Biomedical subjects

S Gogolewski

Publications and source records attributed to S Gogolewski.

At least 19 recordsLinked to original sources

PubMed2001

[Reconstruction of the orbits with polylactate implants: animal experimental results after 12 months and clinical prospects].

In earlier experiments healing of large orbital wall defects in sheep occurred undisturbed by osteoconductive bone growth along biodegradable membranes when there was no interference with additional bone grafts or titanium miniplate osteosynthesis. In this experiment similar bilateral defects were reconstructed with poly(L/DL 80/20) lactide implants using a microporous membrane 0.5 mm thick without further support on one side, an 0.25 mm microporous membrane supported by solid polylactide buttresses and stabilized by polylactide dowels on the opposite side. After 12 months we found a symmetrical reconstruction of the normal anatomy of the orbits in CT and X-ray examinations. In contrast, histologic investigations revealed massive foreign-body reactions around degrading buttress implants and dowels especially. Milder reactions occurred in some orbits along the membranes as well, in contrast to our earlier experiments with 4-month follow-up. None of the implants had degraded completely 12 months after surgery. In our 12-month long-term survey, polylactide microporous membranes confirmed their osteoconductive potential in orbital wall reconstruction. Nevertheless, massive polylactic implants should not be considered for clinical application in the orbit because of significant late foreign-body reactions.

Animals↗

PubMed2000

In vitro growth and activity of primary chondrocytes on a resorbable polylactide three-dimensional scaffold.

Sheep articular chondrocytes were cultured for 3, 6, and 9 weeks on a three-dimensional porous scaffold from poly(L/DL-lactide) 80/20%. Cell growth and activity was estimated from the amount of proteoglycans attached to the polylactide scaffold and the amounts of DNA and proteins measured in the cell lysate. Cell morphology was assessed from scanning electron microscopy. Histochemical staining of proteoglycans present in the sponge was used to visualize the chondrocyte ingrowth in the scaffold. The amounts of DNA, proteins, and proteoglycans increased with time of culturing. Chondrocytes on the polylactide scaffold maintained their round shape. The cell ingrowth into the sponge progressed with time of culturing and proceeded from the upper surface of the sponge toward its lower surface. At 9 weeks, the chondrocytes filled the whole scaffold and reached the opposite side of the sponge. The proteoglycans network was, however, more dense at the upper half of the scaffold.

Absorbable Implants↗

PubMed2000

Bioresorbable polymers in trauma and bone surgery.

During the last few decades interest in resorbable polymeric materials has been steadily increasing. As with other materials for implantable devices, they have to satisfy several biological and technical requirements. Implants should maintain adequate mechanical properties in vivo for the time required and degrade at an effective rate. The conditions of polymer synthesis, further processing into implants and the sterilization process determine the mechanical properties of resorbable implants. Degradation of implants is manifested by implant fragmentation, strength loss and the decrease of polymer molecular weight. The rate of degradation and the tissue reaction are strongly affected by the material chemical composition and to some extent also by the mechanical properties. Potentially, devices made from bioresorbable polymers can overcome problems associated with metal implants like stress protection, potential for corrosion, wear and debris formation, as well as the necessity of implant removal. Resorbable polymers have proven to be good materials for a range of devices in trauma surgery. However, modifications and optimizations are still required. Three-dimensional porous scaffolds in various geometrical forms offer a good potential for the manufacture of tissue-engineered implants in the future.

Absorbable Implants↗

PubMed2000

Bone regeneration in segmental defects with resorbable polymeric membranes: IV. Does the polymer chemical composition affect the healing process?

Diaphyseal segmental defects 10 mm in length in the radii of 36 skeletally mature rabbits were covered with tubular microporous membranes prepared from poly(L/D-lactide) (18 rabbits) and poly(L/DL-lactide) (18 rabbits) to determine whether chemical composition of the membrane affected the bone healing in the defect. The results of a previous study in which similar defects of the rabbits radii were not covered with membranes or covered with poly(L-lactide) membranes were used as controls. The control defects were rapidly filled with overlying muscle and soft tissues, producing a radio-ulnar synostosis. The osseous activity of control defects was limited to the bone ends. The defects covered with membranes were progressively filled with new bone. At 1 year, complete bone regeneration in the defects covered with the poly(L/D-lactide) membrane was found in 16 cases, no regeneration in 1 animal and pseudoarthrosis in 1 animal. For the poly(L/DL-lactide) membrane there was complete bone regeneration in 17 cases (1 animal died during surgery). The quality of the interface between the new bone and the membrane seemed to be affected by the chemical structure of the polylactides used for membranes preparation. For poly(L/D-lactide), the connective tissue layer entirely separated the new bone from the polymeric membrane. This has been observed before for poly(L-lactide) membranes. In the case of poly(L/DL-lactide) the new bone was formed in some places in direct contact with the membrane and the membrane fragments were osteointegrated. The differences in chemical composition of the polylactide membranes did not have an evident effect on the bone regeneration process in segmental defects of the rabbit radii.

Animals↗

PubMed1999

Intramedullary fixation by resorbable rods in a comminuted phalangeal fracture model. A biomechanical study.

The mechanical rigidity of three different methods of resorbable intramedullary fixation (bone peg, and polyglycolide rods with and without interlocking) was assessed in a comminuted phalangeal fracture model and the results compared with two commonly used internal fixation devices (lateral plate, crossed K-wires) in a cadaver model. Each fixation technique was tested for its biomechanical strength in apex palmar bending, compression and torsion. Failure testing for the three resorbable methods was also done. The results showed that lateral plating provided the best rigidity in apex palmar bending and torsion, followed by intramedullary bone peg fixation. All resorbable intramedullary fixations had rigidity that was at least the same as crossed K-wires. For the torque test, polyglycolide rods with interlocking provided better rigidity than without interlocking. There was no significant difference between the different methods in the compression test, except that the intramedullary bone peg was significantly stiffer than K-wires.

Biomechanical Phenomena↗

PubMed1998

Improvement of patency rate in heparin-coated small synthetic vascular grafts.

BACKGROUND: Graft thrombosis and intimal hyperplasia represent the major causes of graft failure. Heparin has been shown to have a beneficial effect on long-term patency and on prevention of intimal hyperplasia. Thus, the purpose of the present study was to evaluate the effect of heparin coating on patency rate and intimal hyperplasia in small synthetic vascular grafts. METHODS AND RESULTS: Two synthetic grafts (expanded polytetrafluoroethylene [ePTFE], and polyurethane) with and without heparin coating were implanted in the infrarenal aorta (diameter, 2 mm) of 40 Whistar rats. Animals survived 8 weeks after implantation. Graft patency, intimal thickness, and percentage of diameter stenosis were determined by light microscopy at the proximal respectively distal anastomosis and in the middle of the graft. Uncoated grafts showed a patency rate of 70% for ePTFE and 60% for polyurethane grafts. Heparin-coated grafts showed a patency rate of 100% for ePTFE and 90% for polyurethane grafts. Intimal hyperplasia was observed in all grafts mainly at the anastomosis site. Intimal wall thickness and percentage of stenosis were significantly more pronounced in the polyurethane than ePTFE grafts (P < 0.01). Heparin coating significantly reduced overall graft thrombosis (P < 0.05) but had no significant effect on intimal hyperplasia. CONCLUSIONS: Small grafts show a high rate of graft thrombosis and an enhanced intimal hyperplasia. ePTFE grafts show significantly less intimal hyperplasia and percentage of stenosis than polyurethane grafts. Heparin coating significantly reduced graft thrombosis but had no significant effect on intimal hyperplasia. Thus, heparin coating seems to be beneficial for graft patency, and ePTFE appears to be superior to polyurethane as graft material.

Animals↗

PubMed1998

[Experimental reconstruction of the sheep orbit with biodegradable implants].

In a complex animal model in sheep, polydioxanone (PDS) and polylactic membranes were used for the reconstruction of large orbital-wall defects. In a long-term experiment over 1 year, polylactic implants alone showed the best performance as compared with combinations involving autogenous bone grafts and titanium miniplate fixation. As soon as these polylactic implants are approved for human surgery, they will be used to solve the still challenging problem of anatomical reconstruction of large comminuted fractures of more than one orbital wall.

Animals↗

PubMed1997

Effect of in vivo and in vitro degradation on molecular and mechanical properties of various low-molecular-weight polylactides.

The in vivo and in vitro degradation of low-molecular-weight poly(L-lactide), poly(L/D-lactide), and poly (L/DL-lactide) rods was investigated. The low-molecular-weight fast-degrading materials were used to accelerate the degradation process and make the test conditions more critical. In the in vivo study the rods were implanted in the soft tissue of sheep and explanted at 1, 3, 6, and 12 months. In the in vitro experiments the samples were subjected to aging at 37 degrees C in the phosphate buffer using two different modes. In the so-called pseudodynamic mode the aging buffer was regularly replaced if the pH dropped more than 0.5. In the static mode the buffer was not changed over the whole testing period of 52 weeks. The mechanical, molecular, and crystalline properties of the rods were measured and their appearance in the course of aging was evaluated using scanning electron microscopy. It was found that the changes in the mechanical properties of poly(L-lactide), poly(L/D-lactide), and poly(L/DL-lactide) samples subjected to in vitro degradation tests in both the static and pseudodynamic modes are in good approximation with data obtained from the in vivo study. The pH of the buffer solution had no evident effect on the mechanical properties or the rate of degradation as estimated from the drop in molecular weight of the aged samples. The replacement of the aging buffer to maintain a constant pH at 7.4 does not seem to be critical for the degradation of the polylactides. In vitro degradation tests can be used as a relevant procedure for predicting the in vivo functionality of implants from the polylactides used if the criteria for assessing such a functionality are the changes in mechanical properties and molecular weight.

Animals↗

PubMed1997

Positional stability of polylactide pins with various surface textures in sheep tibia.

Resorbable pins with a smooth or textured surface were produced from poly(L-lactide) P(L)LA poly(L/D-lactide) 95/5% P(L/D)LA, and poly(L/DL-lactide) 95/5% P(L/DL)LA by injection molding. The pins were implanted in sheep tibiae to establish whether the pin surface geometry and the polymer composition used for the pin preparation affect their positional stability in bone; i.e., can the pin design and its ability to swell in body fluids protect against loosening. Three of the 32 P(L)LA pins with a smooth surface loosened but none of the P(L/D)LA and P(L/DL)LA pins with a smooth surface did. This may indicate that expansion of the pin upon swelling protects against loosening, even if the pin's surface geometry is not optimal. None of the pins with a textured surface were loose, independent of the polymer used for the pin preparation. The textured surface of these pins allowed the ongrowth of new bone and hence, implant anchoring, secured the positional stability of the implant in the bone.

Animals↗

PubMed1997

The use of a resorbable augmentation device to secure plating of osteoporotic bones. An in vitro study.

Osteotomies in porotic human cadaveric humeri were fixed with metallic plates and screws in 3 experimental groups. In group I, osteotomies of the 3 arbitrarily chosen humeri were plated without reinforcement. The osteotomies of the contralateral 3 humeri were plated after reinforcement with a poly(L-lactide) augmentation device. In group II, osteotomies on one side were plated without reinforcement, but those of the contralateral humeri were plated after reinforcement with methylmethacrylate. In group III, the osteotomies of 3 humeri were plated and reinforced with poly(L-lactide) and in the 3 contralateral humeri were plated after reinforcement with methylmethacrylate. The pullout strength for screws from bones augmented with poly(L-lactide) was identical to those where methylmethacrylate had been used. The bones with poly(L-lactide) augmentation had a higher torsional stiffness than those with methylmethacrylate cement and those which were not reinforced. Resorbable polymeric medullary augmentation devices can be used to enhance plating of osteoporotic bones.

Bone Cements↗

PubMed1997

Long-term in vivo degradation and bone reaction to various polylactides. 1. One-year results.

Injection-moulded pins from poly(L-lactide), poly(L/DL-lactide) (95/5%) were implanted in the cortex of the tibiae of sheep. The bone-implant interface was evaluated to observe whether there is any bone resorption caused by the implants. The molecular weight and crystallinity changes upon implantation were also measured. There was no net bone loss around the implants or sterile cyst formation in any of the animals implanted with polylactides up to 1 year. The new bone formed around the poly(L-lactide) and poly(L/D-lactide) pins was separated from the implants with a thin layer of connective tissue. For the implants from poly(L/DL-lactide), there was direct apposition of bone on the polymeric material. At 1 year of implantation, the implants were not completely resorbed, although the molecular weight of polylactides was reduced from 40,000-50,000 to 500-300. The crystallinity at 1 year was about 45% for poly(L/DL-lactide) and poly(L/DL-lactide) and 65% for poly(L-lactide), respectively, indicating the presence in the degraded material of thermodynamically stable crystals.

Animals↗

PubMed1997

Effect of thermal treatment on sterility, molecular and mechanical properties of various polylactides. 2. Poly(L/D-lactide) and poly(L/DL-lactide).

Pins for orthopaedic applications injection-moulded from as-supplied poly(L/D-lactide) 95/5% and poly(L/DL-lactide) 95/5%, raw as-supplied polymers or raw methanol-extracted polymers were heat-treated for a predetermined time at 135 degrees C under moisture-free argon. The sterility, molecular weight, polydispersity, mechanical properties, and crystallinity of the heat-treated samples were evaluated. All the samples heat treated under argon were sterile after 2 h exposure to heat. The heat-treated pins and raw as-supplied polymers showed a continuous decrease in molecular weight over the entire 50 h of heating, the decrease being more substantial for poly(L/D-lactide) than poly(L/DL-lactide). Raw methanol-extracted polymers showed an increase of molecular weight after 2 h of heat treatment, followed by a gradual decrease of molecular weight up to 50 h. A drop in the bending strength, an increase in the bending moduli, and no change in the shear strength was observed for polylactide pins during the first 5 h of thermal treatment. For both the polymers, there was a progressive increase in crystallinity over time of thermal treatment, and practically no change in the melting temperature.

Bone Nails↗

PubMed1997

Resorbable polymeric inserts as a means of enhancing fixation of fractures of porotic bones. I. Stability of mechanical properties and viscoelasticity of the inserts aged in vitro.

A titanium screw-poly(L-lactide) medullary insert system intended for use in the fixation of porotic bone fractures was subjected to in vitro ageing at 37 degrees C and pH = 7.4 for up to 6 months. The pull-out force of the screw from the insert and the viscoelastic properties of the insert were measured. The pull-out force did not change up to 6 months of ageing, indicating that the polymeric insert provides a good purchase for the screws. The viscoelastic properties of the insert provides of bone and did not change substantially with temperatures up to 52 degrees C. This indicates that the medullary insert would maintain its properties in vivo even if the body temperature was increased. The molecular weight of the insert at 6 months was reduced by 60%, but the molecular weight reduction did not affect the mechanical properties of the insert.

Bone Screws↗

PubMed1997

Blood-filled spaces with and without filler materials in guided bone regeneration. A comparative experimental study in the rabbit using bioresorbable membranes.

The aim of the present study was to evaluate the effect of natural deproteinized bone mineral on the temporal and spatial pattern of bone formation in a guided bone regeneration model system while using a bioresorbable membrane device. A periosteal skin flap was raised uncovering the calvaria of 20 rabbits. A stiff hemispherical dome made of polylactic acid was placed onto the roughened calvaria and anchored by screws. Prior to placement, the dome was either filled with peripheral blood (control group, 8 rabbits) or with blood and OsteoGraf/N-300 (test group, 12 rabbits). At 1 month, histologic sections revealed bone regeneration in both test and control domes to various degrees. In the test domes, bone height reached 78% (67-83) and bone volume was 11% (6-17), while in the control domes, bone height was 45% (14-67) and bone volume 6% (1-11). At 2 months, bone height was unchanged in the test group at 70% (67-83) and bone volume had only slightly increased to 16% (11-21). In the controls, height increased to 86% (60-100) and volume to 20% (9-27). Thus, in this model system, natural bone mineral fill contributed to accelerate initial bone neogenesis, while it did not contribute to increasing bone volume or bone height at later observation stages.

Animals↗

PubMed1997

The biological effect of natural bone mineral on bone neoformation on the rabbit skull.

The aim of this study was to evaluate the effect of deproteinized bovine bone graft material on new bone formation in a guided bone regeneration model system. In 20 rabbits, a periosteal skin flap was raised uncovering the calvaria. A form stable hemispherical dome made of poly-lactic acid (PLA) was placed onto the roughened calvaria. Prior to placement, the dome was either filled with peripheral blood alone (control group, 8 rabbits), or with blood and OsteoGraf/N-300 (test group, 12 rabbits). The wound was closed for primary healing. Morphometric assessment of 1- and 2-month undecalcified histologic specimens revealed better tissue fill in the test domes at 1 month (test 99%, control 55%) (P < 0.05) and 2 months (t, 100%; c, 82%). The fraction of the new bone within the regenerated tissue was higher in the test specimens at 1 month (t, 22%; c, 12%) (P < 0.05) and 2 months (t, 34%; c, 24%). The fraction of the entire space underneath the domes occupied by bone was higher in the test at 1 month, but higher in the controls at 2 months. The fraction of the bone substitute material in contact with bone increased from 1 month (34% +/- 14) to 2 months (45% +/- 5). The surface fraction of osteoblast layers was tendentially higher in the test at 1 month but higher in the control specimens at 2 months. In both test and control, initially woven bone was formed which underwent subsequent remodeling. Cellular degradation of the deproteinized bone graft was frequently detected. It is concluded that deproteinized bovine bone mineral has osteoconductive properties and can initially accelerate new bone formation during guided bone regeneration by increased recruitment of osteoblasts.

Animals↗

PubMed1997

The significance of angiogenesis in guided bone regeneration. A case report of a rabbit experiment.

A dome-shaped bioresorbable membrane was fixed to the wounded rabbit calvaria and filled with a bioresorbable fibre conglomerate. After 4 weeks, the histologic preparation revealed an intimate spatial and temporal correlation between newly formed blood vessels and de novo extraskeletal bone formation. These observations emphasize the significance of angiogenesis in guided bone generation.

Animals↗

PubMed1997

Regeneration of diaphyseal bone defects using resorbable poly(L/DL-lactide) and poly(D-lactide) membranes in the Yucatan pig model.

OBJECTIVES: To determine the effects of tubular resorbable polymer membranes on the healing of a segmental diaphyseal bone defect. DESIGN: A randomized prospective study using the minipig model. Animals were evaluated with in vivo roentgenograms on a biweekly basis until explanted at twelve weeks. SETTING: After surgery, animals were allowed unrestricted activity and weight bearing between twenty-four and forty-eight hours. ANIMALS: Fifteen yearling Yucatan minipigs. INTERVENTION: A 2.5- to 3.0-centimeter mid-diaphyseal defect was created in the middle third of the radius. Animals were assigned in groups of three to receive the following implants: (a) poly(L/DL-lactide), (b) poly(L/DL-lactide)-CaCO3, (c) poly(D-lactide), (d) poly(D-lactide)-CaCO3, and (e) an untreated defect. No adjunctive internal or external fixation was used as the ulna was left intact. MAIN OUTCOME MEASURES: The limbs were studied with in vivo anterior-posterior and lateral radiographs at biweekly intervals for the presence and pattern of bone formation. All limbs were explanted at twelve weeks postimplantation for methyl-methacrylate embedding and histologic and microradiographic study. RESULTS: The bone defects covered with membranes were completely reconstituted by six to eight weeks. Untreated defects healed with less bone formation and in a more disorganized pattern. Histologic evaluation of the implants demonstrated that the entire lumen of the implant was filled with bone, with some periosteal bone formation occurring on the outer surface of the membrane. There was direct apposition of bone onto the membrane surface or minimal fibrous tissue interposition between membrane and new bone. There was no foreign body or adverse reaction to the membrane. Untreated defects showed woven bone formation with clefts and irregularly shaped margins occupied by fibrous tissues or surrounding muscle tissues. CONCLUSIONS: This study supports the concept that a membrane enhances bone defect healing by excluding nonosseous tissues from a defect and providing structural scaffolding for periosteal and endosteal bone regeneration.

Absorption↗

PubMed1996

Enhancement of the mechanical properties of polylactides by solid-state extrusion. II. Poly(L-lactide), poly(L/D-lactide), and poly(L/DL-lactide.

Polylactides with various degrees of chain regularity-crystalline poly(L-lactide); amorphous poly(L/D-lactide), and amorphous poly(L/DL-lactide)-were processed into high-strength, high-modulus resorable rods using solid-state extrusion through a conical die. The rods with a highly fibrillated structure had flexural strengths at a yield of up to 215 MPa and flexural modulus of up to 13.7 GPa. The initially amorphous poly(L/DL-lactide) developed approximately 25% of crystallinity after solid-state extrusion. Poly(L/D-lactide) remained amorphous independently of the treatment procedure applied. The shear strengths, flexural strengths, and flexural moduli of the solid-state extruded rods increased with increasing draw ratio. For the semicrystalline materials, solid-state extrusion enhanced the crystallinity. The achievable draw ratios during solid-state extrusion, and in consequence the final mechanical properties, were lower for poly(L/D-lactide) and poly(L/DL-lactide) than for poly(L-lactide).

Calorimetry, Differential Scanning↗