Basic Science of Bone Healing

Sathyendra, Vikram; Darowish, Michael

doi:10.1016/j.hcl.2013.08.002

Cited by 67 publications

(52 citation statements)

References 40 publications

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“…Remodeling is regulated by a variety of inflammatory cytokines, including IL-1, IL-6, TNF-a, and interferon-g 6,24 . IL-1 and IL-6 concentrations, which rise initially during the inflammation phase, increase again during the remodeling phase in concert with an increase in TNF-a, which is related to stimulation of osteoclast function and resorption of the mineralized callus 10 .…”

Section: Remodeling Phasementioning

confidence: 99%

The Biological Basis for Nonunions

Brinker

O’Connor

2016

JBJS Rev

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Fracture nonunion is a failure of the biological processes of fracture-healing. Critical cellular events in fracture-healing include the inflammatory response, differentiation and proliferation of progenitor cells, formation of fibrocartilage callus, angiogenesis and subsequent mineralization of the callus, vascular union (restoration of normal medullary circulation), and conversion of woven bone to lamellar bone. All critical events are closely regulated and coordinated by numerous cytokines and growth factors, which are expressed in complex spatial and temporal patterns throughout the repair process. At all phases of fracture-healing, poor cellular and metabolic capacity (e.g., chronic disease), excessive instability, and poor vascularity inhibit cellular responses and healing. Many biological treatments to prevent or treat nonunions are emerging in clinical use, including stem-cell and bone-marrow-aspirate preparations, various progenitor cells and growth factors (e.g., recombinant human bone morphogenetic proteins), and gene therapy.

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Section: Remodeling Phasementioning

confidence: 99%

The Biological Basis for Nonunions

Brinker

O’Connor

2016

JBJS Rev

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“…Four typical events occur during bone injury repair process: hematoma formation, organization of hematoma, primary trabecular bone formation and bone reshaping and remodeling 1–3 . New blood vessels formation, or angiogenesis, is an important event in the hematoma organization process, and some studies have suggested that angiogenesis occurs prior to the onset of osteogenesis 4, 5 .…”

Section: Introductionmentioning

confidence: 99%

CD31hiEmcnhi Vessels Support New Trabecular Bone Formation at the Frontier Growth Area in the Bone Defect Repair Process

Wang

Gao

Cheng

et al. 2017

Sci Rep

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CD31hiEmcnhi vessels were a subtype of vessels in the murine skeletal system, with high levels of platelet and endothelial cell adhesion molecule-1 (PECAM-1/CD31) and endomucin (Emcn). They were reported coupling angiogenesis and osteogenesis during bone development. We investigated the distribution of these vessels in rat tibiae and their temporal and spatial distribution during the bone defect repair process to improve our understanding of the importance of these vessels. We confirmed that CD31hiEmcnhi vessels were specially distributed around the trabecular bones near metaphysis and endosteum in rat tibiae. At 3 days post bone injury, CD31hiEmcnhi vessels proliferated and were extensively distributed across the entire repair area. At 7 and 14 days post-injury, these vessels decreased but were specially distributed around the growing trabecular bones near the frontier growth area, suggesting that these vessels support new bone formation. The distribution of CD31hiEmcnhi vessels and the transcriptions of Hif-1α and VEGFA, as well as BMP2 and Osterix decreased at 7 and 14 days post-injury under osteoporotic conditions, in combination with insufficient osteogenesis. Our research is of great significance to help understand the important role of CD31hiEmcnhi vessels in supporting new trabecular bones formation during bone defect repair process.

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“…We do not perform this hybrid decompression procedure for patients with cervical ruptured disc herniation, cervical kyphosis, cervical instability, or comorbidities such as severe diabetes mellitus, which we consider contraindications for this procedure. Considering the possibility of autograft lamina nonunion, hybrid decompression with autograft employing a Centerpiece is not indicated for patients with severe diabetes, who have low bone-regeneration ability [21] and in whom there is a high incidence of deep wound infection. In our department, we consider patients with cervical instability to be indicated for the laminectomy-plus-fusion procedure [5], [22], [23] and patients with cervical ruptured disc herniation or kyphosis to be indicated for an anterior procedure or anterior-plus-posterior approach [24], [25].…”

Section: Discussionmentioning

confidence: 99%

Laminoplasty and Laminectomy Hybrid Decompression for the Treatment of Cervical Spondylotic Myelopathy with Hypertrophic Ligamentum Flavum: A Retrospective Study

et al. 2014

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ObjectiveTo report the outcomes of a posterior hybrid decompression protocol for the treatment of cervical spondylotic myelopathy (CSM) associated with hypertrophic ligamentum flavum (HLF).BackgroundLaminoplasty is widely used in patients with CSM; however, for CSM patients with HLF, traditional laminoplasty does not include resection of a pathological ligamentum flavum.MethodsThis study retrospectively reviewed 116 CSM patients with HLF who underwent hybrid decompression with a minimum of 12 months of follow-up. The procedure consisted of reconstruction of the C4 and C6 laminae using CENTERPIECE plates with spinous process autografts, and resection of the C3, C5, and C7 laminae. Surgical outcomes were assessed using Japanese Orthopedic Association (JOA) score, recovery rate, cervical lordotic angle, cervical range of motion, spinal canal sagittal diameter, bone healing rates on both the hinge and open sides, dural sac expansion at the level of maximum compression, drift-back distance of the spinal cord, and postoperative neck pain assessed by visual analog scale.ResultsNo hardware failure or restenosis was noted. Postoperative JOA score improved significantly, with a mean recovery rate of 65.3±15.5%. Mean cervical lordotic angle had decreased 4.9 degrees by 1 year after surgery (P<0.05). Preservation of cervical range of motion was satisfactory postoperatively. Bone healing rates 6 months after surgery were 100% on the hinge side and 92.2% on the open side. Satisfactory decompression was demonstrated by a significantly increased sagittal canal diameter and cross-sectional area of the dural sac together with a significant drift-back distance of the spinal cord. The dural sac was also adequately expanded at the time of the final follow-up visit.ConclusionHybrid laminectomy and autograft laminoplasty decompression using Centerpiece plates may facilitate bone healing and produce a comparatively satisfactory prognosis for CSM patients with HLF.

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Basic Science of Bone Healing

Cited by 67 publications

References 40 publications

The Biological Basis for Nonunions

The Biological Basis for Nonunions

CD31hiEmcnhi Vessels Support New Trabecular Bone Formation at the Frontier Growth Area in the Bone Defect Repair Process

Laminoplasty and Laminectomy Hybrid Decompression for the Treatment of Cervical Spondylotic Myelopathy with Hypertrophic Ligamentum Flavum: A Retrospective Study

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