Browsing by Subject "FEMUR"

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  • Eriksson, E.; Björkenheim, R.; Strömberg, G.; Ainola, M.; Uppstu, P.; Aalto-Setälä, L.; Leino, V-M; Hupa, L.; Pajarinen, J.; Lindfors, N. C. (2021)
    Surgical management of critical-sized diaphyseal defects involves multiple challenges, and up to 10% result in delayed or non-union. The two-staged induced membrane technique is successfully used to treat these defects, but it is limited by the need of several procedures and bone graft. Repeated procedures increase costs and morbidity, while grafts are subject to donor-site complications and scarce availability. To transform this two-staged technique into one graft-independent procedure, we developed amorphous porous scaffolds sintered from the clinically used bioactive glass S53P4. This work constitutes the first evaluation of such scaffolds in vivo in a critical-sized diaphyseal defect in the weight-bearing rabbit femur. We provide important knowledge and prospects for future development of sintered S53P4 scaffolds as a bone substitute. Critical-sized diaphysis defects are complicated by inherent sub-optimal healing conditions. The two staged induced membrane technique has been used to treat these challenging defects since the 1980 & rsquo;s. It involves temporary implantation of a membrane-inducing spacer and subsequent bone graft defect filling. A single-staged, graft-independent technique would reduce both socio-economic costs and patient morbidity. Our aim was to enable such single-staged approach through development of a strong bioactive glass scaffold that could replace both the spacer and the graft filling. We constructed amorphous porous scaffolds of the clinically used bioactive glass S53P4 and evaluated them in vivo using a critical sized defect model in the weight-bearing femur diaphysis of New Zealand White rabbits. S53P4 scaffolds and standard polymethylmethacrylate spacers were implanted for 2, 4, and 8 weeks. Induced membranes were confirmed histologically, and their osteostimulative activity was evaluated through RT-qPCR of bone morphogenic protein 2, 4, and 7 (BMPs). Bone formation and osseointegration were examined using histology, scanning electron microscopy, energy-dispersive X-ray analysis, and micro-computed tomography imaging. Scaffold integration, defect union and osteosynthesis were assessed manually and with X-ray projections. We demonstrated that S53P4 scaffolds induce osteostimulative membranes and produce osseointegrative new bone formation throughout the scaffolds. We also demonstrated successful stable scaffold integration with early defect union at 8 weeks postoperative in critical-sized segmental diaphyseal defects with implanted sintered amorphous S53P4 scaffolds. This study presents important considerations for future research and the potential of the S53P4 bioactive glass as a bone substitute in large diaphyseal defects. Statement of significance Surgical management of critical-sized diaphyseal defects involves multiple challenges, and up to 10% result in delayed or non-union. The two-staged induced membrane technique is successfully used to treat these defects, but it is limited by the need of several procedures and bone graft. Repeated procedures increase costs and morbidity, while grafts are subject to donor-site complications and scarce availability. To transform this two-staged technique into one graft-independent procedure, we developed amorphous porous scaffolds sintered from the clinically used bioactive glass S53P4. This work constitutes the first evaluation of such scaffolds in vivo in a critical-sized diaphyseal defect in the weight-bearing rabbit femur. We provide important knowledge and prospects for future development of sintered S53P4 scaffolds as a bone substitute. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of Acta Materialia Inc. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )
  • Maijanen, Heli; Junno, Juho-Antti; Keisu, Asla; Niinimäki, Jaakko; Lehenkari, Petri; Oura, Petteri (2021)
    Sex estimation is an important part of osteological analysis of skeletons and forensic identification process. Traditionally cranial and pelvic traits are utilized for accurate sex estimation. However, post-cranial measurements have also been proven to accurately estimate sex especially from robust bones such as the femur. In this study, we investigated the potential of knee breadth dimensions in sex estimation in a Finnish population. To conduct this study we utilized a study sample (n=1654) belonging to the Northern Finland Birth Cohort 1966. All individuals were 46 years of age at the time of the examination. Three knee breadth dimensions were measured from subjects' knee posteroanterior radiographs: femoral biepicondylar breadth (FBEB), mediolateral breadth of the femoral condyles (FCML), and mediolateral breadth of the tibial plateau (TPML). Sex estimation was performed using logistic regression. The study clearly demonstrated that all three measurements were different between males and females. Sectioning points for individual knee breadth measurements were 82.9 mm for FBEB, 76.6 mm for FCML and 75.4 mm for TPML. The classification rates ranged from 90.9 % to 93.6 %. The less commonly used measurements of FCML and TPML showed higher accuracy than FBEB in sex estimation. Our study confirmed that knee breadths can be successfully utilized to improve sex estimation in cases where the skeleton is only partially preserved and other major components of sex estimation are absent. We can also provide new standards for sex estimation from the knee joint in a Finnish population.
  • Mäkitaipale, Johanna; Sievänen, Harri; Laitinen-Vapaavuori, Outi (2018)
    Rabbit bones are brittle and prone to fissure formation. Radiographs of very young and old rabbits are often indicative of decreased bone density. The aim of this study was to investigate the tibial bone parameters in pet rabbits, and their association with age, sex, castration and dental disease. Eighty-seven (43 female/5 spayed, 44 male/19 castrated) pet rabbits (mean age 2.6 years, range 0.3-9.3 years) of various breeds were studied, of which 37 had dental disease. Right tibiae were scanned with peripheral quantitative CT at the distal (4percent) and mid-shaft sites (50percent of the tibial length). Analysed bone parameters included the total cross-sectional area, cortical bone area and density, trabecular bone density and strength-strain index. The mean diaphyseal cortical density was high (about 1400 mg/cm(3)) in comparison to many other species. Within the studied age range, age was weakly but positively associated with diaphyseal cortical density, with the juvenile rabbits clearly showing the lowest values. There was no tendency for age-related decrease in trabecular or cortical bone density at least up to six years of age. Neither were sex, castration nor dental disease associated with decreased tibial bone density.