SEARCH · PubMed Health

Results for “Tibia”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,441 records · Page 80Linked to original sources

PubMed1992

Histology of a lengthened human tibia.

We describe the histology of a specimen taken from an amputated leg seven months after a 15 cm bone gap in the tibia had been closed by bone transport. Lengthening appeared to have occurred by repeated minor trauma to the bone, with the fractured trabeculae in sufficiently close contact for the repair process to proceed. Osteogenesis did not occur through a cartilage phase, but the fracture gaps were bridged by collagen fibres, around which new bone formed. Microfractures had repaired by primary healing with woven bone and with no microcallus. Small regions of bone were necrotic. Resorption of the necrotic bone and remodelling of the immature bundle and woven bone were still at an early stage, suggesting that complete remodelling in man may take years rather than months.

Accidents, Traffic↗

PubMed1992

Infection after intramedullary nailing of the tibia. Incidence and protocol for management.

There is concern about the incidence and serious nature of infection after intramedullary nailing of the tibia, especially for open injuries. We have reviewed 459 patients with tibial fractures treated by primary reamed nailing. The incidence of infection was 1.8% in closed and Gustilo type I open fractures, 3.8% in type II, and 9.5% in type III fractures (5.5% in type IIIa, 12.5% in type IIIb). These incidences appear to be acceptable in comparison with other published results. We describe the different modes of presentation of infection in these cases, and suggest a protocol for its management, which has been generally successful in our series.

Age Factors↗

PubMed1999

Subperiosteal ganglion cyst of the tibia. A communication with the knee demonstrated by delayed arthrography.

We report a patient with a subperiosteal ganglion cyst of the tibia which was imaged by radiography, arthrography, CT and MRI. The images were correlated with the arthroscopic surgical and histological findings. Spiculated formation of periosteal new bone on plain radiographs led to the initial suspicion of a malignant tumour. Demonstration of the cystic nature of the tumour using cross-sectional imaging was important for the precise diagnosis. Communication between the ganglion cyst and the knee was shown by a delayed arthrographic technique, and the presence of this communication was confirmed at arthroscopy and surgically.

Arthrography↗

PubMed2002

Friction burns within the tibia during reaming. Are they affected by the use of a tourniquet?

We have carried out a prospective, randomised trial to measure the rise of temperature during reaming of the tibia before intramedullary nailing. We studied 34 patients with a mean age of 35.1 years (18 to 63) and mean injury severity score of 10 (9 to 13). The patients were randomised into two groups: group 1 included 18 patients whose procedure was undertaken without a tourniquet and group 2, 16 patients in whom a tourniquet was used. The temperature in the bone was measured directly by two thermocouples inserted into the cortical bone near the isthmus of the tibial diaphysis. Reaming was carried out to at least 1.5 mm above the required diameter of the nail. Blood loss was assessed by recording the preoperative and postoperative haemoglobin (Hb) level. The minimum clinical follow-up was six months. In group 1 (no tourniquet), the mean Hb dropped 2.8 g/dl from 14.3 +/- 1.02 g/dl to 11.5 +/- 1.04 g/dl (p = 0.0001), whereas with the tourniquet, the mean decrease was 1.3 g/dl from 14 +/- 1 g/dl to 12.7 +/- 1.3 g/dl (p = 0.007). This difference was not statistically significant. The mean initial tibial temperature was 35.6 degrees C (SD 0.6) and rose with reaming to levels between 36.3 degrees C and 51.6 degrees C. The highest temperatures were obtained with the largest reamers (11 and 12 mm, p = 0.0001) and the most rapid rise with the smallest diameters of medullary canal (8 or 9 mm). The rise of temperature was transient (20 s). We were unable to identify any effect of the use of a tourniquet on the temperature achieved. Reamed intramedullary tibial nailing induces a transient elevation of temperature which is directly related to the amount of reaming.

Adolescent↗

PubMed2005

Mechanical testing of impaction bone grafting in the tibia: initial stability and design of the stem.

Clinical experience of impaction bone grafting for revision knee arthroplasty is limited, with initial stability of the tibial tray emerging as a major concern. The length of the stem and its diameter have been altered to improve stability. Our aim was to investigate the effect of the type of stem, support of the rim and graft impaction on early stability of the tray. We developed a system for impaction grafting of trays which we used with morsellised bone in artificial tibiae. Trays with short, long thick or long thin stems were implanted, with or without support of the rim. They were cyclically loaded while measuring relative movement. Long-stemmed trays migrated 4.5 times less than short-stemmed trays, regardless of diameter. Those with support migrated 2.8 times less than those without. The migration of short-stemmed trays correlated inversely with the density of the impacted groups. That of impaction-grafted tibial trays was in the range reported for uncemented primary trays. Movements of short-stemmed trays without cortical support were largest and sensitive to the degree of compaction of the graft. If support of the rim was sufficient or a long stem was used, impacted morsellised bone graft achieved adequate initial stability.

Arthroplasty, Replacement, Knee↗

PubMed2006

Osteofibrous dysplasia of the tibia. Is there a need for a radical surgical approach?

Osteofibrous dysplasia is an unusual developmental condition of childhood, which almost exclusively affects the tibia. It is thought to follow a slowly progressive course and to stabilise after skeletal maturity. The possible link with adamantinoma is controversial and some authors believe that they are part of one histological process. We retrospectively reviewed 16 patients who were diagnosed as having osteofibrous dysplasia initially or on the final histological examination. Their management was diverse, depending on the severity of symptoms and the extent of the lesion. Definitive (extraperiosteal) surgery was localised "shark-bite" excision for small lesions in five patients. Extensive lesions were treated by segmental excision and fibular autograft in six patients, external fixation and bone transport in four and proximal tibial replacement in one. One patient who had a fibular autograft required further excision and bone transport for recurrence. Six initially underwent curettage and all had recurrence. There were no recurrences after localised extraperiosteal excision or bone transport. There were three confirmed cases of adamantinoma. The relevant literature is reviewed. We recommend extraperiosteal excision in all cases of osteofibrous dysplasia, with segmental excision and reconstruction in more extensive lesions.

Adamantinoma↗

PubMed1997

Regional responsiveness of the tibia to intermittent administration of parathyroid hormone as affected by skeletal unloading.

To determine whether the acute inhibition of bone formation and deficit in bone mineral induced by skeletal unloading can be prevented, we studied the effects of intermittent parathyroid hormone (PTH) administration (8 micrograms/100 g/day) on growing rats submitted to 8 days of skeletal unloading. Loss of weight bearing decreased periosteal bone formation by 34 and 51% at the tibiofibular junction and tibial midshaft, respectively, and reduced the normal gain in tibial mass by 35%. Treatment with PTH of normally loaded and unloaded animals increased mRNA for osteocalcin (+58 and +148%, respectively), cancellous bone volume in the proximal tibia (+41 and +42%, respectively), and bone formation at the tibiofibular junction (+27 and +27%, respectively). Formation was also stimulated at the midshaft in unloaded (+47%, p < 0.05), but not loaded animals (-3%, NS). Although cancellous bone volume was preserved in PTH-treated, unloaded animals, PTH did not restore periosteal bone formation to normal nor prevent the deficit in overall tibial mass induced by unloading. We conclude that the effects of PTH on bone formation are region specific and load dependent. PTH can prevent the decrease in cancellous bone volume and reduce the decrement in cortical bone formation induced by loss of weight bearing.

Animals↗

PubMed1999

Temporal and spatial characterization of regenerate bone in the lengthened rabbit tibia.

A rabbit model of bilateral tibial lengthening was used to investigate temporal and spatial changes in new bone volume and architecture during regenerate bone formation. Tibiae were lengthened 9.0 mm at 0.75 mm/day after a 6-day latency period. Animals were euthanized at four time points, and new bone volume and architecture within the distraction gap were assessed by microcomputed tomography and histomorphometry. New bone formation began before day 18 postsurgery and increased markedly between day 18 (completion of distraction) and day 24. This period of high bone formation activity might therefore be optimal for biologic and mechanical interventions aimed at enhancing bone regeneration. Regions of both endochondral and intramembranous bone formation were observed throughout the consolidation period. Significant increases in bone volume fraction were observed early in the consolidation period and were attributed to significant increases in trabecular thickness. This suggested that increased mineral density in the gap tissue with time was a consequence of increased osteoblast activity and associated trabecular thickening. New bone formation was shown to be highly oriented toward the distraction axis throughout lengthening. More bone formed consistently in lateral and proximal regions of the distraction gap, perhaps due to improved blood supply or progenitor cell availability in these areas. No differences in trabecular architecture were detected between regions having more or less bone volume, suggesting that bony tissue differentiation in all regions of the distraction gap was similar. Homotypical variations in measures of bone architecture were small; thus, these outcome variables seem appropriate for determining the effects of biological and mechanical interventions on bone regeneration in this animal model.

Animals↗

PubMed2000

The mechanical properties of cancellous bone in the proximal tibia of ovariectomized rats.

The "mature rat model" is an effective and often-used surrogate for studying mechanisms and characteristics of estrogen-deficient osteopenia. The purpose of this study was to extend our understanding of this animal model to include the mechanical properties of cancellous bone in the proximal tibia. Female Sprague-Dawley rats were divided into two groups (n=13 each) at 14 weeks of age: an ovariectomized group (OVX) and a sham-operated control group (sham). The study terminated after a duration of 5 weeks. Specimens 2 mm long were cut from the proximal tibial metaphysis just below the growth plate and tested using two methods: (1) "whole-slice" compression, in which the entire specimen is loaded between two larger flat platens and (2) "reduced-platen" compression (RPC), which uses platens sized and aligned to load only the cancellous bone in the center of the sample. Three-point bending tests also were conducted on the femur. The short duration of estrogen deficiency yielded only minimal differences (< 10%) in femoral cortical bone but dramatic reductions (approximately 60%) in cancellous bone properties as determined by the RPC method. Ultimate stress was 7.23 MPa +/- 1.97 MPa for OVX versus 18.1 MPa +/- 5.21 MPa for sham; and elastic modulus was 252 MPa +/- 104 MPa for OVX versus 603 MPa +/- 180 MPa for sham. These changes in mechanical properties are similar in many respects to the dramatic effects reported in histomorphometric studies. For the whole-slice method, differences in mechanical properties between the two groups were not as large because the test directly loads both cancellous and cortical bone, and the latter is not affected as severely by estrogen deficiency. In this case, ultimate stress and elastic modulus were only 30% (or less) lower for the OVX group.

Animals↗

PubMed2005

Distal tibia areal bone mineral density: use in detecting low aBMD of the hip in young women.

Dual-energy X-ray absorptiometry (DXA) is a primary clinical tool for identification of adults with low areal bone mineral density (aBMD) and who are at increased risk for future osteoporosis and fragility fractures. Procedures for several aBMD scans of clinical interest might be limited by artifact, inaccessible anatomical regions, and positioning errors. Sites for scanning that overcome these limitations need further investigation for application to large-scale screening and relevance to clinical decisions regarding diagnosis and treatment. In this study, 146 women (mean +/- SE age = 20.1 +/- 0.1 yr, height = 163.3 +/- 0.2 cm, weight = 60.0 +/- 0.2 kg) underwent DXA of the total body (TB) and right and left total proximal femurs (TPF), total forearms (TF), and distal tibiae (DT). Osteopenia was identified in 24 women. Areal BMD was positively related among all measurement sites (r = 0.55-0.81, all p < 0.001). Total body, TF, and DT aBMD each displayed low sensitivity (0.29-0.33) and high specificity (0.95-0.98) to detect osteopenia of the TPF. Addition of TB fat-free mass slightly enhanced the predictive value of DT aBMD. Overall, DT aBMD can discriminate between osteopenic and normal subjects with comparable accuracy to TB or TF aBMD.

Absorptiometry, Photon↗

PubMedDate not supplied

Electromagnetic modulation of biological processes: bicarbonate effect and mechanistic considerations in the Ca-uptake by embryonal chick tibia in vitro.

Electromagnetically induced currents pulsating at very low frequency stimulated calcium uptake by chick embryo tibia rudiments only when bicarbonate was present in the culture medium. A bicarbonate-dependent Ca2+-ATPase might be implicated in coupling of the electromagnetic signal with processes that promote Ca-transport and storage in bone tissue.

Animals↗

PubMed2004

Effect of enamel matrix derivative (Emdogain) on bone defects in rabbit tibias.

The aim of this study was to assess the effect of an enamel matrix derivative (Emdogain, Biora, AB, Malmö, Sweden) on bone healing. Ten New Zealand rabbits, weighing about 2.5 kg, were used. One 8-mm bone defect was created in each tibia. The defect on the right leg was filled with Emdogain, whereas the defect on the opposite leg was left unfilled as control. A total of 20 defects were created. Five rabbits each were killed at 4 and 8 weeks with an overdose of Tanax. Block sections containing the defects were retrieved and the specimens processed for light microscopy examination. The slides were stained with acid and basic fuchsin and toluidine blue. Histologically, no differences were noted in both groups at each observation period; in the test group, remnants of the implanted Emdogain were not present at 4 weeks. Newly formed bone was detectable in both groups at all observation times. At 8 weeks, both groups showed mature bone, and in the test group the material implanted was not visible. No inflammatory cells were visible in both groups. In conclusion, our results indicate that Emdogain implanted in bone defects is fully resorbed after 4 to 8 weeks and does not adversely affect bone formation.

Animals↗

PubMed2000

Bone regeneration using Bioglass: an experimental study in rabbit tibia.

Bioglass (BG) has been shown recently to be osteoconductive and osteopromotive in different experimental and clinical conditions. The aim of the present study was to evaluate BG particles in bone defects in rabbit tibia. In control sites, bone was observed only in the peripheral areas of the defects, while in test sites, newly formed bone was found around all BG particles, even those located in the central portion of the defect. Osteoblasts were actively secreting osteoid matrix directly on the granules' surface. BG seems to be a highly osteoconductive material.

Animals↗

PubMedDate not supplied

New bone formation in the female rabbit tibia.

The current study aims to evaluate the new bone formation in polyvinylpyrrolidone (PVP) grafts inserted into the tibia of ten female rabbits. The animals were submitted to oophorectomy in order to induce an osteopenic condition and densitometrically analyzed at the beginning of the experiment, at three months and at seven months. During the 16 weeks of osseointegration, the animals were submitted to subcutaneous injections of three bone markers at one-week intervals, four weeks for each. Before the third densitometric analysis, the animals were sacrificed and material was collected for histological evaluation, in which osteoid formations and mineralized bone tissue were observed surrounding the grafts, even within the medullary cavity. Only small quantities of new bone were found in the osteopenic animals, indicating the high osteocondutivity of PVP and its efficacy in inducing osteopenia. Among the samples with no graft, a high level of disorganization of the material was observed in the oophorectomized group, confirming the efficacy of oophorectomy.

Animals↗

PubMed1982

Scanning electron microscopic observations of rat tibia using the HCl-collagenase method.

The metaphysis of rat tibia was examined by scanning electron microscopy (SEM) using the HCl-collagenase method (EVAN et al., 1976) and the three-dimensional structure of osteocytes and the relationship between osteocytes and osteoblasts were demonstrated. After the HCl-collagenase treatment, the bone matrix near the exposed surface was completely removed but the cellular components retained their structural integrity. Young osteocytes located close to osteoblasts showed flattened, spindly shapes. They were connected with adjacent osteoblasts by short, wide and slightly branched processes. On the other hand, the osteocytes located in the deeper portion of trabecular bone were smaller in size, being round or oval and flattened in shape. They were connected with both osteoblasts and neighboring osteocytes by long and more extensively branched processes forming a complicated network. From these results, it is suggested that osteoblasts extend their processes perpendicularly to the bone surface, with these processes branching off and connecting to each other at the osteoid layer.

Animals↗

PubMed1994

Immunohistochemical localization of vacuolar H(+)-ATPase in osteoclasts of rat tibiae.

The localization of vacuolar H(+)-atpASE (V-ATPase) in osteoclasts of rat tibiae was examined immunohistochemically using antibodies to 57 kD and 72 kD subunits of V-ATPase, with confocal laser scanning microscopy and transmission electron microscopy. The two antibodies showed similar immunoreactivities in osteoclasts. We distinguished three patterns of immunoreactivity in osteoclasts: The first pattern was that immunoreactivity was diffusely detected in cytoplasm of osteoclasts; The second one was that osteoclasts showed intense immunoreactivity in their regions contacting with bone surface; and the last was that little immunoreactivity was seen in osteoclasts. Post-embedding methods with protein A-gold complex revealed that the subunits of V-ATPase were localized not only on the membranes of the ruffled borders of osteoclasts, but also around the Golgi apparatus and accumulated tubular lysosomes. These findings suggest that: 1) immunoreactive patterns for V-ATPase in osteoclasts reflect the polarity and activity of osteoclasts; and 2) V-ATPase on ruffled borders may be transported through tubular lysosomes.

Animals↗

PubMed1997

The effects of diabetes on the interface between hydroxyapatite implants and bone in rat tibia.

We examined the influence of diabetes on the implant-bone interface of hydroxyapatite (HA) implants inserted transcortically and extending into the medullary canal of rat tibiae, and quantitatively assessed the differences in bone reaction using an image processing system. Forty male Wistar King A rats (aged 5 weeks) were used in this experiment; they were sacrificed 84 days after implant placement. Toluidine blue-stained undecalcified sections were prepared for histological observation and image analysis, and the labeled sections were observed by confocal laser scanning microscopy. The HA implants in the bone marrow area in the control group were completely encapsulated with a bone layer, and there were some osteoblast-like cells in the bone lacunae apposing the implant surface. The HA implants in the diabetes-induced (DI) group were partially surrounded with a thin bone layer, and there were some fibroblasts running parallel to the implant surface at areas of no bone contact. Quantitative evaluation indicated that the control group showed significantly higher bone contact rate, bone contact thickness, and bone contact area than the DI group. The DI group showed approximately 30% reduction in the percentage of bone contact and 50% reduction in the thickness and the area of surrounding bone tissue.

Animals↗

PubMed1998

Uncontrolled diabetes hinders bone formation around titanium implants in rat tibiae. A light and fluorescence microscopy, and image processing study.

This study examined the influence of diabetes mellitus on bone formation around cylindrical titanium (Ti) implants (1.0 mm in diameter and 1.5 mm in length) inserted transcortically and extending into the medullary canal of rat tibiae using light and fluorescence microscopies and image processing. Forty-eight male Wistar King A rats (age 5 weeks) were used in this experiment. Streptozotocin was injected intraperitoneally to induce diabetes and the serum glucose concentration was checked to ensure the induction of diabetes prior to implant placement and at the time of sacrifice. The animals were sacrificed 7, 28, 56, or 84 days after placement. Toluidine blue-stained undecalcified sections were prepared for histological observation and image analysis. The Ti implants in the control group became increasingly encapsulated with a bone layer. The implants in the diabetes-induced (DI) group were also surrounded with a thin bone layer. Abundant adipocytes were observed in the DI group as compared with the control group. Quantitative evaluation indicated that the control group showed a significantly higher percent of bone contact, and thickness of surrounding bone and area than the DI group. Consequently, the present study suggests that uncontrolled diabetes would hinder bone formation around Ti implants in rats.

Adipocytes↗