An Overview of Bone Grafting Techniques for the Diabetic Charcot Foot and Ankle

Ramanujam, Crystal L.; Facaros, Zacharia; Zgonis, Thomas

doi:10.1016/j.cpm.2012.07.005

Cited by 16 publications

(12 citation statements)

References 19 publications

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“…In DM, however, bone regeneration procedures result in a greater degree of variability and increased infection rates [14–15]. Growth factors have been extensively studied and found to be beneficial for bone regeneration in humans [16–17].…”

Section: Introductionmentioning

confidence: 99%

Locally delivered salicylic acid from a poly(anhydride-ester): Impact on diabetic bone regeneration

Wada

Elazizi

et al. 2013

Journal of Controlled Release

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Diabetes mellitus (DM) involves metabolic changes that can impair bone repair, including a prolonged inflammatory response. A salicylic acid-based poly(anhydride-ester) (SA-PAE) provides controlled and sustained release of salicylic acid (SA) that locally resolves inflammation. This study investigates the effect of polymer-controlled SA release on bone regeneration in diabetic rats where enhanced inflammation is expected. Fifty-six Sprague-Dawley rats were randomly assigned to two groups: diabetic group induced by streptozotocin (STZ) injection or normoglycemic controls injected with citrate buffer alone. Three weeks after hyperglycemia development or vehicle injection, 5 mm critical sized defects were created at the rat mandibular angle and treated with SA-PAE/bone graft mixture or bone graft alone. Rats were euthanized 4 and 12 weeks after surgery, then bone fill percentage in the defect region was assessed by micro-computed tomography (CT) and histomorphometry. It was observed that bone fill increased significantly at 4 and 12 weeks in SA-PAE/bone graft-treated diabetic rats compared to diabetic rats receiving bone graft alone. Accelerated bone formation in normoglycemic rats caused by SA-PAE/bone graft treatment was observed at 4 weeks but not at 12 weeks. This study shows that treatment with SA-PAE enhances bone regeneration in diabetic rats and accelerates bone regeneration in normoglycemic animals.

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Section: Introductionmentioning

confidence: 99%

Locally delivered salicylic acid from a poly(anhydride-ester): Impact on diabetic bone regeneration

Wada

Elazizi

et al. 2013

Journal of Controlled Release

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“…In these instances, grafting may be necessary to fill the void. Several options exist including autogenous grafting from the fibula, iliac crest, proximal tibia, or decorticated osteotomized material [97]. Orthobiologic products can be used as an alternative to improve bone healing; e.g.…”

Section: Treatmentmentioning

confidence: 99%

“…Orthobiologic products can be used as an alternative to improve bone healing; e.g. demineralized bone matrix (DBM), osteoconductive and osteoinductive allografts, calcium phosphate, calcium sulfate and hydroxyapatite substitutes, bone marrow aspirates and platelet rich plasma [95,97].…”

Section: Treatmentmentioning

confidence: 99%

Diabetic Foot Ulcers — Treatment and Prevention

Shapiro¹,

Koshimune²,

Moellmer³

2013

Type 2 Diabetes

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“…The current “gold standard” to treat orthopedic and oral‐facial defects is bone grafting, which does not address the underlying diabetic complications. Diabetic subjects under these treatments therefore suffer from a greater degree of variability in treatment outcomes and increased infection rates . Although studies have demonstrated that growth factors such as bone morphogenic proteins (BMP) are beneficial for bone regeneration in humans, these proteins are extremely expensive and have unresolved safety concerns.…”

Section: Introductionmentioning

confidence: 99%

“…Diabetic subjects under these treatments therefore suffer from a greater degree of variability in treatment outcomes and increased infection rates. 8,9 Although studies have demonstrated that growth factors such as bone morphogenic proteins (BMP) are beneficial for bone regeneration in humans, 10 these proteins are extremely expensive and have unresolved safety concerns. For example, high complication rates and potential carcinogenicity of BMPs in humans are known: the BMP signaling pathway leads to enhanced proliferation in serous ovarian cancer-a potential therapeutic target.…”

Section: Introductionmentioning

confidence: 99%

Sustained, localized salicylic acid delivery enhances diabetic bone regeneration via prolonged mitigation of inflammation

Bien-Aime

Mattos

et al. 2016

J Biomedical Materials Res

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Diabetes is a metabolic disorder caused by insulin resistance and/or deficiency and impairs bone quality and bone healing due to altered gene expression, reduced vascularization, and prolonged inflammation. No effective treatments for diabetic bone healing are currently available, and most existing treatments do not directly address the diabetic complications that impair bone healing. We recently demonstrated that sustained and localized delivery of salicylic acid (SA) via an SA-based polymer provides a low-cost approach to enhance diabetic bone regeneration. Herein, we report mechanistic studies that delve into the biological action and local pharmacokinetics of SA-releasing polymers shown to enhance diabetic bone regeneration. The results suggest that low SA concentrations were locally maintained at the bone defect site for more than 1 month. As a result of the sustained SA release, a significantly reduced inflammation was observed in diabetic animals, which in turn, yielded reduced osteoclast density and activity, as well as increased osteoblastogenesis. Based upon these results, localized and sustained SA delivery from the SA-based polymer effectively improved bone regeneration in diabetic animals by affecting both osteoclasts and osteoblasts, thereby providing a positive basis for clinical treatments. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2595-2603, 2016.

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An Overview of Bone Grafting Techniques for the Diabetic Charcot Foot and Ankle

Cited by 16 publications

References 19 publications

Locally delivered salicylic acid from a poly(anhydride-ester): Impact on diabetic bone regeneration

Locally delivered salicylic acid from a poly(anhydride-ester): Impact on diabetic bone regeneration

Diabetic Foot Ulcers — Treatment and Prevention

Sustained, localized salicylic acid delivery enhances diabetic bone regeneration via prolonged mitigation of inflammation

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