Effect of mechanical stability on fracture healing — an update

Jagodzinski, Michael; Krettek, Christian

doi:10.1016/j.injury.2007.02.005

Cited by 186 publications

(132 citation statements)

References 44 publications

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“…Consistent with the high sensitivity of the regenerative processes in the cortical calvarial defect to the highfrequency signal, even cortical bone can respond to this mechanical signal if the skeleton is undergoing modeling [17,49]. Together with recent data suggesting mechanical stimuli may accelerate differentiation and/or proliferation of cells in general [19,25], and encourage differentiation of mesenchymal stem cells toward the osteogenic cell lineage [9,38], this may suggest the presence of specific stem cells and osteogenic cell populations are critical for efficacy of high-frequency mechanical signals. The benefit of the applied mechanical signal continued even during the 4-week rest period, perhaps suggesting the additional bone and vessels formed during the treatment period acted as a secondary resource for osteogenic and stem cells or the mechanism triggered by the signal remained active even after the stimulus had subsided [42].…”

Section: Discussionsupporting

confidence: 66%

Extremely Small-magnitude Accelerations Enhance Bone Regeneration: A Preliminary Study

Hwang

Lublinsky

Seo

et al. 2008

Clin Orthop Relat Res

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High-frequency, low-magnitude accelerations can be anabolic and anticatabolic to bone. We tested the hypothesis that application of these mechanical signals can accelerate bone regeneration in scaffolded and nonscaffolded calvarial defects. The cranium of experimental rats (n = 8) in which the 5-mm bilateral defects either contained a collagen scaffold or were left empty received oscillatory accelerations (45 Hz, 0.4 g) for 20 minutes per day for 3 weeks. Compared with scaffolded defects in the untreated control group (n = 6), defects with a scaffold and subject to oscillatory accelerations had a 265% greater fractional bone defect area 4 weeks after the surgery. After 8 weeks of healing (1-week recovery, 3 weeks of stimulation, 4 weeks without stimulation), the area (181%), volume (137%), and thickness (53%) of the regenerating tissue in the scaffolded defect were greater in experimental than in control animals. In unscaffolded defects, mechanical stimulation induced an 84% greater bone volume and a 33% greater thickness in the defect. These data provide preliminary evidence that extremely low-level, high-frequency accelerations can enhance osseous regenerative processes, particularly in the presence of a supporting scaffold.

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Section: Discussionsupporting

confidence: 66%

Extremely Small-magnitude Accelerations Enhance Bone Regeneration: A Preliminary Study

Hwang

Lublinsky

Seo

et al. 2008

Clin Orthop Relat Res

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“…The few bioreactor designs that allow for such patient-specific or jointshape-like geometries, indicated in Table 1 as 'GEOM', all use unconfined compression setups [45,47,59,67]. It should be noted that the deformation or mechanical loading of the material in these systems is probably not homogenous and it will therefore be even more challenging to obtain reproducible results with these systems, compared to regular bioreactor systems.…”

Section: Discussionmentioning

confidence: 99%

“…To further enhance nutrient delivery to cells in the center of constructs, bioreactors have been designed by which perfusion is forced through the constructs (Fig. 1D) [40][41][42][43][44][45][46][47][48][49]. This forced perfusion not only delivers nutrients, but induces shear forces to the seeded cells as well.…”

Section: Bioreactors and Mechanical Stimu-lationmentioning

confidence: 99%

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Review on Patents for Mechanical Stimulation of Articular Cartilage Tissue Engineering

Donkelaar¹,

Schulz

2008

BIOMENG

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Abstract:To repair articular cartilage defects in osteoarthritic patients with three-dimensional tissue engineered chondrocyte grafts, requires the formation of new cartilage with sufficient mechanical properties. The premise is that mechanical stimulation during the culturing process is necessary to reach this aim. Therefore, mechanical stimulation systems have been integrated in aseptic bioreactors for in vitro cultivation of tissue engineered cartilage. These vary from simple unconfined compression systems to advanced bioreactors in which deformation and loading are fully controlled. Fluid handling in these devices is another decisive parameter for the success of cartilage tissue engineering.Over the last decades bioreactor developments have resulted in the filing of many patents. The aim of this paper is to review these patents, categorize them according to their possibilities for mechanical stimulation and fluid handling systems and finally to discuss them in the context of the demands of a functional tissue engineered cartilage from a mechanical perspective.

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“…A rigidez do sistema de instrumentação é responsável pela estabilidade inicial da coluna vertebral logo após a fixação da fratura e é durante este período inicial do pós-operatório (antes da consolidação da fratura) que ocorrem as perdas de redução com a fixação pedicular curta 2,11,12 . Portanto, o objetivo deste estudo é avaliar a rigidez biomecânica da fixação pedicular curta e compará-la com a rigidez biomecânica da coluna vertebral íntegra e da coluna vertebral com fratura explosão, para uma melhor compreensão dos motivos da falência inicial deste tipo de instrumentação.…”

Section: Introductionunclassified

Estudo biomecânico da fixação pedicular curta na fratura-explosão toracolombar

et al. 2011

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RESUMOObjetivo: Comparar a rigidez biomecânica entre a coluna toracolombar intacta, a coluna com fratura explosão e a coluna com fratura explosão associada à fixação pedicular curta em suínos. Métodos: 30 amostras de coluna toracolombar (T11-L3) de suínos foram divididas em três grupos com 10 amostras cada. O Grupo 1 representava a coluna intacta, o Grupo 2 representava a coluna com fratura explosão e o Grupo 3 a fratura explosão associada à fixação pedicular curta. Foi realizado o corte ósseo em "V" do terço médio do corpo vertebral comprometendo a coluna anterior e média de L1 para simular a fratura explosão. No Grupo 3 foi realizada a fixação pedicular com Pinos de Schanz. Os grupos foram submetidos ao teste biomecânico em compressão axial controlada. Os parâmetros de carga (N) e deslocamento (mm) eram gerados em um gráfico instantâneo e a rigidez (N/mm) foi determinada. O teste era interrompido quando ocorria uma queda súbita na curva no gráfico indicando falência da amostra. Resultados: A rigidez das colunas fraturadas foi 53% menor do que a rigidez das colunas intactas, sendo essa diferença estatisticamente significativa (p < 0,05). A fixação pedicular curta apresentou uma rigidez 50% maior do que a coluna fraturada. Esse aumento foi estatisticamente significativo (p < 0,05). A rigidez da fixação pedicular curta foi 30% menor do que a rigidez das colunas intactas. Essas diferenças foram estatisticamente significativas (p < 0,05). Conclusão: A fixação pedicular curta não é suficiente para restabelecer a rigidez da coluna intacta nos testes biomecânicos in vitro de compressão axial pura em modelos de fratura toracolombar de suínos.

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Effect of mechanical stability on fracture healing — an update

Cited by 186 publications

References 44 publications

Extremely Small-magnitude Accelerations Enhance Bone Regeneration: A Preliminary Study

Extremely Small-magnitude Accelerations Enhance Bone Regeneration: A Preliminary Study

Review on Patents for Mechanical Stimulation of Articular Cartilage Tissue Engineering

Estudo biomecânico da fixação pedicular curta na fratura-explosão toracolombar

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