A Study of Experimental Trauma to the Distal Femoral Epiphysis in Rabbits

Ford, Lee T.; Key, J. Albert

doi:10.2106/00004623-195638010-00008

Cited by 75 publications

(27 citation statements)

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“…Although growth plate fractures are of common occurrence, little is understood regarding the molecular and cellular processes leading to the bone bridge formation. Earlier studies have suggested that bone bridge formation was related to damage to the stem cells of the growth plate resting zone [ 181, or related to physical damage to the epiphysis basement bone plate [7] or to the physeal-epiphyseal border [20]. It has also been suggested that a physical damage to the growth plate and mixing of the epiphyseal and metaphyseal blood circulations contribute to the bone formation In the growth plate defect [I I].…”

Section: Discussionmentioning

confidence: 99%

Intramembranous ossification mechanism for bone bridge formation at the growth plate cartilage injury site

Chen

Zhou

McCarty

et al. 2004

Journal Orthopaedic Research

133

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Salter's type I11 and type IV growth plate injuries often induce bone bridge formation at the injury site. To understand the cellular mechanisms, this study characterized proximal tibia1 transphyseal injury in rats. Histologically, bony bridge trabeculae appeared on day 7, increased on day 10, and became well-constructed on day 14 with marrow. Prior to and during bone bridging, there was no cartilage proteoglycan metachromatic staining and no collagen-)< immunostaining at the injury site, nor was there any up-regulation of BrdU-labelled chondrocyte proliferation at the adjacent physeal cartilage, suggesting no new cartilage formation at the injury site. However, infiltration of vimentin-immunopositive mesenchymal cells from metaphysis and epiphysis was apparent on day 3, with the mesenchymal population being prominent on days 7 and 10 and subsided on day 14. Among these infiltrates were osteoprogenitor precursors expressing osteoblast differentiation factor (cbf-al ) on day 3, along with some cbf-a1 osteoblast-like cells lining bone trabeculae on days 7 and 10. Some mesenchymal cells and trabecula-lining cells were also alkaline phosphataseimmunopositive, further suggesting their osteoblast differentiation. From day 7 onwards, some trabecula-lining cells became osteocalcin-producing mature osteoblasts. These results suggest that bone bridge formation after growth plate injury occurs directly via intramembranous ossification through recruitment of marrow-derived osteoprogenitor cells.Crown

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Section: Discussionmentioning

confidence: 99%

Intramembranous ossification mechanism for bone bridge formation at the growth plate cartilage injury site

Chen

Zhou

McCarty

et al. 2004

Journal Orthopaedic Research

133

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“…Risk of growth arrest exists in the peripheral portion of the distal physis/perichondrial ring of the femur [38], so a femoral tunnel exiting in this area is likely best avoided. The close relationship between the femoral attachment of the ACL and the adjacent femoral physis demands respect for techniques using all-epiphyseal femoral tunnels or the over-the-top technique.…”

Section: Principlesmentioning

confidence: 99%

Pediatric anterior cruciate ligament reconstruction outcomes

Peterson

Ayeni

2016

Curr Rev Musculoskelet Med

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Treatment of pediatric anterior cruciate injuries have become an area of controversy sparking much debate about best management strategies. Delaying surgery until skeletal maturity has often been shown to result in unfavorable outcomes due to concomitant meniscal and chondral injuries in this population. There have been numerous techniques used to reconstruct the ACL in the skeletally immature patient; however, most studies are limited by small patient numbers and other methodological concerns. With recent publications reporting failure rates as high as 15-25 % and growth disturbances being uncommon but now reported within almost every technical category, patient and caregiver education become of paramount importance. Key principles will be outlined that may help to avoid some of the pitfalls that occur when dealing with this unique population.

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“…Physeal injury in the peripheral region of the physis or to the perichondral ring may increase the likelihood of physeal arrest and secondary growth disturbance. 20 Historically, PCL injury has been a very rare occurrence in young athletes, although the medical literature has shown increased reports of this injury in recent publications. The indications and techniques for treatment of PCL injury in skeletally immature athletes are evolving, but surgical treatment for PCL injury may cause physeal damage and subsequent growth alteration.…”

Section: Discussionmentioning

confidence: 99%