Effect on pedicle screw stability of polymethylmethacrylate volume and distribution in synthetic bone block for patients with osteoporosis / 解放军医学杂志

Objective To compare the stability of injectable pedicle screw with different lateral holes augmented with different volume of polymethylmethacrylate (PMMA) in synthetic bone block used for patients with osteoporosis,and analyze the relationship between screw stability and injected volume and distribution pattern of PMMA.Methods The synthetic bone blocks used for patients with osteoporosis were randomly divided into groups A,B,C and D according to the screw difference,and the blocks in each group were then randomly divided again into subgroups 0,1,2 and 3 according to the difference of PMMA volume.A pilot hole was prepared in advance using the same method in all samples.Pedicle screws of type A-C were directly inserted into vertebrae of groups A-C respectively,and then different volumes of PMMA (0,1.0,1.5 and 2.0ml) were injected through screw into the blocks of subgroups 0,1,2 and 3 respectively.The pilot hole was filled with different volumes of PMMA (0,1.0,1.5 and 2.0ml) followed by insertion of screw in groups D0,D1,D2 and D3 respectively.X-ray examination was performed to evaluate the screw position and PMMA distribution,and axial pull-out test was performed to measure the maximum axial pullout strength (Fmax).Results X-ray examination revealed that PMMA wrapt the anterior 1/3 part of screw in groups A1-A3,wrapt the middle 1/3 part of screw in groups B1-B3 and groups C1-C3,and evenly wrapt the full length of screw in groups D1-D3.Two factor ANOVA showed that both volume and distribution of PMMA significantly influenced Fmax (P＜0.05),but no marked interaction existed between the two factors (P=0.877).Among groups with the same screw,no significant difference of Fmax was found between the groups injected of 1.0ml and 1.5ml PMMA and those of 1.5ml and 2.0ml PMMA (P＞0.05),but the Fmax was significantly higher in groups with injection of 2.0ml PMMA than that in groups with injection of 1.0ml PMMA (P＜0.05).Among the groups injected with same volume of PMMA,no significant differences on Fmax were found among the groups A0-D0,A2-D2 and A3-D3 (P＞0.05).The Fmax was significantly lower in group A1 than in group DI (P=0.026),and no significant differences existed between the other two groups injected with the same volume of PMMA (P＞0.05).Conclusion PMMA can significantly enhance the stability of different injectable pedicle screws in synthetic bone block used for patients with osteoporosis,and the stability is significantly correlated with injected volume and distribution pattern of PMMA.

Clinical analysis of mandibular reconstructions using synthetic bones based on three-dimensional printing technology in 149 cases / 上海交通大学学报（医学版）

Objective-To assess the clinical value of the computer-assisted three-dimensional reconstruction technique design and evaluate the climcal experience of manufacture artificial bone precision to repair the mandibular defect.Methods· From 2001 to 2016,163 computer-assisted reconstruction surgeries had been performed in Craniofacial Department,Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine.During six months followup,the measurement data was conducted and compared with three-dimensional CT result.Random measurement of the three key anatomical points pre-and post-operative carried out with statistical error was used to evaluate the accuracy of computer-assisted three-dimensional reconstruction in mandibular defects repairation and to investigate the clinical application value of the operation time and postoperative complication rate.Results· From July 2001 to July 2016,a total of 163 patients underwent computer-assisted three-dimensional reconstruction of artificial bone repair for mandibular defects;149 patients met the statistical criteria in which preoperative design and postoperative actual effect's average distance error (1.27±0.15) mm,operation time (2.5±1.2) h.Conclusion· Threedimensional design of artificial bone to repair the mandibular defect is a valuable technology,by relying on quantitative design and preoperative simulation to simplify the difficulty and improve the accuracy of surgery.The patients showed high satisfaction rate with low surgical complications and long-term efficacy.

Effect observation of autogenous bone,allograft bone and BMP synthetic bone in treatment of lumbar spondylo-listhesis / 局解手术学杂志

Objective To explore the clinical effect of autogenous bone,allograft bone and BMP synthetic bone in the treatment of lum-bar spondylolisthesis,and provide more basis to choose transplant material.Methods A total of 96 patients with lumbar spondylolisthesis were chosen as research subjects,who were cured in our hospital from January 2014 to January 2015.They were divided into group A(who were treated with autogenous bone),group B(who were treated with allograft bone)and group C(who were treated with BMP synthetic bone), according to prospective study method.The indicators of the operation,postoperative adverse reactions,change of intervertebral disc height and bone graft fusion rate of three groups were compared.Results Difference of the operation indexes of three groups had no statistical sig-nificance(P >0.05).The incidences of adverse reactions in group A and group C had no statistically significant difference(P >0.05),but both less than that in group B,with statistically significant difference(P 0.05),but both more than that in group B,with statistically significant difference(P 0.05).And the fusion rates of group A and C in each period were significantly higher than that of group B,with statistically significant difference(P 0.05),but both better than that of group B,with statistically significant difference (P <0.05).Conclusion BMP synthetic bone used in lumbar spondylolisthesis has the same clinical effect as autologous bone.But BMP synthetic bone has faster bone graft fusion rate than autologous bone.And it is beneficial to patients’recovery.

Osteoconductive and osseointegration properties of a commercial hydroxyapatite compared to a synthetic product / Comparación de las propiedades de osteoconducción y osteointegración de una hidroxiapatita reabsorbible comercial con una hidroxiapatita reabsorbible sintetizada / Comparação das propriedades da osteocondução e osteointegração de uma hidroxiapatita reabsorvivel comercial sintetizada

The effects of two types of hydroxylapatite on bone synthesis and properties were evaluated. An osteoconductive resorbable hydroxyapatite (OseoU), synthesized at two different temperatures of calcination (Type A and Type B) was compared with a commercial mixture of hydroxyapatite (Osteogen®), commonly used in several surgical procedures involving bone loss. The synthesis was performed in the laboratories of the University of Antioquia by precipitating a mixture of calcium nitrate and ammonium phosphate. The products obtained and the commercial hydroxyapatite were characterized by scanning electron microscopy (SEM), X- ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and energy dispersive spectroscopy (EDS). Osteoconductive and osseointegration characteristics were measured according to the products ability to induce local cell differentiation into bone forming cells. These characteristics were evaluated in hydroxyapatite implants performed in 70 New Zealand breed rabbits distributed into seven groups of 10 animals each, tested at 7, 14, 21, 28, 42, 60 and 90 days after the surgical procedure.

En el presente artículo se evalúan las propiedades de osteoconducción y osteointegración de una hidroxiapatita reabsorbible (OseoU), procesada a dos temperaturas diferentes de calcinación (Tipo A y Tipo B), con el propósito de compararlas con un preparado comercial de hidroxiapatita (Osteogen®), utilizado para múltiples procedimientos quirúrgicos en los cuales se involucra la pérdida de tejido óseo. La síntesis se realizó en los laboratorios de la Universidad de Antioquia por el método de precipitación acuosa de la mezcla de nitrato de calcio y de fosfato de amonio. Los productos obtenidos y la hidroxiapatita comercial fueron caracterizados por microscopia electrónica de barrido (SEM), difracción de rayos X (DRX), espectroscopia de infrarrojo transformada de Fourier (FTIR) y espectrometría por energía dispersiva (EDS). Las características de osteoconducción y osteointegración fueron medidas de acuerdo a la capacidad de los productos para inducir la diferenciación de células locales a células formadoras de hueso. Dichas características, se evaluaron en implantes de hidroxiapatita realizados en 70 conejos de la raza Nueva Zelanda distribuidos en siete grupos de 10 animales cada uno, evaluados a los 7, 14, 21, 28, 42, 60 y 90 días de efectuado el procedimiento quirúrgico. Los resultados obtenidos demostraron que el OseoU y el Osteogen®, presentaron características similares en cuanto a la estructura cristalina, la composición química y la adsorción, con apreciables diferencias morfológicas con respecto a la forma de las partículas. Al realizar el análisis de varianza no se encontraron diferencias estadísticas significativas para las variables histopatológicas evaluadas en las dos hidroxiapatitas (p>0.05), indicando que las hidroxiapatitas sintetizadas en la Universidad de Antioquia (OseoU) tuvieron el mismo resultado que la hidroxiapatita comercial (Osteogen®) en la osteoconducción y la osteointegración del tejido óseo.

No presente estudo foram avaliadas as propriedades de ostecondução e osteointegração de uma hidroxiapatita reabsorvivel (OseoU), processada a duas temperaturas de calcinaçao (Tipo A e B), com o propósito de serem comparadas com um produto comercial (Osteogen®), utilizado para múltiples procedimentos cirúrgicos nos quais se envolve a perda do tecido osso. Asíntese foi realizada nos laboratorios da Universidad de Antioquia pelo método de precipitação aquosa da mistura de nitrato de cálcio e fosfato de amônio. Os produtos obtidos e a hidroxiapatita comercial foram caracterizados por microscopia eletrônica de barrido (SEM), difração raios X (DRX), espectroscopia de infravermelho transformada de Fourier (FTIR) e espectrometria por energia dispersiva (EDS). As características de osteocondução e osteointegração foram mensuradas de acordo à capacidade dos produtos para induzir a diferenciação das células locais formadoras do osso. Estas características foram avaliadas em implantações de hidroxiapatita realizadas em 70 coelhos da raça Nova Zelândia distribuídos em sete grupos de 10 animais cada um, avaliados aos 7, 14, 21, 28, 42, 60 e 90 dias de efetuado o procedimento cirúrgico. Os resultados obtidos demonstraram que o OseoU e o Osteogen® apresentaram características similares em quanto à estrutura cristalina, a comparação química e à absorção, com apreciáveis diferenças morfológicas com respeito à forma das partículas. Ao realizar as análises de variâncias não foram encontradas diferencias estatísticas significativas para as variáveis histopatológicas avaliadas nas duas hidroxiapatitas (p>0.05), indicando que as hidroxiapatitas sintetizadas na Universidad de Antioquia (OseoU) tiveram o mesmo resultado que a hidroxiapatita comercial (Osteogen®) em osteocondução e osteointegração do tecido ósseo.

Clinical study of Osteoset~ synthetic bone transplants and internel fixations on calcaneus fracture / 中国矫形外科杂志

[Objective]To evaluate curative effects of Osteoset~ synthetic bone transplants and internel fixations on calcaneus fracture.[Method]Twenty-three patients with calcaneus fracture,who were treated by Osteoset~ synthetic bone transplants and internel fixation,were followed up by plain X-Rays and JOA functional questionnaires.Fracture patterns were based on Sanders methods.[Result]A series of 23 patients,7 of which were sanders Ⅱ,15 were sanders Ⅲ,3 were sanders Ⅳ,were treated with ORIF and Osteoset~ implants.The preoperative Blher's angle was 4.8 degrees(standard deviation 6.6 degrees).Blher's angle increased to a mean of 26.8 degrees(SD 8.6 degrees) postoperatively.In the first 3 months after surgery,a mean decrease in the Blher's angle of 0.4 degrees(SD 2.27 degrees) occurred.One month after surgery osteoset synthetic bone transplants,which was replaced by new bone,were gradually absorbed and degraded.JOA questionnaires suggested that the whole effective rate was 92 percent.[Conclusion]Osteoset synthetic bone transplants and internel fixations has good therapeutic effects on patients with comminuted calcaneus fracture.Osteoset~ synthetic bone has the same effects as autogenous bone.

Biomechanical evaluation of repairation of cancellous bone defect with calcium sulphate / 中国矫形外科杂志

[Objeetive]To report the repairing offect of cancellous bone defect with calcium sulphate.[Method]A defect 5mm in diameter and 12 mm in deep,which was drilled in the lateral aspect of rabbit lateral femoral condyle,was filled with CCaS(Citrated Calcium Sulphate)cylinder or Osteoset tablets respectively.Rabbits were killed 3,6,13 weeks after surgery.And then general oberservations and mechanical analyzing were conducted.[Result]After surgery,rabbits had good movements,spirits and eating,good healing of incision.There was no arthroedema and inflammatory response around the joints.Mechanical analyzing reports:both anticompressive strength and elasticity coefficient in the artificial bone repair bone defect area 3 weeks after surgery,were higher than in that of normal femur condyle;Anti-compressive strength and elasticity coefficient in the defect area 6 weeks,which drop comparing to 3 weeks,was lower than that of normal femur condyle;Anti-compressive strength and elasticity coefficient 13 weeks,which is higher than 6 weeks,is approaching normal.Mechanics intensity of two groups in the different time had no significant difference,but was significantly higher than one of the same time blank group.[Conclusion]To some extent,Calcium Sulphate has mechanical supportive effects on cancelloues bone defect in spite of the absorption and degradation of Calcium Sulphate.There is no significant difference between Citrated Calcium Sulphate and Osteoset tablets.

The Effect of the Synthetic Bone Glass on the Fibrovascularization into Porous Polyethylene Orbital Implant

PURPOSE: To evaluate the effect of the synthetic bone glass particulate (BG) on the fibrovascular ingrowth into porous polyethylene orbital implant (PP). METHODS: Forty eight rabbits were divided into 4 groups according to the surgical techniques and implanted materials. One eye was enucleated one eye and PP was implanted in group 1, was eviscerated and PP was implanted in group 2, was enucleated and BG, containing 30% by weight synthetic bone glass particulate, was implanted in group 3, and was eviscerated and BG was implanted in group 4. All implants of each group were assessed by histologic study at the first, second, fourth, and eighth weeks postoperatively. The area of fibrovascular ingrowth was calculated by histologic examination. RESULTS: There were no statistically significant differences in the fibrovascular ingrowth among these groups. A greater number of vessels per unit area and matured fibrous tissue was found in the more outer zone at longer time after implantation, but there was not statistically significant difference among the four groups. CONCLUSIONS: On the basis of this study, the synthetic bone glass particulate did not significantly increase the rate of fibrovascular ingrowth into porous polyethylene orbital implant in rabbits.