PURPOSE OF THE STUDY Tendon injuries continue to be a highly topical issue. Research and clinical activities in this area aim to achieve an optimal repair of the damaged tendon. Such suture is characterised by maximum tensile strength, resistance to gapping at the repair site, preservation of smooth surface, prevention of adhesions and facilitation of fast rehabilitation and active tendon movement. The suture as such is required to show mechanical resistance in particular. Considered optimal is the use of core suture of the tendon in combination with epitendinous suture. The group of researchers has for several years already been exploring new materials. They can contribute to better balance between adequate mechanical strength of the suture and biological support of healing. MATERIAL AND METHODS The study was carried out as an ex vivo experiment on porcine tendon models. A tendon segment was obtained from slaughtered animals and a total rupture of the tendon was imitated by sharp cutting of its central portion. Subsequently, the tendon was repaired by Adelaide suture using coated braided polyester (Ethibond) and two types of new polyamide 6 based (PA6) sutures. The first suture was designed as an unabsorbable polyester core (PES silk) surrounded by absorbable PA6 nanofibres. The second suture was created by braiding a PES silk yarn and two viscose yarns with PA6 nanofibres into a composite surgical suture. As a part of the study also examined was the tensile strength of suture with the use of other stitches, effect of the shape of the needle s point on the tensile strength of the suture and the effect of secured mattress peritendinous suture. The tensile strength of the suture was tested until failure and the achieved maximum load was monitored. RESULTS The PES core yarn with PA6 nanofibre braiding showed lower tensile strength (28.5 ± 5.2 N) than the yarn braided from one PES yarn and two viscose yarns with PA6 nanofibres (45.7 ± 6.7 N). Both newly developed sutures, however, fail to achieve the tensile strength of Ethibond (100.3 ± 19.1 N). In case of Ethibond suture using various types of stitches, the lowest tensile strength was observed in McLarney 4-strand core suture (68.8 ± 18.7 N). A higher tensile strength was achieved by Adelaide 4-strand core suture (83.6 ± 11.2 N). The highest tensile strength was seen in 6-strand core Savage suture (147.4 ± 22.7 N). When the effect of the type of needle was tested, a statistically significant difference between the taper point needle (72.0 ± 7.0 N) and reverse cutting needle (63.3 ± 9.6 N) was observed. In case of McLarney suture the epitendinous stitch increased the tensile strength by 46.2% and in case of Adelaide suture by 48.3%. CONCLUSIONS For tendon core suture, the use of sutures with multiple longitudinal segments seems more appropriate. The epitendinous suture can considerably reinforce the basic load-bearing core suture. Also observed was not an insignificant effect of the needle profile on the resulting tensile strength of the suture. In materials developed by us, more suitable seems to be the design of braiding of absorbable nanofibers with a load-bearing non-absorbable yarn. While the mechanical tensile strength of new materials is lower, the benefits are expected in the form of biological support of healing. Moreover, the nanofibers can be used as a carrier of biological and therapeutic substances. Further improvement of mechanical properties of the newly developed biomaterial can be foreseen if the material of the load-bearing non-absorbable yarn is changed or the load-bearing yarn and nanofibres ratio modified. This pilot study shall use the findings for further development and modification of new materials in basic research and shall also verify the biological aspects and the course of healing in in vivo studies. Key words: tendon, suture, pig, biomaterials, nanofibres, mechanical testing, healing, polyester, Adelaide.
- MeSH
- biokompatibilní materiály * MeSH
- biomechanika MeSH
- lidé MeSH
- pilotní projekty MeSH
- prasata MeSH
- šicí techniky MeSH
- šlachy * chirurgie MeSH
- sutura MeSH
- testování materiálů MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
This study was conducted as an in vivo experiment in adult miniature pigs with the aim to test two new biomaterials. An iatrogenic defect was made into the central femoral diaphysis in the experimental animals and subsequently fixated by bridging plate osteosynthesis. Into the defect we implanted a cancellous autograft (control group), a pasty injectable scaffold (EXP A), and a porous 3D cylinder (EXP B). Radiological examination was performed in all animals at 0, 10, 20, 30 weeks after surgical procedure and histological assessment was performed. In the newly formed bone the osteoblastic activity was monitored. In terms of radiology, the most effective method was observed in the control group (completely healed 100%) compared to experimental groups EXP A (70.0%) and EXP B (62.5%). Histological assessment showed a higher cell count in the place of bone defect in the control group compared to experimental groups. Between the experimental groups, a higher count of bone marrow cells was found in group EXP B. Both newly developed biomaterials seem to be suitable as replacements for large bone defects, having good workability and applicability. However, compared to the control group treated with a cancellous autograft, the newly formed bone did not reach the same number of cells settling in and in some cases, full radiological healing was not reached. Nevertheless, the material was found to be grown into the original bone in all cases within the experimental groups. The new biomaterials have a great potential as a substitute in the treatment of large bone defects.
- MeSH
- autologní štěp chirurgie MeSH
- biokompatibilní materiály * klasifikace terapeutické užití MeSH
- fraktury femuru * diagnostické zobrazování terapie veterinární MeSH
- prasata chirurgie MeSH
- radiografie metody MeSH
- vnitřní fixace fraktury metody veterinární MeSH
- výzkum MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
- MeSH
- mechanické testy metody MeSH
- poranění šlachy chirurgie veterinární MeSH
- prasata chirurgie MeSH
- sutura * normy veterinární MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- hodnotící studie MeSH
- práce podpořená grantem MeSH
INTRODUCTION Traumatic bone injuries or pathological processes may sometimes result in very extensive bone defects. Currently, the standard procedure applied in clinical humane as well as veterinary medicine to fill a bone defect is the autogenous bone graft which, however, necessitates a more invasive procedure for the patient and in the cases of extensive defects it fails to provide adequate amount of graft. Synthetic bone replacements can be used with no further burden for the patient and can simultaneously be used as the carriers for bioactive molecules or therapeutic drugs. For clinical use, an easy and simple application is one of the requirements that have to be taken into consideration. These requirements are best satisfied by preparations in the form of gel, which may be injected into the defects of various shapes even through minimal surgical approach. MATERIAL AND METHODS Synthetic transparent PGD-AlphaProA hydro-peptide-gel was used as a basis to develop a composite hydrogel scaffold. This gel was enriched by cryogenically ground poly- -caprolactone nanofibers (PCL) in a ratio of 1 ml of gel to 16 μg of nanofibres. In experimental animals (laboratory rat Wistar, n=20), a single regular circular defect of 1.5 mm in diameter was drilled by a low speed drill machine across the whole width of distal femur diaphysis, identically in both the hind legs. In the right hindleg, this defect was filled by injection of 0.05 ml of the composite peptide gel with nanofibers (experimental defect). In the contralateral limb a similar defect was left untreated, without filling (control defect), for spontaneous healing. The group of experimental animals was subsequently divided into four sub-groups (A, B, C, D) for the purpose of further follow-up. One week after the surgical implantation, in the first group of experimental animals (Group A; n = 5) lege artis euthanasia was performed, a radiological examination of both the hind legs was carried out and a sample of the bone from both the control and experimental defect was collected for histologic examination. The other groups of experimental animals were evaluated similarly at 2, 4 and 6 weeks after the surgical procedure (Group B, C, D; n = 5). These groups of experimental animals were assessed using various histological techniques by two independent pathologists. RESULTS A difference between the control and the experimental bone defect was observed only at the healing stage at two weeks after the implantation, when a tendency for greater formation of new bone trabeculas was seen in the defect treated with the composite hydro-peptide-gel with PCL nanofibers. The results show a slightly higher angiogenesis and cellularity at the bone defect site with an increase of newly formed bone tissue and faster colonisation of lamellar bone structures by bone marrow cells at early stages of the healing process (1-2 weeks old defect). In the experimental and control groups, at the later stage of healing (4-6 weeks old defect), the process of healing and bone modelling at the defect site shows no detectable morphological differences. CONCLUSIONS The experimental use of hydro-peptide-gel with PCL nanofibers in vivo in laboratory rats shows very good applicability into the defect site and, compared to the untreated defect within two weeks after the implantation, accelerates the bone healing. This fact could be an advantage especially at the early stage of healing, and thus accelerate the healing of more extensive defects. Key words: peptide gel, polycaprolactone, PCL, replacement, bone, healing, scaffold, nanofibers, biomaterial.
- MeSH
- biokompatibilní materiály škodlivé účinky terapeutické užití MeSH
- buněčné struktury fyziologie MeSH
- femur chirurgie MeSH
- hojení fraktur fyziologie MeSH
- kosti a kostní tkáň abnormality cytologie zranění patologie MeSH
- kostní náhrady škodlivé účinky terapeutické užití MeSH
- krysa rodu rattus MeSH
- látky indukující angiogenezi MeSH
- modely u zvířat MeSH
- nanovlákna terapeutické užití MeSH
- nemoci kostí patologie terapie MeSH
- polyestery aplikace a dávkování MeSH
- potkani Wistar MeSH
- transplantace kostí metody MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
PURPOSE OF THE STUDY In developing new or modifying the existing surgical treatment methods of spine conditions an integral part of ex vivo experiments is the assessment of mechanical, kinematic and dynamic properties of created constructions. The aim of the study is to create an appropriately validated numerical model of canine cervical spine in order to obtain a tool for basic research to be applied in cervical spine surgeries. For this purpose, canine is a suitable model due to the occurrence of similar cervical spine conditions in some breeds of dogs and in humans. The obtained model can also be used in research and in clinical veterinary practice. MATERIAL AND METHODS In order to create a 3D spine model, the LightSpeed 16 (GE, Milwaukee, USA) multidetector computed tomography was used to scan the cervical spine of Doberman Pinscher. The data were transmitted to Mimics 12 software (Materialise HQ, Belgium), in which the individual vertebrae were segmented on CT scans by thresholding. The vertebral geometry was exported to Rhinoceros software (McNeel North America, USA) for modelling, and subsequently the specialised software Abaqus (Dassault Systemes, France) was used to analyse the response of the physiological spine model to external load by the finite element method (FEM). All the FEM based numerical simulations were considered as nonlinear contact statistic tasks. In FEM analyses, angles between individual spinal segments were monitored in dependence on ventroflexion/ /dorziflexion. The data were validated using the latero-lateral radiographs of cervical spine of large breed dogs with no evident clinical signs of cervical spine conditions. The radiographs within the cervical spine range of motion were taken at three different positions: in neutral position, in maximal ventroflexion and in maximal dorziflexion. On X-rays, vertebral inclination angles in monitored spine positions were measured and compared with the results obtain0ed from FEM analyses of the numerical model. RESULTS It is obvious from the results that the physiological spine model tested by the finite element method shows a very similar mechanical behaviour as the physiological canine spine. The biggest difference identified between the resulting values was reported in C6-C7 segment in dorsiflexion (Δφ = 5.95%), or in C4-C5 segment in ventroflexion (Δφ = -3.09%). CONCLUSIONS The comparisons between the mobility of cervical spine in ventroflexion/dorsiflexion on radiographs of the real models and the simulated numerical model by finite element method showed a high degree of results conformity with a minimal difference. Therefore, for future experiments the validated numerical model can be used as a tool of basic research on condition that the results of analyses carried out by finite element method will be affected only by an insignificant error. The computer model, on the other hand, is merely a simplified system and in comparison with the real situation cannot fully evaluate the dynamics of the action of forces in time, their variability, and also the individual effects of supportive skeletal tissues. Based on what has been said above, it is obvious that there is a need to exercise restraint in interpreting the obtained results. Key words: cervical spine, kinematics, numerical modelling, finite element method, canine.
- MeSH
- krční obratle diagnostické zobrazování fyziologie MeSH
- počítačová rentgenová tomografie MeSH
- počítačová simulace * MeSH
- psi MeSH
- rozsah kloubních pohybů * fyziologie MeSH
- zobrazování trojrozměrné MeSH
- zvířata MeSH
- Check Tag
- psi MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
UNLABELLED: PURPOSE OF THE STUDY In a long-term perspective, it is better to remove implants after fracture healing. However, subsequent full or excessive loading of an extremity may result in refracture, and the bone with holes after screw removal may present a site with predilection for this. The aim of the study was to find ways of how to decrease risk factors for refracture in such a case. This involved support to the mechanical properties of a bone during its remodelling until defects following implant removal are repaired, using a material tolerated by bone tissue and easy to apply. It also included an assessment of the mechanical properties of a bone after filling the holes in it with a newly developed biodegradable polymer-composite gel ("bone paste"). The composite also has a prospect of being used to repair bony defects produced by pathological processes. MATERIAL AND METHODS Experiments were carried out on intact weight-bearing small bones in dogs. A total of 27 specimens of metacarpal/metatarsal bones were used for ex vivo testing. They were divided into three groups: K1 (n = 9) control undamaged bones; K2 (n = 9) control bones with iatrogenic damage simulating holes left after cortical screw removal; EXP (n = 9) experimental specimens in which simulated holes in bone were filled with the biodegradable self-hardening composite. The bone specimens were subjected to three-point bending in the caudocranial direction by a force acting parallel to the direction of drilling in their middiaphyses. The value of maximum load achieved (N) and the corresponding value of a vertical displacement (mm) were recorded in each specimen, then compared and statistically evaluated. RESULTS On application of a maximum load (N), all bone specimens broke in the mid-part of their diaphyses. In group K1 the average maximum force of 595.6 ± 79.5 N was needed to break the bone; in group K2 it was 347.6 ± 58.6 N; and in group EXP it was 458.3 ± 102.7 N. The groups with damaged bones, K2 and EXP, were compared and the difference was found to be statistically significant (p ≤ 0.05). CONCLUSIONS The recently developed biodegradable polymer-composite gel is easy and quick to apply to any defect, regardless of its shape, in bone tissue. The ex vivo mechanical tests on canine short bones showed that the composite applied to defects, which simulated holes left after screw removal, provided sufficient mechanical support to the bone architecture. The results of measuring maximum loading forces were statistically significant. However, before the composite could be recommended for use in veterinary or human medical practice, thorough pre-clinical studies will be required. KEY WORDS: fracture fixation, mechanical testing, bone plate, cortical screw, refracture.
- MeSH
- biokompatibilní materiály terapeutické užití MeSH
- biomechanika MeSH
- fraktury kostí chirurgie terapie MeSH
- metakarpální kosti zranění chirurgie MeSH
- metatarzální kosti zranění chirurgie MeSH
- odstranění implantátu * MeSH
- psi MeSH
- zvířata MeSH
- Check Tag
- psi MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH