Thesis (Ph. D.)--University of Missouri-Columbia, 1997. / Typescript. Vita. Includes bibliographical references (leaves 82-86). Also available on the Internet.

Thesis (Ph. D.)--University of Hong Kong, 2010. / Includes bibliographical references (leaves 201-220). Also available in print.

Thesis (Ph. D.)--Drexel University, 2005. / Includes abstract and vita. Includes bibliographical references (leaves 317-318).

Thesis (Ph. D.)--University of Alabama at Birmingham, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--University of Alabama at Birmingham, 1997. / Includes bibliographical references.

published_or_final_version / Orthopaedics and Traumatology / Doctoral / Doctor of Philosophy

Thesis (Ph. D.)--University of Hong Kong, 2006. / Title proper from title frame. Also available in printed format.

Thesis (Ph. D.)--West Virginia University, 2002. / Title from document title page. Document formatted into pages; contains xi, 95 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 85-92).

Anterior cruciate ligament (ACL) rupture is a major clinical problem in sports medicine. The current mainstay of treatment is arthroscopic-assisted ACL reconstruction with a soft tissue tendon graft. However, the affected patients are required to abstain from any pivoting activity for at least six to nine months after the operation to protect the graft-host bone interface in order to allow the graft to heal. In this study, a method to accelerate the graft healing within the bone tunnel is proposed by using a local application of an osteoconductive bone cement (Strontium enriched calcium phosphate cement, Sr-CPC) at the graft-host bone interface. It is postulated that Sr-CPC can induce earlier new bone formation in the gap between the graft and host bone tunnel and hence can result in an accelerated healing of the graft within the bone tunnel in ACL reconstruction. Preparation of Sr-CPCs using the conventional setting method (a dissolution/precipitation process) leads to a delay in setting. This study adopted a new setting reaction, a chelate reaction, to manufacture a Sr-CPC system. The Sr-CPC system was fast-setting, injectable and cohesive, and it was suitable for use in minimally invasive orthopaedics surgeries (e.g. arthroscopic-assisted ACL reconstruction). In order to investigate the biocompatibility and osteoconductivity of the Sr-CPC, in vitro cell experiments and an in vivo animal study were carried out. The in vitro experiments showed that the Sr-CPC was biocompatible with no local toxicity. In addition, a higher proliferation rate of osteoblastic-like MG-63 cells, accompanying higher alkaline phosphatase activity, was found in the Sr-CPC group. The in vivo study using a rat femur metaphyseal bone defect model showed evidence of earlier endochondral ossification which was noted at 2 weeks post operation. Moreover, a higher peri-cement bone formation rate, accompanied by a higher cement resorption rate, was found in the Sr-CPC group at 32 weeks after the operation compared with the convention calcium phosphate cement group. To study the effect of the Sr-CPC on the graft healing within the bone tunnel, a one-stage bilateral ACL reconstruction using an Achilles tendon allograft was performed in 30 rabbits. One study (15 rabbits) was to investigate the effect of the Sr-CPC on the healing of a soft tissue tendon graft within the bone tunnel, and the other study (15 rabbits) was to study the difference between the Sr-CPC and the conventional CPC in the healing of a soft tissue tendon graft within the bone tunnel. The Sr-CPC treated graft showed an accelerated healing at all of the time points when compared with the non-treated graft; and at time points of 3 to 12 weeks when compared with the CPC treated graft. In conclusion, a strontium enriched calcium phosphate cement, which is suitable for the arthroscopic use, was manufactured. It is biocompatible, osteoconductive and degradable. It accelerates the graft healing within the bone tunnels in a rabbit ACL reconstruction model using an Achilles tendon allograft when compared with both of the non-treated group and the conventional CPC-treated group. / published_or_final_version / Orthopaedics and Traumatology / Doctoral / Doctor of Philosophy

Thesis (doctoral)--Rijksuniversiteit te Utrecht.