The Pavlik Harness in the Treatment of Congenital Dislocating Hip: Report on a Multicenter Study of the European Paediatric Orthopaedic Society

The results of functional treatment using the Pavlik harness in congenital dislocation and congenital dysplasia of the hip in children aged less than 11 months were examined by an EPOS study group. This study was conducted on 3,611 hips in 2,636 patients for a period of 1-9 years after treatment. The reduction rate was 92% in grade Tonnis 2 and 3; the healing rate was 80%. In children with dysplastic hips, the healing rate was 95.35%. Avascular necrosis of the femoral head was observed in 2.38%. The Pavlik harness is designed for outpatient treatment if the parents are complian

A novel approach for the production of human recombinant BMP-2 for bone tissue engineering applications

Bone tissue engineering has been an increasing field of research during the last years. The ideal approach for a regenerative application would consist in the use of cells from the patient, scaffolding materials and differentiation growth factors. Bone morphogenetic protein-2 (BMP-2) is one such growth factors with a strong ability to induce new bone and cartilage formation and has been used as a powerful osteoinductive component of several late-stage tissue engineering products for bone grafting. In this work, we aimed at obtaining high yields of human recombinant BMP-2 in a stable, pure and biologically active form by use of a new bacteria expression system that circumvents the disadvantages of conventional recombinant protein preparation methods and to perform a study of the stability conditions and the functionality of these peptides in vitro in human mesenchymal stem cells and C2C12 murine cell line.info:eu-repo/semantics/publishedVersio

A novel system for producing human recombinant BMP-2 and study of the growth factor stabilizing conditions

Bone tissue engineering has been an increasing field of research during the last years. The ideal approach for a regenerative application would consist in the use of cells from the patient, scaffolding materials and differentiation growth factors. Bone morphogenetic protein-2 (BMP-2) is one such growth factors with a strong ability to induce new bone and cartilage formation and has been used as a powerful osteoinductive component of several late-stage tissue engineering products for bone grafting. In this work, we aimed at obtaining high yields of human recombinant BMP-2 in a stable, pure and biologically active form by use of a new bacteria expression system that circumvents the disadvantages of conventional recombinant protein preparation methods and to perform a study of the stability conditions and the functionality of these peptides in vitro in human mesenchymal stem cells and C2C12 murine cell line.Portuguese Foundation for Science and Technology (PhD Grant to PC Bessa, SFRH/BD/17049/2004). This work was also partially supported by the European STREP HIPPOCRATES (NMP3-CT-2003-505758) and carried out under the scope of European NoE EXPERTISSUES (NMP3-CT-2004- 500283).info:eu-repo/semantics/publishedVersio

Expression, purification and in vitro biological activity from human recombinant BMP-2 produced by a novel approach

Bone tissue engineering has been an increasing field of research during the last years. The ideal approach for a regenerative application would consist in the use of cells from the patient, scaffolding materials and differentiation growth factors. Bone morphogenetic protein-2 (BMP-2) is one such growth factors with a strong ability to induce new bone and cartilage formation and has been used as a powerful osteoinductive component of several late-stage tissue engineering products for bone grafting. In this work, we aimed at obtaining high yields of human recombinant BMP-2 in a stable, pure and biologically active form by use of a new bacteria expression system that circumvents the disadvantages of conventional recombinant protein preparation methods and to perform a study of the stability conditions and functionality of these peptides in vitro in human mesenchymal stem cells and C2C12 murine cell line.Portuguese Foundation for Science and Technology, FCT (PhD Grant to PC Bessa, to PC Bessa, SFRH/BD/17049/2004 SFRH/BD/17049/2004 ). This work was ). This work was also partially supported by the European STREP HIPPOCRATES (NMP3 also partially supported by the European STREP HIPPOCRATES (NMP3--CTCT--2003 2003--505758) and carried out under the scope of 505758) and carried out under the scope of European NoE EXPERTISSUES (NMP3 European NoE EXPERTISSUES (NMP3--CTCT- -2004 2004 --500283). 500283info:eu-repo/semantics/publishedVersio

Focal osteoporosis defects play a key role in hip fracture

$\textbf{BACKGROUND}$: Hip fractures are mainly caused by accidental falls and trips, which magnify forces in well-defined areas of the proximal femur. Unfortunately, the same areas are at risk of rapid bone loss with ageing, since they are relatively stress-shielded during walking and sitting. Focal osteoporosis in those areas may contribute to fracture, and targeted 3D measurements might enhance hip fracture prediction. In the FEMCO case-control clinical study, Cortical Bone Mapping (CBM) was applied to clinical computed tomography (CT) scans to define 3D cortical and trabecular bone defects in patients with acute hip fracture compared to controls. Direct measurements of trabecular bone volume were then made in biopsies of target regions removed at operation. $\textbf{METHODS}$: The sample consisted of CT scans from 313 female and 40 male volunteers (158 with proximal femoral fracture, 145 age-matched controls and 50 fallers without hip fracture). Detailed Cortical Bone Maps (c.5580 measurement points on the unfractured hip) were created before registering each hip to an average femur shape to facilitate statistical parametric mapping (SPM). Areas where cortical and trabecular bone differed from controls were visualised in 3D for location, magnitude and statistical significance. Measures from the novel regions created by the SPM process were then tested for their ability to classify fracture versus control by comparison with traditional CT measures of areal Bone Mineral Density (aBMD). In women we used the surgical classification of fracture location ('femoral neck' or 'trochanteric') to discover whether focal osteoporosis was specific to fracture type. To explore whether the focal areas were osteoporotic by histological criteria, we used micro CT to measure trabecular bone parameters in targeted biopsies taken from the femoral heads of 14 cases. $\textbf{RESULTS}$: Hip fracture patients had distinct patterns of focal osteoporosis that determined fracture type, and CBM measures classified fracture type better than aBMD parameters. CBM measures however improved only minimally on aBMD for predicting any hip fracture and depended on the inclusion of trabecular bone measures alongside cortical regions. Focal osteoporosis was confirmed on biopsy as reduced sub-cortical trabecular bone volume. $\textbf{CONCLUSION}$: Using 3D imaging methods and targeted bone biopsy, we discovered focal osteoporosis affecting trabecular and cortical bone of the proximal femur, among men and women with hip fracture.Arthritis Research UK (grant no. ARC17822) and Cambridge National Institute for Health Research (NIHR) Biomedical Research Centre

Isokinetic strength of the trunk flexor muscles after surgical repair for incisional hernia

Purpose The repair of incisional hernias can be accomplished by open or laparoscopic techniques. The Biodex® dynamometer measures muscle strength during isokinetic movement. The objectives of this study are to compare the strength of the trunk Xexors between patients who underwent repair for incisional hernia and a control group, and to compare trunk Xexion after two kinds of operative techniques for incisional hernias with and without approximation of the rectus abdominis muscles. Methods The trunk Xexion of 30 patients after different operative techniques for midline incisional hernias and of 12 healthy subjects was studied with the Biodex® isokinetic dynamometer. Results The mean torque/weight (N m/kg) for trunk Xexion was significantly higher in the control group compared to the patient group after incisional hernia repair. A significantly higher peak torque/weight [coefficient 24.45, 95% confidence interval (CI) -0.05; 48.94, P = 0.05] was found in the two-layered suture technique without mesh compared to the laparoscopic technique after adjusting for gender. Conclusions The isokinetic strength of the trunk Xexor muscles is reduced after an operation for incisional hernia. There is some evidence that a two-layered suture repair with approximation of the rectus abdominis muscles results in higher isokinetic strength of the trunk Xexor muscles compared to the laparoscopic technique

The Pavlik Harness in the Treatment of Congenital Dislocating Hip: Report on a Multicenter Study of the European Paediatric Orthopaedic Society

The results of functional treatment using the Pavlik harness in congenital dislocation and congenital dysplasia of the hip in children aged less than 11 months were examined by an EPOS study group. This study was conducted on 3,611 hips in 2,636 patients for a period of 1-9 years after treatment. The reduction rate was 92% in grade Tonnis 2 and 3; the healing rate was 80%. In children with dysplastic hips, the healing rate was 95.35%. Avascular necrosis of the femoral head was observed in 2.38%. The Pavlik harness is designed for outpatient treatment if the parents are complian