. In this study, we use subjective and objective metrics to evaluate virtual reality efficacy to reduce anxiety and pain in a pediatric orthopedic cohort. A prospective randomized controlled trial included patients between age 5 and 17 years, presenting to a tertiary care pediatric orthopedic clinic. Parallel groups underwent orthopedic procedures in clinic, utilizing immersive and interactive virtual reality distraction therapies versus standard of care. Procedures included cast application, cast removal, bone pin removal, and fracture reduction. All preprocedure parameters were similar between the groups. Primary outcome was the difference between maximum procedural heart rate and baseline. Secondary outcomes included Wong Baker FACES Rating Scale (Wong & Baker, 1988, Oklahoma, USA) for pain and Visual Analog Scale scores for anxiety. Ninety-five patients (66 M, 29 F) underwent 59 cast removals, 26 cast applications, 7 percutaneous pin removals, and 3 fracture reductions. Average patient age in the virtual reality and control cohorts was 10.1 (5-17) and 10.6 (5-17), respectively. Average change in maximum heart rate in the virtual reality and control groups was 10.6 ± 10.1 versus 18.4 ± 11.0 (p = 0.00048). The virtual reality group demonstrated trends toward lower perceived anxiety (1.7 ± 2.8 versus 2.9 ± 3.6, p = 0.0666) when compared to controls. This level 1 study is the first to utilize objective biometric measurements to evaluate use of interactive virtual reality during multiple types of pediatric orthopedic procedures in the clinical setting. The findings suggest that an interactive and immersive virtual reality experience can be effective in reducing pain and anxiety. Level 1, Randomized Controlled Trial.

A new ring fixator system for automated bone fixation.

In the field of orthopaedics, external fixators are commonly employed for treating extremity fractures and deformities. Computer-assisted systems offer a promising and less error-prone treatment alternative to manual fixation by utilising a software to plan treatments based on radiological and clinical data. Nevertheless, existing computer-assisted systems have limitations and constraints. This work represents the culmination of a project aimed at developing a new automatised fixation system and a corresponding software to minimise human intervention and associated errors, and the developed system incorporates enhanced functionalities and has fewer constraints compared to existing systems. The automatised fixation system and its graphical user interface (GUI) demonstrate promising results in terms of accuracy, efficiency, and reliability. The developed fixation system and its accompanying GUI represent an improvement in computer-assisted fixation systems. Future research may focus on further refining the system and conducting clinical trials.

The Novel Impact of Augmented Reality and 3D Printing in the Diagnosis of Complex Acetabular Fractures: A Comparative Randomized Study in Orthopedic Residents.

Augmented reality (AR) and 3D printing (3DP) are novel technologies in the orthopedic field. Over the past decade, enthusiasm for these new digital applications has driven new perspectives in improving diagnostic accuracy and sensitivity in the field of traumatology. Currently, however, it is still difficult to quantify their value and impact in the medical-scientific field, especially in the improvement of diagnostics in complex fractures. Acetabular fractures have always been a challenge in orthopedics, due to their volumetric complexity and low diagnostic reliability. Background/Objectives: The goal of this study was to determine whether these methods could improve the learning aspect and diagnostic accuracy of complex acetabular fractures compared to gold-standard CT (computed tomography). Methods: Orthopedic residents of our department were selected and divided into Junior (JUN) and Senior (SEN) groups. Associated fractures of acetabulum were included in the study, and details of these were provided as CT scans, 3DP models, and AR models displayed on a tablet screen. In a double-blind questionnaire, each resident classified every fracture. Diagnostic accuracy (DA), response time (RT), agreement (R), and confidence (C) were measured. Results: Twenty residents (JUN = 10, SEN = 10) classified five fractures. Overall DA was 26% (CT), 18% (3DP), and 29% (AR). AR-DA was superior to 3DP-DA (p = 0.048). DA means (JUN vs. SEN, respectively): CT-DA was 20% vs. 32% (p < 0.05), 3DP-DA was 12% vs. 24% (p = 0.08), and AR-DA was 28% vs. 30% (p = 0.80). Overall RT was 61.2 s (±24.6) for CT, 35.8 s (±20.1) for 3DP, and 46.7 s (±20.8) for AR. R was fairly poor between methods and groups. Overall, 3DPs had superior C (65%). Conclusions: AR had the same overall DA as CT, independent of experience, 3DP had minor differences in DA and R, but it was the fastest method and the one in which there was the most confidence. Intra- and inter-observer R between methods remained very poor in residents.

Does the Information Quality of ChatGPT Meet the Requirements of Orthopedics and Trauma Surgery?

The integration of artificial intelligence (AI) in medicine, particularly through AI-based language models like ChatGPT, offers a promising avenue for enhancing patient education and healthcare delivery. This study aims to evaluate the quality of medical information provided by Chat Generative Pre-trained Transformer (ChatGPT) regarding common orthopedic and trauma surgical procedures, assess its limitations, and explore its potential as a supplementary source for patient education. Using the GPT-3.5-Turbo version of ChatGPT, simulated patient information was generated for 20 orthopedic and trauma surgical procedures. The study utilized standardized information forms as a reference for evaluating ChatGPT's responses. The accuracy and quality of the provided information were assessed using a modified DISCERN instrument, and a global medical assessment was conducted to categorize the information's usefulness and reliability. ChatGPT mentioned an average of 47% of relevant keywords across procedures, with a variance in the mention rate between 30.5% and 68.6%. The average modified DISCERN (mDISCERN) score was 2.4 out of 5, indicating a moderate to low quality of information. None of the ChatGPT-generated fact sheets were rated as "very useful," with 45% deemed "somewhat useful," 35% "not useful," and 20% classified as "dangerous." A positive correlation was found between higher mDISCERN scores and better physician ratings, suggesting that information quality directly impacts perceived utility. While AI-based language models like ChatGPT hold significant promise for medical education and patient care, the current quality of information provided in the field of orthopedics and trauma surgery is suboptimal. Further development and refinement of AI sources and algorithms are necessary to improve the accuracy and reliability of medical information. This study underscores the need for ongoing research and development in AI applications in healthcare, emphasizing the critical role of accurate, high-quality information in patient education and informed consent processes.

Platelet-rich plasma as a new treatment method in orthopedics

Introduction and purposePlatelet-rich plasma (PRP) therapy represents a technology designed to enhance tissue repair by locally administering one's own bioactive agents, aiming to influence physiological processes like inflammation, angiogenesis, and extracellular matrix synthesis. Recently, the use of PRP therapy has become a subject of discussion in the orthopedic field. This review comprehensively examines the mechanisms, contemporary applications, clinical evidence, safety aspects, and potential future advancements of PRP in orthopedic treatment. Research has documented the efficacy of PRP injections in achieving full regeneration and enabling a comeback to competitive sports. PRP injections could serve as a viable alternative treatment for individuals with lateral tendonitis when compared to surgery. Further research investigating the impact of PRP on the bone healing process following a fracture is warranted. Materials and methods The methodology for conducting literature search involved utilizing medical subject headings terms to explore PubMed. Search terms included: "plasma-rich therapy", "tendinopathy", "injury" " articular cartilage ", "bone fracture " ConclusionsResearch at different evidence levels has shown that PRP is safe and has beneficial effects in above uses. Due to the autologous nature of the therapy, side effects are minimal. In the majority of cases, PRP therapy alleviates pain sensations in both short- and long-term observations, facilitating a faster return to daily functionality. However, additional randomized, controlled clinical trials are anticipated to be conducted in the future. Progressing further necessitates the standardization of methods for preparing plasma and procedures for its application.

First person – Arun-Kumar Kaliya-Perumal

ABSTRACT First Person is a series of interviews with the first authors of a selection of papers published in Disease Models &amp; Mechanisms, helping researchers promote themselves alongside their papers. Arun-Kumar Kaliya-Perumal is first author on ‘Genetic regulation of injury-induced heterotopic ossification in adult zebrafish’, published in DMM. Arun conducted the research described in this article while a PhD student in Prof. Philip Ingham’s lab at Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. He will soon join the Rehabilitation Research Institute of Singapore as a Research Fellow, where he will pursue his interest in translational research within the field of orthopedics, focusing on enhancing the quality of healthcare delivery in Singapore.

Investigations on Microstructure and Mechanical Properties of HAp Nanocomposites reinforced with ZrO2 and TiO2

In the contemporary context, approximately 15 million individuals in India grapple with bone-related issues stemming from accidents, fractures, bone mass depletion, and the natural aging process. To address this challenge, a diverse array of biomaterials has been innovated to rectify or enhance bone deficiencies within the human body. Nevertheless, over the past decade, calcium phosphate-based bioceramic materials have gained significant prominence as synthetic alternatives for bone and dental applications in the fields of orthopaedics and dentistry. One such bioactive ceramic, Hydroxyapatite (HAp), boasts exceptional versatility and can find utility in both dental and orthopaedic contexts. In the current research, exhaustive research was conducted to explore the impact of HAp/(ZrO2+TiO2) hybrid nano-composites synthesized through a mechanical synthesis process employing high-energy ball milling (HEBM), incorporating varying weight proportions. The resulting “HAp/(ZrO2+TiO2) nano-composites” were subjected to characterization through scanning electron microscopy combined with energy-dispersive X-ray spectroscopy (SEM-EDX) and X-ray diffraction (XRD). Furthermore, the study assessed the influence of these nano-composites regarding the HAp nano-composites’ mechanical characteristics.

Protocole à fin de constitution d’un registre français des prothèses de hanche

INTRODUCTION: Use of joint prostheses is growing widely, in particular in developed countries. The « Société Française de Chirurgie Orthopédique et Traumatologique » (SOFCOT) has submitted in 2007 to the «Commission Nationale Informatique et liberté» (CNIL) a project for creating a hip prostheses registry. More recently, the « Conseil National Professionnel de chirurgie Orthopédique et Traumatologique » (CNP-COT) developed a national implants and observatory registry on surgical orthopaedic and traumatologic practices and pathologies (RENACOT) aiming to assure traceability and materio-vigilance of hip implants used in France. The main objective of the study is to report the current state of surgical techniques, used implants and their evolutions in hip arthroplasty in France using retrospective data provided by a multicenter registry since 2006.MATERIAL ET METHODS: On the one hand, the research systematically lists the main characteristics of all implants used in hip arthroplasty; and on the other hand, these informations are correlated with epidemiologic, demographic data, CROMs and PROMs. The study group consists by all patients receiving a hip reconstruction either in traumatology (femoral neck fractures) or above all for degenerative diseases. The data are collected in 2 questionnaires. The link between primary and revision surgery of the same prosthesis is automatic through the patient social security N°, sex and operated side.RESULTS: Patient demographics provides the corresponding population epidemiologic information’s. Registered data are available through 3 modes: 1- In running time, the registry board members only can accede to all collected data by internet 2- A biennal report of the national hip replacement activity 3- Any particular request about a specific matter or implant DISCUSSION One of the major registry interests in case of revision is the possibility to assure an automatic link with the corresponding primary arthroplasty. This is only possible if the primary questionnaire is already implemented and if the correspondence between the primary arthroplasty and the same hip reoperation/revision can automatically be established from the moment where both questionnaires are correctly completed in the registry. The CNP, through the RENACOT spreading use, aims to extend such registry practice to all orthopaedic and traumatologic surgical fields.

Controversies in promoting young talent in orthopedics and trauma surgery

The field of orthopedics and trauma surgery is facing aserious shortage of new talent due to the increasing average age of active surgeons and agrowing need for staff. The appeal of these specialties is declining among medical students. This trend could be reversed by introducing practice-oriented curricula, mentoring programs, and early integration into professional societies. The quality of surgical education, especially bedside teaching, needs to be improved, as it is often compromised by alack of time and insufficient pedagogical training of the educators. The practical year (PY) is crucial to attract students to these specialties, but data indicate that the quality of training in orthopedics and trauma surgery is inferior compared to other fields. Professional societies could enhance junior development through targeted programs. Moreover, the problem of recruitment is compounded by imbalanced gender ratios and working conditions that do not align with modern family models or efficient surgical training. There needs to be arethinking of work scheduling and task distribution in surgery to make the profession more attractive and to ensure the quality of training.

The 100 most cited articles in artificial intelligence related to orthopedics.

This bibliometric study aimed to identify and analyze the top 100 articles related to artificial intelligence in the field of orthopedics. The articles were assessed based on their number of citations, publication years, countries, journals, authors, affiliations, and funding agencies. Additionally, they were analyzed in terms of their themes and objectives. Keyword co-occurrence, co-citation of authors, and co-citation of references analyses were conducted using VOSviewer (version 1.6.19). The number of citations of these articles ranged from 32 to 272, with six papers having more than 200 citations The years of 2019 (n: 37) and 2020 (n: 19) together constituted 56% of the list. The USA was the leading contributor country to this field (n: 61). The most frequently used keywords were "machine learning" (n: 26), "classification" (n: 18), "deep learning" (n: 16), "artificial intelligence" (n: 14), respectively. The most common themes were decision support (n: 25), fracture detection (n: 24), and osteoarthrtitis staging (n: 21). The majority of the studies were diagnostic in nature (n: 85), with only two articles focused on treatment. This study provides valuable insights and presents the historical perspective of scientific development on artificial intelligence in the field of orthopedics. The literature in this field is expanding rapidly. Currently, research is generally done for diagnostic purposes and predominantly focused on decision support systems, fracture detection, and osteoarthritis classification.

The Application of Virtual Reality in Shoulder Surgery Rehabilitation.

To achieve a positive functional prognosis in orthopedic surgery, particularly in shoulder surgeries, effective rehabilitation is essential. Recently, there has been growing interest in the use of virtual reality (VR) in the field of orthopedics, particularly for preoperative education and training, as well as clinical and home-based rehabilitation. This report describes the process of developing an application utilizing Meta Quest 2 VR technology (Meta, CA, USA) for rehabilitation after shoulder surgery. This application assists patients in performing postoperative exercises at home by wearing VR equipment tailored to their postoperative weeks. The advantages of VR rehabilitation lie in overcoming the limitations of traditional rehabilitation methods and providing patients with a better rehabilitation experience. Moreover, automating the rehabilitation process and reducing patients' visits to clinics can lead to cost savings. This report raises expectations for the potential and scalability of VR utilization, extending beyond orthopedics to other fields. In addition, it anticipates that with better feedback and motivation, the rehabilitation effects for patients can be further enhanced.

Musculoskeletal Health Systematic Review: Clinical and Pharmacological, Organizational and Legal, Administration and Pharmaceutical Management Aspects

This article examines current aspects of musculoskeletal health and pharmacotherapy of disorders of the human musculoskeletal system. An objective review of disorders of the musculoskeletal system was conducted in the areas of administration, clinical and pharmacological, organizational and legal, pharmaceutical management. The results of the systematic review show that the availability of diagnoses in the section "Orthopedics and traumatology" on the platform of the state expert center of the Ministry of Health of Ukraine is limited. It is necessary and urgent to expand the scientific base for practicing doctors. The study confirmed the importance of using new clinical protocols in medical and pharmaceutical practice for the implementation of evidence-based medicine and evidence-based pharmacy in Ukraine. Gradual improvement of medical and pharmaceutical practice allows to increase the quality, efficiency, safety, availability of pharmacotherapy for patients with disorders of the musculoskeletal system. The paper examines guidelines developed on the basis of health evidence provided by Duodecim Medical Publications. The study shows the availability of a wide range of treatment methods and helps to determine optimal therapy strategies in the field of orthopedics. It was found that non-steroidal anti-inflammatory drugs and analgesics are more often prescribed for the pharmacotherapy of disorders of the musculoskeletal system, which emphasizes the perspective of further clinical and pharmacological, organizational and legal researches in the pharmaceutical development and management of new drugs.

The new medical licensing regulations (ÄApprO) : Status and expected challenges

BackgroundThe amendment to the medical licensing regulations (ÄApprO) was decided at the federal level in the version of the "Master Plan for Medical Studies 2020" passed in 2017. In addition to the organizational effort involved in redesigning the curricular teaching, the expected costs associated with the implementation of the new licensing regulations due to the necessary additional time and, therefore, personnel expenditure are of particular importance. Taking into account the different forms of study and the 20% scope for study-design provided to the individual faculties, the process of transferring the teaching content to the new modules confronts us with an enormous organizational challenge.Significance of O&UDiseases of the musculoskeletal system are of particular medical, social and economic importance. Therefore, the training of future physicians in the field of orthopedics and traumatology must be taken into account. The visibility of the field of orthopedics and traumatology must not be lost with the introduction of the new medical licensing regulations (ÄApprO).ImplementationThe implementation of the new medical licensing regulations at German universities will be costly and necessitates an increased number of staff. However, there is agreat opportunity to position orthopedics and traumatology as a"central player" in the modular, interdisciplinary and interprofessional course landscape. It is, therefore, important to take on concrete responsibility for the design of the new teaching programs and to bring in our specialist and interdisciplinary skills wherever sensible and possible.

In vitro corrosion and cytocompatibility of Mg-Zn-Ca alloys coated with FHA

In the field of orthopedics, it’s crucial to effectively slow down the degradation rate of Mg alloys. This study aims to improve the degradation behavior of Mg-Zn-Ca alloys by electrodepositing fluorohydroxyapatite (FHA). We investigated the microstructure and bond strength of the deposition, as well as degradation and cellular reactions. After 15–30 days of degradation in Hanks solution, FHA deposited alloys showed enhanced stability and less pH change. The strong interfacial bond between FHA and the Mg-Zn-Ca substrate was verified through scratch tests (Critical loads: 10.73 ± 0.014 N in Mg-Zn-0.5Ca alloys). Cellular studies demonstrated that FHA-coated alloys exhibited good cytocompatibility and promoted the growth of MC3T3-E1 cells. Further tests showed FHA-coated alloys owed improved early bone mineralization and osteogenic properties, especially in Mg-Zn-0.5Ca. This research highlighted the potential of FHA-coated Mg-Zn-0.5Ca alloys in orthopedics applications.

Indirect co-culture of osteoblasts and endothelial cells in vitro based on a biomimetic 3D composite hydrogel scaffold to promote the proliferation and differentiation of osteoblasts.

The field of orthopedics has long struggled with the challenge of repairing and regenerating bone defects, which involves a complex process of osteogenesis requiring coordinated interactions among different types of cells. The crucial role of endothelial cells and osteoblasts in bone vascularization and osteogenesis underscores the importance of their intimate interaction. However, efforts to bioengineer bone tissue have been impeded by the difficulty in establishing proper angiogenesis and osteogenesis in tissue structures. This study presents a novel approach to bone tissue engineering, involving a three-dimensional composite hydrogel scaffold composed of sodium alginate microspheres encapsulated in type I collagen. Using this scaffold, a three-dimensional indirect co-culture system was established for osteoblasts and endothelial cells to evaluate the osteogenic differentiation potential of osteoblasts. Results demonstrate that the non-contact co-culture system of endothelial cells and osteoblasts constructed by the composite hydrogel scaffold loaded with microspheres holds promise for bone tissue engineering. The innovative concept of an indirect co-culture system presents exciting prospects for conducting intercellular communication studies and offers a valuable in vitro tissue platform to investigate tissue regeneration.

Distraction Osteogenesis by Ring Fixator in Post Traumatic Tibial Bone Loss

Background: Reconstructing segmental bone loss defects presents a significant challenge within the field of orthopedics. The purpose of this study is to assess the clinical and radiological results of using the Ilizarov technique for tibia reconstruction following traumatic bone loss. Methods: This study was a prospective study involving 30 patients who experienced tibial bone loss in the diaphysis or metaphysis following trauma. These patients were treated with a ring fixator (Ilizarov) from March 2021 to February 2023. Unfortunately, five patients were lost to follow-up, leaving a cohort of 25 patients who were observed for a duration ranging from 9 to 12 months. Results: The current study involved 25 patients with post-traumatic tibial bone loss. The age range was 14 to 48 years, with a mean age of 28.4±8.8 years. Among the cases, 18 had a moderate defect (72%), which was significantly higher than those with a minor defect (20%) (P ≤ 0.05). Deformity was less than 7° in most cases (96%), while only one case had deformity greater than 7° (4%) (P ≤ 0.05(. Leg length discrepancy was less than 2.5 cm in the majority (96%), with only one case having a 3 cm length discrepancy (4%) (P ≤ 0.05). By the end of the follow-up period, all patients showed perfect union, enabling them to engage in daily activities post-operatively. Conclusion: The success of corticotomy and solid docking relies on well-vascularized bone and soft tissue. Soft tissue compromise at the corticotomy site can hinder healthy tissue regeneration.