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  1. Article: Three-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible.

    Sapienza, Lucas G / Thomas, Justin J / Mai, Weiyuan / Hanania, Alexander N / Hunjan, Sandeep / Sandulache, Vlad C / Chen, Albert C

    Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology

    2022  Volume 27, Issue 3, Page(s) 519–526

    Abstract: Background: The purpose of this study was to describe the topography, extension (volume), and timing of severe osteoradionecrosis (ORN) that required mandible resection in patients previously treated for head and neck cancer at a high-volume Veterans ... ...

    Abstract Background: The purpose of this study was to describe the topography, extension (volume), and timing of severe osteoradionecrosis (ORN) that required mandible resection in patients previously treated for head and neck cancer at a high-volume Veterans Affairs Medical Center.
    Materials and methods: The records from a reference hyperbaric oxygen clinic were retrospectively analyzed (n = 50, 2018-2021). Inclusion criteria were: I) severe ORN defined as progressive ORN that required resection; II) pathologic confirmation of ORN; and III) availability of pre-operative CT-imaging. Using a radiotherapy (RT) imaging software, we performed a detailed volumetric (3D) analysis of the bone involvement by ORN. Time intervals from RT to surgery for ORN and from surgery to the last follow-up were calculated.
    Results: All patients that met inclusion criteria (n = 10) were male with significant smoking history (median 47.5 pack-years) and a median age of 57 years old at the time of RT. The primary tumors were: oropharynx (n = 6), oral cavity (n = 3) and nasopharynx (n = 1). The median time from RT to ORN surgery was 8 years. The most common ORN location was the posterior lateral body (molar) and six patients had associated fractures. The mean ORN volume was 3.6 cc (range: 0.6-8.3), corresponding to a mean 6.3% (range: 0.7-14) of the total mandibular volume. After a median follow-up of 13.5 months, no recurrence of ORN occurred. Three patients died of non-cancer and non-ORN-recurrence related causes (1 y OS 77.1%).
    Conclusion: Severe ORN occurred after a median of 8 years from the previous RT and usually affected the posterior lateral body. Surgical resection achieved excellent ORN control.
    Language English
    Publishing date 2022-07-29
    Publishing country Poland
    Document type Journal Article
    ZDB-ID 2188087-6
    ISSN 1507-1367
    ISSN 1507-1367
    DOI 10.5603/RPOR.a2022.0057
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    Zs.A 6108: Show issues Location:
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  2. Article ; Online: Onsite versus offsite radiation treatment of malignant spinal cord compression: lessons from a safety net health system.

    Chen, Albert C / Bonnen, Mark D / Mok, Henry

    The British journal of radiology

    2017  Volume 90, Issue 1072, Page(s) 20160922

    Abstract: Objective: Metastatic spinal cord compression (MSCC) is an oncologic emergency that often warrants emergent treatment; but, it is unclear whether radiation treatment (RT) can be optimally managed from an offsite radiotherapy facility.: Methods: ... ...

    Abstract Objective: Metastatic spinal cord compression (MSCC) is an oncologic emergency that often warrants emergent treatment; but, it is unclear whether radiation treatment (RT) can be optimally managed from an offsite radiotherapy facility.
    Methods: Patient charts from consecutive patients with MSCC who were treated with radiotherapy alone at either an onsite hospital radiation department (from 2008 to 2012) or an offsite radiotherapy centre (2012-2015) were reviewed. Patient clinical parameters were compared across groups with either the χ
    Results: A total of 45 patients were identified, with 19 patients treated onsite in the hospital department and 26 patients treated at the offsite radiotherapy centre with median follow-up of 42 days vs 48.5 days, respectively. The ambulatory rate over time, overall survival and cancer-specific survival were not significantly different between the two eras. Patients treated in-hospital were more likely to start treatment the same day as the consult ("sim and treat") (79% vs 27%, p = 0.006) and were more likely to not complete treatment (26% vs 4%, p = 0.029) as compared with those treated in the offsite centre.
    Conclusion: Patients with MSCC can be feasibly treated at an offsite radiotherapy centre with outcomes similar to those treated in-hospital. Advances in knowledge: This is the first study in literature to compare outcomes between onsite and offsite RT of MSCC.
    MeSH term(s) Ambulatory Care/methods ; Ambulatory Care Facilities/statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Radiology Department, Hospital/statistics & numerical data ; Spinal Cord Compression/radiotherapy ; Spinal Neoplasms/radiotherapy ; Survival Analysis ; Treatment Outcome
    Language English
    Publishing date 2017-04
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 2982-8
    ISSN 1748-880X ; 0007-1285
    ISSN (online) 1748-880X
    ISSN 0007-1285
    DOI 10.1259/bjr.20160922
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  3. Article ; Online: Consistent multimodality approach to oral cavity and high-risk oropharyngeal cancer in veterans.

    Hernandez, David J / Alam, Bahar / Kemnade, Jan O / Huang, Andrew T / Chen, Albert C / Sandulache, Vlad C

    American journal of otolaryngology

    2021  Volume 42, Issue 6, Page(s) 103166

    Abstract: Purpose: High-risk oropharyngeal squamous cell carcinoma (OPSCC) associated with tobacco exposure remains difficult to treat due to high rates of locoregional recurrence similar to oral cavity squamous cell carcinoma (OCSCC). Current NCCN guidelines ... ...

    Abstract Purpose: High-risk oropharyngeal squamous cell carcinoma (OPSCC) associated with tobacco exposure remains difficult to treat due to high rates of locoregional recurrence similar to oral cavity squamous cell carcinoma (OCSCC). Current NCCN guidelines allow for surgical management of this disease, but oncologic and functional data in the modern era remain scarce. We sought to compare and contrast oncologic and functional considerations for surgical management of OPSCC and OCSCC in a cohort of Veterans.
    Materials and methods: We conducted a retrospective review of patients treated at the Michael E. DeBakey Veterans Affairs Medical Center between 2017 and 2020, treated using a homogenous, multi-modality algorithm.
    Results: OPSCC tumors presented with a higher rate of perineural invasion (p < 0.05) and extranodal extension (p = 0.02) compared to OCSCC tumors. Compliance with NCCN guidelines for adjuvant treatment were lower for OPSCC patients primarily due to a higher rate of previous irradiation; re-irradiation could be delivered in 75% of patients when recommended by NCCN guidelines. Total glossectomy was accompanied by concomitant total laryngectomy in 100% of OPSCC patients and 0% of OCSCC.
    Conclusion: Surgical resection and free flap reconstruction of high-risk OPSCC generates oncologic outcomes comparable to OCSCC with comparable complication rates but a lower overall functional status. Reconstruction focused on rapid healing allows for high-rates of re-irradiation and minimal treatment delays.
    Level of evidence: level 4.
    MeSH term(s) Aged ; Combined Modality Therapy ; Female ; Free Tissue Flaps ; Glossectomy ; Humans ; Laryngectomy ; Male ; Middle Aged ; Mouth/surgery ; Neoplasm Invasiveness ; Oropharyngeal Neoplasms/pathology ; Oropharyngeal Neoplasms/radiotherapy ; Oropharyngeal Neoplasms/surgery ; Otorhinolaryngologic Surgical Procedures/methods ; Practice Guidelines as Topic ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk ; Squamous Cell Carcinoma of Head and Neck/pathology ; Squamous Cell Carcinoma of Head and Neck/radiotherapy ; Squamous Cell Carcinoma of Head and Neck/surgery ; Treatment Outcome ; Veterans ; Veterans Health
    Language English
    Publishing date 2021-07-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604541-8
    ISSN 1532-818X ; 0196-0709
    ISSN (online) 1532-818X
    ISSN 0196-0709
    DOI 10.1016/j.amjoto.2021.103166
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    Zs.A 1637: Show issues Location:
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  4. Article ; Online: Combined Mapping of Multiple clUsteriNg ALgorithms (COMMUNAL): A Robust Method for Selection of Cluster Number, K.

    Sweeney, Timothy E / Chen, Albert C / Gevaert, Olivier

    Scientific reports

    2015  Volume 5, Page(s) 16971

    Abstract: In order to discover new subsets (clusters) of a data set, researchers often use algorithms that perform unsupervised clustering, namely, the algorithmic separation of a dataset into some number of distinct clusters. Deciding whether a particular ... ...

    Abstract In order to discover new subsets (clusters) of a data set, researchers often use algorithms that perform unsupervised clustering, namely, the algorithmic separation of a dataset into some number of distinct clusters. Deciding whether a particular separation (or number of clusters, K) is correct is a sort of 'dark art', with multiple techniques available for assessing the validity of unsupervised clustering algorithms. Here, we present a new technique for unsupervised clustering that uses multiple clustering algorithms, multiple validity metrics, and progressively bigger subsets of the data to produce an intuitive 3D map of cluster stability that can help determine the optimal number of clusters in a data set, a technique we call COmbined Mapping of Multiple clUsteriNg ALgorithms (COMMUNAL). COMMUNAL locally optimizes algorithms and validity measures for the data being used. We show its application to simulated data with a known K, and then apply this technique to several well-known cancer gene expression datasets, showing that COMMUNAL provides new insights into clustering behavior and stability in all tested cases. COMMUNAL is shown to be a useful tool for determining K in complex biological datasets, and is freely available as a package for R.
    MeSH term(s) Algorithms ; Cluster Analysis ; Computational Biology/methods ; Computer Simulation ; Databases, Genetic ; Genome, Human ; Humans ; Neoplasms/genetics ; Reproducibility of Results
    Language English
    Publishing date 2015-11-19
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/srep16971
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  5. Article ; Online: Endoscopic assessment of radiological stage IVA cervical cancer: A bivariate meta-analysis supporting an evidence-based staging algorithm proposal.

    Sapienza, Lucas G / Thomas, Justin J / Showalter, Timothy N / Echeverria, Alfredo E / Ludwig, Michelle S / Chen, Albert C / Jo, Eunji / Calsavara, Vinícius F / Hilsenbeck, Susan G / Jhingran, Anuja / Frumovitz, Michael M / Baiocchi, Glauco

    Gynecologic oncology

    2022  Volume 165, Issue 3, Page(s) 642–649

    Abstract: Objective: To optimize the use of confirmatory endoscopic exams (cystoscopy/proctoscopy) in the staging of locally advanced cervical cancer (LACC), the present study evaluates the predictive value of radiological exams (CT and MRI) to detect bladder/ ... ...

    Abstract Objective: To optimize the use of confirmatory endoscopic exams (cystoscopy/proctoscopy) in the staging of locally advanced cervical cancer (LACC), the present study evaluates the predictive value of radiological exams (CT and MRI) to detect bladder/rectum invasion.
    Methods: A systematic search of databases (PubMed and EMBASE) was performed (CRD42021270329). The inclusion criteria were: a) cervix cancer diagnosis; b) staging CT and/or MRI (index test); c) staging cystoscopy and/or proctoscopy (standard test); and d) numbers of true positives (TP), true negatives (TN), false positives (FP), and false negatives (FN) provided. A random-effects bivariate meta-analysis of positive predictive value (PPV) and negative predictive value (NPV) was performed with moderator analyses by imaging modality (CT and MRI) and prevalence.
    Results: Nineteen studies met the inclusion criteria, totaling 3480 and 1641 patients for bladder and rectum analyses, respectively. For bladder invasion (prevalence ranged from 0.9% to 34.5%), the overall PPV was 45% (95% confidence interval, 33%-57%, based on 19 studies). Per subgroup, the PPV was 31% for MRI/prevalence ≤6%, 33% for CT/prevalence ≤6%, and 69% for CT/prevalence >6%. For rectal invasion (prevalence ranged from 0.4% to 20.0%), the overall PPV was 30% (95% confidence interval, 17%-47%, based on 8 studies). Per subgroup, the PPV was 36% for MRI/prevalence ≤1%, 17% for MRI/prevalence >1%, and 38% for CT/prevalence >1%. The overall NPV for bladder invasion and rectal invasion were 98% (95% confidence interval, 97%-99%) and 100% (95% confidence interval, 99%-100%), respectively. Considering prevalence and radiological modality, the point estimate of NPV varied from 95% to 100% for bladder invasion and from 99% to 100% for rectum invasion.
    Conclusions: Due to low PPV (<50%) of radiological staging, endoscopic exams may be necessary to correctly assess radiological stage IVA LACC. However, they are not necessary after negative radiological exam (NPV ≥95%).
    MeSH term(s) Algorithms ; Cystoscopy ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Neoplasm Staging ; Radiography ; Uterine Cervical Neoplasms/pathology
    Language English
    Publishing date 2022-04-08
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Review
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2022.03.026
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    Zs.A 885: Show issues Location:
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  6. Article ; Online: Persistent ethnicity-associated disparity in anti-tumor effectiveness of immune checkpoint inhibitors despite equal access.

    Florez, Marcus A / Kemnade, Jan O / Chen, Nan / Du, Wendy / Sabichi, Anita L / Wang, Daniel Y / Huang, Quillan / Miller-Chism, Courtney N / Jotwani, Aparna / Chen, Albert C / Hernandez, David / Sandulache, Vlad C

    Cancer research communications

    2021  Volume 2022

    Abstract: We reviewed response to immune checkpoint inhibitors (ICI) of 207 patients with diagnoses of lung or head and neck cancer treated with chemotherapy/ICI combination therapy and ICI monotherapy between 2015 and 2020 at one of three clinical pavilions ... ...

    Abstract We reviewed response to immune checkpoint inhibitors (ICI) of 207 patients with diagnoses of lung or head and neck cancer treated with chemotherapy/ICI combination therapy and ICI monotherapy between 2015 and 2020 at one of three clinical pavilions associated with the Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine. Two of these pavilions (Harris Health System and the Michael E. DeBakey Veterans Affairs Medical Center) serve large minority populations and provide equal access to care regardless of means. 174 patients had a diagnosis of lung cancer (non-small cell or small cell) and 33 had a diagnosis of head and neck squamous cell carcinoma (HNSCC). 38% self-identified as Black, 45% as non-Hispanic White, and 18% as Hispanic. The objective response rate (ORR) was similar for lung cancer (35.057%) and HNSCC patients (30.3%) (p=0.894). The ORR for Hispanic and Black patients was lower compared to non-Hispanic White patients (H 27.0%, B 32.5%, W 38.7%; H vs. W p=0.209; B vs. W p=0.398). When considering only patients treated with ICI monotherapy, the ORR for Hispanic patients dropped further to 20.7% while the ORR of Black and non-Hispanic White patients remained about the same (B 29.3% and W 35.9%, H vs. W p=0.133; B vs. W p=0.419). Immune related adverse events were the lowest in the Hispanic population occurring in only 30% of patients compared to 40% of patients in the Black cohort and 50% of the non-Hispanic White cohorts.
    MeSH term(s) Humans ; Ethnicity ; Squamous Cell Carcinoma of Head and Neck/drug therapy ; Immune Checkpoint Inhibitors/pharmacology ; Retrospective Studies ; Head and Neck Neoplasms/drug therapy ; Lung Neoplasms/drug therapy
    Chemical Substances Immune Checkpoint Inhibitors
    Language English
    Publishing date 2021-11-10
    Publishing country United States
    Document type Review ; Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, Non-U.S. Gov't
    ISSN 2767-9764
    ISSN (online) 2767-9764
    DOI 10.1158/2767-9764.CRC-21-0143
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  7. Article ; Online: Goblet cell LRRC26 regulates BK channel activation and protects against colitis in mice.

    Gonzalez-Perez, Vivian / Martinez-Espinosa, Pedro L / Sala-Rabanal, Monica / Bharadwaj, Nikhil / Xia, Xiao-Ming / Chen, Albert C / Alvarado, David / Gustafsson, Jenny K / Hu, Hongzhen / Ciorba, Matthew A / Lingle, Christopher J

    Proceedings of the National Academy of Sciences of the United States of America

    2020  Volume 118, Issue 3

    Abstract: Goblet cells (GCs) are specialized cells of the intestinal epithelium contributing critically to mucosal homeostasis. One of the functions of GCs is to produce and secrete MUC2, the mucin that forms the scaffold of the intestinal mucus layer coating the ... ...

    Abstract Goblet cells (GCs) are specialized cells of the intestinal epithelium contributing critically to mucosal homeostasis. One of the functions of GCs is to produce and secrete MUC2, the mucin that forms the scaffold of the intestinal mucus layer coating the epithelium and separates the luminal pathogens and commensal microbiota from the host tissues. Although a variety of ion channels and transporters are thought to impact on MUC2 secretion, the specific cellular mechanisms that regulate GC function remain incompletely understood. Previously, we demonstrated that leucine-rich repeat-containing protein 26 (LRRC26), a known regulatory subunit of the Ca
    MeSH term(s) Animals ; Colitis/genetics ; Colitis/pathology ; Colitis/prevention & control ; Colitis/therapy ; Colon/metabolism ; Colon/pathology ; Disease Models, Animal ; Goblet Cells/metabolism ; Goblet Cells/pathology ; Humans ; Intestinal Mucosa/metabolism ; Intestinal Mucosa/pathology ; Large-Conductance Calcium-Activated Potassium Channels/genetics ; Membrane Potentials/genetics ; Mice ; Mucin-2/genetics ; Patch-Clamp Techniques
    Chemical Substances Large-Conductance Calcium-Activated Potassium Channels ; Lrrc26 protein, mouse ; Muc2 protein, mouse ; Mucin-2
    Language English
    Publishing date 2020-12-21
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 209104-5
    ISSN 1091-6490 ; 0027-8424
    ISSN (online) 1091-6490
    ISSN 0027-8424
    DOI 10.1073/pnas.2019149118
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    Zs.A 1148: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  8. Article ; Online: Matrix Rigidity Controls Epithelial-Mesenchymal Plasticity and Tumor Metastasis via a Mechanoresponsive EPHA2/LYN Complex.

    Fattet, Laurent / Jung, Hae-Yun / Matsumoto, Mike W / Aubol, Brandon E / Kumar, Aditya / Adams, Joseph A / Chen, Albert C / Sah, Robert L / Engler, Adam J / Pasquale, Elena B / Yang, Jing

    Developmental cell

    2020  Volume 54, Issue 3, Page(s) 302–316.e7

    Abstract: Mechanical cues from the extracellular matrix (ECM) regulate various cellular processes via distinct mechanotransduction pathways. In breast cancer, increased ECM stiffness promotes epithelial-to-mesenchymal transition (EMT), cell invasion, and ... ...

    Abstract Mechanical cues from the extracellular matrix (ECM) regulate various cellular processes via distinct mechanotransduction pathways. In breast cancer, increased ECM stiffness promotes epithelial-to-mesenchymal transition (EMT), cell invasion, and metastasis. Here, we identify a mechanosensitive EPHA2/LYN protein complex regulating EMT and metastasis in response to increasing ECM stiffness during tumor progression. High ECM stiffness leads to ligand-independent phosphorylation of ephrin receptor EPHA2, which recruits and activates the LYN kinase. LYN phosphorylates the EMT transcription factor TWIST1 to release TWIST1 from its cytoplasmic anchor G3BP2 to enter the nucleus, thus triggering EMT and invasion. Genetic and pharmacological inhibition of this pathway prevents breast tumor invasion and metastasis in vivo. In human breast cancer samples, activation of this pathway correlates with collagen fiber alignment, a marker of increasing ECM stiffness. Our findings reveal an EPHA2/LYN/TWIST1 mechanotransduction pathway that responds to mechanical signals from the tumor microenvironment to drive EMT, invasion, and metastasis.
    MeSH term(s) Animals ; Breast Neoplasms/metabolism ; Cell Adhesion/physiology ; Cell Line, Tumor ; Cell Movement/physiology ; Epithelial-Mesenchymal Transition/genetics ; Epithelial-Mesenchymal Transition/physiology ; Extracellular Matrix/metabolism ; Humans ; Mammary Neoplasms, Animal/metabolism ; Mechanotransduction, Cellular/genetics ; Mice ; Nuclear Proteins/metabolism ; Receptor, EphA2/genetics ; Receptor, EphA2/metabolism ; Tumor Microenvironment/genetics ; Tumor Microenvironment/physiology ; Twist-Related Protein 1/metabolism
    Chemical Substances Nuclear Proteins ; TWIST1 protein, human ; Twist-Related Protein 1 ; Receptor, EphA2 (EC 2.7.10.1)
    Language English
    Publishing date 2020-06-22
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2054967-2
    ISSN 1878-1551 ; 1534-5807
    ISSN (online) 1878-1551
    ISSN 1534-5807
    DOI 10.1016/j.devcel.2020.05.031
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  9. Article: Comparison of height and weight after 12 vs. 18 Gy cranial radiation therapy in pediatric acute lymphoblastic leukemia (ALL) patients.

    Chen, Albert C / Okcu, M Fatih / Dreyer, ZoAnn E / Kamdar, Kala Y / Sonabend, Rona Y / Suzawa, Hilary S / Jo, Eunji / Paulino, Arnold C

    Advances in radiation oncology

    2017  Volume 2, Issue 2, Page(s) 228–234

    Abstract: Purpose: To compare the effect of 12 versus 18 Gy cranial radiation therapy (RT) on height and weight indices among pediatric patients with acute lymphoblastic leukemia (ALL).: Methods and materials: Records of children with ALL who were 2 to 14 ... ...

    Abstract Purpose: To compare the effect of 12 versus 18 Gy cranial radiation therapy (RT) on height and weight indices among pediatric patients with acute lymphoblastic leukemia (ALL).
    Methods and materials: Records of children with ALL who were 2 to 14 years old at the time of RT and were treated at a single institution between 2000 and 2011 were reviewed. Patients' height, weight, and body mass index were converted into z-scores using the Centers for Disease Control growth charts to normalize the values to number of standard deviations from the mean. These values were measured at the pre-RT clinic visit and subsequent yearly intervals. The z-scores of the growth indices were fitted into a generalizing estimating equations model and analyzed by various clinical factors.
    Results: A total of 48 patients met the study criteria, including 32 boys and 16 girls. The median age at the time of RT was 7 years (range, 2-14 years). Patients were separated into 2 dose groups: 12 Gy (n = 30) and 18 Gy (n = 18). Median follow-up was 4.9 years (range, 3.0-11.8 years) and 6.0 years (range, 3.1-10.5 years) and the median pre-RT height z-scores were -0.55 (range, -2.2 to 1.4) and -0.85 (range, -3.1 to 0.8) for the 2 groups, respectively (
    Conclusions: Compared with 18 Gy, patients with ALL who received 12 Gy of cranial RT had less height impairment in the first 3 years post-RT, but further prospective studies are needed.
    Language English
    Publishing date 2017-02-01
    Publishing country United States
    Document type Journal Article
    ISSN 2452-1094
    ISSN 2452-1094
    DOI 10.1016/j.adro.2017.01.010
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  10. Article ; Online: Impact insertion of osteochondral grafts: Interference fit and central graft reduction affect biomechanics and cartilage damage.

    Su, Alvin W / Chen, Yunchan / Wailes, Dustin H / Wong, Van W / Cai, Shengqiang / Chen, Albert C / Bugbee, William D / Sah, Robert L

    Journal of orthopaedic research : official publication of the Orthopaedic Research Society

    2017  Volume 36, Issue 1, Page(s) 377–386

    Abstract: An osteochondral graft (OCG) is an effective treatment for articular cartilage and osteochondral defects. Impact of an OCG during insertion into the osteochondral recipient site (OCR) can cause chondrocyte death and matrix damage. The aim of the present ... ...

    Abstract An osteochondral graft (OCG) is an effective treatment for articular cartilage and osteochondral defects. Impact of an OCG during insertion into the osteochondral recipient site (OCR) can cause chondrocyte death and matrix damage. The aim of the present study was to analyze the effects of graft-host interference fit and a modified OCG geometry on OCG insertion biomechanics and cartilage damage. The effects of interference fit (radius of OCG - radius of OCR), loose (0.00 mm), moderate (0.05 mm), tight (0.10 mm), and of a tight fit with OCG geometry modification (central region of decreased radius), were analyzed for OCG cylinders and OCR blocks from adult bovine knee joints with an instrumented drop tower apparatus. An increasingly tight (OCG - OCR) interference fit led to increased taps for insertion, peak axial force, graft cartilage axial compression, cumulative and total energy delivery to cartilage, lower time of peak axial force, lesser graft advancement during each tap, higher total crack length in the cartilage surface, and lower chondrocyte viability. The modified OCG, with reduction of diameter in the central area, altered the biomechanical insertion variables and biological consequences to be similar to those of the moderate interference fit scenario. Micro-computed tomography confirmed structural interference between the OCR bone and both the proximal and distal bone segments of the OCGs, with the central regions being slightly separated for the modified OCGs. These results clarify OCG insertion biomechanics and mechanobiology, and introduce a simple modification of OCGs that facilitates insertion with reduced energy while maintaining a structural interference fit. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:377-386, 2018.
    MeSH term(s) Animals ; Biomechanical Phenomena ; Bone Transplantation ; Cartilage, Articular/pathology ; Cartilage, Articular/physiology ; Cartilage, Articular/surgery ; Cattle ; Chondrocytes/physiology ; Chondrocytes/transplantation ; Transplants
    Language English
    Publishing date 2017-09-05
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 605542-4
    ISSN 1554-527X ; 0736-0266
    ISSN (online) 1554-527X
    ISSN 0736-0266
    DOI 10.1002/jor.23645
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