Fracture Repair

Sfeir, Charles; Ho, L. T.; Doll, Bruce; Azari, Kodi; Hollinger, Jeffrey O.

doi:10.1385/1-59259-863-3:021

Cited by 78 publications

(125 citation statements)

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“…The median values of BA/TA were calculated for each harvesting time point comprising eight animals. Remodeling phase a The right column shows their classification in the standard scheme of healing phases to describe the bone healing process (e.g., Sfeir et al 4 ).…”

Section: Single Image Analysismentioning

confidence: 99%

“…Usually the process of secondary fracture healing is subdivided into three main phases: the inflammatory phase, the reparative phase, and the remodeling phase. 4 These phases, however, are not well separated in time, and significant overlap can occur between them. During the inflammatory phase, vascular damage leads to hematoma formation.…”

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confidence: 99%

“…The reparative phase includes revascularization and the formation of fibrous tissue and cartilage, and new bone is formed at the periosteal side of the cortex by intramembranous ossification. [4][5][6] Soft callus bridging occurs via cartilage, which is later transformed into bone by endochondral ossification. During the remodeling phase, lamellar bone replaces woven bone, the callus is resorbed, and finally the original shape of the bone is restored.…”

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Temporal tissue patterns in bone healing of sheep

Vetter

Epari

Seidel

et al. 2010

Journal Orthopaedic Research

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Secondary fracture healing in long bones leads to the successive formation of intricate patterns of tissues in the newly formed callus. The main aim of this work was to quantitatively describe the topology of these tissue patterns at different stages of the healing process and to generate averaged images of tissue distribution. This averaging procedure was based on stained histological sections (2, 3, 6, and 9 weeks post-operatively) of 64 sheep with a 3 mm tibial mid-shaft osteotomy, stabilized either with a rigid or a semi-rigid external fixator. Before averaging, histological images were sorted for topology according to six identified tissue patterns. The averaged images were obtained for both fixation types and the lateral and medial side separately. For each case, the result of the averaging procedure was a collection of six images characterizing quantitatively the progression of the healing process. In addition, quantified descriptions of the newly formed cartilage and the bone area fractions (BA/TA) of the bony callus are presented. For all cases, a linear increase in the BA/TA of the bony callus was observed. The slope was greatest in the case of the most rigid stabilization and lowest in the case of the least stiff. This topological description of the progression of bone healing will allow quantitative validation (or falsification) of current mechano-biological theories. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J. Orthop. Res. 28: 1440Res. 28: -1447Res. 28: , 2010 Keywords: bone healing; tissue pattern; osteotomy; animal model; averaged image Secondary fracture healing of long bones proceeds via the formation of a callus. 1-3 The task of the callus is to stabilize the fracture fragments resulting in a reduction of the strains in the fracture area, allowing the bone ends to be united. Usually the process of secondary fracture healing is subdivided into three main phases: the inflammatory phase, the reparative phase, and the remodeling phase. 4 These phases, however, are not well separated in time, and significant overlap can occur between them. During the inflammatory phase, vascular damage leads to hematoma formation. The reparative phase includes revascularization and the formation of fibrous tissue and cartilage, and new bone is formed at the periosteal side of the cortex by intramembranous ossification. [4][5][6] Soft callus bridging occurs via cartilage, which is later transformed into bone by endochondral ossification. During the remodeling phase, lamellar bone replaces woven bone, the callus is resorbed, and finally the original shape of the bone is restored. [7][8][9][10] To understand the progression of the healing process, and in particular the influence of the mechanical environment, a number of animal experiments have been performed. In these experiments, either "static" fixators with different degrees of stability [11][12][13][14] or "dynamic" fixators, which induce micro-movement to stimulate callus formation, 15,16 were used. These experiments d...

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Section: Single Image Analysismentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Temporal tissue patterns in bone healing of sheep

Vetter

Epari

Seidel

et al. 2010

Journal Orthopaedic Research

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“…1). [1][2][3][4][5][6][7][8] The subsequent bone-healing process overlaps with this inflammatory phase spatiotemporally via both bone developmental pathways: intramembranous (IM) and endochondral (EC) ossification. [1][2][3][4][5][6][7][8] Large defects above a ''critical-size,'' however, cannot be restored without intervention and often lead to nonunion.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] The subsequent bone-healing process overlaps with this inflammatory phase spatiotemporally via both bone developmental pathways: intramembranous (IM) and endochondral (EC) ossification. [1][2][3][4][5][6][7][8] Large defects above a ''critical-size,'' however, cannot be restored without intervention and often lead to nonunion. 9,10 Although current surgical intervention strategies, most notably autologous bone grafting (ABG), have yielded favorable bone healing outcomes in these situations, it is clear from the past decade's surge in clinically available tissue-engineered bone implants, some coupled with stem cell-based therapeutics (SCBTs), that alternative bone regenerative strategies have gained a significant market share.…”

Section: Introductionmentioning

confidence: 99%

Endochondral Ossification for Enhancing Bone Regeneration: Converging Native Extracellular Matrix Biomaterials and Developmental Engineering In Vivo

Dennis

Berkland

Bonewald

et al. 2015

Tissue Engineering Part B: Reviews

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Application of Bioreactor Concept and Modeling Techniques to Bone Regeneration and Augmentation Treatments

Deccó¹,

Zuchuat²

2016

Advanced Surfaces for Stem Cell Research

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During almost two decades of research in the field of Tissue Engineering and Regenerative Medicine, a variety of biomaterials and techniques have been developed, and a series of results and clinical evidence have been published to support and improve bone regeneration and augmentation processes. The latest techniques include the use of growth factors and platelet-rich plasma preparations in combination with natural or artificial scaffolds, membranes, and stem cells. However, the application of these concepts depends heavily on a favorable microenvironment for the regeneration, which is provided by the use of the bioreactor. The bioreactor is a system in which a microenvironment can be created to promote bone regeneration by providing favorable biomechanical conditions, protecting against infection, and allowing proper nutrition of the regenerating tissue by vascularization. The latest research in this field is very promising as preliminary studies have shown good results concerning bone quality and architecture. In relation to the bioreactor principle, computational modeling represents a very effective tool to predict bone ingrowth. In addition, based on the obtained results, the use of these data to prevent diseases in the human osseous-articular system is expected in the near future.

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Fracture Repair

Cited by 78 publications

References 0 publications

Temporal tissue patterns in bone healing of sheep

Temporal tissue patterns in bone healing of sheep

Endochondral Ossification for Enhancing Bone Regeneration: Converging Native Extracellular Matrix Biomaterials and Developmental Engineering In Vivo

Application of Bioreactor Concept and Modeling Techniques to Bone Regeneration and Augmentation Treatments

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