• Title/Summary/Keyword: PCL augmentation

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Sinus augmentation with poly(ε) caprolactone-β tricalcium phosphate scaffolds, mesenchymal stem cells and platelet rich plasma for one-stage dental implantation in minipigs

  • Jeong-Hun Nam;Akram Abdo Almansoori;Oh-Jun Kwon;Young-Kwon Seo;Bongju Kim;Young-Kyun Kim;Jong-Ho Lee;KangMi Pang
    • Journal of Periodontal and Implant Science
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    • v.53 no.3
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    • pp.218-232
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    • 2023
  • Purpose: This study evaluated the efficacy of a tube-shaped poly(ε) caprolactone - β tricalcium phosphate (PCL-TCP) scaffold with the incorporation of human umbilical cord-derived mesenchymal stem cells (hUCMSCs) and platelet-rich plasma (PRP) for bone regeneration in the procedure of single-stage sinus augmentation and dental implantation in minipigs. Methods: Implants were placed in the bilateral sides of the maxillary sinuses of 5 minipigs and allocated to a PCL-TCP+hUCMSCs+PRP group (n=5), a PCL-TCP+PRP group (n=5), and a PCL-TCP-only group (n=6). After 12 weeks, bone regeneration was evaluated with soft X-rays, micro-computed tomography, fluorescence microscopy, and histomorphometric analysis. Results: Four implants failed (2 each in the PCL-TCP+hUCMSCs+PRP and PCLTCP+hUCMSC groups). An analysis of the grayscale levels and bone-implant contact ratio showed significantly higher mean values in the PCL-TCP+hUCMSCs+PRP than in the PCL-TCP group (P=0.045 and P=0.016, respectively). In fluoromicroscopic images, new bone formation around the outer surfaces of the scaffolds was observed in the PCLTCP+hUCMSCs+PRP group, suggesting a tenting effect of the specially designed scaffolds. Bone regeneration at the scaffold-implant interfaces was observed in all 3 groups. Conclusions: Using a tube-shaped, honeycombed PCL-TCP scaffold with hUCMSCs and PRP may serve to enhance bone formation and dental implants' osseointegration in the procedure of simultaneous sinus lifting and dental implantation.

Arthroscopic Repair of Acute Posterior Cruciate Ligament Rupture with Autogenous Hamstring Tendon Graft Augmentation - Technical Note (급성 후방 십자 인대 파열의 관절경하 봉합술 및 자가 슬괵 이식건 보강술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Sung, Kee-Lyong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.70-76
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    • 2005
  • Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

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Treatment of Ruptured Posterior Cruciate Ligament using Augmentation of the Synthetic Polyester Prosthetic Ligament (Synthetic Polyester Prosthetic Ligament 보강술을 이용한 후방 십자 인대 손상의 치료)

  • Sohn, Sung-Won;Jeon, Si-Hyun;Park, Jin-Uck
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.121-125
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    • 2002
  • Purpose : The purpose of this study was to assess the clinical outcomes and radiological changes of arthroscopic augmentation with synthetic polyester ligament for posterior cruciate ligament injury Materials and Methods : The assessment was made among 60 patients who underwent arthroscopic augmentation with synthetic polyester ligament (ABC ligament, Surgicraft, U.K.) into the substance of ruptured PCL proper under the arthroscopic control from January, 1990 to January, 1996 and whose follow-up period was more than 5 years (average 7.8 years). The results were analyzed by using the posterior stress radiographs by Telos stress device, KT-2000 arthrometer and the clinical assessment by using Lysholm knee score. Results : The average difference of posterior displacement on stress radiographs were 13.2 mm preperatively and 3.6 mm at last follow up. Both knee showed minimal difference on KT-2000 arthrometer (0.7 mm on 20 lb) at the last follow-up. The mean Lysholm knee score was 49.2 preoperatively and improved to 84.3 post-operatively. Conclusion : Authors observed that long-term results of arthroscopic augmentation with synthetic polyester ligament for PCL injury were similar with those using human allograft. Taking these results into consideration, the synthetic polyester ligament is assumed to be a method of treatment of the PCL injury.

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Posterior Cruciate Ligament Augmentation Using an Autogenous Hamstring Tendon Graft and the Posterior-Posterior Triangulation Technique (만성 단독 후방십자인대 파열에서 자가 슬괵건과 후-후 삼각술기를 이용한 만성 후방십자인대 보강술)

  • Kim, Yeung Jin;Chae, Soo Uk;Choi, Byong San;Kim, Jong Yun;Lee, Hwang Yong;Han, Chang Wan;Han, Su Hyoun
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.24-30
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    • 2013
  • Purpose: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique with preservation of ligament remnant or elongated ligament. Materials and Methods: From January 2002 to December 2009, we performed PCL augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique in 32 patients. The mean age was 35.2 years. Twenty two cases were male and 10 cases were female. Average follow-up period was 5 years and 5 months (range: 2-7.9). Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, International Knee Documentation Cominittee (IKDC) grade, and second look arthroscopic examination. Results: At last follow up posterior displacement by the Telos stress test decreased from $10.8{\pm}5.1\;mm$ to $2.8{\pm}3.7\;mm$ (p<0.05). The final Lysholm knee score improved from $60.4{\pm}5.8$ to $84.6{\pm}4.8$. Tegner activity score improved from 3.2 to 4.8. The final IKDC grade was A in 18, B in 11, C in 3. Postoperative Lysholm knee score, IKDC grades, Tegner activity scale, and posterior displacement demonstrated statistically significant improvement compared to the preoperative state (p<0.05). Conclusion: Arthroscopic PCL reconstruction using an autogenous hamstring tendon with preservation of ligament remnant showed a good clinical results and posterior stability.

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Comparative Biomechanical Study of Stiffness on Ligamentous Attached Sites of Distal Femur - Experimental Laboratory Study on Cadaver Femora - (원위 대퇴골 인대 부착부의 강도 비교 - 사체의 대퇴골에 행한 실험적 연구 -)

  • Kwak, Ji-Hoon;Sim, Jae-Ang;Yang, Sang-Hoon;Kim, Dong-Hee;Lee, Beom-Koo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.26-32
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    • 2009
  • Purpose: This study was performed to compare the strength of ligamentous attached sites of cadaveric distal femur and to obtain reliable biomechanical data to use in ligamentous reconstruction or augmentation. Materials and Methods: Fifteen cadaveric distal femurs were used for this study. After measuring the bone density, 5.0 mm cannulated screw (Experiment 1) or reconstructed porcine ligament (Experiment 2) was inserted into the each ligamentous attached sites of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). In experiment 2, reconstructed porcine graft was fixed with bioabsorbable screw in ligamentous insertion sites. And we measured the maximal pullout force of each ligamentous attached sites of cadaveric distal femur. Results: Average bone mineral density was $1.205{\pm}0.137\;g/cm^2$ in experiment 1, $1.236{\pm}0.089\;g/cm^2$ in experiment 2, which showed no statistically significant differences. In experiment 1, average pull-out strength of ACL, PCL, MCL and LCL group were $519.1{\pm}111.7$ N, $638.9{\pm}144.4$ N, $169.7{\pm}56.0$ N, $225.6{\pm}61.5$ N respectively. In experiment 2, the average pull-out strength were $310.6{\pm}31.0$ N, $379.9{\pm}47.4$ N, $104.0{\pm}14.4$ N, $131.5{\pm}21.9$ N respectively. In experiment 1, there was no significant difference between ACL and PCL group and between MCL and LCL group. However, the maximal pullout strength of MCL and LCL group were significantly lower than that of ACL and PCL group (p<0.01). Experiment 2 showed the same results of experiment 1. Conclusion: Because stiffness of MCL and LCL attached sites are much lower than that of ACL and PCL attached sites, we may consider augmented fixation in ligamentous reconstructions of MCL and LCL.

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