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Biomedical subjects

L Coutelier

Publications and source records attributed to L Coutelier.

At least 19 recordsLinked to original sources

Bone regenerate formation in cortical bone during distraction lengthening. An experimental study.

The aim of this study was to delineate the pattern of bone regeneration from cortical bone segments during distraction lengthening. The lengthening procedure was applied for various periods through the Ilizarov system on the forearms of mature dogs. Bone was sectioned either by corticotomy, preserving the nutrient artery integrity, or by osteotomy. When an osteotomy was performed, the marrow cavity was in some cases plugged with either resorbable bone wax or nonresorbable material. Under distraction, both periosteal and medullary callus on either side of the gap gave rise to new bone trabeculae. The trabeculae on either side were oriented along the direction of distraction and progressively approached one another. This striated callus emerging from both sides was the most characteristic pattern of bone regeneration subsequent to distraction lengthening. Fusion was achieved approximately four weeks after the end of the lengthening period. Most of the new bone was formed by membranous ossification; some cartilaginous nodules developed. Corticalization of the bone trabeculae that had begun at three months was not fully achieved at five months after the lengthening period. There were no differences found in the pattern of bone healing and the amount of newly formed bone after corticotomy or osteotomy with or without resorbable bone wax plugging.

Animals

[What becomes of the interposed capsule in Colonna's arthroplasty?].

A total hip replacement had to be performed 25 years after a Colonna arthroplasty. The acetabulum has been cut off for examination (articular cartilage and subchondral bone). The evolution of the case is detailed. Histological examination shows that the capsular tissue became articular cartilage, but not a normal one. This observation confirms that Colonna arthroplasty can give a good joint for more than 20 years but not longer.

Adult

Massive bone allografts in large skeletal defects after tumor surgery: a clinical and microradiographic evaluation.

Massive deep-frozen bone allografts were implanted in 13 patients after en bloc tumor resection. Patients were followed up for 14 months to 17 years. Most of the reconstructive procedures included a segmental bone allograft with knee or ankle fusion. Graft infections were the most critical complications in regard to the end results, finally requiring amputation in two cases. There were three stress fractures; two of which were successfully treated without further complication. Graft incorporation was assessed by bone scintimetry in four cases. Isotope uptake by the center of the graft was found to be superior to control bone segments at only 15 years after surgery. Two recovered allograft specimens were available for a microradiographic study. Creeping substitution was a very slow process, initiated at the outer surface of the graft and characterized at 2-3 years after implantation by large, incompletely filled osteons. The present investigation demonstrates that massive bone allografts are very slowly revascularized and are intimately anchored by the host bone. Provided that tumor control is effective and graft infection is avoided, reconstructive surgery with massive bone allografts represents a successful alternative to prosthetic implants in young adult with a long life expectancy.

Adolescent

Canine cortical bone autograft remodeling in two simultaneous skeletal sites.

The morphological and physical aspects of cortical bone autografts implanted in dogs for 1-9 months in two differently located skeletal defects are reported with a twofold aim: to provide a reference system for further comparison with various allografts and to delineate a general pattern of cortical bone graft healing. A 3-cm osteoperiosteal gap was created in the diaphyseal segment of the ulna and fibula of mature dogs. The grafts, freed from periosteum and bone marrow, were then inverted and replaced for the autografts in the left limb bone without internal fixation or external splints. On the right side, different allografts were tested. A group of three animals also had an unfilled segmental resection on the right as control. Dogs were observed for 1, 2, 3, 6, and 9 months and were able to bear weight within 3 days. Twenty-eight ulnae and 27 fibulae were available for this autograft study. Fluorochromes were injected at mid-term and at the end of the observation. All the grafts were assessed morphologically by cross-section microradiographs and ultraviolet light microscopy, and a morphometric analysis for porosity and fluorescence was done. To evaluate the physical aspects of graft healing, the recovered ulnar autografts, when available, were submitted to photon absorptiometry and to torsional loading. Morphologically, resorption was found to invade the cortical bone graft transversely through radial tunnels, and in addition to the host-bone-graft junction, the entire transplant surface provided another way for revascularization. The highest porosity level was achieved 2 months after surgery for both ulna and fibula, while new bone formation, as assessed by fluorochromes, was most important at 3 months. At 9 months, porosity remained above the normal range as determined in a set of five nongrafted dogs. While the lack of correlation for porosity between the two grafts suggests that local factors are more important in graft resorption, the observed correlation for fluorescence indicates that new bone deposition is more dependent upon skeletal metabolic activity. Within each graft, porosity and new bone formation were not well correlated. In the ulna, the bone mineral content (BMC) reflected the graft volumetric variations during the remodeling, with the lowest mean value at 3 months. For each graft, BMC was well correlated with the torsional stiffness. When torsionally loaded, the maximal tangential shear stress at failure of the graft was negatively related to its cortical porosity.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals

The osteoinductive capacity of differently HCl-decalcified bone alloimplants.

Three procedures to obtain bone inductive implants were tested heterotopically in 3-month-old allogeneic rats: 1) antigen-extracted HCl-decalcified at 4 degrees C, autolysed implant (AAA bone); 2) HCl-decalcified implant at 4 degrees C; 3) HCl-decalcified implant at room temperature. Each type of implant was either deep-frozen at -35 degrees C for at least 2 months or immediately freeze-dried. The bone inductive capacity of the differently HCl-decalcified cortical bone implant was evaluated at 2 months by isotopic strontium incorporation and by ash-weight measurements. Bone HCl-decalcification alone, either at 4 degrees C or at room temperature, gave a higher new bone yield than the freeze-dried AAA bone. The type or short-term preservation technique had no effect on the osteoinductive capacity of either of the differently treated implants, AAA bone expected.

Animals

[Microradiographic aspects of massive bone allografts in man].

Two stored frozen massive bone allografts were implanted after resection of femoral and tibial tumours in two patients. Eighteen and thirty months later the authors had the opportunity to make a microscopic examination of the grafts. The cortical bone grafts were incorporated by the classic "creeping substitution." The repair of the cortical transplant was very incomplete and showed large resorption cavities. The newly-formed living bone was not fully mineralized. These phenomena related only to the outer area of the cortical bone, the dead intra-cortical area being left unaffected by the process. Cancellous bone graft repair was faster and more efficient.

Adolescent

[The induction of chondrogenesis after fracture repair].

Various experimental models have been used in young rabbits to determine the conditions necessary to induce chondrogenesis in the inner layer of periosteum after injury. Chondrogenesis will always occur in the presence of a haematoma, torn periosteum and bone, but if one of these factors in missing such a response may not necessarily occur.

Age Factors

[The internal remodeling of compact bone in children].

The internal remodeling of bone in children is characterized by the presence of large osteones with irregular undermineralized deposits and large Havers canals. These Havers canals undergo a lateral displacement by progressive erosion of their internal side. These remodeling units decrease progressively in number and in dimensions and disappear after the age of 12 years. The metabolic necessities of childhood would explain the importance of the remodeling. The decentred form evokes a relation to strains imposed on the bone.

Adolescent