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Bai Y, Li X, Wu K, Heng BC, Zhang X, Deng X. Biophysical stimuli for promoting bone repair and regeneration. MEDICAL REVIEW (2021) 2025; 5:1-22. [PMID: 39974560 PMCID: PMC11834751 DOI: 10.1515/mr-2024-0023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/19/2024] [Indexed: 02/21/2025]
Abstract
Bone injuries and diseases are associated with profound changes in the biophysical properties of living bone tissues, particularly their electrical and mechanical properties. The biophysical properties of healthy bone are attributed to the complex network of interactions between its various cell types (i.e., osteocytes, osteoclast, immune cells and vascular endothelial cells) with the surrounding extracellular matrix (ECM) against the backdrop of a myriad of biomechanical and bioelectrical stimuli arising from daily physical activities. Understanding the pathophysiological changes in bone biophysical properties is critical to developing new therapeutic strategies and novel scaffold biomaterials for orthopedic surgery and tissue engineering, as well as provides a basis for the application of various biophysical stimuli as therapeutic agents to restore the physiological microenvironment of injured/diseased bone tissue, to facilitate its repair and regeneration. These include mechanical, electrical, magnetic, thermal and ultrasound stimuli, which will be critically examined in this review. A significant advantage of utilizing such biophysical stimuli to facilitate bone healing is that these may be applied non-invasively with minimal damage to surrounding tissues, unlike conventional orthopedic surgical procedures. Furthermore, the effects of such biophysical stimuli can be localized specifically at the bone defect site, unlike drugs or growth factors that tend to diffuse away after delivery, which may result in detrimental side effects at ectopic sites.
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Affiliation(s)
- Yunyang Bai
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaochan Li
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ke Wu
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Boon C. Heng
- Department of Dental Materials & Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xuehui Zhang
- Department of Dental Materials & Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NMPA Key Laboratory for Dental Materials, Beijing Laboratory of Biomedical Materials & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xuliang Deng
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
- Department of Dental Materials & Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NMPA Key Laboratory for Dental Materials, Beijing Laboratory of Biomedical Materials & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
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Wu XR, He XH, Xie YF. Characteristics of gut microbiota dysbiosis in patients with colorectal polyps. World J Gastrointest Oncol 2025; 17:98872. [PMID: 39817124 PMCID: PMC11664624 DOI: 10.4251/wjgo.v17.i1.98872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 09/05/2024] [Accepted: 09/19/2024] [Indexed: 12/12/2024] Open
Abstract
This editorial, inspired by a recent study published in the World Journal of Gastrointestinal Oncology, covers the research findings on microbiota changes in various diseases. In recurrent colorectal polyps, the abundances of Klebsiella, Parvimonas, and Clostridium increase, while those of Bifidobacterium and Lactobacillus decrease. This dysbiosis may promote the formation and recurrence of polyps. Similar microbial changes have also been observed in colorectal cancer, inflammatory bowel disease, autism spectrum disorder, and metabolic syndrome, indicating the role of increased pathogens and decreased probiotics in these conditions. Regulating the gut microbiota, particularly by increasing probiotic levels, may help prevent polyp recurrence and promote gut health. This microbial intervention strategy holds promise as an adjunctive treatment for patients with colorectal polyps.
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Affiliation(s)
- Xian-Rong Wu
- School of Life Health Information Science and Engineering, Chongqing Post and Communications University, Chongqing 400065, China
| | - Xiao-Hong He
- School of Life Health Information Science and Engineering, Chongqing Post and Communications University, Chongqing 400065, China
| | - Yong-Fang Xie
- School of Life Health Information Science and Engineering, Chongqing Post and Communications University, Chongqing 400065, China
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Ganse B. Methods to accelerate fracture healing - a narrative review from a clinical perspective. Front Immunol 2024; 15:1384783. [PMID: 38911851 PMCID: PMC11190092 DOI: 10.3389/fimmu.2024.1384783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 05/14/2024] [Indexed: 06/25/2024] Open
Abstract
Bone regeneration is a complex pathophysiological process determined by molecular, cellular, and biomechanical factors, including immune cells and growth factors. Fracture healing usually takes several weeks to months, during which patients are frequently immobilized and unable to work. As immobilization is associated with negative health and socioeconomic effects, it would be desirable if fracture healing could be accelerated and the healing time shortened. However, interventions for this purpose are not yet part of current clinical treatment guidelines, and there has never been a comprehensive review specifically on this topic. Therefore, this narrative review provides an overview of the available clinical evidence on methods that accelerate fracture healing, with a focus on clinical applicability in healthy patients without bone disease. The most promising methods identified are the application of axial micromovement, electromagnetic stimulation with electromagnetic fields and direct electric currents, as well as the administration of growth factors and parathyroid hormone. Some interventions have been shown to reduce the healing time by up to 20 to 30%, potentially equivalent to several weeks. As a combination of methods could decrease the healing time even further than one method alone, especially if their mechanisms of action differ, clinical studies in human patients are needed to assess the individual and combined effects on healing progress. Studies are also necessary to determine the ideal settings for the interventions, i.e., optimal frequencies, intensities, and exposure times throughout the separate healing phases. More clinical research is also desirable to create an evidence base for clinical guidelines. To make it easier to conduct these investigations, the development of new methods that allow better quantification of fracture-healing progress and speed in human patients is needed.
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Affiliation(s)
- Bergita Ganse
- Innovative Implant Development (Fracture Healing), Clinics and Institutes of Surgery, Saarland University, Homburg, Germany
- Department of Trauma, Hand and Reconstructive Surgery, Clinics and Institutes of Surgery, Saarland University, Homburg, Germany
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Li G, Tang X, Li J, Dong M. A novel approach to characterize the correction path features for the tibia deformity correction. Biomed Eng Lett 2024; 14:511-521. [PMID: 39529962 PMCID: PMC11550302 DOI: 10.1007/s13534-023-00346-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/23/2023] [Accepted: 12/15/2023] [Indexed: 11/16/2024] Open
Abstract
Preoperative correction path planning is an important preparation for obtaining the desired correction. However, a convenient and effective model has not been proposed to characterize the correction path features, especially how to visualize the growth process of the bone cross-section has not been investigated. In this paper, a new characterization approach of the correction path features and corresponding evaluation indexes are proposed for the tibia deformity correction. We represent the growth process of new bone cross-section by a series of continuous and discrete circles. Based on the definition and assumptions of the bone cross-section, three evaluation indexes are proposed to assist the clinician in critically comparing and analyzing the feasibility of preoperatively correction approaches. A motor-driven parallel external fixator (MD-PEF) is developed to verify the proposed characterization approach. Finally, the features of the generated correction paths are compared and analyzed based on three correction methods. The results show that the proposed method can well present the growth process of bone cross-section and can detect the overlap phenomenon between bone cross-sections. And the approach of joint adjustment for equal bone distraction can generate a smooth correction path, uniform distraction rate and effectively avoid the overlap of bone cross-sections. This study is an important addition to facilitating the development of deformity correction techniques.
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Affiliation(s)
- Guotong Li
- Department of Mechanical Engineering, Tsinghua University, Beijing, 100084 China
| | - Xiaoqiang Tang
- Department of Mechanical Engineering, Tsinghua University, Beijing, 100084 China
| | - Jianfeng Li
- Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing, 100124 China
| | - Mingjie Dong
- Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing, 100124 China
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Orth M, Ganse B, Andres A, Wickert K, Warmerdam E, Müller M, Diebels S, Roland M, Pohlemann T. Simulation-based prediction of bone healing and treatment recommendations for lower leg fractures: Effects of motion, weight-bearing and fibular mechanics. Front Bioeng Biotechnol 2023; 11:1067845. [PMID: 36890916 PMCID: PMC9986461 DOI: 10.3389/fbioe.2023.1067845] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/10/2023] [Indexed: 02/22/2023] Open
Abstract
Despite recent experimental and clinical progress in the treatment of tibial and fibular fractures, in clinical practice rates of delayed bone healing and non-union remain high. The aim of this study was to simulate and compare different mechanical conditions after lower leg fractures to assess the effects of postoperative motion, weight-bearing restrictions and fibular mechanics on the strain distribution and the clinical course. Based on the computed tomography (CT) data set of a real clinical case with a distal diaphyseal tibial fracture, a proximal and a distal fibular fracture, finite element simulations were run. Early postoperative motion data, recorded via an inertial measuring unit system and pressure insoles were recorded and processed to study strain. The simulations were used to compute interfragmentary strain and the von Mises stress distribution of the intramedullary nail for different treatments of the fibula, as well as several walking velocities (1.0 km/h; 1.5 km/h; 2.0 km/h) and levels of weight-bearing restriction. The simulation of the real treatment was compared to the clinical course. The results show that a high postoperative walking speed was associated with higher loads in the fracture zone. In addition, a larger number of areas in the fracture gap with forces that exceeded beneficial mechanical properties longer was observed. Moreover, the simulations showed that surgical treatment of the distal fibular fracture had an impact on the healing course, whereas the proximal fibular fracture barely mattered. Weight-bearing restrictions were beneficial in reducing excessive mechanical conditions, while it is known that it is difficult for patients to adhere to partial weight-bearing recommendations. In conclusion, it is likely that motion, weight bearing and fibular mechanics influence the biomechanical milieu in the fracture gap. Simulations may improve decisions on the choice and location of surgical implants, as well as give recommendations for loading in the postoperative course of the individual patient.
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Affiliation(s)
- Marcel Orth
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Saarbrücken, Germany
| | - Bergita Ganse
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Saarbrücken, Germany.,Werner Siemens Endowed Chair of Innovative Implant Development (Fracture Healing), Saarland University, Saarbrücken, Germany
| | | | - Kerstin Wickert
- Chair of Applied Mechanics, Saarland University, Saarbrücken, Germany
| | - Elke Warmerdam
- Werner Siemens Endowed Chair of Innovative Implant Development (Fracture Healing), Saarland University, Saarbrücken, Germany
| | - Max Müller
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Saarbrücken, Germany
| | - Stefan Diebels
- Chair of Applied Mechanics, Saarland University, Saarbrücken, Germany
| | - Michael Roland
- Chair of Applied Mechanics, Saarland University, Saarbrücken, Germany
| | - Tim Pohlemann
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Saarbrücken, Germany
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Lotzien S, Rosteius T, Jettkant B, Cibura C, Rausch V, Schildhauer TA, Geßmann J. Locking the Taylor Spatial Frame - The effect of three additional longitudinal rods on osteotomy site movements. Clin Biomech (Bristol, Avon) 2022; 100:105820. [PMID: 36401977 DOI: 10.1016/j.clinbiomech.2022.105820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/21/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND In clinical practice, even when the fixator is locked, a noticeable laxity of the construct can be observed. This study was designed to measure the stiffness of the fixator and to analyze the movements of the osteotomy site. Furthermore, the effect of three additional longitudinal rods on the locking of the construct was analyzed. METHODS Five synthetic tibia/fixator models (Model A) were tested under rotational torque (40 Nm) and axial compression (700 N). Three additional rigid rods were subsequently mounted, and the tests were repeated (Model B). The movements of the fixator as well as the osteotomy site were registered by a digital optical measurement system. Load- deformation curves, and so stiffness of the models, were calculated and compared. FINDINGS Under rotational and axial loadings, Model A was found to be less rigid than Model B (p = 0.034; p = 0.194). Notably, Model A showed a region of laxity around neutral rotational (ΔF = 5 Nm) and axial (ΔF = 16.64 N) loading before a linear deformation trend was measured. Concomitantly, greater osteotomy site movement was measured for Model A than for Model B under full loading (p = 0.05) and within the region of increased laxity (p = 0.042). INTERPRETATION The fixator showed an element of laxity around neutral axial and rotational loading, which transferred to the bone and led to a notable amount of osteotomy gap movement. Mounting three additional rods increased the stiffness of the construct and therefore reduced the movement of the osteotomy site.
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Affiliation(s)
- Sebastian Lotzien
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle- de-la-Camp Platz 1, 44789 Bochum, Germany.
| | - Thomas Rosteius
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle- de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Birger Jettkant
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle- de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Charlotte Cibura
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle- de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Valentin Rausch
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle- de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Thomas Armin Schildhauer
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle- de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Jan Geßmann
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle- de-la-Camp Platz 1, 44789 Bochum, Germany
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Li G, Li J, Zuo S, Dong M. Influence of parameter deviation on the closeness of the tibial limb and external fixator based on a novel collision detection algorithm. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3502. [PMID: 34114336 DOI: 10.1002/cnm.3502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/21/2021] [Accepted: 06/04/2021] [Indexed: 06/12/2023]
Abstract
The Ortho-SUV frame (OSF) is a hexapod external fixator widely applied in orthopedics deformity correction. The possibility of collision between OSF's struts and the soft tissue is an essential but overlooked issue. To avoid the issue, a novel collision detection algorithm is established based on a cone-cylinder model of the tibial limb-strut interaction for detecting the closeness of the tibial limb and external fixator. The algorithm is constructed using the vector analysis based on the model of the minimum distance between the truncated cone generatrix and the cylinder axis. The motion simulation is performed on the overall alignment through the Solidworks-motion module to verify the feasibility of the algorithm. Subsequently, the installation parameter deviations of the bone-fixator system are described to investigate the influence of orientation and position deviation on the closeness of the tibial limb and external fixator through the numerical method. The investigation results show that the orientation deviation γ (around the z-axis), the position deviation τ1 and τ2 (along the x and y-axes, respectively) have greater sensitivity to closeness and the influence of multiple deviations on the closeness has the property of superposition. The proposed algorithm can assist clinicians to strictly design and appraise frame configurations prior to their application to avoid the collision between the external fixator and the limbs during the correction. It has great application significance in the development of computer-aided correction software.
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Affiliation(s)
- Guotong Li
- Beijing Key Laboratory of Advanced Manufacturing Technology, Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing, PR China
| | - Jianfeng Li
- Beijing Key Laboratory of Advanced Manufacturing Technology, Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing, PR China
| | - Shiping Zuo
- Beijing Key Laboratory of Advanced Manufacturing Technology, Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing, PR China
| | - Mingjie Dong
- Beijing Key Laboratory of Advanced Manufacturing Technology, Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing, PR China
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Iliadis AD, Bebja R, Wang K, Moazen M, Wright J, Calder P, Goodier D. Reducing the Risk of Ring Breakage in Taylor Spatial Frames: The Effect of Frame Configuration on Strain at the Half-ring Junction. Strategies Trauma Limb Reconstr 2020; 15:146-150. [PMID: 34025794 PMCID: PMC8121110 DOI: 10.5005/jp-journals-10080-1508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim We have encountered four cases with Taylor spatial frames (TSF) (Smith & Nephew, Memphis, TN, USA) with breakage at the half-ring junction of the distal ring. This study examines the strain produced on different locations of the distal ring during loading and the effects on the strain of altering the frame construct. Materials and methods We mounted two ring TSF constructs on tibia saw bone models. The proximal ring was the same in all constructs and consisted of a 2/3 180 mm ring attached with three wires. Construct 1 is reproducing the configuration of cases where failure was seen. The distal 155 mm ring is attached with three half pins. The half-ring junction is located in the midline. Construct 2 has a different half pin placement and an additional wire on the distal ring. Constructs 3 and 4 have the same half pin configuration to construct 1 but the distal ring is rotated 60° internally and externally, respectively. Strain gauges were attached to different locations and measurements recorded during loading. Statistical analysis was performed. Results Highest strain values were recorded at the half-ring junction of constructs 1 and 2 (>600 microstrains (με) in tension). Rotating the ring 60° internally significantly reduces the strain at the half-ring junction (<300 με) whilst external rotation by 60° further reduces the strain (<180 με). Ring strain is higher in areas close to half pin attachments. Conclusion The highest strain is in the half-ring junction as the half rings are subjected to different loading modes. The thickness of the half-ring is halved and the second moment of area reduced further increasing breakage risk. Placing this junction close to the half pin–frame interface, as dictated by the anatomical safe zone further increases the strain. Rotating the distal ring 60° significantly reduces the strain at the half-ring junction. Clinical significance Ring breakage is a rare but significant complication. This is the first study to address this potential mode of TSF failure. Insights and technical tips from this study can help reduce this. How to cite this article Iliadis AD, Bebja R, Wang K, et al. Reducing the Risk of Ring Breakage in Taylor Spatial Frames: The Effect of Frame Configuration on Strain at the Half-ring Junction. Strategies Trauma Limb Reconstr 2020;15(3):146–150.
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Affiliation(s)
- Alexios D Iliadis
- Paediatric and Limb Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom
| | - Roland Bebja
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Katherine Wang
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Mehran Moazen
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Jonathan Wright
- Paediatric and Limb Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom
| | - Peter Calder
- Paediatric and Limb Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom
| | - David Goodier
- Paediatric and Limb Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom
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