Biomaterials from the sea: Future building blocks for biomedical applications.

Marine resources have tremendous potential for developing high-value biomaterials. The last decade has seen an increasing number of biomaterials that originate from marine organisms. This field is rapidly evolving. Marine biomaterials experience several periods of discovery and development ranging from coralline bone graft to polysaccharide-based biomaterials. The latter are represented by chitin and chitosan, marine-derived collagen, and composites of different organisms of marine origin. The diversity of marine natural products, their properties and applications are discussed thoroughly in the present review. These materials are easily available and possess excellent biocompatibility, biodegradability and potent bioactive characteristics. Important applications of marine biomaterials include medical applications, antimicrobial agents, drug delivery agents, anticoagulants, rehabilitation of diseases such as cardiovascular diseases, bone diseases and diabetes, as well as comestible, cosmetic and industrial applications.

Experimental and Theoretical Investigation of Effects of Ethanol and Acetic Acid on Carcinogenic NDMA Formation in Simulated Gastric Fluid.

N-nitrosodimethylamine (NDMA), as a representative of endogenously formed N-nitroso compounds (NOCs), has become the focus of considerable research interest due to its unusually high carcinogenicity. In this study, effects of ethanol and acetic acid on the formation of NDMA from dimethylamine (DMA) and nitrite in simulated gastric fluid (SGF) were investigated. Experimental results showed that ethanol in the concentrations of 1-8% (v/v) and acetic acid in the concentrations of 0.01-8% (v/v) exhibit inhibitory and promotion effects on the formation of NDMA, respectively. Moreover, they are both in a dose-dependent manner with the largest inhibition/promotion rate reaching ∼70%. Further experimental investigations indicate that ethanol and acetic acid are both able to scavenge nitrite in SGF. It implies that there are interactions of ethanol and acetic acid with nitrite or nitrite-related nitrosating agents rather than DMA. Theoretical calculations confirm the above experimental results and demonstrate that ethanol and acetic acid can both react with nitrite-related nitrosating agents to produce ethyl nitrite (EtONO) and acetyl nitrite (AcONO), respectively. Furthermore, the reactivities of ethyl nitrite, acetyl nitrite, and dinitrogen trioxide reacting with DMA were found in the order of AcONO > N2O3 ≫ EtONO. This is probably the main reason why there are completely different effects of ethanol and acetic acid on NDMA formation. On the basis of the above results, two requirements for a potential inhibitor of NOCs formation in SGF were provided. The results obtained in this study will be helpful in better understanding the inhibition/promotion mechanisms of compounds on NDMA formation in SGF and searching for protective substances to prevent carcinogenic NOCs formation.

The Effects of Diamond-Like Carbon Films on Fretting Wear Behavior of Orthodontic Archwire-Bracket Contacts.

This study aims to assess the effects of diamond-like carbon (DLC) films on fretting wear behavior of orthodontic archwire-bracket contacts. 'Mirror-confinement-type electron cyclotron resonance (MCECR) plasma sputtering' was utilized to deposit carbon films on stainless steel archwires and brackets. Nanostructure of carbon films such as the bonding structure, cross-sectional thickness and surface roughness were studied. The fretting wear behavior of various archwire-bracket contacts were investigated by using a self-developed tester in ambient air and artificial saliva. The results indicated that DLC-coated wires showed significantly low friction coefficient than the uncoated wires independently of the applied environments. Nevertheless, the DLC-coated and uncoated brackets showed no significant differences in the friction coefficient. Microscopic analysis showed that low wear took place for the DLC-coated surfaces. It is proposed that the application of DLC coating on archwires can decrease the orthodontic fretting wear and coefficient of friction. Unfortunately it does not affect the frictional properties for brackets at present.

ß2-Adrenergic signal transduction plays a detrimental role in subchondral bone loss of temporomandibular joint in osteoarthritis.

The present study tested whether activation of the sympathetic tone by aberrant joint loading elicits abnormal subchondral bone remodeling in temporomandibular joint (TMJ) osteoarthritis. Abnormal dental occlusion was created in experimental rats, which were then intraperitoneally injected by saline, propranolol or isoproterenol. The norepinephrine contents, distribution of sympathetic nerve fibers, expression of ß-adrenergic receptors (ß-ARs) and remodeling parameters in the condylar subchondral bone were investigated. Mesenchymal stem cells (MSCs) from condylar subchondral bones were harvested for comparison of their ß-ARs, pro-osteoclastic gene expressions and pro-osteoclastic function. Increases in norepinephrine level, sympathetic nerve fiber distribution and ß2-AR expression were observed in the condylar subchondral bone of experimental rats, together with subchondral bone loss and increased osteoclast activity. ß-antagonist (propranolol) suppressed subchondral bone loss and osteoclast hyperfunction while ß-agonist (isoproterenol) exacerbated those responses. MSCs from experimental condylar subchondral bone expressed higher levels of ß2-AR and RANKL; norepinephrine stimulation further increased their RANKL expression and pro-osteoclastic function. These effects were blocked by inhibition of ß2-AR or the PKA pathway. RANKL expression by MSCs decreased after propranolol administration and increased after isoproterenol administration. It is concluded that ß2-AR signal-mediated subchondral bone loss in TMJ osteoarthritisis associated with increased RANKL secretion by MSCs.

Biphasic silica/apatite co-mineralized collagen scaffolds stimulate osteogenesis and inhibit RANKL-mediated osteoclastogenesis.

The effects of a biphasic mineralized collagen scaffold (BCS) containing intrafibrillar silica and apatite on osteogenesis of mouse mesenchymal stem cells (mMSCs) and inhibition of receptor activator of nuclear factor κB ligand (RANKL)-mediated osteoclastogenesis were investigated in the present study. mMSCs were cultured by exposing to BCS for 7 days for cell proliferation/viability examination, and stimulated to differentiate in osteogenic medium for 7-21 days for evaluation of alkaline phosphatase activity, secretion of osteogenic deposits and expression of osteoblast lineage-specific phenotypic markers. The effect of BCS-conditioned mMSCs on osteoclastogenesis of RAW 264.7 cells was evaluated by tartrate-resistant acid phosphatase staining and resorption pit analysis. The contributions of mitogen-activated protein kinase (MAPK) and phosphatidylinositol-3 kinase (PI3K) signal transduction pathways to osteogenesis of mMSCs and their osteoprotegerin (OPG) and RANKL expressions were also evaluated. Compared with unmineralized, intrafibrillarly-silicified or intrafibrillarly-calcified collagen scaffolds, BCS enhanced osteogenic differentiation of mMSCs by activation of the extracellular signal regulated kinases (ERK)/MAPK and p38/MAPK signaling pathways. After mMSCs were exposed to BCS, they up-regulated OPG expression and down-regulated RANKL expression through activation of the p38/MAPK and PI3K/protein kinase B (Akt) pathways, resulting in inhibition of the differentiation of RAW 264.7 cells into multinucleated osteoclasts and reduction in osteoclast function. These observations collectively suggest that BCS has the potential to be used in bone tissue engineering when the demand for anabolic activities is higher than catabolic metabolism during the initial stage of wound rehabilitation.

Investigation of dental pulp stem cells isolated from discarded human teeth extracted due to aggressive periodontitis.

Recently, human dental pulp stem cells (DPSCs) isolated from inflamed dental pulp tissue have been demonstrated to retain some of their pluripotency and regenerative potential. However, the effects of periodontal inflammation due to periodontitis and its progression on the properties of DPSCs within periodontally compromised teeth remain unknown. In this study, DPSCs were isolated from discarded human teeth that were extracted due to aggressive periodontitis (AgP) and divided into three experimental groups (Groups A, B and C) based on the degree of inflammation-induced bone resorption approaching the apex of the tooth root before tooth extraction. DPSCs derived from impacted or non-functional third molars of matched patients were used as a control. Mesenchymal stem cell (MSC)-like characteristics, including colony-forming ability, proliferation, cell cycle, cell surface antigens, multi-lineage differentiation capability and in vivo tissue regeneration potential, were all evaluated in a patient-matched comparison. It was found that STRO-1- and CD146-positive DPSCs can be isolated from human teeth, even in very severe cases of AgP. Periodontal inflammation and its progression had an obvious impact on the characteristics of DPSCs isolated from periodontally affected teeth. Although all the isolated DPSCs in Groups A, B and C showed decreased colony-forming ability and proliferation rate (P < 0.05), the decreases were not consistent with the degree of periodontitis. Furthermore, the cells did not necessarily show significantly diminished in vitro multi-differentiation potential. Only DPSCs from Group A and the Control group formed dentin-like matrix in vivo when cell-seeded biomaterials were transplanted directly into an ectopic transplantation model. However, when cell-seeded scaffolds were placed in the root fragments of human teeth, all the cells formed significant dentin- and pulp-like tissues. The ability of DPSCs to generate dental tissues decreased when the cells were isolated from periodontally compromised teeth (P < 0.05). Again, increased periodontal destruction was not necessarily followed by a decrease in the amount of dentin- and pulp-like tissue formed. These findings provide preliminary evidence that periodontally compromised teeth might contain putative stem cells with certain MSC properties, as long as the vitality of the pulp has not been totally damaged. Whether these cells can serve as a source of autologous multipotent MSCs for clinical regenerative therapies warrants further investigation with larger sample sizes and various types of periodontitis.

Intrafibrillar-silicified collagen scaffolds enhance the osteogenic capacity of human dental pulp stem cells.

OBJECTIVES: The present study investigated the effects of intrafibrillar-silicified collagen scaffolds (ISCS) on the osteogenic differentiation of human dental pulp stem cells (hDPSCs) in vitro and in vivo. METHODS: The hDPSCs were co-cultured with ISCS or nonsilicified collagen scaffolds (NCS) in control medium (CM) or osteogenic differentiation medium (ODM). Cell cycle and cell apoptosis were analyzed with flow cytometry to measure the viability of hDPSCs. Reverse transcription-polymerase chain reaction (RT-PCR) and western blotting were used to evaluate the expression levels of osteogenic marker genes and proteins of hDPSCs. Alkaline phosphatase (ALP) staining and alizarin red S assay were used to evaluate the ALP activity of hDPSCs and their calcium deposition potential. In addition, hDPSCs and scaffolds were implanted subcutaneously in nude mice for 8 weeks. Harvested tissues were immunohistochemically stained for osteocalcin (OCN) expression from hDPSCs, and stained with alizarin red S for examination of their calcium deposition in vivo. RESULTS: The ISCS had no adverse effect on hDPSCs, promoted their proliferation, and significantly up-regulated the expression of osteogenesis-related genes and proteins. The hDPSCs co-cultured with ISCS in ODM exhibited the highest ALP activity and calcium deposition in vitro. The ISCS promoted the OCN expression and calcium deposition of hDPSCs after ectopic transplantation in vivo. CONCLUSIONS: Intrafibrillar-silicified collagen scaffolds significantly promoted the proliferation, osteogenic differentiation and mineralization of hDPSCs, when compared with NCS. This study demonstrates combining the use of hDPSCs and ISCS to promote bone-like tissue formation is a promising approach for clinical bone repair and regeneration.

[To explore the safety testing evaluation index of breast-feeding by hepatitis B-positive mothers].

OBJECTIVE: To explore the safety testing evaluation index of breast-feeding by hepatitis B-positive mothers. METHODS: HBV DNA from serum and breast milk of 252 hepatitis B-positive mothers were detected with the real-time quantitative PCR. RESULTS: The total positive rate of HBV DNA in serum had no difference with that in breast milk in hepatitis B-positive mothers (P > 0.05). The positive rate of HBV DNA in serum and breast milk of positive HBeAg were significantly higher than that of hepatitis B-positive mothers with negative HBeAg (P < 0.01). CONCLUSION: To detecte HBeAg and HBV DNA in serum and breast milk have important significance for guiding of breast feeding of hepatitis B-positive mothers.

Biomechanical researches on tissue engineering bone constructed by deproteinated bone.

OBJECTIVE: To study biomechanical changes of newly formed bones 24 weeks after repairing large defects of long bones of goats using heterogeneous deproteinated bone (DPB) prepared by modified methods as an engineering scaffold. METHODS: According to a fully randomized design, 18 goats were evenly divided into three groups: normal bone control group (Group A), autologous bone group (Group B) and experimental group (Group C). Each goat in Groups B and C were subjected to the periosteum and bone defect at middle-lower part of the right tibia (20% of the whole tibia in length), followed by autologous bone or DPB plus autologous MSCs + rhBMP2 implantation, respectively and semi-ring slot fixation; while goats in Group A did not perform osteotomy. At 24 weeks after surgery, biomechanical tests were carried out on the tibias. RESULTS: At 24 weeks after surgery, the results of anti-compression test on tibias in three groups were recorded by a functional recorder presented as linear pressure-deformation curve. The shapes of the curves and their change tendency were similar among three groups. The ultimate pressure values were 10.74 MPa+/-1.23 MPa, 10.11 MPa+/-1.35 MPa and 10.22 MPa+/-1.32 MPa and fracture compression rates were 26.82%+/-0.87%, 27.17%+/-0.75% and 28.22%+/-1.12% in Groups A, B and C, respectively. Comparisons of anti-compression ultimate pressures and fracture compression rates among three groups demonstrated no significant difference (P(AB) equal to 0.415, P(BC) equal to 0.494). Three-point anti-bend test on tibias was recorded as load-deformation curves, and the shapes of the curves and their change tendency were similar among three groups. The ultimate pressure values of the anti-bend test were 481.52 N+/-12.45 N, 478.34 N+/-14.68 N and 475.62 N+/-13.41 N and the fracture bend rates were 2.62 mm+/-0.12 mm, 2.61 mm+/-0.15 mm and 2.81 mm+/-0.13 mm in Groups A, B and C, respectively. There was no significant difference between groups (P(AB) equal to 0.7, P(BC) equal to 0.448). The ultimate anti-torsion torque values were 6.55 Nm+/-0.25 Nm, 6.34 Nm+/-0.18 Nm and 6.42 Nm+/-0.21 Nm and fracture torsion rates were 29.51 degree+/-1.64degree, 28.88 degree+/-1.46 degree and 28.81 degree+/-1.33 degree in Groups A, B and C, respectively. There was no significant difference between groups (P(AB) equal to 0.123, P(BC) equal to 0.346). CONCLUSIONS: The biomechanical characteristics of newly formed bones from heterogeneous DPB for repairing large segmental long bone defect are comparable to those of normal bones and autologous bones. DPB has the potential for clinical usage as bone graft material.

[Effect of experimentally created occlusal disorders on the expression of estrogen in rat condylar cartilage].

OBJECTIVE: To investigate the effect of experimentally created occlusal disorders (ECOD) on the expression of estrogen in rat condylar cartilage. METHODS: The model of ECOD was created by moving right upper and left lower first molars anteriorly. The animals in ECOD were sacrificed at 2, 4, 6, 8 weeks later. In removed occlusal disorders group, the moved first molars were extracted at 6 weeks later, and the animals were sacrificed 2 weeks later. The expression of estrogen was detected by SABC technique of immunocytochemistry, and then was analyzed by the density of estrogen-positive chondrocytes. RESULTS: 1) Estrogen was abundant in mature layer and hypertrophic layer of rat mandibular condylar cartilage. 2) In control group, the expression of estrogen decreased gradually from 6-week-old to 16-week-old. 3) In both childhood and puberty rats, the expression of estrogen in experiment group was significantly higher at 2 weeks after treatment, while no difference was found at 4, 6, 8 weeks after treatment. However, the expression in removed occlusal disorder group was higher than that in control group and 8 weeks of ECOD group. CONCLUSION: In rat condylar cartilage, the expression of estrogen de-creases with age. Induced by ECOD, the expression of estrogen increases in early stage of remodelling activity.

Immunological study on the transplantation of an improved deproteinized heterogeneous bone scaffold material in tissue engineering.

OBJECTIVE: To observe the immune response after the transplantation of a deproteinized heterogeneous bone scaffold and provides the theoretic reference for clinical practice. METHODS: The fresh pig bone and deproteinized bone were transplanted respectively to establish BABL/C thigh muscle pouches model of male mice and take the samples for detection at 1, 2, 4, 6 weeks after operation. Lymphocyte stimulation index, subset analysis, serum specific antibody IgG, cytokine detection and topographic histologic reaction after implantation were investigated. RESULTS: After the transplantation of deproteinized bone, lymphocyte stimulation index, CD(4)(+) and CD(8)(+) T-lymphocyte subsets, serum specific antibody IgG and cytokines in deproteinized bone group were significantly lower than those in fresh pig bone group at each time point (P<0.05). The histological examination found that in fresh bone group at each time point, a large quantity of inflammatory cells infiltrated in the surrounding of bone graft, and they were mainly lymphocytes, including macrophages and monocytes. In deproteinized bone group, there were few inflammatory cells infiltration around bone graft one week after operation. The lymphocytes were decreased as time went by. At 6 weeks, fibroblasts and fibrous tissue grew into the graft, and osteoclasts and osteoprogenitor cells appeared on the verge. CONCLUSIONS: The established heterogeneous deproteinized bone has low immunogenicity and is a potentially ideal scaffold material for bone tissue engineering.

Properties of deproteinized bone for reparation of big segmental defect in long bone.

OBJECTIVE: To explore suitable scaffold material for big segmental long bone defect by studying the properties of the prepared deproteinized bone. METHODS: Cancellated bone were made as 30 mm x mm x 3 mm bone blocks from inferior extremity of pig femur along bone trabecula. The deproteinized bone was prepared with an improved method. Their morphological features, components, cell compatibility, mechanical and immunological properties were investigated respectively. RESULTS: Deproteinized bone maintained natural reticular pore system. The main organic material is collagen I and inorganic composition is hydroxyapatite. It has good mechanical properties, cell adhesion rate and histocompatibility. CONCLUSION: This deproteinized bone can be applicable as scaffold for reparation of big segmental defect in long bone.

Arthroscopically assisted ankle fusion in patients with end-stage tuberculosis.

PURPOSE: Our purpose was to evaluate the clinical outcomes of arthroscopically assisted ankle fusion in patients with end-stage tuberculosis. METHODS: Ten patients, all with end-stage tuberculosis, were operated on by arthroscopically assisted ankle fusion, and a half-ring sulcated external fixator was used. Partial weight-bearing was started on the fourth day. The clinical results were assessed with the American Orthopaedic Foot & Ankle Society score. Ankle fusion was proved by radiographs. RESULTS: At the mean follow-up of 23 months, all fusions were healed; the mean time to radiologic healing was 14.5 weeks. The final American Orthopaedic Foot & Ankle Society score was 66 points. CONCLUSIONS: Arthroscopically assisted debridement and ankle arthrodesis with an external fixator provided a very satisfactory rate of ankle fusion in 10 patients who had no recurrences or other complications. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Cellular compatibility of improved scaffold material with deproteinized heterogeneous bone.

OBJECTIVE: To study cellular compatibility of improved scaffold material with deproteinized heterogeneous bone and provide experimental basis on choosing the scaffold material in bone tissue engineering. METHODS: Bone marrow stromal cells (BMSC) were co-cultured with heterogeneous deproteinized bone in vitro. The contrast phase microscope, scanning electron microscope, MTT assay, flow cytometry were performed and the BGP content and ALP activities were detected in order to observe the cell growth, adhesion in the material, cell cycle and cell viability. RESULTS: The scaffold material of deproteinized heterogeneous bone had no inhibitory effect on cellular proliferation, differentiation and secretion function of BMSCs. CONCLUSIONS: The established heterogeneous deproteinized bone has good biocompatibility with BMSCs and is a potentially ideal scaffold material for bone tissue engineering.

[Treatment of high-energy tibia plateau injury with half-ring external fixation combined with minimum internal fixation].

OBJECTIVE: To evaluate the effect of less invasive surgical treatment for high-energy tibia plateau injury with half-ring external fixation combined with minimum internal fixation. METHODS: From January, 2003 to May,2006, 16 cases of high-energy tibia plateau fracture were treated with half-ring external fixation combined with minimum internal fixation including 10 cases of type V and 6 cases of type VI according to Schatzker's classification. The average age of the patients was 42.4 years (range 25 to 50 years). RESULTS: All patients were followed for an average of 16 months (range 5 to 27 months). All the fractures healed after an average time of 3.5 months. Two patients developed infections of the pin holes. According to the criteria of Rasmussen, excellent results were achieved in 10, good results in 4 cases, moderate in 2, and poor in none. CONCLUSION: Half-ring external fixation combined with minimum internal fixation can be ideal for treatment of complex tibia plateau fracture.

Preparation and physicochemical properties of scaffold materials of heterogeneous deproteinized bone.

OBJECTIVE: To prepare and observe the physicochemical properties of scaffold materials of heterogeneous deproteinized tissue-engineered bone. METHODS: Deproteinized bone was made through a series of physicochemical treatments in pig ribs and analyzed with histological observation, scanning electron microscopy, infrared spectrum, X-ray diffraction and energy dispersive analysis, Kjeldahl determination and mechanics analysis. RESULTS: Interstitial collagen fiber was positive and mucin was negative in deproteinized bone, but, both were positive in fresh bone. Deproteinized bone maintained natural pore network. Its pore size was 472.51 micromolar+/-7.02 micromolar and the porosity was 78.15%+/-6.45%. The results of infrared spectrum showed that collagen was present in deproteinized bone. Both fresh and deproteinized bone had curve of hydroxyapatite. The Ca/P ratios were 1.71+/-0.95 and 1.68+/-0.76 (P larger than 0.05), and the protein contents were 26.6%+/-2.23% and 19.1%+/-2.14% (P less than 0.05) in fresh and deproteinized bone, respectively. There was no significant difference of destruction load under compression and maximal destruction load between fresh and deproteinized bone (P larger than 0.05). The elastic modulus was higher in deproteinized bone than that in fresh bone (P less than 0.05). CONCLUSIONS: Physicochemical properties and mechanic strength of deproteinized tissue-engineered bone meet the demands of ideal scaffold materials. But, its immunogenicity should be observed through further experiments for its clinical applications.

Study of biological safety of scaffold material with heterologous deproteinized bone.

OBJECTIVE: To evaluate the biological safety of manufactured heterologous deproteinized bone and to provide an experimental basis for clinical applications. METHODS: Deproteinized bone (10 mm) and leaching liquor were made from pig ribs with a series of physical and chemical methods, then were evaluated through acute and subacute toxicity test, hemolysis test, pyrogen test, intracutaneous test, intramuscular implantation test and cytotoxity test. RESULTS: No obvious toxicity, hemolysis, pyrogenic characteristics, skin irritation, inflammatory reaction after intramuscular implantation and cytotoxity were observed. CONCLUSIONS: The heterologous deproteinized bone has good biological safety and meets all the demands of scaffold material for tissue engineering.

[Effects of Yiqi Jiangzhuo Decoction on transforming growth factor-beta1 mRNA expression in treating ventricular remodeling in mice with repetitive CVB3m infection caused viral myocarditis].

OBJECTIVE: To investigate the effects of Yiqi Jiangzhuo Decoction (YJD) on transforming growth factor-beta1(TGF-beta1) mRNA expression in treating ventricular remodeling in viral myocarditis. METHODS: After being established into chronic viral myocarditis model by 4 times repetitively infecting with gradient multiplicative CVB3m, 160 male mice were divided into the blank group, the model group, the TCM treated group and the Western medicine treated group. On the 10th, 30th and 60th day after the last time of infection, mice were killed to observe their pathological changes of myocardium with HE staining and to detect TGF-beta1 mRNA expression in myocardial tissue with semi-quantitative RT-PCR method. RESULTS: Pathological changes of myocardium alleviated, and TGF-beta1 mRNA expression distribution area reduced significantly in the two treated groups, as compared with those in the model group (all P < 0.05). CONCLUSION: YJD could inhibit the hyperplasia and reconstruction of ECM by down-regulating TGF-beta1 mRNA expression to improve cardiac pathological changes in myocarditis, so as to prevent the occurrence of ventricular remodeling and the conversion of disease to dilative cardiomyopathy.

The biomechanics of point contact-dynamic compression plate and its effects on bone perfusion.

OBJECTIVE: To compare the mechanical properties of point contact-dynamic compression plate (PC-DCP) and its effects on cortical bone perfusion with that of dynamic compression plates (DCP) in goat tibiae. METHODS: Twenty pairs of matched fresh goat tibiae were used. A transverse fracture model was established. The fractures with a 3mm interspace between the fracture ends were subject to fixations with the DCPs and the PC-DCPs respectively, then the four-points bending tests and the torsion tests were conducted to compare the mechanical properties of the PC-DCP with that of DCP. Another 13 sexually mature goats underwent fixations with the DCPs and the PC-DCPs, respectively, at the mid-shafts of the intact bilateral tibiae. Ischemic zones were observed at four time points (1 day, 2, 6, and 12 weeks after operation) using disulphine blue staining technique. RESULTS: There were no significant differences in mechanical properties, such as bend- and torsion-resistance, between the DCPs and the PC-DCPs. One day, 2, and 6 weeks after operation, on the side of DCP fixation, outer cortical bone ischemia under the plate persisted, and this condition did not reverse until 12 weeks after operation. However, on the side of PC-DCP fixation, cortical bone ischemia occurred only in the periphery of the screw holes and at the contact sites of the PC NUTs 1 day after operation, and it disappeared at 2 weeks after operation. CONCLUSIONS: The PC-DCP has similar biomechanical properties of the DCP, but is less detrimental to local bone blood circulation than the conventional plates.

Histological comparison of fate of ligamentous insertion after reconstruction of anterior cruciate ligament: autograft vs allograft.

OBJECTIVE: To analyze the histological results and the biological remodeling of ligamentous insertion after the reconstruction of anterior cruciate ligament (ACL) with autograft or allograft tendon. METHODS: Extensor digitorum tendon was harvested from hind limb as graft material and transplanted to reconstruct the resected ACL in 12 mongrel dogs. Each free tendon end was secured by holding sutures and then the sutures were tied to the post screw at the femoral and tibial bony tunnel outlet after transplantation respectively. Autograft was randomly performed on one side of knee while allograft on the other side of knee. After transplantation, the histological analysis was undertaken at the 6th, 12th weeks and the 6th month using hematoxylin-eosin (HE) stain under light microscope. RESULTS: The insertion structure of normal ACL typically consisted of four layers, i.e., dense connective tissue, fibrocartilage, mineralized fibrocartilage and bone. There was a distinct regular tidemark line between fibrocartilage and mineralized fibrocartilage. At the 6th week postoperatively, loose connective tissue presented in the interspace between graft and bony tunnel wall in both autograft and allograft groups. At the 12th week postoperatively, the collagenous fibers between autograft and tunnel wall became well organized and the four layers of insertion with discontinuous tidemark line were demonstrated indistinctly in autograft group but not in allograft group. At the 6th month postoperatively, both of a clear and continuous tidemark line and distinct four layers could be seen in autograft group. In allograft group, only a waved discontinuous tidemark line was shown and either the anatomic morphology or the maturity of insertion was inferior to that of autograft group. CONCLUSIONS: At the 6th month postoperatively, although the ligament-cartilage insertion is primarily formed after ACL reconstruction with autograft or allograft tendon, the histological morphology and the maturation of insertion of autograft tendon are better than those of allograft group, which suggests that postoperative rehabilitation should be paid more attention and could be safer if little delayed during ACL reconstruction with allograft tendon.