Journal articles on the topic 'Cancellous bone defects'

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1

Dorea, H. C., H. D. Cantwell, R. Read, L. Armbrust, R. Pool, J. K. Roush, C. Boyle, and R. M. McLaughlin. "Evaluation of healing in feline femoral defects filled with cancellous autograft, cancellous allograft or Bioglass." Veterinary and Comparative Orthopaedics and Traumatology 18, no. 03 (July 2005): 157–68. http://dx.doi.org/10.1055/s-0038-1632947.

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SummaryCancellous bone grafting is a widely accepted technique in human and veterinary orthopaedic surgery. However, the use of autogenous bone graft is limited by the additional surgical time required to harvest the graft, the morbidity associated with the donor site, and the limited availability of cancellous bone, especially in feline patients. Various allografts and bone graft substitutes are available commercially but have not been fully evaluated for efficacy in the cat. The purpose of this study was to compare the incorporation of autogenous and allogenous cancellous bone graft and Bioglass®, a synthetic bone graft substitute, in femoral defects in cats. Four (4.0 mm diameter) defects were created in the lateral diaphyseal cortex of the left femur with an orthopaedic drill. In each femur, one of the cortical defects was filled with autogenous cancellous graft (harvested from the tibia), one was filled with allogenic cancellous graft, and one was filled with Bioglass. The fourth defect remained unfilled. Graft incorporation within the femoral defects was evaluated by radiographic evaluation every two weeks. Six weeks after the grafting procedure, the cats were euthanatized and high detailed radiography, dual energy X-ray absorptiometry (DEXA), histopathology and histomorphometry of the defects were performed. Satisfactory bone healing was observed within all of the defects.
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2

Díaz-Bertrana, C., P. Lafuente, P. Fontecha, I. Durall, and J. Franch. "Beta-tricalcium phosphate as a synthetic cancellous bone graft in veterinary orthopaedics." Veterinary and Comparative Orthopaedics and Traumatology 19, no. 04 (October 2006): 196–204. http://dx.doi.org/10.1055/s-0038-1633001.

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SummaryThe clinical use of β-tricalcium phosphate (β-TCP) as a synthetic cancellous bone graft in veterinary orthopaedics is herein reported. The retrospective study was based on 13 clinical cases belonging to 11 dogs and one cat. The weights of the dogs ranged from 3.4 to 48 kg. One female cat weighing 3.5 kg completed the study. The clinical cases were six arthrodeses (four carpal, two tarsal), one hypertrophic non-union (femur), one atrophic non-union (metacarpal bones) and five long-bone fractures (two femurs, one tibia, two radii) possessing subcritical-sized bone defects. The β-TCP used in this study was presented as irregular interconnected-porous granules and was placed in the bone defects after mixing it with fresh blood. Bone healing was achieved at between eight and 12 weeks in all clinical cases except for the case of the chronic atrophic nonunion in which only one of the four metacarpal bones healed. In the 12 successful cases, the bone defect grafted with β-TCP showed a radiological bone ingrowth of 100% (10 cases), 90% (one case) and 75% (one case). The complete lack of tissue adverse effects in our series, and the good defect healing, allows us to hypothesise that β-TCP can be successfully used as a synthetic bone graft in bone defects with good local biological conditions and where osteoconduction is especially needed for assuring a structural scaffold for newbone ingrowth. When, in addition to osteoconduction, osteoinduction and osteogenesis are necessary for defect healing, the fresh cancellous bone graft remains the gold standard in veterinary orthopaedics.
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3

Verboket, René D., Tanja Irrle, Yannic Busche, Alexander Schaible, Katrin Schröder, Jan C. Brune, Ingo Marzi, Christoph Nau, and Dirk Henrich. "Fibrous Demineralized Bone Matrix (DBM) Improves Bone Marrow Mononuclear Cell (BMC)-Supported Bone Healing in Large Femoral Bone Defects in Rats." Cells 10, no. 5 (May 19, 2021): 1249. http://dx.doi.org/10.3390/cells10051249.

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Regeneration of large bone defects is a major objective in trauma surgery. Bone marrow mononuclear cell (BMC)-supported bone healing was shown to be efficient after immobilization on a scaffold. We hypothesized that fibrous demineralized bone matrix (DBM) in various forms with BMCs is superior to granular DBM. A total of 65 male SD rats were assigned to five treatment groups: syngenic cancellous bone (SCB), fibrous demineralized bone matrix (f-DBM), fibrous demineralized bone matrix densely packed (f-DBM 120%), DBM granules (GDBM) and DBM granules 5% calcium phosphate (GDBM5%Ca2+). BMCs from donor rats were combined with different scaffolds and placed into 5 mm femoral bone defects. After 8 weeks, bone mineral density (BMD), biomechanical stability and histology were assessed. Similar biomechanical properties of f-DBM and SCB defects were observed. Similar bone and cartilage formation was found in all groups, but a significantly bigger residual defect size was found in GDBM. High bone healing scores were found in f-DBM (25) and SCB (25). The application of DBM in fiber form combined with the application of BMCs shows promising results comparable to the gold standard, syngenic cancellous bone. Denser packing of fibers or higher amount of calcium phosphate has no positive effect.
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Schneppendahl, J., T. T. Lögters, M. Sager, M. Wild, M. Hakimi, J. Windolf, J. P. Grassmann, and P. Jungbluth. "Treatment of a diaphyseal long-bone defect with autologous bone grafts and platelet-rich plasma in a rabbit model." Veterinary and Comparative Orthopaedics and Traumatology 28, no. 03 (2015): 164–71. http://dx.doi.org/10.3415/vcot-14-05-0079.

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Summary Introduction: Large bone defects are a therapeutic challenge to surgeons and are often associated with a high morbidity. The use of autologous cancellous bone graft represents an essential therapeutic option and is considered the gold standard. However, the use of platelet-rich plasma (PRP) for improving bone defect healing has been discussed controversially. The aim of this study was to evaluate the treatment of a diaphyseal long-bone defect in a rabbit model with a combination of PRP and autologous cancellous bone. Material and methods: A monocortical long-bone defect in the radial diaphysis of 24 New Zealand white rabbits was filled either with autologous cancellous graft as a control group or with autologous cancellous graft combined with autologous PRP. Histomorphometrical and radiological analysis as well as quantification of platelets and growth factors were performed. The animals were euthanatized after three and six weeks according to the study arms. Results: A significant improvement in bone healing was observed histomorphometrically in the PRP group in the central area of the defect zone (p <0.01) as well as the cortical defect zone (p <0.01). The radiological findings were in accordance with the histomorphometrical results. Comparing native blood and PRP, an enrichment of growth factors and platelets was detectable in the PRP. Conclusion: Within this animal study, the combination of PRP and autologous cancellous bone grafts improved bone healing significantly compared to the sole application of autologous bone. Therefore, further efforts should be initiated to establish the composite of PRP and autologous bone for bone healing disorders in clinical use.
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5

Zheng, Chong, Hai-yang Ma, Yin-qiao Du, Jing-yang Sun, Ji-wei Luo, Dong-bin Qu, and Yong-gang Zhou. "Finite Element Assessment of the Screw and Cement Technique in Total Knee Arthroplasty." BioMed Research International 2020 (October 15, 2020): 1–7. http://dx.doi.org/10.1155/2020/3718705.

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Background. The screw and cement technique is a convenient method used to rebuild medial tibial plateau defects in primary total knee arthroplasty (TKA). The objective of this study was to perform a finite element assessment to determine the effect of different numbers of screws on the stability of TKA and to determine whether differences exist between two different insertion angles. Method. Six tibial finite element models with defects filled with screws and cement and one model with defects filled only with cement were generated. Contact stresses on the surface of cancellous bone in different areas were calculated. Results. Compared to the cement-only technique, the stress on the border of cancellous bone and bone cement decreased by 10% using the screw and cement technique. For bone defects with a 12% defect area and a 12-mm defect depth, the use of 1 screw achieved the greatest stability; for those with a 15% defect area and a 20-mm defect depth, 2 screws achieved the greatest stability. Conclusions. (1) The screw and cement technique is superior to the bone cement-only technique. For tibial defects in which the defect area comprises a large percentage but the depth is less than 5 mm, the screw and cement technique is recommended. (2) Vertical screws can achieve better stability than oblique screws. (3) Screws should be used in moderation for different defects; more is not always better.
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Murata, Koichi, Shunsuke Fujibayashi, Bungo Otsuki, Takayoshi Shimizu, and Shuichi Matsuda. "Repair of Iliac Crest Defects with a Hydroxyapatite/Collagen Composite." Asian Spine Journal 14, no. 6 (December 31, 2020): 808–13. http://dx.doi.org/10.31616/asj.2019.0310.

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Study Design: Retrospective study.Purpose: This study aimed to assess the effect of refilling with hydroxyapatite/collagen (HAp/Col) composite on an iliac crest defect after spinal fusion.Overview of Literature: The use of iliac crest bone graft has been the gold standard in spinal fusion for a long time because of its biological and non-immunologic properties. Few reports have addressed how bone defects recover after iliac crest bone harvest following spinal fusion.Methods: Cancellous bone was collected from the anterior iliac crest during lateral interbody fusion (LIF), and the bone void of the ilium was refilled with a porous HAp/Col composite. We assessed bone recovery using computed tomography (CT). From the 74 patients who underwent LIF between January 2015 and December 2016, we included 49 patients whose iliac crest could be evaluated using CT at 3 months and 1 year after the surgery.Results: Bone defects decreased in a time-dependent manner after the surgery. Cortical closure was observed in 28.5% of the cases 3 months after the surgery; at 1 year postoperatively, 95.9% of the patients had cortical closure. Complete repair of the cancellous bone was achieved in 57.1% of the patients at 3 months after the surgery and in 95.9% at 1 year after the surgery. There were no significant hematomas, infections, iliac crest fractures, or soft tissue herniation.Conclusions: Radiographic recovery of cortical and cancellous bone defects was achieved with high probability via refilling with HAp/Col composite over the 1-year period.
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7

Dogan, E., and Z. Okumus. "Cuttlebone used as a bone xenograft in bone healing." Veterinární Medicína 59, No. 5 (July 15, 2014): 254–60. http://dx.doi.org/10.17221/7519-vetmed.

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This study was conducted to examine the potential of cuttlebone xenograft in the healing of bone using radiography and histology for a period of 24 weeks. One hundred and five New Zealand male rabbits with radius defects in the metaphyseal region were divided into five groups treated with cuttlebone, demineralized bone matrix, bovine cancellous graft, and tricalcium phosphate. The control was no treatment. Clinical, radiological, biochemical and histological evaluations were made 1, 2, 3, 4, 6, 12, and 24 weeks after surgery. Physiological measurements (body temperature, heart rate, and respiratory rate) were not affected by the treatments. The radiological score was greatest in the demineralised bone matrix and tricalcium phosphate groups (score of 8), followed by the bovine cancellous graft (score of 6), cuttlebone (score of 6), and control groups (score of 5). The histological score was greatest in the tricalcium phosphate group (score of 55), followed by the cuttlebone (score of 50), bovine cancellous graft (score of 48), demineralized bone matrix (score of 44) and control groups (score of 42). Oxidative enzyme activities were not different across the treatments. The lack of reinfection and infection responses and faster bone union highlight the potential of cuttlebone xenograft in orthopaedic surgery. &nbsp;
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8

Borghetti, Alain, Giséle Novakovitch, Francis Louise, Didier Simeone, and Jean Fourel. "Cryopreserved Cancellous Bone Allograft in Periodontal Intraosseous Defects." Journal of Periodontology 64, no. 2 (February 1993): 128–32. http://dx.doi.org/10.1902/jop.1993.64.2.128.

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9

Singh, Luthra Jatinder, and Salim A. L. Habsi. "Biological Reconstruction of Varus Deformity in Primary Total Knee Replacement Using Bone Graft and Description of a New Technique." Journal of Orthopaedics, Trauma and Rehabilitation 25, no. 1 (June 1, 2018): 69–72. http://dx.doi.org/10.1016/j.jotr.2017.11.001.

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Peripheral bony defects of the tibia can be seen in patients with osteoarthritis of the knee. These defects must be corrected at the time of total knee replacement to ensure correct placement and alignment of the components. We describe a new technique for correcting large tibial defect by using bone graft, where the uncontained defects were converted to contained defects using bone graft and the contained defect was impacted with cancellous bone. Between 2006 and 2010, 48 cases of primary total knee arthroplasty were reconstructed using autologous bone graft. Of 48 cases, five cases had large tibial defect and were treated with the new technique. Collapse was seen in one knee at 5 months postoperative. The rest of the patients showed improvement in total knee score and limb alignment. We now use this technique to treat large tibial defect during total knee replacement.
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10

Aspenberg, P., J. Wittbjer, and K. G. Thorngren. "Bone matrix and marrow versus cancellous bone in rabbit radial defects." Archives of Orthopaedic and Traumatic Surgery 106, no. 6 (October 1987): 335–40. http://dx.doi.org/10.1007/bf00456866.

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11

Xu, Guo Hua, Xiao Jian Ye, Wen Yuan, Shu Cai, Jian Gang Shi, and Jian Ru Xiao. "Repairing the Dog's Femoral Defect with the Autologous Osteoblast Integrated the Nano-Calcium Phosphate/Zirconia Scaffold." Key Engineering Materials 336-338 (April 2007): 1662–65. http://dx.doi.org/10.4028/www.scientific.net/kem.336-338.1662.

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In this paper, we study the effect of repairing the dog's femoral defects with the artificial bone integrating the nano-calcium phosphates/zirconia porous artificial bone scaffold with the autologous osteoblasts. We transplanted the artificial bone to the femoral defect of the dog, and at the same time, simple scaffold and the autologous cancellous bone were implanted as the control group. 3 months after the transplantation, the specimen was taken out with complete integration with the bone in these 3 groups and the bone defect got the complete bone union. The mechanics strength test showed that the group of the artificial bone was the strongest, followed by the cancellous bone group, and the simple material group was lower, but the strength was stronger than that before the transplantation. In the sixth month, the complete femoral defect repair was found in each group and the complete formation of the Haversian canal can be found on the histology examination. According to the mechanics strength test, there was no significant difference (P<0.05).
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12

Shani, J., and U. Segal. "Surgical management of large segmental femoral and radial bone defects in a dog." Veterinary and Comparative Orthopaedics and Traumatology 23, no. 01 (2010): 66–70. http://dx.doi.org/10.3415/vcot-09-04-0047.

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SummaryIn this case report, we describe the use of a cylindrical titanium mesh cage combined with cancellous bone graft to surgically manage large segmental bone defects in a dog. A seven-year-old, neutered male cross-breed dog, with highly comminuted fractures of the right femur and the left radius and ulna, was referred for treatment. Previous open reduction and internal fixation of these fractures had failed. Following implant removal and debridement of each bone, a 71 mm segmental femoral defect and a 27 mm segmental radial defect were present. A commercially available cylindrical titanium mesh cage was filled with ß-tricalcium phosphate crystals mixed with an equal volume of autogenous cancellous bone graft. The mesh cage was aligned with the proximal and distal parts of each bone using an intramedullary pin passing through the cage, and a locking plate was applied to the proximal and distal fracture fragments to produce compression against the titanium cage. The dog had a successful long-term clinical outcome, and radiographic examination at 22 and 63 weeks after surgery showed the formation of remodelling bridging callus that was continuous across the titanium cage in each of the fractures. Due to the relative simplicity of the technique and the favourable outcome in this case, it should be considered an option when managing comminuted fractures with large bone defects.
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13

Kanjilal, Deboleena, Christopher Grieg, Maya Deza Culbertson, Sheldon S. Lin, Michael Vives, Joseph Benevenia, and J. Patrick O’Connor. "Improved osteogenesis in rat femur segmental defects treated with human allograft and zinc adjuvants." Experimental Biology and Medicine 246, no. 16 (May 26, 2021): 1857–68. http://dx.doi.org/10.1177/15353702211019008.

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Bone allograft is widely used to treat large bone defects or complex fractures. However, processing methods can significantly compromise allograft osteogenic activity. Adjuvants that can restore the osteogenic activity of processed allograft should improve clinical outcomes. In this study, zinc was tested as an adjuvant to increase the osteogenic activity of human allograft in a Rag2 null rat femoral defect model. Femoral defects were treated with human demineralized bone matrix (DBM) mixed with carboxy methyl cellulose containing ZnCl2 (0, 75, 150, 300 µg) or Zn stearate (347 µg). Rat femur defects treated with DBM-ZnCl2 (75 µg) and DBM-Zn stearate (347 µg) showed increased calcified tissue in the defect site compared to DBM alone. Radiograph scoring and µCT (microcomputed tomography) analysis showed an increased amount of bone formation at the defects treated with DBM-Zn stearate. Use of zinc as an adjuvant was also tested using human cancellous bone chips. The bone chips were soaked in ZnCl2 solutions before being added to defect sites. Zn adsorbed onto the chips in a time- and concentration-dependent manner. Rat femur defects treated with Zn-bound bone chips had more new bone in the defects based on µCT and histomorphometric analyses. The results indicate that zinc supplementation of human bone allograft improves allograft osteogenic activity in the rat femur defect model.
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Nečas, Alois, Pavel Proks, Lucie Urbanová, Robert Srnec, Ladislav Stehlík, Michal Crha, Petr Raušer, et al. "Healing of Large Segmental Bone Defect after Implantation of Autogenous Cancellous Bone Graft in Comparison to Hydroxyapatite and 0.5% Collagen Scaffold Combined with Mesenchymal Stem Cells." Acta Veterinaria Brno 79, no. 4 (2010): 607–12. http://dx.doi.org/10.2754/avb201079040607.

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At present, attention is focused on research into possibilities of healing large bone defects by the method of mini-invasive osteosynthesis, using implantation of biomaterials and mesenchymal stem cells (MSCs). This study evaluates the healing of segmental femoral defects in miniature pigs based on the radiological determination of the callus: cortex ratio at 16 weeks after ostectomy. The size of the formed callus was significantly larger (p < 0.05) in animals after transplantation of an autogenous cancellous bone graft (group A, callus : cortex ratio of 1.77 ± 0.33) compared to animals after transplantation of cylindrical scaffold from hydroxyapatite and 0.5% collagen (group S, callus : cortex ratio of 1.08 ± 0.13), or in animals after transplantation of this scaffold seeded with MSCs (group S + MSCs, callus: cortex ratio of 1.15 ± 0.18). No significant difference was found in the size of callus between animals of group S and animals of group S + MSCs. Unlike a scaffold in the shape of the original bone column, a freely placed autogenous cancellous bone graft may allow the newly formed tissue to spread more to the periphery of the ostectomy defect. Implanted cylindrical scaffolds (with and without MSCs) support callus formation directly in the center of original bone column in segmental femoral ostectomy, and can be successfully used in the treatment of large bone defects.
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15

Heikkilä, Jouni T., Heikki J. Aho, Antti Yli-urpo, Risto-Pekka Happonen, and Allan J. Aho. "Bone formation in rabbit cancellous bone defects filled with bioactive glass granules." Acta Orthopaedica Scandinavica 66, no. 5 (January 1995): 463–67. http://dx.doi.org/10.3109/17453679508995588.

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16

Richter, M., F. Laurent, and J. M. Chausse. "Homologous cancellous bone grafts for large jaw defects caused by bone cysts." Journal of Oral and Maxillofacial Surgery 44, no. 6 (June 1986): 447–53. http://dx.doi.org/10.1016/s0278-2391(86)80009-x.

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17

Joo, Min Wook, Seung Jae Chung, Seung Han Shin, and Yang-Guk Chung. "The Effect of Autologous Platelet-Rich Plasma on Bone Regeneration by Autologous Mesenchymal Stem Cells Loaded onto Allogeneic Cancellous Bone Granules." Cells Tissues Organs 203, no. 6 (2017): 327–38. http://dx.doi.org/10.1159/000454915.

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To develop a clinically effective bone regeneration strategy, we compared bone regeneration using allogeneic cancellous bone granule scaffolds loaded with autologous bone marrow-derived mesenchymal stem cells (BM-MSC) with or without autologous platelet-rich plasma (PRP). Critical-sized segmental bone defects were made at the mid-shaft of both radiuses in 41 New Zealand White rabbits. Small-sized allogeneic cancellous bone granules (300-700 μm in diameter) loaded with BM-MSC were implanted on one side, and PRP was added. On the other side, autologous BM-MSC loaded onto allogeneic cancellous granules were grafted as a control. Bone regeneration was assessed by radiographic evaluation at 4, 8, and 16 weeks postimplantation and by micro-computed tomography (micro-CT) and histological evaluation of the retrieved specimens at 8 and 16 weeks. The experimental group did not show significantly higher bone quantity indices than the control group at any time point. Micro-CT analysis revealed that both groups had similar mean total volumes, surface areas, and other parameters at 8 and 16 weeks. Histological evaluation of 8- and 16-week specimens also showed a similar progression of new bone formation and maturation. In this experiment using a contralateral control group in the same individual, an initial single addition of PRP in allogeneic cancellous bone granules loaded with BM-MSC for critical-sized bone defects in the weight-bearing area did not induce a consequent difference in bone healing. Further research into the optimal preparation and application of PRP is necessary. Furthermore, studies involving a greater number of subjects and larger experimental animals could determine the clinical relevance of PRP treatment.
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McLaughlin, R., J. Hoskinson, and Dominique Griffon. "Effects of a Bone Inducing Agent Derived from a Cultured Human Osteosarcoma Cell Line after Orthotopic and Heterotopic Implantation in the Dog." Veterinary and Comparative Orthopaedics and Traumatology 09, no. 01 (1996): 22–8. http://dx.doi.org/10.1055/s-0038-1632497.

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SummaryBIA, a Bone Inducing Agent extracted from a cultured human osteosarcoma cell line (Saos–2), is highly osteoinductive in the skeletal muscle of athymic mice and promotes early osseous union of stabilized femoral non-unions in rats. To evaluate its effect in dogs, ten milligrams of BIA mixed with an equal amount of pure bovine collagen type I was compared with 20 mg of bovine collagen alone, a gelatin capsule alone, and fresh autogenous cancellous graft, after orthotopic and heterotopic implantation in Beagles.For osteoinductive bioassays, each implant was placed in the latissimus dorsi muscle of five Beagles for six weeks. Bone formation was evaluated by thoracic radiographs every two weeks and by high detail radiographs and histology six weeks after implantation. To evaluate the effects of BIA after orthotopic implantation, four cortical defects were created in each left femur of four Beagles. One defect on each femur was randomly filled with BIA plus collagen, collagen alone, a gelatin capsule alone, or autogenous cancellous graft. Radiographic evaluation of the femurs was performed every two weeks for eight weeks. Healing of the defects was assessed with high detail radiographs, dual energy X-ray absorptiometry, histology and histomorphometry eight weeks after implantation.Ten mg of BIA did not induce bone formation six weeks after heterotopic implantation and did not promote bone healing after orthotopic implantation in the dogs. The discrepancy between these results and those obtained in rodents may be related to immunogenic factors or to the dose of BIA used in this study.BIA, a Bone Inducing Agent extracted from a cultured osteosarcoma cell line is highly osteoinductive in rodents. BIA was evaluated and compared with autogenous cancellous bone graft and bovine collagen after orthotopic and heterotopic implantation in Beagles. Each implant was placed in the latissimus dorsi muscle of five Beagles and in femoral cortical defects of four Beagles. Bone formation was evaluated by radiography, dual energy X-ray absorptiometry, histology and histo-morphometry. BIA did not induce bone formation after heterotopic implantation and did not promote bone healing after orthotopic implantation in dogs.
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Srnec, Robert, Andrea Nečasová, Pavel Proks, Miša Škorič, Zita Filipejová, Lucy Vojtová, and Alois Nečas. "Femoral bone defect healing using two novel biocompatible degradable materials." Acta Veterinaria Brno 89, no. 2 (2020): 163–69. http://dx.doi.org/10.2754/avb202089020163.

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This study was conducted as an in vivo experiment in adult miniature pigs with the aim to test two new biomaterials. An iatrogenic defect was made into the central femoral diaphysis in the experimental animals and subsequently fixated by bridging plate osteosynthesis. Into the defect we implanted a cancellous autograft (control group), a pasty injectable scaffold (EXP A), and a porous 3D cylinder (EXP B). Radiological examination was performed in all animals at 0, 10, 20, 30 weeks after surgical procedure and histological assessment was performed. In the newly formed bone the osteoblastic activity was monitored. In terms of radiology, the most effective method was observed in the control group (completely healed 100%) compared to experimental groups EXP A (70.0%) and EXP B (62.5%). Histological assessment showed a higher cell count in the place of bone defect in the control group compared to experimental groups. Between the experimental groups, a higher count of bone marrow cells was found in group EXP B. Both newly developed biomaterials seem to be suitable as replacements for large bone defects, having good workability and applicability. However, compared to the control group treated with a cancellous autograft, the newly formed bone did not reach the same number of cells settling in and in some cases, full radiological healing was not reached. Nevertheless, the material was found to be grown into the original bone in all cases within the experimental groups. The new biomaterials have a great potential as a substitute in the treatment of large bone defects.
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Nesheiwat, F., WM Brown, and KM Healey. "Post-traumatic first metatarsal reconstruction using coralline hydroxyapatite." Journal of the American Podiatric Medical Association 88, no. 3 (March 1, 1998): 130–34. http://dx.doi.org/10.7547/87507315-88-3-130.

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Autogenous bone grafting has been the standard approach to reconstruction of trauma-induced metatarsal defects. However, this treatment has well-known disadvantages related to the harvesting, size, shape, and availability of autografts. The authors used a synthetic hydroxyapatite bone-graft substitute manufactured from a marine coral with a morphology similar to that of cancellous bone in the reconstruction of a large, post-traumatic first metatarsal defect. The authors found grafting with coralline hydroxyapatite to be a safe and effective substitute for autogenous bone grafting in the post-traumatic setting.
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Kashimada, K., T. Yamashita, K. Tsuji, A. Nifuji, S. Mizutani, Y. Nabeshima, and M. Noda. "Defects in growth and bone metabolism in klotho mutant mice are resistant to GH treatment." Journal of Endocrinology 174, no. 3 (September 1, 2002): 403–10. http://dx.doi.org/10.1677/joe.0.1740403.

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Klotho mutant (kl/kl) mice exhibit growth retardation after weaning, and previous electron microscopic examination of GH-producing cells in pituitary glands revealed a reduction in GH granules. However, it has not been known whether growth retardation in klotho mutant mice is related to the loss of GH function. We therefore examined whether treatment with GH could rescue the retardation of growth. At the end of 3 weeks of treatment with human GH, the body weight of wild-type (WT) mice was increased. In contrast, body weight was not increased in klotho mutant mice even after the treatment with human GH. Another feature of klotho mutant mice is the presence of osteopetrosis in the epiphyses of long bones and vertebrae. Treatment with human GH increased trabecular bone volume in the epiphyseal region of WT tibiae. Interestingly, increase in trabecular bone volume by GH treatment was also observed in klotho mutant mice and, therefore, the phenotype of high bone volume in the klotho mice was further enhanced. These findings indicate that a GH receptor system in cancellous bones could operate in mutant mice. Thus, growth retardation in the klotho mutant mice is resistant against GH treatment even when these mice respond to GH treatment in terms of cancellous bone volume.
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Cockshutt, Joanne, A. B. Kuzma, and R. M. McLaughlin. "Stacked Veterinary Cuttable Plates for Treatment of Comminuted Diaphyseal Fractures in Cats." Veterinary and Comparative Orthopaedics and Traumatology 05, no. 01 (1992): 22–25. http://dx.doi.org/10.1055/s-0038-1633139.

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Comminuted long bone fractures in four cats were repaired using stacked 2.0/2.7 mm cuttable plates. The plates were used as “lengthening plates", spanning cortical defects to maintain limb length. The defects were filled with autogenous cancellous bone graft. The plates did not fracture through unfilled screw holes and good to excellent limb function returned in all four cats.
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Touré, A., M. Fusellier, B. Fellah, B. Bouvy, P. Weiss, O. Gauthier, and K. Minier. "BMP-2 delivered from a self-cross-linkable CaP/hydrogel construct promotes bone regeneration in a critical-size segmental defect model of non-union in dogs." Veterinary and Comparative Orthopaedics and Traumatology 27, no. 06 (2014): 411–21. http://dx.doi.org/10.3415/vcot-14-03-0036.

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SummaryObjectives: To determine whether the addition of recombinant human bone morphogenetic protein (rhBMP-2) to a self-crosslinkable cellulosic hydrogel/biphasic calcium phosphate (BCP) granules construct promotes bone healing in critical-size ulnar defects in dogs.Methods: A standardized 2 cm long ulnar ostectomy was performed bilaterally in five dogs to compare bone healing with hydrogel/BCP constructs associated with or without rhBMP-2. Cancellous-bone autografts were used as positive controls in unilateral ulnar defects in five additional dogs. Radiographically, bone healing was evaluated at four, eight, 12, 16 and 20 weeks postoperatively. Histological qualitative analysis with microCT imaging and light and scanning electron microscopy were performed 20 weeks after implantation.Results: All rhBMP-2-loaded constructs induced the formation of well-differentiated mineralized lamellar bone surrounding the BCP granules and bridging bone/implant interfaces as early as eight weeks after surgery. Bone regeneration appeared to develop earlier with the rhBMP-2 constructs than with the cancellous-bone autografts while similar results were obtained at 20 weeks. Constructs without any rhBMP-2 showed osteoconductive properties limited to the bone junctions and a lack of osteoinduction without bone ingrowth within the implantation site. In one dog, the leakage of the hydrogel loaded with rhBMP-2 induced an extensive heterotopic bone formation.Clinical significance: The addition of rhBMP-2 to a self-crosslinkable hydrogel/BCP construct could promote bone regeneration in a critical-size-defect model with similar performance to autologous bone grafts.
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Muroi, Norihiro, Nobuo Kanno, Shuji Suzuki, Yasuji Harada, and Yasushi Hara. "Application of autologous cortical bone grafts for femoral non-union fractures in two dogs." Veterinary Record Case Reports 8, no. 1 (February 2020): e000826. http://dx.doi.org/10.1136/vetreccr-2019-000826.

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Two dogs with non-union fractures and osteomyelitis in the femoral diaphysis were referred to the authors’ hospital. During surgery, the defects were reconstructed using autologous cortical bones harvested from the contralateral femoral diaphysis. Graft fixation was performed by a double-plate technique in both cases. Autogenous cancellous bone was also grafted between the host bone and the graft in both cases. Antibiotics were administered for two to three weeks. In cases 1 and 2, no loosening of the implant or lameness was observed after 31 months and 10 months, respectively. Autologous cortical bone grafts are useful in reconstructing large-sized bone defects of the femoral diaphysis associated with non-union fracture and osteomyelitis.
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Lin, Chun-Cheng, Shih-Chieh Lin, Chao-Ching Chiang, Ming-Chau Chang, and Oscar Kuang-Sheng Lee. "Reconstruction of Bone Defect Combined with Massive Loss of Periosteum Using Injectable Human Mesenchymal Stem Cells in Biocompatible Ceramic Scaffolds in a Porcine Animal Model." Stem Cells International 2019 (November 23, 2019): 1–8. http://dx.doi.org/10.1155/2019/6832952.

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Clinically, in patients who sustain severe open fractures, there is not only a segmental bone defect needed to be reconstructed but also insufficient healing capacity due to concomitant damages to the periosteum and surrounding soft tissues. For studying the reconstruction of bone defects associated with massive loss of periosteum and surrounding soft tissues, there are no well-established preclinical models in large animals in the literature. The purpose of the study was to generate a large animal model of bone defect with massive periosteum loss and to adopt a tissue engineering approach to achieve rapid bony union with stem cells and biomaterials. In this study, a bone defect with massive periosteum stripping was generated in pigs, which was followed by emptying nearby canal marrow including fat and cancellous bone. The stripped periosteum was a mimic to the situation in the Gustilo type 3 open fractures. Bone defects were then reconstructed by impacting the biocompatible ceramic scaffold, morselized tricalcium phosphate (TCP) loaded with human adipose tissue-derived mesenchymal stem cells (hMSCs). Radiological and pathological assessments indicated that TCP and hMSCs synergistically promoted bone healing with increased lamination and ingrowth of vessels. Both bridging periosteum formation and gap filling were induced rapidly. In conclusion, a porcine model of segmental bone loss with damage of surrounding periosteum was created. Reconstruction of such defects with hMSCs and TCP achieved rapid union of bone defects associated with massive periosteal stripping.
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26

Sagliyan, A., E. Karabulut, E. Unsaldi, and I. Yaman. "Evaluation of the activity of intraarticular hyaluronic acid in the repair of experimentally induced osteochondral defects of the stifle joint in dogs." Veterinární Medicína 54, No. 1 (February 11, 2009): 33–40. http://dx.doi.org/10.17221/3043-vetmed.

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The present study examined the results of using hyaluronic acid with autogenetic cancellous grafts in the treatment of experimentally induced osteochondral defects in the stifle joints of dogs. In this study, 10 mature dogs of different breeds, weights and of both sexes were used. General anesthesia and usual operation procedures were followed. A 10 mm deep defect was created on the femoral sulcus of the trochlea with a drill tip of 8 mm in diameter. The defects in the right and left legs were filled with autogenic cancellous grafts taken from the metaphysial region of the tibia. The left legs constituted the experimental group while the right legs served as control group. In the experimental group, 2 mg/kg intraarticular hyaluronic acid was twice administered into the stifle joint, i.e., immediately subsequent to the operation and 1 month afterwards. Parenteral antibiotics were prescribed postoperatively for ten days. Five animals were sacrificed at the third and sixth month after surgery. Macroscopic and microscopic findings obtained from each case were evaluated. On macroscopical examination, trochlear defects were determined to be incompletely filled at the third month in both control and experimental groups. On histopathologic examination, a loose fibrovascular formation in the area where the graft was applied was observed to be present in both control and experimental groups. However, in the experimental group this formation was more superficial, ossification activity was greater and trabeculous bone formation had been initiated. Macroscopical examination carried out in the sixth month determined that in the control group the defect surface did not fill up to the trochlear sulcus level. In the histopathologic examination, in control groups it was found that fibrocartilageous structures were developing in the fibrovascular space even though ossification was incomplete. The macroscopic examination showed that in the experimental group, the defect surface reached the trochlear sulcus level of defects in this month. The histopatologic examination revealed that fibrous tissue comprised a thin layer, under which ossification processes were complete and bone trabeculates fully formed. It was concluded that the usage of autogenic cancellous graft along with hyaluronic acid may be useful in the repair of large osteochondral defects.
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Primley, Donald M. "Dacron mesh tray and cancellous bone in reconstruction of mandibular defects." Journal of Oral and Maxillofacial Surgery 44, no. 10 (October 1986): 840. http://dx.doi.org/10.1016/0278-2391(86)90180-1.

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28

Albert, T. W., J. D. Smith, E. C. Everts, and T. A. Cook. "Dacron Mesh Tray and Cancellous Bone in Reconstruction of Mandibular Defects." Archives of Otolaryngology - Head and Neck Surgery 112, no. 1 (January 1, 1986): 53–59. http://dx.doi.org/10.1001/archotol.1986.03780010055010.

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29

JOHNSON, E. E., M. R. URIST, T. P. SCHMALZRIED, A. CHOTIVICHIT, H. K. HUANG, and G. A. M. FINERMAN. "Autogeneic Cancellous Bone Grafts in Extensive Segmental Ulnar Defects in Dogs." Clinical Orthopaedics and Related Research &NA;, no. 243 (June 1989): 254???265. http://dx.doi.org/10.1097/00003086-198906000-00039.

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30

Voor, Michael J., Eric M. Yoder, and Robert L. Burden. "Xenograft Bone Inclusion Improves Incorporation of Hydroxyapatite Cement Into Cancellous Defects." Journal of Orthopaedic Trauma 25, no. 8 (August 2011): 483–87. http://dx.doi.org/10.1097/bot.0b013e318224a3c2.

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31

Shaheen, Marwa Y., Amani M. Basudan, Abdurahman A. Niazy, Jeroen J. J. P. van den Beucken, John A. Jansen, and Hamdan S. Alghamdi. "Effect of Systemic Zoledronic Acid Dosing Regimens on Bone Regeneration in Osteoporotic Rats." Applied Sciences 11, no. 4 (February 22, 2021): 1906. http://dx.doi.org/10.3390/app11041906.

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The aim of this study was to evaluate the regeneration of bone defects created in the femoral condyle of osteoporotic rats, following intravenous (IV) zoledronate (ZA) treatment in three settings: pre-bone grafting (ZA-Pre), post-bone grafting (ZA-Post), and pre- plus post-bone grafting (ZA-Pre+Post). Twenty-four female Wistar rats were ovariectomized (OVX). After 12 weeks, bone defects were created in the left femoral condyle. All defects were grafted with a particulate inorganic cancellous bovine bone substitute. ZA (0.04 mg/kg, weekly) was administered to six rats 4 weeks pre-bone graft placement. To another six rats, ZA was given post-bone graft placement creation and continued for 6 weeks. Additional six rats received ZA treatment pre- and post-bone graft placement. Control animals received weekly saline intravenous injections. At 6 weeks post-bone graft placement, samples were retrieved for histological evaluation of the bone area percentage (BA%) and remaining bone graft percentage (RBG%). BA% for ZA-Pre (50.1 ± 3.5%) and ZA-Post (49.2 ± 8.2%) rats was significantly increased compared to that of the controls (35.4 ± 5.4%, p-value 0.031 and 0.043, respectively). In contrast, ZA-Pre+Post rats (40.7 ± 16.0%) showed similar BA% compared to saline controls (p = 0.663). For RBG%, all experimental groups showed similar results ranging from 36.3 to 47.1%. Our data indicate that pre- or post-surgical systemic IV administration of ZA improves the regeneration of bone defects grafted with inorganic cancellous bovine-bone particles in osteoporotic bone conditions. However, no favorable effect on bone repair was seen for continued pre- plus post-surgical ZA treatment.
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Ford, Samuel E., and J. Kent Ellington. "Management of Distal Tibial Metaphyseal Bone Defects With an Intramedullary Nitinol Scaffold: A Novel Technique." Foot & Ankle Specialist 10, no. 4 (November 21, 2016): 368–71. http://dx.doi.org/10.1177/1938640016679708.

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Difficult problems that are faced when reconstructing severe pilon fractures include filling metaphyseal defects and supporting an impacted, multifragmented articular surface. Supplements to plate fixation currently available in a surgeon’s armamentarium include cancellous bone autograft, structural bone allograft, demineralized bone matrix, and calcium-based cements. Cancellous autograft possesses limited inherent mechanical stability and is associated with graft site morbidity. Structural allografts incorporate inconsistently and are plagued by late resorption. Demineralized bone matrix also lacks inherent structural stability. Calcium phosphate cements are not rigidly fixed to bone unless fixation is applied from cortical bone or through a plate, which must be taken into consideration when planning fixation. The Conventus DRS (Conventus Orthopaedics, Maple Grove, MN) implant is an expandable nitinol scaffold that takes advantage of the elasticity and shape memory of nitinol alloy. Once deployed and locked, it serves as a stable intramedullary base for fragment-specific periarticular fracture fixation, even in the face of metaphyseal bone loss. Two cases of successful implant use are presented. In both cases, the implant is used to fill a metaphyseal void and provide stable articular support to the distal tibial plafond. Levels of Evidence: Therapeutic Level V: Case Report, Expert Opinion
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Al-Muaid, Jaleel, Mario Franciolli, and Kaj Klaue. "Tubular Remodeling of Massive Cancellous Bone Graft in the Treatment of Long Bone Defects." European Journal of Trauma and Emergency Surgery 33, no. 6 (May 15, 2007): 654–58. http://dx.doi.org/10.1007/s00068-007-6136-3.

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34

Matsushita, Takehiko, Shu Watanabe, Daisuke Araki, Tomoyuki Matsumoto, Koji Takayama, Masahiro Kurosaka, and Ryosuke Kuroda. "High tibial osteotomy combined with cancellous bone graft and osteochondral autograft transplantation in a patient with massive osteochondral defects in the medial femoral condyle." Journal of Orthopaedic Surgery 25, no. 1 (January 1, 2017): 230949901668501. http://dx.doi.org/10.1177/2309499016685016.

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Treatment of massive osteochondral defects of the medial femoral condyle is challenging. A 46-year-old man who had a medial femoral condyle fracture on his left knee underwent osteosynthesis in a hospital, but the pain remained and the patient was referred to our hospital 8 months after the surgery. Radiographs showed a varus alignment of the leg, and magnetic resonance image showed a massive necrotic area in the medial femoral condyle. The patient received high tibial osteotomy (HTO) combined with iliac cancellous bone graft and an osteochondral autograft transplantation. Pain and the knee function markedly improved 2 years after the surgery. A second look arthroscopy showed a well-covered bone graft site with cartilaginous tissue and a well-integrated osteochondral plug. HTO combined with cancellous bone autograft and osteochondral autograft transplantation could be an effective treatment for patients presenting with a varus knee deformity associated with massive osteochondral defects in the medial femoral condyle.
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Arts, J. J. C., J. W. M. Gardeniers, M. L. M. Welten, N. Verdonschot, B. W. Schreurs, and P. Buma. "TCP-HA Granules and Impacted Morselized Cancellous Bone Graft Mixes for Acetabular Reconstruction with the Bone Impaction Grafting Technique. A Loaded and Critical Sized Defect Model in the Goat." Key Engineering Materials 284-286 (April 2005): 869–72. http://dx.doi.org/10.4028/www.scientific.net/kem.284-286.869.

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With the bone impaction grafting technique, a 50/50 volume mix of morselized cancellous bone (MCB) with TCP-HA granules was used to reconstruct a critical sized acetabular defect in the goat. The biological activity of the MCB/TCP-HA mix was assessed after 15 weeks. Defects filled with 100% MCB, currently the gold standard for this technique, were used as controls. In the 100% MCB defects, a new trabecular bone structure was found in which scarce incorporated remnants of the original graft material were present. In the MCB/TCP-HA defects, MCB was also resorbed or incorporated into new bone. Deep in the MCB-TCP-HA defects, large TCP-HA granules were generally totally osseous-integrated with new bone. Superficially, more fragmented TCP-HA granules of various sizes were present in the medullar tissue or in the interface with the cement layer. Here, the crushed TCP-HA granules were generally surrounded by osteoclasts and giant cells. The soft tissue interface between the reconstruction and cement did not differ between both groups. In conclusion, from a biological point of view, this short-term follow-up study suggests that TCP-HA granules can be safely used in a mix with MCB as bone graft extender in acetabular revision surgery with the bone impaction grafting technique.
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36

Horstmann, Peter F., Werner H. Hettwer, and Michael M. Petersen. "Treatment of benign and borderline bone tumors with combined curettage and bone defect reconstruction." Journal of Orthopaedic Surgery 26, no. 3 (September 1, 2018): 230949901877492. http://dx.doi.org/10.1177/2309499018774929.

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Purpose: The management of bone defects following simple curettage of bone tumors is controversial and in light of the numerous emerging substitutes for bone grafts, we wished to review and report our experience with the use of cancellous allograft bone in the treatment of benign and borderline bone tumors. Methods: We reviewed the medical records of 164 consecutive patients with benign or borderline bone tumors treated with simple curettage at our orthopedic oncology center between 2009 and 2013. Postoperative radiological changes were evaluated by a modified Neer’s classification in defects that were subsequently reconstructed with allograft bone ( n = 133). Results: Simple curettage with subsequent defect filling using allograft bone was the surgical procedure performed in the majority of our patients (81%) and was associated with a low overall 2.5-year local recurrence (LR; 9.8%) and complication rate (7.5%). The radiological appearance of the grafted defects was deemed satisfactory in 85% of cases, with signs of either complete or partial healing present 6–12 months postoperatively. With respect to pathology, we found high rates of LR in giant cell tumors (GCTs) of bone, simple cysts (SCs) in children, and preexisting local recurrent disease. We did not observe any allograft-related complications. Conclusions: Simple curettage and bone defect reconstruction with bone allograft is a sufficient treatment for most benign bone lesions and is associated with a low complication rate. For high-risk entities, such as GCTs of bone, SCs in children, and recurrent disease, additional adjuvant treatment could be considered to avoid LR.
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Lewis, Christine S., Jordan Katz, Maribel I. Baker, Peter R. Supronowicz, Elise Gill, and Ronald R. Cobb. "Local Antibiotic Delivery with Bovine Cancellous Chips." Journal of Biomaterials Applications 26, no. 4 (September 6, 2010): 491–506. http://dx.doi.org/10.1177/0885328210375729.

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Infected bone defects and osteomyelitis are encountered frequently in trauma cases. Currently, the standard of care for osteomyelitis cases is prolonged systemic antibiotic therapy and implantation of antibiotic carrier beads. However, this method requires a secondary surgery to remove the beads after the infection has cleared. In the present study a common bone void filler was investigated for its ability to be infused with an antibiotic. This study demonstrates that the xenograft material tested can be loaded with gentamicin and release clinically relevant levels of the drug for at least 14 days in vitro allowing for the inhibition of bacterial growth on the graft. This study also demonstrates that the levels of gentamicin released did not have an adverse effect on primary osteoblast cell proliferation or ability to generate alkaline phosphatase. This bone void filler may represent a viable alternative to current methods of local antibiotic delivery in orthopedic applications.
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Henrich, Dirk, Kerstin Wilhelm, Joerg Warzecha, Johannes Frank, John Barker, Ingo Marzi, and Caroline Seebach. "Human Endothelial-Like Differentiated Precursor Cells Maintain Their Endothelial Characteristics When Cocultured with Mesenchymal Stem Cell and Seeded onto Human Cancellous Bone." Mediators of Inflammation 2013 (2013): 1–12. http://dx.doi.org/10.1155/2013/364591.

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Introduction. Cancellous bone is frequently used for filling bone defects in a clinical setting. It provides favourable conditions for regenerative cells such as MSC and early EPC. The combination of MSC and EPC results in superior bone healing in experimental bone healing models.Materials and Methods. We investigated the influence of osteogenic culture conditions on the endothelial properties of early EPC and the osteogenic properties of MSC when cocultured on cancellous bone. Additionally, cell adhesion, metabolic activity, and differentiation were assessed 2, 6, and 10 days after seeding.Results. The number of adhering EPC and MSC decreased over time; however the cells remained metabolically active over the 10-day measurement period. In spite of a decline of lineage specific markers, cells maintained their differentiation to a reduced level. Osteogenic stimulation of EPC caused a decline but not abolishment of endothelial characteristics and did not induce osteogenic gene expression. Osteogenic stimulation of MSC significantly increased their metabolic activity whereas collagen-1αand alkaline phosphatase gene expressions declined. When cocultured with EPC, MSC’s collagen-1αgene expression increased significantly.Conclusion. EPC and MSC can be coculturedin vitroon cancellous bone under osteogenic conditions, and coculturing EPC with MSC stabilizes the latter’s collagen-1αgene expression.
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Enemark, Hans, John Jensen, and Carles Bosch. "Mandibular Bone Graft Material for Reconstruction of Alveolar Cleft Defects: Long-Term Results." Cleft Palate-Craniofacial Journal 38, no. 2 (March 2001): 155–63. http://dx.doi.org/10.1597/1545-1569_2001_038_0155_mbgmfr_2.0.co_2.

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Objective To analyze the long-term effect of mandibular bone as donor material in bone grafting of the alveolar process defect in patients with unilateral cleft lip and palate (UCLP), compared with iliac crest cancellous bone. Method During a 7-year period, 101 UCLP patients were bone grafted, 57 cases with iliac crest cancellous bone and 44 with mandibular symphyseal bone. The long-term results with an observation time of more than 4 years were analyzed with respect to marginal bone level and dental and gingival condition in the grafted area. Complications were recorded. Results The bone level in the grafted area was satisfactory in both groups. Impaction of cleft-side canines was found in 35% of the patients in both groups. Patients with agenesis of the cleft side lateral incisor had significantly more impacted canines, compared with patients with a cleft-side lateral situated in the lesser maxillary segment, probably due to the fact that the lateral incisors help in guiding the canine down through the grafted area. The number of complications was scarce, although both groups demonstrated some gingival retraction with a longer crown length at the cleft side central incisor. Conclusion The findings of this study have changed our strategy in bone grafting. Timing of orthodontic treatment and bone grafting has been more varied depending on the position and presence of teeth in the cleft area. Bone grafting of the alveolar process is not just a local treatment of a bony defect, but in respect to the burden of treatment, bone grafting of the alveolar process has to be planned in accordance with orthodontic treatment and maxillofacial growth.
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40

Gellrich, N. C., G. Hauschild, M. Fehr, K. H. Bormann, K. Rohn, S. Spalthoff, M. Rücker, H. Kokemüller, and M. C. Nolff. "Comparison of two β-tricalcium phosphate composite grafts used for reconstruction of mandibular critical size bone defects." Veterinary and Comparative Orthopaedics and Traumatology 22, no. 02 (2009): 96–102. http://dx.doi.org/10.3415/vcot-08-04-0038.

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Summary Objective: The aim was to compare osseointegration of blood perfused β-tricalcium phosphate cylinders (β-TCPB) with similar composites that were additionally loaded with cancellous bone and bone marrow (β-TCPB/BM/CB) for mandibular reconstruction. Methods: Twelve German Black-Headed sheep with an average weight of 72.5 ± 10 kg underwent segmental re-section of the right hemi-mandible. The animals that were assigned to group A (n=6) were reconstructed using β-TCPB while the sheep that were assigned to group B received β-TCPB/BM/CB grafts. Tissue quality was histologically assessed and bone-, scaffold-, cartilage- and fibrous-tissue area were estimated using semiautomated histomorphometrical software. Results: Composite grafts that were loaded with bone marrow and cancellous bone (β-TCPB/BM/CB) exhibited significant (p<0.01) higher amounts of bone formation than β-TCPB. The patients that were assigned to group B achieved defect union and a high grade of bone maturation. Residual ceramic remnants were rare and disconnected. Bone maturity within group A was inferior and none of the specimens showed defect union. The defect centre was still occupied by a ceramic core. Clinical significance: Bone and bone marrow augmented β-tricalcium phosphate composites may qualify as a promising alternative to autograft bone for mandibular reconstruction in human and veterinary medicine.
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Silva, R. V., J. A. Camilli, C. A. Bertran, and N. H. Moreira. "The use of hydroxyapatite and autogenous cancellous bone grafts to repair bone defects in rats." International Journal of Oral and Maxillofacial Surgery 34, no. 2 (March 2005): 178–84. http://dx.doi.org/10.1016/j.ijom.2004.06.005.

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42

van Dyk, GE, LM Dejardin, G. Flo, and LL Johnson. "Cancellous bone grafting of large osteochondral defects: an experimental study in dogs." Arthroscopy: The Journal of Arthroscopic & Related Surgery 14, no. 3 (April 1998): 311–20. http://dx.doi.org/10.1016/s0749-8063(98)70148-3.

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43

Pereira, G. C. T., E. N. Kubiak, B. Levine, F. S. Chen, and P. E. Di Cesare. "Cavitary acetabular defects treated with morselized cancellous bone graft and cementless cups." International Orthopaedics 31, no. 4 (September 19, 2006): 445–50. http://dx.doi.org/10.1007/s00264-006-0220-x.

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44

Šponer, Pavel, Tomáš Kučera, Jindra Brtková, Karel Urban, Zuzana Kočí, Pavel Měřička, Aleš Bezrouk, Šimona Konrádová, Alžběta Filipová, and Stanislav Filip. "Comparative Study on the Application of Mesenchymal Stromal Cells Combined with Tricalcium Phosphate Scaffold into Femoral Bone Defects." Cell Transplantation 27, no. 10 (September 11, 2018): 1459–68. http://dx.doi.org/10.1177/0963689718794918.

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This prospective study sought to evaluate the healing quality of implanted ultraporous β-tricalcium phosphate sown with expanded autologous mesenchymal stromal cells (MSCs) into femoral defects during revision hip arthroplasty. A total of 37 osseous defects in 37 patients were treated and evaluated concerning bone regeneration. Nineteen subjects received β-tricalcium phosphate graft material serving as a carrier of expanded autologous MSCs (the trial group A), nine subjects received β-tricalcium phosphate graft material only (the study group B) and nine subjects received cancellous allografts only (the control group C). Clinical and radiographic evaluations were scheduled at 6 weeks, 3, 6, and 12 months post-operatively, and performed at the most recent visit as well. All observed complications were recorded during follow-up to assess the use of an ultraporous β-tricalcium phosphate synthetic graft material combined with expanded MSCs in bone defect repair. The resulting data from participants with accomplished follow-up were processed and statistically evaluated with a Freeman–Halton modification of the Fischer’s exact test, a P < 0.05 value was considered to be significant. Whereas no significant difference was observed between the trial group A with β-tricalcium phosphate synthetic graft material serving as a carrier of expanded autologous MSCs and control group C with cancellous impaction allografting in terms of the bone defect healing, significant differences were documented between the study group B with β-tricalcium phosphate graft material only and control group C. Regarding adverse effects, six serious events were recorded during the clinical trial with no causal relationship to the cell product. β-tricalcium phosphate synthetic graft material serving as a carrier of expanded autologous MSCs appears safe and promotes the healing of bone defects in a jeopardized and/or impaired microenvironment. This clinical trial was registered at the EU Clinical Trials Register before patient recruitment (Registration number: EudraCT number 2012-005599-33; Date of registration: 2013-02-04).
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Lu, Jian, Qi-Yang Wang, and Jia-Gen Sheng. "Exosomes in the Repair of Bone Defects: Next-Generation Therapeutic Tools for the Treatment of Nonunion." BioMed Research International 2019 (August 4, 2019): 1–11. http://dx.doi.org/10.1155/2019/1983131.

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Nonunion with bone defects, a common complication after long bone fracture, is a major challenge for orthopaedic surgeons worldwide because of the high incidence rate and difficulties in achieving successful treatment. Bone defects are the main complications of nonunion. The conventional biological treatments for nonunion with bone defects involve the use of autologous bone grafts or bone graft substitutes and cell-based therapy. Traditional nonunion treatments have always been associated with safety issues and various other complications. Bone grafts have limited autologous cancellous bone and there is a risk of infection. Additionally, problems with bone graft substitutes, including rejection and stimulation of bone formation, have been noted, and the health of the stem cell niche is a major consideration in cell-based therapy. In recent years, researchers have found that exosomes can be used to deliver functional RNA and mediate cell-to-cell communication, suggesting that exosomes may repair bone defects by regulating cells and cytokines involved in bone metabolism. In this review, we highlight the possible relationships between risk factors for nonunion and exosomes. Additionally, we discuss the roles of exosomes in bone metabolism and bone regeneration.
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Giavaresi, Gianluca, Milena Fini, Jonathan Salvage, Nicolò Nicoli Aldini, Roberto Giardino, Luigi Ambrosio, Luigi Nicolais, and Matteo Santin. "Bone regeneration potential of a soybean-based filler: experimental study in a rabbit cancellous bone defects." Journal of Materials Science: Materials in Medicine 21, no. 2 (September 22, 2009): 615–26. http://dx.doi.org/10.1007/s10856-009-3870-6.

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47

Markel, M. D., and P. D. Hanson. "Bone and Cartilage Transplantation." Veterinary and Comparative Orthopaedics and Traumatology 05, no. 04 (1992): 163–69. http://dx.doi.org/10.1055/s-0038-1633104.

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SummaryBone and cartilage transplantation have included autogenic, allogenic, and xenogenic tissues. Non-vascular cortical bone grafts are incorporated through a process of resorption, vascular invasion, and new bone deposition. Cancellous grafts are incorporated through a process of bone deposition followed by resorption. A variety of proteins, enzymes and enzyme inhibitors, collectively termed osteogenins, have been identified to have osteo-inductive activity. The incorporation of cartilage grafts differs from that of bone in several ways, largely due to differences in nutrition of the graft and biology of the incorporation process. The completeness of allograft incorporation is restricted in part by the immune response due to genetic disparity between donor and recipient tissues. Effective methods of sterilizing the graft, to prevent transmission of pathogens from donor to recipient, are important. Veterinary applications of graft material are expanding. While autogenous cancellous grafts to augment fracture repair remain the area of greatest use, segmental allografts for repair of large fracture defects in small animals are also utilized. The application of cartilage and osteochondral grafts in horses represent another area of active research.The use of bone and cartilage transplantation in veterinary surgery continues to expand. What follows is a review of the biologic principles relating to graft incorporation, the effects different storage and handling techniques have on graft incorporation, and the clinical relevance of current research to veterinary application of bone and cartilage transplantation.
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Djapic, T., V. Kusec, M. Jelic, S. Vukicevic, and M. Pecina. "Compressed homologous cancellous bone and bone morphogenetic protein (BMP)-7 or bone marrow accelerate healing of long-bone critical defects." International Orthopaedics 27, no. 6 (December 1, 2003): 326–30. http://dx.doi.org/10.1007/s00264-003-0496-z.

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Chan, Yi-Sheng, Steve Wen-Neng Ueng, Ching-Jen Wang, Shiuann-Sheng Lee, En-Kai Chao, and Chun-Hsiung Shin. "Management of Small Infected Tibial Defects with Antibiotic-Impregnated Autogenic Cancellous Bone Grafting." Journal of Trauma: Injury, Infection, and Critical Care 45, no. 4 (October 1998): 758–64. http://dx.doi.org/10.1097/00005373-199810000-00023.

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Gogolewski, Sylwester, and Katarzyna Gorna. "Biodegradable polyurethane cancellous bone graft substitutes in the treatment of iliac crest defects." Journal of Biomedical Materials Research Part A 80A, no. 1 (January 2007): 94–101. http://dx.doi.org/10.1002/jbm.a.30834.

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