Composite nanofibrous scaffolds with various poly(ε-caprolactone) (PCL)/gelatin ratios (90:10, 80:20, 70:30, 60:40, 50:50 wt.%) were successfully electrospun using diluted acetic and ethyl acetate mixture. The effects of this solvent system on the solution properties of the composites and its electrospinning properties were investigated. Viscosity and conductivity of the solutions, with the addition of gelatin, allowed for the electrospinning of uniform nanofibers with increasing hydrophilicity and degradation. Composite nanofibers containing 30 and 40 wt.% gelatin showed an optimum combination of hydrophilicity and degradability and also maintained the structural integrity of the scaffold. Human mesenchymal stem cells (hMSCs) showed favorable interaction with and proliferation on, the composite scaffolds. hMSC proliferation was highest in the 30 and 40 wt.% gelatin containing composites. Our experimental data suggested that PCL-gelatin composite nanofibers containing 30-40 wt.% of gelatin and electrospun in diluted acetic acid-ethyl acetate mixture produced nanofiber scaffolds with optimum hydrophilicity, degradability, and bio-functionality for stem cell-based bone tissue engineering.
Nanofibrous semi-synthetic polymeric nanocomposite scaffolds were engineered by incorporating a maximum of 15 wt% biopolymeric gelatin nanoparticles (nGs) into the synthetic polymer poly(ε-caprolactone) (PCL) prior to electrospinning. The effect of nGs in altering the physico-chemical properties, cell material interaction and biodegradability of the scaffolds was evaluated. Experimental results showed that the inherent hydrophobicity of PCL scaffolds remained unaltered even after the incorporation of hydrophilic nGs. However, breakdown of the continuous nanofibers into lengths less than 7 µm occurred within four to eight weeks in the presence of nGs in contrast with the greater than two year time frame for the degradation of PCL fibers alone that is known from the literature. In terms of cell-material interaction, human mesenchymal stem cells (hMSCs) were found to attach and spread better and faster on PCL_nG scaffolds compared to PCL scaffolds. However, there was no difference in hMSC proliferation and differentiation into osteogenic lineage between the scaffolds. These results indicate that PCL_nG nanofibrous nanocomposite scaffolds are an improvement over PCL scaffolds for bone tissue engineering applications in that the PCL_nG scaffolds provide improved cell interaction and are able to degrade and resorb more efficiently.
BACKGROUND: - The incidence of distal tibiofibular syndesmotic injury in ankle fractures is about 13%. The integrity of syndesmosis is a critical factor which stabilizes ankle mortise during weight-bearing besides load transmission. The primary purpose of the study was to assess the functional outcome in patients with Weber B and C fractures and to decide whether the syndesmotic screws are to be removed or not before weight-bearing.
MATERIALS AND METHODS: - This was a prospective observational study involving patients (>18 years of age) who had undergone open reduction and internal fixation of an ankle fracture belonging to Weber B or C classification who had screw stabilization of a disrupted syndesmosis. The study period was three years commencing from August 2014. They were divided into two groups based on the syndesmotic screw retention or removal before weight-bearing. The patients were then regularly followed up with American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score and Visual Analogue Score-Foot and Ankle (VAS-FA) score were used to assess the functional outcome. Clinical and radiographic evaluations were done with each follow-up at 4,6,9,12 months.
RESULTS: - We identified 32 fractures in 32 patients. Treatment undertaken was open reduction and internal fixation for the malleolli and syndesmotic screw fixation in all patients, and syndesmotic screws were removed in 17 and retained in 15. None of the patients were managed conservatively. We lost a patient to long-term follow-up. The AOFAS score was seen to be progressively increasing (92.3 – 96.75) and higher in the removed group as compared to retained. The VAS-FA score was also seen to be increasing besides being higher in the removed group (160.17 to 187). None of the patients failed the operative stabilization. Also, none of the patients had long-term complications like non-union, mal-union or screw back out excepting one patient who had persistent pain in the retained group.
CONCLUSION: It is safe and better to remove the syndesmotic screw prior to weight bearing, when compared to retaining them insitu. Level of evidence IV-prognostic
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.