ObjectiveTo review the research progress of the co-culture system for constructing vascularized tissue engineered bone. MethodsThe recent literature concerning the co-culture system for constructing vascularized tissue engineered bone was reviewed, including the selection of osteogenic and endothelial lineages, the design and surface modification of scaffolds, the models and dimensions of the co-culture system, the mechanism, the culture conditions, and their application progress. ResultsThe construction of vascularized tissue engineered bone is the prerequisite for their survival and further clinical application in vivo. Mesenchymal stem cells (owning the excellent osteogenic potential) and endothelial progenitor cells (capable of directional differentiation into endothelial cell) are considered as attractive cell types for the co-culture system to construct vascularized tissue engineered bone. The culture conditions need to be further optimized. Furthermore, how to achieve the clinical goals of minimal invasion and autologous transplantation also need to be further studied. ConclusionThe strategy of the co-culture system for constructing vascularized tissue engineered bone would have a very broad prospects for clinical application in future.
ObjectiveTo summarize the application status and progress of platelet-rich plasma (PRP) in clinical orthopedics. MethodsThe recent related literature concerning the application of PRP in clinical orthopedics was extensively reviewed and analyzed. ResultsRecently, a large number of clinical studies on PRP have been carried out, which are applied in bone defects or nonunion, spinal fusion, osteoarthritis and cartilage injuries, ligament reconstruction, muscle strain, tendon terminal diseases, and a variety of acute and chronic soft tissue injuries. Some results show certain effectiveness, while others demonstrate invalid. ConclusionEasily drawing, achieving autologous transplantation, and the biological repair potential of the musculoskeletal tissues make PRP to be widely used in clinical orthopedics. However, there are still no uniform standards accepted and reliable clinical guidelines about the application of PRP. Furthermore, a variety of PRP products and their respective indications are also different. The clinical evidences with the greater sample size and higher quality are still needed to further support the safety and effectiveness of PRP in clinical orthopedics.
ObjectiveTo review the research progress of the preparation and components of the platelet rich plasma (PRP). MethodsThe recent literature concerning the biological mechanism, preparation, and components of PRP was analyzed and summarized. ResultsThe biological function of PRP depends on a series of intricate cascade of cellular and molecular events. PRP contains different concentrations of platelets, which would release a large number of the activated molecules, and also contains a small amount of white blood cells and red blood cells. The preparation of PRP is based on platelet concentration. Different preparation techniques would lead to different platelet concentrations, recovery ratios, and components. ConclusionThere is no uniform standard for the preparation of PRP. Different preparation methods and technical parameters of PRP will get different components and different concentrations of PRP, which also provide a reference for cl inicians to select the most appropriate PRP for individual patient.
ObjectiveTo research the effect of recombinant adenovirus-bone morphogenetic protein 12 (Ad-BMP-12) transfection on the differentiation of peripheral blood mesenchymal stem cells (MSCs) into tendon/ligament cells. MethodsPeripheral blood MSCs were isolated from New Zealand rabbits (3-4 months old) and cultured in vitro until passage 3. The recombinant adenoviral vector system was prepared using AdEasy system, then transfected into MSCs at passage 3 (transfected group); untransfected MSCs served as control (untransfected group). The morphological characteristics and growth of transfected cells were observed under inverted phase contrast microscope. The transfection efficiency and green fluorescent protein (GFP) expression were detected by flow cytometry (FCM) and fluorescence microscopy. After cultured for 14 days in vitro, the expressions of tendon/ligament-specific markers were determined by immunohistochemistry and real-time fluorescent quantitative PCR. ResultsGFP expression could be observed in peripheral blood MSCs at 8 hours after transfection. At 24 hours after transfection, the cells had clear morphology and grew slowly under inverted phase contrast microscope and almost all expressed GFP at the same field under fluorescence microscopy. FCM analysis showed that the transfection efficiency of the transfected group was 99.57%, while it was 2.46% in the untransfected group. The immunohistochemistry showed that the expression of collagen type Ι gradually increased with culture time in vitro. Real-time fluorescent quantitative PCR results showed that the mRNA expressions of the tendon/ligament-specific genes (Tenomodulin, Tenascin-C, and Decorin) in the transfected group were significantly higher than those in untransfected group (0.061±0.013 vs. 0.004±0.002, t=-7.700, P=0.031; 0.029±0.008 vs. 0.003±0.001, t=-5.741, P=0.020; 0.679±0.067 vs. 0.142±0.024, t=-12.998, P=0.000). ConclusionAd-BMP-12 can significantly promote differentiation of peripheral blood MSCs into tendon/ligament fibroblasts and enhance the expressions of tendon/ligament-specific phenotypic differentiation, which would provide the evidence for peripheral blood MSCs applied for tendon/ligament regeneration.
ObjectiveTo investigate the effectiveness of open reduction by mini incision and absorbable screw internal fixation for the treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture. MethodsBetween January 2006 and July 2012, 90 patients (90 knees) with ACL tibial eminence avulsion fracture were treated. There were 58 males and 32 females, aged from 10 to 58 years with an average of 33.7 years. The causes of injury were traffic accident injury in 60 cases, sports injury in 22 cases, and falling injury in 8 cases. The disease duration was 1-365 days with a median of 106 days. Combined injuries included 14 cases of meniscus injury, 5 cases of medial collateral ligament injury, and 3 cases of avulsion fracture of the anterior horn of the lateral meniscus. All patients underwent open reduction by mini incision and internal fixation with absorbable screw. Postoperative rehabilitation exercise was performed. ResultsTwo patients had delayed healing of incision, and others obtained primary healing. All the patients were followed up 6-72 months (mean, 40.1 months). X-ray examination showed that bone union was achieved in all patients at 3-12 months after operation; nail tail came off in 7 cases at 4-13 months after operation, and the nail tail was taken out under arthroscopy. At 6-12 months after operation, the range of motion (ROM), Tegner score, Lysholm score, and International Knee Documentation Committee (IKDC) score were significantly increased when compared with preoperative ones (P < 0.05). ConclusionA combination of open reduction by mini incision and absorbable screw internal fixation for the treatment of ACL tibial eminence avulsion fracture has the advantages of easy operation, firm fixation, and satisfactory functional rehabilitation, so it is a safe and effective method for the treatment of ACL tibial eminence avulsion fracture.
ObjectiveTo investigate the methods and the effectiveness of arthroscopic treatment combined with repair of the cyst wall using the tendon flap of medial head of gastrocnemius muscle after resection of popliteal cyst. MethodsA retrospective analysis was made on the clinical data of 140 patients with popliteal cyst between August 2009 and June 2014, including 44 males and 96 females with a mean age of 54.68 years (range, 14-80 years). The median course of symptoms was 31 months (range, 20 days to 30 years). According to Rauschning and Lindgren criteria for popliteal cyst grade, 4 cases were rated as grade Ⅰ, 44 cases as grade Ⅱ, and 92 cases as grade Ⅲ. The preoperative Lysholm knee score was 68.99±8.23. Firstly, cyst was resected, then the hernia sac of joint capsule was repaired with the tendon flap of medial head of gastrocnemius muscle, and finally a knee arthroscopy was used for the diagnosis and treatment of intra-articular lesions. ResultsNo complication of nerve or blood vessel injury, infection, or necrosis occurred. The mean follow-up was 26 months (range, 6-64 months). During follow-up, 1 case (0.71%) had cyst recurrence. According to Rauschning and Lindgren criteria for popliteal cyst grade, 37 cases were rated as grade 0, 92 cases as grade Ⅰ, 10 cases as grade Ⅱ, and 1 case as grade Ⅲ at 6 months after operation, showing significant difference when compared with preoperative one (Z=-14.303, P=0.000); the Lysholm knee score (85.51±9.23) was significantly higher than preoperative score (t=-15.798, P=0.000). ConclusionArthroscopic treatment combined with repair of the cyst wall with the tendon flap of medial head of gastrocnemius muscle after resection of popliteal cyst is a better way to avoid recurrence.