Treatment of atrophic femoral non-unions according to the diamond concept: Results of one- and two-step surgical procedure

Moghaddam, Arash; Thaler, Benjamin; Brückner, Thomas; Tanner, Michael C.; Schmidmaier, Gerhard

doi:10.1016/j.jor.2016.10.003

Cited by 41 publications

(61 citation statements)

References 40 publications

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“…S. aureus S. epidermidis MetR P. aeruginosa Granules 0.5 -0.8 9.5 9.5 9.5 9.5 Granules 1.0 -2.0 9.5 9.5 9.5 9.5 Granules 2.0 -3. 15 9.5 9.5 9.5 9.5 BonAlive Putty 6.8 8. …”

Section: Resultsmentioning

confidence: 99%

“…To avoid this two-stage procedure, antibiotics have also been incorporated into bone substitutes, such as hydroxyapatite (HA), tricalcium phosphate (TCP) and calcium sulphates (CaS) [12,13]. Another well known method to manage infected bone is a two-stage treatment, by the name of Masquelet technique, where an antibioticcontaining PMMA spacer is implanted in the first stage and the induced membrane compartment is grafted with autograft in the second stage after removal of the spacer [14,15].…”

Section: Introductionmentioning

confidence: 99%

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Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

Stoor¹,

Frantzén²

2017

Biomedical Glasses

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Bacterial infection of bone tissue and bone marrow, referred to as osteomyelitis, is a challenging clinical problem. In this study we analysed the influence of the granule size of the bone substitute bioactive glass (BAG) S53P4 and the novel putty material containing BAG S53P4 on four clinically important bacteria associated with osteomyelitis; Staphylococcus aureus, methicillin resistant Staphylococuus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa. Reference materials were the frequently used biomaterial in surgical bone grafting procedures; tricalcium phosphate and an inert glass. Powder of BAG S53P4 was used as a positive control. The materials were incubated with bacterial suspension and the viability of the microbes was determined as colony forming units after cultivation on agar plates. All pathogens lost their viability in contact with the BAG S53P4 granules and the powder of the BAG S53P4. The reference materials tricalcium phosphate and the inert glass had no effect on the viability of the bacteria. The BAG S53P4 putty containing 0.5-0.8 mm granules did not show any antibacterial effect on any of the tested bacteria. New putty compositions need to be investigated to obtain antibacterial properties for this novel bone regeneration biomaterial.

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“…S. aureus S. epidermidis MetR P. aeruginosa Granules 0.5 -0.8 9.5 9.5 9.5 9.5 Granules 1.0 -2.0 9.5 9.5 9.5 9.5 Granules 2.0 -3. 15 9.5 9.5 9.5 9.5 BonAlive Putty 6.8 8. …”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

Stoor¹,

Frantzén²

2017

Biomedical Glasses

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“…According to previously published protocols [ 6 , 11 , 12 ], clinical and radiologic examination was performed as part of a dedicated follow-up program. In addition, patient data was thoroughly assessed preoperatively and during each follow-up visit.…”

Section: Methodsmentioning

confidence: 99%

“…The Masquelet therapy was established as a safe and clinically effective treatment modality in the treatment of large non-unions [ 5 ]. Despite studies showing satisfying clinical results subsequent to the Masquelet therapy [ 6 , 7 ], early determination of the outcome remains impossible. At present, the outcome is usually assessed as early as 6 months after surgery based on radiologic findings that require ionizing radiation (computed tomography and X-rays) [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Chemokine analysis as a novel diagnostic modality in the early prediction of the outcome of non-union therapy: a matched pair analysis

et al. 2018

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BackgroundDespite the regenerative capability of skeletal tissue fracture, non-union is common. Treatment of non-unions remains challenging, and early determination of the outcome is impossible. Chemokines play an important role in promoting the formation of new bone and remodeling existing bone. Despite their importance regarding the regulation of bone biology, the potential of chemokines as biological markers reflecting osseous regeneration is unknown.The purpose of this study was to determine (1) if serum chemokine expression levels correlate with the outcome of non-union surgery and (2) if chemokine expression analysis can be used to identify patients at risk for treatment failure.MethodsNon-union patients receiving surgical therapy in our institution between March 2012 and March 2014 were prospectively enrolled in a clinical observer study. Regular clinical and radiological follow-up was conducted for 12 months including collection of blood during the first 12 weeks. Based on the outcome, patients were declared as responders or non-responders to the therapy. To minimize biases, patients were matched (age, sex, body mass index (BMI)) and two groups of patients could be formed: responders (R, n = 10) and non-responders (NR, n = 10). Serum chemokine expression (CCL-2, CCL-3, CCL-4, CXCL-10, CCL-11, and interferon gamma (IFN-γ)) was analyzed using Luminex assays. Data was compared and correlated to the outcome.ResultsCCL-3 expression in NR was significantly higher during the course of the study compared to R (p = 0.002), and the expression pattern of CCL-4 correlated with CCL-3 in both groups (NR: p < 0.001 and r = 0.63). IFN-γ expression in NR was continuously higher than in R (p < 0.001), and utilization of CCL-3 and IFN-γ serum expression levels 2 weeks after the treatment resulted in a predictive model that had an AUC of 0.92 (CI 0.74–1.00).ConclusionSerum chemokine expression analysis over time is a valid and promising diagnostic tool. The chemokine expression pattern correlates with the outcome of the Masquelet therapy of lower limb non-unions. Utilization of the serum analysis of CCL-3 and IFN-γ 2 weeks after the treatment resulted in an early predictive value regarding the differentiation between patients that are likely to heal and those that are prone to high risk of treatment failure.Electronic supplementary materialThe online version of this article (10.1186/s13018-018-0961-4) contains supplementary material, which is available to authorized users.

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“…Patienten zeigen eine schnellere Heilung und müssen nach der Verwendung seltener erneut operativ behandelt werden [4]. Somit ist der Einsatz von BMPs bei der operativen Therapie von Pseudarthrosen empfohlen, sofern eine initiale Therapie mit autologer Spongiosa nicht zum Erfolg geführt hat [17].…”

Section: Pseudarthrose Langer Röhrenknochenunclassified

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Haubruck¹,

Schmidmaier²

2018

Orthopädie und Unfallchirurgie up2date

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Treatment of atrophic femoral non-unions according to the diamond concept: Results of one- and two-step surgical procedure

Cited by 41 publications

References 40 publications

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

Chemokine analysis as a novel diagnostic modality in the early prediction of the outcome of non-union therapy: a matched pair analysis

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