Periosteal New-bone Formation Research Articles

The Role of the Diaphyseal Medulla in the Repair and Regeneration of the Femoral Shaft in the Adult Cat

1. A surgical procedure is described which permits selective removal of the medulla froms the diaphysis of the cat femur and the study of the role of marrow elements in bone regenerations and repair. 2. In this experimental model, endosteal-callus formation, in the presence of marrow, precedes and exceeds periosteal-callus formation in the healing of a partial osteotomy without displacement. Cartilage was formed infrequently in the reactive bone callus and only after severing of the fibrous portions of the periosteum. 3. After removal of the medulla, residual narrow elements in the distal and proximal metaphyses and in the surviving endosteum of the Haversian and Volkmann canals appeared to initiate the repair processes which led to complete reconstitution of the medulla. The sequence of events during bone repair repeated the phases of embryonic membranous-bone development. The restorations of the medulla and its contributions to bone healing emphasize the importance of its role osteogenesis. 4. The disruption of the nutrient vessels during removal of the diaphyseal medulla was followed by reorganizations of the greater portions of the cortex of the diaphysis associated with marked though transient periosteal new-bone formation. The response elicited resembled that seen in hypertrophic pulmonary osteoarthropathy. As healing progressed the periosteal new bone was partly resorbed and partly reintegrated into the remodeled cortex of the diaphysis. 5. The experimental offers opportunities for the study of bone inductions and for the testing of substances which might enhance or delay bone repair.

Ankylosis of the Rabbit Elbow Joint by Intra-Articular Papain and Immobilization

The effect of a series of six spaced injections of papain administered into the eblow joints of thirty adult rabbits over a twelve-day period was studied by clinical, roentgenographic, and histological means. Animals were sacrificed two, four, and six weeks after the start of the experiment. A marked chondrolytic effect associated with signs of acute arthritis was noted. Almost all the articular cartilage showed signs of erosion. About 75 per cent of the articular surface was reduced to a basal layer of cartilage several cells in height. A marked periarticular inflammatory reaction developed, with thickening of the capsule, periosteal new-bone formation, and patchy covering of the eroded articular surface with a fibrocartilaginous callus. Twenty-seven rabbits received a series of six papain injections into the elbow joint and later were operated on to immobilize the elbow by extra-articular stapling. A 0.5-centimeter segment of the upper part of the humeral shaft was resected and the nerves to the triceps were divided in the same limb. At autopsy, eight weeks later, osseous ankylosis of the elbow was established in eighteen animals (67 per cent). Fusion did not occur in any of fourteen animals receiving identical treatment using an enzyme inactivated by boiling. Surgical arthrodesis using intra-articular autogenous bone grafts and the same immobilization technique produced fusion in seven of ten animals.

INFLUENCE OF ULTRASOUND ON BONE MINERAL METABOLISM.

THE problem of possible noxious effects of ultrasonic energy on calcified tissues is important because of its wide use in clinical and dental practice. The conditions of transmitting the ultrasound to bones and teeth and their surroundings are more complex than in soft tissues, being in a certain sense similar to those resulting from absorption of roentgen radiations in bones, causing, for example, selective overheating of bones due to increased absorption of ultrasonic energy and various interface effects on their surface. Coarsening of trabecular bone pattern, periosteal new-bone formation, circumscribed foci of bone sclerosis, localized bone necrosis, pseudocystic and cystic appearances and bone fractures were observed in various experiments on animals1,2. Not only were damaging effects on bone noted, but also on the dental germs after 3–4 W/cm2 ultrasonic energy9. The traumatic capacity of ultrasound in dentistry became the object of intense investigations from the middle 1960's because of the still wider use of ultrasonic dental cutting instruments in practice. Enamel defects and dyscrasias, loss of tooth structures, pink or yellow discolorations, mobile and fractured teeth and missing teeth were often correlated with the intensity and exposure time3,8. Thus, it can be concluded that there exists a real danger in application of ultrasound of too high an intensity and of prolonged exposure time.

Bone and Joint Changes Following Burns

The skeletal alterations which occur in association with thermal burns have been arbitrarily classified according to their roentgenographic appearance as: osteoporosis, periosteal new-bone formation, pericapsular calcification, osteophyte formation, heterotopic para-articular ossification, joint destruction, and ankylosis. Possible explanations for each of the skeletal changes are offered, but the true pathogenesis is still obscure. Superimposed trauma may be a precipitating factor in instances of heterotopic calcification and ossification and sepsis may be a factor in intra-articular change. Surgical excision of ectopic osseous or calcified tissue is a feasible procedure but should not be undertaken until the patient's general condition is good and all scar tissue is mature and soft.

Infantile Cortical Hyperostosis

THE syndrome that has become known as infantile cortical hyperostosis, after the suggestion of Caffey and Silverman,1 is characterized by the usually sudden onset of swelling of the face, thorax or extremities, hyperirritability, fever, fluctuating course and roentgenographic evidence of periosteal new-bone formation. Probably the first case was described by Roske,2 but the syndrome was not appreciated until the publication of the descriptions of the clinical and roentgenologic picture.1 , 3 , 4 There are now over 60 cases in the literature. Sherman and Hellyer5 reviewed their x-ray films taken of infants during the preceding twenty years and found no case of infantile cortical . . .

LESIONS OF THE SKELETON AND OF OTHER MESODERMAL TISSUES IN RATS FED SWEET-PEA (LATHYRUS ODORATUS) SEEDS

Diets containing Lathyrus odoratus seeds fed to rats produce a hitherto unrecognized lesion in the epiphyseal plates. These are very wide, the cartilage matrix appears to lose cohesion, and the cartilage cells are grouped in clusters. The same diets produce loosening and detachments of the tendinous and ligamentous insertions. Because of these two lesions, occurring independently or together, the following skeletal conditions developed in the experimental animals: Epiphyseal slippings, metaphyseal fibrous defects, kyphoscoliosis, thoracic deformities, detachments of the tibial tuberosity, subluxations and dislocations of the shoulder, diastasis of the sacro-iliac joints, degeneration of the intervertebral discs, disc herniations, Legg-Perthes-like disease of the femoral head, and valgus of the forepaws. In practically all the experimental rats there were extensive areas of periosteal newbone formation following detachment of the periosteum. Degenerative arthritis was observed in rats fed the experimental diets for several months. Two lesions developed concomitantly,—degeneration of the joint cartilage and loosening of the capsular and ligamentous insertions. Bone lesions resembling those seen in Paget's disease were observed in small groups of older rats. Dissecting aneurysms of the aorta and abdominal and inguinal herniae were observed in many rats. The collagen fibers appeared to be normal on electron-microscope examination. It is surmised that all these lesions are due to defective formation or excessive destruction of the chondroitin sulphate of the ground substance. The possible relationship between these lesions in rats and similar lesions in humans is a matter for further study.

Infantile cortical hyperostosis; an inquiry into the etiology and pathogenesis.

THE syndrome that has become known as infantile cortical hyperostosis, after the suggestion of Caffey and Silverman,1 is characterized by the usually sudden onset of swelling of the face, thorax or extremities, hyperirritability, fever, fluctuating course and roentgenographic evidence of periosteal new-bone formation. Probably the first case was described by Roske,2 but the syndrome was not appreciated until the publication of the descriptions of the clinical and roentgenologic picture.1 , 3 , 4 There are now over 60 cases in the literature. Sherman and Hellyer5 reviewed their x-ray films taken of infants during the preceding twenty years and found no case of infantile cortical . . .

Engelmann's disease (progressive diaphyseal dysplasia)

Summary 1. An additional case of Engelmann's disease has been reported. This is the twelfth of its kind. 2. Clinical examination shows that the disease is systemic, indicated by the presence of muscular weakness and nutritional failure. 3. Roentgen studies reveal that the main lesions of Engelmann's disease are progressive, symmetrical, endostial, and periosteal new-bone formation in the diaphysis of long bones. 4. Microscopically, the lesion is simply that of a solid osteopetrosis. 5. The etiology and pathogenesis of the disease is unknown. The authors believe that the work of Thiersch in developing experimental bone lesions may be of considerable importance in the further investigation of all bone diseases characterized by osteopetrosis.