Thesis (M.S.)--Michigan State University, 2005. / Includes bibliographical references (leaves 57-69). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M.Sc.)--Memorial University of Newfoundland, 2004. / Bibliography: leaves 89-95.

Thesis (M.S.)--Michigan State University, 2005. / Includes bibliographical references (leaves 57-69)

Thesis (Ph. D.)--Oregon State University, 2005. / Includes bibliographical references (leaves 92-96).

Osteoarthritis is a chronic degenerative joint disease that affects the whole joint, including the articulating surfaces and capsular tissues in and around the joint (Hügle and Geurts 2016). Osteoarthritis currently impacts 27 million Americans (Racine 2015). Two prominent features in osteoarthritis that are correlated with greater pain and reduced function are MRI-identified bone marrow lesions and CT-identified subchondral bone cysts (Kumar et al. 2013). At this time, the relationship between bone marrow lesions and subchondral bone cysts has not been confirmed. Nor has the nature of the tissues associated with these clinical signs been fully characterized, pointing to the need for further research to identify the composition of subchondral bone cysts as these cysts could be a potential target for therapeutic intervention. This study focused on characterizing the tissue content of subchondral bone cysts in osteoarthritic femoral heads. Osteoarthritic femoral heads were collected from male and female patients, ranging in age from 43-72 years old, who underwent total hip replacement. After surgery, the femoral heads were fixed in 4% paraformaldehyde and scanned via micro-computed tomography (MicroCT). The MicroCT images were used to identify regions in each head containing large subchondral bone cysts, the primary compressive bone, and anterior cartilage. These regions were mapped to the actual femoral head and guided the dissection of the femoral head. Samples from each of the regions were decalcified, embedded in paraffin, and cut into 5-micron-thick histological sections which were then mounted onto slides. Each section was stained in Safranin-O/Fast green and hematoxylin and eosin to visualize the tissues present. Immunohistochemistry with anti-CD31 was carried out on selected slides to identify blood vessels. The samples within all three regions of the femoral head were graded histologically for the presence of subchondral bone cysts, whether cartilage was within the cyst region, if the histological section matched its corresponding MicroCT image, if the articular cartilage was fibrillated, the presence of sclerotic bone, the presence of osteophytes, and the presence of blood vessels. It was clear that many of these samples were in later stages of osteoarthritis considering most samples exhibited all of the above characteristics, contained fibrous tissue, and had little normal fatty marrow. Typically, subchondral bone cysts presented beneath fibrillated and degenerated articular cartilage, contained fibrous tissue that was much more intensely vascularized and innervated as compared to normal fatty marrow, and was surrounded by sclerotic trabecular bone. In some cases, osteophytes also formed at the articular surface beneath areas of degenerated cartilage. Some subchondral bone cysts contained cartilage and even smooth muscle cells in addition to fibrous connective tissue. The varied location of the subchondral bone cysts shows the need for further research as to how their etiologies develop. The content of the subchondral bone cysts suggests that areas with disrupted trabeculae become intensely vascularized to allow the influx of inflammatory materials and mesenchymal stem cells to lay down fibrous tissue and thicken the surrounding trabeculae to stabilize the weakened microstructure of the femoral head. By gaining a comprehensive understanding of the pathology of osteoarthritis and of subchondral bone cysts in particular, the progression of the disease can be more firmly established and potential new treatments can be developed.

Made available in DSpace on 2014-06-11T19:31:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-07-14Bitstream added on 2014-06-13T20:01:42Z : No. of bitstreams: 1 dias_lggg_dr_jabo.pdf: 2151686 bytes, checksum: 192fc332d876bb868c167e3bd4402379 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / As fraturas de tíbia em cães representam 20% das que ocorrem em ossos longos. Vários métodos são utilizados nas osteossínteses desse osso, contudo, atualmente as hastes bloqueadas vêm ganhando espaço, especialmente por suas vantagens biomecânicas quando comparadas às demais técnicas. O presente trabalho teve por objetivo desenvolver e avaliar o uso de haste intramedular bloqueada angulada para fraturas tibiais em cães, visando minimizar erros de bloqueio de parafusos e consequentemente problemas na consolidação óssea. Hastes anguladas, de aço inoxidável da série 316L, foram confeccionadas nos diâmetros de 5, 6, 7 e 8 mm, com comprimentos variados. Num período de 17 meses, ocorreu a implantação destas em 15 cães com fratura de tíbia. As avaliações clínica e radiográfica ocorreram no pré e pós-operatório imediato e a cada 30 dias até completar quatro meses. Clinicamente, a recuperação da função do membro se deu no período médio de 10 dias após a cirurgia. Em três animais, utilizou-se além da haste angulada e parafusos, pinos de Schanz como bloqueio (fixador externo), que posteriormente foram retirados. Radiograficamente verificou-se consolidação óssea em média de 70 dias de pós-operatório. A haste intramedular bloqueada angulada mostrou-se eficaz como método de osteossíntese em fraturas tibiais de cães. / In dogs, tibial fractures account for approximately 20% of all long bone fractures. Different methods of fracture repair are used in this bone; however, interlocking nails have gained popularity in recent years owing to its biomechanical advantages when compared to other techniques. The present study aimed to develop and to evaluate the usefulness of an angulated interlocking nail model in tibial fractures of dogs to minimize blocking errors arising from inaccurate bolt stabilization, responsible for generation osseous consolidation. Angulated stainless steel pins from series 316L were manufactured with 5, 6, 7 and 8 mm of diameter, and variable length. During 17 months, pins were implanted in 15 dogs with tibial fracture. Clinical and radiographic findings were recorded on preoperative and on the immediate postoperative period, and every 30 days, until the last recheck, 4 months latter. Clinically, animals recovered the hind function on an average of 10 days after surgery. In three dogs, in addition to the angulated interlocking nail and bolts, scat pins (external fixator) were used. Radiographically, bone consolidation was evident on an average of 70 days of postoperative period. The angulated interlocking nail is a feasible method to repair tibial fractures of dogs.

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No. of bitstreams: 1 sembenelli_g_me_jabo.pdf: 2565740 bytes, checksum: d9b68e8304088478cada8ab56efa1c00 (MD5) Previous issue date: 2017-05-30 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O objetivo do presente estudo foi desenvolver placa de TPLO bloqueada modificada e avaliar a eficácia da estabilização óssea proporcionada pelo implante desenvolvido comparativamente a outros dois métodos convencionais de fixação óssea (placa bloqueada e placa bloqueada associada a pino intramedular). Por meio de estudos biomecânicos, avaliaram-se as construções às forças de torção, flexão craniocaudal, flexão mediolateral e compressão axial. Foram utilizadas sessenta tíbias sintéticas dividas em três grupos. O Grupo 1 (placa TPLO modificada), o Grupo 2 (placa bloqueada) e o Grupo 3 (placa bloqueada associada a pino intramedular) foram qsubdivididos em quatro grupos de cinco tíbias. Os ensaios foram realizados até a falha da montagem (implantes e/ou tíbia) e os resultados obtidos comparados entre os grupos. As variáveis estudadas foram analisadas sob delineamento inteiramente casualizado no esquema fatorial 3 por 4 com 5 repetições para cada combinação do esquema fatorial. Os resultados foram submetidos à análise de variância e as médias comparadas entre si pelo teste de Tukey a 5% de probabilidade. No ensaio de compressão axial houve diferença significativa em relação a variável força máxima em que o Grupo 3 obteve maior média, não havendo diferença significativa entre os Grupos 1 e 2. Todas as montagens falharam devido à flexão da placa na região de falha no corpo de prova. No ensaio de flexão em três pontos craniocaudal houve diferença significativa em relação às três variáveis estudas. Na variável força máxima G2>G3=G1, na variável deflexão G3>G1=G2 e na variável rigidez G3=G2, G2=G1 G3>G1. Todas as montagens falharam devido à quebra do corpo de prova. No ensaio de flexão mediolateral houve diferença significativa em relação a variável rigidez em que G3>G2=G1. Todas as montagens falharam devido à flexão da placa na região de falha no corpo de prova. No ensaio de torção houve diferença significativa em relação às variáveis ângulo no pico de torque e rigidez. Na variável ângulo no pico de torque G2>G1=G3. Na variável rigidez G1=G3>G2. Todas as montagens falharam devido à quebra do corpo de prova distal a placa. Conclui-se a placa de TPLO modificada apresentou semelhança biomecânica com a placa reta convencional na maioria das variáveis estudadas. O grupo, da associação placa e pino, obtive maiores índices de rigidez comparativamente aos outros dois grupos, exceto no teste de torção em que o grupo da placa de TPLO modificada apresentou o mesmo índice de rigidez que o da associação placa e pino. / The aim of this study was to develop modified TPLO locked plate and to evaluate the effectiveness of stabilization provided by the implant developed compared to two other conventional methods of stabilization (locked plate and plate-rod). Through biomechanical studies the constructions were evaluated to craniocaudal and mediolateral bending, axial compression and torsional forces. Sixty synthetic tibias were used divided into three groups. Group 1 (modified TPLO plate), Group 2 (locked plate) and Group 3 (plate-rod) were subdivided into four groups of five tibiae. The tests were perfomed until failure of the construction (implants / tibia) and the results compared between the groups. The variables studied were analyzed under a completely randomized design in the factorial scheme 3 by 4 with 5 replicates for each combination of the factorial scheme. The results were submitted to analysis of variance and the means compared to each other by the Tukey test at 5% probability. In the axial compression test there was a significant difference in relation to the variable maximum force in which Group 3 obtained higher mean, not having significant difference between Groups 1 and 2. All constructions failed due to plate bending in the gap region of the synthetic tibia. In the three-point craniocaudal flexion test there was a significant difference in relation to the three variables studied. In the variable force maximum G2> G3 = G1, in the variable deflection G3> G1 = G2 and in the variable stiffness G3 = G2, G2 = G1 G3> G1. All constructions failed because of the breaking of the synthetic tibia. In the three-point craniocaudal flexion test there was a significant difference in relation to the three variables studied. In the variable force maximum G2> G3 = G1, in the variable deflection G3> G1 = G2 and in the variable stiffness G3 = G2, G2 = G1 G3> G1. All constructions failed because of the breaking of the synthetic tibia. In the mediolateral flexion test there was a significant difference in relation to the stiffness variable in which G3> G2 = G1. All constructions failed due to plate bending in the gap region of the synthetic tibia. In the torsion test there was a significant difference in relation to the variables angle at peak torque and stiffness. In the variable angle at the torque peak G2> G1 = G3. In the stiffness variable G1 = G3> G2. All constructs failed due to the breaking of the synthetic tibia distally to the plate. It is concluded that the modified TPLO plate presented biomechanical similarity with the conventional plate in most of the studied variables. The groups of locking plate an plate-rod constructions obtained higher stiffness indices compared to the other two groups, except for the torsion test in which the modified TPLO plate group had the same stiffness index as the plate and plate-rod. / FAPESP: 2015/14602-8

D.Ing. / This thesis studies the application of newer generation engineering materials, specifically carbon fibre reinforced polymers, as bone plates in cases of fractured bones. The application of bone plates subsequent to bone fracture is a very old orthopaedic technique that has always rendered some problems. The rigidity of the bone plate, and thus the plated system as a whole, is of advantage during the healing phase, but of disadvantage later. Bone remodels itself to most efficiently perform the load bearing required of it. In a plated system, the load is born primarily by the plate and therefore protects the underlying bone, leading to osteoporosis and eventual atrophy. All bone plates are made of a material that is totally foreign to the body, and in most cases these are removed after some healing of the bone had occurred. The majority of current research programmes with respect to bone plates are directed towards biodegradable bone plates that reduces in mechanical strength at approximately the same rate as bone gains in its ability to sustain loads. The principle of stimulating bone growth in cases of delayed union and non-union has been studied since the early 1960's. The studies revealed that bone healing can in fact be enhanced by the introduction of a very small electric current to the fracture site. Variations to the mechanisms and position of application of the current, alternating or direct, are well documented. Although the physiological healing process associated with electrical stimulus remains largely unknown, the principle is well established. The phenomenon of galvanic corrosion has been known since the tum of the century. Where two dissimilar materials are in the presence of a conducting media, the more "reactive" of the two materials will react as an anode or electron donor to the other material. An electric current thus will flow from the one material to the other. Having three existing and known phenomena, namely bone plating, bone healing stimulation and galvanic corrosion raises the question of whether these can be combined to yield a solution superior to any current plating mechanism - a plate that would render sufficient mechanical support but act as an electron source and thus as a bone healing stimulus. The purpose of this study is to assess the biological criteria determining the choice of bone plates (inclusive of mechanical, physiological and electrical criteria) and thereafter selecting a material suitable for this dynamic requirement.

Orientador: Bruno Watanabe Minto / Resumo: Os traumas ósseos desencadeiam resposta inflamatória aguda e consequentemente alteram a concentração sérica das proteínas de fase aguda (PFAs), podendo essas serem um parâmetro para avaliação da evolução do processo inflamatório relacionado a ortopedia. Objetivou-se avaliar a efetividade da mensuração de PFAs como um biomarcador laboratorial para diagnóstico e acompanhamento da inflamação relacionada a regeneração óssea. Foram utilizados 22 coelhos, machos jovens sendo realizado ostectomia parcial do osso do rádio direito. Para acompanhamento da evolução do processo inflamatório foram realizados hemograma, mensuração de PFAs (Albumina, Ceruloplasmina, Haptoglobina, Proteína C Reativa e Transferrina) e acompanhamento radiológico. Foi observado a melhor correlação da haptoglobina e da transferrina junto ao processo inflamatório e achados radiológicos frente as demais PFAs mensuradas. A haptoglobina apresentou pico máximo 24 horas dos pós operatório e a transferrina após 36 horas, entretanto essa última PFA já mostrou indícios de alteração (diminuiu) já nas primeiras 6 horas do pós-cirúrgico, antecipadamente a resposta leucocitária. Conclui-se que o conjunto haptoglobina, transferrina e leucograma apresentaram resultados promissores ao diagnóstico e prognóstico de processos inflamatórios relacionados a ortopedia. / Doutor

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Medicine Johannesburg, 2019 / Hand infection is the most common condition seen at Chris Hani Baragwanath Academic Hospital Orthopaedic casualty. In 2017, 31% of orthopaedic admissions at our institution were patients with hand sepsis. Failure to adequately treat these infections results in severe loss of hand function and disability, and this leads to a significant socioeconomic impact in our population. The infected patients are usually started on empiric antibiotics (amoxicillinclavunate (Augmentin)) on admission, and prior to surgical drainage. The purpose of this study was to identify the microbiology profile of hand infections and their antibiotic sensitivity at our institution. The laboratory results of antimicrobial sensitivity were compared with the antibiotics started empirically. The impact of associated co-morbidities on the microbiology profile was also assessed. The results showed that Staphylococcus aureus (S. aureus) is the most common cultured organism. Most organisms were sensitive to cloxacillin. The culture results in HIV infected patients did not differ to those in the uninfected population. Acquired Methicillin-Resistant S. Aureus remains low in our population setting. / E.K. 2019