Extracellular matrix mimicking scaffold promotes osteogenic stem cell differentiation: A new approach in osteoporosis research.

BACKGROUND: Osteoporosis is a common metabolic disease, with mesenchymal stem cells discussed to play an important role in its pathomechanism. For in vitro osteoporosis studies, selection of adequate culture conditions is mandatory so as to preserve cell properties as far as possible. A suitable cell culture surface would ideally provide reproducible experimental conditions by resembling those in-vivo. OBJECTIVE: Generating an improved growth surface for osteogenic differentiation of human bone marrow derived mesenchymal stem cells (hBMSCs). METHODS: We modified electrospun gelatine meshes with hydroxyapatite nanopowder. The potential beneficial impact of the ensuing culture conditions were evaluated by cultivating and comparing the growth of cells from osteoporotic and non-osteoporotic donors on either hydroxyapatite-gelatine (HA) meshes, pure gelatine meshes, or 2D standard tissue culture surfaces. RESULTS: After 21 days of differentiation, cells grown on pure or HA-gelatine meshes showed significantly higher mineralization levels compared to cells cultured in standard conditions. The amount of mineralization varied considerably in hBMSC cultures of individual patients but showed no significant difference between stem cells obtained from osteoporotic or non-osteoporotic donors. CONCLUSIONS: Overall, these results indicate that the use of HA-gelatine meshes as growth surfaces may serve as a valuable tool for cultivation and differentiation of mesenchymal stem cells along the osteogenic lineage, facilitating future research on osteoporosis and related issues.

Algorithm for anticoagulation management in geriatric hip fracture patients--Surgeons save Blood.

During the past decades, the number of hip fractures has been increasing steadily. Perioperative thromboprophylaxis has become a routine aspect in the care of geriatric hip fracture patients. In addition, a large proportion of these patients are already anticoagulated because of internistic comorbidities before they sustained the hip fracture. Although the management of preexisting anticoagulation in both orthopedic elective and emergency procedures is well reported, proximal femoral fractures are classified as "acute" and therefore represent neither of these two categories. In this study, we review the different options of handling preexisting anticoagulation and antiaggregation as well as perioperative thromboprophylaxis. The Innsbruck Algorithm for the management of anticoagulation in geriatric hip fracture patients suggests how perioperative bleeding risk can be minimized, while still addressing the underlying disease.