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Effects of bisphosphonate on bone reaction after placement of titanium implants in tibiae of ovariectomized rats.

PURPOSE: This study was undertaken to investigate the action of bisphosphonate on bone reactions after the placement of titanium screw implants into the tibiae of ovariectomized rats. MATERIALS AND METHODS: Twelve-week-old female Wistar rats were divided into 4 groups of 18 animals each. The first group (Sham) was sham-operated, the second group (OVX) was ovariectomized only, the third group (Estrogen) was ovariectomized and received continuous estrogen with a 17beta-estradiol pellet, and the fourth group (YM-175) was ovariectomized and received bisphosphonate at a dose of 10 microg/kg of body weight. Titanium screw implants were placed in the proximal metaphyses of the tibiae 168 days after surgery. The animals were sacrificed 7, 14, and 56 days after implant placement. Undecalcified sections were prepared and evaluated by light microscopy. Histomorphometric measurements were obtained with a computer-based image analyzer to quantify the unit bone mass around the implant and the rate of implant-bone contact. RESULTS: Ovariectomies significantly reduced implant-bone contact and the bone volume around the implants. However, in the YM-175 group, only slight differences in both bone contact and bone volume were noted compared with the Sham and Estrogen group. The woven structure of new bone in the YM-175 group was also replaced by mature lamellar bone, as in the other groups. DISCUSSION AND CONCLUSION: These results suggested that bisphosphonate preserved the implant-bone contact and bone volume around the implants.

Animals↗

Hydatid cyst of the tibia.

A case of hydatid cyst of the tibia, which manifested as a pathologic fracture is being reported. Pain and swelling of left lower limb with inability to bear the weight were the main features. Tender swelling was also noted at the upper and middle third of tibia. Open biopsy revealed the hydatid cyst wall and scolices of Echinococcus granulosus. Albendazole treatment was followed by curettage and bone grafting.

Adult↗

Torsional tibia vara.

Infantile tibial torsion and tibia vara are common childhood deformities with controversial methods of measurement and treatment. The authors believe that the two deformities are different manifestations of the same entity for which the term "torsional tibia vara" is adopted. A practical method of measurement and a decisive method of conservative treatment are presented for this disorder. The concept as well as the methods of measurement and treatment have been successfully practiced by the senior author (H.Z.) for the past 20 years.

Bone Diseases, Developmental↗

[Pseudarthrosis of the tibia treated by the Ilizarov method].

21 (50%) patients suffering on pseudoarthrosis tibia were treated by ilizarov method, from total of 42 discussed in the paper. The ilizarov method in combination with Judet method was used with 21 patients (50.0%) suffering on pseudoarthrosis tibia. Plastic procedures were performed with 12 (28.6%) covering the skin and soft tissues defects, while 10 (23.8) by myocutal lobes. The non-infectious hypertrophic pseudoarthrosis cases were treated only by ilizarov method 14 (33.3%), while the atrophic ones (39.1%) by ilizarov Judet and spondioplastics. Prior infected contact pseudoarthrosis was performed with 9 (64.3%), 6 (66.6%) only by the ilizarov method, while 3 (33.3%) by ilizarov, Judet and spongioplastics were performed with 3 cases (60.0%), while 2 (40.0%) lifting graft. Healing cases (92.9%), but we did not with 3 cases (7.1%). An average time of treatment was three weeks and joints rehabilitation lasted 7 weeks.

External Fixators↗

Estimation of adult stature from fragmentary tibias.

Linear-regression equations derived from measurements of tibial condyles from 100 individuals in the Hamann-Todd Collection retrodicted known stature with a level of confidence comparable to many of the existing stature-estimation techniques. Statures of an independent control group were estimated with similar success. The strong linear relationship that exists between the length of the tibia and the size of the condyles allows adult stature (of American whites and blacks) to be estimated from the proximal tibia. Since complete tibial length is not required, this technique could prove useful in forensic science and archaeological cases where less-than-intact elements are recovered.

Adult↗

Giant-cell reparative granuloma of the tibia.

Giant-cell reparative granuloma (GCRG) occurs in the jaw, temporal bone, and short tubular bones of the hands and feet. Although GCRG can affect long bones, only small numbers of such cases have been sporadically reported. This report describes a giant-cell reparative granuloma in the proximal tibia in a 60-year-old woman, describes features of GCRG in long bones and reviews the literature. A 60-year-old female patient was referred to us with complaints of moderately tender swelling of the right leg. Whole-body scintigraphic scanning was performed, which incidentally also disclosed a distal femoral lesion. The patient was admitted for surgery and incisional biopsies were performed on both lesions. Pathology analysis of the specimen from the tibia showed new bone lamellae encircled by osteoblasts and multinucleated giant cells which were more numerous in the haemorrhagic regions of the stroma; the latter displayed fibroblasts, histiocytes and inflammatory cells. The specimen from the femoral lesion showed typical features of a benign enchondroma. The patient was readmitted for surgery. The femoral enchondroma was curetted and the cavity was packed with bone graft. The tibial GCRG was treated with marginal resection, autogenous and allogenous bone grafting and intramedullary nailing. Follow-up examination after two years showed no clinical or radiological evidence of a recurrence. Although GCRG is uncommon, it should be considered whenever a lucent, expansile, and possibly destructive lesion of a long bone is encountered. It should be distinguished from true giant cell tumours occurring in the same locations because they have different biologic behaviours.

Bone Diseases↗

Callus area and glycosaminoglycans content of the traumatized tibia in rats.

UNLABELLED: The aim of the present work is the quantification of the post-traumatic bone healing histology (total callus morphometry) and histochemistry of the glycosaminoglycans (GAG) content (microspectrometry) in rats tibia after segment osteotomy and bicortical perforation of trained and immobilized animals. MATERIAL AND METHODS: A quantified investigation of post-traumatic bone repair histology and GAG content after osteotomy and perforation of tibia in 105 young adult male Wistar rats has been performed. The repair was studied in normal and affected (training and immobilization) animals at 1-42 days after operation. RESULTS: The posttraumatic bone repair is an ordinary process of osteohisto- and organogenesis, and dependent on the environment factors (mode and degree of trauma, training of animals, etc.). The repair is trauma-dependent; after osteotomy the total callus area is significantly larger respectively to perforation. Otherwise, the training did not significantly influence the repair callus area and GAG content and therefore did not accelerate the bone repair, whereas the immobilization of animals depressed these processes and the bone repair was inhibited. CONCLUSIONS: Quantified study of histology and histochemistry of bone repair after perforation gave important new, more detailed results on the reparative histogenesis of the bone tissues: repair dynamics of callus areas, dynamics of GAG concentration, effects of mode and degree of trauma, training and immobilization on the repair process.

Animals↗

Variability of the metaphyseal-diaphyseal angle in tibia vara: a comparison of two methods.

Although Levine and Drennan described the metaphyseal-diaphyseal angle (MDA) in tibia vara using the lateral border of the tibial cortex, there is a lack of uniformity in the literature. The authors measured the MDA using both the lateral border and the center of the tibial shaft in 132 knees (66 patients) with bowleg deformity and examined whether there is a significant difference between these two measurements. At angles < or =11 degrees there was significant variance between the two methods. At angles >11 degrees, there was excellent correlation between the two methods and no statistical difference between the two methods. The authors conclude that either method of defining the longitudinal axis is acceptable to measure the MDA for the diagnosis and monitoring of tibia vara.

Bone Diseases, Developmental↗

[Radiological study on repair of goat tibia defect with marrow stromal stem cells and bio-derived bone].

OBJECTIVE: To investigate the ability to repair goat tibia defect with marrow stromal stem cells (MSCs) and bio-derived bone, and the feasibility of the compounds as bone substitute material. METHODS: MSCs were cultured with the bio-derived bone in vitro, and the 20 mm tibia defect of goat was made and fixed with plate. Eighteen goats were divided into experimental group, control group and blank group. The defects were not filled with anything in blank group, with tissue engineering bone in experimental group and bio-derived bone in control group. The repair capability was assessed by physical, X-ray and bone mineral density examinations 8, 12, 16, and 24 weeks after operation. RESULTS: In experimental group, the defects were partially repaired 8 weeks, and completely repaired 12 and 16 weeks; there was significant difference in bone density between experimental group and control group (P < 0.05) 8, 12 and 16 weeks, but no significant difference 24 weeks. The defects of blank group were not repaired 24 weeks. CONCLUSION: The tissue engineering bone can efficiently repair bone defect, and its repair capability is better than that of bio-derived bone alone both in quantity and quality of bone formation.

Animals↗

[Tomodensitometry measurements of proximal tibia and acceleration in marathon athletes].

We evaluated bone adaptation of the tibia to mechanical stresses in male marathon runners and in sedentary controls in function of the ground impact measured by accelerometry and of the bone mineral density assessed by peripheral quantitative computed tomography (QCT). Sixty-three subjects (51 runners and 12 controls) were enrolled. All had measurements of bone mineral density of the proximal tibia and of acceleration at the same site during a jogging at 9 km/hour. The results show a significant higher cortical BMD in runners with the higher value of late accelerations (at 50 ms after the contact with the ground). The late acceleration might be related to muscle contraction.

Adult↗

Effects of bisphosphate treatment and mechanical loading on bone modeling in the rat tibia.

Bisphosphonate treatment has been shown to decrease endosteal bone formation and increase periosteal bone apposition in the rat tibial diaphysis. This study tested the hypothesis that the increase in periosteal apposition is a compensatory attempt to maintain skeletal mass appropriate for the mechanical load. Twenty-four rats were divided into four groups. In two of the groups, one hindlimb in each rat was immobilized with a sling device to increase the mechanical load on the opposite limb. Daily injections of dichloromethylene bisphosphonate (Cl2MBP) were given at 10 mg/kg to one immobilized group and one mobile group. The other two groups were given daily injections of normal saline. Fluorescent bone labels were administered at two-week intervals. All rats were killed after ten weeks of treatment, and calcified tibial cross sections were prepared for fluorescence microscopy. Bone dimensions and periosteal and endosteal apposition rates were calculated. When compared with saline controls, Cl2MBP treatment decreased endosteal apposition rate in all tibias. Periosteal apposition rate was increased with Cl2MBP treatment in all tibias except the unloaded limb of immobilized rats. The Cl2MBP-induced increase in periosteal apposition rate was greatest in loaded limbs and was proportional to the relative amount of body weight supported.

Animals↗

Histological evaluation of the early bone response to hydroxyapatite (HA) implanted in rabbit tibia.

This study is to qualitatively evaluate a locally produced hydroxyapatite (HA), made by AMREC-SIRIM in an experimental animal bone defect using New Zealand White (NZW) rabbits. HA cylindrical blocks measuring 2.5 mm (D) x 1.0 mm (H) were implanted in the rabbits' left tibia. The tibias were harvested within one to three weeks post-implantation. The implantion site was cut into thin undecalcified sections of about 30 microm to 60 microm and stained with Toluidine Blue and Goldner's Masson Trichrome. Microscopic examinations using standard light microscopy of these slides were performed.

Animals↗

Anatomic considerations of pin placement in the proximal tibia and its relationship to the peroneal nerve.

Peroneal nerve impalement is a recognized complication of percutaneous placement of wires, which is gaining increased usage with the application of the techniques of Ilizarov, Monticelli, and Spinelli. Dissections of the peroneal nerve in the proximal tibia were performed in ten anatomic specimens (20 legs) to define (1) its relationship to palpable landmarks, (2) distribution of major branches to the musculature, and (3) safe zones of placement of percutaneous wires in the proximal tibia. The anterior recurrent tibial nerve was frequently in an area of risk where it courses proximally in the anterior compartment. A safe zone is located anterior to the palpable portion of the fibular head and up to 2 cm distal to the tip of the fibular head.

Humans↗

[Experimental study on repair of goat tibia defect with marrow stromal cell and bio-derived bone].

OBJECTIVE: To investigate the feasibility of repairing goat tibia defect with marrow stromal cells (MSCs). METHODS: MSCs were cocultured with the bio-derived bone in vitro, and the 20 mm tibia defects were made and fixed with plate in 35 goats, and they were divided into the experimental group, control group and blank group. The defects on the right side were filled with tissue engineering bone as the experimental group, the defects on the left side with bio-derived bone as the control group in 33 goats, and the defect on the both sides were not filled with any materials as the blank group in 2 goats. The repair capability was assessed physically, histopathologically and biomechanically at 2, 4, 6, 8, 12, 16 and 24 weeks after operation in 3 groups. RESULTS: By physical, histopathological and biomechanical examinations, the bio-derived bone was partially absorbed in the experimental group and was rarely absorbed in the control group in the 4th week; the defects were partially repaired in the experimental group, and in the control group, few new bones were observed in the two ends of the implants, in which there was fibrous tissue. The effects of biomechanics had no statistically significant difference between the experimental group and the control group (P>0.05) in the 8th week; the defects were perfectly repaired in the experimental group and the effects of biomechanics had statistically significant difference between two groups (P<0.05) in the 12th weeks. The defects were not repaired in the 24th week in the blank group. CONCLUSION: The tissue engineering bone can efficiently repair bone defect, and its repair capability is better than that of bio-derived bone alone both in quantity and in quality of bone formation.

Animals↗

Effects of chronic ethanol consumption and pair feeding on rates of protein synthesis and nucleic acid composition in rat tibia.

An investigation was made into the chronic effects of ethanol feeding on bone (represented by the tibia). Treated rats were fed a liquid diet containing ethanol as 36% of total calories, and controls were pair-fed identical amounts of the same diet in which ethanol was substituted by isocaloric glucose. Bone DNA and RNA contents in ethanol-fed rats were not significantly different from glucose-fed controls at days 3, 7, 14, 28 and 42 of treatment. Fractional rates of bone protein synthesis were measured with [43H]-phenylalanine. At 3, 7, 14, 28 and 42 days, ethanol feeding had no effect on free and protein-bound specific radioactivities, nor on fractional or absolute rates of protein synthesis. Synthesis rates relative to RNA (RNA activities) and DNA (cellular efficiencies) were also not significantly altered by ethanol feeding at these time points. Comparisons were made between rats fed a standard solid laboratory diet ad libitum (i.e. normal rats), and those fed restricted amounts of glucose-containing liquid diet (i.e. dietary-restricted rats) for 42 days. In normal rats, there was an increase in tibial mass and accretion of total collagen content, but in dietary-restricted rats, this accretion was markedly impaired. Furthermore, whilst RNA and DNA contents were increased in tibia of normal rats, the contents of these nucleic acids were reduced in bones of dietary restricted rats. Fractional rates of bone protein synthesis in normal rats were unaltered after 42 days, but reduced by feeding the control liquid diet in restricted amounts.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcoholism↗

Proximal osteotomy of the tibia for the treatment of genu recurvatum in adults.

Twenty-seven opening-wedge osteotomies of the proximal part of the tibia were performed in twenty-five patients who had genu recurvatum. In sixteen knees, the genu recurvatum was due entirely to osseous deformity. In the remaining eleven knees, it was due to a combination of osseous and soft-tissue deformity; in five, the deformity was predominantly osseous and in six, primarily in the soft tissues (the ligaments and capsule). The average age of the patients was twenty-three years (range, fifteen to fifty-four years). The osteotomy was proximal to the tibial tuberosity in twenty-two knees. In eighteen of these knees, the tuberosity was detached with its patellar ligament and then reattached to the proximal part of the tibia over the block of bone in the opened wedge; in the remaining four knees, the tibial tuberosity was not detached. The osteotomy was distal to the tuberosity in five knees. The patients were followed for an average of 14.5 years (range, three to thirty years). Of the eighteen knees in which the osteotomy had been proximal to the tibial tuberosity and the tuberosity had been detached and then reattached, nine (50 per cent) had a result that was excellent; five (28 per cent), good; and four (22 per cent), fair. Of the four knees in which the operation had been proximal to but without detachment of the tuberosity, one had a result that was excellent; two, good; and one, fair. Of the five knees in which the osteotomy was distal to the tibial tuberosity, one had a result that was good; three, fair; and one, poor. Of the twenty-one knees in which the deformity was entirely or predominantly osseous, eighteen (86 per cent) had an excellent or good result. None of the six knees in which the deformity was predominantly in the soft tissues had an excellent or good result. Patients in whom the deformity was not primarily osseous, and those in whom the operation was distal to the tibial tubercle, were much more likely to have a fair or poor result.

Adolescent↗

Giant cell tumours of the maxilla and tibia presenting concurrently as an initial manifestation of primary parathyroid adenoma.

A 14 years female of Afghan origin reported with maxillofacial and tibia growths causing progressive deformities since nine months, both were giant cell tumours on histopathology. Serum calcium was normal, but the parathyroid hormone was exaggerated (678 pg/ml). Ultrasound indicated and Tc-99m Setamibi scan confirmed a left lower parathyroid lesion. A 4cm length mass was identified, removed and proved to be a parathyroid adenoma. Two weeks later a subtotal maxillectomy and six weeks later anterior wedge osteotomy of the tibia were carried out. Serum parathyroid hormone level normalized.

Adenoma↗