Biology of Bone Graft and the Use of Bovine Bone for Revision of Total Hip Arthroplasty with Acetabular Reconstruction

The use of bone graft in orthopaedic surgeries has become essential in many situations in which there is a bone defect. This includes bone tumour procedures, fracture operations where there was a loss of bone tissue and revision arthroplasty surgeries. In this chapter, we will introduce aspects related to history of bone transplantation, the biological and mechanical aspects, as well sterilization, transmission of infectious diseases and biological safety, and concluding, the functioning of tissue banks and screening of musculoskeletal tissue donors

Influence of donor microbiota and of graft storage on corneal transplantation

Introdução: O transplante de córneas é o principal tratamento para pessoas que apresentam distúrbios de curvatura ou transparência da córnea. No Brasil, não há protocolo unifcado para meios de preservação, tempo de armazenamento e antibióticos utilizados. A preocupação é a de que patógenos possam ser transferidos aos receptores de transplantes. Objetivo: Realizar o levantamento da microbiota ocular de doadores de córneas a fm de verifcar uma possível correlação com infecções em receptores e, dessa forma, auxiliar na melhoria de metodologias e protocolos de armazenamento de córneas. Método: Foi conduzido a partir de revisão da literatura, nas bases de dados PubMed, SciELO e nos portais: periódicos da CAPES, Anvisa, Ministério da Saúde e ABTO, entre 2018 e 2020. Resultados: Estudos baseados em cultivo de microrganismos trazem Staphylococcus coagulase negativa (SCN) de 30% a 100% das amostras isoladas de conjuntivas. Em menor quantidade estão Streptococcus, Corynebacterium e Propionibacterium. Bactérias Gramnegativas aparecem em número inferior, representadas pelos gêneros Haemophilus, Neisseria, Pseudomonas, Enterobacter, Escherichia, Proteus e Acinetobacter. Já as técnicas independentes de cultivo trazem Pseudomonas como a principal colonizadora da conjuntiva. Também apresentam uma diversidade maior de colonizadores, mostrando um potencial campo de estudos, no qual a superfície ocular pode ter uma diversidade muito maior de espécies e potenciais agentes patogênicos. Os principais meios de preservação utilizados no Brasil levam os antimicrobianos gentamicina e estreptomicina em sua composição, porém estudos têm mostrado que as bactérias presentes nos meios de preservação são resistentes a esses antibióticos. Conclusões: Os dados apontam para a necessidade de reavaliação da efciência desses meios de preservação na descontaminação das córneas para transplante.Introduction: Corneal transplantation it is the main treatment for people who have corneal curvature or transparency disorders. In Brazil, there is no unified protocol on the means of preservation, storage time and antibiotics used. The concern is that pathogens are transferred to transplant recipients, causing eye infections after transplantation. Objective: Examine ocular microbiota of corneal donors, to verify a possible correlation with infections in recipients and thus assist in improving corneal storage methodologies and protocols. Method: Literature review conducted in PubMed, SciELO and the following websites: CAPES Journals, Anvisa, Brazilian Ministry of Health and ABTO, between 2018 and 2020. Results: Studies based on microorganism’s cultivation show coagulase negative Staphylococcus in 30% to 100% of samples isolated from conjunctiva. In lesser quantities are Streptococcus, Corynebacterium and Propionibacterium. Gram-negative bacteria appear in much lower numbers, represented by the genera Haemophilus, Neisseria, Pseudomonas, Enterobacter, Escherichia, Proteus and Acinetobacter. On the other hand, results based on independent cultivation techniques bring Pseudomonas as the main colonizer of the conjunctiva. Also, they have a much greater diversity of colonizers, showing a potential field of study. The ocular surface may have a much greater diversity of species and potential pathogens than was expected. The main means of preservation used in Brazil contain the antimicrobials gentamicin and streptomycin in their composition; however, several studies have shown that bacteria present in the means of preservation are resistant to these antibiotics. Conclusions: These data point to the need for a reassessment of the efficiency of these means of preservation in decontaminating corneas for transplantation

Hip Arthroplasty

Hip replacement is one of the most performed surgical procedures in orthopedic hip surgery. Through this surgery, the patient returns to most of his normal life and a life without pain. The primary indication for a hip arthroplasty remains osteoarthritis (OA). OA is a degenerative disease that affects synovial joints. A successful surgery is always preceded by good planning. The planning in turn takes into account the analysis of the patient and his physical examination and the radiological image. But also, the surgical planning must take into account another important factor, the choice of the surgical approach. In this chapter, the authors script a revision on the history of hip arthroplasty, total hip arthroplasty approaches, implant types, complications associated with hip arthroplasty, outcomes, and perspectives to the future. We wish you a good reading