Page 199 - Demo

Animal experiment: Radiological analysis of the LPM reattachment1977periosteal reaction can be observed on radiographs. This type of repair can still occur during conditions of macro- or micromotion. In the case of absence of periosteum and absence of motion, osteoprogenitor cells are derived directly from the Haversian canals when there is direct contact between the two bony pieces. This type of healing is “contact repair”. If there is a gap between the two pieces, lamellar bone is formed directly or woven bone is formed first and then transformed into lamellar bone if the gap is larger. This type of bone repair is also known as (direct) transformational bone repair.(22)Periosteum was not preserved in our sheep surgeries, and there were no Haversian canals on the prosthetic side. Therefore, only transformational bone repair can occur as a possible form of repair with associated osseointegration of the LPM tendon. This means that the material to which the LPM attaches must be osteoinductive and osteoconductive. Compared with cobalt-chromium-molybdenum alloy, the elasticity of titanium alloy Gr 23 is closer to that of bone. Its roughened surface has good biocompatibility and is osteoconductive.(24) Titanium is considered a bio-inert material that does not possess any osteoinductive properties. However, Tamaddon et al.(25) performed in vitro and in vivo experiments and found that even untreated porous titanium scaffolds can be osteoinductive. Many studies have found that as surface roughness increases, the connection between the implant and the adjacent bone becomes stronger. Yeniyol et al.(26) found that oxalic acid etching improves surface roughness by creating micro-pitting. It also improves cell adhesion, which allows for better osteogenesis. The use of ELI23 titanium allowed for both an osteoinductive and osteoconductive environment, which also allows cementless fixation of titanium implants in orthopedic surgery.(27,28)Sufficient numbers of MSCs, osteoblasts, and osteocytes needed to be present after the periosteum was stripped during the resection. Therefore, part of the resected bone was ground, mixed with a fibrin sealant and applied to the scaffold to provide high concentrations of osteoinductive cells. Spalthoff et al.(29) found that bone marrow aspirate (BMA) provides an abundant and reliable source of growth factors and osteogenic cells. Nikolas de Meurechy NW.indd 197 05-06-2024 10:14