fibrin and Bone-Cysts

To describe the treatment of a subchondral bone cyst in the proximal phalanx with parathyroid hormone peptide-enriched fibrin hydrogel in a warmblood filly. The cyst was localized with computer-assisted orthopaedic surgery, then curetted and finally filled with parathyroid hormone fragment peptide 1-34 (PTH(1-34)) covalently attached to a fibrin hydrogel. The cyst healed quickly without any complications. This result supports the hypothesis that PTH(1-34) delivered locally in a fibrin hydrogel may improve the postoperative prognosis of surgical management of subchondral bone cysts in horses. Subchondral bone cysts are fairly common in horses. Especially in older horses, the prognosis is poor, even after surgical curettage. Therefore, different management protocols have been investigated in conjunction with surgical curettage to improve prognosis. Locally delivered PTH(1-34) seems to be a new method in the treatment of subchondral bone cysts.

Topics: Animals; Arthroscopy; Bone Cysts; Female; Fibrin; Horse Diseases; Horses; Hydrogel, Polyethylene Glycol Dimethacrylate; Lameness, Animal; Prognosis; Teriparatide; Toe Joint; Treatment Outcome

Old calcified fibrin coagula are frequently found in simple bone cysts. They provide a scaffold on which new bone is laid down, in a process analogous to endochondral ossification. It is suggested that these coagula are derived in substantial part from the plasma-like contents of the cyst, after the release of plasma-clotting factors as the result of injury. Major haemorrhage is not involved and in many cases there is no antecedent fracture. The phenomenon is not seen in other common cystic conditions of bone and its recognition is thus helpful in the histological diagnosis of simple bone cyst. Cystic bone infarcts and their possible confusion with simple bone cysts are also briefly discussed.

Topics: Blood Coagulation; Bone Cysts; Fibrin; Fractures, Bone; Hemorrhage; Humans; Osteogenesis; Radiography

The present study comprises a series of 85 patients with jaw cysts with a diameter greater than 20 mm, the majority in the 30-50 mm group. Following enucleation of the cyst, a coagulum consisting of Bioplast fibrin powder, thrombin, the patient's venous blood and an antibiotic was implanted and primary closure performed. The clinical course was uneventful and the operative area healed by first intention in all cases. The nursing period was shortened. Radiographic follow-up showed rapid ossification. The favorable results are attributed to the absence of dead spaces, the role of fibrin in the regeneration process, and a retarded effect of the antibiotic.

Topics: Adolescent; Adult; Aged; Bone Cysts; Bone Regeneration; Dental Implantation; Female; Fibrin; Humans; Jaw Diseases; Male; Middle Aged; Oxytetracycline; Radiography