Search

The aim of the present paper was to highlight the work of Chrysospathis, Garofalidis and Chartofylakidis, who dedicated themselves to the emergence of orthopaedics as an independent branch of medical science in modern Greece. The ancient Greek physicians Hippocrates, Galen and Paulus of Aegina laid the foundations for the emergence of orthopaedics and ancient Greek civilisation undoubtedly played a significant role in the evolution of this medical art throughout the following centuries. In modern Greece, Ioannis Chrysospathis fought for orthopaedics to be a separate medical branch rather than a practice within the context of general surgery. Theodoros Garofalidis also contributed to the evolution of orthopaedics in Greece, while Georgios Hartofilakidis brought pioneer knowledge to the Greek area, contributed to the creation of specialised orthopaedic departments and internationally contributed to the study of hip diseases and the art of total hip arthroplasty.

Reamed intramedullary nailing (RIN) is a surgical method of choice for treatment of diaphyseal fractures. This procedure affects the biological environment of bone tissue locally and systemically. This study investigated the influence of RIN on mesenchymal stem cells (MSCs) in patients with long bone fractures. The axis of C-X-C motif chemokine receptor 4 (CXCR4)/stromal cell-derived factor 1 (SDF-1) was selected since it is considered as major pathway for MSC homing and migration. Iliac crest bone marrow (IC-BM) samples and blood samples were collected at two different time points. One sample was collected before the RIN (BN) and the other immediately after RIN (AN). BM-MSCs were cultured and RT-qPCR was performed for CXCR4 mRNA levels and ELISA for the SDF-1 sera levels. The experimental study revealed that there was a correlation between the increase of SDF-1 levels in peripheral blood and a decrease in the levels of CXCR4 in MSCs in the IC-BM following RIN. The levels of SDF-1 showed a significant increase in the sera of patients after RIN. In conclusion, the present study is the first providing evidence of the effects of RIN on MSC population via the CXCR4/SDF-1 axis. The levels of serum SDF-1 factor were elevated after RIN while increased levels of SDF-1 in peripheral blood were inversely correlated with the mRNA levels of CXCR4 on BM-MSCs after RIN. Therefore, this study contributes to enlighten the systematic effects of RIN on the population of MSCs at a cellular level. [ABSTRACT FROM AUTHOR]

Background: In view of the current interest in exploring the clinical use of mesenchymal stem cells (MSCs) from different sources, we performed a side-by-side comparison of the biological properties of MSCs isolated from the Wharton's jelly (WJ), the most abundant MSC source in umbilical cord, with bone marrow (BM)-MSCs, the most extensively studied MSC population. Methods: MSCs were isolated and expanded from BM aspirates of hematologically healthy donors (n = 18) and from the WJ of full-term neonates (n = 18). We evaluated, in parallel experiments, the MSC immunophenotypic, survival and senescence characteristics as well as their proliferative potential and cell cycle distribution. We also assessed the expression of genes associated with the WNT- and cell cycle-signaling pathway and we performed karyotypic analysis through passages to evaluate the MSC genomic stability. The hematopoiesis-supporting capacity of MSCs from both sources was investigated by evaluating the clonogenic cells in the non-adherent fraction of MSC co-cultures with BM or umbilical cord blood-derived CD34+ cells and by measuring the hematopoietic cytokines levels in MSC culture supernatants. Finally, we evaluated the ability of MSCs to differentiate into adipocytes and osteocytes and the effect of the WNT-associated molecules WISP-1 and sFRP4 on the differentiation potential of WJ-MSCs. Results: Both ex vivo-expanded MSC populations showed similar morphologic, immunophenotypic, survival and senescence characteristics and acquired genomic alterations at low frequency during passages. WJ-MSCs exhibited higher proliferative potential, possibly due to upregulation of genes that stimulate cell proliferation along with downregulation of genes related to cell cycle inhibition. WJ-MSCs displayed inferior lineage priming and differentiation capacity toward osteocytes and adipocytes, compared to BM-MSCs. This finding was associated with differential expression of molecules related to WNT signaling, including WISP1 and sFRP4, the respective role of which in the differentiation potential of WJ-MSCs was specifically investigated. Interestingly, treatment of WJ-MSCs with recombinant human WISP1 or sFRP4 resulted in induction of osteogenesis and adipogenesis, respectively. WJ-MSCs exhibited inferior hematopoiesis-supporting potential probably due to reduced production of stromal cell-Derived Factor-1α, compared to BM-MSCs. Conclusions: Overall, these data are anticipated to contribute to the better characterization of WJ-MSCs and BM-MSCs for potential clinical applications. [ABSTRACT FROM AUTHOR]

The article focuses on the bone marrow mesenchymal stem/stromal cells (BM-MSCs) in the disease progression of B-cell lymphoma. It discusses the anti-apoptotic and chemotactic effect of malignant bone marrow (BM) and healthy donor (HD) derived BM-MSC, determination of MSC's incidence related bone marrow mononuclear cell (BMMC) fraction with the help of colony forming unit-fibroblast (CFU-F) assay.

Calcaneal fractures are complex injuries with high complication rates and they can lead to serious disability. The proper management remains controversial and complications may occur regardless of the chosen type of treatment (operative or nonoperative). The present article reviews the studies that are related to the complications of calcaneal fractures. The incidence, the diagnosis, the prevention and the treatment of these complications were researched and analyzed, with the use of PubMed database, abstracts and original articles in English than investigate the etiology. The aim of the article is to discuss the most suitable management of the complications of calcaneal fractures and recommend a specific treatment as well as prevention methods.Levels Of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

For the evaluation of the functionality and mobility of the spine, several methods have been developed. The purpose of this study was to estimate the test-retest reliability of the Spinal Mouse, a new, non-invasive, computer-assisted wireless telemetry device for the assessment of the curvatures, the mobility and the functionality of the spine. Materials and methods: the test-retest reliability was evaluated in 50 adults with back or low back pain. Twenty four parameters were studied in the sagittal and frontal plane. For the characterization of the precision, the intraclass correlation coefficient and the standard error of measurement were used. Results: in the sagittal plane, 22 of the 24 parameters showed high and good reliability, while only two fair and poor. In the frontal plane, 17 parameters showed high and good reliability, five fair and two poor. Discussion: the Spinal Mouse showed excellent test-retest reliability in the sagittal plane, while a slightly inferior performance in the frontal plane, for the evaluation of curvatures, deformation and mobility of the spine. [ABSTRACT FROM AUTHOR]

During the past few decades, significant advances have been made in the treatment of proximal humerus fractures. Nonetheless, their management remains controversial. T his article describes the key points for decision-making and the currents trends in the treatment of complex proximal humeral fractures. T he surgeon should define the fracture pattern and decide whether surgical intervention will benefit the patient. Furthermore, the preoperative plan needs to evaluate whether the viability of the humeral head can be preserved and proximal humeral anatomy can be restored. Osteosynthesis can be accomplished by various means, including open transosseous sutures, percutaneous fixation, conventional plating, intramedullary nailing, and locking plates. T he latter have gained considerable popularity over the last few years because they address the issue of poor bone stock in elderly patients. Furthermore, prosthetic replacement with either hemiarthroplasty or the more recently introduced reverse total shoulder arthroplasty offers an option in difficult cases that need surgical treatment and are unsuitable for open reduction-internal fixation. Nonetheless, the superiority of any technique has not yet been proven in the clinical setting. [ABSTRACT FROM AUTHOR]

Bone healing represents a physiological process of repair and restoration of function. Recent advances in a variety of medical disciplines have enabled scientists and clinicians to characterise this phenomenon at the molecular level. A number of molecular mediators and cells interact utilising different pathways. Despite the involvement of many local and systemic factors failure of the naturally occurring mechanisms can occur leading to either delayed union or non-union. This review article is focused on the recent understanding of the mechanisms governing the bone repair process. [ABSTRACT FROM AUTHOR]

Summary: The advent of locking plates for the management of metaphyseal fractures, and subsequent experience of biological fracture fixation, has led to the development of minimally invasive percutaneous osteosynthesis (MIPO), which is now proven to have multiple advantages. Soft tissue stripping is minimized, with preservation of vascular pedicles, and the fracture haematoma around the site of injury remains undisturbed promoting fracture healing. While early published results are encouraging, MIPO technique is not applicable to every fracture. To avoid complications, defining the correct indications is of paramount importance. [Copyright &y& Elsevier]

Summary: PubMed and Ovid Medline were searched to investigate the role of intramedullary nailing in the treatment of diaphyseal humeral non-union. Of 474 abstracts, 9 retrieved articles fulfilled our inclusion criteria and described management in 166 cases of humeral shaft non-union using several types of intramedullary nails. Union ranged from 40 to 100%; part of the variation could be explained by the quality index of the selected articles. Exchange nailing alone was not effective. Exposure of the fracture site and use of bone grafting were key to successful treatment. The total incidence of severe complications, including radial nerve damage, was very low. Thus, intramedullary nailing in the treatment of humeral shaft non-unions can lead to successful outcomes when associated with autologous bone grafting. [Copyright &y& Elsevier]