ABSTRACT
A combination of polymeric nanofibrous scaffold and bioactive materials is potentially useful in bone regeneration applications. In the present study, Poly [lactide-co-glycolide] [PLGA] nanofibrous scaffolds, fabricated via electrospinning, were initially coated with Type I collagen and then with nano-hydroxyapatite. The prepared scaffolds were then characterized using SEM and their ability for bone regeneration was investigated in a rat critical size bone defect using digital mammography, multislice spiral-computed tomography [MSCT] imaging, and histological analysis. Electrospun scaffolds had nanofibrous structure with homogenous distribution of n-HA on collagen-grafted PLGA. After 8 weeks of implantation, no sign of inflammation or complication was observed at the site of surgery. According to digital mammography and MSCT, PLGA nanofibers coated simultaneously with collagen and HA showed the highest regeneration in rat calvarium. In addition, no significant difference was observed in bone repair in the group which received PLGA and the untreated control. This amount was lower than that observed in the group implanted with collagen-coated PLGA. Histological studies confirmed these data and showed osteointegration to the surrounding tissue. Taking all together, it was demonstrated that nanofibrous structures can be used as appropriate support for tissue-engineered scaffolds, and coating them with bioactive materials will provide ideal synthetic grafts. Fabricated PLGA coated with Type I collagen and HA can be used as new bone graft substitutes in orthopaedic surgery and is capable of enhancing bone regeneration via characteristics such as osteoconductivity and osteointegration
ABSTRACT
Guidelines on implant removal are not clear and the routine removal of orthopaedic fixation devices after fracture healing remains an issue of debate. Few studies have evaluated long-term outcomes of patients with orthopaedic implants left in-situ and this lake of data has made the orthopaedic surgeons decide on implant removal differently. In order to add new data in this field, we designed this study. In a follow up setting, patients with Tibial shaft fractures who had received orthopaedic implants in year 2008 and earlier were clinically examined for any surgical complications such as pain or limited range of motion. Quality of life of each patient was evaluated using short form 36. The total SF-36 score of the patients was not statistically different from the normal population [P >0.05]. 21 patients [31.2%] reported limited range of motion in ankle and 11 [14.9%] complained of weakness in the affected limb. Clinically, 68.9% of patients had full range of motion in ankle and 70.3% had no tenderness in the affected limb. As most patients were clinically normal and had quality of life scores comparable to the normal population, removal of implants is not advisable in all patients