Journal of orthopaedic research : official publication of the Orthopaedic Research Society
-
Current methods for fracture treatment in osteoporosis are not always sufficient. To develop new fixation strategies (both mechanical and biological) requires pre-clinical testing utilizing appropriate models. The aim of this study was to apply a recently developed sheep model of osteoporosis to the study of healing in a non-critical long bone defect. ⋯ In osteoporotic animals, ex vivo bending stiffness was reduced 21% (p=0.05). Bending stiffness was correlated with callus density (r=0.76, r=0.53); torsional stiffness was correlated with callus area (r=0.60) and to a lesser extent with callus density (r=0.53). This study demonstrated a delay of fracture healing in osteoporotic sheep tibiae with respect to callus formation, mineralization, and mechanical properties.
-
Interfragmentary movements affect the quality and quantity of callus formation. The mounting plane of monolateral external fixators may give direction to those movements. Therefore, the aim of this study was to determine the influence of the fixator mounting plane on the process of fracture healing. ⋯ The group with the anteromedially mounted fixator, initially showing significantly more interfragmentary movements, ended up with a significantly smaller callus diameter and a significantly higher callus stiffness as a result of advanced fracture healing. This demonstrates that the initial phase of healing is sensitive to mechanical conditions and influences the course of healing. Therefore, initial mechanical stability of an osteosynthesis should be considered an important factor in clinical fracture treatment.
-
Non-steroidal anti-inflammatory drugs (NSAIDs) specifically inhibit cyclooxygenase (COX) activity and are widely used as anti-arthritics, post-surgical analgesics, and for the relief of acute musculoskeletal pain. Recent studies suggest that non-specific NSAIDs, which inhibit both COX-1 and COX-2 isoforms, delay bone healing. The objectives of this study were 2-fold; first, to measure the relative changes in the normal expression of COX-1 and COX-2 mRNAs over a 42 day period of fracture healing and second, to compare the effects of a commonly used non-specific NSAID, ketorolac, with a COX-2 specific NSAID, Parecoxib (a pro-drug of valdecoxib), on this process. ⋯ Histological analysis at 21 days showed that the calluses in the ketorolac-treated group contained substantial amounts of residual cartilage while neither the control nor the parecoxib-treated animals showed comparable amounts of cartilage at this stage. These results demonstrate that ketorolac and parecoxib delay fracture healing in this model, but in this study daily administration of ketorolac, a non-selective COX inhibitor had a greater affect on this process. They further demonstrate that a COX-2 selective NSAID, such as parecoxib (valdecoxib), has only a small effect on delaying fracture healing even at doses that are known to fully inhibit prostaglandin production.
-
Comparative Study
Comparison of neuropathic pain induced by the application of normal and mechanically compressed nucleus pulposus to lumbar nerve roots in the rat.
We studied whether applying nucleus pulposus tissue, obtained from tail intervertebral discs that had been subjected to chronic mechanical compression, to the lumbar nerve roots produces hyperalgesia, which is thought to be a pain-related behavior in the rat. An Ilizarov-type apparatus was used for immobilization and chronically applied compression of the rat tail for eight weeks. Three weeks after application of extracted nucleus pulposus tissue on the lumbar nerve roots, motor function, sensitivity to noxious mechanical stimuli was measured. ⋯ The nucleus pulposus in the instrumented vertebrae showed some histological degeneration. In conclusion, chronic mechanical compression of nucleus pulposus, which resulted in degeneration to some extent, enhanced mechanical hyperalgesia, which was induced by application of nucleus pulposus on the nerve root in the rat. Degenerative intervertebral discs might induce more significant pain than normal intervertebral discs.
-
This study addressed the question of whether the level of compressive load would affect the conclusions from statistical analyses aimed at determining how well a lateral meniscal autograft restores tibial contact (as indicated by the maximum contact pressure, mean pressure, and contact area) to that of the intact knee. If statistical analyses indicated that normal tibial contact was not restored with a higher, more physiologic load, then a secondary question was whether an autograft surgically implanted with bone plugs would improve tibial contact compared to that in a meniscectomized knee. Nine, fresh-frozen human cadaveric knees were subjected to a low, non-physiologic compressive load of 400 N and a higher, more physiologic compressive load of 1200 N under three conditions (lateral meniscus intact, lateral meniscus removed and reimplanted as an autograft, and lateral meniscus removed). ⋯ Therefore studies designed to evaluate tibial contact pressure for a meniscal transplant should use a higher, more physiologic compressive load, because lower loads overestimate the transplant's effectiveness. Although none of the contact variables was restored to normal when the compressive load was increased to 1200 N, all of the contact variables were more normal than those of the meniscectomized knee. Thus, lateral meniscal allografts implanted using bone plugs can significantly improve contact pressure relative to a meniscectomized knee at the time of implantation.