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- ItemAcesso aberto (Open Access)Mutações genéticas da deficiência auditiva: avaliação comportamental e eletrofisiológica da audição sem e com prótese auditiva em crianças(Universidade Federal de São Paulo (UNIFESP), 2011-01-26) Vieira, Eliara Pinto [UNIFESP]; Azevedo, Marisa Frasson de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The BMPs, the inductive proteins of bone growth since the beginning of their use have been evaluated in different experimental models aiming to determine their efficacy. We know that some substances can interfere positively or negatively when used in a systemic way or places associated with the BMP. Objective: this study objective to evaluate the possible interferences of antibiotic-therapy by using the active principle of cefazolin in an experimental model with rabbits. Methods: Two groups of female New Zealand rabbits underwent a lumbar spine inter-transverse artrodesys of segment L5-L6 using posterior approach. An homolog bone graft associated with a bio-compound (bovine BMP, 1,0mg and hydroxiapatita, 9,0mg) was used in the first group. The same procedure and bio-compound were used in the second group. However the animals were submitted to a prophylactic antibiotic-therapy with cefazolin starting two hours before the procedure and maintained for 24 hours after surgery. The animals were analyzed for 15 weeks, isolated in captivity and daily evaluated by a veterinarian under the clinical and neurological views and then euthanized, being the surgical pieces removed and submitted to a radiological and histological analysis. Results: For the first group the quantity and location of the implanted material varied among the individuals. However in most of the cases, the quantity and particles of homolog bone was insignificant and disperse along the soft tissue that covers the posterior region of the vertebrae. In the other cases, the particles with reabsorvation filled the reduced space between the transversal processes. For the second group, the quantity of material and its location also varied among the individuals. In most of the cases, several particles of homolog bone filled the space between the lateral processes whose bone neo-formation led to a trapping of these particles. All the cases showed formation in a higher or lower intensity of the cartilaginous tissue in the surface of the transverse processes. The radiological analysis showed in its relative frequency a higher frequency of complete fusion for group 2 when compared to group 1. Conclusion: Under the histological view for the model and experimental period analyzed, we inferred that, despite the fact that none of the proposed treatments had promoted a complete fusion of the vertebraes per bone tissue, the use of homolog bone + bovine BMPs associated with the use of cefazolin promoted a higher cartilaginous and bone formation with lower incidence of rejection of the material grafted in the doer area when compared to the group without the association of cefazolin. Under the radiological view, the relative analysis also showed to be superior in the group where cefazolin was used as a prophylactic antibiotic.
- ItemAcesso aberto (Open Access)Uso da biocerâmica no preenchimento de falhas ósseas(Sociedade Brasileira de Ortopedia e Traumatologia, 2010-01-01) Garrido, Carlos Antonio [UNIFESP]; Sampaio, Tania Clarete Fonseca Vieira Sales; Universidade Federal de São Paulo (UNIFESP); UFMGOBJETIVE: To present the results of the use of biological ceramic in filling bone defects resulting from traumatic or orthopedic injuries. METHODS: We evaluated 36 patients with bone defects caused by trauma or orthopedic injury. Nineteen patients were male (52.8%) and 17 were female (47.2%). Age ranged from 19 to 84 years, with a mean of 45.7 years and median of 37 years. We only included patients with defects which required at least five grams of biological ceramic. Eighteen cases were classified as orthopedic; bone defects were observed in 11 of the total hip arthroplasties; one case of primary total hip arthroplasty, by coxarthrosis; femoral or tibial open wedge osteotomies, five cases; and tarsal arthrodesis, one case. There were 18 cases of trauma-related defects; uninfected pseudarthrosis, 8 cases; recent fractures of the tibial plateau with compression of the spongious bone, 3 cases; and fractures treated with external fixators, 7 cases. The surgical technique consisted of curetting and debriding the injury until viable bone for grafting was found. Biological ceramic was used to fill the gap and some kind of fixation was applied. RESULTS: Of the 36 patients evaluated, we observed that 35 (97.2%) showed integration of biological ceramic, 1 case of open fracture treated with external fixation had poor integration of biological ceramic. CONCLUSION: Treatment of bone defects of orthopedic or traumatic etiology with the use of a phospho-calcium ceramic composed of hydroxyapatite, has been proven as practical, effective and safe.
- ItemAcesso aberto (Open Access)Utilização da densitometria óssea como método de avaliação dos resultados da utilização de BMP bovina em artrodese de coluna em coelhos(Sociedade Brasileira de Ortopedia e Traumatologia, 2005-01-01) Machado, Paulo Roberto Moura [UNIFESP]; Puertas, Eduardo Barros [UNIFESP]; Taga, Eulázio Mikio; Nonose, Nilson; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Universidade São Francisco Serviço de Ortopedia e TraumatologiaThe object of this study is to evaluate the use of the bone densitometry as an evaluation method of the bone increment observed when we used bovine BMP in intertransverse arthrodesis of the rabbits' lumbar spine. Since the discovery of the BMP bone inductive properties, countless experimental models have been proposed. This caused the need of setting up evaluation methods to make possible a better understanding of the found results. Twenty female rabbits from New Zealand, divided in two groups, were submitted to the intertransverse arthrodesis of the lumbar column, segment L5/L6, posterior side. In the first group it was used autologous graft and in the second an association of autologous graft with biocompound (bovine BMP, 1.0 mg and hydroxyapatite, 9.0 mg). The animals were maintained in captivity, isolated and after 15 weeks submitted to the execution of bone densitometry by computerized tomography. 268 bone density measures of the normal bone, 134 measures of the newly formed bone by the association of the isolated autologous graft and 134 measures of the newly formed bone by the association autologous graft and BMP were obtained, what demonstrated a significant bone increment after statistical analysis (p=0.034) of the BMP/HAP group, when compared to the control group. We found this same variation of bone density analyzing the normal bone. The bone densitometry accomplished by the computerized tomography is an alternative method to assess the results when the BMP is used in experimental studies. Further studies should be accomplished for better understanding of the bone density variation found when the measures of the normal bone in the two groups are compared.