ObjectiveTo evaluate the bone repair efficacy of the new nano-hydroxyapatite (n-HA)/polyurethane (PU) composite scaffold in the treatment of chronic osteomyelitis in tibia.MethodsA novel levofloxacin@mesoporous silica microspheres (Lev@MSNs)/n-HA/PU was successfully synthesized. Its surface structure was observed by scanning electron microscopy (SEM). Fifty adult female New Zealand rabbits were randomly selected, and osteomyelitis was induced in the right tibia of the rabbit by injecting bacterial suspension (Staphylococcus aureus; 3×107 CFU/mL), which of the method was described by Norden. A total of 45 animals with the evidence of osteomyelitis were randomly divided into 4 groups, and the right medullary cavity of each animal was exposed. Animals in the blank control group (group A, n=9) were treated with exhaustive debridement only. The remaining animals were first treated by exhaustive debridement, and received implantations of 5 mg Lev@PMMA (group B, n=12), 1 mg Lev@MSNs/n-HA/PU (group C, n=12), and 5 mg Lev@MSNs/n-HA/PU (group D, n=12), respectively. At 12 weeks postoperatively, the right tibia of rabbits were observed by X-ray film, and then gross observation, methylene blue/acid fuchsin staining, and SEM observation of implant-bone interface, as well as biomechanical test (measuring the maximal compression force) were performed.ResultsX-ray films showed that the infection were severer than those of preoperation in group A, while the control of inflammation and bone healing of rabbits in group D were obviously better than those at preoperation. The gross observation showed extensive bone destruction in group A, a significant gap between bone tissue and the material in groups B and C, and close combination between bone tissue and the material in group D. The histology of the resected specimens showed that there was no obvious new bone formation around the materials in groups B and C, and there was abundant new bone formation around the periphery and along the voids of the materials and active bone remodeling in group D. The SEM observation of the bone-implant interface demonstrated that no new bone formation was observed at the bone-implant interface in groups B and C. However, bony connections and blurred boundaries were observed between the material and host bone tissue in group D. The biomechanical test showed the maximal compression force of groups B and D were significantly higher than that of groups A and C (P<0.05), but there was no significant difference between groups B and D (P>0.05).ConclusionThe novel synthetic composite Lev@MSNs/n-HA/PU exhibit good antibacterial activities, osteoconductivity, and biomechanical properties, and show great potential in the treatment of chronic osteomyelitis of rabbits.
Polyetheretherketone is one of the most commonly used materials for the production of orthopaedic implants, but the osseointegration capacity of polyetheretherketone is poor because of its bioinert surface, which greatly limits its clinical application. In recent years, scholars have carried out a lot of research on the modification of polyetheretherketone materials in order to improve its osseointegration capacity. At present, the modification of polyetheretherketone is mainly divided into surface modification and blend modification. Therefore, this paper summarizes the research progress of polyetheretherketone material modification technology and its influence on osseointegration from two aspects of surface modification and blend modification for polyetheretherketone materials used in the field of bone repair, so as to provide a reference for the improvement and transformation of polyetheretherketone materials for bone repair in the future.
In recent years, 3D printing technology, as a new material processing technology, can precisely control the macroscopic and microstructure of biological scaffolds and has advantages that traditional manufacturing methods cannot match in the manufacture of complex bone repair scaffolds. Magnesium ion is one of the important trace elements of the human body. It participates in many physiological activities of the body and plays a very important role in maintaining the normal physiological function of the organism. In addition, magnesium ions also have the characteristics of promoting the secretion of osteogenic proteins by osteoblasts and osteogenic differentiation of mesenchymal stem cells. By combining with 3D printing technology, more and more personalized magnesium-based biological scaffolds have been produced and used in bone regeneration research in vivo and in vitro. Therefore, this article reviews the application and research progress of 3D printing magnesium-based biomaterials in the field of bone regeneration and repair.
Objective To investigate the effect of domestic porous tantalum encapsulated with pedicled fascial flap on repairing of segmental bone defect in rabbits’ radius. Methods A total of 60 New Zealand white rabbits (aged 6- 8 months and weighing 2.5-3.0 kg) were randomly divided into the experimental group and control group (30 rabbits each group). A 1.5 cm segmental bone defect in right radius was established as the animal model. The porous tantalums encapsulated with pedicled fascial flaps (30 mm×20 mm) were implanted in the created bone defect in the experimental group, and the porous tantalums were only implanted in the control group. X-ray films were observed at the day after operation and at 4, 8, and 16 weeks after operation. Specimens were taken out at 4, 8, and 16 weeks after operation for HE staining and toluidine blue staining observation. The maximum load force and bending strength were detected by three point bending biomechanical test, and the Micro-CT analysis and quantitative analysis of the new bone volume fraction (BV/TV) were performed at 16 weeks after operation to compare the bone defect repair abilityin vivo in 2 groups. Results All incisions healed by first intention without wound infection. At 4, 8, and 16 weeks after operation, the X-ray films showed that the implants were well maintained without apparent displacement. As followed with time, the combination between the implants and host bone became more and more closely, and the fracture line gradually disappeared. HE staining and toluidine blue staining showed that new bone mass and maturity gradually increased at the interface and inside materials in 2 groups, and the new bone gradually growed from the interface to internal pore. At 16 weeks after operation, the three point bending biomechanical test showed that the maximum load force and bending strength in the experimental were (96.54±7.21) N and (91.26±1.76) MPa respectively, showing significant differences when compared with the control group [(82.65±5.65) N and (78.53±1.16) MPa respectively] (t=3.715, P=0.004; t=14.801, P=0.000). And Micro-CT analysis exhibited that there were a large amount of new bone at the interface and the surface of implant materials and inside the materials. The new bone BV/TV in the experimental group (32.63%±3.56%) was significantly higher than that in control group (25.07%±4.34%) (t=3.299, P=0.008). Conclusion Domestic porous tantalum encapsulated with pedicled fascial flap can increase local blood supply, strengthen material bone conduction ability, and promote the segmental bone defect repair.
Objective To introduce the basic research and cl inical appl ication of the injectable bone repair biomaterials. Methods The recent original articles about the injectable bone repair biomaterials were extensively reviewed. Results The injectable bone repair biomaterials could fill irregularly shaped defects and might allow bone augmentation, both with minimal surgical intervention, and the injectable bone repair material had a good prospect by the medical profession and attach great importance to the academic material, but there were some deficiencies and shortcomings. Conclusion The injectable bone repair biomaterials may be a future approach to repair bone defect．
Cell sheet technology refers to the preparation of cells into thin sheets, which retains a large amount of extracellular matrix, cell-cell junctions, and has a wide range of applications in the repair and regeneration of osteochondral tissues. This paper discusses the types, properties, and construction methods of stem cell sheets, and reviews the current research status of vascularization of stem cell sheets and their composite application with various cytokines and scaffolding materials for bone and cartilage repair, with the aim of exploring the direction of the further development of stem cell sheets in the field of bone and cartilage.
Objective To review the application and research progress of in-situ tissue engineering technology in bone and cartilage repair. Methods The original articles about in-situ tissue engineering technology in bone and cartilage repair were extensively reviewed and analyzed. Results In-situ tissue engineering have been shown to be effective in repairing bone defects and cartilage defects, but biological mechanisms are inadequate. At present, most of researches are mainly focused on animal experiments, and the effect of clinical repair need to be further studied. Conclusion In-situ tissue engineering technology has wide application prospects in bone and cartilage tissue engineering. However, further study on the mechanism of related cytokines need to be conducted.
ObjectiveTo summarize the application status of hypoxia mimetic agents in bone tissue engineering.MethodsThe related literature about the hypoxia mimetic agents in bone tissue engineering was reviewed and analyzed. And the application status and progress of hypoxia mimetic agents in bone tissue engineering were retrospectively analyzed.ResultsHypoxia mimetic agents have the same effect as hypoxia in up-regulating the level of hypoxia inducible factor 1α (HIF-1α). The combination of hypoxia mimetic agents and scaffolds can up-regulate the level of HIF-1α in bone tissue engineering, thus promoting early vascularization and bone regeneration of the bone defect area, which provides a new idea for using bone tissue engineering to repair bone defect. At present, the commonly used hypoxia mimetic agents include iron chelating agents, oxoglutarate competitive analogues, proline hydroxylase inhibitors, etc.ConclusionHypoxia mimetic agents have a wide application prospect in bone tissue engineering, but they have been used in bone tissue engineering for a short time, more attention should be paid to their possible side effects. In the future research, the hypoxia mimetic agents should be developed in the direction of higher targeting specificity and safety, and the exact mechanism of hypoxia mimetic agents in promoting bone regeneration should be further explored.
ObjectiveTo summarize the clinical application and research status of bioactive glass (BAG) in bone repair.MethodsThe recently published literature concerning BAG in bone repair at home and abroad was reviewed and summarized.ResultsBAG has been widely used in clinical bone repair with a favorable effectiveness. In the experimental aspect, to meet different clinical application needs, BAG has been prepared in different forms, such as particles, prosthetic coating, drug and biological factor delivery system, bone cement, and scaffold. And the significant progress has been made.ConclusionBAG has been well studied in the field of bone repair due to its excellent bone repair performance, and it is expected to become a new generation of bone repair material.
Traditional bone repair materials, such as titanium, polyetheretherketone, and calcium phosphate, exhibit limitations, including poor biocompatibility and incongruent mechanical properties. In contrast, ceramic-polymer composite materials combine the robust mechanical strength of ceramics with the flexibility of polymers, resulting in enhanced biocompatibility and mechanical performance. In recent years, researchers worldwide have conducted extensive studies to develop innovative composite materials and manufacturing processes, with the aim of enhancing the bone repair capabilities of implants. This article provides a comprehensive overview of the advancements in ceramic-polymer composite materials, as well as in 3D printing and surface modification techniques for composite materials, with the objective of offering valuable insights to improve and facilitate the clinical application of ceramic-polymer composite materials in the future.