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Life
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Healing after Trauma
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Healing after Trauma

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 40771

Special Issue Editors

Dr. Claudia Neunaber

E-Mail Website
Guest Editor
Trauma Department, Experimental Trauma Surgery – Laboratory for Musculoskeletal Trauma and Regenerative Therapies Hannover Medical School (MHH), Carl-Neuberg-Str.1, 30625 Hannover, Germany
Interests: bone healing; bone regeneration; stem cells; transplantation; multiple trauma; inflammation; tissue regeneration; biomaterials; implants
Dr. Milena Fini

E-Mail Website
Guest Editor
IRCCS Istituto Ortopedico Rizzoli – Complex Structure Surgical and Technological Sciences, via di Barbiano, 1/10 40136 Bologna, Italy
Interests: biomaterials; musculoskeletal diseases; regenerative/reparative medicine; surgery; osteointegration
Dr. Paolo Cinelli

E-Mail Website
Guest Editor
Center for Clinical Research, Clinic for Trauma Surgery, University Hospital Zurich, Sternwartstrasse 14, CH-8091 Zurich, Switzerland
Interests: transcriptomics; microarrays; gene expression analysis; genotyping; molecular genetics; mouse genetics; transgenic technologies; embryonic stem cells; pluripotency
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Severe trauma is still the leading cause of death and disability globally. Men and younger people in particular suffer from multiple trauma with an average age of ~50 years, whereas 70% of patients are male. These severely injured patients have a particularly high risk of developing multiple organ failure or sepsis, with an incidence according to the literature of between 25% and 40%. Moreover, trauma and fractures in old people aged over 65 are also rapidly growing. Therefore, the underlying repair mechanisms after trauma should be elucidated intensively to be able to develop better therapeutic approaches for our patients and to face injury-related disabilities and complications. For this Special Issue, we would like to invite authors to submit studies that focus on the latest scientific findings on healing after trauma. This includes but is not limited to studies investigating organs and tissues (e.g., liver, brain, heart, musculoskeletal, vascular and nervous tissues, skin), the interplay between several compartments (e.g., blood–brain barrier, intestinal barrier) or the function of different cell types (e.g., macrophages, mesenchymal stem cells, neutrophils) after trauma. Clinical studies and results of in vitro (biological and in silico), ex vivo, and in vivo experiments are welcome.

Dr. Claudia Neunaber
Dr. Milena Fini
Dr. Paolo Cinelli
Guest Editors

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Keywords

  • trauma
  • bone and joints
  • abdomen
  • chest
  • central and peripheral nervous tissue
  • inflammation and infections
  • pain

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Published Papers (15 papers)

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Editorial

Jump to: Research, Review, Other

4 pages, 197 KiB  
Editorial
Healing after Trauma—New Knowledge and Procedures for the Benefit of Our Patients
by Claudia Neunaber, Milena Fini and Paolo Cinelli
Life 2022, 12(5), 611; https://doi.org/10.3390/life12050611 - 19 Apr 2022
Viewed by 1376
Abstract
Severe trauma is still the leading cause of death and disability in the world [...] Full article
(This article belongs to the Special Issue Healing after Trauma)

Research

Jump to: Editorial, Review, Other

11 pages, 2984 KiB  
Article
Inhibition of Pathological Increased Matrix Metalloproteinase (MMP) Activity for Improvement of Bone Regeneration in Diabetes
by Johannes Maximilian Wagner, Felix Reinkemeier, Christoph Wallner, Mehran Dadras, Stephanie Dittfeld, Marius Drysch, Alexander Sogorski, Maxi von Glinski, Marcus Lehnhardt, Björn Behr and Mustafa Becerikli
Life 2022, 12(2), 134; https://doi.org/10.3390/life12020134 - 18 Jan 2022
Cited by 6 | Viewed by 2841
Abstract
Patients with diabetes suffer from poor fracture healing. Molecular reasons are not fully understood and our previous gene expression microarray analyses of regenerating bones from mice with type 2 diabetes (db−/db−) revealed accelerated activation of pathways concerning matrix metalloproteases [...] Read more.
Patients with diabetes suffer from poor fracture healing. Molecular reasons are not fully understood and our previous gene expression microarray analyses of regenerating bones from mice with type 2 diabetes (db−/db−) revealed accelerated activation of pathways concerning matrix metalloproteases (MMPs). Thus, we picked out the pathological MMP acceleration as a target for profound gene expression analyses and additional therapeutic intervention in the present study. In the first part, gene expression of ECM degrading proteinases and inhibitors was investigated three and seven days postoperatively. Mmp3, Mmp9, Mmp13 and gene expression of MMP inhibitor Timp2 was significantly higher in regenerating bone fractures of db−/db− compared to wild type animals. Timp1 and metalloproteinase AdamTS4 showed no differences. In the second part, we locally applied a single dose (1 µL of 5 µM solution) of the broad-spectrum molecular MMP inhibitor Marimastat on tibial defects in db−/db−. We performed immunohistochemical and histological stainings seven days post operation. Impaired bone healing, collagen content, angiogenesis, and osteoclast invasion in db−/db− were restored significantly by application of Marimastat compared to PBS controls (n = 7/group). Hence, local intervention of bone defects by the molecular MMP inhibitor Marimastat might be an alternative therapeutic intervention for bone healing in diabetes. Full article
(This article belongs to the Special Issue Healing after Trauma)
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15 pages, 2432 KiB  
Article
Major Surgical Trauma Impairs the Function of Natural Killer Cells but Does Not Affect Monocyte Cytokine Synthesis
by Roman M. Müller-Heck, Björn Bösken, Ivo Michiels, Marcel Dudda, Marcus Jäger and Stefanie B. Flohé
Life 2022, 12(1), 13; https://doi.org/10.3390/life12010013 - 22 Dec 2021
Cited by 6 | Viewed by 2847
Abstract
Major traumatic and surgical injury increase the risk for infectious complications due to immune dysregulation. Upon stimulation with interleukin (IL) 12 by monocyte/macrophages, natural killer (NK) cells release interferon (IFN) γ that supports the elimination of the pathogen. In the present study, we [...] Read more.
Major traumatic and surgical injury increase the risk for infectious complications due to immune dysregulation. Upon stimulation with interleukin (IL) 12 by monocyte/macrophages, natural killer (NK) cells release interferon (IFN) γ that supports the elimination of the pathogen. In the present study, we investigated the impact of invasive spine surgery on the relationship between monocytes and NK cells upon exposure to Staphylococcus aureus. Mononuclear cells and serum were isolated from peripheral blood of patients before and up to 8 d after surgery and stimulated with inactivated S. aureus bacteria. NK cell and monocyte function were determined by flow cytometry. NK cells continuously lost their ability to produce IFN-γ during the first week after surgery independently from monocyte-derived IL-12 secretion. IFN-γ synthesis was minimal on day 8 and was associated with decreased expression of the IL-12 receptor and activation of transcription factors required for IFNG gene transcription. Addition of recombinant IL-12 could at least partially restore NK cell function. Pre-operative levels of growth/differentiation factor (GDF) 15 in the serum correlated with the extent of NK cell suppression and with hospitalization. Thus, NK cell suppression after major surgery might represent a therapeutic target to improve the immune defense against opportunistic infections. Full article
(This article belongs to the Special Issue Healing after Trauma)
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17 pages, 1779 KiB  
Article
A Comprehensive Framework to Evaluate the Effects of Anterior Cruciate Ligament Injury and Reconstruction on Graft and Cartilage Status through the Analysis of MRI T2 Relaxation Time and Knee Laxity: A Pilot Study
by Gregorio Marchiori, Giorgio Cassiolas, Matteo Berni, Alberto Grassi, Giacomo Dal Fabbro, Milena Fini, Giuseppe Filardo, Stefano Zaffagnini and Nicola Francesco Lopomo
Life 2021, 11(12), 1383; https://doi.org/10.3390/life11121383 - 10 Dec 2021
Cited by 5 | Viewed by 5145
Abstract
Background: Anterior cruciate ligament (ACL) tear represents a common orthopedic traumatic issue that often leads to an early development of osteoarthritis. To improve the diagnostic and prognostic techniques involved in the assessment of the joint after the trauma and during the healing process, [...] Read more.
Background: Anterior cruciate ligament (ACL) tear represents a common orthopedic traumatic issue that often leads to an early development of osteoarthritis. To improve the diagnostic and prognostic techniques involved in the assessment of the joint after the trauma and during the healing process, the present work proposes a multi-parametric approach that aims to investigate the relationship between joint function and soft tissue status before and after ACL reconstruction. Methods: Thirteen consecutive patients who underwent ACL reconstruction were preliminarily enrolled in this study. Joint laxity assessment as well as magnetic resonance imaging with T2 mapping were performed in the pre-operative stage, at four and 18 months after surgery to acquire objective information to correlate knee function and soft tissue condition. Results: Correlations were found between graft and cartilage T2 signal, suggesting an interplay between these tissues within the knee joint. Moreover, graft maturation resulted in being connected to joint laxity, as underlined by the correlation between the graft T2 signal and the temporal evolution of knee function. Conclusions: This preliminary study represents a step forward in assessing the effects of ACL graft maturation on knee biomechanics, and vice versa. The presented integrated framework underlines the possibility to quantitatively assess the impact of ACL reconstruction on trauma recovery and cartilage homeostasis. Moreover, the reported findings—despite the preliminary nature of the clinical impacts—evidence the possibility of monitoring the surgery outcomes using a multi-parametric prognostic investigation tool. Full article
(This article belongs to the Special Issue Healing after Trauma)
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11 pages, 4673 KiB  
Article
Minimally Invasive Internal Fixation of Femoral Shaft Fractures—A Biomechanical Study with a Disruptive Technique
by Frank Layher, Georg Matziolis, Leos N. Kayhan, Matthias Bungartz and Olaf Brinkmann
Life 2021, 11(11), 1254; https://doi.org/10.3390/life11111254 - 17 Nov 2021
Cited by 3 | Viewed by 2258
Abstract
(1) Background: In polytrauma patients, femur fractures are usually stabilised by external fixation for damage control, later being treated with definitive plate or nail osteosynthesis. Screw/rod systems established in spinal surgery might be inserted for internal fixation, providing sufficient fracture stability that subsequent [...] Read more.
(1) Background: In polytrauma patients, femur fractures are usually stabilised by external fixation for damage control, later being treated with definitive plate or nail osteosynthesis. Screw/rod systems established in spinal surgery might be inserted for internal fixation, providing sufficient fracture stability that subsequent intervention is unnecessary. This was to be investigated biomechanically. (2) Methods: The unilaterally applied spinal internal fixator (IF) was subjected to load and deformation analysis on artificial femurs with 32-A3 fracture according to AO classification. Distance of screws to fracture and rod to cortical bone were analysed as parameters influenced surgically as stiffness and deformation of the treated fracture. In addition, the stability of another construct with a second screw/rod system was determined. The axial load in stance phase during walking was simulated. The results were compared against an established fixed-angle plate osteosynthesis (IP). (3) Results: There were no implant failures in the form of fractures, avulsions or deformations. All unilateral IF combinations were inferior to IP in terms of stability and stiffness. The bilateral construct with two screw/rod systems achieved biomechanical properties comparable to IP. 4) Conclusion: Biomechanically, a biplanar screw/rod system is suitable for definitive fracture stabilisation of the femur, despite a damage control approach. Full article
(This article belongs to the Special Issue Healing after Trauma)
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21 pages, 4439 KiB  
Article
Selective Inhibition of IL-6 Trans-Signaling Has No Beneficial Effect on the Posttraumatic Cytokine Release after Multiple Trauma in Mice
by Jil-Madeline Homeier, Katrin Bundkirchen, Marcel Winkelmann, Tilman Graulich, Borna Relja, Claudia Neunaber and Christian Macke
Life 2021, 11(11), 1252; https://doi.org/10.3390/life11111252 - 17 Nov 2021
Cited by 2 | Viewed by 2079
Abstract
While improvements in pre-hospital and in-hospital care allow more multiple trauma patients to advance to intensive care, the incidence of posttraumatic multiple organ dysfunction syndrome (MODS) is on the rise. Herein, the influence of a selective IL-6 trans-signaling inhibition on posttraumatic cytokine levels [...] Read more.
While improvements in pre-hospital and in-hospital care allow more multiple trauma patients to advance to intensive care, the incidence of posttraumatic multiple organ dysfunction syndrome (MODS) is on the rise. Herein, the influence of a selective IL-6 trans-signaling inhibition on posttraumatic cytokine levels was investigated as an approach to prevent MODS caused by a dysbalanced posttraumatic immune reaction. Therefore, the artificial IL-6 trans-signaling inhibitor sgp130Fc was deployed in a murine multiple trauma model (femoral fracture plus bilateral chest trauma). The traumatized mice were treated with sgp130Fc (FP) and compared to untreated mice (WT) and IL-6 receptor knockout mice (RKO), which received the same traumas. The overall trauma mortality was 4.4%. Microscopic pulmonary changes were apparent after multiple trauma and after isolated bilateral chest trauma. Elevated IL-6, MCP-3 and RANTES plasma levels were measured after trauma, indicating a successful induction of a systemic inflammatory reaction. Significantly reduced IL-6 and RANTES plasma levels were visible in RKO compared to WT. Only a little effect was visible in FP compared to WT. Comparable cytokine levels in WT and FP indicate neither a protective nor an adverse effect of sgp130Fc on the cytokine release after femoral fracture and bilateral chest trauma. Full article
(This article belongs to the Special Issue Healing after Trauma)
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14 pages, 3797 KiB  
Article
The Effect of Fat Distribution on the Inflammatory Response of Multiple Trauma Patients—A Retrospective Study
by Zhaoxiong Chen, Silvan Wittenberg, Timo Alexander Auer, Maxim Bashkuev, Pimrapat Gebert, Uli Fehrenbach, Dominik Geisel, Frank Graef, Sven Maerdian and Serafeim Tsitsilonis
Life 2021, 11(11), 1243; https://doi.org/10.3390/life11111243 - 16 Nov 2021
Cited by 4 | Viewed by 1807
Abstract
Objectives In recent years; increasing evidence pointed out the clinical importance of adipose tissue (AT) distribution in various patient populations. In particular, visceral adipose tissue (VAT), when compared to subcutaneous adipose tissue (SAT), was found to play a pivotal role in the development [...] Read more.
Objectives In recent years; increasing evidence pointed out the clinical importance of adipose tissue (AT) distribution in various patient populations. In particular, visceral adipose tissue (VAT), when compared to subcutaneous adipose tissue (SAT), was found to play a pivotal role in the development of inflammatory reaction. The aim of the present study was to examine whether body fat distribution has an impact on the development of systemic inflammatory response syndrome (SIRS) in patients with polytrauma. Methods In our retrospective study; we filtered our institution records of the German Trauma Registry (Trauma Register DGU) from November 2018 to April 2021 and included 132 adult polytrauma patients with injury severity score (ISS) >16. Subsequently; we measured the visceral and subcutaneous adipose tissue area based on whole-body CT scan and calculated the ratio of VAT to SAT (VSr). Thereafter, the patient population was evenly divided into three groups; respectively VSr value less than 0.4 for the first group (low ratio), 0.4–0.84 for the second group (intermediate ratio), and greater than 0.84 for the third group (high ratio). Considering the other influencing factors; the groups were further divided into subgroups in the respective analysis according to gender (male/female), BMI (<25 or ≥25), and ISS (<26 or ≥26). Result VSr was an independent factor from body mass index (BMI) (r2 = 0.003; p = 0.553). VSr in male patients was significantly higher (p < 0.001). Patients with low VSr had higher ISS scores (p = 0.028). Polytrauma patients with higher VSr tended to have lower SIRS scores and significant differences of SIRS score were found on multiple days during the whole hospitalization period. In the low VAT/SAT group, male patients, and patients with BMI greater than 25, both exhibited higher SIRS scores during hospital stay (day 16: p = 0.01; day 22: p = 0.048 and p = 0.011; respectively). During hospitalization, patients with higher ISS score (≥26) in the low VSr group was found to have higher SIRS score (day 16; p = 0.007). Over the hospital stay; serum markers of CRP; CK; and leukocyte in patients with low VSr were higher than those in patients in the intermediate and high VSr groups; with significant difference discovered on multiple days (day 16: 0.014; day 22: p = 0.048). Conclusion Lower VSr is associated with increased inflammatory response and worse clinical outcome in patients with polytrauma. Furthermore; VSr is an independent factor providing additional information to BMI. Full article
(This article belongs to the Special Issue Healing after Trauma)
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15 pages, 2205 KiB  
Article
Direct Current Electrical Fields Improve Experimental Wound Healing by Activation of Cytokine Secretion and Erk1/2 Pathway Stimulation
by Chao Lu, Jonas Kolbenschlag, Andreas K. Nüssler, Sabrina Ehnert, Colin D. McCaig, Urška Čebron, Adrien Daigeler and Cosima Prahm
Life 2021, 11(11), 1195; https://doi.org/10.3390/life11111195 - 5 Nov 2021
Cited by 10 | Viewed by 2759
Abstract
There is growing evidence that cell behaviors can be influenced by the direct current electric fields (EFs). Some behaviors may influence wound healing directly. This study aimed to investigate the effects of EF (200 mV/mm) on immortalized nontumorigenic human epidermal (HaCaT) cells. We [...] Read more.
There is growing evidence that cell behaviors can be influenced by the direct current electric fields (EFs). Some behaviors may influence wound healing directly. This study aimed to investigate the effects of EF (200 mV/mm) on immortalized nontumorigenic human epidermal (HaCaT) cells. We established a setup that can transmit an EF and maintain a stable cell culture environment. An EF was applied to HaCaT cells, and scratch-assays were performed as a model of wound healing to observe cell migration. Proliferation was evaluated by mitochondrial activity, total protein, and DNA content. Secretion of healing-associated cytokines was evaluated via cytokine arrays, and Western blot was applied to investigate signaling pathway alterations. Compared with the control group, the migration of cells exposed to EFs significantly increased (p < 0.01). After 7 days, the changes in proliferation also increased significantly (p < 0.05). The cytokine arrays revealed that granulocyte-macrophage colony-stimulating factor (GM-CSF) was the most abundant factor secreted by HaCaT following EF exposure. The signals for phospho-Erk1/2 showed a significant (p < 0.0001) increase following EF exposure. The results demonstrate that exposure of HaCaT cells to EFs has positive effects on migration, proliferation, and cytokine secretion—three important steps in wound healing—and these effects may be partially mediated by activation of the Erk1/2 signaling pathway. Full article
(This article belongs to the Special Issue Healing after Trauma)
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14 pages, 3587 KiB  
Article
Biomechanical Performance of BoneHelix® Compared with Elastic Stable Intramedullary Nailing (ESIN) in a Pediatric Tibia Fracture Model
by Laura Leonie Brandes, Luis Fernando Nicolini, Johannes Greven, Philipp Lichte, Thomas Thaddäus Stopinski, Martin Sattler, Frank Hildebrand and Miguel Pishnamaz
Life 2021, 11(11), 1189; https://doi.org/10.3390/life11111189 - 5 Nov 2021
Cited by 3 | Viewed by 2266
Abstract
Tibial shaft fractures are common injuries in the pediatric and adolescent populations. Elastic stable intramedullary nailing (ESIN) is the treatment of choice for cases that require surgical stabilization. A new intramedullary device, BoneHelix® (BH), may be an alternative for use with fractures [...] Read more.
Tibial shaft fractures are common injuries in the pediatric and adolescent populations. Elastic stable intramedullary nailing (ESIN) is the treatment of choice for cases that require surgical stabilization. A new intramedullary device, BoneHelix® (BH), may be an alternative for use with fractures that cannot be satisfactorily stabilized with ESIN. This study aimed to assess the biomechanical performance of BH compared with ESIN in a porcine tibia fracture model, observing cyclic fatigue and load to failure. Computed tomography was used to monitor the implant position and to rule out unintended damage. No implant or bone failure occurred during the fatigue testing. An increase in the cumulative plastic displacement was observed in both test groups over the loading cycles applied. Both implant–bone constructs displayed a trend toward closure of the osteotomy gap. During the load-to-failure test, the average loads at failure in specimens instrumented with ESIN and BH were 5364 N (±723) and 4350 N (±893), respectively, which were not statistically significant (p = 0.11). The values of both groups were two to three times higher than the estimated maximal load (2000 N) during physiological weight bearing. The biomechanical results thus indicate equivalent performance and stability by the implants tested. Full article
(This article belongs to the Special Issue Healing after Trauma)
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Graphical abstract

15 pages, 8139 KiB  
Article
The Ideal Time for Iron Administration in Anemia Secondary to Blood Loss—An Experimental Animal Model
by Mirela Tiglis, Ileana Peride, Lucian Cristian Petcu, Tiberiu Paul Neagu, Andrei Niculae, Alexandra Totan, Sabina Andrada Zurac, Ionel Alexandru Checherita and Ioana Marina Grintescu
Life 2021, 11(9), 898; https://doi.org/10.3390/life11090898 - 30 Aug 2021
Cited by 1 | Viewed by 3054
Abstract
Background: Anemia and iron deficiency are two of the main public health problems worldwide, associated with negative outcomes in surgical patients. This experimental study aimed to create a model of acute iron deficiency with anemia through blood loss and extensive surgery. Afterwards, intravenous [...] Read more.
Background: Anemia and iron deficiency are two of the main public health problems worldwide, associated with negative outcomes in surgical patients. This experimental study aimed to create a model of acute iron deficiency with anemia through blood loss and extensive surgery. Afterwards, intravenous iron was administered to correct the iron deficiency and to improve the hematological parameters in distinct moments regarding the surgical time. To assess the optimum time for therapeutic intervention, experimental subjects were compared, performing clinical, paraclinical, and histological examinations, as well. Methods: Male rats (n = 35), aged 11–13 months, were randomly designated into six groups. Anemia and iron deficiency were obtained through a 15% blood volume loss, followed by major surgical intervention (femur fracture and osteosynthesis using Kirschner wire). Therapeutic intervention was obtained with an intravenous ferric carboxymaltose infusion, as follows: group II: intraoperative (n = 7), group III: 48 h after surgery (n = 7), group IV: 48 h before surgery (n = 5), and group V: seven days before surgery (n = 6). Group I (n = 5) was left anemic, while group 0 (n = 5) was nonanemic without therapeutic intervention. Results and Discussion: In group I, serum iron lower than in group 0 (27.04 ± 6.92 μg/dL versus 60.5 ± 2.34 μg/dL), as well as hemoglobin (10.4 ± 0.54 g/dL versus 14.32 ± 2.01 g/dL) and ferritin values (22.52 ± 0.53 ng/mL versus 29.86 ± 3.97 ng/mL), validated the experimental model. Regarding wound healing after surgical trauma, we observed that neovascularization was more significant in group III, followed by group V, with fewer neutrophils, a well-represented and rich in lymphomonocytes inflammatory infiltrate associated with the biggest collagen fiber dimensions. The periosteal reaction and callus area presented thicker trabeculae in groups II and III compared to the anemic group. Conclusions: This original experimental study assessed the effect of perioperative intravenous iron administration at a specific time by comparing the weight, hematological, and iron status-defining parameters, as well as histological characteristics of the included subjects. The present findings highlight that correcting the iron deficiency in emergency settings through intravenous iron administration intraoperatively or 48 h postoperatively could determine the improved bioumoral parameters, as well as a better evolution of the postoperative wound and bone healing compared to the anemic group or subjects that received therapeutic intervention 48 h before surgery. Full article
(This article belongs to the Special Issue Healing after Trauma)
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15 pages, 2079 KiB  
Article
Does Needle Design Affect the Regenerative Potential of Bone Marrow Aspirate? An In Vitro Study
by Nadia Feddahi, Monika Herten, Tjark Tassemeier, Heike Rekasi, Alexander Hackel, Marcel Haversath and Marcus Jäger
Life 2021, 11(8), 748; https://doi.org/10.3390/life11080748 - 26 Jul 2021
Cited by 6 | Viewed by 2872
Abstract
While autologous bone is still the gold standard for treatment of bone defects, its availability is limited. Sufficient numbers of mesenchymal stroma cells (MSC) may be an alternative. Small volumes of bone marrow aspirate (BMA) were harvested with two different needle systems comparing [...] Read more.
While autologous bone is still the gold standard for treatment of bone defects, its availability is limited. Sufficient numbers of mesenchymal stroma cells (MSC) may be an alternative. Small volumes of bone marrow aspirate (BMA) were harvested with two different needle systems comparing the yield and regenerative potency of the MSCs. BMA (10 mL) was aspirated from the posterior iliac crest of 12 patients with degenerative spinal disc disease using both needle systems in each patient: the Jamshidi needle (JAM) and on the contralateral side the Marrow Cellution® Needle (AMC). Number of mononuclear cells (MNCs) and regeneration capacity (colony-forming unit/CFU) were determined. MSCs were characterized for surface markers and their differentiation into trilineages. There was no significant difference between the two harvesting needles regarding the quantity of MNCs in BMA: 5.2 ± 1.8 × 109 MNC/mL for AMC vs. 4.8 ± 2.5 × 109 MNC/mL for JAM, p = 0.182. The quantity of CFUs per ml BMA was similar for both groups: 3717 ± 5556 for AMC and 4305 ± 5507 for JAM (p = 0.695). The potency of MSCs expressed as colony-forming potential per 106 MNC resulted in 0.98 ± 1.51 for AMC and 1.00 ± 0.96 for JAM (p = 0.666). Regardless of the needle design, 10 mL bone marrow aspirate contains a sufficient number of about 40,000 MSCs that can be used to enhance bone healing. Full article
(This article belongs to the Special Issue Healing after Trauma)
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Review

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15 pages, 673 KiB  
Review
Fresh Osteochondral Allograft Transplantation in Osteochondritis Dissecans in the Knee Joint
by Tommaso Roberti di Sarsina, Michele Fiore, Vito Coco, Marco Govoni, Leonardo Vivarelli, Nicola Rani, Nicolandrea Del Piccolo and Dante Dallari
Life 2021, 11(11), 1205; https://doi.org/10.3390/life11111205 - 8 Nov 2021
Cited by 10 | Viewed by 2390
Abstract
Osteochondritis dissecans (OCD) is a chronic and painful joint condition that can occur from childhood through to adult life. Microtrauma, vascular insufficiency, or abnormal endochondral ossification are the most common causes of OCD. Reconstructive techniques for OCD of the knee are typically necessary [...] Read more.
Osteochondritis dissecans (OCD) is a chronic and painful joint condition that can occur from childhood through to adult life. Microtrauma, vascular insufficiency, or abnormal endochondral ossification are the most common causes of OCD. Reconstructive techniques for OCD of the knee are typically necessary when either non-operative or reparative/regenerative operative treatments fail, or when the OCD is irreversible. To analyze the clinical outcomes and failure rates of fresh osteochondral allograft transplantation (FOCA) used as a reconstructive strategy in OCD patients, an in-depth search was carried out on the PubMed, Scopus, and Web of Science databases concerning the existing evidence related to the use of FOCA for OCD patients in the knee joint. A total of 646 studies were found through the search and 2 studies were added after a cross-referenced examination of the articles within the bibliography. Six studies with a total of 303 OCD lesions treated with FOCA, with a mean follow-up of 6.3 years, were included. Although a limited number of low-level evidence studies on this topic are available in previous research, satisfactory clinical results and survival rates of the reconstruction are reported. However, to better define the real advantages of FOCA in the healing process of OCD lesions, comparative studies with different techniques are needed. Full article
(This article belongs to the Special Issue Healing after Trauma)
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Other

3 pages, 187 KiB  
Reply
Reply to Sidiropoulos, K.; Tsikopoulos, K. Comment on “Oldrini et al. PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis. Life 2022, 12, 311”
by Lorenzo Massimo Oldrini, Pietro Feltri, Jacopo Albanese, Francesco Marbach, Giuseppe Filardo and Christian Candrian
Life 2022, 12(8), 1282; https://doi.org/10.3390/life12081282 - 22 Aug 2022
Cited by 2 | Viewed by 1198
Abstract
Thank you for the opportunity to respond to the commentary [...] Full article
(This article belongs to the Special Issue Healing after Trauma)
2 pages, 183 KiB  
Comment
Comment on Oldrini et al. PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis. Life 2022, 12, 311
by Konstantinos Sidiropoulos and Konstantinos Tsikopoulos
Life 2022, 12(8), 1281; https://doi.org/10.3390/life12081281 - 22 Aug 2022
Cited by 1 | Viewed by 1127
Abstract
We read the paper published by Oldrini, L.M. et al. (2022) [...] Full article
(This article belongs to the Special Issue Healing after Trauma)
18 pages, 2429 KiB  
Systematic Review
PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis
by Lorenzo Massimo Oldrini, Pietro Feltri, Jacopo Albanese, Francesco Marbach, Giuseppe Filardo and Christian Candrian
Life 2022, 12(2), 311; https://doi.org/10.3390/life12020311 - 19 Feb 2022
Cited by 22 | Viewed by 4619
Abstract
Purpose: The aim of this study was to quantify the rate of complications and reinterventions in patients treated with PHILOS plate for proximal humerus fractures (PHFs) synthesis. Methods: A comprehensive literature search was performed on the PubMed, Web of Science, Embase, and Cochrane [...] Read more.
Purpose: The aim of this study was to quantify the rate of complications and reinterventions in patients treated with PHILOS plate for proximal humerus fractures (PHFs) synthesis. Methods: A comprehensive literature search was performed on the PubMed, Web of Science, Embase, and Cochrane databases up to 7 October 2021. Studies describing medium and long-term complications in PHF synthesis using the PHILOS plate were included. A systematic review and meta-analysis were performed on complications and causes of reinterventions. Assessment of risk of bias and quality of evidence was performed with the Downs and Black’s “Checklist for Measuring Quality”. Results: Seventy-six studies including 4200 patients met the inclusion criteria. The complication rate was 23.8%, and the main cause was screw cut-out (4.1%), followed by avascular necrosis (AVN) (3.1%) and subacromial impingement (1.5%). In patients over 55 years, the complication rate was 29.5%. In the deltopectoral (DP) approach the complication rate was 23.8%, and in the delto-split (DS) it was 17.5%, but no difference between the two approaches was seen when considering the type of fracture. The overall reintervention rate was 10.5% in the overall population and 19.0% in older patients. Conclusions: Proximal humerus synthesis with a PHILOS plate has high complications and reintervention rates. The most frequent complication was screw cut-out, followed by humeral head AVN and subacromial impingement. These results need to be further investigated to better understand both the type of patient and fracture that is more at risk of complications and reintervention and to compare pros and cons of the PHILOS plate with respect to the other solutions to manage PHFs. Full article
(This article belongs to the Special Issue Healing after Trauma)
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