Results of using various types of implants in experimental management of long bone osteomyelitic defects

Резник, Л. Б.; Stasenko, I.V.; Negrov, D.A.

doi:10.18019/1028-4427-2016-4-81-87

Cited by 3 publications

(1 citation statement)

References 2 publications

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“…One of the current tasks in traumatology and orthopedics is the search for osteoplastic material with osteoconduction and osteoinduction effects on tissues exposed to a purulent process [1][2][3][4][5][6][7][8][9][10]. Today, cellular technologies are increasingly used in clinical situations associated with failed tissue repair.…”

Section: Introductionmentioning

confidence: 99%

Technology for Repairing Osteomyelitic Bone Defects Using Autologous Mesenchymal Stromal Cells on a Collagen Matrix in Experiment

Mitrofanov¹,

Живцов²,

Orlinskaya³

et al. 2021

Sovrem Tehnol Med

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The aim of the study was to develop a technology for repairing an osteomyelitic bone defect using autologous adipose tissue mesenchymal stromal cells (MSCs) bound to a collagen matrix and to test the efficacy of this technique. Materials and Methods. The study was carried out with 17 rabbits. A bone defect was created using a milling cutter applied to the proximal third of the leg. The wound (8.0×4.0 mm and a depth of 4.0 mm) involved the periosteum, cortical layer, and cancellous substance. Staphylococcus aureus strain was used as an infectious agent. After the development of chronic osteomyelitis, the animals underwent osteonecrectomy. In the study group, autologous MSCs in Collatamp EG collagen carrier were placed into the bone defect. MSCs were obtained from adipose tissue and cultured in the matrix for 5 days. In control, the defect was filled with the collagen matrix without cells. Results. On day 14 upon the initiation of chronic osteomyelitis, bacteriological examination of the discharge from the fistula showed the presence of mixed bacterial flora (Staphylococcus aureus and Escherichia coli) in all operated animals. Results of X-ray, laboratory, and histological tests confirmed the formation of a focus of chronic osteomyelitis. Two months after the treatment (collagen with or without MSCs) began, all animals of the study group showed mature bone tissue regenerated in the affected zone. In the control group, proliferation of osteoblasts on the surface of the bone trabeculae was also observed; however, mature osteoid tissue was more often detected in the study group (35.0 vs 20.0% in control). In the study group (MSCs + collagen matrix), there was a decrease in bone marrow fibrosis (50.0 vs 100.0% in control) and cartilage formation (30.0 and 66.7%, respectively). After full treatment, newly formed bone trabeculae were detected more often (100.0 vs 60.0% in control); they were more mature and filled the defect area more efficiently. Conclusion. Our results indicate that the use of a collagen matrix with autologous MSCs is a promising plastic material for repairing osteomyelitic defects following necrectomy. The MSCs were able to increase the density of the filling material in the bone cavity, significantly accelerate the formation of bone beams around the matrix, and increase the tissue volume around the implant. The presence of MSCs significantly decreased the interference of a connective tissue component with osteogenesis and chondrogenesis.

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Section: Introductionmentioning

confidence: 99%

Technology for Repairing Osteomyelitic Bone Defects Using Autologous Mesenchymal Stromal Cells on a Collagen Matrix in Experiment

Mitrofanov¹,

Живцов²,

Orlinskaya³

et al. 2021

Sovrem Tehnol Med

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Bone Regeneration in the Application of a New Device for Osteosynthesis in the Experiment

Suchkov¹,

Павлов²,

Виноградов³

et al. 2019

Acta biomedica scientifica

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Background.Treatment of residual cavities after radical surgery for bone diseases is a vital problem of modern traumatology. Currently, there is an active search for devices both for osteosynthesis and bone-substituting masses. Aims. The purpose of this work was to test a new device for osteosynthesis. It can be used both for fixing bone fragments, and for studying the morphological features of bone regenerate in experiment.Materials and methods.A device for bone osteosynthesis of tubular bones in an experiment (Patent of the Russian Federation N 20116121487) was applied. The device consisted of two half-bushings, fastened to each other by a fierce clamp. Polypropylene was used as the material for the half-bushings, therefore no immunological reactions were observed. On the inner surface there were silicone cylinders, which directed pressure on the fragments and did not disturb the nutrition of the periosteum. The experiment was performed on Wistar rats. The surgical defect of the femur was filled with hydroxyapatite. Two groups of animals were identified. The bone in the first group was fixed by the device. The wire cerclage was used in the second group.Results.The study showed that the developed device does not disturb the nutrition of the periosteum, and also tightly fixes the osteoplastic material in the bone defect. Histological examination showed that bone regeneration was faster when the device was used. On the 21st day of the experiment, the regenerate filled the defect in the control group by 62 %, and in the experimental group by 73 %. The regenerate was represented by a woven bone. In all animals, bone regenerate formed a strong osteo-integrative connection with the maternal bone. In both groups, it looked like a mature bone tissue at the end of the experiment (28 days).Conclusion.The data indicate that the device does not disturb the processes of bone formation and allows for more efficient use osteoplastic material.

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Одноэтапная Микрохирургическая Реконструкция Инфицированных Крупных Дефектов Длинных Трубчатых Костей

et al. 2020

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Введение. Замещение крупных септических костных дефектов конечностей сопряжено с высоким риском послеоперационных инфекционных осложнений. Это мотивирует хирургов к изучению факторов риска подобных осложнений и внедрению новых эффективных микрохирургических технологий реконструкции тканей конечности. Цель. Изучить результаты одноэтапной микрохирургической реконструкции инфицированных крупных дефектов длинных трубчатых костей и условия ее эффективного применения. Материалы и методы. Анализу подвергнуты результаты одноэтапной микрохирургической реконструкции инфицированных крупных костных дефектов верхних и нижних конечностей у 18 пациентов (11 мужчин и 7 женщин). Изучены причины глубоких инфекционных осложнений и условия эффективного применения данной хирургической технологии. Результаты и обсуждение. В раннем послеоперационном периоде (до 30 дней после операции) отмечались осложнения, характерные для васкуляризированной пересадки комплексов тканей (тромбоз сосудистой ножки трансплантата, некроз кожного лоскута). Ни одного случая острого инфекционного процесса в раннем послеоперационном периоде мы не наблюдали. Только у двух пациентов в поздний послеоперационный период (более 30 дней после операции) диагностирован рецидив глубокого инфекционного процесса. Выводы. Условием для успешного применения микрохирургической реконструкции инфицированных дефектов длинных трубчатых костей является радикальная хирургическая санация очага гнойного воспаления пораженного сегмента конечности. Радикальная хирургическая санация, включающая сегментарную резекцию патологически измененной костной ткани и иссечение инфицированных грануляционных и рубцовых тканей, позволяет избежать в послеоперационном периоде глубоких инфекционных осложнений. Introduction. Substitution of large septic bone defects of the limbs is associated with a high risk of postoperative infectious complications. This motivates surgeons to study the risk factors of such complications and introduce new effective microsurgical technologies for limb tissue reconstruction. Purpose. To study the results of one-stage microsurgical reconstruction of infected large defects of long tubular bones and its effective use. Materials and methods. We analyzed the results of one-stage microsurgical reconstruction of infected large bone defects of the upper and lower extremities in 18 patients (11 men and 7 women). We studied the causes of deep infectious complications and the conditions of the effective use of this surgical technology. Results and discussion. Complications were noted in the early postoperative period (up to 30 days after the operation) typical for vascularized transplantation of tissue complexes (transplant vascular pedicle thrombosis, skin flap necrosis). We did not observe a case of acute infectious process in the early postoperative period. Only two patients in the late postoperative period (more than 30 days after surgery) were diagnosed with a relapse of a deep infection process. Conclusions. A condition for the successful use of microsurgical reconstruction of infected defects of long tubular bones is radical surgical debridement of the site of purulent inflammation of the affected segment of the limb. Radical surgical debridement, including segmental resection of pathologically altered bone tissue and excision of infected granulation and scar tissue, lets to avoid deep infectious complications in the postoperative period.

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Results of using various types of implants in experimental management of long bone osteomyelitic defects

Cited by 3 publications

References 2 publications

Technology for Repairing Osteomyelitic Bone Defects Using Autologous Mesenchymal Stromal Cells on a Collagen Matrix in Experiment

Technology for Repairing Osteomyelitic Bone Defects Using Autologous Mesenchymal Stromal Cells on a Collagen Matrix in Experiment

Bone Regeneration in the Application of a New Device for Osteosynthesis in the Experiment

Одноэтапная Микрохирургическая Реконструкция Инфицированных Крупных Дефектов Длинных Трубчатых Костей

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