Design of artificial ligaments possessing both osteogenic activity and antibacterial effect that promotes ligament-bone healing and prevents bacterial infection in bone tunnels for anterior cruciate ligament(ACL)recon...Design of artificial ligaments possessing both osteogenic activity and antibacterial effect that promotes ligament-bone healing and prevents bacterial infection in bone tunnels for anterior cruciate ligament(ACL)reconstruction remains a significant challenge.In this study,black tantalic oxide(BTO)submicro-particles with oxygen vacancies and structure defects were fabricated by using traditional white tan-talic oxide(WTO)through magnesium thermal reduction(MTR)method,and BTO was coated on polyetheretherketone(PEEK)fibers(PKF),which were woven into fabrics(PBT)as artificial ligaments.PBT with BTO coating exhibited excellent photothermal performance,which possessed not only antibac-terial effects in vitro but also anti-infective ability in vivo.PBT with optimized surface properties(e.g.,submicro-topography and hydrophilicity)not only significantly facilitated rat bone mesenchymal stem cells(BMSC)responses(e.g.,proliferation and osteogenic differentiation)in vitro but also stimulated new bone formation for ligament-bone healing in vivo.The presence of oxygen vacancies and structure de-fects in BTO did not change the surface properties and osteogenic activity of BPT while displaying an outstanding photothermal antibacterial effect.In summary,BPT with osteogenic activity and photother-mal antibacterial effect promoted bone regeneration and prevented bacterial infection,thereby promoting ligament-bone healing.Therefore,PBT would have tremendous potential as a novel artificial ligament for ACL reconstruction.展开更多
Current materials comprising suture anchors used to reconstruct ligament-bone junctions still have limitation in biocompatibility,degradability or mechanical properties.Magnesium alloys are potential bone implant mate...Current materials comprising suture anchors used to reconstruct ligament-bone junctions still have limitation in biocompatibility,degradability or mechanical properties.Magnesium alloys are potential bone implant materials,and Mg^(2+) has been shown to promote ligament-bone healing.Here,we used Mg-2 wt.%Zn-0.5 wt.%Y-1 wt.%Nd-0.5 wt.%Zr(ZE21C)alloy and Ti6Al4V(TC4)alloy to prepare suture anchors to reconstruct the patellar ligament-tibia in SD rats.We studied the degradation behavior of the ZE21C suture anchor via in vitro and in vivo experiments and assessed its reparative effect on the ligament-bone junction.In vitro,the ZE21C suture anchor degraded gradually,and calcium and phosphorus products accumulated on its surface during degradation.In vivo,the ZE21C suture anchor could maintain its mechanical integrity within 12 weeks of implantation in rats.The tail of the ZE21C suture anchor in high stress concentration degraded rapidly during the early implantation stage(0-4weeks),while bone healing accelerated the degradation of the anchor head in the late implantation stage(4-12weeks).Radiological,histological,and biomechanical assays indicated that the ZE21C suture anchor promoted bone healing above the suture anchor and fibrocartilaginous interface regeneration in the ligament-bone junction,leading to better biomechanical strength than the TC4 group.Hence,this study provides a basis for further research on the clinical application of degradable magnesium alloy suture anchors.展开更多
Background Allografts were widely used in anterior cruciate ligament （ACL） reconstruction for patients with ACL rupture of the knee. This study was to approve the feasibility of bone-posterior cruciate ligament-bone...Background Allografts were widely used in anterior cruciate ligament （ACL） reconstruction for patients with ACL rupture of the knee. This study was to approve the feasibility of bone-posterior cruciate ligament-bone （BPCLB） allograft transplantation in ACL reconstruction. Methods Eight patients underwent ACL reconstructions with BPCLFI allografts and were followed up for an average period of 32 months after operation. Results Subjective parameters including Intemational Knee Documentation Committee （IKDC）, modified Larson knee ligament, Lysholm, and Tegner rating scales were much improved and side to side KT-2000 arthrometer difference was much less postoperatively. Pivot shift test was negative in all patients. The reconstructed ACL had satisfactory shape and tension. Conclusions BPCLB allograft is an optional choice for ACL reconstruction.展开更多
目的探讨超声骨刀辅助颈椎外科前路可控前移融合术(anterior controllable antedisplacement and fusion,ACAF)治疗颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)的技术要点及临床疗效。方法2022年6月...目的探讨超声骨刀辅助颈椎外科前路可控前移融合术(anterior controllable antedisplacement and fusion,ACAF)治疗颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)的技术要点及临床疗效。方法2022年6月—2024年12月,11例OPLL患者接受超声骨刀辅助ACAF治疗。男8例,女3例;年龄49~74岁,平均56.7岁。OPLL类型:混合型5例,节段型4例,连续型2例。骨化物累及2~5个节段,平均3.2个。病程2~18个月,平均6.2个月。记录手术时间、术中出血量及手术并发症发生情况,采用疼痛视觉模拟评分(VAS)评估疼痛改善情况,日本骨科协会评分(JOA)评估神经功能改善情况;复查颈椎CT及MRI,测算椎管侵占率、椎管面积及脊髓矢状径。结果11例手术均顺利完成;手术时间174~360 min,平均255.9 min;术中出血量170~530 mL,平均345.9 mL。术后除1例出现C5神经根麻痹外,均无脑脊液漏、脊髓功能损伤加重以及喉上神经、喉返神经损伤等并发症发生。患者均获随访,随访时间3~12个月,平均7.2个月。末次随访时,VAS评分较术前降低、JOA评分提高,差异均有统计学意义(P<0.05);基于JOA评分改善率评价,疗效达优2例、良8例、可1例,优良率90.9%。影像学复查示无内固定物松动、断钉等并发症发生,无椎管狭窄加重;术后椎管侵占率较术前减小,椎管面积及脊髓矢状径较术前增大,差异均有统计学意义(P<0.05)。结论ACAF治疗颈椎OPLL术中采用超声骨刀可行精准椎体开槽、游离椎体骨化物复合体,提升手术安全性,获得满意的近期疗效。展开更多
基金supported by the National Natu-ral Science Foundation of China(Nos.32171340,81772343 and 81771990)the Key Medical Program of Science and Technol-ogy Development of Shanghai(No.20S31900400)the National Science Foundation of Shanghai(No.21ZR1447900).
文摘Design of artificial ligaments possessing both osteogenic activity and antibacterial effect that promotes ligament-bone healing and prevents bacterial infection in bone tunnels for anterior cruciate ligament(ACL)reconstruction remains a significant challenge.In this study,black tantalic oxide(BTO)submicro-particles with oxygen vacancies and structure defects were fabricated by using traditional white tan-talic oxide(WTO)through magnesium thermal reduction(MTR)method,and BTO was coated on polyetheretherketone(PEEK)fibers(PKF),which were woven into fabrics(PBT)as artificial ligaments.PBT with BTO coating exhibited excellent photothermal performance,which possessed not only antibac-terial effects in vitro but also anti-infective ability in vivo.PBT with optimized surface properties(e.g.,submicro-topography and hydrophilicity)not only significantly facilitated rat bone mesenchymal stem cells(BMSC)responses(e.g.,proliferation and osteogenic differentiation)in vitro but also stimulated new bone formation for ligament-bone healing in vivo.The presence of oxygen vacancies and structure de-fects in BTO did not change the surface properties and osteogenic activity of BPT while displaying an outstanding photothermal antibacterial effect.In summary,BPT with osteogenic activity and photother-mal antibacterial effect promoted bone regeneration and prevented bacterial infection,thereby promoting ligament-bone healing.Therefore,PBT would have tremendous potential as a novel artificial ligament for ACL reconstruction.
基金supported by Scientific and Technological Project in Henan Province(212102310236,202102210015)National Natural Science Foundation of China(51701184,51671175)+1 种基金the Key Projects of the Joint Fund of the National Natural Science Foundation of China(U1804251)the Postgraduate Independent Innovation Project of Zhengzhou University(20211203).
文摘Current materials comprising suture anchors used to reconstruct ligament-bone junctions still have limitation in biocompatibility,degradability or mechanical properties.Magnesium alloys are potential bone implant materials,and Mg^(2+) has been shown to promote ligament-bone healing.Here,we used Mg-2 wt.%Zn-0.5 wt.%Y-1 wt.%Nd-0.5 wt.%Zr(ZE21C)alloy and Ti6Al4V(TC4)alloy to prepare suture anchors to reconstruct the patellar ligament-tibia in SD rats.We studied the degradation behavior of the ZE21C suture anchor via in vitro and in vivo experiments and assessed its reparative effect on the ligament-bone junction.In vitro,the ZE21C suture anchor degraded gradually,and calcium and phosphorus products accumulated on its surface during degradation.In vivo,the ZE21C suture anchor could maintain its mechanical integrity within 12 weeks of implantation in rats.The tail of the ZE21C suture anchor in high stress concentration degraded rapidly during the early implantation stage(0-4weeks),while bone healing accelerated the degradation of the anchor head in the late implantation stage(4-12weeks).Radiological,histological,and biomechanical assays indicated that the ZE21C suture anchor promoted bone healing above the suture anchor and fibrocartilaginous interface regeneration in the ligament-bone junction,leading to better biomechanical strength than the TC4 group.Hence,this study provides a basis for further research on the clinical application of degradable magnesium alloy suture anchors.
基金This work was supported by grants from the National Key Technologies R＆D Program of China and Beijing Municipal Natural Science Foundation.
文摘Background Allografts were widely used in anterior cruciate ligament （ACL） reconstruction for patients with ACL rupture of the knee. This study was to approve the feasibility of bone-posterior cruciate ligament-bone （BPCLB） allograft transplantation in ACL reconstruction. Methods Eight patients underwent ACL reconstructions with BPCLFI allografts and were followed up for an average period of 32 months after operation. Results Subjective parameters including Intemational Knee Documentation Committee （IKDC）, modified Larson knee ligament, Lysholm, and Tegner rating scales were much improved and side to side KT-2000 arthrometer difference was much less postoperatively. Pivot shift test was negative in all patients. The reconstructed ACL had satisfactory shape and tension. Conclusions BPCLB allograft is an optional choice for ACL reconstruction.
文摘目的探讨超声骨刀辅助颈椎外科前路可控前移融合术(anterior controllable antedisplacement and fusion,ACAF)治疗颈椎后纵韧带骨化症(ossification of the posterior longitudinal ligament,OPLL)的技术要点及临床疗效。方法2022年6月—2024年12月,11例OPLL患者接受超声骨刀辅助ACAF治疗。男8例,女3例;年龄49~74岁,平均56.7岁。OPLL类型:混合型5例,节段型4例,连续型2例。骨化物累及2~5个节段,平均3.2个。病程2~18个月,平均6.2个月。记录手术时间、术中出血量及手术并发症发生情况,采用疼痛视觉模拟评分(VAS)评估疼痛改善情况,日本骨科协会评分(JOA)评估神经功能改善情况;复查颈椎CT及MRI,测算椎管侵占率、椎管面积及脊髓矢状径。结果11例手术均顺利完成;手术时间174~360 min,平均255.9 min;术中出血量170~530 mL,平均345.9 mL。术后除1例出现C5神经根麻痹外,均无脑脊液漏、脊髓功能损伤加重以及喉上神经、喉返神经损伤等并发症发生。患者均获随访,随访时间3~12个月,平均7.2个月。末次随访时,VAS评分较术前降低、JOA评分提高,差异均有统计学意义(P<0.05);基于JOA评分改善率评价,疗效达优2例、良8例、可1例,优良率90.9%。影像学复查示无内固定物松动、断钉等并发症发生,无椎管狭窄加重;术后椎管侵占率较术前减小,椎管面积及脊髓矢状径较术前增大,差异均有统计学意义(P<0.05)。结论ACAF治疗颈椎OPLL术中采用超声骨刀可行精准椎体开槽、游离椎体骨化物复合体,提升手术安全性,获得满意的近期疗效。
文摘目的对骨髓间充质干细胞(BMSCs)介入对前交叉韧带(ACL)重建术后腱骨愈合影响的动物实验研究进行荟萃分析,并根据以往研究首次划分并探讨术后不同时期BMSCs介入对腱骨愈合的影响。方法检索建库至2024年3月PubMed、Embase、Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、中国知网、万方数据库并浏览纳入文献的参考文献,收集关于BMSCs用于动物ACL术后腱骨愈合疗效的研究。根据纳入与排除标准独立进行文献筛选、质量评价及资料提取,使用RevMan 5.4软件对结局指标进行荟萃分析。结果共纳入10项研究,包括254只动物(实验组127只,对照组127只)。荟萃分析结果显示:术后4周应用BMSCs可显著提升腱骨界面新骨体积/总骨组织体积(BV/TV)、极限载荷及刚度(P<0.001),但对骨隧道横截面积无明显影响(P=0.412);术后12周时,BMSCs组与对照组相比在骨隧道横截面积、BV/TV、极限载荷及刚度方面差异均具有统计学意义(P<0.001)。组织学结果显示BMSCs可显著加快腱骨界面愈合进程。结论BMSCs可加速腱骨界面骨组织生长的积极影响,进而有效提升其生物力学强度。未来可对BMSCs应用于动物实验后的长期效果进行进一步研究,且在应用BMSCs时也应注意到与细胞因子、生物材料等组织工程技术联合使用的广阔前景。
