Bone intramedullary reaming grafts the fracture site with CD146 + skeletal progenitors and downmodulates the inflammatory environment

Rocha, Leonardo Rosa; Sartore, Rafaela C.; Leal, Ana Carolina; Duarte, Maria Eugênia Leite; Guimarães, João Antônio Matheus; Bonfim, Danielle Cabral

doi:10.1016/s0020-1383(17)30774-x

Cited by 4 publications

(4 citation statements)

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“…Furthermore, reaming down-signals the local inflammatory state, which enhances the availability and action of the osteogenic and angiogenic growth factors bFGF and PDGF-AB. 12 We believe that our novel step of over-reaming by 2.5 mm allows for greater mechanical bone grafting than the standard accepted reaming technique. We also did not encounter any intraoperative complications, such as cortical penetration, with reamer or nail that can occur due to deflection from pathologically thickened cortical and intramedullary bone.…”

Section: Discussionmentioning

confidence: 89%

“…Furthermore, reaming down-signals the local inflammatory state, which enhances the availability and action of the osteogenic and angiogenic growth factors bFGF and PDGF-AB. 12…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the authors suggest that over-reaming by 2.5 mm mechanically grafts the fracture site with skeletal progenitors, which stimulate angiogenesis and bone healing (Figure 1(c) and (d)). 12…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, the authors suggest that overreaming by 2.5 mm mechanically grafts the fracture site with skeletal progenitors, which stimulate angiogenesis and bone healing (Figure 1(c) and (d)). 12 For all cases, a Gamma3 ® long cephalomedullary nail (Stryker ® ) with 120 neck angle and 1.5 m radius of curvature was used. Static distal locking is always performed with two 5-mm screws to maximise the rigidity of fixation.…”

Section: Surgical Techniquementioning

confidence: 99%

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Bisphosphonate-related atypical femoral fractures: A novel strategy to improve patient outcomes

Sahemey

Nikolaides

Bhattacharya

et al. 2020

Journal of Orthopaedics, Trauma and Rehabilitation

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Background: Atypical femoral fracture (AFF) is a serious adverse event associated with bisphosphonate therapy and prone to complications and delayed union. We propose a technique and management strategy to maximise bone healing and outcomes. Methods: We report on a cohort of patients with AFF using our novel technique of preparing the intramedullary canal and rigid fixation with cephalomedullary nailing. Patients were admitted under a multidisciplinary team with rehabilitation goals of early mobilisation and teriparatide initiation. Clinical and radiographic data were retrospectively reviewed. Results: Twenty-eight AFFs were treated with a mean follow-up of 58.5 weeks and a mean age of 75.2 years old. All cases achieved radiological union by a mean of 6 months and post-operative thigh pain experienced up to 8.7 weeks. No cases underwent revision or experienced intraoperative complication. Conclusion: Our surgical technique and multidisciplinary management are reproducible with excellent results in patients with this rare yet challenging injury.

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Section: Discussionmentioning

confidence: 89%

“…Furthermore, reaming down-signals the local inflammatory state, which enhances the availability and action of the osteogenic and angiogenic growth factors bFGF and PDGF-AB. 12…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

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