Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Basic Research 171 articles


A Daptomycin-Xylitol-loaded Polymethylmethacrylate Bone Cement: How Much Xylitol Should Be Used?

Ali Salehi MS, Ashley Cox Parker MS, Gladius Lewis PhD, Harry S. Courtney PhD, Warren O. Haggard PhD

The rate of release of an antibiotic from an antibiotic-loaded polymethylmethacrylate (PMMA) bone cement is low. This may be increased by adding a particulate poragen (eg, xylitol) to the cement powder. However, the appropriate poragen amount is unclear.

Cumulative Effects of Bone and Soft Tissue Injury on Systemic Inflammation: A Pilot Study

Roman Pfeifer MD, Sophie Darwiche MD, Lauryn Kohut MA, Timothy R. Billiar MD, FACS, Hans-Christoph Pape MD, FACS

In multiply injured patients, bilateral femur fractures invoke a substantial systemic inflammatory impact and remote organ dysfunction. However, it is unclear whether isolated bone or soft tissue injury contributes to the systemic inflammatory response and organ injury after fracture.

Emerging Ideas: Instability-induced Periprosthetic Osteolysis Is Not Dependent on the Fibrous Tissue Interface

Denis Nam MD, Mathias P. G. Bostrom MD, Anna Fahlgren PhD

Stable initial fixation of a total joint arthroplasty implant is critical to avoid the risk of aseptic loosening and premature clinical failure. With implant motion, a fibrous tissue layer forms at the bone-implant interface, leading to implant migration and periprosthetic osteolysis. At the time of implant revision surgery, proresorptive signaling cytokines are expressed in the periimplant fibrous membrane. However, the exact role of this fibrous tissue in causing periprosthetic osteolysis attributable to instability remains unknown.

A Silver Ion-doped Calcium Phosphate-based Ceramic Nanopowder-coated Prosthesis Increased Infection Resistance

Nusret Kose MD, Ali Otuzbir MD, Ceren Pekşen PhD, Abdurrahman Kiremitçi MD, Aydın Doğan PhD

Despite progress in surgical techniques, 1% to 2% of joint arthroplasties become complicated by infection. Coating implant surfaces with antimicrobial agents have been attempted to prevent initial bacterial adhesion to implants with varying success rates. We developed a silver ion-containing calcium phosphate-based ceramic nanopowder coating to provide antibacterial activity for orthopaedic implants.

Nano-ceramic Composite Scaffolds for Bioreactor-based Bone Engineering

Qing Lv PhD, Meng Deng PhD, Bret D. Ulery PhD, Lakshmi S. Nair M.Phil, PhD, Cato T. Laurencin MD, PhD

Composites of biodegradable polymers and bioactive ceramics are candidates for tissue-engineered scaffolds that closely match the properties of bone. We previously developed a porous, three-dimensional poly (D,L-lactide-co-glycolide) (PLAGA)/nanohydroxyapatite (n-HA) scaffold as a potential bone tissue engineering matrix suitable for high-aspect ratio vessel (HARV) bioreactor applications. However, the physical and cellular properties of this scaffold are unknown. The present study aims to evaluate the effect of n-HA in modulating PLAGA scaffold properties and human mesenchymal stem cell (HMSC) responses in a HARV bioreactor.

Bone Turnover Markers Do Not Predict Stress Fracture in Elite Combat Recruits

Ran Yanovich PhD, Rachel K. Evans PhD, Eitan Friedman MD, PhD, Daniel S. Moran PhD

With bone resorption rates greater than formation, stress fracture pathogenesis plausibly involves bone remodeling imbalance. If this is the case, one would anticipate serum levels of bone turnover markers would be higher in patients with stress fractures than in those without.

Are the Left and Right Proximal Femurs Symmetric?

Ernest Y. Young MS, Jeremy Gebhart BS, Daniel Cooperman MD, Nicholas U. Ahn MD

The contralateral femur frequently is used for preoperative templating for THA or hemiarthroplasty when the proximal femur is deformed by degenerative changes or fracture. Although femoral symmetry is assumed in these situations, it is unclear to what degree the contralateral femur is symmetrical.

Emerging Ideas: Engineering the Periosteum: Revitalizing Allografts by Mimicking Autograft Healing

Michael D. Hoffman MS, Danielle S. W. Benoit PhD

To fulfill the need for large volumes, devitalized allografts are used to treat massive bone defects despite a 60%, 10-year postimplantation fracture rate. Allograft healing is inferior to autografts where the periosteum orchestrates remodeling.

pHEMA-nHA Encapsulation and Delivery of Vancomycin and rhBMP-2 Enhances its Role as a Bone Graft Substitute

Xinning Li MD, Jianwen Xu PhD, Tera M. Filion PhD, David C. Ayers MD, Jie Song PhD

Bone grafts are widely used in orthopaedic procedures. Autografts are limited by donor site morbidity while allografts are known for considerable infection and failure rates. A synthetic composite bone graft substitute poly(2-hydroxyethyl methacrylate)-nanocrystalline hydroxyapatite (pHEMA-nHA) was previously developed to stably press-fit in and functionally repair critical-sized rat femoral segmental defects when it was preabsorbed with a single low dose of 300 ng recombinant human bone morphogenetic protein-2/7 (rhBMP-2/7).

A Supplemental Video Teaching Tool Enhances Splinting Skills

Saeed Reza Mehrpour MD, Mohamadreza Aghamirsalim MD, Seyed Mohammad Kalantar Motamedi MD, MPH, Fatemeh Ardeshir Larijani MD, Reza Sorbi MD

The ability to apply casts and splints is a technical skill that requires practice and understanding of basic principles of musculoskeletal medicine. A video in which a given procedure is simulated on a dummy can represent reality under controlled conditions. A decrease in physician competency in musculoskeletal medicine is the result of educational deficiencies at the medical school level.