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PubMedDate not supplied

Utilization of autogenous corticocancellous bone graft from the distal tibia for reconstructive surgery of the foot and ankle.

Procurement of corticocancellous autogenous bone graft from any donor site is not without potential complications. Increased postoperative morbidity, fracture at the donor site, an additional surgical procedure, increased operative time, excessive blood loss, hematoma, and increased relative cost are all factors that must be considered, regardless of donor site. The authors have been using the distal tibia as a source of corticocancellous bone since 1988. A review of 16 patients with distal tibial bone grafts at our institution has demonstrated this area to be readily available and effective with limited morbidity. The distal tibial metaphyseal area has been found to be an excellent source of corticocancellous bone for grafting in reconstructive foot and ankle surgery.

Adolescent↗

PubMedDate not supplied

Primary lymphoma of the calcaneus with recurrence in the distal tibia: a case report.

Primary lymphoma of bone in general is a very rare condition which represents approximately 3% of all primary malignant bone tumors. Of these, less than 1% originate in the foot. The following case presentation demonstrates a patient who presented with primary lymphoma of the calcaneus, diagnosed by open bone biopsy and treated with radiation therapy. The patient remained disease free for almost 3 years, at which time recurrence to the contralateral distal tibia was diagnosed again through open biopsy.

Bone Neoplasms↗

PubMed1995

Effect of age and radiation on bone healing adjacent to hydroxyapatite placed in the tibia of rats.

This study investigated the effect of age and radiation on healing after implantation of hydroxyapatite granule in bone. Two groups of 16 male Wistar rats, aged 4 weeks and 2 years were used for this study. Hydroxyapatite particles were placed into the tibia 28 days after the delivery of 15 Gy of irradiation from a Linac source. The results of the present study suggest that an old rat was more vulnerable to the radiation than a young rat. It seemed that age might also be an important factor in the prognosis of the implanted hydroxyapatite in irradiated bone.

Age Factors↗

PubMed2001

Comparison in localization between cystatin C and cathepsin K in osteoclasts and other cells in mouse tibia epiphysis by immunolight and immunoelectron microscopy.

We compared the distribution of a cysteine proteinase inhibitor, cystatin C, with that of cathepsin K in osteoclasts of the mouse tibia by immunolight and immunoelectron microscopy. Light microscopically, strong immunoreactivity for cystatin C was found extracellularly along the resorption lacuna and intracellularly in the organelles of osteoclasts. In serial sections, various patterns of cystatin C and cathepsin K localization were seen, specifically: (1) some resorption lacuna were positive for both cystatin C and cathepsin K; (2) others were positive for either cystatin C or cathepsin K, but not both; and (3) some lacuna were negative for both. In osteoclasts, the localization of cystatin C was similar to that of cathepsin K. Furthermore, cystatin C immunoreactivity was detected in preosteoclasts and osteoblasts, whereas cathepsin K was seen only in preosteoclasts. Electron microscopically, cystatin C immunoreactive products were found in the rough endoplasmic reticulum (ER), Golgi apparatus, vesicles, granules, and vacuoles of osteoclasts. These cystatin C-positive vesicles had fused or were in the process of fusion with the ampullar vacuoles (extracellular spaces) containing cystatin C-positive, fragmented, fibril-like structures. The extracellular cystatin C was deposited on and between the cytoplasmic processes of ruffled borders, and on and between type I collagen fibrils. In the basolateral region of osteoclasts, cystatin C-positive vesicles and granules also fused with vacuoles that contained cystatin C-positive or negative fibril-like structures. These results indicate that osteoclasts not only synthesize and secrete cathepsin K from the ruffled border into the bone resorption lacunae, but also a cysteine proteinase inhibitor, cystatin C. Therefore, it is suggested that cystatin C regulates the degradation of bone matrix by cathepsin K, both extracellularly and intracellularly.

Animals↗

PubMed2002

Characterization of bone mineral composition in the proximal tibia of cynomolgus monkeys: effect of ovariectomy and nandrolone decanoate treatment.

Life postmenopausal women, ovariectomized cynomolgus monkeys (Macaca fascicularis) experience accelerated loss of bone mass. Treatment of ovariectomized monkeys with nandrolone decanoate results in an increase in bone mass to levels comparable to those of intact animals. The changes in bone composition that occur with these treatments, however, are less well characterized. In the present study, we used synchrotron Fourier-transform infrared microspectroscopy (FT-IRM) and curve-fitting methods to monitor specific changes at cortical, subchondral, and trabecular bone regions in the proximal tibia. Four groups were studied: (1) sham-operated (sham); (2) ovariectomized and treated with placebo for 2 years (ovx); (3) ovx + nandrolone decanoate for 2 years (NAN); and (4) ovx + nandrolone decanoate beginning 1 year after ovx (dNAN). The results demonstrate that ovariectomy and nandrolone treatment did not affect the degree of mineralization as defined by the phosphate/protein ratio, but acid phosphate content (HPO(4)(2-)) in cortical and subchondral bone was increased by ovariectomy, suggesting this bone to be less mature due to increased remodeling that occurs after ovariectomy. In the subchondral and cortical bone regions, ovariectomized monkeys showed a lower total carbonate content (CO(3)(2-)/matrix ratio) than sham controls, specifically due to the decrease in labile carbonate content. In the trabecular region, no change of carbonate content was observed. Treatment with nandrolone decanoate was found to restore the loss in carbonate, where the resulting mineral had a larger quantity of type B carbonate. Finally, we correlated carbonate content with dual-energy X-ray absorptiometry measurements, and found a positive correlation between bone mineral density and type A carbonate in bone, which is stoichiometrically related to the amount of calcium in bone. Therefore, the results presented herein identify significant differences in bone chemistry after ovariectomy and nandrolone treatment, which may help explain previous findings that, although nandrolone decanoate treatment increased bone mass, it could not reverse the decrease in bone strength due to ovariectomy.

Anabolic Agents↗

PubMed1995

Effect of low-energy laser (He-Ne) irradiation on the process of bone repair in the rat tibia.

The effect of low-energy laser (He-Ne) irradiation on bone repair in the tibia of the rat after hole injury was investigated using biochemical and quantitative histomorphometrical methods. The activity of alkaline phosphatase (ALP) showed a sharp peak at 6 days post-injury and a lower peak at 12 days. The overall kinetics of tartrate-resistant acid phosphatase (TRAP) activity coincided with that of ALP but with the higher peak at 12 days postoperatively. Calcium accumulated progressively at the site of injury, peaking at 11 days and then declining. The histological evaluation revealed filling of the intramedullary canal with woven bone at the site of injury at 6 days after surgery, and progressive filling of the hole-injury gap in the cortical bone by membranous ossification. Direct irradiation of the hole injury with He-Ne laser at 5 and 6 days after injury altered the osteoblast and osteoclast cell populations, as reflected by the significant 2.2-fold increase in ALP enzymatic activity over control, nonirradiated rats at 10 days post-injury, and a significant decrease of 40% in TRAP activity at 11 days. Histomorphometrical analysis revealed a more rapid accumulation of reparative new bone in the hole injury of the laser-irradiated rats. The volume fraction (percent of total volume of the injured zone) of the new reparative compact bone was 27 +/- 9%, 88 +/- 9%, and 94 +/- 6% at 10, 13, and 15 days after injury, respectively, in the laser-irradiated rats; respective control values were 9 +/- 7%, 44 +/- 9%, and 58 +/- 5% for the same time intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed1997

Calcium hydroxide ameliorates tobramycin toxicity in cultured chick tibiae.

Results from this laboratory have shown that bone metabolism is directly related to extracellular pH and that high concentrations of tobramycin released from impregnated polymethylmethacryrate (PMMA) beads has pH-dependent toxic effects on bone. In the present study, beneficial effects of calcium hydroxide-impregnated PMMA were investigated regarding tobramycin toxicity and bone metabolism in chick embryo tibiae in vitro. Also using Ca(OH)2 as a pH regulator, the antibiotic efficacy of tobramycin-impregnated PMMA was evaluated with respect to inhibition of Staphylococcus aureus growth. When Ca(OH)2 was added to PMMA beads containing tobramycin, the beads released hydroxyl and calcium ions into the culture medium and released more antibiotic than beads containing only tobramycin. Bone metabolism (glycolysis, total protein synthesis, and collagen synthesis) was enhanced by Ca(OH)2-impregnated beads with or without tobramycin. Additionally, bacterial growth was inhibited more strongly when S. aureus was incubated with tobramycin- and Ca(OH)2-impregnated PMMA disks than with disks containing only tobramycin. This study demonstrates the feasibility of adding Ca(OH)2 to tobramycin-impregnated PMMA beads as a regulator of local pH and a promoter of bone metabolism for protection of bone when high concentrations of tobramycin are used to treat osteomyelitis. It also suggests that lower concentrations of antibiotic may be effective if Ca(OH)2 and tobramycin are administered simultaneously.

Animals↗

PubMed1998

Immunoreactive localization of transforming growth factor-beta type II receptor-positive cells in rat tibiae.

To identify the target cells of transforming growth factor-beta (TGF-beta) in normal bone tissue, we examined TGF-beta type II receptor expression using immunohistochemistry, reverse transcription-polymerase chain reaction (RT-PCR), and in situ hybridization in young rat tibiae. In the epiphyseal growth plate, the TGF-beta type II receptor cDNA was detected by RT-PCR and, alternatively, the TGF-beta type II receptor protein and mRNA expression were observed in the chondrocytes in the lower part of the proliferative cell layer, and in maturative and hypertrophic cell layers by immunohistochemistry and in situ hybridization. Of these, proliferative and maturative chondrocytes, in particular, revealed strong mRNA expression. In the cortical bone area, immunoreactivity for the TGF-beta type II receptor was detected in the fibroblastic cells near the osteoblasts on the endosteal surface of cortical bone. In conclusion, our findings suggest that target cells of TGF-beta in normal bone tissue could be considered mainly as extracellular matrix-producing chondrocytes and undifferentiated preosteoblasts, and TGF-beta may affect matrix production and differentiation of these cells.

Animals↗

PubMed1999

Comparison of three methods for estimation of bone resorption following ovariectomy in the distal femur and the proximal tibia of the rat.

The study of estrogen-deficient bone loss requires accurate assessment of bone resorption; however, there has been considerable variance in the values reported for this variable. We compared three techniques for estimating bone resorption in the adult rat at four anatomical sites, the metaphysis and epiphysis of the distal femur and the proximal tibia. The techniques include an osteoclast-morphology-based method (VK-Oc), a bone-surface-based method (Pit-Oc), and an enzymatic method (AP-Oc). Thirty 6-month-old rats were either ovariectomized (ovx) or sham operated (sham) and killed at 0, 9, or 18 days postoperation. Each method was analyzed for variance in the ovary-intact groups and for the ability to detect the increase in osteoclast surface known to occur following ovariectomy. A 50-fold variation for the estimation of extent of osteoclast surface was entirely accounted for by these three methods for osteoclast estimation. The VK-Oc method was the most consistent for discriminating levels of osteoclast surface between ovary-intact and ovariectomized rats, detecting an increase at three of the four sites. There was no difference between the methods in their ability to produce consistent values for ovary-intact groups. The Pit-Oc method produced the largest numerical difference between the two operation groups with a 2.5-3-fold increase compared with 1.25-1.5-fold for the other methods (p < 0.001). However, the greater variance associated with this method limited the ability to detect the increase in osteoclast surface following ovariectomy. The AP-Oc method lacked the sensitivity of the other two methods. The oophorectomy-induced increase of osteoclast surface in the metaphysis of distal femur was larger and more consistently demonstrated than increases at the other sites.

Animals↗

PubMed1997

Bioactive glass and calcium carbonate granules as filler material around titanium and bioactive glass implants in the medullar space of the rabbit tibia.

The effect of bioactive glass (BG) and calcium carbonate (CC) granules on bone formation around titanium and BG implants projecting into the medullary space of rabbit tibia was studied. The bone marrow tissue was removed and the medullary space was filled either with BG or CC (Biocoral) granules (phi 630-800 microns). Conical titanium and BG implants were inserted into the holes drilled in compact bone using the press fit-technique. Histomorphometry was used to measure the bone-biomaterial area in a 1.0 mm wide zone around the head of the implant and the contact between formed bone and implant. Significantly larger bone-biomaterial area was obtained around titanium implants using BG than CC granules while no difference was found in connection of BG implants. Better bone-implant contact was achieved with BG implants than with titanium implants regardless of the type of granules used. The results indicate that BG may prove to be useful as filler and coating material in connection of implants projecting into bone cavities.

Animals↗

PubMed1990

Post-translational processing of chicken bone phosphoproteins. Identification of the bone phosphoproteins of embryonic tibia.

In order to understand the mechanism of the post-translational processing of bone phosphoproteins in embryonic bone, periosteal bone strips isolated from 12-day-embryonic-chick tibiae were cultured and the bone proteins labelled with Na2H32PO4. Of the total radiolabelled proteins recovered from the medium and bone extracts in the absence of SDS ('medium', 'EDTA extract' and 'EDTA/guanidinium chloride extract'), nearly 80% of the radioactivity was found in the EDTA extract. The three major radiolabelled phosphoproteins in the EDTA extract of apparent Mr 68,000, 63,000 and 58,000 reacted with polyclonal as well as monoclonal antibodies raised against '32-kDa' and '150-kDa' bone phosphoproteins which were derived from 14-week-old chicken. Therefore these phosphorylated embryonic proteins are identified as chicken bone phosphoproteins. Judging from their common N-terminal sequences, differences in the patterns obtained by labelling them with several radioisotopes, and slightly different amino acid compositions, these components seem to have been derived from the same original protein by sequential proteolytic cleavage and other processing such as glycosylation and phosphorylation.

Amino Acid Sequence↗

PubMed1997

Effect of ovariectomy upon weaning on the morphometric parameters of femorae and tibiae of growing rats.

To assess the effects of early ovariectomy on whole bone density and several morphometric and serum markers of bone metabolism, female Wistar rats were ovariectomized or sham-operated upon weaning. The animals were fed ad libitum. After 8 weeks, the increase in the weight gains of ovariectomized rats was minute when compared with the control animals. The whole bone densities of the femorae of ovariectomized rats were slightly reduced when compared with the sham-operated animals. The proximal cross section of the femorae of the ovariectomized rats exhibited enhanced periosteal bone apposition and increased cortical area when compared with the sham-operated animals, but the differences were not statistically significant. The cancellous bone of the femora and the proportional areas of trabeculae of the proximal tibia were reduced in ovariectomized rats. It is concluded that ovariectomy upon weaning caused a clear tendency toward osteopenia. Cancellous bone was clearly affected after ovariectomy, indicating its relation to gonadal hormone regulation even during growth.

Animals↗

PubMed1996

Prenatal findings in chondrodysplasia punctata, tibia-metacarpal type.

Chondrodysplasia punctata, a skeletal dysplasia with craniofacial dysmorphism and joint contractures can occur with rhizomelia, mesomelia or both. The rhizomelic form is generally lethal, whereas one form of mesomelic chondrodysplasia punctata has been described that is associated with a presumably normal lifespan and intelligence. We describe a case of a fetus suspected prenatally of having rhizomelic chondrodysplasia punctata, who was subsequently diagnosed at 1.5 years of age to have the tibia-metacarpal form of chondrodysplasia punctata. The prenatal sonographic findings of second-trimester micromelic bone shortening and third-trimester proximal femoral stippling may be present in the rhizomelic form but are not specific to this condition.

Adult↗

PubMed2002

A case report: reconstruction of a damaged knee following treatment of giant cell tumor of the proximal tibia with cryosurgery and cementation.

OBJECTIVE: Reconstruction of a knee damaged by cement packed to cure a giant-cell tumor is sometimes difficult. We reconstructed such a knee by removal of the cement, autologous bone transplantation and distraction osteogenesis using the Ilizarov apparatus. In this paper the results 29 months after the salvage surgery are given. PATIENT AND METHODS: We saw a 31-year-old woman's knee joint that showed osteoarthritic change after curettage, cryosurgery and cementation performed 4 years previously for a giant-cell tumor of the proximal tibia. We reconstructed the knee joint. This procedure included cement removal, alignment correction by tibial osteotomy, subchondral bone reconstruction by autologous bone transplantation, and filling the defect after removing the bone cement by elongating the diaphysis using the Ilizarov apparatus. RESULTS: Distraction was terminated 4 months later when 54 mm of elongation was performed. All devices were removed 12 months after the surgery. Seventeen months after the removal of the apparatus, the range of motion of the right knee was 0 degrees extension and 110 degrees flexion, and the patient was able to walk without pain. CONCLUSIONS: Although the treatment period is long and there may be some complications of Ilizarov lengthening and distraction osteogenesis, this procedure has numerous benefits. Bony defects can be soundly reconstructed and, at the same time, the alignment of the knee can be corrected. Also it is not necessary to reconstruct the ligaments because the insertions are intact. If osteoarthritis progresses, a surface type total knee replacement can be performed, not constrained type prosthesis, which would be used if the bony structure had not been reconstructed. This procedure may be one of the candidates for reconstructing such knee joints destroyed by bone cement.

Adult↗

PubMed2002

Effect of calcium phosphate surface coating on bone ingrowth onto porous-surfaced titanium alloy implants in rabbit tibiae.

PURPOSE: The purpose of the present study was to determine whether calcium phosphate coating has a significant impact on bone ingrowth into a porous titanium implant. MATERIALS AND METHODS: Porous-surfaced titanium alloy Ti-6Al-4V implants were prepared with or without the addition of a thin surface layer of calcium phosphate applied by sol-gel coating. Implants were placed into the tibiae of 16 rabbits. Implanted sites were allowed to heal for 2 weeks, after which specimens were retrieved for morphometric assessment using backscatter scanning electron microscopy. RESULTS: The data collected show that there is more extensive ingrowth into the porous regions of the calcium phosphate-coated implants than into the control implants. The weighted average ingrowth for the calcium phosphate-coated implants was 2.01, whereas that for the noncoated implants was 1.49; the difference is statistically significant (P <.01). CONCLUSIONS: The addition of a thin layer of calcium phosphate to these implants appears to promote a more extensive implant-to-bone interface by allowing the neck regions to become intimately ingrown with bone even after only 2 weeks of initial healing.

Alloys↗

PubMed2003

Effect of intermittent parathyroid hormone (1-34) treatment on the bone response after placement of titanium implants into the tibia of ovariectomized rats.

PURPOSE: This study investigated the effect of parathyroid hormone (1-34) [PTH(1-34)] on bone reactions after tibial placement of titanium screw implants into ovariectomized rats. MATERIALS AND METHODS: Twelve-week-old female Wistar rats were divided into 3 groups of 24. The first group (Sham group) was sham-operated; the second group (OVX group) was ovariectomized only; and the third group (PTH group) was subcutaneously administered 30 microg/kg PTH in the dorsal region 3 days per week starting the fourth week after ovariectomy until the end of the experiment. Titanium screw implants were placed in the proximal metaphysis of the tibia of all 3 groups at 168 days after surgery. The animals were killed 7, 14, 28, and 56 days after implantation. Undecalcified sections were prepared and evaluated by light microscopy. Histomorphometric measurements were obtained using a computer-based image analyzer to quantify the unit bone mass around the implant and the rate of implant-bone contact. RESULTS: When PTH administration was started 21 days after ovariectomy, the volume density of bone around implants in the PTH group was almost the same as that of the Sham group throughout the entire observation period. This finding suggests that not only can intermittent human PTH(1-34) administration prevent resorption of newly generated trabeculae around an implant but also it can aid in the recovery of bone volume lost due to ovariectomy. CONCLUSION: When dental implants are applied to jaw bone showing trabecular bone loss, it may be possible to increase bone density around an implant by intermittent human PTH(1-34) administration and thereby improve clinical results.

Animals↗

PubMed2001

No relationship between postoperative changes in bone density at the proximal tibia and the migration of the tibial component 2 years after total knee arthroplasty.

The relationship between changes in bone mineral density (BMD) in the proximal tibia and fixation of the tibial component during 2 years postoperatively was investigated in 28 knees. BMD was measured using dual-energy x-ray absorptiometry, and fixation was determined using radiostereometric analysis. BMD decreased at 3 months and returned to baseline level at 24 months, but with large variations on an individual basis. Most of the prosthetic migration occurred within the initial 3 months. The results show that the bone remodeling that occurs during the 2 years after operation has no relation to the migration of the tibial component. The early migration seems to be related more to local activities at the interface rather than to changes in BMD assessed below the interface. The changes in BMD during 2 years reflect the bone remodeling caused by the normalization of alignment after operation and are not related to the implant fixation.

Absorptiometry, Photon↗

PubMed1990

Estradiol benzoate decreases the blood flow through the tibia of female rats.

Effect of estradiol benzoate (EB, Agofollin Depot Spofa, CSSR, 1 mg s.c. once a week for 4 weeks) on local blood flow through the tibia of intact and oophorectomized (OOX) female rats was studied using the 85Sr-microsphere method. In experiment A, the 85Sr-microsphere uptake and blood flow was increased 4 weeks after OOX and significantly decreased after EB in both the intact and OOX animals. In experiment B (intact female rats), the decrease after EB was confirmed both in microsphere uptake and tibial blood flow (48.8% and 57.1% respectively). No changes in the cardiac output and the marked fall of the uptake of labelled microspheres suggest a local circulatory reaction.

Animals↗