Congenital tibial deficiencies: Treatment using the Ilizarov's external fixator

SummaryIntroductionCongenital longitudinal deficiency of the tibia is a rare and often syndromic anomaly. Amputation is usually the preferred treatment option in complete absence of the tibia; however, a conservative management might be implemented in partial forms or in case of amputation refusal. Our experience with the Ilizarov fixator, convinced us this device was the best suited for progressive correction of lower limbs length discrepancies and articular or bone angular limb deformities (ALD). The aim of this study is to highlight the interest of the Ilizarov fixator in the multistage conservative treatment of congenital tibial deficiencies.Material and methodsA retrospective study was conducted in nine patients suffering from Type I or II congenital tibial deficiencies (Jones) and sequentially managed using the Ilizarov technique. The functional outcome after treatment completion was then clinically assessed.ResultsThe different stages of correction were recorded for each individual patient. Patients were assessed at a mean follow-up of 18,3 years (4–32 years). The mean maximum knee flexion was 35° (0°–90°) in type I deficiencies and 118° (90°–140°) in type II deficiencies. One patient underwent amputation and a bilateral knee arthrodesis was performed in another case.DiscussionFew series in the literature report a comparable length of follow-up period in the conservative management of severe congenital tibial deficiencies. In our study, the Ilizarov fixator provided satisfactory progressive corrections of severe congenital tibial deficiencies.Level of EvidenceLevel IV therapeutic retrospective study

Secondary structure of rhBMP-2 in a protective biopolymeric carrier material

Efficient delivery of growth factors is one of the great challenges of tissue engineering. Polyelectrolyte multilayer films (PEM) made of biopolymers have recently emerged as an interesting carrier for delivering recombinant human bone morphogenetic protein 2 (rhBMP-2 noted here BMP-2) to cells in a matrix-bound manner. We recently showed that PEM made of poly(l-lysine) and hyaluronan (PLL/HA) can retain high and tunable quantities of BMP-2 and can deliver it to cells to induce their differentiation in osteoblasts. Here, we investigate quantitatively by Fourier transform infrared spectroscopy (FTIR) the secondary structure of BMP-2 in solution as well as trapped in a biopolymeric thin film. We reveal that the major structural elements of BMP-2 in solution are intramolecular β-sheets and unordered structures as well as α-helices. Furthermore, we studied the secondary structure of rhBMP-2 trapped in hydrated films and in dry films since drying is an important step for future applications of these bioactive films onto orthopedic biomaterials. We demonstrate that the structural elements were preserved when BMP-2 was trapped in the biopolymeric film in hydrated conditions and, to a lesser extent, in dry state. Importantly, its bioactivity was maintained after drying of the film. Our results appear highly promising for future applications of these films as coatings of biomedical materials, to deliver bioactive proteins while preserving their bioactivity upon storage in dry state.This work was supported by the French Ministry of Research through an ANR-EmergenceBIO grant (ANR-09-EBIO-012-01), by the European Commission (FP7 program) via a European Research Council starting grant (BIOMIM, GA 259370), and by GRAVIT (081012_FIBIOS). C.P. is grafetul to IUF for financial support

A spontaneous ad hoc network to share www access

In this paper, we propose a secure spontaneous ad-hoc network, based on direct peer-to-peer interaction, to grant a quick, easy, and secure access to the users to surf the Web. The paper shows the description of our proposal, the procedure of the nodes involved in the system, the security algorithms implemented, and the designed messages. We have taken into account the security and its performance. Although some people have defined and described the main features of spontaneous ad-hoc networks, nobody has published any design and simulation until today. Spontaneous networking will enable a more natural form of wireless computing when people physically meet in the real world. We also validate the success of our proposal through several simulations and comparisons with a regular architecture, taking into account the optimization of the resources of the devices. Finally, we compare our proposal with other caching techniques published in the related literature. The proposal has been developed with the main objective of improving the communication and integration between different study centers of low-resource communities. That is, it lets communicate spontaneous networks, which are working collaboratively and which have been created on different physical places.Authors want to give thanks to the anonymous reviewers for their valuable suggestions, useful comments, and proofreading of this paper. This work was partially supported by the Ministerio de Educacion y Ciencia, Spain, under Grant no. TIN2008-06441-C02-01, and by the "Ayudas complementarias para proyectos de I+D para grupos de calidad de la Generalitat Valenciana" (ACOMP/2010/005).Lacuesta Gilaberte, R.; Lloret, J.; García Pineda, M.; Peñalver Herrero, ML. (2010). A spontaneous ad hoc network to share www access. 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Proceedings of the International Conference on Emerging Security Information, Systems and Technologies (SECURWARE '07), October 2007, Valencia, SpainFoulks EF: Social network therapies and society: an overview. Contemporary Family Therapy 1985, 3(4):316-320.Wang Y, Wu H: DFT-MSN: the delay/fault-tolerant mobile sensor network for pervasive information gathering. Proceedings of the 25th IEEE International Conference on Computer Communications (INFOCOM '06), April 2006Kindberg T, Zhang K: Validating and securing spontaneous associations between wireless devices. In Proceedings of the 6th Information Security Conference (ISC '03), 2003. Springer; 44-53.Al-Jaroodi J: Routing security in open/dynamic mobile ad hoc networks. The International Arab Journal of Information Technology 2007, 4(1):17-25.Stajano F, Anderson RJ: The resurrecting duckling: security issues for ad-hoc wireless networks. 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Ex vivo estimation of cementless acetabular cup stability using an impact hammer

International audienc

The influence of Bone Morphogenic Protein-2 on the consolidation phase in a distraction osteogenesis model.

We asked whether locally applied recombinant-Bone Morphogenic Protein-2 (rh-BMP-2) with an absorbable Type I collagen sponge (ACS) carrier could enhance the consolidation phase in a callotasis model. We performed unilateral transverse osteotomy of the tibia in 21 immature male rabbits. After a latency period of 7 days, a 3-weeks distraction was begun at a rate of 0.5mm/12h. At the end of the distraction period (Day 28) animals were randomly divided into three groups and underwent a second surgical procedure: 6 rabbits in Group I (Control group; the callus was exposed and nothing was added), 6 rabbits in Group II (ACS group; receiving the absorbable collagen sponge soaked with saline) and 9 rabbits in Group III (rh-BMP-2/ACS group; receiving the ACS soaked with 100μg/kg of rh-BMP-2, Inductos(®), Medtronic). Starting at Day 28 we assessed quantitative and qualitative radiographic parameters as well as densitometric parameters every two weeks (Days 28, 42, 56, 70 and 84). Animals were sacrificed after 8 weeks of consolidation (Day 84). Qualitative radiographic evaluation revealed hypertrophic calluses in the Group III animals. The rh-BMP-2/ACS also influenced the development of the cortex of the calluses as shown by the modified radiographic patterns in Group III when compared to Groups I and II. Densitometric analysis revealed the bone mineral content (BMC) was significantly higher in the rh-BMP-2/ACS treated animals (Group III)

The performance of BMP-2 loaded TCP/HAP porous ceramics with a polyelectrolyte multilayer film coating

International audienceDelivering rhBMP-2 (recombinant Bone Morphogenic Protein-2) at low but therapeutically efficient dose is one of the current challenges for bone tissue repair. In this context, Polyelectrolyte Multilayer films (PEM) represent an attractive rhBMP-2 carrier due to their ability to protect proteins from denaturation and to coat a wide variety of materials with complex geometry. Herein, we coated macroporous TCP/HAP granules with a biopolymeric PEM film to deliver rhBMP-2 in a "matrix-bound" manner. In vitro release kinetics indicated that the PEM-coated granules sequestered significant amounts of rhBMP-2. The degree of film cross-linking influenced the quantity of rhBMP-2 trapped within the films. Bare (uncoated) TCP/HAP scaffolds were also able to retain rhBMP-2. Bioactivity of rhBMP-2 in the PEM-coated granules was confirmed on two cell markers: luciferase expression on BMP-responsive-element/Luc C2C12 cells and alkaline phosphatase activity induction on C2C12 cells. Promisingly, rhBMP-2 adsorbed onto PEM-coated and on bare granules in a lesser extent, could be stored and remained bioactive over at least 3 weeks. In vivo, both uncoated and PEM-coated TCP/HAP granules loaded with rhBMP-2 exhibited both osteoconductive and osteoinductive properties. This opens perspective for coating these bioactive PEM on other types of implantable materials, including metal alloy that do not exhibit any affinity for rhBMP-2. (C) 2011 Published by Elsevier Ltd