MedWorm: Bone Graft

Posttransplant anemia in solid organ recipients

Transplantation Reviews — Fri, 19 Mar 2010 17:30:48 +0100

Abstract: Posttransplantation anemia (PTA) is a prevalent sequela of solid organ transplantation and a potential independent risk factor for cardiovascular morbidity and mortality in kidney transplant recipients. There are multiple causes of PTA, some of which are associated with early phase anemia (6 months). Although impaired kidney function contributes to PTA, it is only one of many factors that result in anemia in transplant recipients. Other causes include iron deficiency, medications, infections, acute rejection, inflammation, and erythropoietin deficiency. Unlike in the predialysis chronic kidney disease population, the impact of anemia after kidney transplantation outcomes is unknown. This is in large part due to the absence of controlled trials that address whether correction of a...

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Multicenter Clinical Sample Collection for Microarray Analysis

Springer protocols feed by Pharmacology/Toxicology — Thu, 18 Mar 2010 14:12:11 +0100

In this chapter, we describe numerous methods to extract RNA, DNA, and protein from tissue, represented by kidney transplant biopsies, and from peripheral blood cells collected at various clinical sites. Gene expression profiling and SNP-based genome-wide association studies are done using various microarray platforms. In addition, protocols that enable simultaneous protein purification from these clinical samples, enable additional strategies for understanding of the molecular processes involved in organ transplantation, immunosuppressive drug regimens, and the elements determining allograft success and failure. Successfully establishing a multicenter clinical study was essential to meet our objectives for subject enrollment and transplant outcomes. This chapter focuses on our experience ...

Comparison between VDR analogs and current immunosuppressive drugs in relation to CXCL10 secretion by human renal tubular cells

Transplant International — Thu, 18 Mar 2010 00:00:00 +0100

This study aimed to investigate whether elocalcitol and BXL-01-0029 could decrease the expression of CXCL10 in activated renal tubular cells in vitro and thus be useful in kidney allograft rejection treatment. Experiments were performed in human tubular renal cells stimulated with interferon-[gamma] + tumor necrosis factor-[alpha] with and without VDR agonists, tacrolimus, sirolimus, hydrocortisone, methylprednisolone, cyclosporin A and mycophenolate mofetil. CXCL10 protein secretion and gene expression were measured by ELISA and by quantitative PCR. Specific inhibitors were used to investigate intracellular pathways involved in tubular cells activation. For IC50 determination and comparison, dose-response curves with VDR agonists, tacrolimus and mycophenolic acid were performed. Elocalcit...

Beneficial effects of donor-specific transfusion on renal allograft outcome

Clinical Transplantation — Tue, 16 Mar 2010 00:00:00 +0100

Conclusion: DST imposes a significant beneficial effect on the incidence of AR, DGF and graft function during the first post-transplantation year in transfusion-naïve patients receiving standard immunosuppression therapy. (Source: Clinical Transplantation)

Cementless total hip arthroplasty with subtrochanteric transverse shortening osteotomy for severely dysplastic or dislocated hips.

Hip International — Tue, 16 Mar 2010 00:00:00 +0100

Authors: Yalcin N, Kilicarslan K, Karatas F, Mutlu T, Yildirim H Total hip arthroplasty in dislocated developmental hip dysplasia is a complex, technically demanding procedure with high complication rates. Anatomic abnormalities and the young age of the patients influence the results. Restoration of the anatomic hip center often requires shortening of the femur in order to avoid over-stretching of neurovascular structures. We performed cementless total hip arthroplasty with subtrochanteric transverse osteotomy on 44 hips in 31 patients. There were 29 female and 2 male patients. The average age at the time of the operation was 43.2 (range, 22-63 years) and the mean follow up period was 62 months (range, 24-96 months). Harris hip scores improved from 36.2 to 81.2 with good and excellent ...

Cortical strut allograft as an adjunct to plate fixation for periprosthetic fractures of the femur.

Hip International — Tue, 16 Mar 2010 00:00:00 +0100

Authors: Font-Vizcarra L, Fernandez-Valencia JA, Gallart X, Segur JM, Prat S, Riba J The use of cortical strut allografts in the treatment of periprosthetic femoral fractures remain controversial. Complications such as infection and the potential transmission of disease remain concerns. A retrospective review at a tertiary-care hospital was completed of 21 patients who had sustained a periprosthetic femoral fracture and who were treated using a plate and a deep-frozen cortical strut allograft, between 1996 and 2007. The average age at the time of surgery was 80.3 years old and included 16 women and 5 men. Three patients were lost to follow-up and four died within a few weeks of discharge. The remaining 14 patients were evaluated clinically and radiographically with a mean follow-up of ...

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Uncemented revision hip arthroplasty in B2 and B3 periprosthetic femoral fractures - A prospective analysis.

Hip International — Tue, 16 Mar 2010 00:00:00 +0100

We describe our experience of cementless femoral revision in management of twenty-six patients who sustained periprosthetic fractures of the Vancouver type B2 or B3, between February1999 and March 2005. All patients were managed by revision arthroplasty, using cementless femoral stems. Cortical struts, cable plating systems, bone allograft and demineralised bone matrix were used to aid the reconstruction where indicated. All the fractures had clinical and radiological union. The outcome was graded, subjectively as satisfactory by all patients and this is substantiated objectively, by a post operative mean Harris hip score of 83.04. Uncemented revision appears to be an attractive option for periprosthetic fractures with unstable femoral stems. PMID: 20235063 [PubMed - as supplied by pub...

Sirolimus-based calcineurin inhibitor withdrawal immunosuppressive regimen in kidney transplantation: a single center experience

Clinical and Experimental Nephrology — Mon, 15 Mar 2010 17:56:19 +0100

Conclusions We concluded that conversion from CNIs to SRL is an option and of benefit without significant acute rejection episodes or chronic allograft dysfunction especially in well-selected kidney transplant recipients with good graft function. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10157-010-0269-0Authors Sameer M. Alarrayed, Arabian Gulf University Nephrology and Transplant Unit, Salmaniya Medical Complex, Medical College PO Box 40019 Manama Kingdom of BahrainAmgad E. El-Agroudy, Arabian Gulf University Nephrology and Transplant Unit, Salmaniya Medical Complex, Medical College PO Box 40019 Manama Kingdom of BahrainAhmad S. Alarrayed, Arabian Gulf University Nephrology and Transplant Unit, Salmaniya Medical Complex, Medical College PO Bo...

The use of pedicled temporal musculoperiosteal flap with or without free calvarial bone graft in maxillary reconstructions

European Archives of Oto-Rhino-Laryngology — Mon, 15 Mar 2010 17:54:49 +0100

Abstract Various techniques have been used to repair maxillary defects. The aim of this study was to evaluate the suitability of pedicled temporal musculoperiosteal flap (PTMF) and free calvarial bone graft for the reconstruction of maxillary defects. In this retrospective series, 34 patients operated on from 1995 to 2006 at Turku University Central Hospital because of defects of maxilla reconstructed using PTMF with or without free calvarial bone graft were evaluated. The diagnosis, the indication for surgery, the location and staging of the tumours, and the type of radiotherapy used were reviewed. The classification of the maxillary defects was performed according to the classification of Brown (Br J Oral Maxillofac Surg 40:183–190, 2002) and the success rates of the re...

Spontaneous closure of a coronary fistula due to cardiac allograft vasculopathy

European Heart Journal — Mon, 15 Mar 2010 16:45:22 +0100

(Source: European Heart Journal)

84 Percent Of Male Patients Still Highly Active 15 Years After ACL Knee Reconstruction

Health News from Medical News Today — Mon, 15 Mar 2010 08:00:00 +0100

Eighty-four percent of males who had ACL knee (anterior cruciate ligament) reconstruction with a patellar tendon (the tendon that attaches the knee to the front of the tibia or shin bone) graft continue at a high level of activity 15 years later, according to a study presented at the American Orthopaedic Society for Sports Medicine's Specialty Day in New Orleans, Louisiana (March 13). Additionally, these patients have not developed severe osteoarthritis and their knees remain stable... (Source: Health News from Medical News Today)

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84 Percent Of Male Patients Still Highly Active 15 Years After ACL Knee Reconstruction

Bones / Orthopaedics News From Medical News Today — Mon, 15 Mar 2010 08:00:00 +0100

Eighty-four percent of males who had ACL knee (anterior cruciate ligament) reconstruction with a patellar tendon (the tendon that attaches the knee to the front of the tibia or shin bone) graft continue at a high level of activity 15 years later, according to a study presented at the American Orthopaedic Society for Sports Medicine's Specialty Day in New Orleans, Louisiana (March 13)... (Source: Bones / Orthopaedics News From Medical News Today)

Transurethral injection therapy with carbon-coated beads (Durasphere®) for treatment of recurrent pyelonephritis in kidney transplant patients with vesico-ureteral reflux to the allograft

Clinical Transplantation — Mon, 15 Mar 2010 00:00:00 +0100

Conclusions: Transurethral injection therapy with Durasphere® is a safe and effective minimally invasive treatment option for KTx patients with recurrent RTP. A second treatment seems to be necessary in some cases. (Source: Clinical Transplantation)

Results of isolated posterolateral corner reconstruction

Journal of Orthopaedics and Traumatology — Sun, 14 Mar 2010 12:24:46 +0100

Conclusion Fibular-based technique showed good results in terms of clinical outcome, restoring varus and rotation stability of knees in treatment of chronic isolated PLC injury. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10195-010-0088-9Authors Lawrence Camarda, Clinica Ortopedica e Traumatologica, Policlinico Universitario “P.Giaccone” Via del Vespro 125 90127 Palermo ItalyVincenzo Condello, Ospedale Sacro Cuore Don Calabria, Centro di Chirurgia del Ginocchio Via Settembrini Negrar, Verona ItalyVincenzo Madonna, Ospedale Sacro Cuore Don Calabria, Centro di Chirurgia del Ginocchio Via Settembrini Negrar, Verona ItalyFabrizio Cortese, Ospedale Sacro Cuore Don Calabria, Centro di Chirurgia del Ginocchio Via Settembrini Negrar, Verona ItalyMic...

An easy and safe pattern graft for facial burns

Burns : Journal of the International Society for Burn Injuries — Sat, 13 Mar 2010 13:58:09 +0100

The association and optimization of donor autograft sites, harvesting methods and cutaneous covering (autografts, allografts, artificial skin substitute…) allow to ensure early excision and grafting of burns. Facial burns occur, and when these require skin grafts, these are ideally taken from sites that have good color match, have not been used before, and are fashioned in sizes to cover the aesthetic units of the face and minimize the appearance of scars in the graft seams. (Source: Burns : Journal of the International Society for Burn Injuries)

Sprayed cultured autologous keratinocytes used alone or in combination with meshed autografts to accelerate wound closure in difficult-to-heal burns patients

Burns : Journal of the International Society for Burn Injuries — Sat, 13 Mar 2010 13:58:08 +0100

Extensive deep burns present a significant challenge to the burns surgeon. The limited availability of skin donor sites in such patients means that the time to achieve complete skin cover is prolonged and consequently increases the risk of complications such as sepsis. Research has shown that prompt excision of burned tissue and early wound cover will lead to improved survival, more rapid recovery and reduction in scarring . (Source: Burns : Journal of the International Society for Burn Injuries)

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Processing efficacy in relation to microbial contamination of skin allografts from 723 donors

Burns : Journal of the International Society for Burn Injuries — Sat, 13 Mar 2010 13:58:05 +0100

Abstract: The Siena Skin Bank, established in 2000, processes skin from more than 130 cadaveric donors per year (about 400,000cm2) and distributes it for transplants to treat burns and other types of skin loss. More than 1,500,000cm2 of homologous skin has been transplanted to date. At the Siena Skin Bank we conducted a retrospective study of our data to assess microbial contamination of skin specimens from 723 donors banked in the period 2000–2007. Our aim was to determine factors deleterious for skin quality, to optimize skin banking procedures and to reduce corrective actions. The factors analyzed were: type of donor (multi-organ, multi-tissue, live or cadaver), cause of death, time elapsing between death and procurement, different procurement centres and operator experience. Of the 7...

ETEX Corporation Announces FDA Clearance And Launch Of Carrigen(R) Porous Bone Substitute Material

Health News from Medical News Today — Sat, 13 Mar 2010 09:00:00 +0100

ETEX Corporation, an advanced biomaterials company, announced that the FDA has granted 510(k) clearance of CarriGen® Porous Bone Substitute Material. CarriGen is available for immediate sale through ETEX's independent sales force. CarriGen builds upon the clinically proven benefit of ETEX nanocrystalline calcium phosphate technology by adding the advantage of increased porosity and pore size. CarriGen is the first highly porous bone graft substitute that sets hard upon implantation for a complete defect fill... (Source: Health News from Medical News Today)

15 years after ACL knee reconstruction, 84 percent of male patients still highly active, study says

EurekAlert! - Medicine and Health — Sat, 13 Mar 2010 05:00:00 +0100

(American Orthopaedic Society for Sports Medicine) Eighty-four percent of males who had ACL knee (anterior cruciate ligament) reconstruction with a patellar tendon (the tendon that attaches the knee to the front of the tibia or shin bone) graft continue at a high level of activity 15 years later, according to a study presented today at the American Orthopaedic Society for Sports Medicine's Specialty Day in New Orleans, Louisiana (March 13). Additionally, these patients have not developed severe osteoarthritis and their knees remain stable. (Source: EurekAlert! - Medicine and Health)

Pyogenic spondylodiscitis: An overview

Journal of Infection and Public Health — Fri, 12 Mar 2010 15:45:07 +0100

Summary: Although uncommon, spontaneous and postoperative pyogenic spondylodiscitis entail major morbidity and may be associated with serious long-term sequelae. A review of the literature was done to advance our understanding of the diagnosis, treatment, and outcome of these infections.The principles of conservative treatment are to establish an accurate microbiological diagnosis, treat with appropriate antibiotics, immobilize the spine, and closely monitor for spinal instability and neurological deterioration. The purpose of surgical treatment is to obtain multiple intraoperative cultures of bone and soft tissue, perform a thorough debridement of infected tissue and decompression of neural structures, and reconstruct the unstable spinal column with bone graft with or without concomitant ...

Rehabilitation After Autologous Chondrocyte Implantation in Athletes

Clinics in Sports Medicine — Fri, 12 Mar 2010 15:37:55 +0100

This article reviews the rehabilitation protocols for injured athletes following an ACI procedure. (Source: Clinics in Sports Medicine)

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Risk factor analysis of proximal junctional kyphosis after posterior fusion in patients with idiopathic scoliosis

Injury — Fri, 12 Mar 2010 15:06:27 +0100

Conclusions: There is a high incidence of postoperative proximal junctional kyphosis after posterior fusion to the upper thoracic vertebra within 1.5 years after surgery in adolescents with idiopathic scoliosis. In order to reduce its incidence, the risk factors for PJK should be carefully evaluated before surgery. (Source: Injury)

RTI Biologics™ Launches Two Biologic Implants At Orthopaedic Surgeon Annual Meeting

Health News from Medical News Today — Fri, 12 Mar 2010 08:00:00 +0100

RTI Biologics Inc. (RTI) (Nasdaq: RTIX), the Florida-based processor of orthopedic, dental, surgical specialties and other biologic implants, is launching two new biologic implants for use in sports medicine surgeries at the American Academy of Orthopaedic Surgeons (AAOS) annual meeting in New Orleans this week. BTB Select®, an innovative allograft that provides precision sized tendons for ACL reconstruction, and BioCAP Select™, a composite allograft plug for customized bone void filling, will be introduced at the RTI Biologics exhibit during the AAOS meeting... (Source: Health News from Medical News Today)

The Role of Placental Exosomes in Reproduction

American Journal of Reproductive Immunology — Fri, 12 Mar 2010 00:00:00 +0100

Citation Mincheva-Nilsson L, Baranov V. The Role of Placental Exosomes in Reproduction. Am J Reprod Immunol 2010 Cell communication comprises cell[ndash]cell contact, soluble mediators and intercellular nanotubes. There is, however, another cell[ndash]cell communication by released membrane-bound microvesicles that convey cell[ndash]cell contact 'by proxy' transporting signals/packages of information from donor to recipient cells locally and/or at a distance. The nanosized exosomes comprise a specialized type of microvesicles generated within multivesicular bodies (MVB) and released upon MVB fusion with the plasma membrane. Exosomes are produced by a variety of immune, epithelial and tumor cells. Upon contact, exosomes transfer molecules that can render new properties and/or reprogram thei...

In vivo testing of a biodegradable woven fabric made of bioactive glass fibers and PLGA(80)-A pilot study in the rabbit.

Biomed Res — Fri, 12 Mar 2010 00:00:00 +0100

This study failed to demonstrate the previously seen positive effect of BG 1-98 on osteogenesis, probably due to the changed resorption properties of BG in the form of fibers. Therefore, the feasibility and safety of BG as fibers needs to be reevaluated before use in clinical applications. (c) 2010 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2010. PMID: 20229522 [PubMed - as supplied by publisher] (Source: Biomed Res)

Ultrasound-guided peripheral nerve blocks for anterior cruciate ligament reconstruction: effect of obturator nerve block during and after surgery

Journal of Anesthesia — Thu, 11 Mar 2010 18:13:46 +0100

Conclusion The present results suggest the involvement of the obturator nerve in ACL reconstruction using a hamstring autograft. However, although obturator nerve blockade is crucial for intraoperative analgesia, a continuous obturator nerve block is not necessary beyond 24 h postoperatively. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00540-010-0916-3Authors Shinichi Sakura, University Hospital, Shimane University School of Medicine Surgical Center 89-1 Enya-cho Izumo 693-8501 JapanKaoru Hara, Shimane University School of Medicine Department of Anesthesiology Izumo JapanJunichi Ota, Shimane University School of Medicine Department of Anesthesiology Izumo JapanSaki Tadenuma, Shimane University School of Medicine Department of Anesthesiolog...

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Induction of tolerance to bone marrow allografts by donor-derived host nonreactive ex vivo-induced central memory CD8 T cells

Blood — Thu, 11 Mar 2010 17:02:03 +0100

In conclusion, anti–third-party Tcms, which home to recipient LNs and effectively delete antidonor T cells, could provide an effective and novel tool for overcoming rejection of BM allografts. (Source: Blood)

Allogeneic T regulatory cell-mediated transplantation tolerance in adoptive therapy depends on dominant peripheral suppression and central tolerance

Blood — Thu, 11 Mar 2010 17:02:02 +0100

T regulatory cells (Tregs) represent agents to mediate tolerance to allografts so that the use of immunosuppressive drugs is avoided. In this regard, we previously demonstrated that the adoptive transfer of allogeneic Tregs into IL-2Rβ–/– mice prevented autoimmunity and led to allograft tolerance. Here, we investigated the requirements and mechanisms that favor this long-lasting tolerance. The most potent tolerance required exact matching of all alloantigens between the adoptively transferred allogeneic Tregs and allogeneic skin grafts, but tolerance to such allografts that lacked expression of major histocompatibility complex class I or II molecules also occurred. Thus, Tregs are not required to directly recognize major histocompatibility complex class II alloantigens to ...

AAOS: Bone Graft Substitute Used Mostly Off-Label (CME/CE)

MedPage Today Meeting Coverage — Thu, 11 Mar 2010 13:43:08 +0100

NEW ORLEANS (MedPage Today) -- The vast majority of spinal procedures using bone morphogenetic protein (BMP) involve off-label uses, researchers found. (Source: MedPage Today Meeting Coverage)

Management of symptomatic vertebral haemangioma in a resource challenged environment

Child's Nervous System — Thu, 11 Mar 2010 02:39:36 +0100

Conclusion We have presented two cases with rewarding outcomes in the face of ‘adaptive’ instrumentation due to limited resources. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00381-010-1101-6Authors Augustine A. Adeolu, University College Hospital (UCH) Department of Neurological Surgery Ibadan NigeriaJames A. Balogun, University College Hospital (UCH) Department of Neurological Surgery Ibadan NigeriaAmos O. Adeleye, University College Hospital (UCH) Department of Neurological Surgery Ibadan NigeriaPeter O. Adeoye, UCH Division of Thoracic and Cardiovascular Surgery, Department of Surgery Ibadan NigeriaClement A. Okolo, University College Hospital (UCH) Department of Pathology Ibadan NigeriaGodwin I. Ogbole, University College Hospital (UCH) Departm...

Rigid internal fixation of mandibular fractures using autologous bone grafts: the autologous bone plate

European Journal of Plastic Surgery — Thu, 11 Mar 2010 02:37:58 +0100

Abstract The mandible is the second most commonly fractured part of the maxillofacial skeleton because of its position and prominence. Over the past three decades, many different techniques and approaches have been described in the literature to surgically correct facial fractures. The present study has attempted to study the role of bone grafts in open reduction and internal fixation of mandibular fractures. Fourteen patients with mandibular fracture were considered for the study from August 2006 to August 2008. Autologous bone grafts were used for rigid fixation of these fractures in all the cases. Patients presenting with unilateral fractures of the body of the mandible were considered and enrolled for rigid internal fixation using autologous bone grafts. Fourteen patie...

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Improvement in late renal allograft survival between 1990 and 2002 in Spain: results from a multicentre case–control study

Transplant International — Thu, 11 Mar 2010 00:00:00 +0100

Epidemiological studies have failed to show an improvement in graft survival beyond 1 year after kidney transplantation possibly because of an increased number of expanded donors and older recipients. Thus, we performed a case[ndash]control study matching patients transplanted in different eras by donor and recipient characteristics. We considered renal transplant recipients included in the database of the Spanish Chronic Allograft Dysfunction Study Group in 1990, 1994, 1998 and 2002 (n = 4842). We matched patients from these cohorts considering the following variables: donor and recipient age, cause of donor death, hepatitis C virus, panel reactive antibodies and re-transplantation. We identified a total of 896 patients distributed in four cohorts of 224 matched patients. Between 1990 and...

Combination of clopidogrel and everolimus dramatically reduced the development of transplant arteriosclerosis in murine aortic allografts

Transplant International — Thu, 11 Mar 2010 00:00:00 +0100

Our group has shown that platelet inhibition with clopidogrel, an antagonist of the P2Y12 adenosine diphosphate receptor on platelets, reduced the formation of transplant arteriosclerosis. The aim of this study was to investigate whether a combination of cyclosporin or everolimus with clopidogrel has a beneficial effect on the development of transplant arteriosclerosis. Fully MHC mismatched C57Bl/6 (H2b) donor aortas were transplanted into CBA.J (H2k) recipients and mice received either clopidogrel alone (1 mg/kg/day) or in combination with cyclosporin (2 mg/kg/day) or everolimus (0.05 mg/kg/day). Grafts were analysed by histology and morphometry on day 30 after transplantation. In mice treated with clopidogrel alone, transplant arteriosclerosis was significantly reduced [intima proliferat...

Collagen barrier membranes decrease osteoclastogenesis in murine bone marrow cultures

Clinical Oral Implants Research — Thu, 11 Mar 2010 00:00:00 +0100

Collagen barrier membranes (CBM) are used for guided bone regeneration to support the process of graft consolidation. It remains, unknown however, whether CBM can affect the consolidation of bone grafts by controlling the differentiation of progenitor cells into bone-resorbing osteoclasts and bone-forming osteoblasts. To gain an insight into the underlying mechanisms, we performed in vitro bone marrow cultures on CBM (Bio-Gide®) under conditions that favor osteoclastogenesis and osteoblastogenesis, respectively. Measures of osteoclastogenesis were based on the number of tartrate-resistant acid-phosphatase-positive (TRAP+) multinucleated cells. Resorption assays revealed the activity of mature osteoclasts. Osteoblastogenesis was determined by alkaline-phosphatase activity. Viability was in...

PLIF in thoracolumbar trauma: technique and radiological results

European Spine Journal — Wed, 10 Mar 2010 18:48:34 +0100

Abstract Patients with fractures from the 11th thoracic to the 5th lumbar vertebra had a reconstruction of the anterior column with monocortical iliac crest autograft by using a single dorsal approach. The loss of correction was observed using X-rays pre- and post-operatively, at 3 months and after implant removal (IR). Successful fusion was assessed using computed tomography after the implant removal. To assess the loss of correction and intervertebral fusion rate of this technique. There are still controversial discussions about the treatment modalities of spine lesions, especially in cases of burst fractures. Dorsal, combined and ventral procedures are reported with different assets and drawbacks. We want to present a method to restore the weight-bearing capability...

Traumatic Osteochondral Injury of the Femoral Head Treated by Mosaicplasty: A Report of Two Cases

HSS Journal — Wed, 10 Mar 2010 18:33:39 +0100

In this report, we present two cases of a chondral defect to the femoral head after a traumatic hip dislocation, treated with an osteochondral autograft (OATS) from the ipsilateral knee, and the inferior femoral head, respectively, combined with a surgical dislocation of the hip. At greater than 1 year and greater than 5 years of follow-up, MRI studies have demonstrated good autograft incorporation with maintenance of articular surface conformity, and both patients clinically continue to have no pain and full active range of motion of their respective hips. In our opinion, treatment of osteochondral defects in the femoral head surface using a surgical dislocation combined with an OATS procedure is a promising approach, as full exposure of the femoral head can be obtained wh...

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RTI Biologics Launches Two Biologic Implants at Orthopaedic Surgeon Annual Meeting

HSMN NewsFeed — Wed, 10 Mar 2010 15:38:12 +0100

ALACHUA, Fla.--(HSMN NewsFeed)--RTI Biologics Inc. (RTI) (Nasdaq: RTIX ), the Florida-based processor of orthopedic, dental, surgical specialties and other biologic implants, is launching two new biologic implants for use in sports medicine surgeries at th... Devices, OrthopaedicRTI Biologics, BTB Select, BioCAP Select, allograft (Source: HSMN NewsFeed)

Minimally invasive, no hardware subtalar arthrodesis with autogenous posterior iliac bone graft

Strategies in Trauma and Limb Reconstruction — Wed, 10 Mar 2010 12:54:22 +0100

Abstract Sixteen patients underwent minimally invasive subtalar arthrodesis through a mini-invasive approach with posterior iliac graft between 2004 and 2006. No hardware was used to transfix the arthrodesis and partial weight bearing was allowed immediately. The primary indication for surgery was the squeal of fracture os calcis in terms of subtalar joint arthritis, loss of heel height, malalignment of the hindfoot, and pain with weight bearing. There were 12 male and 4 female patients with a mean age of 30 (range 17–52). Patients were followed up for a period of 40.8 months (range 36–48 months). The mean interval from injury to fusion was 2 (+0.6) years ranging from 6 months to 6 years post fracture. The average clinical rating scale based on the ...

Evaluation of Cardiac Allograft Vasculopathy by Multidetector Computed Tomography and Whole-Heart Magnetic Resonance Coronary Angiography.

Circulation Journal — Wed, 10 Mar 2010 00:00:00 +0100

Conclusions: MDCT, especially 64-detector CT, is feasible for detecting CAV, whereas MRCA currently shows limited sensitivity. PMID: 20215697 [PubMed - as supplied by publisher] (Source: Circulation Journal)

ETEX Corporation Announces FDA Clearance and Launch of Carrigen(R) Porous Bone Substitute Material

HSMN NewsFeed — Tue, 09 Mar 2010 19:57:23 +0100

Carrigen(R) Porous Bone Substitute Material - The First Hard Setting, Highly Porous Bone Graft Substitute CAMBRIDGE, Mass., March 9 (HSMN NewsFeed) --ETEX Corporation, an advanced biomaterials company, announced today that the FDA has granted 510(k) c... Devices, Orthopaedic, FDAETEX Corp, CarriGen, Bone Substitute (Source: HSMN NewsFeed)

Use of ultrasonic pachymetry for measurement of changes in corneal thickness in mouse corneal transplant rejection

British Journal of Ophthalmology — Tue, 09 Mar 2010 12:49:03 +0100

Conclusion In vivo graft pachymetry provides a new and reliable way to objectively diagnose rejection in the mouse model of corneal transplantation. (Source: British Journal of Ophthalmology)

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A Comparison of Posterolateral Lumbar Fusion Comparing Autograft, Autogenous Laminectomy Bone With Bone Marrow Aspirate, and Calcium Sulphate With Bone Marrow Aspirate: A Prospective Randomized Study

Medscape Today Headlines — Tue, 09 Mar 2010 12:04:25 +0100

This study evaluated whether the fusion rate of autogenous laminectomy bone chips and calcium sulfate pellets could be augmented by bone marrow aspirate (BMA) in 1-level lumbar posterolateral fusion. Spine (Source: Medscape Today Headlines)

Cleveland researchers use natural and artificial sheaths to mend traumatic bone loss

EurekAlert! - Medicine and Health — Tue, 09 Mar 2010 05:00:00 +0100

(Case Western Reserve University) Melissa Knothe Tate, of Case Western Reserve University, and Ulf Knothe, of the Cleveland Clinic, have shown that the stem-cell rich periosteum sheath around bone can be used to mend serious bone loss faster and more simply than bone grafts. The pair has developed an artificial periosteum that can be implanted in patients who have too little of the natural covering left. (Source: EurekAlert! - Medicine and Health)

Natural and artificial sheaths used to mend traumatic bone loss

ScienceDaily Headlines — Tue, 09 Mar 2010 05:00:00 +0100

A research team has shown that the stem-cell rich periosteum sheath around bone can be used to mend serious bone loss faster and more simply than bone grafts. The researchers have developed an artificial periosteum that can be implanted in patients who have too little of the natural covering left. (Source: ScienceDaily Headlines)

Osteotech's MagniFuse(TM) Distributed to 68 U.S. Hospitals as Product Revenue Surpasses $1 Million

HSMN NewsFeed — Mon, 08 Mar 2010 12:36:48 +0100

National Launch on Target to begin in Second Quarter 2010 EATONTOWN, N.J., March 8 (HSMN NewsFeed) -- Osteotech, Inc. (Nasdaq:OSTE ), a leader in the emerging field of biologic products for regenerative healing, announced today that its MagniFuse Bon... Regenerative MedicineOsteotech, MagniFuse, Bone Graft (Source: HSMN NewsFeed)

Long-term impact of respiratory viral infection after pediatric lung transplantation

Pediatric Transplantation — Fri, 05 Mar 2010 00:00:00 +0100

Liu M, Mallory GB, Schecter MG, Worley S, Arrigain S, Robertson J, Elidemir O, Danziger-Isakov LA. Long-term impact of respiratory viral infection after pediatric lung transplantation. Pediatr Transplantation 2010 00: 000[ndash]000. © 2010 John Wiley & Sons A/S.Abstract: To evaluate the epidemiology and to investigate the impact of RVI on chronic allograft rejection after pediatric lung transplantation, a retrospective study of pediatric lung transplant recipients from 2002 to 2007 was conducted. Association between RVI and continuous and categorical risk factors was assessed using Wilcoxon rank-sum tests and Fisher's exact tests, respectively. Association between risk factors and outcomes were assessed using Cox proportional hazards models. Fifty-five subjects were followed for a mean of...

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Early Experience with a Novel Nonmetallic Cable in Reconstructive Hip Surgery.

Clinical Orthopaedics and Related Research — Fri, 05 Mar 2010 00:00:00 +0100

CONCLUSIONS: The nonmetallic periprosthetic cables used in this series provided adequate fixation to allow for both osteotomy and fracture healing. We did not observe any complications directly related to the cables. Level of Evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID: 20204557 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)

Induction of Lymphocyte Apoptosis in Rat Liver Allograft by Adenoviral Gene Transfection of Human Interleukin-10

European Surgical Research — Thu, 04 Mar 2010 23:00:00 +0100

Eur Surg Res 2010;44:133141 (DOI:10.1159/000276989) (Source: European Surgical Research)

Low donor-to-recipient weight ratio does not negatively impact survival of pediatric heart transplant patients

Pediatric Transplantation — Thu, 04 Mar 2010 00:00:00 +0100

Tang L, Du W, Delius RE, L'Ecuyer JL, Zilberman MV. Low donor-to-recipient weight ratio does not negatively impact survival of pediatric heart transplant patients.Pediatr Transplantation 2010. © 2010 John Wiley & Sons A/S.Abstract: A major limitation to success in pediatric heart transplantation is donor organ shortage. While the use of allografts from donors larger than the recipient is accepted, the use of undersized donor grafts is generally discouraged. Using the UNOS database, we wanted to evaluate whether using smaller donor hearts affects the short- and long-term survival of pediatric heart transplant patients. A retrospective analysis of data entered into the UNOS database from April 1994 to May 2008 was performed. Pediatric heart transplant recipients (ages 0[ndash]18 yr) with DR...

De novo membranous nephropathy and antibody-mediated rejection in transplanted kidney

Clinical Transplantation — Thu, 04 Mar 2010 00:00:00 +0100

Conclusions: DSA and AMR might play some roles for the pathogenesis in some patients with de novo MN after kidney transplantation. (Source: Clinical Transplantation)

Beta-tricalcium phosphate exerts osteo-conductivity through alpha2beta1 integrin and down-stream MAPK/ERK signaling pathway.

Biochemical and Biophysical Research communications — Wed, 03 Mar 2010 00:00:00 +0100

This study was aimed to investigate the molecular mechanism(s) by which beta-TCP modulates the biological response of primary human osteoblasts (HOBs). It was showed that HOBs seeded into the beta-TCP scaffolds expressed significantly higher levels of osteogenic genes, compared to those cultured on tissue culture plastic; meanwhile these cells showed 7-fold increase in alpha2 integrin subunit gene expression and the activation of MAPK/ERK signaling pathway. In addition, the osteogenic conduction by beta-TCP scaffolds was attenuated directly by inhibiting the mitogen activated protein kinase (MAPK)/extracellular related kinase (ERK) signaling pathway or indirectly by blocking the alpha2beta1 integrin signaling pathway. We concluded that beta-TCP scaffold exerts osteo-conductivity through al...

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Prevention of Renal Interstitial Fibrosis via Histone Deacetylase Inhibition in Rats with Unilateral Ureteral Obstruction.

Transplant Immunology — Wed, 03 Mar 2010 00:00:00 +0100

Authors: Kinugasa F, Noto T, Matsuoka H, Urano Y, Sudo Y, Takakura S, Mutoh S Acute rejection following renal transplantation has become manageable with the introduction of calcineurin inhibitors, FK506 and cyclosporine A. However, chronic allograft dysfunction accompanied by renal interstitial fibrosis, which induces graft loss, remains unresolved. Here, we evaluated the effect of FR276457, a pan-histone deacetylase (HDAC) inhibitor, on interstitial fibrosis in the injured kidneys of a rat model of unilateral ureteral obstruction. The injured kidneys, harvested on Day 14 following the operation, showed progression of interstitial fibrosis, increases of hydroxyproline contents, and mRNA expression of collagen type Ialpha and monocyte chemotactic protein 1 (MCP-1). However, these change...

Humanized Gene Replacement in Mice Reveals the Contribution of Cancer Stroma-Derived HB-EGF to Tumor Growth.

Cell Structure and Function — Tue, 02 Mar 2010 21:38:02 +0100

Authors: Ichise T, Adachi S, Ohishi M, Ikawa M, Okabe M, Iwamoto R, Mekada E Tumor progression is a complex process that involves the interaction of cancer cells with the cancer-surrounding stromal cells. The cancer stroma influences the cancer cell growth and metastatic potential. The EGF family growth factor HB-EGF is synthesized in cancer cells and plays pivotal roles in oncogenic transformation and tumor progression, but the contribution of HB-EGF expressed in tumor stromal cells to tumor growth remains unclear. In the present study, we found that HB-EGF was expressed in host-derived cancer stromal cells in xenograft and allograft mouse tumor models. CRM197 is a specific inhibitor of human HB-EGF that has no effect on mouse HB-EGF. To elucidate whether host-derived stromal HB-EGF c...

In vivo experimental study of hat type cervical intervertebral fusion cage (HCIFC)

International Orthopaedics — Tue, 02 Mar 2010 10:00:12 +0100

Abstract The purpose of this study was to compare the characteristics of interbody fusion achieved using the hat type cervical intervertebral fusion cage (HCIFC) with those of an autologous tricortical iliac crest graft, Harms cage and the carbon cage in a goat cervical spine model. Thirty-two goats underwent C3-4 discectomy and fusion. They were subdivided into four groups of eight goats each: group 1, autologous tricortical iliac crest bone graft; group 2, Harms cage filled with autologous iliac crest graft; group 3, carbon cage filled with autologous iliac bone; and group 4, HCIFC filled with autologous iliac graft. Radiography was performed pre- and postoperatively and after one, two, four, eight and 12 weeks. At the same time points, disc space height, interverteb...

Tissue-engineered matrices as functional delivery systems: Adsorption and release of bioactive proteins from degradable composite scaffolds.

Cell Research — Tue, 02 Mar 2010 00:00:00 +0100

In this study, we investigated this concept by loading porous hydroxyapatite-poly(lactide-co-glycolide) (HA-PLAGA) scaffolds with a model protein, cytochrome c, and then studying its release in a phosphate-buffered saline solution. The HA-PLAGA scaffold has previously been shown to be bioactive, osteoconductive, and to have appropriate physical properties for tissue engineering applications. The loading experiments demonstrated that the HA-PLAGA scaffold could also function effectively as a substrate for protein adsorption and release. Scaffold protein adsorptive loading (as opposed to physical entrapment within the matrix) was directly related to levels of scaffold HA-content. The HA phase of the scaffold facilitated protein retention in the matrix following incubation in aqueous buffer f...

Comparison of the osteoinductivity of bioimplants containing recombinant human bone morphogenetic proteins 2 (Infuse) and 7 (OP-1)

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics — Tue, 02 Mar 2010 00:00:00 +0100

Conclusion: In their clinically available forms, the rhBMP-7–containing OP-1 induced greater bone volume than the rhBMP-2–containing Infuse in the mouse muscle pouch model. (Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics)

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Early Versus Late Start of Isokinetic Hamstring-Strengthening Exercise After Anterior Cruciate Ligament Reconstruction With Patellar Tendon Graft

The American Journal of Sports Medicine — Mon, 01 Mar 2010 23:18:05 +0100

Conclusion The results of this study suggest that hamstring as well as quadriceps strength can be increased via early hamstring strengthening after anterior cruciate ligament reconstruction with no negative impact on knee function. (Source: The American Journal of Sports Medicine)

Revision Ulnar Collateral Ligament Reconstruction Using a Suspension Button Fixation Technique

The American Journal of Sports Medicine — Mon, 01 Mar 2010 23:18:05 +0100

Conclusion Ulnar collateral ligament reconstruction using a suspension button fixation technique reliably restored elbow kinematics to the intact state. Load-to-failure testing demonstrated comparable fixation strength to several historic controls of primary reconstruction techniques despite the simulated ulnar cortical bone loss. Clinical Relevance Ulnar collateral ligament reconstruction using a suspension button fixation technique can be considered in the case of ulnar cortical bone loss in a primary or revision setting. (Source: The American Journal of Sports Medicine)

Early Versus Late Start of Isokinetic Hamstring-Strengthening Exercise After Anterior Cruciate Ligament Reconstruction With Patellar Tendon Graft

The American Journal of Sports Medicine — Mon, 01 Mar 2010 23:18:05 +0100

Revision Ulnar Collateral Ligament Reconstruction Using a Suspension Button Fixation Technique

The American Journal of Sports Medicine — Mon, 01 Mar 2010 23:18:05 +0100

No Difference in Knee Function or Prevalence of Osteoarthritis After Reconstruction of the Anterior Cruciate Ligament With 4-Strand Hamstring Autograft Versus Patellar Tendon-Bone Autograft: A Randomized Study With 10-Year Follow-up

The American Journal of Sports Medicine — Mon, 01 Mar 2010 23:18:04 +0100

Conclusion At 10 years postoperatively, no statistically significant differences in clinical outcome between the 2 graft types were found. The prevalence of osteoarthritis was significantly higher in the operated leg than in the contralateral leg, but there were no significant differences between the 2 groups. The results indicate that the choice of graft type after an anterior cruciate ligament injury has minimal influence on the prevalence of osteoarthritis 10 years after surgery. (Source: The American Journal of Sports Medicine)

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No Difference in Knee Function or Prevalence of Osteoarthritis After Reconstruction of the Anterior Cruciate Ligament With 4-Strand Hamstring Autograft Versus Patellar Tendon-Bone Autograft: A Randomized Study With 10-Year Follow-up

The American Journal of Sports Medicine — Mon, 01 Mar 2010 23:18:04 +0100

Baxter and ApaTech Announce Definitive Agreement

HSMN NewsFeed — Mon, 01 Mar 2010 16:10:01 +0100

Baxter to Acquire All Outstanding Equity of ApaTech, Including ACTIFUSE DEERFIELD, Ill. & LONDON--(HSMN NewsFeed)--Baxter International Inc. (NYSE:BAX ), a global, diversified healthcare company, and ApaTech, a private equity-backed, U.K.-based orthobio... Devices, Orthopaedic, Mergers & AcquisitionsBaxter, ApaTech, ACTIFUSE, bone graft (Source: HSMN NewsFeed)

Functional outcomes after the Ross (pulmonary autograft) procedure assessed with magnetic resonance imaging and cardiopulmonary exercise testing

Heart — Mon, 01 Mar 2010 10:21:17 +0100

Conclusion This study demonstrates minor autograft and homograft dysfunction in the majority of patients after the Ross procedure, associated with good ventricular function and exercise capacity. In addition, minor scar was present in a third of patients with no functional consequences. (Source: Heart)

Final analysis of the UKLG LY02 trial comparing 6–8 cycles of CHOP with 3 cycles of CHOP followed by a BEAM autograft in patients

British Journal of Haematology — Mon, 01 Mar 2010 00:00:00 +0100

In conclusion, no survival benefit was demonstrated for an early autograft in first response. (Source: British Journal of Haematology)

Invasive thymic carcinoma in a patient with combined kidney–pancreas allograft – individual approach to diagnosis and treatment

Transplant International — Mon, 01 Mar 2010 00:00:00 +0100

(Source: Transplant International)

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Impact of freezing on immunology and incorporation of bone allograft

Journal of Orthopaedic Research — Mon, 01 Mar 2010 00:00:00 +0100

This study indicates that in the long run there are no significant consequences; either immunological or biomechanical, of the use of deep frozen allogenous bone as compared to fresh autogenous bone grafts in this animal model. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res (Source: Journal of Orthopaedic Research)

Effect of psoralen on bone formation

Journal of Orthopaedic Research — Mon, 01 Mar 2010 00:00:00 +0100

To compare the amount of new bone and bone cells produced by psoralen in collagen matrix to that produced by collagen matrix in vivo. Eighteen bone defects, 5 mm by 10 mm were created in the parietal bone of nine New Zealand White rabbits. Six defects were grafted with psoralen mixed with collagen matrix. Six defects were grafted with collagen matrix alone (negative control - collagen) and six were left empty (negative control - empty). Animals were killed on day 14 and the defects were dissected and prepared for histological assessment. Quantitative analysis of new bone formation and bone cells were made on 100 sections (50 sections for each group) using image analysis. A total of 454% more new bone was present in defects grafted with psoralen in collagen matrix than those grafted with co...

Massive Femoral Bone Loss: Solutions of Last Resort

Seminars in Arthroplasty — Mon, 01 Mar 2010 00:00:00 +0100

Despite remarkable advances in the field of revision surgery during the last decades, the reconstruction in patients with massive femoral bone loss is still challenging. Proximal femoral replacement (megaprosthesis) and the use of an allograft-prosthesis composite are 2 valuable options for managing severe proximal femoral bone loss conditions. Although an allograft-prosthesis composite has several advantages, such as a potential restoration of proximal femoral bone mass and providing a site for soft-tissue attachment, a proximal femoral replacement has the benefit of being more readily available, technically less demanding, and more expeditious to implant than allograft-prosthesis composite. The outcome of megaprosthesis in non-neoplastic condition is dependent on several different issues...

Massive Acetabular Bone Loss: The Cup-Cage Solution

Seminars in Arthroplasty — Mon, 01 Mar 2010 00:00:00 +0100

This study examines the early results of a new technique of combining a cage with a shell of Trabecular Metal (Zimmer, Warsaw, IN), because this material has the potential to enhance biological fixation. Fourteen patients with major acetabular defects underwent revision total hip arthroplasty with a Cup-Cage construct. Clinical and radiographic outcomes were determined at minimum 2-year follow-up. Complications, reoperations, and functional status (overall satisfaction, pain, limp, and use of gait-aids) were assessed. Radiographs were analyzed for evidence of implant migration, new radiolucent lines, and bone graft resorption. Mean follow-up was 27 months (range: 1-39), excluding 1 death in less than 1 year after surgery. Outcomes were 82% excellent or good, 12% fair, and 6% poor. Average ...

Sinus bone graft using new alloplastic bone graft material (Osteon)—II: clinical evaluation

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: It was concluded that Osteon is suitable for use in sinus graft application. (Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics)

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Proximal femoral allograft-prosthesis composites in revision hip replacement: A 12-YEAR FOLLOW-UP STUDY.

The Journal of Bone and Joint Surgery. British volume — Mon, 01 Mar 2010 00:00:00 +0100

We report the use of an allograft prosthetic composite for reconstruction of the skeletal defect in complex revision total hip replacement for severe proximal femoral bone loss. Between 1986 and 1999, 72 patients (20 men, 52 women) with a mean age of 59.9 years (38 to 78) underwent reconstruction using this technique. At a mean follow-up of 12 years (8 to 20) 57 patients were alive, 14 had died and one was lost to follow-up. Further revision was performed in 19 hips at a mean of 44.5 months (11 to 153) post-operatively. Causes of failure were aseptic loosening in four, allograft resorption in three, allograft nonunion in two, allograft fracture in four, fracture of the stem in one, and deep infection in five. The survivorship of the allograft-prosthesis composite at ten years was 69.0% (95...

Transbronchial human interleukin-10 gene transfer reduces acute inflammation associated with allograft rejection and intragraft interleukin-2 and tumor necrosis factor-α gene expression in a rat model of lung transplantation

The Journal of Heart and Lung Transplantation — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Ex vivo lipid-mediated transbronchial hIL-10 gene transfer attenuated acute inflammation associated with AR, which was related to decreased levels of proinflammatory cytokine gene expression in a rat model of lung transplantation. (Source: The Journal of Heart and Lung Transplantation)

CXC Chemokine Ligand (CXCL) 9 and CXCL10 Are Antagonistic Costimulation Molecules during the Priming of Alloreactive T Cell Effectors.

Journal of Immunology — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Rosenblum JM, Shimoda N, Schenk AD, Zhang H, Kish DD, Keslar K, Farber JM, Fairchild RL Donor Ag-reactive CD4 and CD8 T cell production of IFN-gamma is a principal effector mechanism promoting tissue injury during allograft rejection. The CXCR3-binding chemokines CXCL9 and CXCL10 recruit donor-reactive T cells to the allograft, but their role during the priming of donor-reactive T cells to effector function is unknown. Using a murine model of MHC-mismatched cardiac transplantation, we investigated the influence of CXCL9 and CXCL10 during donor-reactive T cell priming. In allograft recipient spleens, CXCL9 and CXCL10 were expressed as early as 24 h posttransplant and increased with similar kinetics, concurrently with CXCR3 expression on T cells. CXCL9, but not CXCL10, expressio...

Family history of diabetes as a new determinant of insulin sensitivity and secretion in patients who have undergone a simultaneous pancreas-kidney transplant.

Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Immunosuppressive regimen and body mass index were linked with reduced insulin sensitivity after kidney transplant. A family history of diabetes was linked with higher values of insulin secretion and lower insulin sensitivity in patients who underwent a simultaneous pancreas-kidney transplant. PMID: 20199368 [PubMed - in process] (Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation)

Impact of rituximab therapy on response to tetanus toxoid vaccination in kidney-transplant patients.

Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Rituximab impaired the secondary immune response after tetanus toxoid vaccination, but did not abolish it in all patients. PMID: 20199367 [PubMed - in process] (Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation)

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Conversion of cyclosporine to sirolimus before 12 months is associated with marked improvement in renal function and low proteinuria in a South african renal transplant population.

Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Overall, sirolimus therapy was associated with improved estimated glomerular filtration rate, and also an increase in urine protein excretion rates. Maximum benefit was achieved when patients were switched to sirolimus within the first transplant year. PMID: 20199366 [PubMed - in process] (Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation)

Hysterectomy and perioperative morbidity in women who have undergone renal transplantation

American Journal of Obstetrics and Gynecology — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Although patients with renal transplants had perioperative complications, none of these complications led to renal graft loss. Hysterectomy can be considered in these patients when accompanied by diligent postoperative care. (Source: American Journal of Obstetrics and Gynecology)

Recombinant human bone morphogenetic protein-2 on an absorbable collagen sponge with an osteoconductive bulking agent in posterolateral arthrodesis with instrumentation. A prospective randomized trial. Dawson E, Bae HW, Burkus JK, Stambough JL, Glassman SD. J Bone Joint Surg Am. 2009;91(7):1604–13

The Spine Journal — Mon, 01 Mar 2010 00:00:00 +0100

BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) on an absorbable collagen sponge has been shown to be a safe and effective replacement for iliac crest bone graft when used with a threaded fusion device in anterior lumbar interbody arthrodesis. Use of rhBMP-2 on an absorbable collagen sponge in posterolateral lumbar arthrodesis requires the addition of a bulking agent to provide resistance against compression and to serve as an osteoconductive scaffold for new bone formation. (Source: The Spine Journal)

Is a barrier really necessary to prevent radiculitis when using recombinant human bone morphogenetic protein-2 in proximity of nerve roots?

The Spine Journal — Mon, 01 Mar 2010 00:00:00 +0100

We read with interest the article about complications associated with single-level transforaminal lumbar interbody fusion assisted with either autograft iliac crest or recombinant human bone morphogenetic protein-2 absorbed on collagen sponge (rhBMP-2/ACS) (Infuse; Medtronic Sofamor Danek, Memphis, TN, USA) by Rihn et al. . A thin layer of Duraseal (Confluent Surgical, Waltham, MA, USA) was applied posterior to the interbody cage at the annulotomy site and over the exposed dura and nerve root, theoretically providing a watertight seal at the annulotomy site. The rationale behind the use of Duraseal in this fashion was to prevent rhBMP-2 from leaking through the annulotomy into the spinal canal and around the nerve root. According to Dr Vaidya , the authors have shown that the barrier was ...

Reply

The Spine Journal — Mon, 01 Mar 2010 00:00:00 +0100

This study was a retrospective review of the complications associated with transforaminal lumbar interbody fusion (TLIF) using either iliac crest autograft or recombinant human bone morphogenetic protein-2 (rhBMP-2). A few years ago, there was a gradual transition at our institution from the use of iliac crest autograft to the use of rhBMP-2 in the TLIF procedure. This explains the significant difference that existed in the length of clinical follow-up between these two groups, with the iliac crest autograft group having longer clinical follow-up (autograft 35.8 months vs. rhBMP-2 24.4 months, p (Source: The Spine Journal)

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Autologous bone grafting with adjunctive use of acellular dermal matrix for alveolar cleft defects: early outcomes.

The Cleft Palate-Craniofacial Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: These data support the conclusions that using acellular dermal matrix to augment nasal/oral mucosal lining in alveolar bone grafts (1) does not increase mucosal disruption or time to complete healing, (2) prevents postoperative bone graft exposure, and (3) appears to have no negative effect on postoperative bone graft incorporation or canine eruption through the graft site. PMID: 20210633 [PubMed - in process] (Source: The Cleft Palate-Craniofacial Journal)

Autobionics: a new paradigm in regenerative medicine and surgery.

Regenerative Medicine — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Ashrafian H, Darzi A, Athanasiou T The concept of bionics was developed 50 years ago and represented the development of engineering and technology based on natural biological systems. Traditional applications of bionics in healthcare include artificial bionic organs that apply engineering principles to replace or augment physiological functions by integrating electronic, mechanical or electromechanical components to inherent body tissues/organs (we term this as 'exobionics'). Recently, there has been a new wave of bio-inspired treatments that act through the reorganization of the existing biological organs in an individual to enhance physiology. Here, the technology does not replace biological tissue, but rather applies engineering principles to replace or augment physiologica...

Does donor race still make a difference in deceased-donor African-American renal allograft recipients?

American Journal of Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: AA DD renal allograft recipients have equivalent patient but decreased graft survival when transplanted with an AA versus C kidney using current immunosuppression. This may be the result of increased AR, CMV infection, and recurrence/development of FSGS. (Source: American Journal of Surgery)

Outcome of lumbar arthrodesis in patients sixty-five years of age or older. Surgical technique.

The Journal of Bone and Joint Surgery. American volume — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSIONS: This study demonstrates a substantial benefit for patients sixty-five years of age or older with degenerative disc disease who are treated with a single-level lumbar decompression and instrumented arthrodesis, and we conclude that lumbar arthrodesis is a viable and reasonable treatment option for appropriately selected patients sixty-five years of age or older. PMID: 20194346 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

Surgical complications in pediatric and adolescent renal transplantation.

Saudi Journal of Kidney Diseases and Transplantation — Mon, 01 Mar 2010 00:00:00 +0100

Authors: El Atat R, Derouiche A, Guellouz S, Gargah T, Lakhoua R, Chebil M To report the surgical complications among our pediatric and adolescent renal transplants and to compare these results with other reported series in the literature. A total of 50 pediatric and adolescent renal transplants were included in this study. There were 30 boys and 20 girls with a mean age of 13 years (range 6 - 18 years). 70% of patients received their kidneys from living donors. Two patients underwent renal re-transplantation. Among the 52 transplantations, 17 surgical complications were encountered in 15(30%) patients. The incidence of urological and vascular complications was respectively 13.2% and 18.9%. These complications included vesico-ureteral reflux (9.4%), urinary leakage (3.8%), lymphocele (...

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What Do You Need?

Networks Talk — Sun, 28 Feb 2010 00:00:00 +0100

Please drop me a line about what it is that you need in the way of a piece of kit or equipment and which doesn't already exist. Me, well I'd like a kind of laser which could go through tissue and muscle and repair bone, so removing the need for bone grafts, external fixators, or pins and... (Source: Networks Talk)

Effect of combined treatment with FK506, FTY720, and ex vivo graft irradiation in rat small bowel transplantation: Expression of mucosal addressin cell adhesion molecule-1

Pediatric Transplantation — Sun, 28 Feb 2010 00:00:00 +0100

Sugito K, Uekusa S, Kawashima H, Masuko T, Furuya T, Konuma N, Ohashi K, Inoue M, Ikeda T, Koshinaga T. Effect of combined treatment with FK506, FTY720, and ex vivo graft irradiation in rat small bowel transplantation: Expression of mucosal addressin cell adhesion molecule-1.Pediatr Transplantation 2010 © 2010 John Wiley & Sons A/S.Abstract: We studied the effect of the combined treatment with FK506, FTY720, and ex vivo graft irradiation. Five groups of SBT animals were studied on days 3, 5, and 7 after operation (untreated, FK506, FTY720, FK506 + FTY720, FK506 + FTY720 + irradiation). Indirect immunoperoxidase staining was performed against CD4 and MAdCAM-1. The numbers of CD4 positive cells in allografts were also analyzed by flow cytometry. The graft survival was prolonged in all of th...

[Knee arthroplasty revision.]

Der Chirurg — Sat, 27 Feb 2010 00:00:00 +0100

Authors: Scharf HP, Schulze A The number of knee arthroplasties in Germany increases about 6.8% annually. Parallel to the increasing number of primary total knee arthroplasties (TKA) the frequency of TKA revision surgery also goes up and is a growing challenge for orthopedic surgeons. The main reason for revision arthroplasty is aseptic or septic mechanical loosening of the implant. Other reasons are persisting pain, instability or limited range of motion. The aim of preoperative evaluation by examination, x-ray control and serum tests is to understand the mechanism of implant failure. Besides the stable mechanical fixation of the new implant, reconstruction of limb alignment, joint line and balanced extension and flexion gaps must be achieved. Bone defects also need to be reconstructe...

What Do You Need?

Networks Talk — Sat, 27 Feb 2010 00:00:00 +0100

Generation and Accumulation of Immunosuppressive Adenosine by Human CD4+CD25highFOXP3+ Regulatory T Cells [Metabolism]

Journal of Biological Chemistry — Fri, 26 Feb 2010 14:42:02 +0100

This study analyzes the role the adenosinergic pathway plays in suppressive activities of human nTreg. Human CD4+CD25highFOXP3+ Treg overexpress CD39 and CD73, ectonucleotidases sequentially converting ATP into AMP and adenosine, which then binds to A2a receptors on effector T cells, suppressing their functions. CD4+CD39+ and CD4+CD25high T cells express low levels of adenosine deaminase (ADA), the enzyme responsible for adenosine breakdown, and of CD26, a surface-bound glycoprotein associated with ADA. In contrast, T effector cells are enriched in CD26/ADA but express low levels of CD39 and CD73. Inhibitors of ectonucleotidase activity (e.g. ARL67156) and antagonists of the A2a receptor (e.g. ZM241385) blocked Treg-mediated immunosuppression. The inhibition of ADA activity on effector T c...

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Treatment of a severely atrophic maxilla using an immediately loaded, implant-supported fixed prosthesis without the use of bone grafts: A clinical report

Journal of Prosthetic Dentistry — Fri, 26 Feb 2010 14:01:28 +0100

This report describes a clinical approach to using the zygomatic and pterygomaxillary bones to provide additional anchorage for longer implants to support an immediately functional maxillary screw-retained provisional fixed prosthesis. The purpose is to report the problems of patients who have experienced the most severe form of maxillary alveolar resorption and to demonstrate a specific protocol which provides immediately loaded implants without bone grafting. (Source: Journal of Prosthetic Dentistry)

New approach to reduce allograft tissue immunogenicity. Experimental data [ESCVS article - Experimental]

Interactive CardioVascular and Thoracic Surgery — Fri, 26 Feb 2010 01:18:44 +0100

Conclusions: The new devitalizing technology seems effective in decreasing immune response to homologous tissue. It does not affect elasto-mechanic properties and collagenous structure of allografts. The presented data stimulate interest to the anticalcinosis devitalisation technology as an affective tool for improving biocompatibility of allografts. (Source: Interactive CardioVascular and Thoracic Surgery)

Barrier Dysfunction of the Corneal Endothelium in Response to TNF-{alpha}: Role of p38 MAP Kinase [Physiology and Pharmacology]

Investigative Ophthalmology — Fri, 26 Feb 2010 01:05:10 +0100

In this study, the authors investigated the molecular mechanism by which the cytokine induces barrier dysfunction in the corneal endothelium. (Source: Investigative Ophthalmology)

Short-term kidney transplant outcomes among African American recipients do not predict long-term outcomes: donor pair analysis

Clinical Transplantation — Fri, 26 Feb 2010 00:00:00 +0100

In conclusion, early outcomes after kidney transplant did not predict the poor long-term graft survival among AA, and AA recipients appear to be more prone to graft loss because of CAN and late acute rejection. (Source: Clinical Transplantation)

Chronic rejection of a lung transplant is characterized by a profile of specific autoantibodies.

Immunology — Fri, 26 Feb 2010 00:00:00 +0100

Authors: Hagedorn PH, Burton CM, Carlsen J, Steinbrüchel D, Andersen CB, Sahar E, Domany E, Cohen IR, Flyvbjerg H, Iversen M Summary Obliterative bronchiolitis (OB) continues to be the major limitation to long-term survival after lung transplantation. The specific aetiology and pathogenesis of OB are not well understood. To explore the role of autoreactivity in OB, we spotted 751 different self molecules onto glass slides, and used these antigen microarrays to profile 48 human serum samples for immunoglobulin G (IgG) and IgM autoantibodies; 27 patients showed no or mild bronchiolitis obliterans syndrome (BOS; a clinical correlate of OB) and 15 patients showed medium to severe BOS. We now report that these BOS grades could be differentiated by a profile of autoantibodies binding to...

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Candesartan improves blood pressure control and reduces proteinuria in renal transplant recipients: results from SECRET

Nephrology Dialysis Transplantation — Thu, 25 Feb 2010 08:19:39 +0100

Conclusions. SECRET provides insights into the design and conduct of studies in this area and evidence for the utility of candesartan, which showed good safety and tolerability, improved BP control and decreased proteinuria in renal transplant recipients. (Source: Nephrology Dialysis Transplantation)

Effects of pioglitazone on subclinical atherosclerosis and insulin resistance in nondiabetic renal allograft recipients

Nephrology Dialysis Transplantation — Thu, 25 Feb 2010 08:19:39 +0100

Conclusions. These results suggest that pioglitazone treatment reduces the progression of carotid IMT and improves insulin resistance in renal allograft recipients without a history of diabetes. Trial Registration. Clinicaltrials.gov Identifier: NCT00598013 (Source: Nephrology Dialysis Transplantation)

Rapamycin, unlike cyclosporine A, enhances suppressive functions of in vitro-induced CD4+CD25+ Tregs

Nephrology Dialysis Transplantation — Thu, 25 Feb 2010 08:19:38 +0100

Conclusions. Rapamycin, unlike cyclosporine A, does not inhibit the function of CD4+CD25+ Tregs. This implies that rapamycin could contribute to the development of transplantation tolerance by promoting the induction of functional CD4+CD25+ Tregs. Moreover, our results suggest that rapamycin could be combined with functional Tregs. (Source: Nephrology Dialysis Transplantation)

Combined reconstruction for posterolateral rotatory instability with anterior cruciate ligament injuries of the knee

Knee Surgery, Sports Traumatology, Arthroscopy — Thu, 25 Feb 2010 06:47:39 +0100

Abstract If posterolateral rotatory instability (PLRI) injury in patients with a torn anterior cruciate ligament (ACL) is not diagnosed and treated, ACL reconstruction can fail. We retrospectively evaluated the clinical outcome after reconstructions between 2002 and 2007 of both the ACL and the posterolateral corner (PLC) in 44 knees with combined ACL and PLC injuries. The median follow-up duration was 49 months (range, 24–68 months). ACL reconstruction employed autogenous hamstring grafts from the ipsilateral knee. For grade II PLRI, a posterolateral corner sling through the fibular head was placed obliquely from the anteroinferior aspect to the posterosuperior aspect using autogenous hamstring grafts of the contralateral knee. Clinical outcomes were evaluated ...

Evolving Paradigms That Determine the Fate of an Allograft

American Journal of Transplantation — Thu, 25 Feb 2010 00:00:00 +0100

Despite the many advances in both immunological knowledge and the practical application of clinical immunosuppression, the holy grail of indefinite graft survival with immune tolerance in clinical solid organ transplantation remains a distant dream. The tremendous progress made in understanding the molecular and cellular basis of allograft rejection has not been translated into durable modalities that have advanced clinical care and outcomes. Indeed, currently used drugs and treatment protocols, largely directed at inhibiting alloreactive T cells, have not optimally improved allograft survival or function. A shift in emphasis, focusing on under appreciated immune pathways must now be considered to make further improvement. We highlight three areas of recent interest, complement, NK cells a...

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MicroRNAs as Immune Regulators: Implications for Transplantation

American Journal of Transplantation — Thu, 25 Feb 2010 00:00:00 +0100

The explosion of genetic information from recent advances in sequencing technologies, bioinformatics and genomics highlights the importance of understanding mechanisms involved in gene expression and regulation. Over the last decade, it has become clear that small ribonucleic acids (RNAs) are a central component of the cellular gene regulatory network. MicroRNAs (miRNAs) are a family of endogenous, small, noncoding single-stranded RNA of [sim]22 nucleotides in length that act as posttranscriptional gene regulatory elements. MicroRNAs can inhibit de novo protein synthesis by blocking translation through base-pairing with complementary messenger RNA (mRNA) and also suppress translation by promoting degradation of target mRNA. MicroRNAs are intimately involved in a variety of biologic process...

An Unexpected Counter-Regulatory Role of IL-10 in B-Lymphocyte-Mediated Transplantation Tolerance

American Journal of Transplantation — Thu, 25 Feb 2010 00:00:00 +0100

Monoclonal antibody against the CD45RB protein induces stable transplantation tolerance to multiple types of allograft. We have previously established that this tolerance protocol relies on the regulatory function of B lymphocytes for its effect. B lymphocytes have also been reported to participate in immune regulation in several other settings. In most of these systems, the regulatory function of B lymphocytes depends on the production of IL-10. Therefore, we investigated the role of IL-10 in the anti-CD45RB model of B-cell-mediated transplantation tolerance. Surprisingly, using antibody-mediated neutralization of IL-10, IL-10-deficient recipients and adoptive transfer of IL-10-deficient B lymphocytes, we found that IL-10 actually counter-regulates tolerance induced by anti-CD45RB. Furthe...

Beneficial Effect of Rituximab in the Treatment of Recurrent Idiopathic Membranous Nephropathy after Kidney Transplantation.

Clinical Journal of the American Society of Nephrology : CJASN — Thu, 25 Feb 2010 00:00:00 +0100

CONCLUSIONS: Recurrence of iMN is common even in the era of modern immunosuppression. Rituximab seems to be a valuable treatment option for these patients, although lager studies are needed to confirm our data. PMID: 20185599 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

Regenerative Medicine Special Feature: Engineering anatomically shaped human bone grafts [Medical_Sciences]

Proceedings of the National Academy of Sciences — Wed, 24 Feb 2010 05:51:48 +0100

The ability to engineer anatomically correct pieces of viable and functional human bone would have tremendous potential for bone reconstructions... (Source: Proceedings of the National Academy of Sciences)

Regenerative Medicine Special Feature: Engineered vascularized bone grafts [Applied_Biological_Sciences]

Proceedings of the National Academy of Sciences — Wed, 24 Feb 2010 05:51:48 +0100

Clinical protocols utilize bone marrow to seed synthetic and decellularized allogeneic bone grafts for enhancement of scaffold remodeling and fusion.... (Source: Proceedings of the National Academy of Sciences)

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Transplant Pneumonectomy in a Patient With an Acutely Thrombosed Allograft [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:26 +0100

We present a case of an elderly woman who is 3 years postoperative left, single lung transplantation with a history of emphysema that developed extensive infarction of her transplanted lung secondary to thromboembolic disease. She required an allograft pneumonectomy as treatment for this and was eventually discharged on bi-level nasal positive pressure at night and 3 L nasal cannula oxygen during the day. (Source: The Annals of Thoracic Surgery)

Bone sarcomas: Overview of management, with a focus on surgical treatment considerations

Cleveland Clinic Journal of Medicine — Tue, 23 Feb 2010 17:01:32 +0100

Outcomes for patients with bone sarcomas have improved dramatically over the past 40 years, and most bone sarcomas today are treated with surgery and chemotherapy. The most common clinical findings in patients with bone sarcomas are pain and an enlarging bone mass, although pain is not generally a good indicator of malignancy. In general, any patient with a bone mass with indeterminate imaging findings should be referred to an orthopedic oncologist. Bone sarcomas are diagnosed after a biopsy, which is best performed by the surgeon who will be doing the curative resection. Postresection reconstruction of the affected limb is generally done with an allograft-prosthetic composite or a modular metallic prosthetic joint replacement device. Post-therapy follow-up at frequent and regular interval...

Incidence and outcomes of infections in cardiac allograft recipients: A Brazilian perspective

American Journal of Infection Control — Tue, 23 Feb 2010 14:37:31 +0100

To the Editor: Heart transplantation (HT) is an acceptable therapy for end-stage heart disease. Over the past 25 years, more than 80,000 procedures were performed worldwide with overall 5-year survival estimated at 70.0%. In Brazil, HT has been performed since 1984. The long-term results are comparable with those of European and US centers, despite regional and socioeconomic differences and the high proportion of patients with Chagas heart disease (ChD) included in the statistics. Despite many advances in transplantation medicine over this period, infectious complications (IC) influence long-term survival, and their prevention and treatment remain important medical challenges. Several factors appear to influence their incidence, including the degree of immune suppression, coinfection with...

Mandibular Ramus/Coronoid Process Grafts in Maxillofacial Reconstructive Surgery

Journal of Oral and Maxillofacial Surgery — Tue, 23 Feb 2010 14:21:41 +0100

Conclusion: Using both the coronoid process of the mandible and the mandibular ramus as a source for autogenous bone graft can provide sufficient bone in quantity and quality for selected maxillofacial reconstructions. (Source: Journal of Oral and Maxillofacial Surgery)

Transplant Pneumonectomy in a Patient With an Acutely Thrombosed Allograft.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:09:02 +0100

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Can bone scintigraphy predict the final outcome of pasteurized autografts?

Skeletal Radiology — Tue, 23 Feb 2010 07:17:46 +0100

Conclusion Bone scanning can determine the stages of the graft’s rim revascularization and incorporation; however, it cannot detect or predict junction healing or occurrence of complications. Supplementary treatment of unhealed junctions showing either decreased junctional uptake or graft quiescence may be warranted. Otherwise, detection of distant metastasis and early local recurrence remains the main application of Tc99m scanning in the management of bone sarcomas. Content Type Journal ArticleCategory Scientific ArticleDOI 10.1007/s00256-010-0887-3Authors Ahmed Shawky Eid, Ain Shams University Department of Orthopedic Surgery Cairo EgyptDae-Geun Jeon, Korea Cancer Center Hospital Department of Orthopedic Surgery 215-4, Gongneung-dong, Nowon-gu Seoul 139-706 Kor...

Monocortical mandibular bone grafting for reconstruction of alveolar cleft.

The Cleft Palate-Craniofacial Journal — Tue, 23 Feb 2010 00:00:00 +0100

Conclusions: Monocortical mandibular bone grafting appears extremely effective for sufficient bone bridge formation and facilitation of cleft-adjacent teeth eruption. The procedure is advantageous in that the quantity of bone required per unit volume of cleft defect is relatively reduced, and larger clefts can thus be treated. Key Words: cleft lip and palate, alveolar clefts, secondary bone grafting, monocortical mandibular bone graft, bone bridge formation, tooth eruption. PMID: 20180704 [PubMed - as supplied by publisher] (Source: The Cleft Palate-Craniofacial Journal)

Long-term cyclosporine treatment in non transplanted rats and metabolic risk factors of vascular diseases.

Chemico-Biological Interactions — Tue, 23 Feb 2010 00:00:00 +0100

Authors: Böhmer AE, Souza DG, Hansel G, Brum LM, Portela LV, Souza DO Cyclosporine (CsA) is an immunosuppressive agent frequently used in the clinic for prevention of allograft rejection and for the treatment of autoimmune diseases. Despite its desired action on the immune system, CsA treatment may present serious adverse effects, which are masked by the concomitant use of other drugs. The search for effective immunosuppression protocols which does not affect the quality of life of patients is driving research to investigate the CsA involvement in vascular diseases, frequent in patients under immunosuppression. Thus, 45 non transplanted Wistar rats were treated for eight weeks with vehicle or 5 or 15mg/kg CsA (n=15/group) by gavage administration to evaluate the specific influence...

A therapeutic DNA vaccination strategy for autoimmunity and transplantation.

Vaccine — Tue, 23 Feb 2010 00:00:00 +0100

Authors: Li A, Chen J, Hattori M, Franco E, Zuppan C, Ojogho O, Iwaki Y, Escher A De novo autoimmunity induced by an allograft may play a significant role in chronic organ rejection, which remains a major barrier to successful transplantation. Accordingly, immunization with non-polymorphic antigens found in both donor allograft and recipient would be an attractive means to prevent long-term graft rejection, because it would rely on recipient mechanisms of immune homeostasis and could minimize the need to identify appropriate donor polymorphic antigens for induction of graft tolerance. Here we show that intradermal injection of plasmid DNA encoding glutamic acid decarboxylase (GAD) polypeptide, which is synthesized in both pancreatic islet and skin tissue, ameliorated new-onset type 1 d...

Mumps: Not an Innocent Bystander in Solid Organ Transplantation

Medscape Today Headlines — Mon, 22 Feb 2010 21:55:46 +0100

In this video blog, Dr. Ron Shapiro discusses a case report of mumps reinfection leading to allograft failure in a stable renal transplant patient. Medscape Transplantation (Source: Medscape Today Headlines)

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Patient’s Cheek Swelling after Sinus Lift and Bone Graft: Recommendations?

Dental Implants Discussed by Experts — Mon, 22 Feb 2010 11:46:57 +0100

I performed a lateral window with sinus lift and bone graft and placed 3 dental implants. On post-operative recall, the patient presented with a large swelling of the overlying cheek >>Read More and Comment (Source: Dental Implants Discussed by Experts)

Implant Patient’s Cheek Swelling after Sinus Lift and Bone Graft: Recommendations?

Dental Implants Discussed by Experts — Mon, 22 Feb 2010 11:46:57 +0100

Liver transplantation using elderly donors: a risk factor analysis

Clinical Transplantation — Mon, 22 Feb 2010 00:00:00 +0100

Kim DY, Moon J, Island ER, Tekin A, Ganz S, Levi D, Selvaggi G, Nishida S, Tzakis AG. Liver transplantation using elderly donors: a risk factor analysis.Clin Transplant 2010: DOI: 10.1111/j.1399-0012.2010.01222.x. © 2010 John Wiley & Sons A/S.Abstract: Survival after liver transplantation is negatively impacted by use of elderly deceased donors, but excluding them would increase waiting times and waiting list mortality. We reviewed our experience with liver transplantation (LT) utilizing livers from deceased donors 65 yr of age and older to identify those factors that impact graft survival. All adult patients ([ge]18 yr old) who underwent primary LT using deceased donor livers from donors aged [ge]65 yr between February 1995 and November 2003 were included. With multivariate analysis we f...

Selection of massive bone allografts using shape-matching 3-dimensional registration.

Acta Orthopaedica — Mon, 22 Feb 2010 00:00:00 +0100

Authors: Paul L, Docquier PL, Cartiaux O, Cornu O, Delloye C, Banse X Background and purpose Massive bone allografts are used when surgery causes large segmental defects. Shape-matching is the primary criterion for selection of an allograft. The current selection method, based on 2-dimensional template comparison, is inefficient for 3-dimensional complex bones. We have analyzed a 3-dimensional (3-D) registration method to match the anatomy of the allograft with that of the recipient. Methods 3-D CT-based registration was performed to match the shapes of both bones. We used the registration to align the allograft volume onto the recipient's bone. Hemipelvic allograft selection was tested in 10 virtual recipients with a panel of 10 potential allografts, including one from the recipient h...

Radiographic analysis of extracorporeally irradiated autografts

Skeletal Radiology — Sun, 21 Feb 2010 06:53:39 +0100

Conclusion This reconstruction technique is valid for the three methods described; bone stock is retained and, once the graft has healed, it behaves as normal bone. Close radiographic follow-up detects complications early, allowing timely interventions if necessary. Content Type Journal ArticleCategory Scientific ArticleDOI 10.1007/s00256-010-0889-1Authors Bart Poffyn, Ghent University Hospital Department of Orthopaedic Surgery De Pintelaan 185 Ghent 9000 BelgiumGwen Sys, Ghent University Hospital Department of Orthopaedic Surgery De Pintelaan 185 Ghent 9000 BelgiumGeorges Van Maele, Ghent University Department of Public Health Ghent BelgiumLuc Van Hoorebeke, Ghent University Department of Subatomic and Radiation Physics Ghent BelgiumRamses Forsyth, Ghent University ...

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Distress and alexithymia in lung recipients - psychosocial strains and associations with chronic allograft dysfunction.

Swiss Medical Weekly — Sun, 21 Feb 2010 00:00:00 +0100

CONCLUSIONS: Lung transplants go hand-in-hand with increased alexithymia and psychological distress. In addition, psychological distress may contribute to the development of BOS. This association underlines the importance of psychosocial support after lung transplantation. PMID: 20175005 [PubMed - as supplied by publisher] (Source: Swiss Medical Weekly)

BioMimetic Therapeutics Completes Submission Of PMA Application For FDA Approval Of Augment™ Bone Graft

Health News from Medical News Today — Fri, 19 Feb 2010 01:00:00 +0100

BioMimetic Therapeutics, Inc. (NASDAQ: BMTI) today announced it has submitted the third and final module of its Premarket Approval (PMA) application for marketing of Augment™ Bone Graft in the U.S. This final module, containing a comprehensive review of the clinical data related to Augment, completes the PMA application to the FDA. The Company previously announced the filing of both the pre-clinical pharmacology/toxicology and quality/manufacturing modules with the FDA in June of 2009... (Source: Health News from Medical News Today)

BioMimetic Therapeutics Completes Submission Of PMA Application For FDA Approval Of Augment™ Bone Graft

Bones / Orthopaedics News From Medical News Today — Fri, 19 Feb 2010 01:00:00 +0100

BioMimetic Therapeutics, Inc. (NASDAQ: BMTI) today announced it has submitted the third and final module of its Premarket Approval (PMA) application for marketing of Augment™ Bone Graft in the U.S. This final module, containing a comprehensive review of the clinical data related to Augment, completes the PMA application to the FDA... (Source: Bones / Orthopaedics News From Medical News Today)

Effect of Alveolar Bone-Grafting on Nasal Morphology, Symmetry and Nostril Shape of Unilateral Cleft Lip and Palate Patients.

The Cleft Palate-Craniofacial Journal — Fri, 19 Feb 2010 00:00:00 +0100

Conclusion: Under the conditions of this study, mixed-dentition ABG appears to have no significant long-term effect on nasal morphology, symmetry or nostril shape. KEY WORDS: unilateral cleft lip and palate, alveolar bone grafting, nasal morphology, nasal symmetry, nostril shape, stereophotogrammetry. PMID: 20170388 [PubMed - as supplied by publisher] (Source: The Cleft Palate-Craniofacial Journal)

Orthodontic Treatment with Tooth Transplantation for Patients with Cleft Lip and Palate.

The Cleft Palate-Craniofacial Journal — Fri, 19 Feb 2010 00:00:00 +0100

This article describes the use of tooth transplantation and orthodontic tooth alignment in patients with cleft lip and palate (CLP). Due to bone defects in the maxilla, the congenital absence of teeth, especially lateral incisors, is frequently observed in patients with CLP. As compared to orthodontic space closure or prosthodontic treatment, tooth transplantation has several advantages, including induction of alveolar growth potential during adolescence. In this study, 2 CLP patients with congenitally missing teeth were treated successfully by tooth transplantation followed by orthodontic treatment. Our results show that tooth transplantation is a viable alternative to other treatments for patients with CLP accompanied by congenitally missing teeth. KEY WORDS: tooth transplantation, cleft...

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The management of patella infera in current practice

European Journal of Orthopaedic Surgery & Traumatology — Thu, 18 Feb 2010 17:55:01 +0100

Abstract Patella infera described by Caton et al.The measurement is made in 1982 is an accompanying symptom in certain knee affections secondary to the abnormal situation of the patella. The measurement is made on the X-ray with sagittal view after measuring the patellar height, using the original technique described by the author, when the ratio between the articular surface of the patella and the distance form the patellar tip to the tibial tubercle. Indications of surgery may be when this ration is inferior or equals 0.6. The origin of the patella infera can be mechanical or inflammatory. The operative technique addresses the etiology. In current practice, the patellar height and the patellar tendon length may be evaluated using a sagittal section MRI. In the authors’...

Cytomegalovirus Pneumonitis is a Risk for Bronchiolitis Obliterans Syndrome in Lung Transplantation.

American Journal of Respiratory and Critical Care Medicine — Thu, 18 Feb 2010 00:00:00 +0100

CONCLUSIONS: Cytomegalovirus pneumonitis affects over 20% of lung transplant recipients. Despite treatment, it increases the risk for bronchiolitis obliterans syndrome and death. More effective preventative strategies for cytomegalovirus pneumonitis are needed to improve long-term outcomes after lung transplantation. PMID: 20167845 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)

Do locking plates have a role in orthopaedic oncological reconstruction

Archives of Orthopaedic and Trauma Surgery — Wed, 17 Feb 2010 18:27:53 +0100

Conclusion Use of locking plate does not ensure the bony union at the site of reconstruction but it expedite it and allow early mobilization of joints and weight bearing particularly in Indian patients with late presentations. Careful selection of patients and proper preoperative planning including length of resection are essential for optimal outcomes and to minimize complications. Reconstruction should be supported by cortico-cancellous autograft/allograft for stabilization and union at junction of host and autograft/allograft bone and should be given adequate protection. Vicryl mesh helps in containing the morcellized grafts along the long axis of reconstruction. Content Type Journal ArticleCategory Orthopaedic SurgeryDOI 10.1007/s00402-010-1066-7Authors Shish...

Invasive filamentous fungal infections associated with renal transplant tourism

Transplant Infectious Disease — Wed, 17 Feb 2010 00:00:00 +0100

S. Shoham, F. Hinestrosa, J. Moore Jr, S. O'Donnell, M. Ruiz, J. Light. Invasive filamentous fungal infections associated with renal transplant tourism.Transpl Infect Dis 2010. All rights reservedAbstract: 'Transplant tourism,' the practice of traveling abroad to acquire an organ, has emerged as an issue in kidney transplantation. We treated a patient who developed invasive aspergillosis of the allograft vascular anastomosis after receiving a kidney transplant in Pakistan, prompting us to review the literature of invasive mycoses among commercial organ transplant recipients. We reviewed all published cases of infections in solid organ transplant recipients who bought their organs abroad and analyzed these reports for invasive fungal infections. Including the new case reported here, 19 case...

Ischemic Injury Enhances Dendritic Cell Immunogenicity via TLR4 and NF-{kappa}B Activation.

Journal of Immunology — Wed, 17 Feb 2010 00:00:00 +0100

In this study, we sought to investigate the effect of ischemia on DC activity in vitro. Following induction of ischemia, bone marrow-derived DCs were shown to augment allogeneic T cell proliferation as well as the IFN-gamma response. Isc DCs produced greater levels of IL-6, and isc insult was concurrent with NF-kappaB activation. TLR4 ligation was also shown to occur in isc DCs, most likely in response to the endogenous ligand heat shock protein 70, which was found to be elevated in DCs following isc injury, and lack of TLR4 abrogated the observed effects of isc DCs. As compared with control DCs, isc DCs injected into the footpads of mice demonstrated enhanced migration, which was concomitant with increased recipient T cell activity. Moreover, isc DCs underwent a greater degree of apoptosi...

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Polycaprolactone/hydroxyapatite composite scaffolds: Preparation, characterization, and in vitro and in vivo biological responses of human primary bone cells.

Biomed Res — Wed, 17 Feb 2010 00:00:00 +0100

In this study, PCL scaffolds incorporating hydroxyapatite (HAp) particles were fabricated by combined solvent casting and particulate leaching techniques. The average pore dimension was in the range of about 480-500 mum. The porosity, water absorption, and compressive modulus of the scaffold were evaluated. The responses of primary bone cells cultured on the PCL and PCL/HAp scaffolds were examined both in vitro and invivo. In comparison with the cells grown on the PCL scaffold, those cultured on the PCL/HAp counterpart positively expressed the markers of osteogenic differentiation. Cells increased the mRNA expressions of type I collagen and osteocalcin on day 10 and demonstrated a significant increase in calcium deposition. In coherence with the in vitro appearance, histomorphometric analy...

The outcome for secondary alveolar bone grafting in the South West UK region post CSAG.

The Cleft Palate-Craniofacial Journal — Wed, 17 Feb 2010 00:00:00 +0100

Conclusion: The radiographic outcome for alveolar bone grafting has improved with centralization. A small number of patients are being grafted after the ideal chronological age and this needs to be addressed throughout the region. The Kindelan assessment provides a reliable method of early assessment for alveolar bone grafting. Key words: secondary alveolar bone graft, outcome. PMID: 20166811 [PubMed - as supplied by publisher] (Source: The Cleft Palate-Craniofacial Journal)

Clinical application of locked plating system in children. An orthopaedic view

International Orthopaedics — Tue, 16 Feb 2010 18:05:28 +0100

Abstract In recent years, the locked plating system has gained favour in the treatment of certain fractures in adults; however, there is not much information regarding its use in children. We think there could be some advantages and applications such as: an alternative to external fixation, the bridge plating technique, unicortical screws, removal of hardware, metadiaphyseal fractures, periarticular fractures, poor quality bone, and allograft fixation. However, there are some disadvantages to keep in mind and the final decision for using it should be based on the osteosynthesis method principle the surgeon would like to apply. In this review article we discuss the up-to-date possible clinical applications and issues of this system. Content Type Journal ArticleCategory ...

The involvement of alpha-melanocyte-stimulating hormone in the hyperpigmentation of human skin autografts

Burns : Journal of the International Society for Burn Injuries — Tue, 16 Feb 2010 14:02:15 +0100

Conclusions: These results indicate that the function of melanogenesis, transfer of melanin in melanocytes, was dramatically enhanced in skin autografts by α-MSH. The over-expression of α-MSH may play an important role in the hyperpigmentation process of skin autografts and provide a novel mechanism of this process. (Source: Burns : Journal of the International Society for Burn Injuries)

Interleukin-10: A Multi-Faceted Agent of Pregnancy

American Journal of Reproductive Immunology — Tue, 16 Feb 2010 00:00:00 +0100

Citation Thaxton JE, Sharma S. Interleukin-10: a multi-faceted agent of pregnancy. Am J Reprod Immunol 2010 It is widely accepted that pregnancy constitutes a unique developmental event. Unprecedented intrauterine actions of angiogenesis, immunity, and neuroendocrine regulation are juxtaposed to mechanisms of senescence that enable fetal growth and protection. The suppressive and regulatory factors that facilitate healthy pregnancy are under investigation. In non-pregnant systems of infection and inflammation, the cytokine interleukin-10 (IL-10) has been widely investigated because of its potential as a key immunosuppressant in response to a multitude of inflammatory events. In the context of pregnancy, IL-10 levels increase markedly in women during early pregnancy and remain elevated well...

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Augmentation of surgical angiogenesis in vascularized bone allotransplants with host-derived a/v bundle implantation, fibroblast growth factor-2, and vascular endothelial growth factor administration

Journal of Orthopaedic Research — Tue, 16 Feb 2010 00:00:00 +0100

In this study, we examine the role of angiogenic cytokine delivery with biodegradable microspheres to enhance this process. Microsurgical femoral allotransplantation was performed from Dark Agouti to Piebald Virol Glaxo rats. Poly(D,L-lactide-co-glycolide) microspheres loaded with buffer, basic fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF), or both, were inserted intramedullarly along with a recipient-derived arteriovenous (a/v) bundle. FK-506 was administered daily for 14 days, then discontinued. At 28 days, bone blood flow was measured using hydrogen washout. Microangiography, histologic, and histomorphometric analyses were performed. Capillary density was greater in the FGF+VEGF group (35.1%) than control (13.9%) (p < 0.05), and a linear trend was found from ...

Anterior cruciate ligament reconstruction with synthetic grafts. A review of literature

International Orthopaedics — Mon, 15 Feb 2010 17:58:48 +0100

Abstract Anterior cruciate ligament (ACL) rupture, one of the most common knee injuries in sports, results in anteroposterior laxity, which often leads to an unstable knee. Traditional ACL reconstruction is performed with autograft; disadvantages of this technique are donor site morbidity and a long rehabilitation period. In the 1980s, artificial ligaments became an attractive alternative to biological grafts. The initial enthusiasm surrounding their introduction stemmed from their lack of donor morbidity, their abundant supply and significant strength, immediate loading and reduced postoperative rehabilitation. Synthetic grafts made of different materials such as carbon fibers, polypropylene, Dacron and polyester have been utilised either as a prosthesis or as an augmenta...

Noninvasive evaluation of renal allograft fibrosis by transient elastography – a pilot study

Transplant International — Mon, 15 Feb 2010 00:00:00 +0100

This study evaluates the feasibility of TE for the assessment of renal allograft fibrosis. Fifty-seven patients underwent TE by the FibroScan® device. Biopsies were performed in 20 patients. Measurement of parenchymal stiffness by TE was successful in 55 of 57 patients (96.5%). Stiffness was significantly correlated to the extent of interstitial fibrosis (Pearson r: 0.67, P: 0.002, R2: 0.45) and inversely related to estimated glomerular filtration rate (eGFR) (Pearson r: [minus]0.47, P: 0.0003, R2: 0.22). Stiffness values of patients with an eGFR >50 ml/min were significantly lower than in patients with an eGFR [le]50 ml/min (22.2 ± 11.0 vs. 37.1 ± 14.2 kPa, P: 0.0005). The stiffness values of CAI Banff grades 0[ndash]1 differed significantly from grade 2 (P: 0.008) and grade 3 (P: 0.04...

Results of cryopreserved parathyroid autografts: A retrospective multicenter study

Surgery — Mon, 15 Feb 2010 00:00:00 +0100

Conclusion: The reimplantation rate is low, and the functionality of CPAT is less than those published by experienced centers. Logistical and technical problems occurring in less experienced centers are probably the main reasons for nonfunctioning implants. Considering the results of this study, we suggest that cryopreservation of parathyroid glands should be abandoned when not performed in very large experimented centers, that CPAT should be used only for patients with hyperplasic parathyroid tissue, and that tissue samples should be systematically destroyed when patients do not have hypoparathyroidism or after 1 year of storage. (Source: Surgery)

RTI Biologics Donates Matrix HD™ For Surgeries In Haiti

Health News from Medical News Today — Fri, 12 Feb 2010 20:00:00 +0100

RTI Biologics Inc. (RTI) (Nasdaq: RTIX), the Florida-based processor of orthopedic, dental, hernia and other biologic implants, has donated Matrix HD™ sterilized dermis allografts to use in limb salvage procedures for victims of the recent natural disasters in Haiti. A group of surgeons from Barry University and Mercy Hospital in Miami, Fla., will leave this week to treat patients in Haiti, many of whom will need the Matrix HD™ allografts to save their arms or legs from amputation... (Source: Health News from Medical News Today)

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RTI Biologics Donates Matrix HD™ For Surgeries In Haiti

Medical Devices News From Medical News Today — Fri, 12 Feb 2010 20:00:00 +0100

RTI Biologics Inc. (RTI) (Nasdaq: RTIX), the Florida-based processor of orthopedic, dental, hernia and other biologic implants, has donated Matrix HD™ sterilized dermis allografts to use in limb salvage procedures for victims of the recent natural disasters in Haiti. A group of surgeons from Barry University and Mercy Hospital in Miami, Fla... (Source: Medical Devices News From Medical News Today)

A study on strategies for improving growth and body composition after renal transplantation

Pediatric Nephrology — Fri, 12 Feb 2010 07:08:50 +0100

Abstract Allograft function and metabolic effects of four treatment regimens, namely, methylprednisone (MP) standard dose (MP-STD), deflazacort (DFZ), MP-late steroid withdrawal (MP-LSW), and MP-very low dose (MP-VLD), were evaluated in prepubertal patients. MP was decreased by month 4 post-transplantation to 0.2 mg/kg/day in MP-STD and DFZ patients and to <0.1 mg/kg/day in MP-LSW and MP-VLD patients. Starting in month 16 post-transplant, MP was switched to DFZ in the DFZ group and totally withdrawn in the MP-LSW group. Creatinine clearance diminished in the MP-STD and MP-LSW groups from 77 ± 6 to 63 ± 6 ml/min/1.73 m2and from 103 ± 5 to 78 ± 3 ml/min/1.73 m2, respectively (p < 0.01 and p < 0.001, respectively). H...

Disease-specific clinical problems associated with the subchondral bone

Knee Surgery, Sports Traumatology, Arthroscopy — Fri, 12 Feb 2010 07:06:11 +0100

Abstract The subchondral bone is involved in a variety of diseases affecting both the articular cartilage and bone. Osteochondral defects in distinct locations and of variable sizes are the final results of different etiologies. These include traumatic osteochondral defects, osteochondritis dissecans, osteonecrosis, and osteoarthritis. Traumatic osteochondral defects are caused by osteochondral fractures, separating an osteochondral fragment that includes articular cartilage and both subchondral and trabecular bone from the joint surface. In osteochondritis dissecans, the disease originates in the subchondral bone and secondarily affects the articular cartilage. Location, stage, size, and depth of osteochondral lesions play a role in the treatment of traumatic osteochondra...

Gene Expression Profiling of the Donor Kidney at the Time of Transplantation Predicts Clinical Outcomes 2 Years after Transplantation.

Human Immunology — Fri, 12 Feb 2010 00:00:00 +0100

Authors: Bodonyi-Kovacs G, Putheti P, Marino M, Avihingsanon Y, Uknis ME, Monaco AP, Strom TB, Pavlakis M We have previously demonstrated that biomarkers of inflammation and immune activity detected within intra-operative renal transplant allograft biopsies are linked to adverse short term post transplant clinical outcomes. Now we provide a post hoc analysis of our earlier data in the light of longer clinical follow up. Seventy five consecutively performed renal allografts were analyzed for gene expression of proinflammatory molecules, inflammation-induced adhesion molecules and anti-apoptotic genes expressed 15 minutes after vascular reperfusion to determine whether this analysis can aid in predicting long term quality of renal function, proteinuria, graft loss, and death-censored gra...

Shaping of iNKT cell repertoire after unrelated cord blood transplantation.

Clinical Immunology — Fri, 12 Feb 2010 00:00:00 +0100

In this report, we analyze the recovery of iNKT cells after unrelated cord blood transplantation (UCBT) of adult patients with high-risk acute myeloid leukemia. We found that iNKT cells were reconstituted within 1 month after UCBT, at the same time as NK cells and before conventional T cells. These iNKT cells displayed a unique primed/central memory CD4(+)CD45RO(+)CCR7(+)CD62L(+) phenotype soon after the transplant. Interestingly, the functional competence of these cells was poor, except for their high GM-CSF production capacity. However, this post-graft functionally immature state was transient and all of the patients tested had fully functional iNKT cells 3 to 6 months post-UCBT and high cytolytic capacity for destroying primary CD1d(+) myeloid blast cells. Our results raise the possibil...

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Regulatory T cells in transplantation: does extracellular adenosine triphosphate metabolism through CD39 play a crucial role?

Transplantation Reviews — Fri, 12 Feb 2010 00:00:00 +0100

Abstract: Despite tremendous improvements in short-term renal allograft survival, many patients still have chronic rejection or side effects of nonspecific immunosuppression. The discovery of Foxp3+ regulatory T cells (Tregs) has revolutionized the concepts in immunoregulation and offers perspectives for overcoming rejection. Recently, a subset of Foxp3+CD39+ effector/memory-like Tregs (TREM) was identified. The role of CD39+ Tregs in immunoregulation is supported by the occurrence of alopecia areata and experimental autoimmune encephalomyelitis in CD39-deficient mice and by the failure of CD39− Tregs to suppress contact hypersensitivity. In humans, CD39 polymorphisms have been associated with diabetes and nephropathy, and multiple sclerosis patients have reduced numbers of blood CD39+ T...

Donor statin treatment protects against severe acute graft-versus-host disease after related allogeneic hematopoietic cell transplantation

Blood — Thu, 11 Feb 2010 17:01:45 +0100

We retrospectively analyzed outcomes among 567 patients with hematologic malignancies who had hematopoietic cell transplantation from human leukocyte antigen-identical sibling donors between 2001 and 2007 for a correlation between statin use and risk of graft-versus-host disease (GVHD). Compared with allografts where neither the donor nor recipient was treated with a statin at the time of transplantation (n = 464), statin use by the donor and not the recipient (n = 75) was associated with a decreased risk of grade 3-4 acute GVHD (multivariate hazard ratio, 0.28; 95% confidence interval, 0.1-0.9). Statin use by both donor and recipient (n = 12) was suggestively associated with a decreased risk of grade 3 or 4 acute GVHD (multivariate hazard ratio, 0.00; 95% confidence interval, undefined), ...

Transient Epstein-Barr virus reactivation in CD3 monoclonal antibody-treated patients

Blood — Thu, 11 Feb 2010 17:01:44 +0100

Here we report a unique situation in which an early and synchronized Epstein-Barr virus (EBV) reactivation was induced by a 6-day course of treatment with a humanized CD3-specific monoclonal antibody in patients with recent onset of type 1 diabetes. The virologic and immunologic analysis demonstrated that this reactivation was transient, self-limited, and isolated, associated with the rapid advent of an EBV-specific T-cell response. The anti-CD3 antibody administration induced short-lasting immunosuppression and minor yet clear-cut signs of T-cell activation that preceded viral reactivation. Early posttransplant monitoring of renal and islet allograft recipients showed that no comparable phenomenon was observed after the administration of full-dose immunosuppressive therapy. This EBV react...

Augmentation technique for partial ACL ruptures using semitendinosus tendon in the over-the-top position

Knee Surgery, Sports Traumatology, Arthroscopy — Thu, 11 Feb 2010 11:46:38 +0100

Abstract The aim of this study is to present a surgical augmentation technique for partial ACL ruptures in which an isolated, autologous, double-bundle semitendinosus tendon graft is passed over the top of the femur, thus fully preserving the still-intact fibers of the ligament remnant. Between 1992 and 2006, 24 patients underwent ACL semitendinosus autograft reconstruction and were followed up for at least 2 years. The median follow-up was 6.2 years (2–15.6). At the last follow-up examination, the patients were evaluated using the International Knee Documentation Committee scale. Subjective and functional parameters were assessed using the Tegner activity scale and the Lysholm scale. Instrumental evaluation was carried out using the KT-1000 instrument. Sixteen ...