Potential of an ultraporous ß-tricalcium phosphate synthetic cancellous bone void filler and bone marrow aspirate composite graft

Erbe, Erik M.; Marx, Janik; Clineff, Theodore D.; Bellincampi, Lisa D.

doi:10.1007/978-3-642-56071-2_9

Cited by 41 publications

(56 citation statements)

References 18 publications

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“…These results are in agreement with work of Erbe and colleagues [19] who reported positive results with a tricalcium phosphate bone graft substitute and bone marrow aspirate cells. Indeed, the stiffness of the Pro Osteon 500R + AGF + marrow in aged animals was the greatest in the current study and nearly double compared to our previous work [43].…”

Section: Discussionsupporting

confidence: 93%

“…A tissue engineering approach combining an osteoconductive biomaterial scaffold and bone marrow mesenchymal stem cells has also been examined to heal or augment bone regeneration [10, 15,16,17,19,38,39]. This study examined the effects of autologous biological therapy through isolation of multiple growth factors using a twostage buffy coat (BC) sequestration protocol followed by concentration using an ultrafiltration device.…”

Section: Introductionmentioning

confidence: 99%

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Spinal fusion using an autologous growth factor gel and a porous resorbable ceramic

et al. 2004

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Spinal fusion using an autologous growth factor gel and a porous resorbable ceramic

et al. 2004

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“…A number of recent studies recommended the use of bone substitutes in combination with BMA [5,7,16,19,28,32,35,36]. In this pilot study, b-TCP was mixed with local bone resected as part of the procedure and blood oozing from the decorticated laminae thus adding some osteoinductive and osteogenic components as well.…”

Section: Discussionmentioning

confidence: 99%

“…Combined with local bone graft and/or bone marrow aspirate (BMA) from vertebral bodies or the iliac crest the resulting composite features osteoinductive and osteogenic potential as it contains relevant growth factors as well as osteoprogenitor cells [5,7,16,19,28,32,35,36]. The application of these materials as a graft extender in PSF has been reported to be favorable, however, most study results are preliminary [8,9,11,15,22,29,31,33,34,38].…”

Section: Introductionmentioning

confidence: 99%

“…While its meso-and macroporosity provides space for cell seeding and bone and blood vessel ingrowth, the effective wicking of the hydrophilic micropores facilitates the migration of oxygen, nutrients, and cells via capillary forces. Scaffold resorption is mediated through phagocytosis of the nanometer sized particles as part of the remodeling of the newly formed bone [7,16,28]. This prospective randomized pilot study (EBM-Level 1) compares the results of posterior correction and fusion with the use of ultraporous b-TCP as a graft extender versus augmentation with ICBG for the treatment of AIS.…”

Section: Introductionmentioning

confidence: 99%

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A level-1 pilot study to evaluate of ultraporous β-tricalcium phosphate as a graft extender in the posterior correction of adolescent idiopathic scoliosis

et al. 2008

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The objective of this study is to compare the clinical and radiographic results of ultraporous b-tricalcium phosphate (b-TCP) versus autogenous iliac crest bone graft (ICBG), through prospective randomized pilot study (EBM-Level 1), as graft extenders in scoliosis surgery. In the posterior correction of scoliosis, local bone resected as part of the procedure is used as the base bone graft material. Supplemental grafting from the iliac crest is considered the gold-standard in posterior spinal fusion. However, autograft is not available in unlimited quantities, and bone harvesting is a source of significant morbidity. Ultraporous b-TCP might be a substitute for ICBG in these patients and thus eliminate donor site morbidity. A total of 40 patients with adolescent idiopathic scoliosis (AIS) were randomized into two treatment groups and underwent corrective posterior instrumentation. In 20 patients, ICBG harvesting was performed whereas the other half received b-TCP (VITOSS Ò ) to augment the local bone graft. If thoracoplasty was performed, the resected rib bone was added in both groups. Patients were observed clinically and radiographically for a minimum of 20 months postoperatively, with a mean follow-up of 4 years. Overall pain and pain specific to the back and donor site were assessed using a visual analog scale (VAS). As a result, both groups were comparable with respect to the age at the time of surgery, gender ratio, preoperative deformity, and hence length of instrumentation. There was no significant difference in blood loss and operative time. In nine patients of the b-TCP group and eight patients of the ICBG group, thoracoplasty was performed resulting in a rib graft of on average 7.9 g in both groups. Average curve correction was 61.7% in the b-TCP group and 61.2% in the ICBG group at hospital discharge (P = 0.313) and 57.2 and 54.3%, respectively, at follow-up (P = 0.109). Loss of curve correction amounted on average 2.6°in the b-TCP group and 4.2°in the comparison group (P = 0.033). In the ICBG group, four patients still reported donor site pain of on average 2/10 on the VAS at last follow-up. One patient in the b-TCP group was diagnosed with a pseudarthrosis at the caudal end of the instrumentation. Revision surgery demonstrated solid bone formation directly above the pseudarthrosis with no histological evidence of b-TCP in the biopsy taken. In conclusion, the use of b-TCP instead of ICBG as extenders of local bone graft yielded equivalent results in the posterior correction of AIS. The promising early results of this pilot study support that b-TCP appears to be an effective bone substitute in scoliosis surgery avoiding harvesting of pelvic bone and the associated morbidity.

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Cluster analysis of arterial involvement in Takayasu arteritis reveals symmetric extension of the lesions in paired arterial beds

Arnaud

Haroche

Tolédano

et al. 2011

Arthritis & Rheumatism

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Objective. The determinants of vessel targeting are largely unknown in vasculitides. This study was undertaken to identify patterns of vascular involvement in Takayasu arteritis (TA), using objective classification of vascular beds. We postulated that cluster analysis could unveil preferential associations between vascular beds commonly affected by TA.Methods. Peripheral vascular Doppler, computed tomography angiography, and angio-magnetic resonance imaging data from 82 patients with TA (according to the American College of Rheumatology criteria) were studied between January 1995 and May 2006. Crossrelationships of involvement between 24 main arteries were assessed using the phi correlation coefficient. Identification of patterns of vascular involvement was performed using agglomerative hierarchical cluster analysis.Results. Data were obtained from 82 patients (68 women [82.9%] and 14 men [17.1%]). The median duration of followup was 5.1 years (range 1 month to 30 years). For 16 (80%) of 20 paired arteries, the highest correlation of involvement was observed with the contralateral artery. Conversely, disease extension was contiguous in the aorta. Cluster analysis further confirmed that all paired arterial beds, except for the internal and external carotid arteries, clustered with their contralateral counterpart and that the aortic arch, the descending thoracic aorta, and the abdominal aorta clustered together.Conclusion. Our findings reveal that TA lesions mostly develop in a symmetric manner in paired vascular territories and that disease extension is contiguous in the aorta. This may prove useful for improving the radiologic followup of patients with TA and for providing a pattern for further investigations focusing on the mechanisms of vessel specificity in vasculitides.Takayasu arteritis (TA) is a rare chronic vasculitis of unknown etiology predominantly affecting the aorta and its major division branches (1). Although originally believed to be a disease mostly affecting young women of Asian descent, TA is now well recognized in both sexes and in various ethnic groups worldwide (2). The natural history of vascular lesions in TA is not well understood. However, considering the high frequency of involvement of the left aortic arch branches, Ishikawa hypothesized that these lesions begin in the left subclavian artery and subsequently extend to other sites (3).While conventional angiography has long been the gold standard for the assessment of vascular involvement in TA, this imaging modality is now progressively replaced by computed tomography (CT) and magnetic resonance imaging (MRI) angiographies. These latter methods offer several advantages over conventional angiography, including their noninvasiveness and their capability of demonstrating both mural and luminal

show abstract

Potential of an ultraporous ß-tricalcium phosphate synthetic cancellous bone void filler and bone marrow aspirate composite graft

Cited by 41 publications

References 18 publications

Spinal fusion using an autologous growth factor gel and a porous resorbable ceramic

Spinal fusion using an autologous growth factor gel and a porous resorbable ceramic

A level-1 pilot study to evaluate of ultraporous β-tricalcium phosphate as a graft extender in the posterior correction of adolescent idiopathic scoliosis

Cluster analysis of arterial involvement in Takayasu arteritis reveals symmetric extension of the lesions in paired arterial beds

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