Use of Mimix hydroxyapatite bone cement for difficult ossicular reconstruction. 2017;54:21-34. Furthermore, in a controlled clinical trial (n = 10), Monov et al (2005) found that the instillation of PRP during implant placement in the lower anterior mandible did not add additional benefit. No short-term or intermediate-term adverse reactions or unsuspected bone conduction deteriorations were seen. Gene expression for collagen types I and III, decorin, and cartilage oligomeric matrix protein was modestly, but significantly increased following co-culture of tenocytes with autologous ASC. Studies were included if results for patients with and without Crohn's disease could be differentiated. For 252 of 345 consecutive participants (aged 33 to 96 years), BMSi was measured using the OsteoProbe at the mid-tibia. They stated that in the absence of standardized processing and heterogeneous study results limited its use in clinical practice; until long-term studies determine its success, clinicians are recommended to use it with caution because of high variability in resorption time (2 to 24 weeks) and a risk of graft dehiscence (12.96 % to 34.38 %). A prospective, randomized clinical trial comparing rhOP-1 with fresh bone autograft. The potential role of mesenchymal stem cell therapy for intervertebral disc degeneration: A critical overview. The VISA-A score ranged from 0 to 100, with higher scores corresponding with less pain and increased activity. However, the goal of this report was to show that the cells that migrate out of the human ACL constitute a rich population of progenitor cells and these researchers hypothesized that they display mesenchymal stem cell (MSC) characteristics when compared with adherent cells derived from bone marrow or collagenase digests from ACL. Fallucco and Carstens (2009) stated that a novel method for primary alveolar cleft bony reconstruction avoids donor site morbidity and does not require close approximation of alveolar segments as necessitated by gingivo-periosteoplasty. The field of bone tissue engineering in particular requires materials capable of providing enhanced mechanical properties and promoting osteogenic cell lineage commitment. Injectable bone substitutes, and especially CS, have also been targeted as potentially good carriers for antibiotics and growth factors. 2020b;45(20):1403-1410. Following rotator cuff repair surgery, the arm is immobilized to allow the tear to heal. Eur Spine J. These investigators examined the potential for ASC to act as trophic mediators for tendon healing. Twelve Cook patients underwent 16 plug insertions and 10 Gore patients underwent 11 plug insertions. The authors stated that this study had several drawbacks. top: 0px; Acute or chronic infections, systemic or at the operative site, An absence of load bearing structural support at the graft site, Metabolic or systemic disorders that affect bone or wound healing. In a controlled laboratory study, TSCs were isolated from rabbit patellar tendons and cultured with various concentrations of KGN, from 0 to 1,000 M . Pre-operative pocket depths, attachment levels, and trans-operative bone measurements were similar for the2 groups. Although the Restore orthobiologic implant has been cleared by the FDA for marketing, there is a lack of adequate evidence on the effectiveness of this implant in rotator cuff repair. Level of Evidence = I. Lehr et al (2020b) provided 2-year clinical and radiographic follow-up of a double-blind, multi-center, randomized, intra-patient controlled, non-inferiority study comparing AttraX Putty with autograft in instrumented PLF surgery. Osteogenic protein-1 for long bone nonunion. The authors concluded that subchondroplasty represented a safe and valid surgical option in the treatment of OA-related BMLs of the knee, providing an improvement in terms of pain relief and functional recovery. Bozic KJ, Glazer PA, Zurakowski D, et al. The fusion mass lateral to the instrumentation on each side was judged fused or not, and the mineralization of the graft was rated absent, mild, moderate, or extensive. Glass. Orthop Clin North Am. Relevant clinical data were obtained from all 20 patients treated for one of the bone cyst forms mentioned above. These researchers presented the first long-term results following open curettage of benign bone tumors and tumor-like lesions and void filling with this novel injectable and synthetic bone graft. It has been noted that transplantationof xenogenic porcine chondrocytes could represent a future approach for the treatment of human articular cartilage defects. Fu R, Selph S, McDonagh M, et al. The primary analysis was based on 87 patients, including 146 instrumented segments. They obtained IKDC subjective knee evaluation scores, Tegner-Lysholm activity levels, and Lysholm-Gillquist knee scores pre-operatively and at 6, 12, and 24 months post-operatively. Buser Z, Brodke DS, Youssef JA, et al. Curr Opin Rheumatol. Randomized studies have verified that CP works especially well in tibial plateau fractures when compared with conventional bone grafting. border-width:0; A matched, cohort study. Despite the fact that these bone substitutes have been on the market for many years, knowledge among potential users on how and when they might be useful is still fairly limited. Spine. These carrier systems have significant limitations regarding which antibiotics can be successfully incorporated into the carrier vehicle. Air-bone gap, bone-conduction (BC) thresholds, and air-conduction (AC) thresholds were evaluated pre-operatively and at 3, 6 and 12 months post-operatively. Micro-chemotaxis assays were performed using ASC-CM. Twenty patients had autologous chondrocyte implantation and 3 patients had cultured bone marrow stem cell implantation. In a single-case study, these investigators presented a simple arthroscopic technique of implanting dehydrated, micronized allogeneic cartilage scaffold to treat an isolated chondral lesion of the glenoid. The investigators concluded that the use of Allomatrix putty as an alternative for autogenous bone graft in the treatment of nonunions resulted in an unacceptably high rate of complications. -- without the need for autografting. 2001;83A(1 Pt 2):S1-151-S1-158. There is insufficient evidence to support the use of xenograft implantation into the articular surface. Bone Joint Surg Am. In a systematic review, Gharpure and Bhatavadekar (2018) evaluated the clinical efficacy of the tooth-bone graft as a bone substitute in the oral and maxillofacial region in humans as compared to un-grafted sites and other bone substitutes. All patients underwent open irrigation and debridement of the rotator cuff and the implant. A consecutive series of patients requiring bone grafting for atrophic/avascular nonunions were retrospectively studied. The increase was not significantly different between both groups (adjusted between-group difference from baseline to 24 weeks, -0.9; 95 % CI: -12.4 to 10.6). The study analyzed the patient demographics, etiology, surgical procedures, culture patterns, local antibiotics used, radiological status of beads, incidence and characteristics of wound discharge and outcome. Patients with undetectable type VII collagen keratinocyte expression were excluded. Ossiculoplasty with a cartilage-connecting hydroxyapatite prosthesis for tympanosclerotic stapes fixation. Van Rompaey et al (2011) studied hearing outcome in revision stapedotomy cases where extensive erosion of the long process of the incus was observed in a consecutive series where a malleo-vestibular prosthesis was used versus a consecutive series where HA bone cement was used to re-build the eroded long process of the incus and integrate the prosthesis. These complications included swelling of the neck and throat tissue that caused difficulty breathing, swallowing or speaking. 2013;471(4):1152-1158. 2020;78(3):195-201. DeNovo NT consists of manually minced cartilage tissue pieces obtained from juvenile allograft donor joints. Third, individuals with spinal abnormalities and those affected by devices such as plates, screws, silicone implants and prostheses could compromise the interpretation of DXA scans. Second, some subjects were not available at 2-year follow-up. Microsofts Activision Blizzard deal is key to the companys mobile gaming efforts. 2008;134(12):1283-1287. 2007;32(10):1067-1071. From June 2010 through May 2011 adult patients presenting with acute, closed and unstable tibial plateau fractures that needed both grafting and internal fixation, were included in a prospective study with percutaneous or open reduction and internal fixation (ORIF) augmented with an injectable ceramic biphasic bone substitute CBVF to fill residual voids. Kartogenin (KGN) induces tendon stem cells (TSCs) to differentiate into cartilage cells in-vitro and form meniscus-like tissue in-vivo. Health Technology Inquiry Service (HTIS). An age-related decline in cellularity was suggested for the iliac crest aspirates. The Patent Public Search tool is a new web-based patent search application that will replace internal legacy search tools PubEast and PubWest and external legacy search tools PatFT and AppFT. Other complications were not recorded. Since the 1st report of successful cartilage-like tissue regeneration with autologous adipose SVF containing ASCs, there has been a gradual increase in the number of publications confirming such results. All but 1 were level IV studies; therefore, there was significant risk of bias within the presented results. Kanayama M, Hashimoto T, Shigenobu K, et al. Autologous Iliac Crest Bone Grafting (ICBG) is considered the gold-standard graft choice for spinal arthrodesis; however, it is associated with donor site morbidity and a limited graft supply. The publication did not report prior treatment or the duration of the nonunions prior to the AlloMatrix putty treatment. .headerBar { Type VII collagen gene-corrected grafts (approximately 35 cm2) were transplanted onto 6 wounds in each of the patients (n=24 grafts). Development at present seems to be heading towards premixed or directly mixed products as well as new compounds that contain fibers or other components to enhance bending and shear strength. These researchers planned to enroll 136 patients with fresh traumatic depression fractures of the proximal tibia (types AO 41-B2 and AO 41-B3) in 13 participating centers in Germany. AlloStem is partially demineralized allograft bone combined with adipose derived mesenchymal stem cells; it is similar to autograft bone. Unfortunately, the current literature lacks an accepted standard number of MSCs needed to promote bony healing in the setting of arthrodesis, adding another layer of complexity to the issue. ASTM A563 is for Wrought Cobalt-20, Nickel-20, Chromium-3.5, Molybdenum-3.5, Tungsten-5, Iron. Saint-Denis La Plaine : HAS; 2013. Smucker and colleagues (2006) examined if BMP-2 is associated with an increased incidence of clinically relevant post-operative pre-vertebral swelling problems in patients undergoing anterior cervical fusions. Patients with PTRCT who underwent implantation of a collagen-based bio-inductive implant over the bursal surface of the rotator cuff were identified. A total of 100 adult patients underwent a primary, single- or multi-level, thoracolumbar PLF. height:2px; Perfect agreement was realized in almost 60% of patients (48 of 81) with moderate statistical correspondence (weighted kappa = 0.54, P < 0.0001). 2017;29(10):E84-E87. Am J Sports Med. 2012;94(4):298-307. These short-term results with the Gore fistula plug suggested a higher procedural success rate in comparison to the Cook plug. Shahrdar and colleagues (2020) stated that although use of cellular bone allografts (CBA) in orthopedic surgery has become increasingly common, little information is available regarding their short-term clinical performance. After correction for multi-level fusions, resulting in a single score per side, the fusion performance of AttraX Putty was tested with a non-inferiority margin of 15 % using a 90 % CI. A total of 35 patients underwent 39 plug insertions (22 men; mean age of 46 (range of 15 to 79) years). 1999;24(13):1295-1299. The discovery of a new allogeneic tissue processing technique has provided a way to access growth factors naturally found within bone marrow cells. The anal fistula plug is an attractive definitive option due to its minimal risk of incontinence, simple design, and easy application. Boyapati L, Wang HL. Neurosurg. Arch Otolaryngol Head Neck Surg. They also performed multiple statistical sensitivity analyses to address this issue and arrived at the conclusion that missing follow-ups did not bias their results. Of 20 patients, 19 were completely asymptomatic following surgical intervention, and of the 3 with failed repairs, only 1 patient required revision surgery for persistent symptoms. Outcomes of interest were cell yield, viability of cells, composition of SVF, duration, cost and procedure characteristics. Results were reported as the 5-frequency average air conduction gain, bone conduction gain, and ABG. Mesenchymal stem cell characteristics of human anterior cruciate ligament outgrowth cells. A prospective randomized study of posterolateral lumbar fusion using osteogenic protein-1 (OP-1) versus local autograft with ceramic bone substitute: Emphasis of surgical exploration and histologic assessment. Allogeneic morphogenetic protein vs. recombinant human bone morphogenetic protein-2 in lumbar interbody fusion procedures: A radiographic and economic analysis. A total of 110 patients with degenerative spinal disease underwent single or multi-level ALIF using the ABM/P-15 bone graft composite with a mean of 24 months (minimum 15 months) of follow-up were enrolled in the study. CPB 0743 - Spinal Surgery: Laminectomy and Fusion, CPB 0244 - Skin and Soft Tissue Substitutes, CPB 0016 - Back Pain - Invasive Procedures. Wounds. The objective Knee Society Score after a mean follow-up of approximately four years (range of two to eight years) was 89 (range of 70 to 100), and the functional score was 81 (range of 50 to 100). Neman J, Duenas V, Kowolik CM, et al. J Med Assoc Thai. Buchberg et al (2010) compared the Cook Surgisis AFP plug and the newer Gore Bio-A plug in the management of complex anal fistulas. Two-year fusion rate equivalency between Grafton DBM gel and autograft in posterolateral spine fusion:A prospective controlled trial employing a side-by-side comparison in the same patient. The rotator cuff is comprised of four muscles (i.e., infraspinatus, subscapularis, supraspinatus and teres minor) that originate from the scapula. Eur Arch Otorhinolaryngol. The greater efficacy of the fistula plug may be the result of the ability to suture the plug in the primary opening, therefore, closing the primary opening more effectively. In the fibrin glue group, 6 patients (60 %) had persistence of one or more fistulas at 3 months, compared with 2 patients (13 %) in the plug group (p < 0.05, Fisher exact test). Shahlaie K, Kim KD. Difference in fusion rates after 1 and 2 years and between grafts were analyzed with a Generalized Estimating Equations (GEE) model (p < 0.05). UpToDate [online serial]. Digital Journal is a digital media news network with thousands of Digital Journalists in 200 countries around the world. Corpus Christi, TX: Work Loss Data Institute; 2008. 2006;31(1):83-89. Minamide A, Yosida M, Kawakami M, et al. J Orthop Surg Res. Minced cartilage without cell culture serves as an effective intraoperative cell source for cartilage repair. A total of 25 patients were prospectively enrolled: 10 patients underwent fibrin glue closure, and 15 used a fistula plug. At 2-year follow-up, mean ASES and CMS scores improved both clinically and statistically at 1 and 2 years, compared with baseline, for intermediate- and high-grade tears. The authors concluded thatGrafton DBM can extend a smaller quantity of autograft than is normally required to achieve a solid spinal arthrodesis. There were 27 males and 17 females with average age of 44.1 years treated for simple (n = 24) or complex (n = 20) fistulas. There were 16 (66.7 %) articular-sided, 5 (20.8 %) bursal-sided, and 3 (12.5 %) intra-substance tears. (Only 3 patients received cultured bone marrow stem cell implantation). Recent studies also produced contradictory findings on the clinical value of PRP. 2014;3(5):184-188. Only 2 studies validated micro-indentation against traditional mechanical testing techniques. Sammartino G, Tia M, Marenzi G, et al. They carried out a systematic review of all English language articles using Medline, Embase, PubMed, Scopus and Cochrane databases. These studies showed clinically equivalent fusion rates between the2 groups, with similar outcomes in terms of back pain, leg pain, disability and neurological status. Analysis of the results was performed using the paired t-test with significance level at 0.05. There were no significant differences in the reported clinical outcomes across all classes of bone substitutes. At the 1-year follow-up, 50 of 57 (87.7 %) patients in the Osteocel cohort demonstrated a solid fusion compared with 54 of 57 (94.7 %) in the control group (p = 0.19); 7 (12.3 %) patients in the Osteocel cohort were reported as having a failed fusion at 1 year. These investigators then created a control group using a 1:1 matching process on gender, age, fracture pattern, and method of fixation. Defects were treated with BPBM, GTR, and PRP (experimental), or with open-flap debridement (control). The use of DBM as a bone expander to augment autograft is supported, especially in the lumbar spine. Composite powders with 4 different loadings of graphene oxide (GO), i.e., 0, 0.1, 0.5 and 1 wt %, were sintered by spark plasma sintering (SPS) at a relatively low temperature of 550 C, during which in-situ thermal reduction of GO took place. A total of 6 studies were identified and included in this review, with a total of 167 patients 2 studies used subchondroplasty CaP injections, while 4 studies used intra-osseous injections of PRP. Two matched cohorts of adult patients who underwent ACDF with MSC or standard allograft were included. Forty-six patients were randomly assigned (2:1) to receive Grafton DBM Matrix with local bone (30 patients) or autologous ICBG (16 patients). Earrings. Waltham, MA: UpToDate;reviewed February 2019. Preclinical and clinical studies on the use of growth factors for bone repair: A systematic review. Thalgott JS, Klezl Z, Timlin M, Giuffre JM. Plantz et al (2021) note that historically, iliac crest bone autograft has been considered the gold standard bone graft substitute for spinal fusion; however, the significant morbidity associated with harvesting procedures has influenced decision-making and practice patterns. Plugs & Tunnels View all. Spine. In a retrospective, radiographic outcome study, these researchers examined the radiographic fusion rate of Healos with BMA versus autologous bone graft in the same patients PLF. Leung et al (2006) stated that in the past several years, significant progress has been made in the field of stem cell regeneration of the intervertebral disc. In patients treated at a single level with a minimum of 24-month follow-up, 92 % (79/86) of levels achieved solid bridging and 95 % of levels demonstrated ROM of less than 3. These short-term results with the Gore fistula plug suggested a higher procedural success rate in comparison to the Cook plug. The authors concluded that the present study showed that stapedectomy and total ossiculoplasty with cartilage-connecting HA prosthesis is effective and safe for stapes fixation accompanied by fixation or erosion of the malleus and/or incus. 2002;2(1):63-69. There was a statistically significant greater mean intraoperative blood loss in the ICBG group than in the Grafton group (P < 0.0031). Arch Otolaryngol Head Neck Surg. A single magnetic resonance imaging (MRI) scan was used to confirm tendon healing and thickness at a minimum of 6 months post-operatively. In the ICBG group, 4 patients still reported donor site pain of on average 2/10 on the VAS at last follow-up. The authors concluded that cell-based therapy was associated with short-term improvement in function in adolescents and young adults with patellar OCD. They also stated that future clinical studies will attempt to confirm the ability to obtain fusion using only this source of connective tissue progenitor cells. This was a small (n = 17) short-term (6 months follow-up) that examined the use of rhBMP-2 for alveolar cleft bony reconstruction; not for ankle fusion. The authors concluded that adjuvant, local antibiotic therapy with an absorbable bio-composite could help achieve up to 90 % cure rates in diabetic foot ulceration with osteomyelitis. There was no correlation between antibiotic used and wound discharge. This trial entailed 39 cases of osteo-articular infections from April 2013 to November 2016 in whom SHPCS beads were used. Nusselt et al (2014) stated that bone graft substitutes are widely used for reconstruction of post-traumatic bone defects. The osteogenic potential of the cells was characterized using biochemical and molecular biology techniques. Radiographic fusion criteria included less than 5 degrees of angular motion, less than 2 mm of translation, and evidence of bridging bone in the postero-lateral lumbar area in which the graft materials were placed following decortication. 2005;76(10):1768-1777. A radiographic analysis of posterolateral lumbar fusion utilizing an allogeneic growth factor compared to recombinant human bone morphogenetic protein-2 (rhBMP-2). Kadam and associates (2016) reviewed clinically relevant bone substitutes and bone expanders for spinal surgery in terms of effectiveness and associated clinical outcomes, as reported in contemporary spine literature. To-date, favorable fusion rates with use of P-15 have been demonstrated in a limited number of clinical studies in the setting of cervical fusion (the 2018 study by Arnold et al was discussed). Autologous chondrocyte transplantation and osteochondral autografts yield encouraging 2- and 4-year results, but still have to prove their superiority in long-term follow-up studies. The role of platelet-rich plasma in sinus augmentation: A critical review. Tibial plateau fractures when compared with conventional bone grafting for atrophic/avascular nonunions were retrospectively studied mobile gaming.... 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