What’s New in Limb Lengthening and Deformity Correction

Bafor, Anirejuoritse; Iobst, Christopher

doi:10.2106/jbjs.22.00398

Cited by 5 publications

(1 citation statement)

References 78 publications

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“…[ 7 ] However, despite continuous refinements in the Ilizarov technique within clinical practices of orthopedic and plastic surgery, the slow mineralization rate of newly formed bone in the distraction zone remains a major challenge faced by both medical practitioners and patients. [ 8 ] To address this issue, one approach involves exploring physicochemical or biological auxiliary measures directly based on the DO model, which is currently the predominant approach adopted in most relevant studies. [ 9 ] Additionally, recognizing the unique biological characteristics of the DO model distinct from mere segmental bone defect (SBD) healing, and subsequently improving or transforming the Ilizarov technique, represents another highly promising strategy for limb lengthening and reconstruction research.…”

Section: Introductionmentioning

confidence: 99%

Tensile Stress‐Activated and Exosome‐Transferred YAP/TAZ‐Notch Circuit Specifies Type H Endothelial Cell for Segmental Bone Regeneration

Wang,

Li,

Kong

et al. 2024

Advanced Science

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The Ilizarov technique has been continuously innovated to utilize tensile stress (TS) for inducing a bone development‐like regenerative process, aiming to achieve skeletal elongation and reconstruction. However, it remains uncertain whether this distraction osteogenesis (DO) process induced by TS involves the pivotal coupling of angiogenesis and osteogenesis mediated by type H endothelial cells (THECs). In this study, it is demonstrated that the Ilizarov technique induces the formation of a metaphysis‐like architecture composed of THECs, leading to segmental bone regeneration during the DO process. Mechanistically, cell‐matrix interactions‐mediated activation of yes‐associated protein (YAP)/transcriptional co‐activator with PDZ‐binding motif (TAZ) transcriptionally upregulates the expression of Notch1 and Delta‐like ligand 4, which act as direct positive regulators of THECs phenotype, in bone marrow endothelial cells (BMECs) upon TS stimulation. Simultaneously, the Notch intracellular domain enhances YAP/TAZ activity by transcriptionally upregulating YAP expression and stabilizing TAZ protein, thus establishing the YAP/TAZ‐Notch circuit. Additionally, TS‐stimulated BMECs secrete exosomes enriched with vital molecules in this positive feedback pathway, which can be utilized to promote segmental bone defect healing, mimicking the therapeutic effects of Ilizarov technique. The findings advance the understanding of TS‐induced segmental bone regeneration and establish the foundation for innovative biological therapeutic strategies aimed at activating THECs.

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Section: Introductionmentioning

confidence: 99%

Tensile Stress‐Activated and Exosome‐Transferred YAP/TAZ‐Notch Circuit Specifies Type H Endothelial Cell for Segmental Bone Regeneration

Wang,

Li,

Kong

et al. 2024

Advanced Science

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The need for state-of-the-art orthopedic surgical technology in low- to middle income countries

Kholmatov,

Dzhuraev,

Perka

et al. 2024

Arch Orthop Trauma Surg

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Outcomes and outcome measurement instruments in lower-limb lengthening surgery: a scoping review to inform core outcome set development

Yalcinkaya,

Rahbek,

Tirta

et al. 2024

ActaO

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Background and purpose: The heterogeneous outcomes used in lower-limb lengthening surgery (LLLS) complicate evidence synthesis, weakening systematic reviews and clinical recommendations, and reducing research impact. This scoping review maps the outcomes and outcome measurement instruments (OMIs) used in LLLS.Methods: This pre-registered review systematically identified studies reporting outcomes in adults or children who underwent LLLS. Outcomes and OMIs were extracted verbatim, and experts grouped outcome terms under headings using the COMET taxonomy.Results: The search found 5,308 unique hits, including 149 studies from 2020–2024. They reported 2,939 verbatim outcomes, which were consolidated into 92 outcome headings and 27 subheadings. “Life impact” accounted for 13%, while “Clinical outcomes” represented 83% of all outcomes. Among the clinical outcomes, “Musculoskeletal and connective tissue” was the most reported outcome domain (68% of all outcomes). The most frequently reported outcomes were “Lengthening,” “Bone healing,” “Range of motion,” “Limb alignment”, and “Complications.”Conclusion: Outcomes reported for people undergoing LLLS are heterogeneous and vary widely in the definitions and measurement tools used to collect them. Outcomes likely to be important to patients (life impact outcomes), such as quality of life and measures of physical function, are rarely reported.

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What’s New in Limb Lengthening and Deformity Correction

Cited by 5 publications

References 78 publications

Tensile Stress‐Activated and Exosome‐Transferred YAP/TAZ‐Notch Circuit Specifies Type H Endothelial Cell for Segmental Bone Regeneration

Tensile Stress‐Activated and Exosome‐Transferred YAP/TAZ‐Notch Circuit Specifies Type H Endothelial Cell for Segmental Bone Regeneration

The need for state-of-the-art orthopedic surgical technology in low- to middle income countries

Outcomes and outcome measurement instruments in lower-limb lengthening surgery: a scoping review to inform core outcome set development

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