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Anastasova I, Tsekova P, Ignatova M, Stoilova O. Imparting Photocatalytic and Antioxidant Properties to Electrospun Poly(L-lactide- co-D,L-lactide) Materials. Polymers (Basel) 2024; 16:1814. [PMID: 39000670 PMCID: PMC11244129 DOI: 10.3390/polym16131814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/19/2024] [Accepted: 06/25/2024] [Indexed: 07/17/2024] Open
Abstract
The focus of the present study is on the fabrication of effective and eco-friendly hybrid electrospun materials based on poly(L-lactide-co-D,L-lactide) (PLDLLA), Fe3O4 and ZnO with an appropriate design for antioxidant and photocatalytic performance. The design of the fibrous materials was purposely tailored in one step by electrospinning and simultaneous electrospinning/electrospraying. Electrospinning of PLDLLA and its mixture with Fe3O4 resulted in the fabrication of materials with design type "in". Furthermore, the surface of the electrospun PLDLLA and Fe3O4-in-PLDLLA was decorated with ZnO particles by simultaneous electrospraying, thus materials with design type "on" were obtained. In this case, quaternized N,N,N-trimethyl chitosan iodide (QCOS) was used as a sticking agent of ZnO particles onto the fiber's surface. Different structures and morphologies of the electrospun materials were observed by SEM equipped with EDX and TEM. TGA and XRD analyses show that the presence of inorganic particles had an impact on the thermal properties and crystallinity of the electrospun materials. Furthermore, the material type "on" showed improved wettability with a water contact angle less than 90° compared to the material type "in" with an angle larger than 90°. In particular, the presence of Fe3O4 imparts complementary magnetic properties, while ZnO considerably increased the antioxidant activity of the fibrous materials. Materials with design type "on" displayed over 70% radical scavenging capacity in contrast to the material type "in" with less than 20% capacity within 30 min of contact. Moreover, the purposely tailored design type "on" materials provided excellent photocatalytic degradation of model organic pollutant methylene blue dye under UV light irradiation even after 5-fold use, and at the end of the fifth cycle these materials degraded more than 90% of the dye. These results reveal not only a strategy for the fabrication of electrospun hybrid bio-based materials with targeted design but also provide a promising, simple and effective way for mitigating water pollution.
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Affiliation(s)
- Ina Anastasova
- Laboratory of Bioactive Polymers, Institute of Polymers, Bulgarian Academy of Sciences, Akad. G. Bonchev St., bl. 103A, 1113 Sofia, Bulgaria
| | - Petya Tsekova
- Laboratory of Bioactive Polymers, Institute of Polymers, Bulgarian Academy of Sciences, Akad. G. Bonchev St., bl. 103A, 1113 Sofia, Bulgaria
| | - Milena Ignatova
- Laboratory of Bioactive Polymers, Institute of Polymers, Bulgarian Academy of Sciences, Akad. G. Bonchev St., bl. 103A, 1113 Sofia, Bulgaria
| | - Olya Stoilova
- Laboratory of Bioactive Polymers, Institute of Polymers, Bulgarian Academy of Sciences, Akad. G. Bonchev St., bl. 103A, 1113 Sofia, Bulgaria
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2
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Inglis JE, Goodwin AM, Divi SN, Hsu WK. Advances in Synthetic Grafts in Spinal Fusion Surgery. Int J Spine Surg 2023; 17:S18-S27. [PMID: 37748919 PMCID: PMC10753330 DOI: 10.14444/8557] [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: 09/27/2023] Open
Abstract
Degenerative spine disease is increasing in prevalence as the global population ages, indicating a need for targeted therapies and continued innovations. While autograft and allograft have historically demonstrated robust results in spine fusion surgery, they have significant limitations and associated complications such as infection, donor site morbidity and pain, and neurovascular injury. Synthetic grafts may provide similar success while mitigating negative outcomes. A narrative literature review was performed to review available synthetic materials that aim to optimize spinal fusion. The authors specifically address the evolution of synthetics and comment on future trends. Novel synthetic materials currently in use include ceramics, synthetic polymers and peptides, bioactive glasses, and peptide amphiphiles, and the authors focus on their success in both human and animal models, physical properties, advantages, and disadvantages. Advantages include properties of osteoinduction, osteoconduction, and osteogenesis, whereas disadvantages encompass a lack of these properties or growth factor-induced complications. Typically, the use of synthetic materials results in fewer complications and lower costs. While the development and tuning of synthetic materials are ongoing, there are many beneficial alternatives to autografts and allografts with promising fusion results.
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Affiliation(s)
- Jacqueline E Inglis
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alyssa M Goodwin
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Srikanth N Divi
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Wellington K Hsu
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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3
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Feng S, Li J, Tian J, Lu S, Zhao Y. Application of Single-Cell and Spatial Omics in Musculoskeletal Disorder Research. Int J Mol Sci 2023; 24:2271. [PMID: 36768592 PMCID: PMC9917071 DOI: 10.3390/ijms24032271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
Musculoskeletal disorders, including fractures, scoliosis, heterotopic ossification, osteoporosis, osteoarthritis, disc degeneration, and muscular injury, etc., can occur at any stage of human life. Understanding the occurrence and development mechanism of musculoskeletal disorders, as well as the changes in tissues and cells during therapy, might help us find targeted treatment methods. Single-cell techniques provide excellent tools for studying alterations at the cellular level of disorders. However, the application of these techniques in research on musculoskeletal disorders is still limited. This review summarizes the current single-cell and spatial omics used in musculoskeletal disorders. Cell isolation, experimental methods, and feasible experimental designs for single-cell studies of musculoskeletal system diseases have been reviewed based on tissue characteristics. Then, the paper summarizes the latest findings of single-cell studies in musculoskeletal disorders from three aspects: bone and ossification, joint, and muscle and tendon disorders. Recent discoveries about the cell populations involved in these diseases are highlighted. Furthermore, the therapeutic responses of musculoskeletal disorders, especially single-cell changes after the treatments of implants, stem cell therapies, and drugs are described. Finally, the application potential and future development directions of single-cell and spatial omics in research on musculoskeletal diseases are discussed.
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Affiliation(s)
- Site Feng
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - Jiahao Li
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
| | - Jingjing Tian
- Medical Science Research Center, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Sheng Lu
- The Key Laboratory of Digital Orthopaedics of Yunnan Provincial, Department of Orthopedic Surgery, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming 650032, China
| | - Yu Zhao
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
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4
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Abdelgawad M, Elkodous MA, El Rouby WMA. Biodegradable Polymers in Biomedical Applications: A Focus on Skin and Bone Regeneration. HANDBOOK OF BIODEGRADABLE MATERIALS 2023:1015-1043. [DOI: 10.1007/978-3-031-09710-2_45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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5
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Busch A, Jäger M. [Synthetic bone replacement substances]. ORTHOPADIE (HEIDELBERG, GERMANY) 2022; 51:1023-1032. [PMID: 36307604 DOI: 10.1007/s00132-022-04319-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Bone substitute materials have been successfully used for bone defects in orthopedics and trauma surgery for a long time; however, there are cases, especially in bone defects with a critical size, in which the treatment is complicated. Nowadays, multiple bone substitute materials are available. Autologous cancellous bone grafts remain the gold standard among the bone replacement materials; however, donor site morbidity and the limited availability of autologous cancellous bone represent restrictions for autologous bone grafting. Allogeneic cancellous bone grafts have also been successfully for years in the treatment of bone defects; however, infection rates of more than 10% have been described for the use of allogeneic cancellous bone. By introducing synthetic bone substitutes further alternatives are currently available to the user for the individual treatment of bone defects. The aim of this study is to demonstrate the advantages and disadvantages of various synthetic bone substitute materials.
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Affiliation(s)
- André Busch
- Lehrstuhl für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Essen, Deutschland.
- Klinik für Orthopädie, Unfall- und Wiederherstellungschirurgie Katholisches Klinikum Essen, Philippusstift, Essen, Deutschland.
| | - Marcus Jäger
- Lehrstuhl für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Essen, Deutschland
- Klinik für Orthopädie, Unfall- und Wiederherstellungschirurgie Katholisches Klinikum Essen, Philippusstift, Essen, Deutschland
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6
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Ramezani Dana H, Ebrahimi F. Synthesis, properties, and applications of polylactic
acid‐based
polymers. POLYM ENG SCI 2022. [DOI: 10.1002/pen.26193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Hossein Ramezani Dana
- Mechanics, Surfaces and Materials Processing (MSMP) – EA 7350 Arts et Metiers Institute of Technology Aix‐en‐Provence France
- Texas A&M Engineering Experiment Station (TEES) Texas A&M University College Station Texas USA
| | - Farnoosh Ebrahimi
- PRISM Polymer, Recycling, Industrial, Sustainability and Manufacturing Technological University of the Shannon (TUS) Athlone Ireland
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7
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Tawade P, Tondapurkar N, Jangale A. Biodegradable and biocompatible synthetic polymers for applications in bone and muscle tissue engineering. JOURNAL OF MEDICAL SCIENCE 2022. [DOI: 10.20883/medical.e712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In medicine, tissue engineering has made significant advances. Using tissue engineering techniques, transplant treatments result in less donor site morbidity and need fewer surgeries overall. It is now possible to create cell-supporting scaffolds that degrade as new tissue grows on them, replacing them until complete body function is restored. Synthetic polymers have been a significant area of study for biodegradable scaffolds due to their ability to provide customizable biodegradable and mechanical features as well as a low immunogenic effect due to biocompatibility. The food and drug administration has given the biodegradable polymers widespread approval after they showed their reliability. In the context of tissue engineering, this paper aims to deliver an overview of the area of biodegradable and biocompatible synthetic polymers. Frequently used synthetic biodegradable polymers utilized in tissue scaffolding, scaffold specifications, polymer synthesis, degradation factors, as well as fabrication methods are discussed. In order to emphasize the many desired properties and corresponding needs for skeletal muscle and bone, particular examples of synthetic polymer scaffolds are investigated. Increased biocompatibility, functionality and clinical applications will be made possible by further studies into novel polymer and scaffold fabrication approaches.
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Laubach M, Kobbe P, Hutmacher DW. Biodegradable interbody cages for lumbar spine fusion: Current concepts and future directions. Biomaterials 2022; 288:121699. [PMID: 35995620 DOI: 10.1016/j.biomaterials.2022.121699] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022]
Abstract
Lumbar fusion often remains the last treatment option for various acute and chronic spinal conditions, including infectious and degenerative diseases. Placement of a cage in the intervertebral space has become a routine clinical treatment for spinal fusion surgery to provide sufficient biomechanical stability, which is required to achieve bony ingrowth of the implant. Routinely used cages for clinical application are made of titanium (Ti) or polyetheretherketone (PEEK). Ti has been used since the 1980s; however, its shortcomings, such as impaired radiographical opacity and higher elastic modulus compared to bone, have led to the development of PEEK cages, which are associated with reduced stress shielding as well as no radiographical artefacts. Since PEEK is bioinert, its osteointegration capacity is limited, which in turn enhances fibrotic tissue formation and peri-implant infections. To address shortcomings of both of these biomaterials, interdisciplinary teams have developed biodegradable cages. Rooted in promising preclinical large animal studies, a hollow cylindrical cage (Hydrosorb™) made of 70:30 poly-l-lactide-co-d, l-lactide acid (PLDLLA) was clinically studied. However, reduced bony integration and unfavourable long-term clinical outcomes prohibited its routine clinical application. More recently, scaffold-guided bone regeneration (SGBR) with application of highly porous biodegradable constructs is emerging. Advancements in additive manufacturing technology now allow the cage designs that match requirements, such as stiffness of surrounding tissues, while providing long-term biomechanical stability. A favourable clinical outcome has been observed in the treatment of various bone defects, particularly for 3D-printed composite scaffolds made of medical-grade polycaprolactone (mPCL) in combination with a ceramic filler material. Therefore, advanced cage design made of mPCL and ceramic may also carry initial high spinal forces up to the time of bony fusion and subsequently resorb without clinical side effects. Furthermore, surface modification of implants is an effective approach to simultaneously reduce microbial infection and improve tissue integration. We present a design concept for a scaffold surface which result in osteoconductive and antimicrobial properties that have the potential to achieve higher rates of fusion and less clinical complications. In this review, we explore the preclinical and clinical studies which used bioresorbable cages. Furthermore, we critically discuss the need for a cutting-edge research program that includes comprehensive preclinical in vitro and in vivo studies to enable successful translation from bench to bedside. We develop such a conceptual framework by examining the state-of-the-art literature and posing the questions that will guide this field in the coming years.
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Affiliation(s)
- Markus Laubach
- Australian Research Council (ARC) Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000 Australia; Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia; Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - Philipp Kobbe
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Dietmar W Hutmacher
- Australian Research Council (ARC) Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000 Australia; Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia; Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; Max Planck Queensland Center for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD 4000, Australia.
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9
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Kervran M, Vagner C, Cochez M, Ponçot M, Saeb M, Vahabi H. A review on thermal degradation of polylactic acid (PLA)/polyhydroxybutyrate (PHB) blends. Polym Degrad Stab 2022. [DOI: 10.1016/j.polymdegradstab.2022.109995] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Abdelgawad M, Elkodous MA, El Rouby WMA. Biodegradable Polymers in Biomedical Applications: A Focus on Skin and Bone Regeneration. HANDBOOK OF BIODEGRADABLE MATERIALS 2022:1-29. [DOI: 10.1007/978-3-030-83783-9_45-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/11/2022] [Indexed: 09/01/2023]
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11
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Cheah CW, Al-Namnam NM, Lau MN, Lim GS, Raman R, Fairbairn P, Ngeow WC. Synthetic Material for Bone, Periodontal, and Dental Tissue Regeneration: Where Are We Now, and Where Are We Heading Next? MATERIALS 2021; 14:ma14206123. [PMID: 34683712 PMCID: PMC8537464 DOI: 10.3390/ma14206123] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 01/21/2023]
Abstract
Alloplasts are synthetic, inorganic, biocompatible bone substitutes that function as defect fillers to repair skeletal defects. The acceptance of these substitutes by host tissues is determined by the pore diameter and the porosity and inter-connectivity. This narrative review appraises recent developments, characterization, and biological performance of different synthetic materials for bone, periodontal, and dental tissue regeneration. They include calcium phosphate cements and their variants β-tricalcium phosphate (β-TCP) ceramics and biphasic calcium phosphates (hydroxyapatite (HA) and β-TCP ceramics), calcium sulfate, bioactive glasses and polymer-based bone substitutes which include variants of polycaprolactone. In summary, the search for synthetic bone substitutes remains elusive with calcium compounds providing the best synthetic substitute. The combination of calcium sulphate and β-TCP provides improved handling of the materials, dispensing with the need for a traditional membrane in guided bone regeneration. Evidence is supportive of improved angiogenesis at the recipient sites. One such product, (EthOss® Regeneration, Silesden, UK) has won numerous awards internationally as a commercial success. Bioglasses and polymers, which have been used as medical devices, are still in the experimental stage for dental application. Polycaprolactone-TCP, one of the products in this category is currently undergoing further randomized clinical trials as a 3D socket preservation filler. These aforementioned products may have vast potential for substituting human/animal-based bone grafts.
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Affiliation(s)
- Chia Wei Cheah
- Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (C.W.C.); (M.N.L.); (G.S.L.)
| | - Nisreen Mohammed Al-Namnam
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4BW, UK;
| | - May Nak Lau
- Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (C.W.C.); (M.N.L.); (G.S.L.)
| | - Ghee Seong Lim
- Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (C.W.C.); (M.N.L.); (G.S.L.)
| | - Renukanth Raman
- Oral Health Division, Ministry of Health Malaysia, Putrajaya 62590, Malaysia;
| | - Peter Fairbairn
- Department of Periodontology and Implant Dentistry, School of Dentistry, University of Detroit Mercy, 2700 Martin Luther King, Jr. Boulevard, Detroit, MI 48208, USA;
| | - Wei Cheong Ngeow
- Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (C.W.C.); (M.N.L.); (G.S.L.)
- Correspondence: ; Tel.: +60-3-79674962; Fax: +60-3-79674534
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Dedukh N, Makarov V, Pavlov A. Біоматеріал на основі полілактиду та його використання як кісткових імплантатів (аналітичний огляд літератури). PAIN, JOINTS, SPINE 2021. [DOI: 10.22141/2224-1507.9.1.2019.163056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
У багатьох галузях медицини широке застосування отримали імплантати з різних синтетичних та природних біоматеріалів. Серед матеріалів, що частіше використовують для створення імплантатів, полілактид (PLA), особливістю якого є біодеградація в ділянках імплантації, остеоінтеграція, здатність індукувати процеси утворення кісткової тканини та висока біосумісність з організмом. Мета огляду: проаналізувати та узагальнити дані щодо перебудови в кістці біорезорбуючих біоматеріалів на основі полілактиду та визначити тенденції розвитку проблеми. В огляді літератури подано загальну характеристику та визначено історичні віхи розвитку проблеми та використання деградуючих полімерів у кістковій хірургії. Надані дані щодо факторів, що впливають на біодеградацію в кістках цього біоматеріалу, та визначено особливості його остеоінтеграції залежно від складу. Наведено дані щодо використання PLA та співполімерів у кістковій хірургії та регенераторній медицині. Важливим напрямком майбутніх досліджень буде розробка композитних біоматеріалів на основі PLA з бажаними якостями остеоінтеграції та керованою біодеградацією. Подано нові тенденції розвитку напрямку використання в кістковій хірургії імплантатів на основі композитних матеріалів, виготовлених на основі PLA, та новітні способи створення імплантатів та композитів із використанням 3D-принтера.
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13
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Ebrahimi F, Ramezani Dana H. Poly lactic acid (PLA) polymers: from properties to biomedical applications. INT J POLYM MATER PO 2021. [DOI: 10.1080/00914037.2021.1944140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Farnoosh Ebrahimi
- Materials Research Institute, Athlone Institute of Technology, Athlone, Ireland
| | - Hossein Ramezani Dana
- Laboratoire de Mécanique, Surface, Matériaux Procédés (MSMP) – EA 7350, Arts et Metiers Institute of Technology, HESAM Université, Aix-en-Provence, France
- Texas A&M Engineering Experiment Station (TEES), Texas A&M University, College Station, TX, USA
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14
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Fairag R, Li L, Ramirez-GarciaLuna JL, Taylor MS, Gaerke B, Weber MH, Rosenzweig DH, Haglund L. A Composite Lactide-Mineral 3D-Printed Scaffold for Bone Repair and Regeneration. Front Cell Dev Biol 2021; 9:654518. [PMID: 34307346 PMCID: PMC8299729 DOI: 10.3389/fcell.2021.654518] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 06/21/2021] [Indexed: 01/08/2023] Open
Abstract
Orthopedic tumor resection, trauma, or degenerative disease surgeries can result in large bone defects and often require bone grafting. However, standard autologous bone grafting has been associated with donor site morbidity and/or limited quantity. As an alternate, allografts with or without metallic or polyether-etherketone have been used as grafting substitutes. However, these may have drawbacks as well, including stress shielding, pseudarthrosis, disease-transmission, and infection. There is therefore a need for alternative bone substitutes, such as the use of mechanically compliant three-dimensional (3D)-printed scaffolds. Several off-the-shelf materials are available for low-cost fused deposition 3D printing such as polylactic acid (PLA) and polycaprolactone (PCL). We have previously described the feasibility of 3D-printed PLA scaffolds to support cell activity and extracellular matrix deposition. In this study, we investigate two medical-grade filaments consistent with specifications found in American Society for Testing and Materials (ASTM) standard for semi-crystalline polylactide polymers for surgical implants, a pure polymer (100M) and a copolymeric material (7415) for their cytocompatibility and suitability in bone tissue engineering. Moreover, we assessed the impact on osteo-inductive properties with the addition of beta-tricalcium phosphate (β-TCP) minerals and assessed their mechanical properties. 100M and 7415 scaffolds with the additive β-TCP demonstrated superior mesenchymal stem cells (MSCs) differentiation detected via increased alkaline phosphatase activity (6-fold and 1.5-fold, respectively) and mineralized matrix deposition (14-fold and 5-fold, respectively) in vitro. Furthermore, we evaluated in vivo compatibility, biosafety and bone repair potential in a rat femur window defect model. 100M+β -TCP implants displayed a positive biosafety profile and showed significantly enhanced new bone formation compared to 100M implants evidenced by μCT (39 versus 25% bone volume/tissue volume ratio) and histological analysis 6 weeks post-implantation. These scaffolds are encouraging composite biomaterials for repairing bone applications with a great potential for clinical translation. Further analyses are required with appropriate evaluation in a larger critical-sized defect animal model with long-term follow-up.
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Affiliation(s)
- Rayan Fairag
- Department of Surgery, Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada
- Research Institute of McGill University Health Center, Montreal General Hospital, Montreal, QC, Canada
- Department of Orthopedic Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Li Li
- Department of Surgery, Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada
- Research Institute of McGill University Health Center, Montreal General Hospital, Montreal, QC, Canada
| | | | | | | | - Michael H. Weber
- Department of Surgery, Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada
- Research Institute of McGill University Health Center, Montreal General Hospital, Montreal, QC, Canada
| | - Derek H. Rosenzweig
- Department of Surgery, Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada
- Research Institute of McGill University Health Center, Montreal General Hospital, Montreal, QC, Canada
| | - Lisbet Haglund
- Department of Surgery, Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada
- Research Institute of McGill University Health Center, Montreal General Hospital, Montreal, QC, Canada
- Shriners Hospital for Children, Montreal, QC, Canada
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15
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Ikuta Y, Nakasa T, Sumii J, Nekomoto A, Adachi N. Histopathological and Radiographic Features of Osteolysis After Fixation of Osteochondral Fragments Using Poly-L-Lactic Acid Pins for Osteochondral Lesions of the Talus. Am J Sports Med 2021; 49:1589-1595. [PMID: 33780270 DOI: 10.1177/03635465211001758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Fixation of osteochondral fragments is a potential option for treating an osteochondral lesion of the talus (OLT) involving large lesions in the remaining articular cartilage surface. Bioabsorbable devices, especially those made of poly-L-lactic acid (PLLA), can be used for the fixation of an OLT. Postoperative osteolysis surrounding the PLLA pins is occasionally observed; however, the significance of osteolysis remains unknown. PURPOSE To elucidate the association between osteolysis surrounding the PLLA pins, histopathological findings in subchondral bone, and preoperative Hounsfield unit (HU) values at the pin fixation site. STUDY DESIGN Case Series; Level of evidence, 4. METHODS This retrospective analysis included 20 patients with OLT (11 men and 9 women; mean age, 20.9 years; 1 bilateral case). Tissue from the osteochondral fragment was collected intraoperatively using a bone biopsy needle for histological evaluation. The fragment was fixed through the biopsy hole using a PLLA pin. Osteolysis surrounding the PLLA pin was assessed at 1 year postoperatively using magnetic resonance imaging (MRI). Histopathological scores were assigned based on trabecular bone loss, empty lacunae, inflammatory granulation tissue, cartilage-like tissue, and the presence of osteoclasts. The HU values around the pin insertion site, detected on the postoperative MRI scans, were measured using the region of interest based on the preoperative coronal and sagittal computed tomography (CT) images. RESULTS Osteolysis was observed postoperatively in 9 ankles (42.9%). Histopathological evaluation revealed that the osteolysis group had a significantly higher pathological score than the nonosteolysis group (10.2 vs 6.3; P < .001). Lower HU values were identified in the osteolysis group on preoperative coronal and sagittal CT images (P < .05). The histopathological score negatively correlated with preoperative HU values (Pearson r = -0.46; P = .037). CONCLUSION Intraoperative biopsy of the OLT allowed for histopathological evaluation of the same site as that of the PLLA pin fixation. Our findings suggest that preoperative subchondral trabecular deterioration is associated with the incidence of postoperative osteolysis surrounding the PLLA pin. Additionally, low preoperative HU values in subchondral bone under OLT may serve as a predictor of osteolysis surrounding the PLLA pin.
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Affiliation(s)
- Yasunari Ikuta
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Tomoyuki Nakasa
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Junichi Sumii
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akinori Nekomoto
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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16
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Ahmad Raus R, Wan Nawawi WMF, Nasaruddin RR. Alginate and alginate composites for biomedical applications. Asian J Pharm Sci 2021; 16:280-306. [PMID: 34276819 PMCID: PMC8261255 DOI: 10.1016/j.ajps.2020.10.001] [Citation(s) in RCA: 181] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/26/2020] [Accepted: 10/07/2020] [Indexed: 12/22/2022] Open
Abstract
Alginate is an edible heteropolysaccharide that abundantly available in the brown seaweed and the capsule of bacteria such as Azotobacter sp. and Pseudomonas sp. Owing to alginate gel forming capability, it is widely used in food, textile and paper industries; and to a lesser extent in biomedical applications as biomaterial to promote wound healing and tissue regeneration. This is evident from the rising use of alginate-based dressing for heavily exuding wound and their mass availability in the market nowadays. However, alginate also has limitation. When in contact with physiological environment, alginate could gelate into softer structure, consequently limits its potential in the soft tissue regeneration and becomes inappropriate for the usage related to load bearing body parts. To cater this problem, wide range of materials have been added to alginate structure, producing sturdy composite materials. For instance, the incorporation of adhesive peptide and natural polymer or synthetic polymer to alginate moieties creates an improved composite material, which not only possesses better mechanical properties compared to native alginate, but also grants additional healing capability and promote better tissue regeneration. In addition, drug release kinetic and cell viability can be further improved when alginate composite is used as encapsulating agent. In this review, preparation of alginate and alginate composite in various forms (fibre, bead, hydrogel, and 3D-printed matrices) used for biomedical application is described first, followed by the discussion of latest trend related to alginate composite utilization in wound dressing, drug delivery, and tissue engineering applications.
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Affiliation(s)
- Raha Ahmad Raus
- Department of Biotechnology Engineering, International Islamic University Malaysia, Kuala Lumpur 50728, Malaysia
| | - Wan Mohd Fazli Wan Nawawi
- Department of Biotechnology Engineering, International Islamic University Malaysia, Kuala Lumpur 50728, Malaysia
- Nanoscience and Nanotechnology Research Group (NanoRG), International Islamic University Malaysia, Kuala Lumpur 50728, Malaysia
| | - Ricca Rahman Nasaruddin
- Department of Biotechnology Engineering, International Islamic University Malaysia, Kuala Lumpur 50728, Malaysia
- Nanoscience and Nanotechnology Research Group (NanoRG), International Islamic University Malaysia, Kuala Lumpur 50728, Malaysia
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17
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Ali MA, Aly NM, Mabrouk M, El-Sayed SAM, Beherei HH. A novel synthetic approach to produce cellulose-based woven scaffolds impregnated with bioactive glass for bone regeneration. Int J Biol Macromol 2021; 181:905-918. [PMID: 33872612 DOI: 10.1016/j.ijbiomac.2021.04.086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/10/2021] [Accepted: 04/14/2021] [Indexed: 11/26/2022]
Abstract
Tissue-engineering has become the best alternative solution for replacing the damaged tissues. However, the cost of scaffold materials is still a big challenge, so the development of cost-effective scaffolds is highly encouraged. In this research, different types of cotton textile-scaffolds as a cellulosic material were developed to be utilized as a substrate for cells proliferation. They were loaded with bioactive glass (BG) doped with silver nanoparticles (AgNPs). The effect of the loaded materials on the physicochemical and mechanical characteristics of the cellulosic textile scaffolds was investigated by means of FTIR, contact angle, physical and mechanical properties of the cotton fabrics, in addition to assessing their antimicrobial activity. Moreover, the biomineralization was evaluated after soaking in Simulated Body Fluid (SBF) using ICP and SEM accessorized with EDX. Cells proliferation capacities of the developed cellulosic woven-scaffolds were assessed against MG63 cell line at different incubation times. The physicochemical and mechanical features of these fabrics demonstrated a positive influence for the existence of BG impregnation, especially those doped with AgNPs. The antimicrobial features were also affirmed for the cellulosic scaffolds. More pronounced influence was observed on the biomineralization of the scaffold impregnated with BG doped with 0.5% Ag. The percentages of proliferated cells were very close to negative control (100% ± 10). This approach offers a novel and affordable alternative cellulosic woven-scaffolds for bone regeneration.
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Affiliation(s)
- Marwa A Ali
- Spinning and Weaving Engineering Department, Textile Industries Research Division, National Research Centre, 33El-Bohouth St., P.O.12622, Dokki, Giza, Egypt
| | - Nermin M Aly
- Spinning and Weaving Engineering Department, Textile Industries Research Division, National Research Centre, 33El-Bohouth St., P.O.12622, Dokki, Giza, Egypt
| | - Mostafa Mabrouk
- Refractories, Ceramics and Building Materials Department, National Research Centre, 33El-Bohouth St., P.O. 12622, Dokki, Giza, Egypt.
| | - Sara A M El-Sayed
- Refractories, Ceramics and Building Materials Department, National Research Centre, 33El-Bohouth St., P.O. 12622, Dokki, Giza, Egypt
| | - Hanan H Beherei
- Refractories, Ceramics and Building Materials Department, National Research Centre, 33El-Bohouth St., P.O. 12622, Dokki, Giza, Egypt
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18
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Contreras-Ramírez JM, Monsalve M. Ring-Opening Polymerization of 2,2-Dimethyltrimethylene Carbonate Using Samarium Acetate(III) as an Initiator. POLYMER SCIENCE SERIES B 2021. [DOI: 10.1134/s1560090421020044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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19
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Rezaei A, Giambini H, Miller AL, Liu X, Elder BD, Yaszemski MJ, Lu L. OPF/PMMA cage system as an alternative approach for the treatment of vertebral corpectomy. APPLIED SCIENCES (BASEL, SWITZERLAND) 2020; 10:6912. [PMID: 33986953 PMCID: PMC8115301 DOI: 10.3390/app10196912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The spinal column is the most common site for bone metastasis. Vertebral metastases with instability have historically been treated with corpectomy of the affected vertebral body and adjacent intervertebral discs, and are more recently treated with separation surgery. With demographics shifting towards an elderly population, a less invasive surgical approach is necessary for the repair of vertebral defects. We have modified a previously reported expandable hollow cage composed of an oligo[poly(ethylene glycol) fumarate] (OPF) containment system that could be delivered via a posterior-only approach. Then, the polymer of interest, poly(methyl methacrylate) (PMMA) bone cement, was injected into the lumen of the cage after expansion to form an OPF/PMMA cage. We compared six different cage formulations to account for vertebral body and defect size, and performed a cage characterization via expansion kinetics and mechanical testing evaluations. Additionally, we investigated the feasibility of the OPF/PMMA cage in providing spine stability via kinematic analyses. The in-vitro placement of the implant using our OPF/PMMA cage system showed improvement and mechanical stability in a flexion motion. The results demonstrated that the formulation and technique presented in the current study have the potential to improve surgical outcomes in minimally invasive procedures on the spine.
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Affiliation(s)
- Asghar Rezaei
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Hugo Giambini
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Alan L. Miller
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Xifeng Liu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Benjamin D. Elder
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Michael J. Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
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20
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Hajebi S, Mohammadi Nasr SA, Rabiee N, Bagherzadeh M, Ahmadi S, Rabiee M, Tahriri M, Tayebi L, Hamblin MR. Bioresorbable composite polymeric materials for tissue engineering applications. INT J POLYM MATER PO 2020. [DOI: 10.1080/00914037.2020.1765365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sakineh Hajebi
- Department of Polymer Engineering, Sahand University of Technology, Tabriz, Iran
- Institute of Polymeric Materials, Sahand University of Technology, Tabriz, Iran
| | | | - Navid Rabiee
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
| | | | - Sepideh Ahmadi
- Student Research Committee, Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Rabiee
- Biomaterials Group, Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | | | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, USA
| | - Michael R. Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Dermatology, Harvard Medical School, Boston, MA, USA
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Johannesburg, South Africa
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21
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Zhao F, Xu H, Xue W, Li Y, Sun J, Wang F, Jiang G, Li L, Wang L. Iodinated poly( p-dioxanone) as a facile platform for X-ray imaging of resorbable implantable medical devices. J Biomater Appl 2020; 35:39-48. [PMID: 32192387 DOI: 10.1177/0885328220912842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Currently, implantable fibrous medical devices still suffer from invisibility under current clinical imaging techniques. To address this problem, 2, 3, 5-triiodobenzoic acid (TIBA) was recruited as a contrast agent, and then a set of iodinated poly(p-dioxanone) (PPDO) fibers was fabricated via melt-spinning hybrid blends of PPDO with TIBA (PPDO/TIBA). The impact of TIBA content on the rheological behavior of blends was evaluated firstly. The physical, chemical, and thermal properties of PPDO/TIBA fibers were investigated accordingly by SEM, FTIR, DSC, and TGA. Moreover, the radiopaque property of PPDO/TIBA hybrid fibers as a potential radio-opacifying platform for medical devices was verified in vitro and in vivo. Finally, the accumulated release results of the hybrid fibers during in vitro degradation indicate the continual X-ray visibility of the hybrid fibers maintains for 22 days. This intriguing iodinated platform may pave the way for constructing fibrous materials with in-situ X-ray tracking property.
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Affiliation(s)
- Fan Zhao
- College of Textiles, Donghua University, Shanghai, China.,Key laboratory of Textile Science and Technology, Ministry of Education, Donghua University, Songjiang, Shanghai, China
| | - Haiyan Xu
- College of Textiles, Donghua University, Shanghai, China.,Key laboratory of Textile Science and Technology, Ministry of Education, Donghua University, Songjiang, Shanghai, China
| | - Wen Xue
- College of Textiles, Donghua University, Shanghai, China.,Key laboratory of Textile Science and Technology, Ministry of Education, Donghua University, Songjiang, Shanghai, China
| | - Yan Li
- College of Textiles, Donghua University, Shanghai, China.,Key laboratory of Textile Science and Technology, Ministry of Education, Donghua University, Songjiang, Shanghai, China
| | - Jing Sun
- Department of Pediatric Cardiology of Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fujun Wang
- College of Textiles, Donghua University, Shanghai, China.,Key laboratory of Textile Science and Technology, Ministry of Education, Donghua University, Songjiang, Shanghai, China
| | - Guansen Jiang
- Hangzhou Rejoin Mastin Medical Device Co., Ltd, Hangzhou, China
| | - Lingchen Li
- Hangzhou Rejoin Mastin Medical Device Co., Ltd, Hangzhou, China
| | - Lu Wang
- College of Textiles, Donghua University, Shanghai, China.,Key laboratory of Textile Science and Technology, Ministry of Education, Donghua University, Songjiang, Shanghai, China
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22
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Bochicchio B, Barbaro K, De Bonis A, Rau JV, Pepe A. Electrospun poly(d,l-lactide)/gelatin/glass-ceramics tricomponent nanofibrous scaffold for bone tissue engineering. J Biomed Mater Res A 2020; 108:1064-1076. [PMID: 31967393 DOI: 10.1002/jbm.a.36882] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/04/2020] [Accepted: 01/06/2020] [Indexed: 12/15/2022]
Abstract
Electrospun scaffolds are emerging as extracellular matrix (ECM)mimicking structures for tissue engineering thanks to their nanofibrous architecture. For the development of suitable electrospun scaffolds for bone tissue engineering, the addition of inorganic components has been implemented with the aim to confer important bioactivity like osteoinduction, osteointegration, and cell adhesion to the scaffolds. In this context, we propose a tricomponent electrospun scaffold composed of poly(d,l-lactide), gelatin and RKKP glass-ceramics. The bioactive RKKP glass-ceramic system has attracted interest, due to the presence of ions such as La3+ and Ta5+ , which turned out to be valuable as growth supporting agents for bones. In this work, RKKP glass-ceramics were embedded inside the microfibers of electrospun scaffolds and the structural and biological properties were investigated. Our results showed that the glass-ceramic microparticles were uniformly distributed in the fibrous structure of the scaffold. Furthermore, the glass-ceramics promoted biomineralization of the scaffolds and improved cell viability and osteogenic differentiation. The mineralized layer formed on RKKP-containing scaffolds after incubation in simulated body fluid medium has been shown to be hydroxyapatite by Raman spectroscopy and X-ray diffraction. The results on differentiation studies of canine adipose-derived mesenchymal stem cells grown on the electrospun scaffolds suggest that on varying the content of RKKP in the scaffold, it is possible to drive the differentiation toward chondrogenic or osteogenic commitment. The presence of ions, like La3+ and Ta5+ , in the RKKP embedded polymeric composite scaffolds could play a role in supporting cell growth and promoting differentiation.
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Affiliation(s)
- Brigida Bochicchio
- Dipartimento di Scienze, Università degli Studi della Basilicata, Potenza, Italy
| | - Katia Barbaro
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Rome, Italy
| | - Angela De Bonis
- Dipartimento di Scienze, Università degli Studi della Basilicata, Potenza, Italy
| | - Julietta V Rau
- Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche (ISM-CNR), Rome, Italy
| | - Antonietta Pepe
- Dipartimento di Scienze, Università degli Studi della Basilicata, Potenza, Italy
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23
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Schachtner J, Frohbergh M, Hickok N, Kurtz S. Are Medical Grade Bioabsorbable Polymers a Viable Material for Fused Filament Fabrication? J Med Device 2019; 13:0310081-310085. [PMID: 31700564 DOI: 10.1115/1.4043841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/17/2019] [Indexed: 11/08/2022] Open
Abstract
Lumbar fusion surgery has grown in popularity as a solution to lower back pain. Surgical site infection (SSI) is a serious complication of spinal surgery, affecting as high as 8.5% of the patient population. If the SSI cannot be eradicated with intravenous antibiotics, the next step is second surgery, which increases the cost imposed on the patient and extends recovery time. An implantable ultrasound-triggered polyether ether ketone device for the dispersal of antibiotics has been developed as a potential solution. In this study, the device was constructed of bioabsorbable medical grade polymer, enabling gradual degradation, and manufactured via fused filament fabrication (FFF). A novel bioabsorbable filament was manufactured and validated with gel permeation chromatography (GPC) and differential scanning calorimetry (DSC). The filament was consistent in molecular weight and thermal properties (p = 0.348 and p = 0.487, respectively). The filament was utilized for FFF of the device. Dimensional accuracy of the device was assessed with μCT analysis. Dimensional differences between the printed device and intended design were minimal. Degradation of raw material, filament, and the device was performed in accordance to ASTM F1635-16 for a month to determine how melting the material impacted the degradation properties. The degradation rate was found to be similar among the samples weeks one through three however, the raw material degraded at a slower rate by the final week (p = 0.039). This study demonstrated the feasibility of utilizing medical grade bioabsorbable polymers in FFF.
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Affiliation(s)
- Jaclyn Schachtner
- Department of Biomedical Engineering,Drexel University, 3440 Market Street, Suite 600, Philadelphia, PA 19104
| | - Michael Frohbergh
- Exponent, Inc., 3440 Market Street, Suite 600, Philadelphia, PA 19104 e-mail:
| | - Noreen Hickok
- Department of Orthopedics, Thomas Jefferson University, 1015 Walnut Street Curtis Building, Room 501, Philadelphia, PA 19107 e-mail:
| | - Steven Kurtz
- Exponent, Inc., 3440 Market St. Suite 600, Philadelphia, PA 19104 e-mail:
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24
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Lyubov DM, Tolpygin AO, Trifonov AA. Rare-earth metal complexes as catalysts for ring-opening polymerization of cyclic esters. Coord Chem Rev 2019. [DOI: 10.1016/j.ccr.2019.04.013] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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25
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Koutserimpas C, Alpantaki K, Chatzinikolaidou M, Chlouverakis G, Dohm M, Hadjipavlou AG. The effectiveness of biodegradable instrumentation in the treatment of spinal fractures. Injury 2018; 49:2111-2120. [PMID: 30526920 DOI: 10.1016/j.injury.2018.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION A variety of biodegradable implants (screws, rods, plates and cages) are available which are composed of many different biodegradable polymers with varying characteristics. The present review of animal and clinical studies examines the efficacy and safety of biodegradable implants in spinal fracture intervention. METHODS A review of the literature through March 2018 was performed using PubMed and Cochrane databases. Success rates were calculated according to sufficient tissue biocompatibility, solid clinical fusion and propensity for osseointegration. RESULTS 49 articles (24 animal and 25 human studies) were included. In animal experiments, the overall success rate for spinal fusion was 60.3%, while the mean success rate regarding the cervical spine was 51.8% compared to 68.1% for the lumbar spine (p = 0.002). In studies involving control group(s): the mean bioabsorbable implant success rate for spinal fusion was 42% compared to 57% for conventional implants (p = 0.0016). In the lumbar spine pL-lactide acid (PLLA) had 75.2% success rate compared to poly (L-lactide-co-DL-lactide) (PLDLLA) at 53.4% (p = 0.003). In clinical studies, the overall mean success rate was 89%, while the mean success rate regarding the cervical spine was 92%, as compared to 83.6% for the lumbar spine (p = 0.001). In studies involving control group(s): the mean bioabsorbable implant success rate was 75% compared to a conventional implant mean success rate of 97% (p<0.0001). In the cervical spine PLLA had a 98.7% success rate compared to 90% with PLDLLA (p = 0.015). In the lumbar spine PLDLLA had 84.7% success rate compared to 63.6% for poly-glycolic acid (PGA) (p = 0.085). DISCUSSION Studies combined biodegradable and conventional implants. Polymers were used in various combinations and surface modification of the implants also varied. Comparison studies were of small sample size. Animal and clinical studies diverged. The current data are not encouraging. The end-point of assessing osseointegration varies in the studies and is indeterminate. In early stages the structure comparison of osseous restoration using biodegradable implants appears inferior to utilization of conventional cages and instrumentation. There is no statistically significant evidence supporting the efficacy of biodegradable implants replacing traditional instrumentation. There is a lack of prospective clinical trials with long-term follow-up regarding utilization of biodegradable implants and the available data does not support their routine use in spinal fracture intervention.
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Affiliation(s)
- Christos Koutserimpas
- Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital of Athens, Greece
| | - Kalliopi Alpantaki
- Department of Materials Science and Technology, University of Crete, Heraklion, Greece
| | - Maria Chatzinikolaidou
- Department of Materials Science and Technology, University of Crete, Heraklion, Greece; Institute of Electronic Structure and Laser (IESL), Foundation for Research and Technology Hellas (FORTH), Heraklion, Greece
| | - Gregory Chlouverakis
- Division of Biostatisctics, School of Medicine, University of Crete, Crete, Greece
| | - Michael Dohm
- Department of Orthopaedic Surgery, University of Arizona, Tucson, AZ, USA
| | - Alexander G Hadjipavlou
- Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, TX, USA.
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26
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Cao L, Chen Q, Jiang LB, Yin XF, Bian C, Wang HR, Ma YQ, Li XQ, Li XL, Dong J. Bioabsorbable self-retaining PLA/nano-sized β-TCP cervical spine interbody fusion cage in goat models: an in vivo study. Int J Nanomedicine 2017; 12:7197-7205. [PMID: 29042769 PMCID: PMC5633287 DOI: 10.2147/ijn.s132041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
STUDY DESIGN This is an experimental animal study. OBJECTIVE The objective of this study was to compare an anterior cervical discectomy and interbody fusion of a novel polylactide/nano-sized β-tricalcium phosphate (PLA/nβ-TCP) bioabsorbable self-retaining cervical fusion cage (BCFC) with an autologous bone graft and polyetheretherketone (PEEK) cages. BACKGROUND Although PLA cervical cages have potential advantages compared with traditional materials, they are not currently routinely used in spine surgery because of undesirable effects such as the lack of osteoconductivity and osteolysis around the implant. This study involved the manufacturing of a bioabsorbable cage from PLA/nβ-TCP that was then used as a device for anterior cervical discectomy and fusion (ACDF) on a goat cervical spine fusion model. MATERIALS AND METHODS Eighteen goats underwent C3/C4 discectomy and were randomly divided into three groups based on the following methods: Group A (n=6), an autologous bone graft; Group B (n=6), PEEK cage filled with an autologous graft; and Group C (n=6), BCFC filled with an autologous iliac bone. Radiography was performed preoperatively and postoperatively and at 1, 4, 8, and 12 weeks after the operation. Disc space height (DSH) was measured at the same time. After 12 weeks, the fused segments were harvested and evaluated with functional radiographic views, biomechanical testing, and histological analyses. RESULTS Over a 12-week period, the BCFC and PEEK cage groups exhibited significantly higher DSH values than the bone graft group. Additionally, the BCFC group yielded a significantly lower range of motion in axial rotation than both the autologous bone graft and PEEK cage groups. A histologic evaluation revealed an increased intervertebral bone volume/total volume ratio and better interbody fusion in the BCFC group than in the other groups. CONCLUSION The BCFC device exhibited better results than the autologous bone graft and PEEK cages in single-level ACDF models in vivo. This device may be a potential alternative to the current PEEK cages.
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Affiliation(s)
- Lu Cao
- Department of Orthopaedic Surgery, Zhongshan Hospital
| | - Qian Chen
- Department of Orthopaedic Surgery, Zhongshan Hospital
| | - Li-Bo Jiang
- Department of Orthopaedic Surgery, Zhongshan Hospital
| | - Xiao-Fan Yin
- Department of Orthopaedic Surgery, Zhongshan Hospital.,Department of Orthopaedic Surgery, Minhang Hospital, Fudan University, Shanghai, China
| | - Chong Bian
- Department of Orthopaedic Surgery, Zhongshan Hospital
| | - Hui-Ren Wang
- Department of Orthopaedic Surgery, Zhongshan Hospital
| | - Yi-Qun Ma
- Department of Orthopaedic Surgery, Zhongshan Hospital
| | - Xiang-Qian Li
- Department of Orthopaedic Surgery, Zhongshan Hospital
| | - Xi-Lei Li
- Department of Orthopaedic Surgery, Zhongshan Hospital
| | - Jian Dong
- Department of Orthopaedic Surgery, Zhongshan Hospital
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27
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Ginjupalli K, Shavi GV, Averineni RK, Bhat M, Udupa N, Nagaraja Upadhya P. Poly(α-hydroxy acid) based polymers: A review on material and degradation aspects. Polym Degrad Stab 2017. [DOI: 10.1016/j.polymdegradstab.2017.08.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Li Y, Jiang L, Xiong C, Peng W. Effect of Different Surface Treatment for Bamboo Fiber on the Crystallization Behavior and Mechanical Property of Bamboo Fiber/Nanohydroxyapatite/Poly(lactic-co-glycolic) Composite. Ind Eng Chem Res 2015. [DOI: 10.1021/acs.iecr.5b02724] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ye Li
- Chengdu Institute
of Organic Chemistry, Chinese Academy of Sciences, Chengdu 610041, PR China
- University of the Chinese Academy of Sciences, Beijing 100039, PR China
| | - Liuyun Jiang
- Chengdu Institute
of Organic Chemistry, Chinese Academy of Sciences, Chengdu 610041, PR China
- Key Laboratory
of Sustainable Resources Processing and Advanced Materials, College
of Chemistry and Chemical Engineering, Hunan Normal University, Changsha 410081, PR China
| | - Chengdong Xiong
- Chengdu Institute
of Organic Chemistry, Chinese Academy of Sciences, Chengdu 610041, PR China
| | - Wanjia Peng
- Chengdu Institute
of Organic Chemistry, Chinese Academy of Sciences, Chengdu 610041, PR China
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Biodegradable Materials for Bone Repair and Tissue Engineering Applications. MATERIALS 2015; 8:5744-5794. [PMID: 28793533 PMCID: PMC5512653 DOI: 10.3390/ma8095273] [Citation(s) in RCA: 354] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 08/09/2015] [Accepted: 08/24/2015] [Indexed: 12/21/2022]
Abstract
This review discusses and summarizes the recent developments and advances in the use of biodegradable materials for bone repair purposes. The choice between using degradable and non-degradable devices for orthopedic and maxillofacial applications must be carefully weighed. Traditional biodegradable devices for osteosynthesis have been successful in low or mild load bearing applications. However, continuing research and recent developments in the field of material science has resulted in development of biomaterials with improved strength and mechanical properties. For this purpose, biodegradable materials, including polymers, ceramics and magnesium alloys have attracted much attention for osteologic repair and applications. The next generation of biodegradable materials would benefit from recent knowledge gained regarding cell material interactions, with better control of interfacing between the material and the surrounding bone tissue. The next generations of biodegradable materials for bone repair and regeneration applications require better control of interfacing between the material and the surrounding bone tissue. Also, the mechanical properties and degradation/resorption profiles of these materials require further improvement to broaden their use and achieve better clinical results.
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Guitian Oliveira N, Sirgado T, Reis L, Pinto LF, da Silva CL, Ferreira FC, Rodrigues A. In vitro assessment of three dimensional dense chitosan-based structures to be used as bioabsorbable implants. J Mech Behav Biomed Mater 2014; 40:413-425. [DOI: 10.1016/j.jmbbm.2014.09.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 08/30/2014] [Accepted: 09/08/2014] [Indexed: 01/14/2023]
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Barthel AK, Dass M, Dröge M, Cramer JM, Baumann D, Urban M, Landfester K, Mailänder V, Lieberwirth I. Imaging the intracellular degradation of biodegradable polymer nanoparticles. BEILSTEIN JOURNAL OF NANOTECHNOLOGY 2014; 5:1905-1917. [PMID: 25383302 PMCID: PMC4222285 DOI: 10.3762/bjnano.5.201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 09/30/2014] [Indexed: 06/04/2023]
Abstract
In recent years, the development of smart drug delivery systems based on biodegradable polymeric nanoparticles has become of great interest. Drug-loaded nanoparticles can be introduced into the cell interior via endocytotic processes followed by the slow release of the drug due to degradation of the nanoparticle. In this work, poly(L-lactic acid) (PLLA) was chosen as the biodegradable polymer. Although common degradation of PLLA has been studied in various biological environments, intracellular degradation processes have been examined only to a very limited extent. PLLA nanoparticles with an average diameter of approximately 120 nm were decorated with magnetite nanocrystals and introduced into mesenchymal stem cells (MSCs). The release of the magnetite particles from the surface of the PLLA nanoparticles during the intracellular residence was monitored by transmission electron microscopy (TEM) over a period of 14 days. It was demonstrated by the release of the magnetite nanocrystals from the PLLA surface that the PLLA nanoparticles do in fact undergo degradation within the cell. Furthermore, even after 14 days of residence, the PLLA nanoparticles were found in the MSCs. Additionally, the ultrastructural TEM examinations yield insight into the long term intercellular fate of these nanoparticles. From the statistical analysis of ultrastructural details (e.g., number of detached magnetite crystals, and the number of nanoparticles in one endosome), we demonstrate the importance of TEM studies for such applications in addition to fluorescence studies (flow cytometry and confocal laser scanning microscopy).
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Affiliation(s)
- Anne-Kathrin Barthel
- Max-Planck-Institute for Polymer Research, Ackermannweg 10, 55123 Mainz, Germany
| | - Martin Dass
- Max-Planck-Institute for Polymer Research, Ackermannweg 10, 55123 Mainz, Germany
| | - Melanie Dröge
- Max-Planck-Institute for Polymer Research, Ackermannweg 10, 55123 Mainz, Germany
| | - Jens-Michael Cramer
- Max-Planck-Institute for Polymer Research, Ackermannweg 10, 55123 Mainz, Germany
| | - Daniela Baumann
- Max-Planck-Institute for Polymer Research, Ackermannweg 10, 55123 Mainz, Germany
| | - Markus Urban
- Max-Planck-Institute for Polymer Research, Ackermannweg 10, 55123 Mainz, Germany
| | - Katharina Landfester
- Max-Planck-Institute for Polymer Research, Ackermannweg 10, 55123 Mainz, Germany
| | - Volker Mailänder
- Max-Planck-Institute for Polymer Research, Ackermannweg 10, 55123 Mainz, Germany
- 3rd Department of Medicine (Hematology, Oncology, and Pneumology), University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Ingo Lieberwirth
- Max-Planck-Institute for Polymer Research, Ackermannweg 10, 55123 Mainz, Germany
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Chen AP, Lau JYC, Alvares RDA, Cunningham CH. Using [1-(13) C]lactic acid for hyperpolarized (13) C MR cardiac studies. Magn Reson Med 2014; 73:2087-93. [PMID: 25046652 DOI: 10.1002/mrm.25354] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 06/09/2014] [Accepted: 06/13/2014] [Indexed: 01/20/2023]
Abstract
PURPOSE Hyperpolarized [1-(13) C]lactate in solution may be a clinically relevant and safe substrate for real time MR investigations of key metabolic pathways. The potential of using hyperpolarized [1-(13) C]lactate for magnetic resonance studies of cardiac metabolism in vivo was explored. METHODS Neat [1-(13) C]lactic acid was hyperpolarized using the dynamic nuclear polarization process. Cardiac MR spectroscopy experiments were performed in vivo using hyperpolarized [1-(13) C]lactate and [1-(13) C]pyruvate in solutions. RESULTS A high degree of polarization was achieved for [1-(13) C]lactate in solution (16.7%). (13) C-bicarbonate was observed in rat hearts in vivo after either hyperpolarized [1-(13) C]lactate or hyperpolarized [1-(13) C]pyruvate was infused, but lower (13) C-bicarbonate to substrate ratio was observed with hyperpolarized [1-(13) C]lactate infusions. The response of (13) C-bicarbonate signal as a function of hyperpolarized [1-(13) C]lactate doses was also investigated and a saturation of (13) C-bicarbonate signal was observed at the highest dose of [1-(13) C]lactate used (0.69 mmol/kg). CONCLUSION This study demonstrated that the use of neat [1-(13) C]lactic acid as the DNP sample is a potential alternative to [1-(13) C]pyruvic acid for cardiac hyperpolarized (13) C MR studies. Hyperpolarized [1-(13) C]lactate may enable noninvasive assessment of cardiac PDH flux in cardiac patients in the near future.
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Affiliation(s)
| | - Justin Y C Lau
- Department of Medical Biophysics, University of Toronto, Toronto, Canada.,Imaging Research, Sunnybrook Research Institute, Toronto, Canada
| | - Rohan D A Alvares
- Department of Chemistry, University of Toronto, UTM, Mississauga, Canada
| | - Charles H Cunningham
- Department of Medical Biophysics, University of Toronto, Toronto, Canada.,Imaging Research, Sunnybrook Research Institute, Toronto, Canada
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Li Y, Wu ZG, Li XK, Guo Z, Wu SH, Zhang YQ, Shi L, Teoh SH, Liu YC, Zhang ZY. A polycaprolactone-tricalcium phosphate composite scaffold as an autograft-free spinal fusion cage in a sheep model. Biomaterials 2014; 35:5647-59. [DOI: 10.1016/j.biomaterials.2014.03.075] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 03/27/2014] [Indexed: 01/18/2023]
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Kargupta R, Bok S, Darr CM, Crist BD, Gangopadhyay K, Gangopadhyay S, Sengupta S. Coatings and surface modifications imparting antimicrobial activity to orthopedic implants. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2014; 6:475-95. [PMID: 24867883 DOI: 10.1002/wnan.1273] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 03/23/2014] [Accepted: 04/06/2014] [Indexed: 12/24/2022]
Abstract
Bacterial colonization and biofilm formation on an orthopedic implant surface is one of the worst possible outcomes of orthopedic intervention in terms of both patient prognosis and healthcare costs. Making the problem even more vexing is the fact that infections are often caused by events beyond the control of the operating surgeon and may manifest weeks to months after the initial surgery. Herein, we review the costs and consequences of implant infection as well as the methods of prevention and management. In particular, we focus on coatings and other forms of implant surface modification in a manner that imparts some antimicrobial benefit to the implant device. Such coatings can be classified generally based on their mode of action: surface adhesion prevention, bactericidal, antimicrobial-eluting, osseointegration promotion, and combinations of the above. Despite several advances in the efficacy of these antimicrobial methods, a remaining major challenge is ensuring retention of the antimicrobial activity over a period of months to years postoperation, an issue that has so far been inadequately addressed. Finally, we provide an overview of additional figures of merit that will determine whether a given antimicrobial surface modification warrants adoption for clinical use.
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Affiliation(s)
- Roli Kargupta
- Department of Bioengineering, University of Missouri, Columbia, MO, USA
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Toncheva A, Spasova M, Paneva D, Manolova N, Rashkov I. Polylactide (PLA)-Based Electrospun Fibrous Materials Containing Ionic Drugs as Wound Dressing Materials: A Review. INT J POLYM MATER PO 2014. [DOI: 10.1080/00914037.2013.854240] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dreher ML, Nagaraja S, Bui H, Hong D. Characterization of load dependent creep behavior in medically relevant absorbable polymers. J Mech Behav Biomed Mater 2014; 29:470-9. [DOI: 10.1016/j.jmbbm.2013.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 09/30/2013] [Accepted: 10/07/2013] [Indexed: 10/26/2022]
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Fabrication of novel poly(lactic acid)/amorphous magnesium phosphate bionanocomposite fibers for tissue engineering applications via electrospinning. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 33:2302-10. [DOI: 10.1016/j.msec.2013.01.058] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 12/16/2012] [Accepted: 01/23/2013] [Indexed: 11/22/2022]
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Fredericks DC, Gandhi AA, Grosland NM, Smucker JD. Assessment of BioPlex interbody fusion device in a sheep lumbar fusion model. THE IOWA ORTHOPAEDIC JOURNAL 2013; 33:33-39. [PMID: 24027458 PMCID: PMC3748889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the bioPlex bioresorbable interbody device in a sheep lumbar fusion model and compare it to the concorde, a standard carbon fiber interbody cage. BACKGROUND Lumbar interbody fusion devices are made from a variety of materials, including titanium alloys, carbon-fiber, and PEEK. The BioPlex Continuous Phase Composite (CPC) is a unique bioresorbable material comprised of Pro Osteon 500R and 70:30 Poly (L/D, L-lactic acid). The BioPlex device is radiolucent, resorbable and due to its bulk nanoporosity of 8%, has a more consistent degradation profile as compared to a polymer alone. METHODS A total of twenty five male Suffolk sheep were used in this study; nineteen of which were implanted with a bioPlex or concorde device at the L3-L4 and L5-L6 levels using a modified transforaminal/lateral approach. A discectomy was performed and each implant (filled with autologous bone) was placed within the disc space. The sheep were sacrificed at 6, 12, 24 months postimplantation. Fusion was assessed via motion, radiographic and histological data. RESULTS The BioPlex and Concorde implanted levels had significantly less motion (p<0.05) than the normal controls in flexion/extension and lateral bending at 6, 12, and 24 months. No significant difference in motion was detected between the bioPlex and concorde implants. CT fusion scores correlated with the motion analysis in all the three cases. CONCLUSION In comparison to the concorde device, the bioPlex implant appears to have equivalent radiographic and biomechanical fusion success.
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Affiliation(s)
- Douglas C Fredericks
- Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, The University of Iowa , Iowa City, IA , United States
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Antibacterial fluoroquinolone antibiotic-containing fibrous materials from poly(l-lactide-co-d,l-lactide) prepared by electrospinning. Eur J Pharm Sci 2012; 47:642-51. [DOI: 10.1016/j.ejps.2012.08.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 07/18/2012] [Accepted: 08/07/2012] [Indexed: 11/17/2022]
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Zhou H, Bhaduri SB. Deposition of PLA/CDHA composite coating via electrospraying. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2012; 24:784-96. [DOI: 10.1080/09205063.2012.714726] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Huan Zhou
- a Department of Bioengineering , The University of Toledo , Toledo , OH , 43606 , USA
- b Department of Mechanical, Industrial and Manufacturing Engineering , The University of Toledo , Toledo , OH , 43606 , USA
| | - Sarit B. Bhaduri
- b Department of Mechanical, Industrial and Manufacturing Engineering , The University of Toledo , Toledo , OH , 43606 , USA
- c Department of Surgery (Dentistry) , The University of Toledo , Toledo , OH , 43606 , USA
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Zhou H, Lawrence JG, Bhaduri SB. Fabrication aspects of PLA-CaP/PLGA-CaP composites for orthopedic applications: a review. Acta Biomater 2012; 8:1999-2016. [PMID: 22342596 DOI: 10.1016/j.actbio.2012.01.031] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 12/14/2011] [Accepted: 01/25/2012] [Indexed: 01/20/2023]
Abstract
For several decades, composites made of polylactic acid-calcium phosphates (PLA-CaP) and polylactic acid-co-glycolic acid-calcium phosphates (PLGA-CaP) have seen widespread uses in orthopedic applications. This paper reviews the fabrication aspects of these composites, following the ubiquitous materials science approach by studying "processing-structure-property" correlations. Various fabrication processes such as microencapsulation, phase separation, electrospinning, supercritical gas foaming, etc., are reviewed, with specific examples of their applications in fabricating these composites. The effect of the incorporation of CaP materials on the mechanical and biological performance of PLA/PLGA is addressed. In addition, this paper describes the state of the art on challenges and innovations concerning CaP dispersion, incorporation of biomolecules/stem cells and long-term degradation of the composites.
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Ergun A, Chung R, Ward D, Valdevit A, Ritter A, Kalyon DM. Unitary bioresorbable cage/core bone graft substitutes for spinal arthrodesis coextruded from polycaprolactone biocomposites. Ann Biomed Eng 2011; 40:1073-87. [PMID: 22179683 DOI: 10.1007/s10439-011-0484-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 12/01/2011] [Indexed: 12/14/2022]
Abstract
A unitary bioresorbable cage/core bone graft substitute consisting of a stiff cage and a softer core with interconnected porosity is offered for spinal arthrodesis. Polycaprolactone, PCL, was used as the matrix and hydroxyapatite, HA, and β-tricalcium phosphate, TCP, were used in the formulation of the cage layer to impart modulus increase and osteoconductivity while the core consisted solely of PCL. The crystallinity, biodegradation rate (under accelerated conditions) and mechanical properties, i.e., the uniaxial compression, relaxation modulus upon step compression and cyclic compressive fatigue properties, of the co-extruded cage/core bone graft substitutes could be manipulated by changes in the concentration of HA/TCP in the cage layer. The cyclic fatigue behavior of the cage/core bone graft substitutes were also compared to the behavior of bovine vertebral cancellous bone characterized under similar testing conditions. The biocompatibility of the cage/core bone graft substitutes were assessed via in vitro culturing of human bone marrow derived stromal cells, BMSCs. The cell proliferation rates, time dependencies of the alkaline phosphates (ALP) activity and the expressions of bone markers, i.e., Runx2, ALP, collagen type I, osteopontin and osteocalcin, and the collected μ-CT images demonstrated the differentiation of BMSCs via osteogenic lineage and formation of mineralized bone tissue to indicate the biocompatibility of the cage/core bone graft substitutes.
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Affiliation(s)
- Asli Ergun
- Department of Chemical Engineering & Materials Science, Stevens Institute of Technology, Hoboken, NJ 07030, USA
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Evaluation of bioabsorbable multiamino acid copolymer/α-tri-calcium phosphate interbody fusion cages in a goat model. Spine (Phila Pa 1976) 2011; 36:E1615-22. [PMID: 21270683 DOI: 10.1097/brs.0b013e318210ca32] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
STUDY DESIGN A study of cervical interbody fusion using polyamino acid-based bioabsorbable fusion cages in a goat model. OBJECTIVE To compare interbody fusion of a bioabsorbable multiamino acid copolymer/α-tri-calcium phosphate (MAACP/α-TCP) fusion cage with an autologous tricortical iliac-crest bone graft and a titanium cage. SUMMARY OF BACKGROUND DATA Polyamino acid is widely used as a carrier for drug delivery. To our knowledge, no study investigates interbody fusion cage made of polyamino acid. METHODS A total of 15 sheep underwent C3/C4 discectomy and fusion. The following stabilization techniques were used: group A, autologous tricortical iliac crest bone graft (n = 5); group B, MAACP/α-TCP cage filled with autologous cancellous bone graft (n = 5); group C, titanium cage filled with autologous cancellous bone graft (n = 5). Radiographic scans to determine disc space height were performed before and after surgery and after 4, 8, and 12 weeks, respectively. After 12 weeks, the C3/C4 motion segment was isolated and sectioned to create a 5-mm thick parasagittal section from which lateral radiographs were obtained. All the radiographs were encoded and reviewed in a blinded fashion to evaluate interbody fusion within the cage devices according to a three-point radiographic score. Biomechanical testing was performed in flexion, extension, axial rotation, and lateral bending to determine range of motion (ROM). Histomorphological and histomorphometrical analyses were performed to evaluate fusion and foreign-body reactions associated with the bioabsorbable cages. RESULTS Radiographic results showed that the disc space height (DSH) in MAACP/α-TCP cage group was better than that of bone graft group and the best radiographic score was found in MAACP/α-TCP cage group. Biomechanical test showed that no significant difference was found in ROM between MAACP/α-TCP cage group and titanium cage group whereas the value of ROM in bone graft group was the largest. Histologic evaluation showed a higher intervertebral bone volume/total volume ratio and a better interbody fusion in the MAACP/α-TCP cage group than in the other two groups. Two MAACP/α-TCP cages showed microcracks and the other three cages had maintained their original geometry. All MAACP/α-TCP cages showed excellent biocompatibility. CONCLUSION After 12 weeks, there was no significant difference between the MAACP/α-TCP cage and the titanium cage in distractive properties and biomechanical properties. Compared with titanium cages, MAACP/α-TCP cages showed an advanced interbody fusion. Although MAACP/α-TCP cages developed cracks after only 12 weeks, they showed significantly better distractive properties, biomechanical properties, and an advanced interbody fusion than the tricortical iliac crest bone graft. Improvement should be made to insure the strength of MAACP/α-TCP cage last at least 6 month after implantion.
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Fusion performance of low-dose recombinant human bone morphogenetic protein 2 and bone marrow-derived multipotent stromal cells in biodegradable scaffolds: a comparative study in a large animal model of anterior lumbar interbody fusion. Spine (Phila Pa 1976) 2011; 36:1752-9. [PMID: 21673630 DOI: 10.1097/brs.0b013e31822576a4] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A large animal study comparing interbody fusion of a bioresorbable scaffold loaded with either low-dose recombinant human bone morphogenetic protein 2 (rhBMP-2) or bone marrow-derived multipotent stromal cells (BMSCs). OBJECTIVE To compare the quality of fusion resulting from implantation of medical grade poly (ε-caprolactone)-20% tricalcium phosphate (mPCL/TCP) scaffolds and two different bone growth stimulating agents. SUMMARY OF BACKGROUND DATA Nondegradable cages have been used for interbody fusion with good results. However, the overall advantage of lifelong implantation of a nondegradable device remains a subject of ongoing debate. The use of bioresorbable scaffolds might offer superior alternatives. In this study, we evaluated the quality of fusion obtained with two potential bone graft substitutes. METHODS Eleven Yorkshire pigs underwent a bisegmental (L2/L3; L4/L5) anterior lumbar interbody fusion (ALIF) in four groups, namely: (1) mPCL/TCP + 0.6 mg rhBMP-2; (2) mPCL/TCP + BMSCs; (3) mPCL/TCP (negative control); and (4) autologous bone grafts (positive control). RESULTS. The mean radiographic scores at 9 months were 3.0, 1.7, 1.0, and 1.8 for groups 1 to 4, respectively. The bone volume fraction of group 1 was two-folds higher than group 2. Histology, micro-computed tomographic scanning and biomechanical evaluation demonstrated solid and comparable fusion between groups 1 and 4. However, group 2 showed inferior quality of fusion when compared with groups 1 and 4 while group 3 showed no fusion even at 9 months. In addition, there was no evidence of implant rejection, chronic inflammation or any other complications. CONCLUSION mPCL/TCP scaffolds loaded with low-dose rhBMP-2 is comparable to autograft bone as a bone graft substitute in this large animal ALIF model. Although BMSCs lagged behind autograft bone and rhBMP-2, evidence of bone ingrowth in this group warrants further investigation. Our results suggest that mPCL/TCP scaffolds loaded with rhBMP-2 or BMSCs may be a viable alternative to conventional cages and autograft bone.
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Costi JJ, Freeman BJC, Elliott DM. Intervertebral disc properties: challenges for biodevices. Expert Rev Med Devices 2011; 8:357-76. [PMID: 21542708 DOI: 10.1586/erd.11.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Intervertebral disc biodevices that employ motion-preservation strategies (e.g., nucleus replacement, total disc replacement and posterior stabilization devices) are currently in use or in development. However, their long-term performance is unknown and only a small number of randomized controlled trials have been conducted. In this article, we discuss the following biodevices: interbody cages, nuclear pulposus replacements, total disc replacements and posterior dynamic stabilization devices, as well as future biological treatments. These biodevices restore some function to the motion segment; however, contrary to expectations, the risk of adjacent-level degeneration does not appear to have been reduced. The short-term challenge is to replicate the complex biomechanical function of the motion segment (e.g., biphasic, viscoelastic behavior and nonlinearity) to improve the quality of motion and minimize adjacent level problems, while ensuring biodevice longevity for the younger, more active patient. Biological strategies for regeneration and repair of disc tissue are being developed and these offer exciting opportunities (and challenges) for the longer term. Responsible introduction and rigorous assessment of these new technologies are required. In this article, we will describe the properties of the disc, explore biodevices currently in use for the surgical treatment of low back pain (with an emphasis on lumbar total disc replacement) and discuss future directions for biological treatments. Finally, we will assess the challenges ahead for the next generation of biodevices designed to replace the disc.
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Affiliation(s)
- John J Costi
- School of Computer Science, Engineering & Mathematics, Faculty of Science & Engineering, Flinders University, GPO Box 2100, Adelaide, South Australia 5001, Australia.
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Aslani FJ, Hukins DWL, Shepherd DET. Effect of side holes in cervical fusion cages: a finite element analysis study. Proc Inst Mech Eng H 2011; 225:986-92. [DOI: 10.1177/0954411911413509] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to investigate the effect of side holes on the predicted von Mises stress levels in cervical spinal fusion cages subjected to compressive loading. Models with between zero and ten side holes were developed. Finite element analysis (FEA) was used to simulate compression of the cage, made from the polymer PEEK (polyetheretherketone), between two adjacent vertebrae. The analyses were validated by experimental tests. In all of the models, the von Mises stress was highest at the cage–vertebrae interface with peak stresses of between 14 and 18 MPa. Increasing the Young’s modulus of the vertebrae from 12 to 30 GPa increased the peak stress on average by 29 per cent. The stresses in the models were lower than the compressive strength of PEEK (118 MPa), and are well within the PEEK fatigue strength reported (60 MPa at 10 million cycles). This study suggests that the number of side holes had a negligible effect on the stress distribution within the cage; the stress magnitudes were fairly constant across all of the models and did not change substantially with the number of holes. Hence, a cervical cage with side holes is unlikely to fail in compression.
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Affiliation(s)
- F J Aslani
- School of Mechanical Engineering, University of Birmingham, Edgbaston, UK
| | - D W L Hukins
- School of Mechanical Engineering, University of Birmingham, Edgbaston, UK
| | - D E T Shepherd
- School of Mechanical Engineering, University of Birmingham, Edgbaston, UK
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Vergroesen PPA, Kroeze RJ, Helder MN, Smit TH. The use of poly(L-lactide-co-caprolactone) as a scaffold for adipose stem cells in bone tissue engineering: application in a spinal fusion model. Macromol Biosci 2011; 11:722-30. [PMID: 21400658 DOI: 10.1002/mabi.201000433] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 12/30/2010] [Indexed: 11/07/2022]
Abstract
Since the early 1990s, tissue engineering has been heralded as a strategy that may solve problems associated with bone grafting procedures. The original concept of growing bone in the laboratory, however, has proven illusive due to biological, logistic, and regulatory problems. Fat-derived stem cells and synthetic polymers open new, more practicable routes for bone tissue engineering. In this paper, we highlight the potential of poly(L-lactide-co-caprolactone) (PLCL) to serve as a radiolucent scaffold in bone tissue engineering. It appears that PLCL quickly and preferentially binds adipose stem cells (ASCs), which proliferate rapidly and eventually differentiate into the osteogenic phenotype. An in vivo spinal fusion study in a goat model provides a preclinical proof-of-concept for a one-step surgical procedure with ASCs in bone tissue engineering.
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The effect of ethylene oxide, glow discharge and electron beam on the surface characteristics of poly(L-lactide-co-caprolactone) and the corresponding cellular response of adipose stem cells. Acta Biomater 2010; 6:2060-5. [PMID: 19944190 DOI: 10.1016/j.actbio.2009.11.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 11/02/2009] [Accepted: 11/16/2009] [Indexed: 11/23/2022]
Abstract
Bioabsorbable polymers are increasingly being used in tissue engineering strategies. Despite the knowledge that some sterilization techniques may affect the physical properties of these polymers, this aspect is often overlooked. We speculate that the type of sterilization method used may influence cellular responses by altering the surface characteristics. We cultured adipose stem cells on bioabsorbable poly(l-lactide-co-caprolactone) (PLCL) sheets, sterilized using either ethylene oxide (EO), argon glow discharge (aGD) or electron beam (e-beam). Significantly higher values for surface roughness in the order EO>aGD>e-beam and significant differences in contact angles (EO>e-beam>aGD) and surface energies (aGD>e-beam>EO) were observed. Increased cell attachment and proliferation rates were observed with lower contact angles. The alkaline phosphatase activity was significantly higher for the ethylene oxide sterilized PLCL sheet. In conclusion, the type of sterilization for bioabsorbable polymers should be considered in the design of new scaffolds, since it might affect, or can be used to enhance, the outcome of the tissue engineered construct.
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Porter JR, Ruckh TT, Popat KC. Bone tissue engineering: a review in bone biomimetics and drug delivery strategies. Biotechnol Prog 2010; 25:1539-60. [PMID: 19824042 DOI: 10.1002/btpr.246] [Citation(s) in RCA: 204] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Critical-sized defects in bone, whether induced by primary tumor resection, trauma, or selective surgery have in many cases presented insurmountable challenges to the current gold standard treatment for bone repair. The primary purpose of a tissue-engineered scaffold is to use engineering principles to incite and promote the natural healing process of bone which does not occur in critical-sized defects. A synthetic bone scaffold must be biocompatible, biodegradable to allow native tissue integration, and mimic the multidimensional hierarchical structure of native bone. In addition to being physically and chemically biomimetic, an ideal scaffold is capable of eluting bioactive molecules (e.g., BMPs, TGF-betas, etc., to accelerate extracellular matrix production and tissue integration) or drugs (e.g., antibiotics, cisplatin, etc., to prevent undesired biological response such as sepsis or cancer recurrence) in a temporally and spatially controlled manner. Various biomaterials including ceramics, metals, polymers, and composites have been investigated for their potential as bone scaffold materials. However, due to their tunable physiochemical properties, biocompatibility, and controllable biodegradability, polymers have emerged as the principal material in bone tissue engineering. This article briefly reviews the physiological and anatomical characteristics of native bone, describes key technologies in mimicking the physical and chemical environment of bone using synthetic materials, and provides an overview of local drug delivery as it pertains to bone tissue engineering is included.
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Affiliation(s)
- Joshua R Porter
- Department of Mechanical Engineering, School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523, USA
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