In vivo biocompatibility of SrO and MgO doped brushite cements

Strontium-Doped Whitlockite Scaffolds for Enhanced Bone Regeneration

Bone graft substitutes to repair critical-sized bone fractures have experienced significant development over the last few decades. Among them, whitlockite (WH)-based bone grafts have proven to be effective in mediating bone healing. In the current study, a next generation, nature-inspired scaffold was developed with strontium-functionalized whitlockite nanoparticles (nSrWH) to enhance the intrinsic properties of WH. A series of nSrWH (with 2.5, 5, 7.5% Sr atomic substitution) were fabricated using a rapid-mixing wet precipitation route. Subsequently, the functionalized whitlockite was integrated into a gelatin-chondroitin sulfate scaffold and subjected to both in vitro and in vivo studies to investigate its osteogenic potential. Results indicated that nSrWH-containing scaffolds promoted osteogenic differentiation while inhibiting osteoclast activity. The positive impact of nSrWH was found to be dose-dependent, with the 7.5% Sr atomic substitution exhibiting the most significant results. Furthermore, the scaffold induced superior de novo bone regeneration compared to its undoped counterpart in the mouse calvarial critical-sized defect model. Collectively, these findings suggest that nSrWH nanoparticles inherit the beneficial properties of whitlockite, coupled by the therapeutic effects of Sr2+, operating in concert for an overall enhanced bone regeneration. As such, they constitute promising candidates to meet the biomedical requirements for bioactive bone graft substitutes.

Recent trends of stem cell therapies in the management of orthopedic surgical challenges

Emerged health-related problems especially with increasing population and with the wider occurrence of these issues have always put the utmost concern and led medicine to outgrow its usual mode of treatment, to achieve better outcomes. Orthopedic interventions are one of the most concerning hitches, requiring advancement in several issues, that show complications with conventional approaches. Advanced studies have been undertaken to address the issue, among which stem cell therapy emerged as a better area of growth. The capacity of the stem cells to renovate themselves and adapt into different cell types made it possible to implement its use as a regenerative slant. Harvesting the stem cells, particularly mesenchymal stem cells (MSCs) is easier and can be further grown in vitro . In this review, we have discussed orthopedic-related issues including bone defects and fractures, nonunions, ligament and tendon injuries, degenerative changes, and associated conditions, which require further approaches to execute better outcomes, and the advanced strategies that can be tagged along with various ways of application of MSCs. It aims to objectify the idea of stem cells, with a major focus on the application of MSCs from different sources in various orthopedic interventions. It also discusses the limitations, and future scopes for further approaches in the field of regenerative medicine. The involvement of MSCs may transition the procedures in orthopedic interventions from predominantly surgical substitution and reconstruction to bio-regeneration and prevention. Nevertheless, additional improvements and evaluations are required to explore the effectiveness and safety of mesenchymal stem cell treatment in orthopedic regenerative medicine.

Advances in magnesium-containing bioceramics for bone repair

Reconstruction of bone defects or fractures caused by ageing, trauma and tumour resection is still a great challenge in clinical treatment. Although autologous bone graft is considered as gold standard, the source of natural bone is limited. In recent years, regenerative therapy based on bioactive materials has been proposed for bone reconstruction. Specially, numerous studies have indicated that bioactive ceramics including silicate and phosphate bioceramics exhibit excellent osteoinductivity and osteoconductivity, further promote bone regeneration. In addition, magnesium (Mg) element, as an indispensable mineral element, plays a vital role in promoting bone mineralisation and formation. In this review, different types of Mg-containing bioceramics including Mg-containing calcium phosphate-based bioceramics (such as Mg-hydroxyapatite, Mg-biphasic calcium phosphate), Mg-containing calcium silicate-based bioceramics (such as Mg2SiO4, Ca2MgSi2O7 and Mg-doped bioglass), Mg-based biocements, Mg-containing metal/polymer-bioceramic composites were systematacially summarised. Additionally, the fabrication technologies and their materiobiological effects were deeply discussed. Clinical applications and perspectives of magnesium-containing bioceramics for bone repair are highlighted. Overall, Mg-containing bioceramics are regarded as regenerative therapy with their optimised performance. Furthermore, more in-depth two-way researches on their performance and structure are essential to satisfy their clinical needs.

Enhanced osteogenesis and bactericidal performance with additively manufactured MgO and Cu-added CpTi for load-bearing implants

Titanium, being the ultimate choice of metallic material for implant applications, its bio-inertness causes delayed bone-tissue integration at the implant site and prevents expedited healing for the patient. This can cause a severe issue for patients with immunocompromised bone health. Infections at the implant site are another concern; titanium does not offer inherent antimicrobial properties. Current strategies addressing the issues above include using cemented implants as a coating on Ti6Al4V bulk material for orthopedic applications. Roadblock arises with coating failure due to weak interfacial bond at the Ti-cement interface, resulting in revision surgeries. We have added osteogenic MgO and antibacterial Cu to CpTi and processed them using metal additive manufacturing (AM) to address these issues. Mg, an essential trace element in the body, has been proven to enhance osseointegration in vivo. Cu has been popular for its bactericidal capabilities. With 1 wt.% of MgO addition in the CpTi matrix, we have observed a four-fold increase in the mineralized bone formation at the bone-implant interface in vivo. The presence of 3 wt.% of Cu showed no cytotoxicity markers, and adding Cu to CpTi-MgO chemical makeup showed similar in vivo performance to CpTi-MgO. In vitro bacterial studies with gram-positive Staphylococcus aureus bacteria showed 81% bacterial efficiency displayed by CpTi-MgO-Cu at the end of 72 h of culture. Our findings highlight the synergistic benefits of CpTi-MgO-Cu, which exhibit superior early-stage osseointegration and antimicrobial capabilities.