Strain Rate and Timing of Stimulation in Mechanical Modulation of Fracture Healing

Goodship, Allen E.; Cunningham, J L; Kenwright, J

doi:10.1097/00003086-199810001-00012

Cited by 196 publications

(119 citation statements)

References 22 publications

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“…Physical agents may be synergistic with endogenous synthesized, or exogenously applied, growth factors in repair. In fact, mechanical stimulation through external fixators has been shown to stimulate fracture repair [18,24]. EMF exposure has also been shown to accelerate healing and the incorporation of bone grafts [1, 6,45].…”

Section: Resultsmentioning

confidence: 99%

Upregulation of basal TGFβ₁ levels by EMF coincident with chondrogenesis – implications for skeletal repair and tissue engineering

Aaron

Wang

Ciombor

2002

Journal Orthopaedic Research

101

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Members of the TGFP/BMP gene family regulate cartilage and bone development. These genes are re-expressed in bone repair and are thought to mediate chondro-and osteoprogenitor cell differentiation. These observations have led to a therapeutic strategy of introducing these growth factors into experimental cartilage and bone defects. Therapeutic efficacy, however, has been limited by diffusion or inactivation of these growth factors from the desired site and by the inability to deliver sustained concentrations of growth factors. This study demonstrates an increase in basal TGFP mRNA and protein levels in association with chondrogenic differentiation in endochondral ossification. mRNA is increased by 158%; protein by 23%, and cells immunopositive for TGFP by 343% at maximal TGFP expression. Importantly, the pattern of TGFP expression is preserved throughout the developmental sequence. Our data suggest that the exposure to a specific electromagnetic field (EMF) enhances, but does not disorganize, chondrogenesis and endochondral calcification as well as the normal physiologic expression of TGFP. The ability to increase TGFP at a moderately low dose for sustained periods of time without disorganizing its physiology suggests the ability to establish temporal concentration gradients of growth factors for the purpose of stimulating skeletal repair.

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Section: Resultsmentioning

confidence: 99%

Upregulation of basal TGFβ₁ levels by EMF coincident with chondrogenesis – implications for skeletal repair and tissue engineering

Aaron

Wang

Ciombor

2002

Journal Orthopaedic Research

101

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“…Advantages of early full weight bearing for ankle mobility are a topics of controversial debate [6,24]. Isolated reports of negative consequences for fracture healing following early full weight bearing [5] conflict with studies that show that a certain amount of mechanical stimulation promotes fracture healing [9,10].…”

Section: Discussionmentioning

confidence: 99%

The dynamic vacuum orthosis: a functional and economical benefit?

Franke

Goldhahn

Audigé

et al. 2007

International Orthopaedics (SICO

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In a prospective, randomised study, 27 patients with internally fixed ankle fractures were treated postoperatively for a period of six weeks by application of either a new dynamic vacuum orthosis with permitted mobilisation to 10°-0°-10°at the ankle joint or a synthetic cast. Full weight bearing was allowed in both groups after two weeks. The cast group was prescribed four weeks of physiotherapy following six weeks of immobilisation. After ten weeks, the Olerud and Molander score showed a significant difference in favour of the orthosis. Early functional outcomes were significantly better for this group after six weeks and ten weeks. Patients in the orthosis group who were in formal employment returned to work 24 days earlier than those in the control group. Treatment of the orthosis patients took up three to four times less working time for the medical personnel. A saving of 38 euros on directly ascertainable costs could be evaluated. Rehabilitation of ankle fractures with a dynamic vacuum orthosis leads to better early functional results and greater patient satisfaction. The orthosis fulfils the conditions for early return to work. Treatment with an orthosis not only reduces working time for medical personnel but economises on expenditure for treatment and rehabilitation.

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“…While many of the genetic mechanism regulating fetal skeletogenesis also play a role in adult skeletal regeneration (Vortkamp et al, 1998;Ferguson et al, 1999), the mechanical environment is known to play a key role in regulating the outcomes of fracture repair (Goodship and Kenwright 1985;Kenwright and Goodship 1989;Kenwright et al, 1991;Chao et al, 1998;Goodship et al, 1998;Goodship et al, 2009). A number of hypotheses have been proposed for how MSC differentiation is regulated by the mechanical environment during events such as fracture repair.…”

Section: Repairmentioning

confidence: 99%

The role of mechanical signals in regulating chondrogenesis and osteogenesis of mesenchymal stem cells

Kelly

Jacobs

2010

Birth Defects Research Pt C

216

152

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It is becoming increasingly clear that Mesenchymal Stem Cell (MSC) differentiation is regulated by mechanical signals. Mechanical forces generated intrinsically within the cell in response to its extracellular environment, and extrinsic mechanical signals imposed upon the cell by the extracellular environment, play a central role in determining MSC fate. This paper reviews chondrogenesis and osteogenesis during skeletogenesis, and then considers the role of mechanics in regulating limb development and regenerative events such as fracture repair. However, observing skeletal changes under altered loading conditions can only partially explain the role of mechanics in controlling MSC differentiation. Increasingly, understanding how epigenetic factors such as the mechanical environment regulate stem cell fate is undertaken using tightly controlled in vitro models. Factors such as bio-engineered surfaces, substrates and bioreactor systems are used to control the mechanical forces imposed upon, and generated within, MSCs. From these studies, a clearer picture of how osteogenesis and chondrogenesis of MSCs is regulated by mechanical signals is beginning to emerge. Understanding the response of MSCs to such regulatory factors is a key step towards understanding their role in disease and regeneration.3

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Strain Rate and Timing of Stimulation in Mechanical Modulation of Fracture Healing

Cited by 196 publications

References 22 publications

Upregulation of basal TGFβ₁ levels by EMF coincident with chondrogenesis – implications for skeletal repair and tissue engineering

Upregulation of basal TGFβ₁ levels by EMF coincident with chondrogenesis – implications for skeletal repair and tissue engineering

The dynamic vacuum orthosis: a functional and economical benefit?

The role of mechanical signals in regulating chondrogenesis and osteogenesis of mesenchymal stem cells

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Strain Rate and Timing of Stimulation in Mechanical Modulation of Fracture Healing

Cited by 196 publications

References 22 publications

Upregulation of basal TGFβ1 levels by EMF coincident with chondrogenesis – implications for skeletal repair and tissue engineering

Upregulation of basal TGFβ1 levels by EMF coincident with chondrogenesis – implications for skeletal repair and tissue engineering

The dynamic vacuum orthosis: a functional and economical benefit?

The role of mechanical signals in regulating chondrogenesis and osteogenesis of mesenchymal stem cells

Contact Info

Product

Resources

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Upregulation of basal TGFβ₁ levels by EMF coincident with chondrogenesis – implications for skeletal repair and tissue engineering

Upregulation of basal TGFβ₁ levels by EMF coincident with chondrogenesis – implications for skeletal repair and tissue engineering