A new review paper published in the ESSKA journal show that use of bisphosphonates for the treatment of stress fractures should be limited. Another review paper from the same journal revealed that short- or mid-term clinical and histological results of tissue-engineering techniques with scaffolds are not better than conventional ACI.
Two japanese research fellows, Dr. Yosuke Shima and Dr. Junji Iwasa, each spent one year at the Oslo Sports Trauma Research Center from 2007 to 2008.
The two clinicians have - besides other projects - carried out extensive litterature research on hot topics within bone remodelling and within tissue engeneering techniques with scarffolds. These review papers now are published in the Journal of Knee Surgery of Sports Traumatology and Athroscopy.
Use of bisphosphonates for the treatment of stress fractures in athletes
Dr. Yosuke Shima, PhD, Kanazawa University Hospital, has in a literature review investigated the potential role of bisphosphonates for the treatment of stress fractures in athletes.
Given the inhibitory action on osteoclast-mediated bone resorption, short-termsuppression of bone remodeling using bisphosphonates could potentially treat and prevent stress fractures from becoming regular fractures.
While there are some animal studies showing the scientific basis of bisphosphonates on stress fractures, there is no conclusive evidence to prove any effect of
bisphosphonates on stress fracture healing in humans.
The authors conclude that, further well-designed clinical trials should be carried out to establish their usefulness and safety. Until more knowledge is available, it is prudent to limit the use of bisphosphonates for the treatment of stress fractures.
Involved in this literature review were also Lars Engrebretsen, Junji Iwasa, Katsuhiki Kitaoka and Katsuro Tomita.
Read the article.
Clinical application of scaffolds for cartilage tissue engineering
Dr. Junji Iwasa, PhD, Shimane University School of Medicine, has published a review paper aimed to summarize science and clinical literature on scaffolds clinically available for the treatment of articular cartilage injuries.
The use of tissue-engineered grafts based on scaffolds seems to be as effective as conventional ACI clinically. However, there is limited evidence that scaffold techniques result in homogeneous distribution of cells.
Similarly, few studies exist on the maintenance of the chondrocyte phenotype in scaffolds. Both of which would be potential advan-tages over the first generation ACI.
Results from former studies showed that the mean clinical score in all of the clinical literature on scaffold techniques significantly improved compared with preoperative values, and more than 80% of patients had an excellent or good outcome.
None of the short- or mid-term clinical and histological results of these tissue-engineering techniques with scaffolds were reported to be better than conventional ACI.
After reviewing all available literature on this topic, the authors conclude that firm recommendations on which cartilage repair procedure is to be preferred is not known for sure. Randomized clinical trials and longer follow-up periods are needed for more widespread information regarding the clinical effectiveness of scaffold-based, tissue-engineered cartilage repair.
Co-authors on this paper were Lars Engebretsen, Yosuke Shima and Mitsuo Ochi.
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