Regenerative medicine

Question 1

tissue repair

Answer 1

where remodelling replaces damage tissue
forms inferior tissue (scar)

Question 2

tissue regeneration

Answer 2

where we expect remodelling to restore native tissue
no scar

Question 3

what does the liver and bone have in common

Answer 3

both have the ability to regenerate

Question 4

what is special about bone

Answer 4

if injured in anyway it will try to repair by forming new bone

Question 5

why do fractures unite

Answer 5

because the bone is broken

Question 6

cells in the bone

Answer 6

osteocytes
osteoblasts
osteoclasts

Question 7

2 components of extracellular matrix

Answer 7

organic,35%
inorganic, 65%

Question 8

organic components of the extracellular matrix

Answer 8

type 1 collagen
osteocalcin
osteonectin
proteoglycans
glycosaminoglycans
ground substance

Question 9

inorganic components of extracellular matrix

Answer 9

hydroxyapatite

Question 10

what is in the image

Answer 10

cortical bone

Question 11

what is in the image

Answer 11

cancellous bone

Question 12

prerequisites for bone healing

Answer 12

adequate blood supply
adequate mechanical stability

Question 13

blood supply to diaphyseal bone

Answer 13

nutrient artery
metaphyseal vessels
periosteal vessels

Question 14

nutrient artery

Answer 14

intramedullary
supplies inner 2/3 of cortex

Question 15

metaphyseal vessels

Answer 15

rich supply from soft tissue

Question 16

periosteal vessels

Answer 16

supplies outer 1/3

Question 17

label the blood supply of the bone

Answer 17

Question 18

what are the 2 mechanisms of bone healing

Answer 18

direct/primary
indirect/secondary

Question 19

primary bone healing

Answer 19

no motion at the fracture site
no callus formation

Question 20

secondary bone healing

Answer 20

motion at the fracture site
callus formation

Question 21

direct bone healing

Answer 21

no motion or callus
rigid internal fixation
osteoblast form cutting cones across the fracture site
osteoblasts lay down lamellar bone behind
osteons form late
slow process

Question 22

indirect healing

Answer 22

unstable
callus stabilises
direct healing between cortices

Question 23

stages of the healing cascade

Answer 23

inflammation, 0-5 days
repair,5-42 days
late repair
regeneration and remodelling

Question 24

inflammation

Answer 24

haematoma
necrotic material
phagocytosis

Question 25

repair

Answer 25

granulation tissue acid environment periosteum, osteogenic cells cortical osteoclasis

Question 26

late repair

Answer 26

fibrous tissue replaced by cartilage endochondral ossification periostea healing >> membranous ossification

Question 27

regeneration and remodelling

Answer 27

replacement of callus (woven bone with lamellar bone) continued osteoclasis mechanical strain

Question 28

what is articular cartilage

Answer 28

65-80% water type 2 collagen proteoglycans chondrocytes matrix components

Question 29

what is in the image

Answer 29

articular cartilage

Question 30

what does the classic healing response require

Answer 30

site specific cells for phagocytosis and tissue synthesis vascular supply

Question 30

what does the classic healing response require

Answer 30

site specific cells for phagocytosis and tissue synthesis vascular supply

Question 31

3 phase response

Answer 31

phagocytosis inflammatory remodelling

Question 32

limitation of articular cartilage

Answer 32

chondrocytes imprisoned in a mesh of collagen and proteoglycans avascular nature of cartilage

Question 33

treatment options

Answer 33

Question 34

surgical treatment options

Answer 34

marrow stimulation techniques osteochondral autograft transfer osteochondral allograft transfer autologous chondrocyte implantation

Question 35

marrow stimulation techniques

Answer 35

abrasion arthroplasty subchondral drilling micro fracture

Question 36

why do chondral lesions not heal

Answer 36

need blood supply need site specific cells for phagocytosis

Question 37

osteochondral autograft transfer

Answer 37

mosaicplasty

Question 38

lavage and debridement beneficial for

Answer 38

low energy trauma mechanical symptoms minimal malalignment stable ligaments low BMI short term 50-70% benefit

Question 39

micro fracture in 1959

Answer 39

drilling generates heat incomplete debridement

Question 40

what is in the image

Answer 40

micro fracture

Question 41

autologous chondrocyte implanttion

Answer 41

biopsy implantation

Question 42

criteria in deciding treatment

Answer 42

Question 43

what occurs after treatment

Answer 43

synthetics scaffolds minced cartilage techniques 2nd and 3rd generation cell based synthetic meniscus