Low-intensity pulsed ultrasound as a useful adjuvant during distraction osteogenesis: a prospective, randomized controlled trial.

Background: Low-intensity pulsed ultrasound (LIPUS) was proven to have a positive impact on bone healing in animal and clinical studies.

Methods: In this prospective, randomized controlled trial the effect of LIPUS during distraction osteogenesis was investigated. Thirty-six patients who underwent distraction osteogenesis (>2 cm) were enrolled.

Sterilization of heat-sensitive silicone implant material by low-pressure gas plasma.

Background: In recent years, plasma treatment of medical devices and implant materials has gained more and more acceptance. Inactivation of microorganisms by exposure to ultraviolet (UV) radiation produced by plasma discharges and sterilization of medical implants and instruments is one possible application of this technique. The aim of this study was to evaluate the effectiveness of this sterilization technique on silicone implant material.

Plasma mediated collagen-I-coating of metal implant materials to improve biocompatibility.

This study describes the collagen-I coating of titanium and steel implants via cold low-pressure gas plasma treatment. To analyze the coatings in terms of biocompatibility osteoblast-like osteosarcoma cells and human leukocytes were cultivated on the metal surfaces. Two different implant materials were assessed (Ti6Al4V, X2CrNiMo18) and four different surface properties were evaluated: (a) plasma pretreated and collagen-I coated implant materials; (b) collagen-I dip-coated without plasma pretreatment; (c) plasma treated but not collagen-I coated; (d) standard implant materials served as control.

Enhanced cell adhesion to silicone implant material through plasma surface modification.

Silicone implant material is widely used in the field of plastic surgery. Despite its benefits the lack of biocompatibility this material still represents a major problem. Due to the surface characteristics of silicone, protein adsorption and cell adhesion on this polymeric material is rather low.

In vivo analysis of tissue response to plasma-treated collagen-I-coated titanium alloys.

Purpose: The aim of this study was to evaluate the in vivo tissue response to low-pressure plasma-pretreated collagen-I-coated titanium implant in a middle-term mouse model.

Methods: Plasma-treated collagen-coated titanium implants were transplanted into the dorsal skinfold chambers of BALB/c mice. Untreated, regular titanium implant material served as control.

[Uncemented arthroplasty of the hip].

Prognosis of cemented total hip replacement seems to be excellent for elderly patients. In younger age the outcome is less favourable and early revision is more common. Thus, different concepts with better prognosis and preservation of bone stock for possible revisions were needed.

[Surface modification of metal implant materials by low-pressure plasma treatment].

Background: Plasma treatment leads to a significant change of surface free energy of medical implant materials. These changes strongly influence protein and cell adhesion on the material surface. The aim of the study was to quantify the plasma-induced surface changes and to analyse whether the change of treatment parameters, such as pressure, gas mixture, energy and treatment time, influences the surface free energy of the implant materials.

[False aneurysm of the deep femoral artery due to pertrochanteric fracture of the hip with displaced fragment of the lesser trochanter].

We report the case of an 82-year-old man with a pertrochanteric fracture of the hip and an avulsion of the lesser trochanter. During the third postoperative week after unproblematic correction with a gamma nail, a swelling of the proximal thigh occurred. Angiographs showed a false aneurysm of the deep femoral artery which was treated by suture.

Ultrasound-induced modifications of cytoskeletal components in osteoblast-like SAOS-2 cells.

In clinical and experimental studies an acceleration of fracture healing and increased callus formation induced by low-intensity pulsed ultrasound (LIPUS) has been demonstrated. The exact molecular mechanisms of ultrasound treatment are still unclear. In this study ultrasound transmitted cytoskeletal and growth rate changes of SAOS-2 cells were examined.

[A double inductively coupled low-pressure plasma for sterilization of medical implant materials].

The potential of plasma treatment in medicine is only slowly gaining acceptance. Inactivation of germs through exposure to UV radiation produced by plasma discharges and sterilization of medical implant devices and instruments is one possible application of this technique. In addition, due to the manifold possibilities of coating through plasma processes, quick sterilization-coating combinations of medical implant devices are possible.

Fusion of the septic knee with external hybrid fixator.

Arthrodesis is a well-recognized salvage procedure in patients with septic destruction of knee joints. It offers the opportunity for restoring weight bearing capability and significant pain relief as well as eradication of infection, but at the expense of joint motion. However, arthrodesis in order to joint sepsis may be difficult to achieve because of poor bone stock, persistent infection and soft tissue compromise.

[Desmoplastic neurotropic melanoma. Diagnosis and therapeutic procedures for a rare clinical entity].

Desmoplastic neurotropic melanoma is an exceedingly rare variant of the malignant melanomas. Since the initial description, only about 500 cases have been reported in the literature. These melanomas mostly occur on the head, neck, and face, and a wide local excision of the tumor is probably the most important prognostic factor.

Morphological characterization and in vitro biocompatibility of a porous nickel-titanium alloy.

Disks consisting of macroporous nickel-titanium alloy (NiTi, Nitinol, Actipore) are used as implants in clinical surgery, e.g. for fixation of spinal dysfunctions.

[Efficiency of low-intensity pulsed ultrasound on distraction osteogenesis in case of delayed callotasis -- clinical results].

Aim: Low-intensity pulsed ultrasound has been proven to accelerate fracture healing both clinically and experimentally. In this study the influence of low-intensity pulsed ultrasound during distraction-osteogenesis in case of delayed callotasis was investigated.

Method: 20 patients could be included in this study.

[Indications and implementation of recommendations of the working group "Tissue Regeneration and Tissue Substitutes" for autologous chondrocyte transplantation (ACT)].

For the treatment of full-thickness articular cartilage lesions of the knee joint, as a result of trauma or osteochondritis dissecans, a variety of biological reconstruction techniques have been developed. Different studies, some of which were performed as randomised, prospective clinical studies, showed that the autologous chondrocyte transplantation (ACT) provides the most satisfying and reliable method of cartilage reconstruction in the adult when applied to defects exceeding 4 cm (2). Based on these results, ACT seems to be of economic benefit, as the risk of developing osteoarthritis correlates significantly with the size of the cartilage defect, when not treated properly and in time.

[An open wedge tibial head osteotomy using continuous callus distraction. An alternative method for the treatment of of varus arthrosis].

High tibial osteotomy is an accepted method for treatment of medial osteoarthritis. An alternative technique is an open-wedge osteotomy and consecutive callotasis (CO) using an external fixator. The purpose of this study was to evaluate the clinical and radiological results and the efficiency of this technique for precise correction.

[Application of low intensity, pulsed ultrasound on distraction osteogenesis of the humerus. Case report].

Low intensity pulsed ultrasound accelerates fracture healing both clinically and experimentally. Based on recently published animal studies, an improvement in regenerative bone maturation after distraction osteogenesis due to low intensity, pulsed ultrasound is also expected. We report on an 18 year-old female patient suffering from an acquired shortening of the right upper arm of 10 cm after humeral osteitis as a baby.

Inhibition of PMN apoptosis after adherence to dip-coated calcium phosphate surfaces on a NiTi shape memory alloy.

Nickel-titanium shape-memory alloys (NiTi-SMA) were coated with calcium phosphate by dipping in oversaturated calcium phosphate solution (CaP-coating). Polymorphonuclear neutrophil granulocytes (PMN) belong to the first cells which will adhere to implant materials. We analyzed the apoptosis of isolated human PMN after cell culture on non-coated and CaP-coated NiTi-SMA by light and scanning electron microscopy (cell morphology) and by flow cytometry (DNA-fragmentation).

[Radio-ulnar and radio-scaphoid-lunate arthrodesis in chronic polyarthritis. Clinical and radiologic follow-up of 32 cases].

Introduction: In 75% of all cases of rheumatoid arthritis the wrist is affected and in 12% is the region of initial manifestation of this chronic inflammatory joint disease. To prevent destruction of the wrist through carpal dislocation, radiolunate and radioscapholunate arthrodeses have increased in importance.

Methods: During a 6.

[Improved osseointegration of titanium implants of different surface characteristics by the use of bone morphogenetic protein (BMP-3): an animal study performed at the metaphyseal bone bed in dogs].

Aim: Aim of this study was to determine whether coating of titanium implants of various surfaces with BMP-3 would improve the osseous integration of the implants into the orthotopic bony implant bed.

Method: In this experimental study 190 micro g per implant of highly purified bone morphogenetic protein 3 (BMP-3) precipitate isolated from porcine bone were available for the coating of each of 24 cylindrical test implants (12 with hydroxyapatite and 12 with plasmapore surface). The remaining 24 test implants with the same surface makeup served as negative controls.

Fusion of the septic ankle: experience with 15 cases using hybrid external fixation.

Background: In cases of septic joint destruction, an unfavorable situation of soft tissues and chronic osteomyelitis are responsible for high failure rates of ankle fusions. We wanted to evaluate the control of infection and the fusion rate using hybrid external fixators for the fusion of the septic ankle in a prospective study.

Methods: From 1996 to 1998, 15 arthrodeses were performed using hybrid external fixators.

[Histologic and histomorphometric follow-up observations of osseointegration of corundum-blasted BMP-3 coated titanium test implants (Ti6Al4V) at orthotopic site in the giant rabbit].

Aim: To establish whether the additional coating of titanium implants with Bone Morphogenetic Protein-3 (BMP-3) might enhance osseous integration.

Method: Each of 15 cylindrical titanium test implants (Ti-6AI-4V) was coated using 230 micrograms porcine BMP-3. A further 15 implants with identical (corundium-blasted) surface served as negative controls.

[Intramedullary abscess of the spinal cord--a rare pathology. Case report, therapeutic regimen and review of the literature].

Although the presence of an intramedullary abscess of the spinal cord is extremely rare, it is most important to be aware of its existence in the differential diagnosis of neurological diseases. Existing neurological deficits with progressive symptoms of paraplegia should always be regarded as suspect and a differential diagnosis of an intramedullary abscess of the spinal cord should then be included in the therapeutical regimen. A correct diagnosis using MR-tomography followed by an early surgical treatment strategy are essential for the affected patients, simply because an early diagnosis and an immediate operative intervention represent decisive prognostic factors independent from the cause of infection.

Calcium phosphate coating of nickel-titanium shape-memory alloys. Coating procedure and adherence of leukocytes and platelets.

Nickel-titanium shape-memory alloys (NiTi-SMA) were coated with calcium phosphate by dipping in oversaturated calcium phosphate solution. The layer thickness (typically 5-20 micrometer) can be varied by choice of the immersion time. The porous nature of the layer of microcrystals makes it mechanically stable enough to withstand both the shape-memory transition upon cooling and heating and also strong bending of the material (superelastic effect).

Superior efficacy in suppression of heterotopic bone formation using fractionated irradiation of 5 x 2 Gy compared to a single dose of 7 Gy. An experimental study in rats.

Postoperative irradiation of the operative field is an established method to prevent heterotopic ossification in total hip arthroplasty. In this study two theoretical dose-equivalent regimens of radiation therapy were compared. Allogenic bone matrix was implanted in both thighs of 50 adult male Wistar rats to induce heterotopic ossification.