Intraosseous Pressure in the Femoral Head and Greater Trochanter Before and 1-3 Years After Osteotomy for Osteoarthritis of the Hip Joint

Termansen, Niels B.; Okholm, K

doi:10.3109/17453677608998979

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Intraosseous pressure (IOP) and bone blood flow have been studied by authors interested in bone circulation, bone diseases and bone pain for more than 70 years (Arnoldi et al 1980; Lemperg and Arnoldi 1978; Liu and Ho 1991; Owen et al 1980; Termansen and Okholm 1976; Wilkes and Visscher 1975). Measurement techniques have varied.…”

Section: Introductionmentioning

confidence: 99%

An in vitro model to explore subchondral perfusion and intraosseous pressure

Beverly

Murray

2019

J EXP ORTOP

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Background Little is known about subchondral perfusion physiology. We developed a 3Rs (Replace, Reduce, Refine) compliant in vitro calf foot model to explore perfusion and intraosseous pressure (IOP). Methods Calf feet were catheterised and perfused with serum. IOP was measured at three sites, the metacarpal diaphysis (MCD), metacarpal subchondral epiphysis (MCS) and proximal phalanx diaphysis (PPD) using intraosseous needles with pressure transducers and digital recorders. Fresh (< 4 h post mortem) and old feet (> 4 h post mortem) were perfused at different pressures, with and without a proximal tourniquet. Results There was a wide range in basal IOP with a mean IOP of 30.0 mmHg, SD 14.4, range 7.6 mmHg to 52.7 mmHg ( n = 40 records) in 15 subjects. There was no significant difference between the three sites tested ( p = 0.54, 0.12 and 0.051). At each individual site IOP correlated with perfusion pressure (r = 0.993). With a proximal venous tourniquet, IOP increased from 15.1 mmHg (SD 11.3 mmHg) to 44.9 mmHg (SD 24 mmHg), p < 0.0001, n = 9. Filling and emptying curves during perfusion and with using a tourniquet were similar, indicating that the model behaves in an elastic hydrodynamic manner. In fresh feet IOP peaked after about 1 min irrespective of perfusion pressure, possibly due to auto regulation. Older feet showed a continuously rising IOP and became oedematous. There was no significant difference in IOP between fresh and old feet perfused with serum at 150 cms pressure for 1 min. Conclusion Though basal intraosseous pressure varies, IOP behaves predictably. IOP measurements reflect the perfusion microclimate at the individual needle tip. This 3Rs compliant model will be used for further exploration of subchondral perfusion physiology with loading.

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Section: Introductionmentioning

confidence: 99%

An in vitro model to explore subchondral perfusion and intraosseous pressure

Beverly

Murray

2019

J EXP ORTOP

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“…Within the manifold there were a pressure gauge and pressure relief valve. These were used to adjust the pressure levels if it was outside the normal, physiological range of 0.1–1.1 psi [ 19 , 20 ]. Syringe needles (21 ½ gauge) were used to cannulate the bone, because their width (0.5 mm) matched the inner diameter of four main arteries (0.5–8.5 mm).…”

Section: Discussionmentioning

confidence: 99%

The Preservation of Bone Cell Viability in a Human Femoral Head through a Perfusion Bioreactor

et al. 2018

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Current methods for drug development and discovery involve pre-clinical analyses that are extremely expensive and time consuming. Animal models are not the best precedent to use, when comparing to human models as they are not synonymous with the human response, thus, alternative methods for drug development are needed. One of which could be the use of an ex vivo human organ where drugs could be tested and the effects of those drugs could be observed. Finding a viable human organ to use in these preliminary ex vivo studies is difficult due to the availability, cost, and viability. Bone tissue and marrow contain a plethora of both bone and stem cells, however, these cells need constant perfusion to be viable over a longer time range. Here we maintain bone cell sustainability in an ex vivo model, through the use of human femoral heads in a novel bioreactor. This bioreactor was designed to directly perfuse cell culture media (DMEM) through the vasculature of a femoral head, providing ideal nutrients and conditions required for maintaining organ viability. We show, for the first time, that cells within a femoral head can stay alive up to 12 h. Further development could be used to determine the effects of drugs on a human organ system and could aid in the understanding of the progression of bone diseases and pathologies.

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Osteotomy of the Patella in Chondromalacia

Morscher¹

1978

Arch. Orthop. Traumat. Surg.

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There are many factors involved in the aetiology of chondromalacia of the patella. If possible, the appropriate operative procedure should be chosen for each patient, hence attempting to eliminate the cause of softening of the cartilage. Increased pressure over the lateral facet, with or without reduced pressure over the medial facet of the patella, resulting from lateral positioning or tilting of the patella, the Wiberg/Baumgartl-types III and IV, and the "Hunter's Hat" form are important causes. With reduced pressure, the cartilage is inadequately stressed and consequently receives insufficient nourishment. As the medial facet is particularly thick and has little contact with the femoral condyle, nutritional disturbance is almost a normal occurrence. Longitudinal osteotomy of the patella has been found to improve the contact of the medial surface of the patella with the femoral condylar groove. The analgesic effect of this surgical procedure may derive from the resultant reduction in subchondral interstitial pressure, presuming that the pain in chondromalacia patellae, like that of osteoarthritis, is a manifestation of raised intramedullary pressure. To ensure an improvement in patellar tracking the osteotomy is combined with a lateral capsular release.

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Intraosseous Pressure in the Femoral Head and Greater Trochanter Before and 1-3 Years After Osteotomy for Osteoarthritis of the Hip Joint

Cited by 4 publications

References 7 publications

An in vitro model to explore subchondral perfusion and intraosseous pressure

An in vitro model to explore subchondral perfusion and intraosseous pressure

The Preservation of Bone Cell Viability in a Human Femoral Head through a Perfusion Bioreactor

Osteotomy of the Patella in Chondromalacia

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