The normal and fractured physis: an anatomic and physiologic overview

Hosseinzadeh, Pooya; Milbrandt, Todd A.

doi:10.1097/bpb.0000000000000245

Cited by 7 publications

(3 citation statements)

References 76 publications

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“…Related to these examples of structural and genetic studies of physes, various animal models have been coincidentally established to study growth plates in their healthy and diseased states. In this regard, different animal models have shown similarity to human models in demonstrating altered microscopic architecture under mechanical compression ( Hosseinzadeh and Milbrandt, 2016 ; Alberty et al, 1993 ; Stokes et al, 2007 ; Rudicel et al, 1985 ; Amini et al, 2010 ). More recently, Bries et al ( Bries et al, 2012 ) reported that, as in human physes ( Scharschmidt et al, 2009 ), there was decreased gene expression of aggrecan, type II and type X collagen in rabbit physes subjected to compression.…”

Section: Introductionmentioning

confidence: 99%

An investigation to validate the equivalence of physes obtained from different anatomic regions in a single animal species: Implications for choosing experimental controls in clinical studies

Widmer¹,

Steiner

Morscher

et al. 2019

Bone Reports

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Control tissue in studies of various orthopedic pathologies is difficult to obtain and presumably equivalent biopsies from other anatomic sites have been utilized in its place. However, for growth plates, different anatomic regions are subject to dissimilar mechanical forces and produce disproportionate longitudinal growth. The purpose of this study was to compare gene expression and structure in normal physes from different anatomic regions within a single animal species to determine whether such physes were equivalent. Thirteen female New Zealand white rabbits (five 15-week-old and eight 19-week-old animals) were euthanized and physes harvested from their proximal and distal femurs and proximal tibiae. Harvested physes were divided into groups for histological, immunohistochemical (IHC), and reverse transcription-quantitative polymerase chain reaction analyses. All physes analyzed demonstrated no apparent differences in morphology or proteoglycan staining intensity on histological examination or in type II collagen presence determined by IHC study. Histomorphometric measures of physeal height as well as gene expression of type II collagen and aggrecan were found to be statistically significantly equivalent ( p < 0.05) among the three different bones from the total number of rabbits. Summary data suggest that the structural similarities and statistical equivalence determined among the various physes investigated in the rabbit validate these tissues in this species for use as surrogate controls by which physeal abnormalities may be compared and characterized in the absence of otherwise normal control tissues. Other species may exhibit the same similarities and equivalence among different physes so that such tissues may serve in like manner as controls for assessing a variety of orthopedic conditions, including those occurring in humans.

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Section: Introductionmentioning

confidence: 99%

An investigation to validate the equivalence of physes obtained from different anatomic regions in a single animal species: Implications for choosing experimental controls in clinical studies

Widmer¹,

Steiner

Morscher

et al. 2019

Bone Reports

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“…The metaphyseal portion of long bones is typically the primary site for the seeding of hematogenous musculoskeletal infections [ 9 – 12 ]. The physis, which is located within the metaphyseal portion, is the center at which endochondral ossification occurs to promote long bone growth in the developing skeleton [ 13 ]. This region of the bone is highly vascular due to the high cellular metabolic activity required for new bone formation [ 14 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Predilection for developing a hematogenous orthopaedic implant-associated infection in older versus younger mice

et al. 2021

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Background The pathogenesis of hematogenous orthopaedic implant-associated infections (HOIAI) remains largely unknown, with little understanding of the influence of the physis on bacterial seeding. Since the growth velocity in the physis of long bones decreases during aging, we sought to evaluate the role of the physis on influencing the development of Staphylococcus aureus HOIAI in a mouse model comparing younger versus older mice. Methods In a mouse model of HOIAI, a sterile Kirschner wire was inserted retrograde into the distal femur of younger (5–8-week-old) and older (14–21-week-old) mice. After a 3-week convalescent period, a bioluminescent Staphylococcus aureus strain was inoculated intravenously. Bacterial dissemination to operative and non-operative legs was monitored longitudinally in vivo for 4 weeks, followed by ex vivo bacterial enumeration and X-ray analysis. Results In vivo bioluminescence imaging and ex vivo CFU enumeration of the bone/joint tissue demonstrated that older mice had a strong predilection for developing a hematogenous infection in the operative legs but not the non-operative legs. In contrast, this predilection was less apparent in younger mice as the infection occurred at a similar rate in both the operative and non-operative legs. X-ray imaging revealed that the operative legs of younger mice had decreased femoral length, likely due to the surgical and/or infectious insult to the more active physis, which was not observed in older mice. Both age groups demonstrated substantial reactive bone changes in the operative leg due to infection. Conclusions The presence of an implant was an important determinant for developing a hematogenous orthopaedic infection in older but not younger mice, whereas younger mice had a similar predilection for developing periarticular infection whether or not an implant was present. On a clinical scale, diagnosing HOIAI may be difficult particularly in at-risk patients with limited examination or other data points. Understanding the influence of age on developing HOIAI may guide clinical surveillance and decision-making in at-risk patients.

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“…Trauma to long bones can result in the formation of a “bony bar,” which can span the physis, halt bone growth, and cause limb length discrepancies and/or angular deformities 2–5 . The current treatment to prevent these deformities includes surgical resection of the bony bar, followed by insertion of an inert interpositional material, such as silicone to prevent bony bar reformation 6,7 . However, these treatments are largely unsuccessful as the bony bar commonly recurs and negatively affects bone growth 8–10 .…”

Section: Introductionmentioning

confidence: 99%

Anti‐VEGF antibody delivered locally reduces bony bar formation following physeal injury in rats

Erickson

Newsom

Fletcher

et al. 2020

Journal Orthopaedic Research

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Physeal injuries can result in the formation of a “bony bar” which can lead to bone growth arrest and deformities in children. Vascular endothelial growth factor (VEGF) has been shown to play a role in bony bar formation, making it a potential target to inhibit bony repair tissue after physeal injury. The goal of this study was to investigate whether the local delivery of anti‐VEGF antibody (α‐VEGF; 7.5 μg) from alginate:chitosan hydrogels to the tibial physeal injury site in rats prevents bony bar formation. We tested the effects of quick or delayed delivery of α‐VEGF using both 90:10 and 50:50 ratio alginate:chitosan hydrogels, respectively. Male and female 6‐week‐old Sprague‐Dawley rats received a tibial physeal injury and the injured site injected with alginate‐chitosan hydrogels: (1) 90:10 (Quick Release); (2) 90:10 + α‐VEGF (Quick Release + α‐VEGF); (3) 50:50 (Slow Release); (4) 50:50 + α‐VEGF (Slow Release + α‐VEGF); or (5) Untreated. At 2, 4, and 24 weeks postinjury, animals were euthanized and tibiae assessed for bony bar and vessel formation, repair tissue type, and limb lengthening. Our results indicate that Quick Release + α‐VEGF reduced bony bar and vessel formation, while also increasing cartilage repair tissue. Further, the quick release of α‐VEGF neither affected limb lengthening nor caused deleterious side‐effects in the adjacent, uninjured physis. This α‐VEGF treatment, which inhibits bony bar formation without interfering with normal bone elongation, could have positive implications for children suffering from physeal injuries.

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The normal and fractured physis: an anatomic and physiologic overview

Cited by 7 publications

References 76 publications

An investigation to validate the equivalence of physes obtained from different anatomic regions in a single animal species: Implications for choosing experimental controls in clinical studies

An investigation to validate the equivalence of physes obtained from different anatomic regions in a single animal species: Implications for choosing experimental controls in clinical studies

Predilection for developing a hematogenous orthopaedic implant-associated infection in older versus younger mice

Anti‐VEGF antibody delivered locally reduces bony bar formation following physeal injury in rats

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