Musculoskeletal Tissue Regeneration (eBook)

About the Editor 6
Foreword 10
Preface 12
Contents 14
Contributors 18
Color Plates 22
Section I 24
Musculoskeletal and Wound Treatment Through the Ages: A Brief Historical Tour 25
1.1. Introduction 25
1.2. History of Wound Repair and Musculoskeletal Treatment 26
1.3. Discussion 37
1.4. Conclusions 38
References 38
Musculoskeletal Fundamentals: Form, Function, and a Survey of Healing Strategies 41
2.1. Introduction 41
2.2. Musculoskeletal Tissues Basics and Their Natural Healing Processes 42
2.3. The Application of Stem Cells in Regeneration of Musculoskeletal Tissues 46
2.4. The Application of Gene Therapy in the Regeneration of Musculoskeletal Tissues 49
2.5. The Application of Tissue Engineering in the Regeneration of Musculoskeletal Tissues 51
2.6. Conclusion 55
References 55
Overview of Fracture Repair 61
3.1. Fracture Wound Healing 61
3.2. Angiogenesis 64
References 78
Section II 85
Autograft Bone 87
4.1. Introduction 87
4.2. Cortical Autograft 89
4.3. Cancellous Autograft 92
4.4. Cells and other Autogenous Products 96
4.5. Future Trends and Needs 97
4.6. Conclusion 97
References 98
Biology of Bone Allograft and Clinical Application 103
5.1. Introduction 104
5.2. Basic Science 104
5.3. Clinical Applications 106
5.4. Future Trends and Needs 109
5.5. Conclusion 111
References 111
Demineralized Bone Matrix: Maximizing New Bone Formation for Successful Bone Implantation 115
6.1. Introduction 116
6.2. Remodeling in Demineralized Bone 116
6.3. Methods for Measuring Osteoinductivity in Demineralized Bone 117
6.4. Extent of Demineralization and Particle Size Affect Osteoinductivity Assessments 121
6.5. Methods for Demineralizing Bone 122
6.6. Demineralized Bone Matrix Carrier Products 132
6.7. Optimizing Osteoinductivity and Safety of DBM 133
6.8. Future Trends and Needs 136
6.9. Conclusion 137
References 137
Deproteinized Bovine Bone Xenograft 141
7.1. Introduction 141
7.2. Basic Science 143
7.3. Pre-clinical Studies and Clinical Studies 145
7.4. Future Trends – DBB as a Carrier for Growth Factors 160
7.5. Conclusions 161
References 161
Bioactive Bioceramics 175
8.1. Introduction 175
8.2. Basic Science 178
8.3. Review of Pre-clinical Studies 191
8.4. Clinical Review: Applications of Bioactive Bioceramics 192
8.5. Future Trends 194
8.6. Conclusion 195
References 197
Distraction Osteogenesis of the Orthopedic Skeleton: Basic Principles and Clinical Applications 205
9.2. Biologic Basis of New Bone Formation 208
9.3. Basic Principles of Osteodistraction 213
9.4. Conclusions 217
9.5. Future Trends and Needs 217
References 217
Distraction Osteogenesis of the Facial Skeleton 221
10.1. Introduction 222
10.2. Fundamentals of Bone Healing 222
10.3. Fundamentals of Distraction Osteogenesis 224
10.4. Distraction Osteogenesis in the Facial Skeleton 228
10.5. Distraction Osteogenesis in the Lower Facial Skeleton - Mandible 228
10.6. Distraction Osteogenesis in the Middle Facial Skeleton – Maxilla and Zygoma 237
10.7. Distraction Osteogenesis in the Upper Facial Skeleton – Frontal Bones and Upper Orbit 242
10.8. Conclusions 243
References 243
Bone Morphogenetic Proteins and Other Bone Growth Factors 247
11.1. Introduction 248
11.2. Basic Science 249
11.3. Review of Preclinical Studies 251
11.4. Clinical Review 254
11.5. Future Trends and Needs 257
11.6. Conclusions 261
References 262
Biological Approaches to Spinal Fusion 269
12.1. Introduction 269
12.2. The Biology of Spinal Fusion 270
12.3. Allograft and Synthetic Osteoconductive Materials 272
12.4. Demineralized Bone Matrices 273
12.5. Bone Morphogenetic Proteins and Osteoinductive Growth Factors 274
12.6. Autologous Bone Marrow and Stem Cells 276
12.7. Future Trends and Needs 276
12.8. Conclusion 277
References 277
Electrical Bone Stimulation 281
13.1. Introduction 281
13.2. Basic Science – Mechanism of Action 282
13.3. Clinical Science 293
13.4. Future Trends and Needs 297
13.5. Conclusion 297
References 297
Section III 311
Meniscus Repair Techniques 313
14.1. Introduction 313
14.2. Basic Science 314
14.3. Operative Evaluation 318
14.4. Methods of Meniscal Repair 319
14.5. Clinical Review 325
14.6. Clinical Results of Specific Repair Techniques 326
14.7. Repair Aftercare - Rehabilitation 327
14.8. Current Advances and Future Possibilities 327
14.9. Conclusions 328
References 329
Lessons Learned From Our First 100 Meniscus Allograft Transplants in Arthritic Knees 335
15.1. Introduction 335
15.2. The Meniscus: A Clinical Review 336
15.3. The Meniscus Allograft 336
15.4. What is the Work-up? 339
15.5. Surgical Technique 340
15.6. Postoperative Rehabilitation 342
15.7. Summary of Published Results 344
15.8. Future Trends and Needs 344
15.9. Conclusions 346
References 346
Tissue Engineering of the Meniscus 349
16.1. Introduction 350
16.6. Future Trends and Needs 361
16.7. Conclusion 362
References 363
Osteochondral Grafts 369
17.1. Introduction 369
17.2. Concepts and Basic Science 373
17.3. Review of Preclinical Studies 377
17.4. Clinical Review 378
17.5. Future Trends and Needs 386
17.6. Conclusions 387
References 387
Autologous Chondrocyte Cartilage Repair 391
18.1. Introduction 392
18.2. Basic Science of Cartilage 392
18.4. Autologous Chondrocyte Transplantation 397
18.5. Future Trends and Needs 407
18.6. Conclusion 410
References 411
Autograft and Allograft ACL Reconstruction: Construct Rationale 417
19.1. Introduction 417
19.2. Basic Science 418
19.3. Future Trends 433
19.4. Conclusions 435
References 436
Tissue Engineered Anterior Cruciate Ligament Graft 441
20.1. Introduction 442
20.2. Anterior Cruciate Ligament - Form, Function and Properties 443
20.3. Ligament Tissue Engineerng Principles 448
20.4. Bioactive Factors – Growth Factors, Gene Therapy 454
20.5. Assessment of ACL Graft Performance in the Animal Model 455
20.6. Future Directions 455
20.7. Conclusions 457
References 457
Biologic Scaffold Materials for Orthopaedic Soft Tissue Reconstruction 465
21.1. Introduction 465
21.2. Basic Science 466
21.3. Preclinical and Clinical Studies 472
21.4. Future Trends and Needs 474
21.5. Conclusions 474
References 475
Muscle Repair after Injury and Disease 481
22.1. Introduction 481
22.2. Cellular Processes for Muscle Repair 482
22.3. Factors Affecting Muscle Healing 490
22.4. Conclusions 492
References 493
Section IV 503
Principles of Musculoskeletal Tissue Banking 505
23.1. Introduction 505
23.2. Selection and Assessment of Donors 507
23.3. Excision of Allografts 510
23.4. Processing of Musculoskeletal Allografts 513
23.5. Cryopreserved Osteochondral Allografts 517
23.6. Fresh Articular Cartilage Allografts 518
23.7. Freeze-Drying 519
23.8. Bone Allografts for Clinical Transplantation 520
23.9. Secondary Sterilization 520
23.10. Biology of Bone Allografts 521
23.11. Discussion and Conclusions 526
References 527
Bioabsorbable Polymer Applications in Musculoskeletal Fixation and Healing 531
24.1. Introduction 531
24.2. Basic Science 532
24.3. Review of Preclinical Studies 541
24.4. Clinical Review 542
24.5. Future Trends and Needs 545
24.6. Conclusions 546
References 546
Tissue Adhesives: Science, Products and Clinical Use 553
25.1. Introduction 554
25.2. Methods of Action and Products 555
25.3. Clinical Use 561
25.4. Trends and Future Needs 566
25.5. Conclusion 567
References 567
Platelet-Rich Plasma in Orthopedics 569
26.1. Introduction 570
26.2. Basic Science 570
26.3. Review of Preclinical Studies 577
26.4. Clinical Review 581
26.5. Future Trends and Needs 585
26.6. Conclusions 586
Reference 586
Gene Therapy Approaches for Musculoskeletal Tissue Regeneration 591
27.1. Introduction 591
27.2. Limitations of Current Methods for Bone and Cartilage Regeneration 592
27.3. Basic Science 594
27.4. Review of Preclinical Studies 599
27.5. Clinical Review 605
27.6. Future Trends and Needs 605
27.7. Conclusions 606
References 607
Paradigms of Tissue Engineering with Applications to Cartilage Regeneration 615
28.1. Introduction 615
28.2. Background 616
28.3. Tissue Engineering Paradigms 620
28.4. Future Trends and Needs 631
28.5. Conclusions 631
References 632
Section V 639
The Future of Musculoskeletal Tissue Regeneration: A Clinical Perspective 641
29.1. Introduction – Hurdles from the Bench to Bedside 641
29.2. The Keys to Musculoskeletal Regeneration: Cells, Signals and Matrices 642
29.3. Characterizing the Future Musculoskeletal Patient 649
References 652
Index 657