Clinically, cartilage damage is frequently accompanied with subchondral bone injuries caused by disease or trauma. However, the construction of biomimetic scaffolds to support both cartilage and subchondral bone regeneration remains a great challenge. Herein, a novel strategy is adopted to realize the simultaneous repair of osteochondral defects by employing a self‐assembling peptide hydrogel (SAPH) FEFEFKFK (F, phenylalanine; E, glutamic acid; K, lysine) to coat onto 3D‐printed polycaprolactone (PCL) scaffolds. Results show that the SAPH‐coated PCL scaffolds exhibit highly improved hydrophilicity and biomimetic extracellular matrix (ECM) structures compared to PCL scaffolds. In vitro experiments demonstrate that the SAPH‐coated PCL scaffolds promote the proliferation and osteogenic differentiation of rabbit bone mesenchymal stem cells (rBMSCs) and maintain the chondrocyte phenotypes. Furthermore, 3% SAPH‐coated PCL scaffolds significantly induce simultaneous regeneration of cartilage and subchondral bone after 8‐ and 12‐week implantation in vivo, respectively. Mechanistically, by virtue of the enhanced deposition of ECM in SAPH‐coated PCL scaffolds, SAPH with increased stiffness facilitates and remodels the microenvironment around osteochondral defects, which may favor simultaneous dual tissue regeneration. These findings indicate that the 3% SAPH provides efficient and reliable modification on PCL scaffolds and SAPH‐coated PCL scaffolds appear to be a promising biomaterial for osteochondral defect repair.
Background
The purpose of this study was to assess the clinical outcome of percutaneous kyphoplasty (PKP) assisted with mixed reality (MR) technology in treatment of osteoporotic vertebral compression fracture (OVCF) with intravertebral vacuum cleft (IVC).
Method
Forty cases of OVCF with IVC undergoing PKP were randomized into a MR technology-assisted group (group A) and a traditional C-arm fluoroscopy group (group B). Both groups were performed PKP and evaluated by VAS scores, ODI scores, radiological evidence of vertebral body height, and kyphotic angle (KA) at pre-operation and post-operation. The volume of injected cement, fluoroscopy times, and operation time were recorded. And cases of non-PMMA-endplates-contact(NPEC) in radiological evidence was also recorded postoperatively. The clinical outcomes and complications were evaluated afterwards. All patients received 10 to 14 months follow-up, with an average of 12 months.
Result
This MR-assisted group (group A) acquired more about the amount of the polymethyl methacrylate (PMMA) injection and postoperative vertebral height and less about postoperative KA, fluoroscopy times, and operation time compared with the control group (group B) (
P
< 0.05). The VAS scores and ODI scores in both groups have improved, but more significantly in group A (
P
< 0.05). Also, more cases achieve both-endplates-touching of cement in group A (
P
< 0.05). And there are less of the loss of vertebral height, KA, and occurrence of re-collapse of the vertebra in group A during the follow-up (
P
< 0.05).
Conclusion
PKP assisted with MR technology can accurately orientate the position of IVC area, which can be augmented by the balloon leading to more satisfied vertebral height improvement, cement diffusion, and pain relief.
Trial registration
ClinicalTrials.gov Identifier:
NCT03959059
. Registered 25 September 2016.
Background
This was a prospective comparative study of mixed reality (MR) technology assisted lumbar pedicle screws placement and traditional lumbar pedicle screws placement.
Material/Methods
Fifty cases of lumbar pedicle screws placement were randomly divided into 2 groups: 25 cases with MR technology in group A, and 25 cases without MR technology in group B. All patients had their scores on the Oswestry disability index (ODI) of low back pain and the visual analog scale (VAS) of the affected lower limb recorded at pre-operation. Blood loss, operative duration, success rate of first penetration by tap, and number of times C-arm fluoroscopy was performed were recorded at intraoperation. The postoperative drainage was recorded. The ODI of low back pain and VAS of the affected lower limb were recorded at 1, 3, and 6 months after operation.
Results
Group A had less bleeding, shorter operation time, higher success rate of first penetration by tap, and fewer times using C-arm fluoroscopy at intraoperation (
P
<0.05). There was significant difference in ODI scores and VAS scores at 1 mouth after operation (
P
<0.05). The postoperative drainage of group A was less than group B (
P
<0.05). The implantation accuracy of group A was higher than group B (
P
<0.05). The postoperative recovery rate of low back pain of group A was faster than group B (
P
<0.05).
Conclusions
The safety of spinal surgery and implantation accuracy of pedicle screw fixation system could be increased by MR technology.
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