Abstract:
BACKGROUND:Mesenchymal stromal cells (MSCs) have been shown in rodent models to promote primary and pulmonary metastatic sarcoma growth when injected in the presence of gross tumor. In theory, this would limit their use in a clinical setting after limb salvage treatment for osteosarcoma. Although concerning, these models do not translate to the clinical setting wherein MSCs could be used after primary tumor resection to aid in bone healing and incorporation of tumor endoprostheses. If we can determine whether the use of MSCs in this setting is safe, it might improve our ability to augment bone healing in patients undergoing limb salvage. QUESTIONS/PURPOSES:The purpose of this study was to determine (1) whether MSCs promote pulmonary metastatic disease progression in a murine osteosarcoma model; and/or (2) whether they affect local disease recurrence in the presence of microscopic residual osteosarcoma. METHODS:An orthotopic model of luciferase-expressing osteosarcoma was developed. At 10 days, resection of the primary tumor was performed. One hundred fourteen female C3H mice were inoculated with DLM8-luc osteosarcoma in the proximal tibia. Ninety-four mice developed orthotopic osteosarcoma with luciferase expression. Mice with bioluminescent evidence of a primary tumor received either a microscopically "clean" amputation at a time when residual microscopic metastatic disease was present in the lungs (pulmonary metastasis group; n = 65) or a "dirty" amputation (local recurrence group; n = 29). Mice were randomized to receive intravenous MSCs, MSCs at the surgical site, or no MSCs. Mice were monitored for development and progression of pulmonary metastasis and local recurrence by bioluminescence imaging and daily measurements at the surgical site. The number of pulmonary nodules, time to first evidence of metastasis, and size of recurrent tumor were compared using Kruskal-Wallis, analysis of variance, Welch's, t-tests, or Mann-Whitney tests as appropriate for the specific data sets with p < 0.05 considered significant. RESULTS:Mice receiving intravenous MSCs had a faster time to first detection of pulmonary metastasis (2.93 ± 1.90 days) compared with mice with local injection of MSCs (6.94 ± 6.78 days) or no MSCs (5.93 ± 4.55 days) (p = 0.022). MSC treatment did not influence whether mice developed local recurrence (p = 0.749) or size of recurrent tumors (p = 0.221). CONCLUSIONS:MSCs delivered to the surgical site did not promote local recurrence or size of recurrent tumors, but intravenous injection of MSCs did hasten onset of detection of pulmonary metastatic disease. Although local administration of MSCs into a surgical site does not appear to promote either pulmonary metastatic disease or local recurrence, large variation within groups and small numbers diminished statistical power such that a Type II error cannot be ruled out. CLINICAL RELEVANCE:If MSCs are to be used to augment bone healing in the postlimb salvage setting in patients with osteosarcoma, it will be important to understand their influence, if any, on pulmonary micrometastsis or residual microscopic local disease. Although murine models do not completely recapitulate the clinical scenario, these results suggest that intravenous delivery of MSCs may promote micrometastatic pulmonary disease. Local administration into a surgical wound, even in the presence of residual microscopic disease, may be safe, at least in this murine model, but further investigation is warranted before considering the use of MSCs for clinical use in patients with osteosarcoma.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Aanstoos ME,Regan DP,Rose RJ,Chubb LS,Ehrhart NPdoi
10.1007/s11999-015-4362-2subject
Has Abstractpub_date
2016-03-01 00:00:00pages
707-15issue
3eissn
0009-921Xissn
1528-1132pii
10.1007/s11999-015-4362-2journal_volume
474pub_type
杂志文章abstract::A new instrumentation for posterior spinal surgery consists of metallic rods carved with diamond-shaped asperities on which vertebral hooks or screws can be screwed in any position, level, or degree of rotation. The rods are interlocked by means of devices for transverse traction (DTTs), rectangular constructs with mu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-02-01 00:00:00
abstract::Dislocation is a well documented complication after a two-stage revision arthroplasty for a deep periprosthetic hip infection. We are aware of no reports specifically evaluating the risk factors for dislocation after reimplantation for infection. We hypothesized greater age, increase in the number of operations on the...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000218747.92118.3a
更新日期:2006-06-01 00:00:00
abstract::This report is a prospective review of 450 low-friction arthroplasties (LFAs) performed by a single surgeon from 1972 to 1983 in a community hospital. The clinical results show sustained quality of the result over a maximum follow-up period of 11 years. The radiologic review shows a slight increase in the number and s...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract::Mechanically the wrist is the most complex joint in the body, providing a large range of motion in the flexion-extension and radial-ulnar deviation planes. By virtue of the constraints at the radiocarpal level, strong torque may be delivered to the grasping hand for work in the grasping mode through the rotational axi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Outcomes for minimally invasive scoliosis correction surgery have been reported for mild adult scoliosis. Larger curves historically have been treated with open surgical procedures including facet resections or posterior column osteotomies, which have been associated with high-volume blood loss. Further, min...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3565-2
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Although morbid obesity is considered a modifiable risk factor for periprosthetic joint infection (PJI), there is no consensus regarding an appropriate threshold for body mass index (BMI) above which a high risk for infection may outweigh the benefits of surgery. QUESTIONS/PURPOSES:(1) Is there a BMI cutoff...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999.0000000000000141
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Combat-wounded service members are surviving battle injuries more than ever. Given different combat roles held by men and women, female service members should survive wounds at an unprecedented rate. QUESTIONS/PURPOSES:We determined whether the casualty rates for females differ from their male counterparts ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-1840-z
更新日期:2011-07-01 00:00:00
abstract::The regeneration of bone remains an elusive yet important goal in the field of orthopaedic surgery. Despite its limitations, autogenous cancellous bone grafting continues to the most effective means by which bone healing is enhanced clinically. Biosynthetic bone grafts currently are being developed as an alternative t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-199910001-00011
更新日期:1999-10-01 00:00:00
abstract:UNLABELLED:Total knee replacement effectively relieves arthritis pain but improvement in physical function varies. A clearer understanding of the patient attributes associated with differing levels of functional gain after TKR is critical to surgical decision making. We reviewed 8050 primary, unilateral TKR patients en...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0428-8
更新日期:2008-11-01 00:00:00
abstract::A small amount of partially purified, water-soluble murine osteosarcoma-derived bone morphogenetic protein (BMP) was implanted into the dorsal muscles of mice in combination with calf skin gelatin or collagen as carriers. Changes in the ribs adjacent to the implants were then chronologically observed. On implantation ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-02-01 00:00:00
abstract::Almost all computer-assisted orthopaedic surgery systems that rely on the anterior pelvic plane definition, such as in computed tomography and magnetic resonance image-based, fluoroscopy-based, and nonimage total hip replacement approaches, are derived from identifying two pairs of pelvic bony landmarks: anterior supe...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000164027.06880.3a
更新日期:2005-08-01 00:00:00
abstract::The efficiency of ultraviolet light and fluorescence macrophotography in screening various tissues of the locomotor system was tested on 46 human and 43 animal specimens from surgical, experimental and autopsy material, examined as living tissues during operation, or as fresh, frozen or fixed specimens. After visual e...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197511000-00033
更新日期:1975-11-01 00:00:00
abstract::Radial polydactyly, a common congenital problem, most often occurs as thumb duplication. It appears in pentadactylous, polydactylous, and hypoplastic hands and is simulated by complex syndactyly. Classically, there are three categories for radial polydactyly: severe hypoplasia, partial duplication, and total duplicati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1985-05-01 00:00:00
abstract::The reliability of a closed double helix electrode in the lower limbs was studied. This electrode is an implanted intramuscular electrode and is used for a totally implantable functional electrical stimulation system. Eighty electrodes were evaluated retrospectively with a mean period of 15 months. The total implant t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::One hundred four patients with rheumatoid arthritis of the wrist were evaluated a minimum of 12 months post-operatively (average of 34 months). Seventy patients had 87 arthroplasties and 34 patients had 41 arthrodeses performed on the Arthritis Service of Rancho Los Amigos Hospital (Downey, California), from 1962 to 1...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract::The best treatment for intramuscular hemangiomas is unclear in part because the outcome is variable, with recurrence rates ranging from 18% to 61%. This variance is due to deficiencies in previous reports such as an inadequate population size, lack of life table analyses, lack of uniform pathologic criteria, and loose...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e318063c61b
更新日期:2007-06-01 00:00:00
abstract::For a mean period of 7.8 years, the morphology of knee deformity and its annual changes in 8 patients (16 knees; mean age at the initial examination, 8.4 years) with multiple hereditary exostoses were evaluated radiographically. Knee deformity developed during the growth spurt period. Genu valgum with a femorotibial a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:Wide variation exists in reported prevalence estimates and management standards of developmental dysplasia of the hip (DDH). Discrepancies in diagnosticians' opinions may explain some of this variation. QUESTIONS/PURPOSES:We sought to determine (1) the consistency with which pediatric orthopaedic surgeons r...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2846-5
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Nailing comminuted femur fractures may result in leg shortening, producing significant complications including pelvic tilt, narrowing of the hip joint space, mechanical and functional changes in gait, an increase in energy expenditures, and strains on spinal ligaments, leading to spinal deformities. The freq...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3292-0
更新日期:2014-09-01 00:00:00
abstract::Mini-incision total knee arthroplasty can be accomplished through versions of exposures used in standard total knee arthroplasty. Modifications of the medial parapatellar, subvastus, and midvastus approaches are presented, and potential advantages and disadvantages of each approach are reviewed. When making the transi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
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更新日期:2004-11-01 00:00:00
abstract::In the past decade, two concepts have caused considerable controversy in orthopedic surgery of the knee. Some orthopedic centers contend that osteotomy of the tibia is the procedure of choice for unicompartmental gonarthrosis of the knee and resist the concept of unicompartmental arthroplasty. The other concept is tha...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::Rheumatoid arthritis frequently involves the hindfoot. It may produce a proliferative synovial hypertrophy around the tendons and a gradual destruction of the joints. Unfortunately, this part of the foot frequently is overlooked when caring for these patients who often have multiple areas of involvement giving pain an...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199707000-00009
更新日期:1997-07-01 00:00:00
abstract::The Total Condylar Prosthesis is a non-hinged unit designed to: replace the patellofemoral articulation; improve fixation of the tibial component by means of a stout central peg; permit accurate and reproducible insertion. The cruciate ligaments are excised to obtain better tibial fixation. Instability has not been a ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-10-01 00:00:00
abstract::Magnetic resonance venography is a recently developed, noninvasive means of visualizing the proximal veins of the lower extremity and pelvis. Magnetic resonance venography is compared with standard contrast venography in the diagnosis of proximal deep vein thrombosis after total joint arthroplasty. Two hundred seven e...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章
doi:10.1097/00003086-199610000-00029
更新日期:1996-10-01 00:00:00
abstract::A 4-year-old boy with congenital pseudarthrosis of the tibia had two unsuccessful operative attempts for union. After these procedures the patient had a 6-cm leg length discrepancy and an equinovalgus foot deformity. Because of these deformities he underwent Syme amputation at the ankle and was fitted with a total con...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:The most important objective of clinical classifications of slipped capital femoral epiphysis (SCFE) is to identify hips associated with a high risk of avascular necrosis (AVN)--so-called unstable or acute slips; however, closed surgery makes confirmation of physeal stability difficult. Performing the capita...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2339-y
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Osteoid osteoma has a nidus surrounded by sclerotic bone with a size usually less than 20 mm. Its diagnosis is made on typical presentation of nocturnal pain and imaging findings. Excision of the niduses, which are often small and difficult to precisely identify, sometimes may result in resection of surround...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1265-0
更新日期:2010-07-01 00:00:00
abstract::The successful treatment of osteomyelitis with commercially prepared gentamicin-polymethylmethacrylate (PMMA) (Septopal) beads and surgical debridement has led to the use of this technique in the United States. However, commercially prepared gentamicin-PMMA beads are not currently available to orthopedic surgeons in t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-11-01 00:00:00
abstract::Osteochondritis dissecans of the capitellum produces an area of focal necrosis that may result in a potentially unstable relationship between the capitellum and the radial head. Seven patients with developmental instability of the radial head secondary to osteochondritis dissecans of the capitellum treated between 198...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199705000-00006
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:There is no consensus as to which surgical approach to the treatment of giant cell tumor of bone is most appropriate or which patients are at a higher risk for recurrence or metastasis. QUESTIONS/PURPOSES:Therefore, we asked: (1) Are there subsets of patients who are associated with a more recalcitrant dise...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2172-8
更新日期:2012-03-01 00:00:00