Introduction:The purpose of the present study seeks to determine the signal timing of BMP–7 and TGF-β1 from a novel chitosan based hydrogel system that may affect chondrocyte proliferation resulting in the presence of a synergism seen conspicuously in consecutive controlled delivery.Methods:Four groups of cultured chondrocytes were seeded on a novel designed chitosan based hydrogel. The hydrogel was left empty (control) in one group and loaded with BMP–7, TGF-β1 and their combination in the other groups, respectively. Hydrogel structure was analyzed with scanning electron microscope. The release kinetics of Growth Factors (GFs) was determined with ELISA. Chondrocyte viability and toxicity after being tested with MTS and collagen type II synthesis, were quantified with western blotting. Canonical regression analysis was used for measuring statistical evaluation.Results:Chitosan based hydrogel allowed controlled release of GFs in different time intervals for BMP–7 and TGF-β1. Double peak concentration gradient was found to be present in the group loaded with both GFs. In this group, substantially higher chondrocyte growth and collagen synthesis were also detected. Conclusions:We concluded that, chitosan based hydrogel systems may be adjusted to release GFs consecutively during biodegradation at the layers of surface, which may increase the cell number and enhance collagen type II synthesis.

A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Both Bone Morphogenetic Protein 7 (BMP-7) and Transforming Growth Factor Beta 1 (TGF-β1) have stimulating effects on chondrocyte proliferation. These growth factors act at different time points of the biological repair process. We aimed to design a hydrogel, which would enable consecutive controlled release of the growth factors. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : We designed a chitosan particle impregnated Poly (vinylalcohol) (PVA)-borax hydrogel (CPBH). CPBH allowed controlled release of BMP-7 and TGF-β1 at different time points. Hydrogel structure was analyzed by Scanning Electron Microscope (SEM). The release kinetics of Growth Factors (GFs) were determined with enzyme-linked immunosorbent assay (ELISA) and UV-spectrophotometer. Chondrocyte viability and toxicity were tested through CellTiter 96 ® Non-Radioactive Cell Proliferation (MTS) ELISA. R Re es su ul lt ts s: : The designed hydrogel showed high swelling and mucoadhesion characteristics under acidic conditions. CPBH released BMP-7 first and rapidly and TGF-β1 consecutively and slowly. It also allowed controlled release of protein/peptide based drugs for 21 days without altering their bioactive properties. At the end of 21 days, 82.62% of BMP-7 and 98.34% of TGF-β1 were consecutively released. The difference between the groups was significant (for TGF-β1, p<0.05 and for BMP-7, p<0.001). C Co on nc cl lu us si io on n: : The controlled and slow release of growth factors has been shown to be beneficial on cartilage regeneration. As it is not cytotoxic, we suggest that this hydrogel might be used in medical and pharmaceutical applications areas. K Ke ey y W Wo or rd ds s: : Delayed-action preparations; hydrogels; TGF-β1 protein, human; bone morphogenetic protein 7 Ö ÖZ ZE ET T A Am ma aç ç: : Kemik Morfojenik Proteini-7 (BMP-7) ve Transforme edici Büyüme Faktörü Beta-1 (TGF-β1)'in kıkırdak hücreleri üzerinde prolifere edici etkileri bulunmaktadır. Bu büyüme faktörlerinin etkisi biyolojik tamir sürecinin farklı zamanlarında gerçekleşmektedir. Bu çalışmada, büyüme faktörlerinin ardışık ve kontrollü olarak salınımını gerçekleştirecek bir hidrojel tasarlamayı amaçladık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu amaçla kitosan emdirilmiş polivinil alkol (PVA)-boraks hidrojeli (CPBH) tasarlandı. Bu hidrojel BMP-7 ve TGF-β1'in farklı zamanlarda kontrollü salınımını sağladı. Tasarladığımız hidrojelin yüzey yapısı taramalı elektron mikroskobu (SEM) ile değerlendirildi. Büyüme faktörlerinin salım kinetiği enzim aracılı immün deney (ELISA) ve ultraviyole (UV)spektrofotometre ile saptandı. Kondrosit canlılığı ve toksisite testi "CellTiter 96 ® Non-Radioactive Cell Proliferation (MTS)" ELISA yöntemiyle değerlendirildi. B Bu ul lg gu ul la ar r: : Tasarlanan hidrojel, asidik ortam koşullarında büyük oranda şişme ve mukoadezyon özellikleri sergiledi. CPBH, önce hızlı bir biçimde BMP-7'nin, sonra da yavaş olarak TGF-β1'in salınımını ardışık olarak gerçekleştirdi. İçerisindeki p...

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While isolated traumatic dislocation of the elbow is uncommon among children, it can be successfully treated by urgent closed reduction, proper fixation of the elbow and appropriate timely rehabilitation. However, it should be considered that some patients may develop cubitus valgus deformity in a later period. Therefore, each patient with a simple traumatic elbow dislocation should be followed, and the parents should be informed of the potential for any deformity development.

Aim: To present the functional and radiological results and evaluate the effectiveness of a computer-assisted external fixator (spider frame) in patients with lower extremity shortness and deformity. Materials and methods: The study comprised 17 patients (14 male, 3 female) who were treated for lower extremity long bone deformity and shortness between 2012 and 2015 using a spider frame. The procedure’s level of difficulty was determined preoperatively using the Paley Scale. Postoperatively, the results for the patients who underwent tibial operations were evaluated using the Paley criteria modified by ASAMI, and the results for the patients who underwent femoral operations were evaluated according to the Paley scoring system. The evaluations were made by calculating the External Fixator and Distraction indexes. Results: The mean age of the patients was 24.58 years (range, 5–51 years). The spider frame was applied to the femur in 10 patients and to the tibia in seven. The mean follow-up period was 15 months (range, 6–31 months) from the operation day, and the mean amount of lengthening was 3.0 cm (range, 1–6 cm). The mean duration of fixator application was 202.7 days (range, 104–300 days). The mean External Fixator Index was 98 days/cm (range, 42–265 days/cm). The mean Distraction Index was 10.49 days/cm (range, 10–14 days/cm). Conclusion: The computer-assisted external fixator system (spider frame) achieves single-stage correction in cases of both deformity and shortness. The system can be applied easily, and because of its high-tech software, it offers the possibility of postoperative treatment of the deformity.