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Field distributions in the rat tibia with and without a porous implant during electrical stimulation: a parametric modeling.

Expeditious post-operative ingrowth of bone is necessary for clinically successful fixation of porous joint prostheses. Electrical or electromagnetic fields to stimulate bone growth into porous implants have been used; however, they produced nonconvincing data. This was partially attributable to the lack of quantification of the localized electric fields produced in the pores of the implants. Therefore, this study set out: i) to quantify the local electric field values induced into the surface pores of nonconducting implants by "capacitive" coupling and to determine the magnitude of the macroscopically applied capacitively coupled electrical currents to induce specific electric field amplitudes in the pores, ii) to identify the important dielectric properties of the implant-tissue interface, and iii) to create the basis for successfully applying electrical fields in an animal model to stimulate bone ingrowth. A finite element method was used to calculate the electric field gradients and current densities present in a rat tibia modeled with a porous intramedullary implant when capacitively stimulated. Results indicated that while the current density in the pores are reduced in comparison to the region just outside the pore by about one order of magnitude, a significant current density still exists in the pore region. Furthermore, the presence of the implant increases the current densities in the trabecular bone while decreasing these values in the cortical bone. Replacing the trabecular bone in the pore by saline increases the current density in the pore by three-fold, but decreases the voltage gradient by a similar factor.

Animals↗

Dominant mesomelic dwarfism of the hypoplastic tibia, radius type.

A new type of mesomelic dwarfism in two male siblings and their father is presented. The responsible mutant gene manifests itself phenotypically as a severe dysostosis of the tibia with shortening, bowing and pseudarthrosis and as a mild dysostosis of the radius. The fibulae and ulnae are secondarily affected, but the rest of the skeleton is normal. The disorder has an autosomal dominant mode of inheritance. It can be differentiated rather easily from the already known forms of mesomelic dwarfism.

Chromosome Aberrations↗

Development of sensory innervation in rat tibia: co-localization of CGRP and substance P with growth-associated protein 43 (GAP-43).

The development of sensory innervation in long bones was investigated in rat tibia in fetuses on gestational days (GD) 16-21 and in neonates and juvenile individuals on postnatal days (PD) 1-28. A double immunostaining method was applied to study the co-localization of the neuronal growth marker growth-associated protein 43 (GAP-43) and the pan-neuronal marker protein gene product 9.5 (PGP 9.5) as well as that of two sensory fibre-associated neuropeptides, calcitonin gene-related peptide (CGRP) and substance P (SP). The earliest, not yet chemically coded, nerve fibres were observed on GD17 in the perichondrium of the proximal epiphysis. Further development of the innervation was characterized by the successive appearance of nerve fibres in the perichondrium/periosteum of the shaft (GD19), the bone marrow cavity and intercondylar eminence (GD21), the metaphyses (PD1), the cartilage canals penetrating into the epiphyses (PD7), and finally in the secondary ossification centres (PD10) and epiphyseal bone marrow (PD14). Maturation of the fibres, manifested by their immunoreactivity for CGRP and SP, was visible on GD21 in the epiphyseal perichondrium, the periosteum of the shaft and the bone marrow, on PD1 in the intercondylar eminence and the metaphyses, on PD7 in the cartilage canals, on PD10 in the secondary ossification centres and on PD14 in the epiphyseal bone marrow. The temporal and topographic pattern of nerve fibre appearance corresponds with the development of regions characterized by active mineralization and bone remodelling, suggesting a possible involvement of the sensory innervation in these processes.

Animals↗

In vitro biomechanical and histological assessment of pilot hole diameter for positive-profile external skeletal fixation pins in canine tibiae.

This study was conducted to evaluate the effect of pilot hole (PH) diameter (0, 1.5, 2.0, 2.7, 3.1, 3.3, 3.5, and 3.7 mm) on the biomechanical and microstructural performance of positive-profile threaded external skeletal fixation pins (3.18 mm inner diameter, 3.97 mm outer diameter) using cadaveric canine tibiae. Eight pins per pilot hole diameter (four pins per bone) were used to assess differences in end-insertional torque and pin pull-out strength. Histological evaluation of eight bicortical pin tracts per pilot hole diameter was accomplished using computer-interfaced videomicroscopy on specimens processed using a bulk-staining technique. Compared with no predrill, use of 2.7 mm PH increased end-insertional torque and pull-out strength by 25% and 13.5%, respectively. No significant differences were observed in biomechanical variables for the PH diameter range of 2.0 to 3.1 mm. Compared with no predrill, use of a 3.1 mm PH increased thread area by 18%. Microfracturing around the threads decreased as PH diameter increased. Damage to the interface at the entry and exit sites of both near and far cortices also decreased as PH diameter increased. It was concluded that predrilling a PH whose diameter approximates, but does not exceed the inner diameter of the positive profile pin will not only improve initial pin stability compared with no predrilling, but it will also reduce microstructural damage that may lead to excessive bone resorption and premature pin loosening.

Animals↗

Combination tibial plateau leveling osteotomy and cranial closing wedge osteotomy of the tibia for the treatment of cranial cruciate ligament-deficient stifles with excessive tibial plateau angle.

OBJECTIVE: To describe a surgical technique, and outcome, for treatment of cranial cruciate ligament (CrCL) deficient stifle joints with excessive tibial plateau angle (TPA) by combined tibial plateau leveling osteotomy and cranial closing wedge osteotomy (TPLO/CCWO). STUDY DESIGN: Retrospective clinical study. ANIMALS: Fifteen client-owned dogs (18 stifle joints). METHODS: Medical records of dogs that had TPLO/CCWO were reviewed. Pre- and postoperative TPA, CCWO technique, method of fixation and complications were recorded. In-hospital re-evaluation of limb function and length of time to radiographic healing was reviewed. Long-term outcome was assessed by owner telephone interview. RESULTS: Mean pre- and postoperative TPA was 42 degrees and 8 degrees, respectively. The Slocum biradial saw was used to create the CCWO in 4 stifle joints (mean postoperative TPA, 16 degrees) and a sagittal saw was used in 14 stifle joints (mean postoperative TPA, 5 degrees). Postoperative surgical complications were documented in 77.8% of cases; including patellar tendon thickening (61.1%), and implant loosening or breakage (27.8%), seroma formation (11.1%), and local irritation (11.1%). A second surgical procedure was performed in one-third of cases primarily to retrieve implants. Mean time to documented radiographic healing was 18 weeks. Final in-hospital re-evaluation of limb function (mean, 23 weeks postoperatively) was recorded as no lameness in 73.3% and mild lameness in 26.7%. All interviewed owners were satisfied with outcome and 90.9% reported marked improvement or a return to preinjury status. CONCLUSIONS: Long-term clinical outcome of TPLO/CCWO was very good in dogs with excessive TPA, with high owner satisfaction. Longer healing times and a higher complication rate were observed compared with TPLO alone. CLINICAL RELEVANCE: TPLO/CCWO of the tibia in stifle joints with excessive TPA allows for full correction of the TPA to 5 degrees without eliminating buttress support of the tibial tuberosity.

Animals↗

The impact of nicotine on osseointegration. An experimental study in the femur and tibia of rabbits.

OBJECTIVES: The aim of the present study was to analyze the effect of an enhanced systematic dose of nicotine on osseointegration of titanium implants. MATERIAL AND METHODS: Sixteen female rabbits received either nicotine (n=8) or saline (n=8) administered subcutaneously via mini-osmotic pumps for 2 months. The pump delivered 6 mug/kg/min of nicotine for the animals in the test group. Blood was withdrawn and plasma cotinine levels were measured weekly. Thirty-two titanium implants were inserted into the femur and tibia of all rabbits after 4 weeks and after 6 weeks of nicotine/placebo exposure. Thus, 2- and 4-week healing groups were created. Biomechanical evaluation by (i) resonance frequency analysis test (RFA) on all implants after insertion and before sacrifice and (ii) removal torque test (RMT) on tibial implants before sacrifice was performed. All implants placed in the femur were processed to undecalcified ground sections. The percentage of bone-to-implant contact (BIC) and of bone area within the threads (BD-i) were measured. RESULTS: No significant difference in RMT and RFA values was found between the test and the control group. Histomorphometric measurements of the BIC and the peri-implant BD-i showed no significant differences between the test and the control group after 2 or after 4 weeks. CONCLUSION: Nicotine exposure for a short period of time even in a high dose did not have a significant impact on implant osseointegration in rabbits.

Animals↗

Effect of bone matrix-derived growth factors on skull and tibia in the growing rat.

Aberration in cranial skeletal morphology during growth due to metabolic bone diseases associated with hypocalcemia is related to abnormalities in cranial suture growth. It was found in previous experimental studies that a changed cranial growth pattern induced by hypocalcemia and secondary hyperparathyroidism was dependent on a decreased bone apposition in viscerocranial growth sites. Of interest was the observation that obliterative osteogenesis occurred with this disturbance. In vitro studies have shown that when bone resorption is stimulated by parathyroid hormone, mitogenic factors for bone cells are released from the matrix. The aim of the current study was to elucidate a possible local regulatory mechanism for bone growth especially with regard to cranial growth. Two groups of young rats were injected daily with 150 micrograms and 750 micrograms respectively of bone matrix-derived growth factor preparation (BMDGF) for 2 weeks. By using cephalometric analysis, the BMDGF administration was shown to alter skull morphology during growth. Since the high doses of BMDGF caused markedly more changes than the low dose, the overall effect on craniofacial growth seemed to be dose dependent. The high dose of BMDGF induced a decrease in cortical bone apposition found in this region, as well as in the diaphysis of the tibia. Also a change in position of the viscerocranium in relation to the cranial base was found in the BMDGF-treated rats: the flexure between the viscerocranium and the cranial base being greater compared with the normal skull. This change in relationship seemed to be related to the enhanced bone apposition found in the viscerocranial sutures of BMDGF-treated rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Analysis of model variables and fixation post length effects on stresses around a prosthesis in the proximal tibia.

A two-dimensional, finite element model of a single-posted, metal, tibial prosthetic component implanted with PMMA in the proximal tibia is developed. The effects upon the stresses at the PMMA-bone interface and in the cancellous bone around the component due to the inclusion in the model of the cortical shell and the heterogeneity and anisotropy of the cancellous bone, are demonstrated. Various lengths of the fixation post are considered. The cortical shell adds support and stiffness to the bone structure, and allows generation of significant stresses proximally. The heterogeneity of the cancellous bone, as assumed here, dictates the form of the stress distributions and the magnitudes and locations of the peak stress values around the post of the component. Peak stress values can occur at locations proximal to the post tip. The anisotrophy of the cancellous bone significantly alters the magnitudes of the stresses. Lower stresses along the post interface and higher stresses beneath the plate of the prosthesis are seen in the anisotropic models. Lengthening of the fixation post reduces stresses proximally, but the effects of post lengthening upon the maximum stress values around the post are highly dependent upon the assumed properties of the cancellous bone.

Analysis of Variance↗

Subperiosteal expansion and cortical remodeling of the human femur and tibia with aging.

Increases with aging in subperiosteal dimensions and second moments of area (measures of bending and torsional rigidity) in femoral and tibial cross sections are documented in an archeological sample from the American Southwest. Significant differences between cross-sectional sites and between sexes in the pattern of cortical remodeling with age are also present. These differences appear to be related to variations in the stress or strain levels in different regions of the femur and tibia which result from in vivo mechanical loadings of the lower limb.

Adult↗

Location of 64K collagen producer chondrocytes in developing chicken embryo tibiae.

The synthesis of a new low-molecular-weight collagen by cultured chicken embryo chondrocytes has been recently demonstrated (Capasso et al., Exp. Cell Res. 142:197-206, 1982; Gibson et al., J. Cell Biol. 93:767-774, 1982; Schmid and Conrad, J. Biol. Chem. 257:12444-12450, 1982). In this paper we report results on the location of chondrocytes synthesizing this new collagen (64K collagen) in the developing chicken embryo. The 64K collagen is synthesized in very large amounts by cells concentrated at the diaphysis of 9-day-old and at the epiphysis of 17-day-old embryo tibiae. These regions are characterized by a remodeling of the cartilage matrix leading to the replacement of the cartilage with bone tissue; therefore, this collagen appears to be a marker of a specific developmental stage of chondrocytes. The origin of cells competent for the synthesis of the 64K collagen is also discussed.

Animals↗

Hypoplastic tibiae with postaxial polysyndactyly: a new dominant syndrome?

A five year old boy is reported with hypoplastic, bowed tibiae and postaxial polysyndactyly. Sixteen relatives of both sexes in four generations either have bilateral syndactyly or postaxial polydactyly or both. The nature of the condition and the possible mode of inheritance are discussed.

Child, Preschool↗

Four sibs with dislocated elbows, bowed tibiae, scoliosis, deafness, cataract, microcephaly, and mental retardation: a new MCA/MR syndrome.

We report four sibs with an MCA/MR syndrome whose parents were first cousins. The sibs had mental retardation, microcephaly, hearing problems, cataract, and multiple osseous malformations, such as dislocated elbows, bowed tibiae, and scoliosis. Review of published reports and the use of the London Dysmorphology Database suggest that this family presents a new syndrome.

Abnormalities, Multiple↗

Disturbance in the growth of the tibia and femur in dogs.

The clinical and radiographic features associated with premature cessation of the growth of the tibia (four) and femur (eight) in 12 dogs are described. Surgical correction of the resultant deformity was possible in only a few cases. Trauma was thought to be the cause of the local growth plate disorder.

Animals↗

Deformity of the proximal tibia in dogs.

A condition has been recognised in five young dogs in which the proximal tibia exhibited cranial bowing. This altered conformation, sometimes accompanied by bow legs (genu varum), occurs bilaterally, but to differing degrees. The deformity apparently altered the biomechanics of the stifle joint so that degenerative joint disease and rupture of the cranial cruciate ligament followed in four of the five dogs. The aetiology is unknown, but the most likely cause appears to be retardation of growth in the caudal aspect of the proximal tibial physis. Treatment involving surgical techniques to correct the joint instability was only moderately successful.

Animals↗

Fractures of the lateral margin of the distal tibia. The Tillaux fracture.

Fractures of the lateral margin of the distal tibia are usually avulsion fractures of the anterior or posterior tibial tubercle, caused when the anterior or posterior inferior tibiofibular ligament fails to tear during an injury. Since they are generally the result of external rotation and abduction, they are almost always seen in association with other fractures and ligamentous injuries at the ankle joint. While their presence usually does not change the therapeutic approach, occasionally a large fragment may require a separate fixation screw. Fractures of the posterior tibial tubercle should not be confused with fractures of the posterior articular margin (posterior malleolus), which have a worse prognosis.

Adolescent↗

Anterior translocation of the tibia at MR imaging: a secondary sign of anterior cruciate ligament tear.

The authors evaluated measurement of the degree of anterior subluxation ("translocation") of the tibia in regard to the femur as a predictor of anterior cruciate ligament (ACL) tear. Eighty-nine magnetic resonance (MR) imaging studies of patients with either an arthroscopically confirmed intact (n = 29), acutely torn (n = 27), or chronically torn (n = 33) ACL were retrospectively reviewed. The degree of translocation was measured on hard-copy images by using two methods. Buckling of the posterior cruciate ligament (PCL) was also evaluated. Anterior tibial translocation, when measured at the midsagittal plane of the lateral femoral condyle with regard to a plane parallel to the cephalocaudal axis of the image, was a relatively specific indicator of ACL disruption. Subluxation of 5 mm or more had 58% sensitivity, 93% specificity, and 69% accuracy for an ACL tear. All knees with subluxation of 7 mm or more had torn ACLs. Buckling of the PCL was less sensitive and less accurate than anterior translocation as an indicator of ACL disruption.

Anterior Cruciate Ligament↗