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Seesala VS, Sheikh L, Basu B, Mukherjee S. Mechanical and Bioactive Properties of PMMA Bone Cement: A Review. ACS Biomater Sci Eng 2024. [PMID: 39240690 DOI: 10.1021/acsbiomaterials.4c00779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2024]
Abstract
Over the past few decades, poly(methyl methacrylate) (PMMA) based bone cement has been clinically used extensively in orthopedics for arthroplasty and kyphoplasty, due to its biocompatibility and excellent primary fixation to the host bone. In this focused review, we discuss the use of various fillers and secondary chemical moieties to improve the bioactivity and the physicochemical properties. The viscosity of the PMMA blend formulations and working time are crucial to achieving intimate contact with the osseous tissue, which is highly sensitive to organic or inorganic fillers. Hydroxyapatite as a reinforcement resulted in compromised mechanical properties of the modified cement. The possible mechanisms of the additive- or filler-dependent strengthening or weakening of the PMMA blend are critically reviewed. The addition of layered double hydroxides with surface functionalization appears to be a promising approach to enhance the bonding of filler with the PMMA matrix. Such an approach consequently improves the mechanical properties, owing to enhanced dispersion as well as contributions from crack bridging. Finally, the use of emerging alternatives, such as nanoparticles, and the use of natural biomolecules were highlighted to improve bioactivity and antibacterial properties.
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Affiliation(s)
- Venkata Sundeep Seesala
- Advanced Materials and Characterization Group, Research and Development Division, Tata Steel Ltd, Jamshedpur 831001, India
| | - Lubna Sheikh
- Advanced Materials and Characterization Group, Research and Development Division, Tata Steel Ltd, Jamshedpur 831001, India
| | - Bikramjit Basu
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bengaluru 560012, India
| | - Subrata Mukherjee
- Advanced Materials and Characterization Group, Research and Development Division, Tata Steel Ltd, Jamshedpur 831001, India
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2
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Zhang C, Cai X, Li M, Peng J, Mei J, Wang F, Zhang R, Zhou Y, Fang S, Xia D, Zhao J. Preclinical Evaluation of Bioactive Small Intestinal Submucosa-PMMA Bone Cement for Vertebral Augmentation. ACS Biomater Sci Eng 2024; 10:2398-2413. [PMID: 38477550 PMCID: PMC11005825 DOI: 10.1021/acsbiomaterials.3c01629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/25/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
In vertebroplasty and kyphoplasty, bioinert poly(methyl methacrylate) (PMMA) bone cement is a conventional filler employed for quick stabilization of osteoporotic vertebral compression fractures (OVCFs). However, because of the poor osteointegration, excessive stiffness, and high curing temperature of PMMA, the implant loosens, the adjacent vertebrae refracture, and thermal necrosis of the surrounding tissue occurs frequently. This investigation addressed these issues by incorporating the small intestinal submucosa (SIS) into PMMA (SIS-PMMA). In vitro analyses revealed that this new SIS-PMMA bone cement had improved porous structure, as well as reduced compressive modulus and polymerization temperature compared with the original PMMA. Furthermore, the handling properties of SIS-PMMA bone cement were not significantly different from PMMA. The in vitro effect of PMMA and SIS-PMMA was investigated on MC3T3-E1 cells via the Transwell insert model to mimic the clinical condition or directly by culturing cells on the bone cement samples. The results indicated that SIS addition substantially enhanced the proliferation and osteogenic differentiation of MC3T3-E1 cells. Additionally, the bone cement's biomechanical properties were also assessed in a decalcified goat vertebrae model with a compression fracture, which indicated the SIS-PMMA had markedly increased compressive strength than PMMA. Furthermore, it was proved that the novel bone cement had good biosafety and efficacy based on the International Standards and guidelines. After 12 weeks of implantation, SIS-PMMA indicated significantly more osteointegration and new bone formation ability than PMMA. In addition, vertebral bodies with cement were also extracted for the uniaxial compression test, and it was revealed that compared with the PMMA-implanted vertebrae, the SIS-PMMA-implanted vertebrae had greatly enhanced maximum strength. Overall, these findings indicate the potential of SIS to induce efficient fixation between the modified cement surface and the host bone, thereby providing evidence that the SIS-PMMA bone cement is a promising filler for clinical vertebral augmentation.
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Affiliation(s)
- Chi Zhang
- Department
of Orthopaedic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo 315010, China
- Zhejiang
Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Xiongxiong Cai
- Department
of Orthopaedic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo 315010, China
| | - Mei Li
- Key
Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang
Province, The First Affiliated Hospital
of Ningbo University, Ningbo 315010, China
| | - Jing Peng
- Zhejiang
Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Jin Mei
- Institute
of Biomaterials, The First Affiliated Hospital
of Ningbo University, Ningbo 315010, China
| | - Fangfang Wang
- Institute
of Biomaterials, The First Affiliated Hospital
of Ningbo University, Ningbo 315010, China
| | - Rui Zhang
- Institute
of Biomaterials, The First Affiliated Hospital
of Ningbo University, Ningbo 315010, China
| | - Yingjie Zhou
- Institute
of Biomaterials, The First Affiliated Hospital
of Ningbo University, Ningbo 315010, China
| | - Shuyu Fang
- Department
of Clinical Laboratory, The First Affiliated
Hospital of Ningbo University, Ningbo 315010, China
| | - Dongdong Xia
- Department
of Orthopaedic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo 315010, China
| | - Jiyuan Zhao
- Zhejiang
Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
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Sheng X, Li C, Wang Z, Xu Y, Sun Y, Zhang W, Liu H, Wang J. Advanced applications of strontium-containing biomaterials in bone tissue engineering. Mater Today Bio 2023; 20:100636. [PMID: 37441138 PMCID: PMC10333686 DOI: 10.1016/j.mtbio.2023.100636] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 07/15/2023] Open
Abstract
Strontium (Sr) and strontium ranelate (SR) are commonly used therapeutic drugs for patients suffering from osteoporosis. Researches have showed that Sr can significantly improve the biological activity and physicochemical properties of materials in vitro and in vivo. Therefore, a large number of strontium containing biomaterials have been developed for repairing bone defects and promoting osseointegration. In this review, we provide a comprehensive overview of Sr-containing biomaterials along with the current state of their clinical use. For this purpose, the different types of biomaterials including calcium phosphate, bioactive glass, and polymers are discussed and provided future outlook on the fabrication of the next-generation multifunctional and smart biomaterials.
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Affiliation(s)
| | | | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China
| | - Yu Xu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China
| | - Yang Sun
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China
| | - Weimin Zhang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China
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Stocco TD, Bassous N, Oliveira Lobo A. Nanostructured materials for bone tissue replacement. Nanomedicine (Lond) 2023. [DOI: 10.1016/b978-0-12-818627-5.00003-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
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5
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Montazerian M, Gonçalves GVS, Barreto MEV, Lima EPN, Cerqueira GRC, Sousa JA, Malek Khachatourian A, Souza MKS, Silva SML, Fook MVL, Baino F. Radiopaque Crystalline, Non-Crystalline and Nanostructured Bioceramics. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7477. [PMID: 36363085 PMCID: PMC9656675 DOI: 10.3390/ma15217477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Radiopacity is sometimes an essential characteristic of biomaterials that can help clinicians perform follow-ups during pre- and post-interventional radiological imaging. Due to their chemical composition and structure, most bioceramics are inherently radiopaque but can still be doped/mixed with radiopacifiers to increase their visualization during or after medical procedures. The radiopacifiers are frequently heavy elements of the periodic table, such as Bi, Zr, Sr, Ba, Ta, Zn, Y, etc., or their relevant compounds that can confer enhanced radiopacity. Radiopaque bioceramics are also intriguing additives for biopolymers and hybrids, which are extensively researched and developed nowadays for various biomedical setups. The present work aims to provide an overview of radiopaque bioceramics, specifically crystalline, non-crystalline (glassy), and nanostructured bioceramics designed for applications in orthopedics, dentistry, and cancer therapy. Furthermore, the modification of the chemical, physical, and biological properties of parent ceramics/biopolymers due to the addition of radiopacifiers is critically discussed. We also point out future research lacunas in this exciting field that bioceramists can explore further.
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Affiliation(s)
- Maziar Montazerian
- Northeastern Laboratory for Evaluation and Development of Biomaterials (CERTBIO), Federal University of Campina Grande, Campina Grande 58429-900, PB, Brazil
| | - Geovanna V. S. Gonçalves
- Northeastern Laboratory for Evaluation and Development of Biomaterials (CERTBIO), Federal University of Campina Grande, Campina Grande 58429-900, PB, Brazil
| | - Maria E. V. Barreto
- Northeastern Laboratory for Evaluation and Development of Biomaterials (CERTBIO), Federal University of Campina Grande, Campina Grande 58429-900, PB, Brazil
| | - Eunice P. N. Lima
- Northeastern Laboratory for Evaluation and Development of Biomaterials (CERTBIO), Federal University of Campina Grande, Campina Grande 58429-900, PB, Brazil
| | - Glauber R. C. Cerqueira
- Northeastern Laboratory for Evaluation and Development of Biomaterials (CERTBIO), Federal University of Campina Grande, Campina Grande 58429-900, PB, Brazil
| | - Julyana A. Sousa
- Northeastern Laboratory for Evaluation and Development of Biomaterials (CERTBIO), Federal University of Campina Grande, Campina Grande 58429-900, PB, Brazil
| | - Adrine Malek Khachatourian
- Department of Materials Science and Engineering, Sharif University of Technology, Tehran 11155-1639, Iran
| | - Mairly K. S. Souza
- Northeastern Laboratory for Evaluation and Development of Biomaterials (CERTBIO), Federal University of Campina Grande, Campina Grande 58429-900, PB, Brazil
| | - Suédina M. L. Silva
- Northeastern Laboratory for Evaluation and Development of Biomaterials (CERTBIO), Federal University of Campina Grande, Campina Grande 58429-900, PB, Brazil
| | - Marcus V. L. Fook
- Northeastern Laboratory for Evaluation and Development of Biomaterials (CERTBIO), Federal University of Campina Grande, Campina Grande 58429-900, PB, Brazil
| | - Francesco Baino
- Institute of Materials Physics and Engineering, Department of Applied Science and Technology, Politecnico di Torino, 10129 Torino, Italy
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6
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Injectable bioactive polymethyl methacrylate–hydrogel hybrid bone cement loaded with BMP-2 to improve osteogenesis for percutaneous vertebroplasty and kyphoplasty. Biodes Manuf 2022. [DOI: 10.1007/s42242-021-00172-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Sneha KR, Sailaja GS. Intrinsically radiopaque biomaterial assortments: a short review on the physical principles, X-ray imageability, and state-of-the-art developments. J Mater Chem B 2021; 9:8569-8593. [PMID: 34585717 DOI: 10.1039/d1tb01513c] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
X-ray attenuation ability, otherwise known as radiopacity of a material, could be indisputably tagged as the central and decisive parameter that produces contrast in an X-ray image. Radiopaque biomaterials are vital in the healthcare sector that helps clinicians to track them unambiguously during pre and post interventional radiological procedures. Medical imaging is one of the most powerful resources in the diagnostic sector that aids improved treatment outcomes for patients. Intrinsically radiopaque biomaterials enable themselves for visual targeting/positioning as well as to monitor their fate and further provide the radiologists with critical insights about the surgical site. Moreover, the emergence of advanced real-time imaging modalities is a boon to the contemporary healthcare systems that allow to perform minimally invasive surgical procedures and thereby reduce the healthcare costs and minimize patient trauma. X-ray based imaging is one such technologically upgraded diagnostic tool with many variants like digital X-ray, computed tomography, digital subtraction angiography, and fluoroscopy. In light of these facts, this review is aimed to briefly consolidate the physical principles of X-ray attenuation by a radiopaque material, measurement of radiopacity, classification of radiopaque biomaterials, and their recent advanced applications.
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Affiliation(s)
- K R Sneha
- Department of Polymer Science and Rubber Technology, Cochin University of Science and Technology, Kochi - 682022, India.
| | - G S Sailaja
- Department of Polymer Science and Rubber Technology, Cochin University of Science and Technology, Kochi - 682022, India. .,Interuniversity Centre for Nanomaterials and Devices, CUSAT, Kochi - 682022, India.,Centre for Advanced Materials, CUSAT, Kochi - 682022, India
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8
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Huang C, Yu M, Li H, Wan X, Ding Z, Zeng W, Zhou Z. Research Progress of Bioactive Glass and Its Application in Orthopedics. ADVANCED MATERIALS INTERFACES 2021. [DOI: 10.1002/admi.202100606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Chao Huang
- Department of Orthopaedics West China Hospital of Sichuan University No. 37 Guoxue Alley, Wuhou District Chengdu 610041 P. R. China
| | - Min Yu
- Department of Anesthesiology North‐Kuanren General Hospital No. 69 Xingguang Avenue, Yubei District Chongqing 401121 P. R. China
| | - Hao Li
- Department of Orthopaedics West China Hospital of Sichuan University No. 37 Guoxue Alley, Wuhou District Chengdu 610041 P. R. China
| | - Xufeng Wan
- Department of Orthopaedics West China Hospital of Sichuan University No. 37 Guoxue Alley, Wuhou District Chengdu 610041 P. R. China
| | - Zichuan Ding
- Department of Orthopaedics West China Hospital of Sichuan University No. 37 Guoxue Alley, Wuhou District Chengdu 610041 P. R. China
| | - Weinan Zeng
- Department of Orthopaedics West China Hospital of Sichuan University No. 37 Guoxue Alley, Wuhou District Chengdu 610041 P. R. China
| | - Zongke Zhou
- Department of Orthopaedics West China Hospital of Sichuan University No. 37 Guoxue Alley, Wuhou District Chengdu 610041 P. R. China
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9
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Abstract
Some treatment options available to repair bone defects are the use of autogenous and allogeneic bone grafts. The drawback of the first one is the donor site’s limitation and the need for a second operation on the same patient. In the allograft method, the problems are associated with transmitted diseases and high susceptibility to rejection. As an alternative to biological grafts, polymers can be used in bone repair. Some polymers used in the orthopedic field are poly(methyl methacrylate), poly(ether-ether-ketone), and ultra-high molecular weight polyethylene (UHMWPE). UHMWPE has drawn much attention since it combines low friction coefficient and high wear and impact resistance. However, UHMWPE is a bioinert material, which means that it does not interact with the bone tissue. UHMWPE composites and nanocomposites with hydroxyapatite (HA) are widely studied in the literature to mitigate these issues. HA is the main component of the inorganic phase in the natural bone, and the addition of this bioactive filler to the polymeric matrix aims to mimic bone composition. This brief review discusses some polymers used in orthopedic applications, focusing on the UHMWPE/HA composites as a potential bone substitute.
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10
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黄 勇, 李 理, 石 展, 崔 旭, 潘 浩, 李 兵. [Application and research status of bioactive glass in bone repair]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2020; 34:660-666. [PMID: 32410437 PMCID: PMC8171856 DOI: 10.7507/1002-1892.201908093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/30/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To summarize the clinical application and research status of bioactive glass (BAG) in bone repair. METHODS The recently published literature concerning BAG in bone repair at home and abroad was reviewed and summarized. RESULTS BAG 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. CONCLUSION BAG 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.
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Affiliation(s)
- 勇华 黄
- 广西医科大学第四附属医院 柳州市工人医院骨科(广西柳州 545005)Department of Orthopedics, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker’s Hospital, Liuzhou Guangxi, 545005, P.R.China
| | - 理 李
- 广西医科大学第四附属医院 柳州市工人医院骨科(广西柳州 545005)Department of Orthopedics, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker’s Hospital, Liuzhou Guangxi, 545005, P.R.China
| | - 展英 石
- 广西医科大学第四附属医院 柳州市工人医院骨科(广西柳州 545005)Department of Orthopedics, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker’s Hospital, Liuzhou Guangxi, 545005, P.R.China
| | - 旭 崔
- 广西医科大学第四附属医院 柳州市工人医院骨科(广西柳州 545005)Department of Orthopedics, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker’s Hospital, Liuzhou Guangxi, 545005, P.R.China
| | - 浩波 潘
- 广西医科大学第四附属医院 柳州市工人医院骨科(广西柳州 545005)Department of Orthopedics, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker’s Hospital, Liuzhou Guangxi, 545005, P.R.China
| | - 兵 李
- 广西医科大学第四附属医院 柳州市工人医院骨科(广西柳州 545005)Department of Orthopedics, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker’s Hospital, Liuzhou Guangxi, 545005, P.R.China
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Li C, Sun J, Shi K, Long J, Li L, Lai Y, Qin L. Preparation and evaluation of osteogenic nano-MgO/PMMA bone cement for bone healing in a rat critical size calvarial defect. J Mater Chem B 2020; 8:4575-4586. [PMID: 32242606 DOI: 10.1039/d0tb00074d] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The clinical outcomes of polymethylmethacrylate (PMMA) bone cement used to fill gaps or marrow cavities of bones and bone defects are limited due to poor handling properties, mismatched mechanical properties with natural bone and lack of osteogenesis for bone healing. In this study, a series of PMMA bone cements containing active nano-MgO particles (nano-MgO/PMMA) were prepared. The handling and mechanical properties were systemically evaluated according to an International Standardization Organization standard (ISO 5833:2002). The biocompatibility and osteogenic activity of nano-MgO/PMMA were also analysed in vitro. The osteogenic effects of nano-MgO/PMMA were assessed in a rat calvarial critical bone defect model. The addition of less than 15 wt% nano-MgO to PMMA improved the handling properties of PMMA. Compared with PMMA, the compression modulus and strength of 20MP (20 wt% nano-MgO to PMMA) decreased to 0.725 ± 0.023 GPa and 25.38 ± 2.82 MPa, respectively. In vitro studies with MC3T3-E1 showed that nano-MgO/PMMA had better biocompatibility than the PMMA group after 7 days of culture. The nano-MgO/PMMA groups showed more calcium nodules and higher osteogenic gene expression levels than PMMA after 12 days of osteogenic induction of the rat BMSCs. The in vivo studies analysed by micro-CT and histomorphology results proved that nano-MgO/PMMA could significantly enhance new bone formation. The mean new bone mineral density in the nano-MgO/PMMA group was 50% greater than that in the PMMA group. In addition, biomechanical tests showed that nano-MgO/PMMA was superior to PMMA in bone-bonding strength after 12 weeks implantation. Therefore, the nano-MgO/PMMA bone cement has good potential in joint fixation and bone defect filling applications.
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Affiliation(s)
- Cairong Li
- Centre for Translational Medicine Research & Development, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China.
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12
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Novel Osteogenic Behaviors around Hydrophilic and Radical-Free 4-META/MMA-TBB: Implications of an Osseointegrating Bone Cement. Int J Mol Sci 2020; 21:ijms21072405. [PMID: 32244335 PMCID: PMC7177939 DOI: 10.3390/ijms21072405] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 12/15/2022] Open
Abstract
Poly(methyl methacrylate) (PMMA)-based bone cement, which is widely used to affix orthopedic metallic implants, is considered bio-tolerant but lacks osteoconductivity and is cytotoxic. Implant loosening and toxic complications are significant and recognized problems. Here we devised two strategies to improve PMMA-based bone cement: (1) adding 4-methacryloyloxylethyl trimellitate anhydride (4-META) to MMA monomer to render it hydrophilic; and (2) using tri-n-butyl borane (TBB) as a polymerization initiator instead of benzoyl peroxide (BPO) to reduce free radical production. Rat bone marrow-derived osteoblasts were cultured on PMMA-BPO, common bone cement ingredients, and 4-META/MMA-TBB, newly formulated ingredients. After 24 h of incubation, more cells survived on 4-META/MMA-TBB than on PMMA-BPO. The mineralized area was 20-times greater on 4-META/MMA-TBB than PMMA-BPO at the later culture stage and was accompanied by upregulated osteogenic gene expression. The strength of bone-to-cement integration in rat femurs was 4- and 7-times greater for 4-META/MMA-TBB than PMMA-BPO during early- and late-stage healing, respectively. MicroCT and histomorphometric analyses revealed contact osteogenesis exclusively around 4-META/MMA-TBB, with minimal soft tissue interposition. Hydrophilicity of 4-META/MMA-TBB was sustained for 24 h, particularly under wet conditions, whereas PMMA-BPO was hydrophobic immediately after mixing and was unaffected by time or condition. Electron spin resonance (ESR) spectroscopy revealed that the free radical production for 4-META/MMA-TBB was 1/10 to 1/20 that of PMMA-BPO within 24 h, and the substantial difference persisted for at least 10 days. The compromised ability of PMMA-BPO in recruiting cells was substantially alleviated by adding free radical-scavenging amino-acid N-acetyl cysteine (NAC) into the material, whereas adding NAC did not affect the ability of 4-META/MMA-TBB. These results suggest that 4-META/MMA-TBB shows significantly reduced cytotoxicity compared to PMMA-BPO and induces osteoconductivity due to uniquely created hydrophilic and radical-free interface. Further pre-clinical and clinical validations are warranted.
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13
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Kargozar S, Montazerian M, Fiume E, Baino F. Multiple and Promising Applications of Strontium (Sr)-Containing Bioactive Glasses in Bone Tissue Engineering. Front Bioeng Biotechnol 2019; 7:161. [PMID: 31334228 PMCID: PMC6625228 DOI: 10.3389/fbioe.2019.00161] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/20/2019] [Indexed: 12/22/2022] Open
Abstract
Improving and accelerating bone repair still are partially unmet needs in bone regenerative therapies. In this regard, strontium (Sr)-containing bioactive glasses (BGs) are highly-promising materials to tackle this challenge. The positive impacts of Sr on the osteogenesis makes it routinely used in the form of strontium ranelate (SR) in the clinical setting, especially for patients suffering from osteoporosis. Therefore, a large number of silicate-, borate-, and phosphate-based BGs doped with Sr and produced in different shapes have been developed and characterized, in order to be used in the most advanced therapeutic strategies designed for the management of bone defects and injuries. Although the influence of Sr incorporation in the glass is debated regarding the obtained physicochemical and mechanical properties, the biological improvements have been found to be substantial both in vitro and in vivo. In the present study, we provide a comprehensive overview of Sr-containing glasses along with the current state of their clinical use. For this purpose, different types of Sr-doped BG systems are described, including composites, coatings and porous scaffolds, and their applications are discussed in the light of existing experimental data along with the significant challenges ahead.
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Affiliation(s)
- Saeid Kargozar
- Tissue Engineering Research Group (TERG), Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maziar Montazerian
- Center for Research, Technology and Education in Vitreous Materials, Federal University of São Carlos, São Carlos, Brazil
| | - Elisa Fiume
- Department of Applied Science and Technology, Institute of Materials Physics and Engineering, Politecnico di Torino, Turin, Italy
| | - Francesco Baino
- Department of Applied Science and Technology, Institute of Materials Physics and Engineering, Politecnico di Torino, Turin, Italy
- Interuniversity Center for the Promotion of the 3Rs Principles in Teaching and Research, Italy
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14
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Goto K, Kuroda Y, Kawai T, Kawanabe K, Matsuda S. The use of a bioactive bone cement containing apatite-wollastonite glass-ceramic filler and bisphenol-a-glycidyl methacrylate resin for acetabular fixation in total hip arthroplasty. Bone Joint J 2019; 101-B:787-792. [DOI: 10.1302/0301-620x.101b7.bjj-2018-1391.r2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Aims In the 1990s, a bioactive bone cement (BABC) containing apatite-wollastonite glass-ceramic (AW-GC) powder and bisphenol-a-glycidyl methacrylate resin was developed at our hospital. In 1996, we used BABC to fix the acetabular component in primary total hip arthroplasty (THA) in 20 patients as part of a clinical trial. The purpose of this study was to investigate the long-term results of primary THA using BABC. Patients and Methods A total of 20 patients (three men and 17 women) with a mean age of 57.4 years (40 to 71), a mean body weight of 52.3 kg (39 to 64), and a mean body mass index (BMI) of 23.0 kg/m2 (19.8 to 28.6) were evaluated clinically and radiologically. Survival analyses were undertaken, and wear analyses were carried out using a computer-aided method. Results The mean follow-up was 17.6 years (1.5 to 21.1). Radiological loosening occurred in four sockets with aseptic loosening at a mean of 7.8 years (1.5 to 20.7). Kaplan–Meier survival analyses using revision of the acetabular component, radiological loosening of the acetabular component, and the worst-case scenario with revision of the acetabular component to include the two patients lost to follow-up as endpoints yielded survival rates of 94.7%, 84.4%, and 85.0% at ten years, and 70.0%, 84.4%, and 62.8% at 20 years, respectively. Wear analysis revealed a mean linear wear rate of 0.068 mm per year. Conclusion The long-term results of primary THAs using BABC were unsatisfactory. Its brittle nature and poor handling properties need to be improved before it becomes an alternative method of fixing the acetabular component in cemented THA. Cite this article: Bone Joint J 2019;101-B:787–792.
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Affiliation(s)
- K. Goto
- Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan
| | - Y. Kuroda
- Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan
| | - T. Kawai
- Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan
| | - K. Kawanabe
- Department of Orthopaedic Surgery, Shiga General Hospital, Shiga, Japan
| | - S. Matsuda
- Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan
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Sun X, Wu Z, He D, Shen K, Liu X, Li H, Jin W. Bioactive injectable polymethylmethacrylate/silicate bioceramic hybrid cements for percutaneous vertebroplasty and kyphoplasty. J Mech Behav Biomed Mater 2019; 96:125-135. [PMID: 31035063 DOI: 10.1016/j.jmbbm.2019.04.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/21/2019] [Accepted: 04/23/2019] [Indexed: 12/30/2022]
Abstract
Polymethylmethacrylate (PMMA) cement has been widely used to fill and stabilize hard tissue defects in clinical surgery, especially in percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP). However, the dense body of pure PMMA in defects has no ability to promote bone regeneration. We herein aim to fabricate novel PMMA/silicate bioceramic hybrid cements by adding bioactive calcium silicate (CS) particles into PMMA to endow PMMA/CS hybrid cements with bioactivity and biodegradability without losing the excellent mechanical strength and injectability. Following comprehensive characterization of the physicochemical properties and in vitro bioactivity study, our results showed compared with PMMA cement, the constructed PMMA/CS hybrid cements possessed significantly lower curing temperatures and simultaneously retained the acceptable mechanical strength and injectability. Moreover, obvious bioactive ion release and hydroxyapatite formation could be detected and observed after the PMMA/CS hybrid cements were soaked in simulated body fluid, indicating their pronounced bioactivity. A further in vivo study of the PMMA/CS hybrid cements on goat vertebral body defect models reflected that the PMMA/CS hybrid cements could be biodegraded well and could significantly promote new bone formation in defects 6 months of post-injection. Our results suggest that PMMA/CS hybrid cements may be promising candidates for PVP and PKP in clinic.
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Affiliation(s)
- Xin Sun
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 280 Mohe Road, Shanghai, 201999, China
| | - Zhi Wu
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China
| | - Dan He
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China
| | - Kangping Shen
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 280 Mohe Road, Shanghai, 201999, China
| | - Xingzhen Liu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 280 Mohe Road, Shanghai, 201999, China
| | - Haiyan Li
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.
| | - Wenjie Jin
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 280 Mohe Road, Shanghai, 201999, China.
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