Lumbar Interbody Fusion Conducted on a Porcine Model with a Bioresorbable Ceramic/Biopolymer Hybrid Implant Enriched with Hyperstable Fibroblast Growth Factor 2.

Many growth factors have been studied as additives accelerating lumbar fusion rates in different animal models. However, their low hydrolytic and thermal stability both in vitro and in vivo limits their workability and use. In the proposed work, a stabilized vasculogenic and prohealing fibroblast growth factor-2 (FGF2-STAB®) exhibiting a functional half-life in vitro at 37 °C more than 20 days was applied for lumbar fusion in combination with a bioresorbable scaffold on porcine models. An experimental animal study was designed to investigate the intervertebral fusion efficiency and safety of a bioresorbable ceramic/biopolymer hybrid implant enriched with FGF2-STAB® in comparison with a tricortical bone autograft used as a gold standard. Twenty-four experimental pigs underwent L2/3 discectomy with implantation of either the tricortical iliac crest bone autograft or the bioresorbable hybrid implant (BHI) followed by lateral intervertebral fixation. The quality of spinal fusion was assessed by micro-computed tomography (micro-CT), biomechanical testing, and histological examination at both 8 and 16 weeks after the surgery. While 8 weeks after implantation, micro-CT analysis demonstrated similar fusion quality in both groups, in contrast, spines with BHI involving inorganic hydroxyapatite and tricalcium phosphate along with organic collagen, oxidized cellulose, and FGF2- STAB® showed a significant increase in a fusion quality in comparison to the autograft group 16 weeks post-surgery (p = 0.023). Biomechanical testing revealed significantly higher stiffness of spines treated with the bioresorbable hybrid implant group compared to the autograft group (p < 0.05). Whilst histomorphological evaluation showed significant progression of new bone formation in the BHI group besides non-union and fibrocartilage tissue formed in the autograft group. Significant osteoinductive effects of BHI based on bioceramics, collagen, oxidized cellulose, and FGF2-STAB® could improve outcomes in spinal fusion surgery and bone tissue regeneration.

Nanotechnology and mesenchymal stem cells with chondrocytes in prevention of partial growth plate arrest in pigs.

INTRODUCTION: This study describes the results achieved using a combination of allogeneic mesenchymal stem cells (MSCs) with chondrocytes (CHC) and a new scaffold consisting of type-I collagen and chitosan nanofibers in the prevention of partial growth plate arrest after iatrogenic injury in pigs. MATERIAL AND METHODS: The miniature pig was selected as an experimental model to compare the results in the left femoral bones (MSCs and CHC in scaffold transplantation into the iatrogenic partial distal growth plate defect) and right femoral bones (scaffold alone transplantation). The experimental group consisted of 10 animals. Bone marrow from os ilium as the source of MSCs was used. A porous cylinder consisting of 0.5% by weight type-I collagen and 30% by weight chitosan, was the optimal choice. The length of the bone and angular deformity of distal femur after the healing period was measured and the quality and structure of the newly formed cartilage was histologically examined. RESULTS: Transplantation of the composite scaffold in combination with MSCs and chondrocytes led to the prevention of growth disorder and angular deformity in the distal epiphysis of the left femur. Compared to the right (control) femur, tissue similar to hyaline cartilage with signs of columnar organization typical of the growth plate occurred in most cases. CONCLUSIONS: The promising results of this study reveal the new and effective means for the prevention of bone bridge formation after growth plate injury.

Use of locking compression plates for deformity correction of the forearm bones in children.

THE AIM OF THE STUDY: The aim of our study was to assess treatment results of angular deformities in distal radius by a system of the locking compression plates (LCP) at our clinic. METHODS: Our source data was collected prospectively from the records of patients where the locking compression plate was used for angulation correction of distal forearm between 2006 and 2007. The patients were divided by sex, the age range was defined and two groups were formed based on the initial diagnosis: the group of posttraumatic deformities (2 patients; 29 %) and the group of no traumatic deformities (3 patients with congenital shortening of ulna, valgus deformity and overgrowth of radius and 2 patients with exostoses multiplices with shortening of ulna and overgrowth of radius with ulnar angulation). The following parameters were set: radial articular angle and carpal slip prior to and after angulation correction, the healing period, the range of movement of the surrounding joints and occurrence of complications. RESULTS: We recorded only one case of delayed healing which was subsequently sustained by autospongioplastics and adjusted to normal. In the rest of the cases deformity correction occurred and the defined parameters were then corrected to normal. We observed no postoperative complications or permanent consequences. CONCLUSIONS: A two-year follow-up period monitoring treatment and therapeutic results of deformities in the forearm bones at our clinic, confirmed a minimal incidence of complications and a high percentage of successfully treated cases.

Endovascular abdominal aortic aneurysm repair: a 7 year experience at the Launceston General Hospital.

BACKGROUND: To review our 7 year experience of endovascular abdominal aortic aneurysm repair (EVR) and to compare this to open repair (OR) during the same time period. METHODS: One hundred and one EVR and 65 OR patients were studied. Parameters analysed included patient and procedure details, intensive care unit (ICU) and hospital admission time, and morbidity and mortality with particular emphasis on procedure-related problems. RESULTS: Endovascular grafts were deployed with successful abdominal aortic aneurysm (AAA) exclusion in 100 patients. Primary technical success was achieved in 84%, clinical success in 86% and secondary success in 90% of cases. Complications occurred in 63% and 88% of EVR and OR patients, respectively. Early device-related complications occurred in 40 EVR patients (40%); 24 (60%) were corrected immediately by further stenting. Late device-related complications occurred in 15 EVR patients (15%); four (27%) required additional stenting. Most of the complications in the OR group were systemic (89%) resulting in longer ICU and hospital stays (median 48 vs 17 h and 13 vs 4 days for OR and EVR, respectively). Death within 30 days of the procedure occurred in three EVR patients. There was no perioperative mortality in the OR group. CONCLUSION: Endovascular AAA repair can be undertaken successfully in a district general hospital. The majority of local and device-related complications can be corrected immediately, while those persisting beyond the initial procedure usually resolve spontaneously. EVR offers a minimally invasive approach to a problem that in the past has involved major surgery.