Hassib Keskes

Chitosan-based bioglass composite for bone tissue healing : Oxidative stress status and antiosteoporotic performance in a ovariectomized rat model

Tissue engineering has opened up a new therapeutic avenue promising a revolution in regenerative medicine. Considerable attention has been given to chitosan composite materials and their applications in the field of the bone graft substitutes. We evaluated the antioxidative properties of chitosan-doped bioactive glass (BG-CH) with 17 wt% chitosan, and their applications in the guided bone regeneration. BG-CH was produced by a freeze-drying process and implanted in the femoral condyles of ovariectomized rats. Grafted bone tissues were carefully removed to evaluate the oxidative stress analysis, histomorphometric profile and mineral bone distribution by using inductively coupled plasma optical emission spectrometry (ICP-OES). A significant decrease of thiobarbituric acid-reactive substances (TBARs) was observed after BG-CH implantation. Superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) activities significantly increased in ovariectomized group implanted with chitosan-doped bioactive glass (OVXBG-CH) as compared to ovariectomized group implanted with bioactive glass (OVX-BG). The histomorphometric analysis showed that bone/tissue volume (BV/TV), osteoblast number (N.Ob) and osteoblast surface/bone surface (Ob.S/BS) were significantly higher in OVX-BG-CH group than in OVX-BG group. On the other hand, a rise in Ca and P ion concentrations in the implanted microenvironment was shown to lead to the formation/deposition of Ca-P phases. Trace elements such as Sr and Fe were detected in the newly formed bone and involved in bone healing. These results suggested that BG-CH composites could become clinically useful as a therapeutic and implantable material.

Genotoxicity effect, antioxidant and biomechanical correlation: experimental study of agarose-chitosan bone graft substitute in New Zealand white rabbit model.

Bone loss associated with skeletal trauma or metabolic diseases often requires bone grafting. In such situations, a biomaterial is necessary for migrated cells to produce new tissue. In this study, agarose–chitosan was implanted in the femoral condyle of New Zealand White rabbits that were divided into three groups: Group I was used as control; Groups II and III were used as implanted tissue with agarose–chitosan and presenting empty defects, respectively. This study evaluated the agarose–chitosan biocompatibility by determining the in vivo genotoxicity, oxidative stress balance that correlated with the hardness mechanical property. Moreover, the histopathological and quantitative elements analyzed by using inductively coupled plasma optical emission spectrometry were determined. After 30 days of implantation, the in vivo analysis of genotoxicity showed that agarose–chitosan did not induce chromosome aberration or micronucleus damage. A significant decrease in thiobarbituric and acid-reactive substance was observed after agarose–chitosan implantation in the bone tissue. Superoxide dismutase, catalase and glutathione peroxidase were significantly enhanced in agarose–chitosan–treated group compared with that of control group. A negative correlation coefficient of the mechanical property with malonyldialdehyde level was detected (R = −0.998). The histological study exhibited a significantly increased angiogenesis and newly formed tissue. No presence of inflammatory process, necrotic or fibrous tissue was detected. Major and trace elements such as Ca, P, Zn, Mg and Fe were increased significantly in the newly formed bone. These findings show that agarose–chitosan biomaterial implantation might be effective for treating trauma and bone regeneration.

The potential restorative effects of strontium-doped bioactive glass on bone microarchitecture after estrogen-deficieny induced osteoporosis: Physicochemical and histomorphometric analyses

Strontium (Sr) compounds have become increasingly popular in the field of osteoporosis treatment. However, the quality of new bone after implantation of strontium-containing bioceramics has yet to be investigated. In the present study, the newly formed bone tissue around strontium-doped bioactive glass (BG-Sr) implants was characterized. BG-Sr was implanted in the femoral condyl of ovariectomised rats (OVX). The resected bone was prepared for analysis using several physico-chemical and biological assays such as Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy, energy-dispersive X-ray, and histomorphometry. BG-Sr biomaterial favored calcium phosphate layer integration on the surface of the glass and offered better bioactivity. Moreover, the histomorphometric analysis demonstrated that BV/TV, N. Ob were significantly higher in BG-Sr treated rats groups than those of BG groups. However, Ob. S/BS, and OV/BV were significantly lower in BG-Sr treated rats groups than those of BG groups. The (Oc.S/BS) was significantly decreased in BG-Sr groups, when compared with that of BG rat groups. On the other hand, the MS/BS had not significantly decreased in the BG-Sr treated rats groups when compared with that of BG groups, however; it was significantly higher when compared with control and OVX groups. These findings suggest that BG-Sr can be used as an inhibitory therapeutic potential of osteoporosis by delivering strontium to stimulate new bone remodeling.

The periosteum-like effect of fresh human amniotic membrane on bone regeneration in a rabbit critical-sized defect model

OBJECTIVE The purpose of this study was to investigate the effect of fresh human amniotic membrane (FHAM) as a substitute of periosteum to enhance bone regeneration in critical-sized defects. METHODS Tibial diaphyseal bone defects were created in forty New Zealand white rabbits and treated with FHAM or left empty. Treatment groups consisted of: FHAM implanted in the place of removed periosteum (FHAMP group); FHFAM implanted to fill the entire defect (FHAMF group) compared to negative control group; empty defect with removing the periosteum (NC group) and positive control group; and empty defect without removing the periosteum (PC group). Bone regeneration was evaluated by radiographic, micro-computed tomography (μ-CT) and histological analyses at 4 and 8weeks post-surgery. RESULTS Radiographic and μ-CT analysis demonstrated clearly enhanced new bone formation in positive control group (PC) and FHAMP group compared to negative control group (NC) and FHAMF group. Histological staining exhibited remaining woven bones and cartilage matrix in the FHAMP group, immature lamellar bone with medellury cavity and marrow bone formation in PC group from 4weeks post-operatively. For FHAMF group, a little new bone formation was detected only from 8weeks post-operatively, and an absence of any sign of healing in NC group at both time points. CONCLUSION The results provide that FHAM increases bone regeneration in critical-sized defects when it is implanted in the place of the removed periosteum, but its additive effect does not have the same effect of the natural periosteum.

Spontaneous and simultaneous complete bilateral rupture of the quadriceps tendon in a patient receiving hemodialysis: A case report and literature review

The spontaneous and simultaneous rupture of both quadriceps tendons is uncommon and has rarely been reported in the literature. The current case involves a 43-year-old man with end-stage renal disease requiring hemodialysis for the past 20 years. The patient experienced bilateral knee pain and swelling and was unable to bear weight. Physical examination revealed bilateral quadriceps tendon defect above the patella and loss of active extension. Although plain radiographs of both knees showed no fracture or widening of the joint space, an inferiorly positioned patella was observed. Ultrasonography of the knees revealed a quadriceps tendon defect at the upper edge of each patella, while MR imaging revealed a tear in each quadriceps tendon from the superior poles of the patella. The patient then underwent surgical correction wherein the tendons were repaired using sutures passed through drill holes in the patella. The knees were immobilized with splints for 4 wk before starting physiotherapy. The patient subsequently regained full functional activity within 1 year.

Anterior transolecranon dislocation of the elbow in a child: A case report and review of literature

Anterior transolecranon dislocation of the elbow is rarely observed in children, reported in only a small series. The present case involves an anterior transolecranon dislocation of the left elbow joint in a 7-year-old child, which was surgically treated. Two attempts of closed reduction failed because the radial head had buttonholed via the joint capsule. After its release, open reduction was easily performed; osteosynthesis of the olecranon was not performed. Remarkably, good result was obtained, despite a mild flexion deformity at the last follow-up. This case report aims to highlight this treatment method, which may be considered for such an uncommon injury.

Bursite tuberculeuse de l’épaule chez une insuffisante rénale chronique: à propos d’un cas

Tuberculosis of the shoulder is rare. It encompasses all articular and periarticular tuberculouses of the shoulder. Its insidious evolution, mimicking inflammatory and degenerative diseases, reflects the frequency of its diagnostic delay. We report a rare case of tuberculous bursitis of the shoulder in a woman living in rural areas, with renal insufficiency and treated for peritoneal TB and psoas. The anamnesis revealed signs of tuberculous impregnation. Clinical examination showed painful swelling of the shoulder associated with stiffness. MRI of the shoulder objectified infectious bursal disease. Its tuberculous origin was confirmed by the histological examination of ultrasound-guided synovial biopsy. The patient underwent TB treatment with good outcome. At 9-year follow-up, the patient had satisfactory articular function with no recurrence of infectious disease.

Arthrose post-traumatique carpo-métacarpienne du cinquième doigt traitée par arthroplastie stabilisée: à propos de deux cas et revue de la littérature

Old fractures and dislocations of the base of the fifth metacarpal may result in post-traumatic arthrosis which is troublesome from a functional point of view and characterized by a difficult management. Stabilized arthroplasty is based on arthroplastic resection of the base of the fifth metacarpal associated with lateral diaphysometaphyseal arthrodesis between the fourth and the fifth metacarpal. This study involving two patients aimed to describe the advantages and the peculiarities of stabilized arthroplasty compared to other techniques in the treatment of the sequelae of fractures and dislocations of the base of the fifth metacarpal.

Localisation épiphysaire de la tuberculose

Introduction : nous rapportons un cas de tuberculose de l’epiphyse femorale inferieure ayant un aspect radiographique caracteristique d’un chondroblastome. Methodes : il s’agissait d’un garcon de 8 ans qui a consulte pour gonalgies droites depuis 3 mois, avec notion de traumatisme du pied il y a 1 mois. A l’examen, ce garcon etait apyretique, il marchait avec discrete boiterie droite. Le genou n’avait pas de signes inflammatoires et pas de choc rotulien, sa mobilite etait normale et il y avait des douleurs moderees du bord interne du genou. Le bilan biologique a montre une VS a 14, fibrinemie a 2.2, CRP et Latex Waler-Rose negatifs. La radiographie a montre une lacune epiphysaire sous chondrale du condyle femoral interne. A l’IRM, elle faisait 16*11 mm, en hyposignal T1 et hypersignal T2 avec important œdeme perilesionnel qui prend le contraste. Le diagnostic de chondroblastome a ete evoque et une biopsie a ete realisee par un abord direct Trans-cartilagineux. Resultats : Le tissu preleve etait puriforme et le diagnostic d’osteomyelite subaigue etait evoque. L’examen anatomopathologique a confirme le diagnostic de tuberculose. Il n’y avait pas d’autres localisations tuberculeuses et l’enfant a ete mis sous antituberculleux. Au recul de 2 ans, l’enfant est asymptomatique et on a constate un comblement progressif de la lesion epiphysaire. Conclusion : La tuberculose doit etre evoquee devant toute lesion epiphysaire solitaire de l’enfant. Elle vient en 3eme position apres l’osteomyelite et le chondroblastome.

Les formes septicopyohémiques de l’ostéomyélite aigüe

Introduction : les formes septicopyohemiques de l’osteomyelite aigue sont rares. Le but de notre travail est d’etudier les caracteristiques epidemiologiques, cliniques et evolutives de cette pathologie grave.