[show abstract][hide abstract] ABSTRACT: Abstract Aim. The purpose of this study was to investigate proliferation, morphology, mineralization and mRNA expressions of mineralized tissue associated proteins of PDL cells on smooth (S), sandblasted small-grit (SSG), sandblasted large-grit (SLG) and sodium titanate (NaTi) coated titanium alloys, in vitro. Methods and materials: PDL cells were cultured with DMEM media containing 10% FBS on the S, SSG, SLG and NaTi titanium surfaces. PDL cell proliferation, mineralization and immunohistochemistry experiments for Bone Sialoprotein (BSP) were performed. The morphology of the PDL cells was examined using confocal and scanning electron microscopy (SEM). Gene expression profiles of cells were evaluated using a quantitative-polymerase chain reaction (Q-PCR) for type I collagen (COL I), Osteocalcin (OCN), osteopontin (OPN) and Runt-related transcription factor-2 (Runx2) on days 7 and 14. Results. Proliferation results on days 6 and 10 were similar in groups, while those of day 13 revealed a decrease in the NaTi group when compared to the S group. NaTi surface induced BSP mRNA expression which was correlated with mineralization tests and BSP immunostaining results. Increased Runx2 mRNA expression was also noted in the NaTi surface when compared to other surfaces. Conclusions. This study considers the NaTi surface as a potential alternative to SSG and SLG surfaces. This surface might provide a promising environment for PDL ligament-anchored implants.
[show abstract][hide abstract] ABSTRACT: BACKGROUND: Acute effects of physical exercise on the deformational behaviour of articular cartilage and changes in cartilage oligomeric matrix protein (COMP) are definite. However, conclusive positive effects of fitness exercise on functional adaptation of articular cartilage have not been proved. AIM: Therefore, in this parallel-group randomised controlled trial, we tested the hypothesis that adequate amount of physical exercise with enough impact would be able to stimulate the functional behaviour of articular cartilage. METHODS: We evaluated 44 healthy males for their physical-fitness levels and their blood samples were obtained before, immediately after and 0.5h after a 30-min walking exercise. Thereafter, participants were assigned to the running, the cycling, the swimming and the control groups. At the end of 12weeks of intervention, the same measurement procedures were applied. Mixed repeated-measures analysis of variance (ANOVA) design was used for statistics. (Level of evidence: 2). RESULTS: Pre-test measurements showed that 30min of walking significantly increased serum-COMP levels in all groups. The post-tests revealed that the COMP level of all groups, except running, showed an increase after a 30-min walking activity. CONCLUSION: Overall, it was concluded that, 12weeks of regular, weight-bearing, high-impact physical exercise (i.e., running) decreases the deformational effect of walking activity. This finding is an evidence of functional adaptation of articular cartilage to specific environmental requirements.
[show abstract][hide abstract] ABSTRACT: Rhythm training is an integral part of sports. The purposes of the study were to analyze the effects of rhythm training on tennis performance and rhytmic competence of tennis players, to compare the improvement levels of tennis specific and general rhythm training and to examine the effects of shorter and longer tempos on rhythmic competence. Thirty university students whose mean score of International Tennis Number (ITN) was 7.3 (±0.9) were divided randomly into three sub-groups: Tennis Group, General Rhythm Training Group and Tennis-Specific Rhythm Training Group. The experimental procedure lasted 8 weeks. During this period, all groups had the same tennis training twice a week. The Tennis Group had regular tennis training sessions. In addition to regular tennis training sessions, the General Rhythm Training Group followed the general rhythm training sessions and the Tennis-Specific Rhythm Training Group had tennis-specific rhythm training. The measurement instruments were ITN, Rhythmic Competence Analysis Test and Untimed Consecutive Rally Test. The results indicated that participation in tennis-specific or general rhythm training resulted in progress in tennis playing levels, forehand consistency performance and rhythmic competence of the participants. On the other hand, attendance to the regular 8-week tennis training was enough to solely increase the tennis playing level but not sufficient to develop forehand consistency performance and rhythmic competence. Although the participants in the TRTG had better improvement scores than the ones in the GRTG, no significant difference was found between the rhythm training groups. The results also revealed that participants exhibited higher rhythmic competence scores on fast tempo compared to slow tempo.
Journal of Human Kinetics 06/2012; 33:123-32. · 0.46 Impact Factor
[show abstract][hide abstract] ABSTRACT: mRNA expressions related to osteogenic differentiation of MC3T3-E1 cells on electro-polished smooth (S), sandblasted small-grit (SSG) and sandblasted large-grit (SLG) surfaces of titanium alloys were investigated in vitro. Gene expression profiles of cells were evaluated using the RT2 Profiler PCR microarray on day 7. Mineralizing tissue-associated proteins, differentiation factors and extracellular matrix enzymes mRNA expressions were measured using Q-PCR. SLG surface upregulated 23 genes over twofolds and downregulated 3 genes when compared to the S surface. In comparison to the SSG surface, at least a twofold increase in 25 genes was observed in the SLG surface. BSP, OCN, OPN, COL I and ALP mRNA expressions increased in the SLG group when compared to the S and the SSG groups. BMP-2, BMP-6 and TGF-β mRNA expressions increased in both the SSG and the SLG surfaces. MMP-2 and MMP-9 mRNA expressions increased as the surface roughness increased. This study demonstrated that surface roughness of titanium implants has a significant effect on cellular behavior and SLG surface apparently increased gene expressions related to osteogenesis when compared to the S and the SSG surfaces.
[show abstract][hide abstract] ABSTRACT: Osteomyelitis caused by Methicillin-resistant Staphylococcus aureus (MRSA) often requires surgery and prolonged systemic antibiotic treatment. Local antibiotic delivery systems of bioceramics or polymers have been developed to treat osteomyelitis. A disadvantage of biodegradable polymers is the initial burst of antibiotics into the environment; one advantage of bioceramics is its osteoconductivity. We therefore developed a vancomycin-containing poly-l-lactic acid/β-tricalcium phosphate (PLLA/β-TCP) composite to control antibiotic release and stimulate bone formation.
We (1) characterized these composites, (2) assessed vancomycin release in inhibitory doses, and (3) determined whether they would permit cell adhesion, proliferation, and mineralization in vitro.
We molded 250 vancomycin-containing (VC) and 125 vancomycin-free (VUC) composites using PLLA, β-TCP, and chloroform. One hundred twenty-five VC composites were further dip-coated with PLLA (CVC) to delay antibiotic release. Composites were characterized according to their pore structure, size, volume, density, and surface area. Vancomycin release and bioactivity were determined. Adhesion, proliferation, and mineralization were assessed for two and three replicates on Days 3 and 7 with mesenchymal stem (MSC) and Saos type 2 cells.
Pore size, volume, apparent density, and surface area of the CVC were 3.5 ± 1.9 μm, 0.005 ± 0.002 cm(3)/g, 1.18 g/cm(3) and 3.68 m(2)/g, respectively. CVC released 1.71 ± 0.13 mg (63.1%) and 2.49 ± 0.64 mg (91.9%) of its vancomycin on Day 1 and Week 6, respectively. MSC and Saos type 2 cells attached and proliferated on composites on Days 3 and 7.
Vancomycin-containing PLLA/β-TCP composites release antibiotics in inhibitory doses after dip coating and appeared biocompatible based on adhesion, proliferation, and mineralization.
Vancomycin-containing PLLA/β-TCP composites may be useful for controlling MRSA but will require in vivo confirmation.
Clinical Orthopaedics and Related Research 09/2011; 469(11):3222-8. · 2.79 Impact Factor
[show abstract][hide abstract] ABSTRACT: Skeletal muscles deteriorate after ovariectomy. Molecular pathway of this deterioration has not been defined. Tumor necrosis factor (TNF)-alpha activation is assumed to trigger muscle atrophy and administration of its antagonist is hypothesized to recover this atrophy in rats. Slow-twitch soleus and fast-twitch extensor digitorum longus muscle functions were investigated in intact, ovariectomized (OVX), and OVX plus 10 µg/g/week TNF-alpha antagonist administered female rats. Maximum isometric twitch and tetanic contraction responses were lower in the OVX groups. Maximum isometric twitch amplitudes recovered in the extensor digitorum longus but not in the soleus muscles after TNF-alpha antagonist administration. The decrease in responses to tetanic stimulations recovered in the OVX-TNF group at frequencies higher than 20 Hz in both muscle types. OVX animals body weight was 21% higher than intact animals. Muscle weight to body weight ratios of the OVX groups were higher than the control group which recovered after TNF-alpha antagonist administration. Findings suggest that the functional loss in OVX rat muscles is TNF-alpha pathway dependent. Skeletal muscle atrophy and function after OVX recovered by TNF-alpha antagonist administration.
Journal of Orthopaedic Research 02/2011; 29(2):275-80. · 2.88 Impact Factor
[show abstract][hide abstract] ABSTRACT: Vibration analysis is a promising technique in diagnosing metabolic bone diseases such as osteoporosis and monitoring fracture healing. The aim of this study is to observe the structural dynamic property changes of the tibia extracted from the vibration analysis data.
In this study, bone mineral density and vibration measurements were made both in in vivo and in vitro conditions. The relationship between structural dynamic properties, obtained and bone mineral densities measured were investigated. Also, the effect of soft tissues on measured structural dynamic properties was analyzed.
Natural frequency of the tibia decreased with decreasing bone mineral density that presented a weak correlation with the bone mineral density values measured by dual energy X-ray densitometer of the femur. In the case of in vitro experiments, it was observed that the effect of muscles on measurement results is higher than that of the effect of the skin and the fibula which makes the modal identification procedure difficult. However, having very large percentage changes in the loss factors when mineral content and collagen are reduced is an encouraging result to believe that damping measurements may yield a promising technique in diagnosing progressing osteoporosis and monitoring fracture healing period.
The utilization of natural frequency alone as a diagnosing tool does not seem to be a sufficient method although there is a correlation between this parameter and bone mineral density. However, in vitro experiments showed that the identification of the loss factor is a promising technique in diagnosing progressing osteoporosis.
[show abstract][hide abstract] ABSTRACT: Fatigue is an indispensible part of a basketball game which may affect an athlete’s shooting kinematics. Although
kinematic analyses of various sports related movements were extensively done, this study is the first to consider the
effects of fatigue on the kinematics of free throw shooting. After measuring the resting heart rate, ten collegiate level,
male basketball players (21.8±1.6 y; 192.8±3.6 cm; 84.1±8.5 kg) were asked to perform free throws. Two successful
and two unsuccessful free throws were selected. Thereafter, participants were asked to complete the fatigue protocol,
which included 30m sprints and 5 vertical jumps at each end, until they reached volitional exhaustion. Additional
two successful and two unsuccessful free throws were collected. All shots were recorded by using two digital cameras operating at 60 Hz and placed in a stereoscopic view. The elbow, trunk, knee and ankle joint angles were measured before and after the ball release and at the ball release point. The selected joint angles were compared between
successful and unsuccessful free throws, as well as before and after the completion of fatigue protocol. The results
demonstrated that fatigue did not effect free throw shooting kinematics (p>0.05) and there was no significant joint
angle difference between successful and unsuccessful shots (p>0.05). This study suggested that high level athletes
are able to cope with the possible detrimental effects of fatigue while performing coordinated movements such as free
Journal of Human Kinetics 01/2010; 24:51-56. · 0.46 Impact Factor
[show abstract][hide abstract] ABSTRACT: With an aging population the frequency of postmenopausal fractures is increasing. Methods to enhance the repair of osteoporotic bone repair therefore become more important to reduce the society burden of care. We asked if absorbable collagen sponges containing recombinant human bone morphogenetic protein-2 (rhBMP-2) have the potential to enhance bone repair. We randomly assigned 40 rats into the ovariectomy and sham operation groups. A segmental defect was created in the right tibia 12 weeks after ovariectomy. rhBMP-2-containing absorbable collagen sponges were implanted into the defect in half of the animals in each group. We analyzed radiographs and histological sections and performed three-point bending tests to assess repair. Radiological scores in the rhBMP-2 applied rats were higher than those in controls at the end of 8 weeks after tibial osteotomy. The specimens failed under higher loads in the rhBMP-2-applied groups and histology revealed a higher fracture healing score, including callus formation, bone union, marrow changes, and cortex remodeling. We observed no adverse tissue responses such as fibrous connective tissue formation and inflammatory cellular infiltration. rhBMP-2 in absorbable collagen sponges enhanced bone repair in segmental tibial defects of ovariectomized rats. The sponges with rhBMP-2 appeared to enhance bone repair.
Clinical Orthopaedics and Related Research 09/2009; 467(12):3113-20. · 2.79 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of this study was to compare the effect of lower extremity position changes on hip bone mineral density measured by dual energy X-ray absorptiometry.
Sixty-nine healthy university students (30 men, 39 women; mean age 21.9+/-1.6; range 20 to 25 years) participated in this study. Participants were evaluated in two groups as male and female. A special positioning device was produced and used during bone mineral density measurements. Measurements were performed in positions of external 30 degrees , external 15 degrees , neutral 0 degrees , internal 15 degrees , and internal 30 degrees of hip rotations. Measurements were evaluated at shaft, wards and trochanteric region of proximal femur. Differences between positions at shaft, wards, trochanter and total values were compared using repeated measures of analysis of variance.
External rotation significantly increased bone mineral density values measured by dual energy X-ray absorptiometry in both male and female. The lowest bone mineral density value was measured at 30 degrees internal rotation in both sexes. There were slight differences between neutral, 15 degrees and 30 degrees internal rotation positions, but these differences were not statistically significant.
Our findings suggest that position differences are important in adult healthy male and female during bone mineral density measurements of proximal femur using dual energy X-ray absorptiometry.
Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery. 02/2009; 20(2):71-7.
[show abstract][hide abstract] ABSTRACT: Objectives: The aim of this study was to investigate
the joint angle differences in successful and unsuccessful
tennis serves of junior tennis players.
Patients and methods: Nine healthy junior tennis
players (5 girls, 4 boys; mean age 11.8±0.8 years; height
153.6±7.2 cm; body mass index 42.3±4.1 kg; playing
experience 6.2±1.5 years) volunteered to participate in
this study. They were asked to perform tennis serves
as fast as they can as if they were in an actual game.
Successful and unsuccessful serves were recorded using
two high speed cameras and then analyzed using Pictran
software. Angle changes in pre-impact, impact and postimpact
phases were compared.
Results: The results of paired sample t-tests revealed
nosignificant differences between successful and unsuccessful
tennis serves in all three phases.
Conclusion: This study failed to show differences
between successful and unsuccessful tennis serves in
pre-impact, impact and post-impact phases. However,
future research with more detailed analyses would be
needed to reveal the possible changes in the joints while
Eklem hastaliklari ve cerrahisi = Joint diseases & related surgery 01/2009; · 0.66 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of this study was to investigate the joint angle differences in successful and unsuccessful tennis serves of junior tennis players.
Nine healthy junior tennis players (5 girls, 4 boys; mean age 11.8+/-0.8 years; height 153.6+/-7.2 cm; body mass index 42.3+/-4.1 kg; playing experience 6.2+/-1.5 years) volunteered to participate in this study. They were asked to perform tennis serves as fast as they can as if they were in an actual game. Successful and unsuccessful serves were recorded using two high speed cameras and then analyzed using Pictran software. Angle changes in pre-impact, impact and post-impact phases were compared.
The results of paired sample t-tests revealed nosignificant differences between successful and unsuccessful tennis serves in all three phases.
This study failed to show differences between successful and unsuccessful tennis serves in pre-impact, impact and post-impact phases. However, future research with more detailed analyses would be needed to reveal the possible changes in the joints while serving.
Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery. 01/2009; 20(3):156-60.
[show abstract][hide abstract] ABSTRACT: Because not all infants can be screened for DDH by experts, early diagnosis of developmental dysplasia of the hip (DDH) by primary health care professionals is important. We developed a broadband electroacoustic sound transmission-detection (sonospectrography) system and explored its utility in 22 patients (average age, 5.9 years; range, 0.3-14 years) with unilateral DDH in this preliminary study. Distinct from ultrasonography, the sonospectrography system functions by sound transmission and recording through tissues to differentiate between normal and abnormal hips. All hips were examined at four different hip and knee positions. The normal hip served as the control. The sonospectrography system was able to detect unilateral DDH. Dysplastic hips had lower sound transmission values when compared to normal hips in all patients and all four positions; however, the highest (X = 88.8 +/- 30.2 Hz) and lowest (X = 8.3 +/- 5.4 Hz) sound transmission mean values were obtained at different positions in the normal hips and those with DDH. Sound transmission values of dysplastic hips were always lower than that of normal hips when the hip and knee was flexed during measurements. Sound transmission values decreased with age. The sonospectrography system may offer a new noninvasive method in the diagnosis of unilateral DDH but requires further study of sensitivity and specificity of detecting dysplastic hips without subluxation in newborn infants. LEVEL OF EVIDENCE: Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.
Clinical Orthopaedics and Related Research 05/2008; 466(4):802-8. · 2.79 Impact Factor
[show abstract][hide abstract] ABSTRACT: Porous interconnected hydroxyapatite (HA) and HA/tricalcium phosphate (TCP) (60/40) ceramics are promising materials for hard tissue repair. However, the mechanical properties of these materials have not been accurately determined under weight-bearing conditions. In this study, newly developed HA and HA/TCP (60/40) ceramics were used with intramedullary fixation in segmental bone defects of rabbits. Early radiological, histological, densitometric and biomechanical changes were evaluated. The mean radiological grade of healing and bonding to bone was higher in HA/TCP (60/40) ceramics than that of pure HA ceramics but the difference was not statistically significant. The densities of both implanted ceramics improved with time, supported by the histological evaluation of bone matrix ingrowth into ceramic pores, whereas the densities at the bone-ceramic interface decreased gradually. Flexural resonant frequencies and three-point bending strength increased, revealing an increase in mechanical stability during this early critical time interval where implant and/or bone-implant interface failures occur frequently. It can be concluded that both HA and HA/TCP (60/40) ceramics have a limited application in the treatment of load-bearing segmental bone defects but did not fail at the early stages of implantation.
[show abstract][hide abstract] ABSTRACT: The number of the people with osteoporosis increases as the population ages. Increasing numbers of patients with osteoporotic fractures may have a serious economic impact on society and on the quality of life of the patient. We review some literature and provide expert opinion on the burden of osteoporosis. Awareness among clinicians and health care professionals on osteoporosis should be increased to overcome the burden of the disease. Although most of the osteoporotic fractures are treated by orthopaedic surgeons, many patients with these problems are not diagnosed appropriately and treated for probable osteoporosis. Appropriate diagnosis of the disease is essential to prevent osteoporotic fractures and related mortality and morbidity. Indirect costs and sociologic and psychological impact of fractures should be evaluated together with the direct costs of the disease. LEVEL OF EVIDENCE: Economic and decision analysis, level V (expert opinion). See the Guidelines for Authors for a complete description of the levels of evidence.
Clinical Orthopaedics and Related Research 03/2006; 443:19-24. · 2.79 Impact Factor
[show abstract][hide abstract] ABSTRACT: Vibration analysis seldom has been used in detecting structural and mechanical changes in physiologic and pathologic bone conditions. We sought to correlate natural frequency of the radius measured by vibration analyses with bone mineral density measured by dual-energy xray absorptiometry and quantitative computed tomography (including cortical thickness). Sixty sedentary men between 50 and 70 years old were deemed osteopenic or healthy. A higher natural frequency of the dominant and nondominant radius was seen in the healthy men compared with the osteopenic men. Natural frequency was consistent with bone mineral density in dominant and nondominant radius in both groups. Moreover, there was a correlation between bone mineral density measured by dual-energy xray absorptiometry and natural frequency in the dominant and nondominant radius. Cortical thickness of the dominant and nondominant radius also correlated with natural frequency. We concluded natural frequency measured by vibration analysis is a precise method for the assessment of structural properties of bone and correlates with the bone mineral density of the radius. LEVEL OF EVIDENCE: Diagnostic study, Level II (Testing of previously developed diagnostic criteria on consecutive patients [with universally applied reference "gold" standard]). See the Guidelines for Authors for a complete description of the levels of evidence.
Clinical Orthopaedics and Related Research 03/2006; 443:94-100. · 2.79 Impact Factor