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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 10, 1394-1400.
doi: 10.1302/0301-620X.88B10.17139  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Systemic effects of severe trauma on the function and apoptosis of human skeletal cells

K. Eid, MD, Trauma Surgeon, Orthopaedic Surgeon1; L. Labler, MD, Trauma Surgeon1; W. Ertel, MD, FACS, Trauma Surgeon, Professor, Director2; O. Trentz, MD, Trauma Surgeon, Professor, Director1; and M. Keel, MD, Trauma Surgeon1

1 Division of Trauma Surgery, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
2 Director Department of Trauma and Reconstructive Surgery, Benjamin Franklin Medical Center, Hindenburgdamm 30, 12203, Germany.

Correspondence should be sent to Dr K. Eid; e-mail: karim.eid{at}usz.ch

Systemic factors are believed to be pivotal for the development of heterotopic ossification in severely-injured patients. In this study, cell cultures of putative target cells (human fibroblastic cells, osteoblastic cells (MG-63), and bone-marrow stromal cells (hBM)) were incubated with serum from ten consecutive polytraumatised patients taken from post-traumatic day 1 to day 21 and with serum from 12 healthy control subjects.

The serum from the polytraumatised patients significantly stimulated the proliferation of fibroblasts, MG-63 and of hBM cells. The activity of alkaline phosphatase in MG-63 and hBM cells was significantly decreased when exposed to the serum of the severely-injured patient. After three weeks in 3D cell cultures, matrix production and osteogenic gene expression of hBM cells were equal in the patient and control groups. However, the serum from the polytraumatised patients significantly decreased apoptosis of hBM cells compared with the control serum (4.3% vs 19.1%, p = 0.031).

Increased proliferation of osteoblastic cells and reduced apoptosis of osteoprogenitors may be responsible for increased osteogenesis in severely-injured patients.




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T. W. Axelrad, B. Steen, D. W. Lowenberg, W. R. Creevy, and T. A. Einhorn
Heterotopic ossification after the use of commercially available recombinant human bone morphogenetic proteins in four patients
J Bone Joint Surg Br, December 1, 2008; 90-B(12): 1617 - 1622.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General