One of the 4 Crohn's disease-associated fistulas healed (25 %) and 4 of 32 (12.5 %) procedures resulted in healing of crypto-glandular fistulas. Intact specimens were treated with 10° opening wedge osteotomies, identical surgical techniques as clinically used and fixation provided by iBalance PEEK implant (Arthrex, Naples FL); 9 specimens were augmented with calcium phosphate injectable cement, Quickset (Arthrex Inc., Naples Fl). BMC Musculoskelet Disord. Clin Oral Implants Res. Intravenous vancomycin and meropenem were administered after sampling with substitution to targeted antibiotic therapy for between 6 weeks and 6 months; average follow-up was 15 months. In the fibrin glue group, 6 patients (60 %) had persistence of one or more fistulas at 3 months, compared with 2 patients (13 %) in the plug group (p < 0.05, Fisher exact test). This study examined a total of 20 revision cases of surgically treated oto-sclerosis where extensive incus erosion was observed during revision surgery. These researchers stated that in most recent years, focus has been shifted to the use of ceramics in minimally invasive surgeries or implementation of nano-structured surface modification features to promote osteo-inductive properties. A total of 54 consecutive patients underwent surgery for idiopathic scoliosis using the same technique -- 30 received a graft consisting of a mixture of cortico-cancellous autologous and allogenic bone frozen at -80 degrees, and 24 patients were grafted with a mixture of cortico-cancellous autologous bone and sticks of tri-calcium phosphate (TCP, Biosorb, SBM, Lourdes, France). Bone stiffness plays a crucial role in the press-fit stability of orthopaedic implants. Anderson and colleagues (2005) reviewed the rationale and discussed the results of cellular strategies that have been proposed or investigated for disc degeneration. Patients who participated in research were more likely to comply with post-operative medications and physiotherapy, thus resulting in better health outcomes. The surgical procedure combined posterior lumbar interbody fusion (PLIF) and PLF with internal fixation over 1 or 2 levels using silicated calcium phosphate (SiCaP; n = 51) or BMP-2 (n = 52) as graft material in patients with a degenerative disorder of the lumbar spine. 2013;8:49. Center for Medicare and Medicaid Services (CMS). Sixty patients (aged 22.4 ± 7.4 years, 62 knees) with osteochondritis dissecans of a femoral condyle (45 medial and 17 lateral) were treated with osteochondral autologous transplantation, autologous chondrocyte implantation with bone graft, biomimetic nanostructured osteochondral scaffold (MaioRegen) implantation, bone-cartilage paste graft, or a "1-step" bone-marrow-derived cell transplantation technique. Regeneration of intervertebral disc by mesenchymal stem cells: Potentials, limitations, and future direction. New and Emerging Health Technology Report. Cochrane Database Syst Rev. ISASS recommendations and coverage criteria for bone graft substitutes used in spinal surgery. This ileal conduit is a urostomy and not an ileostomy because it is a urinary diversion rather than a fecal diversion. These researchers presented the first long-term results following open curettage of benign bone tumors and tumor-like lesions and void filling with this novel injectable and synthetic bone graft. There were 19 males and 4 females. Mean follow-up was 11 months (range of 2 to 22 months). Hydroxyapatite bone cement was used to repair defects at the incudo-stapedial connection in 82 ears with retraction pockets. Although the claim of cellular bone matrices containing osteogenic cells with osteoinductive properties is attractive, little is known about their clinical success when used in anterior cervical discectomy and fusion (ACDF). 2005;19(6):E13. The mean follow-up was 126 days (standard = 69.4). In a randomized controlled study, Camargo et al (2005) compared the clinical effectiveness of a combination therapy consisting of bovine porous bone mineral (BPBM), guided tissue regeneration (GTR), and PRP in the regeneration of periodontal intra-bony defects in humans. A damaged meniscus can be replaced with a KGN-treated autologous tendon graft. An H, Yeung C, Field J, Roh M. A radiographic analysis of posterolateral lumbar fusion utilizing an allogeneic growth factor compared to recombinant human bone morphogenetic protein-2 (rhbmp-2). OsteoAMP produced higher rates of fusion at 6, 12, and 18 months (pââ¤â0.01). The authors concluded that the present study showed that stapedectomy and total ossiculoplasty with cartilage-connecting HA prosthesis is effective and safe for stapes fixation accompanied by fixation or erosion of the malleus and/or incus. The PMMA and BOP grafts led to lower fusion rates, and PMMA, HA, and BOP had greater risks of graft fragmentation, settling, and instrumentation problems compared with iliac crest bone graft. Recently, MSCs has been studied for its use in orthopedic application (e.g., healing long bone defects, intervertebral disc repair and regeneration as well as spinal arthrodesis procedures). Yang XB, Bhatnagar RS, Li S, Oreffo RO. The use of cell surface marker combinations allows for enrichment of the stem cell population but is inadequate for prospective isolation. Interventions for replacing missing teeth: Surgical techniques for placing dental implants. Patient Care Handouts help you to take care of yourself or someone else after you’ve seen a healthcare provider, and tell when to call for help. P-15 promoted human bone marrow stromal cell attachment, spreading, and alignment on ABM as well as alkaline phosphatase-specific activity in basal and osteogenic cultures. The authors concluded that patients should be cautioned regarding potentially high failure rates; however, longer follow-up and a larger patient population are needed to confirm significant differences in fistula plug efficacy. 2019;14(1):372. Tissue Eng. The postoperative ABG closure to within 20 and 10 dB at 12 months was, respectively, 80 and 40 % in the HA bone cement group and 57.1 and 28.6 % in the standard ossiculoplasty group (no statistically significant difference). } The authors concluded that RPI appeared to be a useful tool for scientific investigation; however further work is needed to examine the feasibility of using RPI for assessing differences between healthy and diseased bone in a clinical setting. 2005;16(2):280-287. Cochrane Database Syst Rev. were not assessed. Patients were observed serially with radiographs, clinical examinations, and appropriate clinical indicators, including Oswestry Disability Index (ODI), Short-Form 36, and visual analog scale scores. Sandhu et al (2003) stated that OP-1 has been studied in limited pilot studies of posterolateral fusion. Post-operative air-bone gap was 26.5 (15.3) dB; it was 23.8 (15.7) dB in the titanium group and 29.8 (14.6) dB in the HA group (p = 0.18). Arch Otolaryngol Head Neck Surg. Based on these findings, these researchers proposed that progenitor cells from the lumbar vertebral marrow would be suitable candidate for osseous graft supplementation in spinal fusion procedures. The product was approved by the FDA in 1992 as a bone void filler for repair of metaphyseal defects and long bone cyst and tumor defects. Cheng et al (2010) had previously isolated and identified stem cells from human anterior cruciate ligament (ACL). Statistical analysis was performed with Fisher's exact test. Recently, RPI has opened the possibility of directly assessing the mechanical characteristics of cortical bone in living individuals, adding a new dimension to the assessment of bone strength. Data are most robust for polymethylmethacrylate beads; these are typically removed within 2 to 4 weeks. Neurosurg Focus. Ky et al (2008) evaluated the effectiveness of the Surgisis (Anal Fistula Plug) in multiple patients and presented early clinical results along with notable clinical observations from their experience. In order to determine if SCT has enough clinical evidence to bone ridge augmentation in humans, a systematic review and meta-analysis were carried out. The differences between the experimental and control groups were 2.22 (+/- 0.39) mm on buccal and 2.12 (+/- 0.34) mm on lingual sites for pocket depth, 3.05 (+/- 0.51) mm on buccal and 2.88 (+/- 0.46) mm on lingual sites for gain in clinical attachment, and 3.46 (+/- 0.96) mm on buccal and 3.42 (+/- 0.02) mm on lingual sites for defect fill. However, the outcome variables await rigorous validation, and standardization of RPI techniques between studies is lacking, complicating comparisons of RPI data across studies. Vaccaro et al (2008) examined the safety and the clinical and radiographical efficacy of OP-1 (rhBMP-7) Putty as compared with an iliac crest bone autograft control in un-instrumented, single-level postero-lateral spinal arthrodesis. Calcium phosphates are highly biocompatible and in addition, they act as synthetic osteo-conductive scaffolds after implantation in bone. Vaccaro AR, Lawrence JP, Patel T, et al. For CP, a number of clinical studies have shown that it can be useful for augmentation of metaphyseal fractures when a space is present. Chhabra N, Houser SM. Subjects randomly received either autograft (n = 154) or i-Factor (n = 165) in a cortical ring allograft and followed using radiological, clinical, and patient-reported outcomes. In contrast, Freymiller and Aghaloo (2004) stated: "Practitioners involved with bone grafting have high hopes that PRP will be proven to be of benefit in bone graft healing. Anderson DJ, Sexton DJ. Risbud and colleagues (2006) evaluated the osteogenic potential of MSCs isolated from the bone marrow of the human vertebral body (VB). #closethis { Thus far, most of the reports have been limited to treatments of OA of knees. Two independent investigators searched the Entrez PubMed, SCOPUS and Web of Science databases for eligible randomized clinical trials that describe SCT for alveolar bone formation. Cellular therapy for disc degeneration. Int Forum Allergy Rhinol. A random-effects meta-analysis model was used to evaluate the percentage of bone formation in the selected studies. Scordino et al (2017) noted that there has been a resurgence in the use of opening wedge high tibial osteotomy (owHTO). These conclusions are in agreement with the observations of Sanchez et al (2003) and Grageda (2004). Li and colleagues (2017) stated that 45S5 Bioglass (45S5) is one of the most widely used biomaterials in ceramic-based bone graft substitutes by virtue of its excellent biocompatibility and bioactivity. Ferrari J. Hallux valgus deformity (bunion). Cell matrix or stem cell-based products and the synthetic peptides have inadequate data. A retrospective chart review of patients treated with Cook and Gore fistula plugs between August 2007 and December 2009 was performed. Both histochemical staining and qRT-PCR showed that the chondrogenic differentiation of TSCs was increased with KGN concentration. HA for securing total or partial ossicular replacement prosthesis. This function: In the 2nd group a rapid proliferation of chondrocytes appeared with development of hyaline cartilage with alcianblue-positive matrix. All patients suffered from primary musculoskeletal system disorders (enchondroma 63.6 %, giant cell tumor 18 %, aneurysmal bone cyst 9 %, fibrous dysplasia 9 %, Gaucher disease 3 %). } Kanayama et al (2006) evaluated the osteo-inductive property of OP-1 or BMP-7 and fusion rate in human instrumented postero-lateral lumbar fusion through radiographic examination, surgical exploration, and histologic assessment. In addition, different physical and chemical properties of various ceramics further contribute to the limited evidence. 2004;(428):140-145. Tenocytes were grown in co-culture with autologous ASC or allogeneic SVF. The clinical outcomes of interest were post-operative infections, delayed or non-healing wounds, adverse surgical site reactions, and repeat surgery for formal irrigation and debridement. Institute for Clinical Effectiveness and Health Policy (IECS). Examples include Vivigen, OsteoAMP, OsteoAMP Select, and Intergro. 2018;42(12):2915-2923. Overall, there were no differences between the treatment groups in terms of fusion, functional outcomes, or complications, except in 1 study that found higher rates of HA graft absorption. 2007;63(6):1324-1328. 2003;(1): CD003606. Spine (Phila Pa 1976). Twelve Cook patients underwent 16 plug insertions and 10 Gore patients underwent 11 plug insertions. 2019;37(6):1429-1439. i-Factor Bone Graft is a bone graft substitute that consists of P-15 bound to an ABM; thus, it contains both osteo-conductive and osteo-inductive properties. The authors concluded that the short-term success rates are promising; further analysis is needed to explain the definite role of this technique in comparison with traditional surgical techniques. The authors concluded that there is a clear publication bias in the literature, mostly favoring BMP. National Institute for Health and Clinical Excellence (NICE). From June 2010 through May 2011 adult patients presenting with acute, closed and unstable tibial plateau fractures that needed both grafting and internal fixation, were included in a prospective study with percutaneous or open reduction and internal fixation (ORIF) augmented with an injectable ceramic biphasic bone substitute CBVF to fill residual voids. Courses are being offered throughout the United States touting the benefits of PRP. They obtained IKDC subjective knee evaluation scores, Tegner-Lysholm activity levels, and Lysholm-Gillquist knee scores pre-operatively and at 6, 12, and 24 months post-operatively. The meniscus formation i- vivo was examined by histological analysis and immune staining. Resorbable extracellular matrix grafts in urologic reconstruction. The main AE was post-procedural pain. Computed tomography and plain film radiographic measures included assessment of bridging bone, disc height, disc angle, and segmental range of motion (ROM). Safar et al (2009) analyzed the efficacy of the Cook Surgisis AFP anal fistula plug for the management of complex anal fistulas. Mean patient satisfaction level was 7.5; 10 patients had both a pre-operative and post-operative MRI available for comparison. Health Technology Assessment. With many other outstanding qualities, nacre represents a natural and multi-use biomaterial as a bone graft substitute. The authors concluded that even without access to formal physical therapy, [their] patient had excellent functional outcomes at his final follow-up visit. Moon et al (2019) stated that beneficial effects of human adipose-derived SVF cell injection on microcirculation have been recently reported in in-vitro and in-vivo studies. Thalgott JS, Fritts K, Giuffre JM, Timlin M. Anterior interbody fusion of the cervical spine with coralline hydroxyapatite. 1996;29(11):1241-1244. Huang and colleagues (2017) stated that the meniscus is one of the most commonly injured parts of the body, and meniscal healing is difficult. In a single-center, phase I clinical trial, these researchers evaluated the safety and wound outcomes following genetically corrected autologous epidermal grafts in patients with RDEB. Kon et al (2012) stated that osteochondritis dissecans is a relatively common cause of knee pain. Recently, stem cell therapy (SCT) has emerged as a promising biological substitute or adjuvant to enhance bone healing. They carried out a systematic review of all English language articles using Medline, Embase, PubMed, Scopus and Cochrane databases. However, these researchers observed a statistically significant difference in ABG gain at 6 and 12 months favoring the HA bone cement cases. The fusion mass lateral to the instrumentation on each side was judged fused or not, and the mineralization of the graft was rated absent, mild, moderate, or extensive. The authors concluded that SVF and ASC are promising therapies for a variety of human diseases, especially for patients with severe cases refractory to current medical treatments. 2005;19(3):E4. J Mech Behav Biomed Mater. Bone morphogenetic proteins and spinal surgery for degenerative disc disease. While cellularized allografts are known to harbor endogenous cells, the identity of these cells remains obscure, largely due to the lack of bona fide markers for stem and progenitor cells. At 2 years, the fusion rate was 97.30 % and 94.44 % in i-Factor and autograft subjects, respectively (p = 0.2513), and neurological success rate was 94.87 % (i-Factor) and 93.79 % (autograft; p = 0.7869); NDI improved 28.30 (i-Factor) and 26.95 (autograft; p = 0.1448); VAS arm pain improved 5.43 (i-Factor) and 4.97 (autograft) (p = 0.2763); VAS neck pain improved 4.78 (i-Factor) and 4.41 (autograft; p = 0.1652), Short Form-36 (SF-36v2) Physical Component Score improved 10.23 (i-Factor) and 10.18 (autograft; p = 0.4507), and SF36v2 Mental Component Score improved 7.88 (i-Factor) and 7.53 (autograft; p = 0.9872). Fourth, in this study, these investigators examined men only; thus these observations may not be generalized to women or other populations. Spine. Instructions for use. Spine. The authors concluded that the 2 in-house-developed bone fillers revealed overall good results and are budding new developments for clinical use. 2003;28(4):317-323. The authors concluded that these studies indicated the potential of P-15 to generate appropriate biomimetic microenvironments for osteoblasts and demonstrated the potential for the exploitation of extracellular matrix cues for osteogenesis and, ultimately, bone regeneration. There is currently insufficient evidence to support the use of mesenchymal stem cell therapy for orthopedic applications including repair or regeneration of musculoskeletal tissue, spinal fusion, and long bone nonunions. Recently, a synthetic 15-amino acid polypeptide bound to an anorganic bone material (ABM) that mimics the cell-binding domain of type-I collagen opened a possibility for osteogenic and osteo-inductive roles of this hybrid graft material. Patients with implanted HA prostheses composed a matched control group. Allareddy et al (2015) estimated the prevalence of complications in children who had insertion of rhBMP at the time of spinal fusion procedures (SFP) and examined if the use of rhBMP is associated with an increased risk of complications.
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