RESUMEN
This in vivo study investigated whether the bioactivity of anodizing coating, produced by plasma electrolytic oxidation (PEO), on mini-plate in femur fracture could be improved with the association of photobiomodulation (PBM) therapy. From the 20 ovariectomized Wistar female rats, 8 were used for model characterization, and the remaining 12 were divided into four groups according to the use of PBM therapy by diode laser (808 nm; power: 100 mW; energy: 6.0 J; energy density: 212 J/cm2; power density: 3.5 W/cm2) and the type of mini-plate surface (commercially pure titanium mini-plate -cpTi- and PEO-treated mini-plate) as follow: cpTi; PEO; cpTi/PBM; and PEO/PBM. After 60 days of surgery, fracture healing underwent microstructural, bone turnover, histometric, and histologic adjacent muscle analysis. Animals of groups with PEO and PBM showed greater fracture healing than cpTi control group under histometric and microstructural analysis (P < 0.05); however, bone turnover was just improved in PBM's groups (P < 0.05). there was no difference between cpTi and PEO without PBM (P > 0.05). Adjacent muscle analysis showed no metallic particles or muscle alterations in all groups. PEO and PBM are effective strategies for bone repair in fractures, however their association does not provide additional advantages.
Asunto(s)
Fracturas del Fémur/radioterapia , Láseres de Semiconductores/uso terapéutico , Terapia por Luz de Baja Intensidad , Animales , Modelos Animales de Enfermedad , Estrógenos/análisis , Femenino , Fracturas del Fémur/patología , Fémur/diagnóstico por imagen , Fémur/patología , Curación de Fractura/efectos de la radiación , Ovariectomía , Ratas , Ratas Wistar , Microtomografía por Rayos XRESUMEN
This report described pathological fracture of the femoral head (physeal dysplasia) in four male cats (three mixed breed and one Bengal), with an average age of 16 months, treated by an ostectomy of the femoral head and neck. Three cats were neutered and one entire. All presented with mild intermittent lameness in the pelvic limbs. Displacement of the femoral epiphysis and resorption of the femoral neck were present and excision of the femoral head and remaining neck was performed in all cases. Hstological examination showed mild foci of compaction and trabecular fibrosis with deposition of fibrous connective tissue, permeated by granulation tissues, consistent with the original diagosis. Limb function improved in all patients from 2 to 4 weeks postoperatively. Diagnosis of physeal dysplasia is challenging and treatment is different from acute traumatic fractures. Femoral head and neck excision was considered a good alternative in these patients.(AU)
Este trabalho descreve a fratura patológica da cabeça do femur (displasia fiseal) em quatro machos (três raças mistas e um Bengal), com idade média de 16 meses, que foram tratados com ostectomia da cabeça e colo femorais. Três gatos eram castrados e um inteiro. Todos apresentaram leve claudicação intermitente nos membros pélvicos. O deslocamento da epífise femoral e a reabsorção do colo femoral estavam presentes, a excisão da cabeça e colo femoral foi realizada em todos os casos. O exame histológico mostrou focos de compacteção e fibrose trabecular com deposição de tecido conjuntivo fibroso, permeado por tecidos de granulação, consistentes com o suposto diagnóstico. A função dos membros melhorou em todos os paciente entre dois a quatro semanas pós-operatório. O diagnóstico da displasia fiseal pe desafiador e o tratamento é diferente das fraturas traumáticas agudas. A excisão de cabeça e colo femoral é considerada uma boa alternativa nesses pacientes.(AU)
Asunto(s)
Animales , Masculino , Gatos , Enfermedades de los Gatos/diagnóstico , Enfermedades de los Gatos/fisiopatología , Enfermedades de los Gatos/cirugía , Fracturas del Fémur/patología , Fracturas del Fémur/cirugía , Fracturas del Fémur/veterinaria , Gatos/anomalíasAsunto(s)
Humanos , Animales , Femenino , Anciano , Perros , Equinococosis Hepática/cirugía , Equinococosis Hepática/diagnóstico por imagen , Huesos/patología , Albendazol/uso terapéutico , Equinococosis Hepática/tratamiento farmacológico , Fracturas del Fémur/cirugía , Fracturas del Fémur/patología , Fracturas del Fémur/diagnóstico por imagen , Fracturas de Cadera/cirugía , Fracturas de Cadera/patología , Fracturas de Cadera/diagnóstico por imagenRESUMEN
The effects of kinin B1 receptor (B1 R) deletion were examined on femur bone regeneration in streptozotocin (STZ)-type 1 diabetes. Diabetes induction in wild-type C57/BL6 (WTC57BL6) mice led to decrease in body weight and hyperglycemia, compared to the non-diabetic group of the same strain. The lack of B1 R did not affect STZ-elicited body weight loss, but partially prevented hyperglycemia. Diabetic mice had a clear delay in bone regeneration, and displayed large areas of loose connective tissue within the defects, with a reduced expression of the mineralization-related protein osteonectin, when compared to the non-diabetic WTC57/BL6. The non-diabetic and diabetic B1 R knockout (B1 RKO) mice had bone regeneration levels and osteonectin expression comparable to that seen in control WTC57/BL6 mice. WTC57/BL6 STZ-diabetic mice also showed a marked reduction of collagen contents, with increased immunolabeling for the apoptosis marker caspase-3, whereas diabetic B1 RKO had collagen levels and caspase-3 activity comparable to those observed in non-diabetic WTC57/BL6 or B1 RKO mice. No significant difference was detected in the number of tartrate-resistant acid phosphatase (TRAP)-stained cells, or in RANK/RANKL/OPG system immunolabeling throughout the experimental groups. Data bring novel evidence on the relevance of kinin B1 R under type 1 diabetes with regards to its role in bone regeneration.
Asunto(s)
Regeneración Ósea , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 1/metabolismo , Fracturas del Fémur/metabolismo , Fémur/metabolismo , Curación de Fractura , Receptor de Bradiquinina B1/deficiencia , Animales , Apoptosis , Caspasa 3/metabolismo , Colágeno/metabolismo , Diabetes Mellitus Experimental/genética , Diabetes Mellitus Experimental/patología , Diabetes Mellitus Experimental/fisiopatología , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/patología , Diabetes Mellitus Tipo 1/fisiopatología , Fracturas del Fémur/genética , Fracturas del Fémur/patología , Fracturas del Fémur/fisiopatología , Fémur/patología , Fémur/fisiopatología , Masculino , Ratones Endogámicos C57BL , Ratones Noqueados , Osteonectina/metabolismo , Receptor de Bradiquinina B1/genética , Transducción de Señal , Factores de TiempoRESUMEN
Nonunion fractures occur frequently in humans, with profound implications (medical and non-medical). Although there are numerous animal models to study pathogenesis and treatment of nonunion fractures, there is apparently the lack of a definitive model for atrophic nonunion fracture. Therefore, the objective was to develop a low-cost rat model of nonunion fracture with a vascular deficit that enabled standardized quantitative analysis of bone growth and regeneration. The model was developed with two surgeries, performed apart. The first involved osteotomy of the femur diaphysis, removal of periosteum and endosteum, isolation of the fracture site using a latex artefact (Penrose drain tube), and reduction of the fracture using an intramedullary pin, whereas the second surgery was to remove the latex artefact. Based on radiographic imaging, micro-CT and histological analyses done 125 days after the fracture was induced, there was clear evidence of atrophic nonunion fracture, without pin migration or specimen loss. Perceived advantages of this model included low cost, ease of reproducibility, lack of specimen loss, and, finally, the potential to assess bone growth and regeneration under poor vascular conditions.
Asunto(s)
Fracturas del Fémur/patología , Fijación de Fractura , Fracturas Mal Unidas/patología , Microrradiografía , Osteotomía/métodos , Animales , Atrofia , Fenómenos Biomecánicos , Modelos Animales de Enfermedad , Curación de Fractura , Ratas , Reproducibilidad de los ResultadosRESUMEN
Reports of atypical femoral fractures (AFFs) in patients receiving long- term bisphosphonate therapy have raised concerns regarding the genesis of this rare event. Using high-resolution peripheral quantitative computed tomography (HR-pQCT), we conducted a study to evaluate bone microarchitecture in patients who had suffered an AFF during long-term bisphosphonate treatment. The aim of our study was to evaluate if bone microarchitecture assessment could help explain the pathophysiology of these fractures. We compared bone volumetric density and microarchitectural parameters measured by HR-pQCT in the radius and tibia in 20 patients with AFFs with 35 postmenopausal women who had also received long-term bisphosphonate treatment but had not experienced AFFs, and with 54 treatment-naive postmenopausal women. Control groups were similar in age, body mass index (BMI), and bone mineral density (BMD). Mean age of the 20 patients with AFFs was 71 years, mean lumbar spine T-score was -2.2, and mean femoral neck T-score was -2. Mean time on bisphosphonate treatment was 10.9 years (range, 5-20 years). None of the patients had other conditions associated with AFFs such as rheumatoid arthritis, diabetes or glucocorticoid use. There were no statistically significant differences in any of the parameters measured by HR-pQCT between postmenopausal women with or without treatment history and with or without history of atypical fractures. We could not find any distinctive microarchitecture features in the peripheral skeleton of women who had suffered an atypical fracture of the femur while receiving bisphosphonate treatment. This suggests that risk of developing an atypical fracture is not related to bone microarchitecture deterioration. Our results indicate that there may be other individual factors predisposing to atypical fractures in patients treated with bisphosphonates, and that those are independent of bone microarchitecture. In the future, identification of those factors could help prevent and understand the complex physiopathology of these rare events.
Asunto(s)
Conservadores de la Densidad Ósea/uso terapéutico , Difosfonatos/uso terapéutico , Fracturas del Fémur/patología , Posmenopausia , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Persona de Mediana EdadRESUMEN
The purpose of this study was to evaluate the influence of helium-neon laser on bone repair of femur and tibia in rabbits. For this purpose, 15 New Zealand rabbits underwent bilateral bone damage (tibia and femur) using a spherical bur. Helium-neon laser light, at a fluency of 6 J∕cm(2) and wavelength of 632.8 nm was applied on the left legs (laser group). The right tibia or femur lesions (control group) served as negative control. All sections were histopathologically analyzed using HE sections and the morphometric data from bone tissue and hyaline cartilage were achieved. Histopathological analysis showed regular bone trabeculae covered by osteoblastic cells after 1 week in the group exposed to laser therapy from femur and tibia indistinctly. After 3 weeks, the laser group showed new bone formation coming from the bony walls in the femur and tibia as well. On the 5th week, well-defined trabecula undergoing remodeling process was detected for the most intense pattern in tibia only. Morphometric analysis revealed significant statistical differences (p < 0.05) in the bone tissue for the laser-exposed group on 1st and 3rd weeks. After 5th week, bone formation was increased to tibia only. Taken together, such findings suggest that helium-neon laser is able to improve bone repair in rabbits being the most pronounced effect in tibia.
Asunto(s)
Regeneración Ósea/efectos de la radiación , Láseres de Gas/uso terapéutico , Terapia por Luz de Baja Intensidad/métodos , Animales , Fracturas del Fémur/patología , Fracturas del Fémur/radioterapia , Curación de Fractura/efectos de la radiación , Masculino , Conejos , Fracturas de la Tibia/patología , Fracturas de la Tibia/radioterapiaRESUMEN
OBJECTIVE: To verify if the finite element method can correctly estimate the performance of polyacetal and polyamide 6 intramedullary nails in stabilizing a femoral fracture in calves and to estimate the performance of a polypropylene nail in same conditions. STUDY DESIGN: Computational and experimental study. SAMPLE POPULATION: Finite element models (FEMs). METHODS: Based on a 3-dimensional finite element method (FEM) of the femoral diaphysis, 3 models were constructed to simulate an oblique simple fracture stabilized by an intramedullary nail composed of 1 of 3 distinct polymers. Models were tested under 6 loading conditions that simulated a static calf or a calf in different walking phases. Maximum bone and implant stresses were compared to yield and rupture stresses of specific materials. RESULTS: Under static conditions, all polymers were resistant to critical deformation and rupture because maximum von Mises stresses were lower than the respective yield and rupture stresses. However, during walking, maximum stresses exceeded the yield and rupture limits of the polymers, in agreement with a previous in vivo study, which used polyacetal and polyamide nails. CONCLUSIONS: FEM correctly estimated that polyacetal and polyamide 6 nails would fail to immobilize an oblique femoral diaphyseal fracture in calves that were allowed to walk freely during the early postoperative period. FEM can be useful in the development of new bovine orthopedic devices.
Asunto(s)
Clavos Ortopédicos/veterinaria , Bovinos/lesiones , Fracturas del Fémur/veterinaria , Análisis de Elementos Finitos , Polímeros , Animales , Materiales Biocompatibles , Fenómenos Biomecánicos , Fracturas del Fémur/patología , Fijación Intramedular de Fracturas/métodos , Fijación Intramedular de Fracturas/veterinaria , Ensayo de Materiales , Modelos BiológicosRESUMEN
El Síndrome de Compresión Longitudinal del Miembro Inferior (SCLMI) es la asociación de una fractura diafisiaria de fémur con una fractura de cadera ipsilateral. Es una condición clínica muy rara con una incidencia de 2,5 % al 5 %. La fractura de cadera es considerada de baja energía, ocasionada por la energía residual no disipada de del accidente a alta velocidad, que principalmente originó la fractura diafisiaria, y son fracturas de con mínimo o sin desplazamiento, lo cual dificulta su diagnóstico. Se ha reportado que cerca de un 30 % de las fracturas de cadera en un SCLMI pasa desapercibida. Las lesiones de rodilla ipsilateral se encuentran presentes en 34 % y las de pierna, tobillo y pié en 19 %. Se presenta el caso de un paciente masculino de 24 años, quien ingresa posterior a hecho vial por colisión en moto, presentando fractura diafisiaria del fémur y posterior a la realización de estudios protocolares de pelvis, se diagnóstica la fractura de cadera. Se presenta su tratamiento y evolución
Lower limbs Longitudinal Compression Syndrome (LLLCS) is the association of a femoral shaft fractures with ipsilateral hip fracture. Its a very rare clinical condition with an incidence of 2.5% to 5%. Hip fracture is considered low-energy, caused by residual energy dissipated at high speed crash, which originated mainly diaphyseal fracture, and are fractures with minimal or no displacement, which makes hard their diagnosis. It is reported that about 30% of hip fractures in a LLLCS unnoticed. Ipsilateral knee injuries are present in 34% and leg, ankle and foot in 19%. We report of a 24 years male, who is admitted after motorcycle collision presenting femoral diaphyseal fracture. After post-protocol studies of pelvis, hip fracture is diagnosis. We present his treatment and evolution
Asunto(s)
Humanos , Masculino , Adulto , Extremidad Inferior/lesiones , Fracturas de Cadera/patología , Fracturas del Fémur/patología , Traumatismo Múltiple/complicaciones , Accidentes de TránsitoRESUMEN
PURPOSE: To evaluate the ability of a mixture of α-TCP and autogenous bone (AB) vs. α-TCP alone and AB alone to promote new bone formation and tissue repair in bone defects. METHODS: Bone defects surgically created in 15 male Wistar rats were divided into four groups: Group I (AB), Group II (α-TCP), Group III (α-TCP+AB assessed by light microscopy), and Group IV (α-TCP+AB assessed by scanning electron microscopy). Bone repair findings were assessed at 30, 60, and 120 days postoperatively. RESULTS: The histological findings obtained in Groups I (p=0.459), II (p=0.368), and III (p=0.459) and at 30 days (p=0.717), 60 days (p=0.717), and 120 days (p=0.779) did not show statistically significant differences. Scanning electron microscopy revealed direct contact between the α-TCP+AB implant and the bone tissue at 120 days. CONCLUSION: The α-TCP implant is effective alternative bone substitutes for the treatment of critical size bone defects.
Asunto(s)
Cementos para Huesos/uso terapéutico , Trasplante Óseo/métodos , Fosfatos de Calcio/uso terapéutico , Prótesis e Implantes , Animales , Materiales Biocompatibles/uso terapéutico , Fracturas del Fémur/patología , Masculino , Osteogénesis/efectos de los fármacos , Ratas , Ratas WistarRESUMEN
OBJECTIVE: The aim of this study was to evaluate the bone healing in spontaneously hypertensive rats (SHR) and compare the results with normotensive rats, evaluating male and female animals. METHODS: A bone drill defect was created in the left femur of 24 SHR (12 males and 12 females) and 24 normotensive rats (12 males and 12 females). The animals were divided into two groups and sacrificed 7 and 21 days after the surgical procedure. After the routine laboratory processing, histological and histometric analysis were carried out and data were submitted to ANOVA and Tukeys test (5%). RESULTS: Males and females from the same group had similar histological characteristics. After seven days, all animals presented irregular bone trabeculae. The periosteal osteoblasts were flattened in SHR, and presented a cuboid shape in normotensive animals. After 21 days, the bone defects of all specimens showed a linear closure in all the superficial extension. In addition, SHR presented flattened osteoblasts surrounding the bone trabeculae, while normotensive ones showed cuboidal cells. Statistical analysis of the histometric data indicated similar means between the male and female groups, except for normotensive rats on day 7. In addition, a larger amount of new bone formation was observed in hypertensive when compared to normotensive rats on day 21, in males as well as females. CONCLUSION: We conclude that bone healing in SHR was more significant than in normotensive ones, as shown by the histological and histometric evaluation 21 days after surgery.
Asunto(s)
Regeneración Ósea/fisiología , Fracturas del Fémur/patología , Fémur/patología , Curación de Fractura/fisiología , Hipertensión/fisiopatología , Animales , Modelos Animales de Enfermedad , Femenino , Fracturas del Fémur/fisiopatología , Fémur/fisiopatología , Masculino , Ratas , Ratas Endogámicas SHRRESUMEN
OBJETIVO: O objetivo deste estudo foi avaliar a reparação óssea em ratos espontaneamente hipertensos (SHR) e compará-la com a de ratos normotensos, avaliando machos e fêmeas. MÉTODOS: Um defeito ósseo foi criado no fêmur esquerdo de 24 SHR (12 machos e 12 fêmeas) e 24 ratos normotensos (12 machos e 12 fêmeas). Os animais foram divididos em dois grupos com diferentes períodos de sacrifício: sete e 21 dias após o procedimento cirúrgico. Após processamento laboratorial de rotina, as análises histológica e histométrica foram realizadas e os dados submetidos à análise de variância (ANOVA) e ao teste de Tukey (5 por cento). RESULTADOS: Machos e fêmeas do mesmo grupo apresentaram características histológicas similares. Após sete dias, todos os animais apresentaram trabéculas ósseas irregulares, entretanto, os osteoblastos periosteais eram achatados nos SHR, enquanto nos normotensos, essas células apresentavam formato cúbico. Após 21 dias, todos os espécimes mostraram fechamento linear em toda a extensão superficial do defeito ósseo e os SHR apresentaram osteoblastos achatados, enquanto os normotensos apresentaram células cúbicas circundando as trabéculas ósseas. A análise estatística dos dados histométricos indicou médias similares entre machos e fêmeas, exceto para ratos normotensos, aos sete dias. Além disso, aos 21 dias, foi observada maior neoformação óssea nos ratos hipertensos quando comparados aos normotensos, tanto machos quanto fêmeas. CONCLUSÃO: Concluiu-se que os animais SHR apresentaram maior neoformação e maturidade óssea nos defeitos que animais normotensos, no período de 21 dias após a cirurgia.
OBJECTIVE: The aim of this study was to evaluate the bone healing in spontaneously hypertensive rats (SHR) and compare the results with normotensive rats, evaluating male and female animals. METHODS: A bone drill defect was created in the left femur of 24 SHR (12 males and 12 females) and 24 normotensive rats (12 males and 12 females). The animals were divided into two groups and sacrificed 7 and 21 days after the surgical procedure. After the routine laboratory processing, histological and histometric analysis were carried out and data were submitted to ANOVA and TukeyÆs test (5 percent). RESULTS: Males and females from the same group had similar histological characteristics. After seven days, all animals presented irregular bone trabeculae. The periosteal osteoblasts were flattened in SHR, and presented a cuboid shape in normotensive animals. After 21 days, the bone defects of all specimens showed a linear closure in all the superficial extension. In addition, SHR presented flattened osteoblasts surrounding the bone trabeculae, while normotensive ones showed cuboidal cells. Statistical analysis of the histometric data indicated similar means between the male and female groups, except for normotensive rats on day 7. In addition, a larger amount of new bone formation was observed in hypertensive when compared to normotensive rats on day 21, in males as well as females. CONCLUSION: We conclude that bone healing in SHR was more significant than in normotensive ones, as shown by the histological and histometric evaluation 21 days after surgery.
Asunto(s)
Animales , Femenino , Masculino , Ratas , Regeneración Ósea/fisiología , Fracturas del Fémur/patología , Fémur/patología , Curación de Fractura/fisiología , Hipertensión/fisiopatología , Modelos Animales de Enfermedad , Fracturas del Fémur/fisiopatología , Fémur/fisiopatología , Ratas Endogámicas SHRRESUMEN
Salter-Harris Type-III and Type-IV epiphyseal injuries were created in the distal aspect of the femur in growing rabbits, and the healing process was analyzed both in the absence of any treatment and after treatment with anatomical reduction and fixation with compression with use of a cortical screw. A sham operation was performed on the left knee, to create a control group. Untreated Type-III injuries led to an angular deformity of the femur that became more severe with time. In the group that had an untreated Type-IV injury, a step-off developed on the articular surface and increased with time. Early vascular anastomoses between the epiphysis and the metaphysis preceded the formation of osseous bridges in these lesions. The healing process in the animals that were treated with anatomical reduction and rigid internal fixation occurred without the formation of osseous callus, and no marked abnormalities were discernible in the physis.
Asunto(s)
Fijación Interna de Fracturas , Curación de Fractura , Fracturas de Salter-Harris , Animales , Fracturas del Fémur/patología , Fracturas del Fémur/cirugía , Placa de Crecimiento/irrigación sanguínea , Placa de Crecimiento/patología , Masculino , ConejosRESUMEN
Foi realizado trabalho experimental com ratos machos da raça Wistar, com quatro semanas de vida, nos quais foi executada uma fratura manual, sob anestesia, ao nível da diáfise do fêmur direito, a fim de estudar as alteraçöes da microestrutura da fise distal e as alteraçöes macroscópicas das peças. Após os animais serem sacrificados em grupos iguais ao final de uma, duas, quatro, seis e oito semanas pós-fratura, estudamos os fêmures controles e os fraturados mediante técnicas histológica e histoquímica, avaliaçäo das dismetrias através da mensuraçäo das peças com paquímetro e estudo radiológico. Os resultados demonstraram que do ponto de vista histológico, nos grupos fraturados na 4( e 6( semanas, ocorreu aumento da afinidade pelo alcian blue na placa epifisária, indicativo de maior produçäo de matriz extracelular nesse período. Em relaçäo à macroscopia, observamos hipercrescimento nos fêmures fraturados comparados com o lado contralateral, nos animais em que o periósteo manteve-se íntegro após a fratura.
Asunto(s)
Animales , Masculino , Ratas , Epífisis/patología , Fracturas del Fémur/patología , Diáfisis/lesiones , Epífisis/lesiones , Ratas WistarRESUMEN
Os autores realizaram estudo experimental em 30 coelhos adultos, tendo o intuito de observar as alteraçöes da superfície articular, após a implantaçäo de um parafuso de 2mm, abaixo da cartilagem articular do côndilo medial em sua zona de carga. Uma perfuraçäo de 1,5mm de diâmetro e 6mm de profundidade foi realizada na área correspondente do côndilo lateral, para fins de controle. Os estudos anatomopatológicos realizaram-se duas, oito e 16 semanas após as cirurgias
Asunto(s)
Conejos , Animales , Tornillos Óseos , Cartílago Articular/cirugía , Fracturas del Fémur/cirugía , Cartílago Articular/lesiones , Cartílago Articular/patología , Cicatrización de Heridas , Fijación Interna de Fracturas/instrumentación , Fracturas del Fémur/patologíaRESUMEN
In a previous study we reported a relatively low incidence of hip fracture in our population compared to figures reported elsewhere and speculated that this could be related to differences in bone density. Accordingly, we measured bone density in 259 subjects at necropsy. In 172 males we found that bone density decreased from 0.88 g/cc at age 21-30 to 0.80 at age 70 (NS). In women, density decreased from 1.0 at age 21-30 to 0.84 at age 50, 0.69 at age 60 and 0.64 in those older than 70 years (p less than 0.01). These figures are higher than those reported from USA at all ages and could explain the lower incidence of hip fractures in our population.