The Role of Immune Reactivity in Bone Regeneration

Bucher, Christian H.; Lei, Hong; Duda, Georg N.; Volk, Hans‐Dieter; Schmidt‐Bleek, Katharina

doi:10.5772/62476

Cited by 8 publications

(13 citation statements)

References 128 publications

(145 reference statements)

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“…The transformation into a hard callus depends on remodelling of proliferating cartilage into hypertrophic cartilage, the revascularization of this region, the onset of matrix mineralization and woven bone formation. The stability of the fractured region is increased (increased moment of inertia) to a certain degree through hard callus formation (Bucher et al 2016 ). However, the mechanical properties of the bone have to be restored during the last step of successful bone healing, namely the remodeling phase.…”

Section: Phases Of Bone Healing: Early Critical Role Of Fracture Haemmentioning

confidence: 99%

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The haematoma and its role in bone healing

et al. 2017

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Fracture treatment is an old endeavour intended to promote bone healing and to also enable early loading and regain of function in the injured limb. However, in today’s clinical routine the healing potential of the initial fracture haematoma is still not fully recognized. The Arbeitsgemeinschaft für Osteosynthesefragen (AO) formed in Switzerland in 1956 formulated four AO principles of fracture treatment which are still valid today. Fracture treatment strategies have continued to evolve further, as for example the relatively new concept of minimally invasive plate osteosynthesis (MIPO). This MIPO treatment strategy harbours the benefit of an undisturbed original fracture haematoma that supports the healing process. The extent of the supportive effect of this haematoma for the bone healing process has not been considered in clinical practice so far. The rising importance of osteoimmunological aspects in bone healing supports the essential role of the initial haematoma as a source for inflammatory cells that release the cytokine pattern that directs cell recruitment towards the injured tissue. In reviewing the potential benefits of the fracture haematoma, the early development of angiogenic and osteogenic potentials within the haematoma are striking. Removing the haematoma during surgery could negatively influence the fracture healing process. In an ovine open tibial fracture model the haematoma was removed 4 or 7 days after injury and the bone that formed during the first two weeks of healing was significantly reduced in comparison with an undisturbed control. These findings indicate that whenever possible the original haematoma formed upon injury should be conserved during clinical fracture treatment to benefit from the inherent healing potential.

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Section: Phases Of Bone Healing: Early Critical Role Of Fracture Haemmentioning

confidence: 99%

“…However, the mechanical properties of the bone have to be restored during the last step of successful bone healing, namely the remodeling phase. This remodelling phase can span several months, until form and function of the bone are rebuilt (Bucher et al 2016 ).…”

Section: Phases Of Bone Healing: Early Critical Role Of Fracture Haemmentioning

confidence: 99%

The haematoma and its role in bone healing

et al. 2017

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“…Histological images are stained with Movat Pentacrome (bone= yellow, bone marrow = purple, cartilage = blue-green, erythrocytes = bright red). The fixation used to stabilize a fractured bone is the most important tool in the clinic to facilitate the healing process and allow early mechanical loading of the injured limb [15]. In most cases the fixation is determined by the bone which is fractured and by the type of fracture (e.g.…”

Section: Resultsmentioning

confidence: 99%

“…No cartilage remains; 28 days: remodeling phase. Histological samples stained with Movat Pentachrome: bone = yellow; bone marrow =purple; cartilage = blue-green, muscle = orange; connective tissue = light blue [2,4,6,15,[34][35][36][37][38][39][40][41][42][43]. Periost has been carefully elevated from the bone and was stained with hematoxylin eosin.…”

Section: Resultsmentioning

confidence: 99%

“…The aim of direct healing through exact anatomical repositioning without fracture gap and exclusion of intra-fragmentary movement is not always possible, especially in complex fractures. Therefore, most fractures heal through indirect or secondary healing [15]. Recent development in fracture treatment aims to conserve the original fracture hematoma, for example the MIPO technique fulfills this strategy [6].…”

Section: Histological Analysesmentioning

confidence: 99%

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Research in Fracture Healing and Its Clinical Applications in the Veterinary Practice

Mafamane¹,

Hackenbroich²,

Ellinghaus³

et al. 2017

Journal of Veterinary Science and Animal Husbandry

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Inflammatory response in postmenopausal osteoporotic fracture healing

Chow

Chim

Wang

et al. 2020

Bone & Joint Research

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A balanced inflammatory response is important for successful fracture healing. The response of osteoporotic fracture healing is deranged and an altered inflammatory response can be one underlying cause. The objectives of this review were to compare the inflammatory responses between normal and osteoporotic fractures and to examine the potential effects on different healing outcomes. A systematic literature search was conducted with relevant keywords in PubMed, Embase, and Web of Science independently. Original preclinical studies and clinical studies involving the investigation of inflammatory response in fracture healing in ovariectomized (OVX) animals or osteoporotic/elderly patients with available full text and written in English were included. In total, 14 articles were selected. Various inflammatory factors were reported; of those tumour necrosis factor-α (TNF-α) and interleukin (IL)-6 are two commonly studied markers. Preclinical studies showed that OVX animals generally demonstrated higher systemic inflammatory response and poorer healing outcomes compared to normal controls (SHAM). However, it is inconclusive if the local inflammatory response is higher or lower in OVX animals. As for clinical studies, they mainly examine the temporal changes of the inflammatory stage or perform comparison between osteoporotic/fragility fracture patients and normal subjects without fracture. Our review of these studies emphasizes the lack of understanding that inflammation plays in the altered fracture healing response of osteoporotic/elderly patients. Taken together, it is clear that additional studies, preclinical and clinical, are required to dissect the regulatory role of inflammatory response in osteoporotic fracture healing. Cite this article: Bone Joint Res 2020;9(7):368–385.

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The Role of Immune Reactivity in Bone Regeneration

Cited by 8 publications

References 128 publications

The haematoma and its role in bone healing

The haematoma and its role in bone healing

Research in Fracture Healing and Its Clinical Applications in the Veterinary Practice

Inflammatory response in postmenopausal osteoporotic fracture healing

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