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Mesenchymal stem cells (MSC) can be used to facilitate reparative osteogenesis. In the case of critical-size defects, MSC can attach to allogenic bone implants (AlloI) that serve as a matrix. Objective. Analyze the morphological features of reparative osteogenesis in critical-size defects in femurs of rats (3 and 12 months old) when the defects are filled with MSC along with AlloI. Methods. 60 white lab rats, 3 months (n=30) and 12 months (n=30) old were used. Defects (3mm in depth, 3mm in diameter) were created in the femoral metaphysis of each rat, and filled with AlloI in the control groups and with AlloI and adipose-derived MSC in the experimental groups. Each group contained 15 rats of a particular age. 14, 28, and 90 days after the surgery, histological studies were conducted. Results. The area of AlloI decreased with time. 14 days after the surgery, in the experimental group, the area of AlloI was 1.6 times greater in 3-month-old (3mo) rats than in 12-month-old (12mo) rats. In comparison to the control, the area of AlloI was greater 14 days after surgery in 3mo rats and 28 days after surgery in 12mo rats. 14 and 28 days after the operation, the area of connective tissue was greater in rats of both experimental groups than in the control. For the 3mo rats, the same was true 90 days after the operation. The area of newly formed bone was 1.6 times lower in 3mo rats than in 12mo rats 14 days after the operation. 90 days after the operation, the area was 2.3 greater in 3mo rats. For 12mo rats, the highest area of bone tissue occurred 14 days after the surgery, and subsequently did not significantly change or differ from the control. For 3mo rats, the area of bone tissue was lower than control 14 and 28 days after the surgery, but greater than control 90 days after the surgery. Conclusions. The use of MSC along with AlloI to fill traumatic bone defects causes slower bone formation and excessive formation of connective tissue, independent of the age of the recipient. [ABSTRACT FROM AUTHOR]

The number of elderly people is constantly increasing all over the world. They are most often the patients who need orthopedic surgeries like arthroplasty, osteosynthesis and others. It is known that the process of bone regeneration depends on the patient's age. However, certain characteristics of bone regeneration process depend on the age remain unclear, which is important for developing the best strategies for treatment of elderly patients. Objective. Тo identify age-related features of bone regeneration and to establish possible ways of influencing them in order to optimize the bone regeneration in elderly patients. Methods. Literature search was performed in the PubMed database. Inclusion criteria were original experimental and clinical studies in English. The search depth is accepted for 20 years. Results. It has been experimentally and clinically shown that bone tissue regeneration slows down with age, which is more pronounced in women. According to scientific information, this involves two signaling pathways -- Notch and Wnt/β-Catenin, the activity of which is suppressed with age. However, the regulation of regeneration is a cascade of signaling pathways and macromolecules. The expression of growth factors after fracture changes at older age compared to a younger one. In particular, a decrease in the expression of TGFβ-1 was clinically revealed. In addition, in older patients after fracture, an increase in macrophage colony-stimulating factor and VEGF was recorded. It has been experimentally established that a combination of a slowdown in bone tissue regeneration with a decrease in the content of Indian Hedgehog, Sonic Hedgehog, BMP-2, 4, -7 proteins and MMP-9 in bone callus has been established. Among the ways to overcome the delayed bone regeneration in elderly patients can be the use of modern technologies of cell and gene therapy, inhibitors of macrophages, biologically active factors at certain stages of bone regeneration. For cell therapy, it is important to take into account the age of the cell donor because of the high probability of functional disorders in cells from older donors. [ABSTRACT FROM AUTHOR]

Fractures of the femur are the most severe in terms of medical and social consequences among injuries of bones of the lower extremities. An epidemiological analysis of the prevalence of fractures of the proximal femur (PHB) and the factors leading to their occurrence is the basis for planning of preventive measures and treatment in the elderly and senile. Objective: to study the quantitative and qualitative characteristics of the epidemiological situation regarding PHB fractures in Kharkov residents. Methods: the incidence of PHB was evaluated as a part of an epidemiological study in the population of Kharkov according to 5 medical institutions for 6 years -- from 2011 to 2016. 3.949 patients were included in the analysis. Results: there was a sharp increase (from 5 to 12%) in the number of PHB fractures after 50 years, after 60 -- almost to 20%. The majority of patients (60%) were in the age group 71 years and older. With an increase in age, PHB fractures with damage to the neck were more often recorded. Until the age of 60, more often men turned to medical institutions for injuries of PHB. But after 60 years, the number of women with these fractures increased and by the age of 70 was 1.9 times more than men (p < 0.001). Most elderly patients had concomitant diseases (mainly cardiovascular disease and hypertension), which should be considered when choosing treatment tactics. Conclusions: the occurrence, treatment and prevention of fractures of the proximal femur is an acute medical and social problem. The risk of fractures increases with age, and treatment in elderly patients is usually complicated due to the presence of comorbidity. The results of an epidemiological study can help create the basis for the development in Ukraine of a regional program for the prevention and treatment of patients with PHB fractures. [ABSTRACT FROM AUTHOR]

Lower extremities fractures are ⅓ to ½ of all fractures, that can increase morbidity and mortality. Nowadays there are studies devoted to the age and gender peculiarities of femur fractures in Ukraine, but data of other fractures location is restricted. Objective: to study the frequency and structure of lower extremities fractures depending on the age, sex, location in the population in Vinnitsa region during 2011-2012. Methods: the study was conducted as multicentral epidemiological study RSOF (Registry System of Osteoporotic Fractures). Population of Vinnitsa region was analyzed according to Ukrainian State Committee. We assessed the frequency of lower extremity fractures, its location depending on the age and gender. Results: the frequency of lower extremities fractures is 446.2 per 100 000 in male and 347.45 in female, it increases in patients older than 50 years old (493.1 and 540.1 respectively). Femur fractures prevail in women: 103.0 per 100 000 of population in men and 132.0 in women, after 50 years - 172.1 и 252.4 respectively. Such indexes are connected with the increasing of proximal femur fractures- 158.5 and 228.7 per 100 000 of population. We observed tibia shaft fractures in men more often (226.4 and 162.2 in women) foot fractures (107.2, in women - 43.6 per 100 000). Conclusion: the frequency of lower extremities fractures in population of Vinnitsa region has the age and gender depended peculiarities, which must to be taken into consideration during planning of prophylaxis measures. [ABSTRACT FROM AUTHOR]