Antimicrobial Effect Of Visible Blue Light Used In A Minimally Invasive Intramedullary Fracture Stabilization System

Oijen, Guido W. Van; Croughs, P; Hagenaars, Tjebbe; Verhofstad, Michael H J; Lieshout, Esther M.M. Van

doi:10.7150/jbji.35629

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…Moreover, post-operative imaging displays minimal artifacts, facilitating improved observation of tumor recurrence and bone union. In terms of basic scientific literature, there is evidence demonstrating that visible blue light emitted by the PBSS device can result in a temporary reduction of S. aureus based on in vitro testing [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

The Use of Photodynamic Bone Stabilization to Tamponade Bleeding in a Pathologic Humeral Shaft Fracture: A Case Report

Vemu,

Farii,

Bird

et al. 2023

jocr

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Introduction: Hypervascular tumors such as renal and thyroid carcinoma have a significant risk of intraoperative bleeding. To help mitigate bleeding, interventional preoperative embolization is traditionally used; however, it is success is highly variable. This is the first case report to discuss using expandable balloon implants with a minimally invasive approach to achieve fracture fixation and tamponade acute intraoperative bleeding. Case Report: A 48-year-old male with clear-cell renal cell carcinoma presented with a left humeral shaft pathologic fracture. The patient was scheduled to undergo open biopsy, curettage of tumor, and fracture fixation with an intramedullary device. Intraoperatively, during open biopsy and curettage, brisk bleeding was encountered, which ceased after inserting an intramedullary photodynamic bone stabilization implant (IlluminOss). The implant’s balloon expanded to the diameter of the humerus allowing for tamponade, fracture stability, and a minimally invasive approach. Conclusion: We present a possible intraoperative option for achieving control of bleeding in pathologic long bone fractures by deploying a photodynamic stabilization device. The method described can have applications in specific patients and obviate the need for pre-operative embolization for highly vascular tumors due to the implant’s ability to create tamponade within the bone. Keywords: Photodynamic bone stabilization, IlluminOss, Pathologic fracture, Tamponade, Renal cell carcinoma, Hemorrhage.

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Section: Discussionmentioning

confidence: 99%

The Use of Photodynamic Bone Stabilization to Tamponade Bleeding in a Pathologic Humeral Shaft Fracture: A Case Report

Vemu,

Farii,

Bird

et al. 2023

jocr

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“…The infection rate seems very low in literature; it could be due to the minimal invasiveness which reduces the risk of contamination although, recently, a direct antimicrobial effect of the blue-light applied to induce polymerization was hypothesized [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Even if MC Sweenay et al published a study performed on rabbits in which they demonstrated the perfect compatibility of the IS-PBSS inside active bone without any significant tissue reaction and its integration, a possible limitation in the removal procedure is represented by the unique shape the nail can assume inside the patient's bone; this can make the procedure extremely aggressive from a surgical point of view. [24] The infection rate seems very low in literature; it could be due to the minimal invasiveness which reduces the risk of contamination although, recently, a direct antimicrobial effect of the blue-light applied to induce polymerization was hypothesized [25].…”

Section: Disadvantages and Complicationsmentioning

confidence: 99%

The IlluminOss® photodynamic bone stabilization system for pathological osteolyses and fractures of the humerus: indications, advantages and limits in a series of 12 patients at 24 months of minimum follow‐up

Zoccali¹,

Attala²,

Pugliese

et al. 2021

BMC Musculoskelet Disord

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Background Locked titanium nails are considered the reference treatment for metastatic bone lesions of the humerus in patients with aggressive histotypes, high risk of fracture or when estimated survival is lower than 6 months.Nevertheless, they are responsible for CT and MRI artifacts which interfere with postoperative radiotherapy and follow-up.The IlluminOss® is an intramedullary stabilization system which is introduced inside the humeral canal in a deflated state, and is then distended with a monomer which hardens after exposure to blue light,stabilizing the segment; it does not cause artifacts, allowing easier and more effective radiotherapy and follow-up. The aim of this study is to report our experience, indications, possible advantages and limitations of this stabilization system at 24 months of minimum follow-up in a series of 12 patients affected by pathological fractures or impending fractures of the humerus. Methods This is a retrospective case-series that included all patients who underwent surgery with the IlluminOss® Photodynamic Bone Stabilization System for pathological osteolyses and fractures of the humerus. Intraoperative and postoperative complications were valued. Results 12 patients and 13 procedures were included in the study. All surgeries were performed without intraoperative complications. No early postoperative complications were noted. The wounds healed in all cases and stitches were removed at two weeks from surgery, so the patients were able to perform chemotherapy after three weeks. All patients except one had a painless active range of motion which reached 90°.The VAS score was 7 preoperatively and 2.6 at one month from surgery. Pain relief was also associated to radiotherapy and chemotherapy. Unfortunately, two nail ruptures were reported at 4 and 12 months of follow-up. No artifacts were noted in the postoperative CT scans so the radiotherapy plans were easily performed without the need of dose compensation. Conclusions The IlluminOss® intramedullary stabilization system can provide primary stability in humeral fractures and impending fractures;the surgical technique is easy and minimally invasive.Moreover,it does not present artifacts at postoperative imaging,probably giving a better chance to perform prompt radiotherapy and chemotherapy.However, randomized clinical studies are necessary to verify its potential strength and if precocious adjuvant radio- and chemotherapy are associated to a reduction of the local progression rate.

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“…Also, a preliminary study on sheep provided encouraging results in the treatment of weight-bearing bone fractures [ 30 ]. The system is contraindicated in active or not completely healed infections, even if studies have been carried out on the antimicrobial effect of the light used for the polymerization of the system [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Electrochemotherapy and Simultaneous Photodynamic Bone Stabilization of Upper Limbs in Metastatic Renal Cancer Disease: Case Report and Literature Review

Albertini

Conti

Ratto

et al. 2020

Case Reports in Medicine

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Introduction. Metastatic bone disease represents a systemic pathology that heavily affects the quality of life of oncologic patients causing pain and functional disability. Methodology. We present the case of a patient with a history of renal cell cancer presenting pathologic fractures of both humeri and proximal right radius. Results. After a careful multidisciplinary approach, an adjuvant anticancer therapy and a photodynamic bone stabilization procedure were performed with a minimally invasive technique aiming to minimize pain and local disease progression, while restoring functional autonomy and improving the patient’s quality of life. Electrochemotherapy was delivered on the lytic bone lesions with extraskeletal involvement of the proximal left humerus and the proximal right radius, and then polymeric bone stabilization was performed on both humeri. At two months of follow-up, the patient presented satisfactory functional scores (MSTS score: 12/30 bilaterally; DASH scores: 46.7/100 for the right side and 48.3/100 for the left one), and pain was well controlled with opioid analgesics. Radiographs showed good results in terms of ossification of lytic bone lesions and durability of polymeric stabilization. At four months of follow-up, the patient reported a stable clinical scenario. Six months after surgery, due to extremely poor prognosis after the progression of primary disease, the patient was referred to palliative care and died shortly thereafter. Conclusion. Over the last decade, the management of metastatic bone disease has changed. Low-toxicity and minimally invasive procedures such as electrochemotherapy and polymeric bone stabilization might be performed concomitantly in selected patients, as an alternative to radiation therapy and to more demanding surgical procedures such as plating and adjuvant cementing.

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Antimicrobial Effect Of Visible Blue Light Used In A Minimally Invasive Intramedullary Fracture Stabilization System

Cited by 5 publications

References 18 publications

The Use of Photodynamic Bone Stabilization to Tamponade Bleeding in a Pathologic Humeral Shaft Fracture: A Case Report

The Use of Photodynamic Bone Stabilization to Tamponade Bleeding in a Pathologic Humeral Shaft Fracture: A Case Report

The IlluminOss® photodynamic bone stabilization system for pathological osteolyses and fractures of the humerus: indications, advantages and limits in a series of 12 patients at 24 months of minimum follow‐up

Electrochemotherapy and Simultaneous Photodynamic Bone Stabilization of Upper Limbs in Metastatic Renal Cancer Disease: Case Report and Literature Review

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