Additive manufacturing enables architectured porous material design, but 3D-CAD modelling of these materials is prohibitively computationally expensive. This bottleneck can be removed using a line-based representation of porous materials instead, with strut thickness controlled by the supplied laser energy. This study investigated how laser energy and scan strategy affects strut thickness and mechanical strength of porous materials. Specimens were manufactured using varying laser parameters, 3 scan strategies (Contour, Points, Pulsing), 2 porous architectures and 2 materials (Titanium, Stainless Steel), with strut thickness, density, modulus, mechanical strength and build time measured. Struts could be built successfully as low as 15° with a minimum diameter of 0.13 mm. Strut thickness was linearly related to the specific enthalpy delivered by the laser to the melt-pool. For a given stiffness, Titanium specimens built at low power/slow speed had a 10% higher strength than those built at high power/fast speed. The opposite was found in Stainless Steel. As specimen stiffness increased, the Contour Strategy produced samples with the highest strength:stiffness and strength:weight ratio. The Points strategy offered the fastest build time, 20% and 100% faster than the Contour and Pulsing strategies, respectively. This work highlights the importance of optimising build parameters to maximize mechanical performance

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An increasing volume of work supports utilising the mechanobiology of bone for bone ingrowth into a porous scaffold. However, typically during in vivo testing of implants, the mechanical properties of the bone being replaced are not quantified. Consequently there remains inconsistencies in the literature regarding ‘optimum’ pore size and porosity for bone ingrowth. It is also difficult to compare ingrowth results between studies and to translate in vivo animal testing to human subjects without understanding the mechanical environment. This study presents a clinically applicable approach to determining local bone mechanical properties and design of a scaffold with similar properties. The performance of the scaffold was investigated in vivo in an ovine model. The density, modulus and strength of trabecular bone from the medial femoral condyle from ovine bones was characterised and power-law relationships were established. A porous titanium scaffold, intended to maintain bone mechanical homeostasis, was additively manufactured and implanted into the medial femoral condyle of 6 ewes. The stiffness of the scaffold varied throughout the heterogeneous structure and matched the stiffness variation of bone at the surgical site. Bone ingrowth into the scaffold was 10.73±2.97% after 6 weeks. Fine woven bone, in the interior of the scaffold, and intense formations of more developed woven bone overlaid with lamellar bone at the implant periphery were observed. The workflow presented will allow future in vivo testing to test specific bone strains on bone ingrowth in response to a scaffold and allow for better translation from in vivo testing to commercial implants.

Background: Torus fractures of the distal radius are both a common pediatric forearm fracture and a common source of referral to orthopedic departments. Management of these injuries has moved away from traditional casting methods to using splints and softcasts. Aim: With the recent introduction of a virtual fracture clinic (VFC), we sought to improve our compliance with guidelines while ensuring all patients undergo review in the clinic. Methods: We audited the management of patients before and after the introduction of the VFC with new management protocols for torus fracture patients. Results: There was a 51% decrease in patients managed using plaster of Paris with 5% treated with a softcast and 59% using a splint. Outcome: Using the VFC can improve the management of patients with torus fractures and provide a cost-saving and a more positive experience for patients.

N-(4-hydroxyphenyl)retinamide (4-HPR), a synthetic retinoid is under clinical evaluation as a therapeutic agent in a variety of cancers. Its mechanism(s) of action involves multiple overlapping pathways that still remain unclear. In glioma cells its mechanism of action is not well elucidated. Here, we show that 4-HPR and not all-trans retinoic acid and 9-cis retinoic acid effectively induce apoptosis in glioma cells. 4-HPR-induced apoptosis is associated with hydroperoxide production and loss of mitochondrial membrane potential (Delta Psi(m)). Ultrastructural changes further indicate 4-HPR-induced mitochondrial swelling, endoplasmic reticulum (ER) dilation as well as close proximity of mitochondria and ER. As suggested by dilated ER, 4-HPR treatment increased the free cytosolic Ca(2+) as well as mitochondrial Ca(2+). Chelation of extracellular Ca(2+) by EGTA did not prevent Ca(2+) elevation, thus suggesting involvement of intracellular calcium stores in the release. Buffering of intracellular calcium by BAPTA-AM did not prevent 4-HPR-induced apoptosis; however, blocking the release of Ca(2+) from ER by heparin inhibited apoptosis, indicating the role of depletion of Ca(2+) from ER stores in apoptosis. 4-HPR treatment also resulted in an increase in Bax levels along with its translocation to mitochondria that promote mitochondrial membrane permeabilization. 4-HPR-induced apoptosis was further associated with the release of cytochrome c and apoptosis-inducing factor (AIF) from mitochondria to cytosol and nucleus, respectively, along with caspase-3 and caspase-7 activation. However, AIF nuclear translocation, peripheral chromatin condensation and apoptosis were not completely prevented by general caspase inhibitors, thus suggesting involvement of a caspase-dependent and caspase-independent pathway in 4-HPR-induced apoptosis. Taken together, these results suggest the role of mitochondrial-mediated pathway and ER stress as a key event in 4-HPR-induced apoptosis in glioma cells.