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Artificial Sheath On Natural Bone Cover Could Help Faster Healing In Traumatic Injuries
Melissa Knothe Tate, a joint professor of biomedical engineering and mechanical & aerospace engineering at Case Western Reserve University, and Ulf Knothe, an orthopedic surgeon at the Cleveland Clinic, announce their work at the annual meeting of the Orthopedic Research Society in New Orleans this week.
Knothe used the technique on a wheelchair-bound patient who suffered from cerebral palsy, hip dysplasia and a curved spine exacerbated by legs of differing length. To lengthen her shorter leg while correcting her hip dysplasia, he replaced the hip joint with a long-stemmed prosthesis, in the process cutting and spreading the femur to match the length of its mate. Around the newly-created gap in the femur he left a section of the periosteum, the bone's sleeve-like cover, intact to envelop and heal the gap.
Inside the sleeve, bone grew and matured around the prosthesis stem. The patient has since learned to walk again.
Why does the sleeve work?
"The sock-like sheath on the outside of the bone is a habitat for stem cells," Knothe Tate explained.
In testing on sheep in Switzerland, animals that had the periosteum operation to bridge a 1-inch gap in their leg stood within 24 hours and had substantial bone filling the gap within two weeks. In the lab, Knothe Tate and fellow researchers found that direct and angular pressure on stem cells from periosteum stimulated the cells to develop into bone. They believe the pressure of standing and shifting weight drove the bone growth in the sheep.
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