1
|
Mathey E, Pelletier MH, Walsh WR, Gall K, Carpenter D. Implant Strength Contributes to the Osseointegration Strength of Porous Metallic Materials. J Biomech Eng 2024; 146:101005. [PMID: 38668718 DOI: 10.1115/1.4065405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Indexed: 05/14/2024]
Abstract
Creating the optimal environment for effective and long term osseointegration is a heavily researched and sought-after design criteria for orthopedic implants. A validated multimaterial finite element (FE) model was developed to replicate and understand the results of an experimental in vivo push-out osseointegration model. The FE model results closely predicted global force (at 0.5 mm) and stiffness for the 50-90% porous implants with an r2 of 0.97 and 0.98, respectively. In addition, the FE global force at 0.5 mm showed a correlation to the maximum experimental forces with an r2 of 0.90. The highest porosity implants (80-90%) showed lower stiffnesses and more equitable load sharing but also failed at lower a global force level than the low porosity implants (50-70%). The lower strength of the high porosity implants caused premature plastic deformation of the implant itself during loading as well as significant deformations in the ingrown and surrounding bone, resulting in lower overall osseointegration strength, consistent with experimental measurements. The lower porosity implants showed a balance of sufficient bony ingrowth to support osseointegration strength coupled with implant mechanical properties to circumvent significant implant plasticity and collapse under the loading conditions. Together, the experimental and finite element modeling results support an optimal porosity in the range of 60-70% for maximizing osseointegration with current structure and loading.
Collapse
Affiliation(s)
- Elizabeth Mathey
- Department of Mechanical Engineering, University of Colorado Denver, 1200 Larimer St, Denver, CO 80204
| | - Matthew H Pelletier
- Prince of Wales Clinical School UNSW Sydney, Surgical and Orthopaedic Research Laboratories (SORL), Kensington 2031, Australia
| | - William R Walsh
- Prince of Wales Clinical School UNSW Sydney, Surgical and Orthopaedic Research Laboratories (SORL), Kensington 2031, Australia
| | - Ken Gall
- Pratt School of Engineering, Duke University, Durham, NC 27708
| | - Dana Carpenter
- Department of Mechanical Engineering, University of Colorado Denver, Denver, CO 80217-3364
| |
Collapse
|
2
|
O'Keeffe C, Kotlarz M, Gonçalves IF, Lally C, Kelly DJ. Chemical etching of Ti-6Al-4V biomaterials fabricated by selective laser melting enhances mesenchymal stromal cell mineralization. J Biomed Mater Res A 2024; 112:1548-1564. [PMID: 38515311 DOI: 10.1002/jbm.a.37709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/05/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024]
Abstract
Porous titanium scaffolds fabricated by powder bed fusion additive manufacturing techniques have been widely adopted for orthopedic and bone tissue engineering applications. Despite the many advantages of this approach, topological defects inherited from the fabrication process are well understood to negatively affect mechanical properties and pose a high risk if dislodged after implantation. Consequently, there is a need for further post-process surface cleaning. Traditional techniques such as grinding or polishing are not suited to lattice structures, due to lack of a line of sight to internal features. Chemical etching is a promising alternative; however, it remains unclear if changes to surface properties associated with such protocols will influence how cells respond to the material surface. In this study, we explored the response of bone marrow derived mesenchymal stem/stromal cells (MSCs) to Ti-6Al-4V whose surface was exposed to different durations of chemical etching. Cell morphology was influenced by local topological features inherited from the SLM fabrication process. On the as-built surface, topological nonhomogeneities such as partially adhered powder drove a stretched anisotropic cellular morphology, with large areas of the cell suspended across the nonhomogeneous powder interface. As the etching process was continued, surface defects were gradually removed, and cell morphology appeared more isotropic and was suggestive of MSC differentiation along an osteoblastic-lineage. This was accompanied by more extensive mineralization, indicative of progression along an osteogenic pathway. These findings point to the benefit of post-process chemical etching of additively manufactured Ti-6Al-4V biomaterials targeting orthopedic applications.
Collapse
Affiliation(s)
- Conor O'Keeffe
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
- AMBER, the SFI Research Centre for Advanced Materials and Bioengineering Research, Ireland
| | - Marcin Kotlarz
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
- AMBER, the SFI Research Centre for Advanced Materials and Bioengineering Research, Ireland
| | - Inês F Gonçalves
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
- AMBER, the SFI Research Centre for Advanced Materials and Bioengineering Research, Ireland
| | - Caitríona Lally
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
- AMBER, the SFI Research Centre for Advanced Materials and Bioengineering Research, Ireland
- Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Daniel J Kelly
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
- AMBER, the SFI Research Centre for Advanced Materials and Bioengineering Research, Ireland
- Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| |
Collapse
|
3
|
Øvrebø Ø, Orlando L, Rubenis K, Ciriello L, Ma Q, Giorgi Z, Tognoni S, Loca D, Villa T, Nogueira LP, Rossi F, Haugen HJ, Perale G. The role of collagen and crystallinity in the physicochemical properties of naturally derived bone grafts. Regen Biomater 2024; 11:rbae093. [PMID: 39224130 PMCID: PMC11368411 DOI: 10.1093/rb/rbae093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 07/21/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024] Open
Abstract
Xenografts are commonly used for bone regeneration in dental and orthopaedic domains to repair bone voids and other defects. The first-generation xenografts were made through sintering, which deproteinizes them and alters their crystallinity, while later xenografts are produced using cold-temperature chemical treatments to maintain the structural collagen phase. However, the impact of collagen and the crystalline phase on physicochemical properties have not been elucidated. We hypothesized that understanding these factors could explain why the latter provides improved bone regeneration clinically. In this study, we compared two types of xenografts, one prepared through a low-temperature chemical process (Treated) and another subsequently sintered at 1100°C (Sintered) using advanced microscopy, spectroscopy, X-ray analysis and compressive testing. Our investigation showed that the Treated bone graft was free of residual blood, lipids or cell debris, mitigating the risk of pathogen transmission. Meanwhile, the sintering process removed collagen and the carbonate phase of the Sintered graft, leaving only calcium phosphate and increased mineral crystallinity. Microcomputed tomography revealed that the Treated graft exhibited an increased high porosity (81%) and pore size compared to untreated bone, whereas the Sintered graft exhibited shrinkage, which reduced the porosity (72%), pore size and strut size. Additionally, scanning electron microscopy displayed crack formation around the pores of the Sintered graft. The Treated graft displayed median mechanical properties comparable to native cancellous bone and clinically available solutions, with an apparent modulus of 166 MPa, yield stress of 5.5 MPa and yield strain of 4.9%. In contrast, the Sintered graft exhibited a lower median apparent modulus of 57 MPa. It failed in a brittle manner at a median stress of 1.7 MPa and strain level of 2.9%, demonstrating the structural importance of the collagen phase. This indicates why bone grafts prepared through cold-temperature processes are clinically favourable.
Collapse
Affiliation(s)
- Øystein Øvrebø
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, 20133 Milano, Italy
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
- Material Biomimetic AS, 0349 Oslo, Norway
| | - Luca Orlando
- Industrie Biomediche Insubri SA, 6805 Mezzovico-Vira, Switzerland
- Orlando Engineering & Consulting Srl, 20094 Corsico, Italy
| | - Kristaps Rubenis
- Institute of Biomaterials and Bioengineering, Faculty of Natural Sciences and Technology, Riga Technical University, LV-1007 Riga, Latvia
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia
| | - Luca Ciriello
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, 20133 Milano, Italy
| | - Qianli Ma
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
| | - Zoe Giorgi
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, 20133 Milano, Italy
| | - Stefano Tognoni
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, 20133 Milano, Italy
| | - Dagnija Loca
- Institute of Biomaterials and Bioengineering, Faculty of Natural Sciences and Technology, Riga Technical University, LV-1007 Riga, Latvia
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia
| | - Tomaso Villa
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, 20133 Milano, Italy
| | - Liebert P Nogueira
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
- Oral Research Laboratory, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, 20133 Milano, Italy
| | - Håvard J Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
- Material Biomimetic AS, 0349 Oslo, Norway
| | - Giuseppe Perale
- Industrie Biomediche Insubri SA, 6805 Mezzovico-Vira, Switzerland
- Faculty of Biomedical Sciences, University of Southern Switzerland, 6900 Lugano, Switzerland
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, 1200 Vienna, Austria
| |
Collapse
|
4
|
Scott JW, Ng KCG, Liddle AD, Jeffers JRT. Method for accurate removal of trabecular bone samples from a curved articulating surface of the distal femur. Clin Biomech (Bristol, Avon) 2024; 115:106240. [PMID: 38615548 DOI: 10.1016/j.clinbiomech.2024.106240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/06/2024] [Accepted: 04/09/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Knowing the mechanical properties of trabecular bone is critical for many branches of orthopaedic research. Trabecular bone is anisotropic and the principal trabecular direction is usually aligned with the load it transmits. It is therefore critical that the mechanical properties are measured as close as possible to this direction, which is often perpendicular to a curved articulating surface. METHODS This study presents a method to extract trabecular bone cores perpendicular to a curved articulating surface of the distal femur. Cutting guides were generated from computed tomography scans of 12 human distal femora and a series of cutting tools were used to release cylindrical bone cores from the femora. The bone cores were then measured to identify the angle between the bone core axis and the principal trabecular axis. FINDINGS The method yielded an 83% success rate in core extraction over 10 core locations per distal femur specimen. In the condyles, 97% of extracted cores were aligned with the principal trabecular direction. INTERPRETATION This method is a reliable way of extracting trabecular bone specimens perpendicular to a curved articular surface and could be useful across the field of orthopaedic research.
Collapse
Affiliation(s)
- James W Scott
- Biomechanics Group, Mechanical Engineering Department, Imperial College London, United Kingdom.
| | - K C Geoffrey Ng
- Department of Medical Biophysics, Western University, Canada; Department of Medical Imaging, Western University, Canada; Department of Surgery, Western University, Canada; Robarts Research Institute, Western University, Canada; MSk Lab, Department of Surgery and Cancer, Imperial College London, United Kingdom
| | - Alexander D Liddle
- MSk Lab, Department of Surgery and Cancer, Imperial College London, United Kingdom
| | - Jonathan R T Jeffers
- Biomechanics Group, Mechanical Engineering Department, Imperial College London, United Kingdom
| |
Collapse
|
5
|
Kim M, Schöbel L, Geske M, Boccaccini AR, Ghorbani F. Bovine serum albumin-modified 3D printed alginate dialdehyde-gelatin scaffolds incorporating polydopamine/SiO 2-CaO nanoparticles for bone regeneration. Int J Biol Macromol 2024; 264:130666. [PMID: 38453119 DOI: 10.1016/j.ijbiomac.2024.130666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
Three-dimensional (3D) printing allows precise manufacturing of bone scaffolds for patient-specific applications and is one of the most recently developed and implemented technologies. In this study, bilayer and multimaterial alginate dialdehyde-gelatin (ADA-GEL) scaffolds incorporating polydopamine (PDA)/SiO2-CaO nanoparticle complexes were 3D printed using a pneumatic extrusion-based 3D printing technology and further modified on the surface with bovine serum albumin (BSA) for application in bone regeneration. The morphology, chemistry, and in vitro bioactivity of PDA/SiO2-CaO nanoparticle complexes were characterized (n = 3) and compared with those of mesoporous SiO2-CaO nanoparticles. Successful deposition of the PDA layer on the surface of the SiO2-CaO nanoparticles allowed better dispersion in a liquid medium and showed enhanced bioactivity. Rheological studies (n = 3) of ADA-GEL inks consisting of PDA/SiO2-CaO nanoparticle complexes showed results that may indicate better injectability and printability behavior compared to ADA-GEL inks incorporating unmodified nanoparticles. Microscopic observations of 3D printed scaffolds revealed that PDA/SiO2-CaO nanoparticle complexes introduced additional topography onto the surface of 3D printed scaffolds. Additionally, the modified scaffolds were mechanically stable and elastic, closely mimicking the properties of natural bone. Furthermore, protein-coated bilayer scaffolds displayed controllable absorption and biodegradation, enhanced bioactivity, MC3T3-E1 cell adhesion, proliferation, and higher alkaline phosphatase (ALP) activity (n = 3) compared to unmodified scaffolds. Consequently, the present results confirm that ADA-GEL scaffolds incorporating PDA/SiO2-CaO nanoparticle complexes modified with BSA offer a promising approach for bone regeneration applications.
Collapse
Affiliation(s)
- MinJoo Kim
- Institute of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Cauerstrasse 6, 91058 Erlangen, Germany; Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, 81377 Munich, Germany
| | - Lisa Schöbel
- Institute of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Cauerstrasse 6, 91058 Erlangen, Germany
| | - Michael Geske
- Institute of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Cauerstrasse 6, 91058 Erlangen, Germany; Institute of Polymer Materials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Martensstraße 7, 91058 Erlangen, Germany
| | - Aldo R Boccaccini
- Institute of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Cauerstrasse 6, 91058 Erlangen, Germany.
| | - Farnaz Ghorbani
- Institute of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Cauerstrasse 6, 91058 Erlangen, Germany; Department of Translational Health Sciences, University of Bristol, Bristol BS1 3NY, UK.
| |
Collapse
|
6
|
Liu H, Liu T, Yin Z, Liu X, Tan Y, Zhao Y, Yu H. Bio-functional hydroxyapatite-coated 3D porous polyetherketoneketone scaffold for enhanced osteogenesis and osteointegration in orthopedic applications. Regen Biomater 2024; 11:rbae023. [PMID: 38559647 PMCID: PMC10980557 DOI: 10.1093/rb/rbae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
Polyetherketoneketone (PEKK), a high-performance thermoplastic special engineering material, maintains bone-like mechanical properties and has received considerable attention in the biomedical field. The 3D printing technique enables the production of porous scaffolds with a honeycomb structure featuring precisely controlled pore size, porosity and interconnectivity, which holds significant potential for applications in tissue engineering. The ideal pore architecture of porous PEKK scaffolds has yet to be elucidated. Porous PEKK scaffolds with five pore sizes P200 (225 ± 9.8 μm), P400 (411 ± 22.1 μm), P600 (596 ± 23.4 μm), P800 (786 ± 24.2 μm) and P1000 (993 ± 26.0 μm) were produced by a 3D printer. Subsequently, the optimum pore size, the P600, for mechanical properties and osteogenesis was selected based on in vitro experiments. To improve the interfacial bioactivity of porous PEKK scaffolds, hydroxyapatite (HAp) crystals were generated via in situ biomimetic mineralization induced by the phase-transited lysozyme coating. Herein, a micro/nanostructured surface showing HAp crystals on PEKK scaffold was developed. In vitro and in vivo experiments confirmed that the porous PEKK-HAp scaffolds exhibited highly interconnected pores and functional surface structures that were favorable for biocompatibility and osteoinductivity, which boosted bone regeneration. Therefore, this work not only demonstrates that the pore structure of the P600 scaffold is suitable for PEKK orthopedic implants but also sheds light on a synergistic approach involving 3D printing and biomimetic mineralization, which has the potential to yield customized 3D PEKK-HAp scaffolds with enhanced osteoinductivity and osteogenesis, offering a promising strategy for bone tissue engineering.
Collapse
Affiliation(s)
- Huanhuan Liu
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Taiqing Liu
- Department of Pharmacy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Zhicheng Yin
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, PR China
- Department of Dental Technology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Xiaoyin Liu
- Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Ying Tan
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Yuwei Zhao
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Haiyang Yu
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, PR China
| |
Collapse
|
7
|
Xu J, Wu D, Ge B, Li M, Yu H, Cao F, Wang W, Zhang Q, Yi P, Wang H, Song L, Liu L, Li J, Zhao D. Selective Laser Melting of the Porous Ta Scaffold with Mg-Doped Calcium Phosphate Coating for Orthopedic Applications. ACS Biomater Sci Eng 2024; 10:1435-1447. [PMID: 38330203 DOI: 10.1021/acsbiomaterials.3c01503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Addressing the repair of large-scale bone defects has become a hot research topic within the field of orthopedics. This study assessed the feasibility and effectiveness of using porous tantalum scaffolds to treat such defects. These scaffolds, manufactured using the selective laser melting (SLM) technology, possessed biomechanical properties compatible with natural bone tissue. To enhance the osteogenesis bioactivity of these porous Ta scaffolds, we applied calcium phosphate (CaP) and magnesium-doped calcium phosphate (Mg-CaP) coatings to the surface of SLM Ta scaffolds through a hydrothermal method. These degradable coatings released calcium and magnesium ions, demonstrating osteogenic bioactivity. Experimental results indicated that the Mg-CaP group exhibited biocompatibility comparable to that of the Ta group in vivo and in vitro. In terms of osteogenesis, both the CaP group and the Mg-CaP group showed improved outcomes compared to the control group, with the Mg-CaP group demonstrating superior performance. Therefore, both CaP and magnesium-CaP coatings can significantly enhance the osseointegration of three-dimensional-printed porous Ta, thereby increasing the surface bioactivity. Overall, the present study introduces an innovative approach for the biofunctionalization of SLM porous Ta, aiming to enhance its suitability as a bone implant material.
Collapse
Affiliation(s)
- Jianfeng Xu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Di Wu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Bing Ge
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Maoyuan Li
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Haiyu Yu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Fang Cao
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Weidan Wang
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Qing Zhang
- Integrative Laboratory, Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Pinqiao Yi
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Haiyao Wang
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Liqun Song
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Lingpeng Liu
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Junlei Li
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Dewei Zhao
- Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| |
Collapse
|
8
|
Eichholz KF, Pitacco P, Burdis R, Chariyev-Prinz F, Barceló X, Tornifoglio B, Paetzold R, Garcia O, Kelly DJ. Integrating Melt Electrowriting and Fused Deposition Modeling to Fabricate Hybrid Scaffolds Supportive of Accelerated Bone Regeneration. Adv Healthc Mater 2024; 13:e2302057. [PMID: 37933556 DOI: 10.1002/adhm.202302057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/23/2023] [Indexed: 11/08/2023]
Abstract
Emerging additive manufacturing (AM) strategies can enable the engineering of hierarchal scaffold structures for guiding tissue regeneration. Here, the advantages of two AM approaches, melt electrowriting (MEW) and fused deposition modelling (FDM), are leveraged and integrated to fabricate hybrid scaffolds for large bone defect healing. MEW is used to fabricate a microfibrous core to guide bone healing, while FDM is used to fabricate a stiff outer shell for mechanical support, with constructs being coated with pro-osteogenic calcium phosphate (CaP) nano-needles. Compared to MEW scaffolds alone, hybrid scaffolds prevent soft tissue collapse into the defect region and support increased vascularization and higher levels of new bone formation 12 weeks post-implantation. In an additional group, hybrid scaffolds are also functionalized with BMP2 via binding to the CaP coating, which further accelerates healing and facilitates the complete bridging of defects after 12 weeks. Histological analyses demonstrate that such scaffolds support the formation of well-defined annular bone, with an open medullary cavity, smooth periosteal surface, and no evidence of abnormal ectopic bone formation. These results demonstrate the potential of integrating different AM approaches for the development of regenerative biomaterials, and in particular, demonstrate the enhanced bone healing outcomes possible with hybrid MEW-FDM constructs.
Collapse
Affiliation(s)
- Kian F Eichholz
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin, D02 R590, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, D02 VH29, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, D02 CP49, Ireland
| | - Pierluca Pitacco
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin, D02 R590, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, D02 VH29, Ireland
| | - Ross Burdis
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin, D02 R590, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, D02 VH29, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, D02 CP49, Ireland
| | - Farhad Chariyev-Prinz
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin, D02 R590, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, D02 VH29, Ireland
| | - Xavier Barceló
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin, D02 R590, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, D02 VH29, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, D02 CP49, Ireland
| | - Brooke Tornifoglio
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin, D02 R590, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, D02 VH29, Ireland
| | - Ryan Paetzold
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, D02 CP49, Ireland
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, D04 E4X0, Ireland
| | - Orquidea Garcia
- Johnson & Johnson 3D Printing Innovation and Customer Solutions, Johnson & Johnson Services, Inc., Irvine, CA, 92618, USA
| | - Daniel J Kelly
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin, D02 R590, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, D02 VH29, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, D02 CP49, Ireland
- Department of Anatomy and Regenerative ME, Royal College of Surgeons in Ireland, Dublin, D02 YN77, Ireland
| |
Collapse
|
9
|
Chmielewska A, Dean D. The role of stiffness-matching in avoiding stress shielding-induced bone loss and stress concentration-induced skeletal reconstruction device failure. Acta Biomater 2024; 173:51-65. [PMID: 37972883 DOI: 10.1016/j.actbio.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
It is well documented that overly stiff skeletal replacement and fixation devices may fail and require revision surgery. Recent attempts to better support healing and sustain healed bone have looked at stiffness-matching of these devices to the desired role of limiting the stress on fractured or engrafted bone to compressive loads and, after the reconstructed bone has healed, to ensure that reconstructive medical devices (implants) interrupt the normal loading pattern as little as possible. The mechanical performance of these devices can be optimized by adjusting their location, integration/fastening, material(s), geometry (external and internal), and surface properties. This review highlights recent research that focuses on the optimal design of skeletal reconstruction devices to perform during and after healing as the mechanical regime changes. Previous studies have considered auxetic materials, homogeneous or gradient (i.e., adaptive) porosity, surface modification to enhance device/bone integration, and choosing the device's attachment location to ensure good osseointegration and resilient load transduction. By combining some or all of these factors, device designers work hard to avoid problems brought about by unsustainable stress shielding or stress concentrations as a means of creating sustainable stress-strain relationships that best repair and sustain a surgically reconstructed skeletal site. STATEMENT OF SIGNIFICANCE: Although standard-of-care skeletal reconstruction devices will usually allow normal healing and improved comfort for the patient during normal activities, there may be significant disadvantages during long-term use. Stress shielding and stress concentration are amongst the most common causes of failure of a metallic device. This review highlights recent developments in devices for skeletal reconstruction that match the stiffness, while not interrupting the normal loading pattern of a healthy bone, and help to combat stress shielding and stress concentration. This review summarises various approaches to achieve stiffness-matching: application of materials with modulus close to that of the bone; adaptation of geometry with pre-defined mechanical properties; and/or surface modification that ensures good integration and proper load transfer to the bone.
Collapse
Affiliation(s)
- Agnieszka Chmielewska
- The Department of Materials Science and Engineering, The Ohio State University, Columbus, OH 43210, USA.
| | - David Dean
- The Department of Materials Science and Engineering, The Ohio State University, Columbus, OH 43210, USA; Department of Plastic & Reconstructive Surgery, The Ohio State University, Columbus, OH 43212, USA
| |
Collapse
|
10
|
Hijazi KM, Dixon SJ, Armstrong JE, Rizkalla AS. Titanium Alloy Implants with Lattice Structures for Mandibular Reconstruction. MATERIALS (BASEL, SWITZERLAND) 2023; 17:140. [PMID: 38203994 PMCID: PMC10779528 DOI: 10.3390/ma17010140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/30/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024]
Abstract
In recent years, the field of mandibular reconstruction has made great strides in terms of hardware innovations and their clinical applications. There has been considerable interest in using computer-aided design, finite element modelling, and additive manufacturing techniques to build patient-specific surgical implants. Moreover, lattice implants can mimic mandibular bone's mechanical and structural properties. This article reviews current approaches for mandibular reconstruction, their applications, and their drawbacks. Then, we discuss the potential of mandibular devices with lattice structures, their development and applications, and the challenges for their use in clinical settings.
Collapse
Affiliation(s)
- Khaled M. Hijazi
- School of Biomedical Engineering, Faculty of Engineering, The University of Western Ontario, London, ON N6A 3K7, Canada
- Bone and Joint Institute, The University of Western Ontario, London, ON N6G 2V4, Canada
| | - S. Jeffrey Dixon
- Bone and Joint Institute, The University of Western Ontario, London, ON N6G 2V4, Canada
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON N6A 5C1, Canada
| | - Jerrold E. Armstrong
- Division of Oral and Maxillofacial Surgery, Department of Otolaryngology Head and Neck Surgery, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Amin S. Rizkalla
- School of Biomedical Engineering, Faculty of Engineering, The University of Western Ontario, London, ON N6A 3K7, Canada
- Bone and Joint Institute, The University of Western Ontario, London, ON N6G 2V4, Canada
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON N6A 5C1, Canada
- Chemical and Biochemical Engineering, Faculty of Engineering, The University of Western Ontario, London, ON N6A 5B9, Canada
| |
Collapse
|
11
|
Amani Hamedani H, Stegall T, Yang Y, Wang H, Menon A, Bhalotia A, Karathanasis E, Capadona JR, Hess-Dunning A. Flexible multifunctional titania nanotube array platform for biological interfacing. MRS BULLETIN 2023; 49:299-309. [PMID: 38645611 PMCID: PMC11026245 DOI: 10.1557/s43577-023-00628-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 04/23/2024]
Abstract
Abstract The current work presents a novel flexible multifunctional platform for biological interface applications. The use of titania nanotube arrays (TNAs) as a multifunctional material is explored for soft-tissue interface applications. In vitro biocompatibility of TNAs to brain-derived cells was first examined by culturing microglia cells-the resident immune cells of the central nervous system on the surface of TNAs. The release profile of an anti-inflammatory drug, dexamethasone from TNAs-on-polyimide substrates, was then evaluated under different bending modes. Flexible TNAs-on-polyimide sustained a linear release of anti-inflammatory dexamethasone up to ~11 days under different bending conditions. Finally, microfabrication processes for patterning and transferring TNA microsegments were developed to facilitate structural stability during device flexing and to expand the set of compatible polymer substrates. The techniques developed in this study can be applied to integrate TNAs or other similar nanoporous inorganic films onto various polymer substrates. Impact statement Titania nanotube arrays (TNAs) are highly tunable and biocompatible structures that lend themselves to multifunctional implementation in implanted devices. A particularly important aspect of titania nanotubes is their ability to serve as nano-reservoirs for drugs or other therapeutic agents that slowly release after implantation. To date, TNAs have been used to promote integration with rigid, dense tissues for dental and orthopedic applications. This work aims to expand the implant applications that can benefit from TNAs by integrating them onto soft polymer substrates, thereby promoting compatibility with soft tissues. The successful direct growth and integration of TNAs on polymer substrates mark a critical step toward developing mechanically compliant implantable systems with drug delivery from nanostructured inorganic functional materials. Diffusion-driven release kinetics and the high drug-loading efficiency of TNAs offer tremendous potential for sustained drug delivery for scientific investigations, to treat injury and disease, and to promote device integration with biological tissues. This work opens new opportunities for developing novel and more effective implanted devices that can significantly improve patient outcomes and quality of life. Graphical abstract Supplementary information The online version contains supplementary material available at 10.1557/s43577-023-00628-y.
Collapse
Affiliation(s)
- Hoda Amani Hamedani
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, USA
- Department of Materials Science and Engineering, Case Western Reserve University, Cleveland, USA
| | - Thomas Stegall
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, USA
| | - Yi Yang
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, USA
| | - Haochen Wang
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, USA
| | - Ashwin Menon
- Department of Mechanical Engineering, Case Western Reserve University, Cleveland, USA
| | - Anubhuti Bhalotia
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, USA
| | - Efstathios Karathanasis
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, USA
- Case Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, USA
| | - Jeffrey R. Capadona
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, USA
| | - Allison Hess-Dunning
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, USA
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, USA
| |
Collapse
|
12
|
Deering J, Mahmoud D, Rier E, Lin Y, do Nascimento Pereira AC, Titotto S, Fang Q, Wohl GR, Deng F, Grandfield K, Elbestawi MA, Chen J. Osseointegration of functionally graded Ti6Al4V porous implants: Histology of the pore network. BIOMATERIALS ADVANCES 2023; 155:213697. [PMID: 37979439 DOI: 10.1016/j.bioadv.2023.213697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/11/2023] [Accepted: 11/05/2023] [Indexed: 11/20/2023]
Abstract
The additive manufacturing of titanium into porous geometries offers a means to generate low-stiffness endosseous implants with a greater surface area available for osseointegration. In this work, selective laser melting was used to produce gyroid-based scaffolds with a uniform pore size of 300 μm or functionally graded pore size from 600 μm to 300 μm. Initial in vitro assessment with Saos-2 cells showed favourable cell proliferation at pore sizes of 300 and 600 μm. Following implantation into rabbit tibiae, early histological observations at four weeks indicated some residual inflammation alongside neovessel infiltration into the scaffold interior and some early apposition of mineralized bone tissue. At twelve weeks, both scaffolds were filled with a mixture of adipocyte-rich marrow, micro-capillaries, and mineralized bone tissue. X-ray microcomputed tomography showed a higher bone volume fraction (BV/TV) and percentage of bone-implant contact (BIC) in the implants with 300 μm pores than in the functionally graded specimens. In functionally graded specimens, localized BV/TV measurement was observed to be higher in the innermost region containing smaller pores (estimated at 300-400 μm) than in larger pores at the implant exterior. The unit cell topology of the porous implant was also observed to guide the direction of bone ingrowth by conducting along the implant struts. These results suggest that in vivo experimentation is necessary alongside parametric optimization of functionally graded porous implants to predict short-term and long-term bone apposition.
Collapse
Affiliation(s)
- Joseph Deering
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON, Canada
| | - Dalia Mahmoud
- Department of Mechanical Engineering, McMaster University, Hamilton, ON, Canada; Production Engineering Department, Faculty of Engineering, Alexandria University, Alexandria 21544, Egypt
| | - Elyse Rier
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | - Yujing Lin
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Anna Cecilia do Nascimento Pereira
- Center of Engineering, Modeling and Applied Social Sciences, Federal University of ABC (UFABC), Santo André, Brazil; 4D Printing and Biomimetics' (4DB) Research Group, Federal University of ABC (UFABC), Santo André, Brazil
| | - Silvia Titotto
- Center of Engineering, Modeling and Applied Social Sciences, Federal University of ABC (UFABC), Santo André, Brazil; 4D Printing and Biomimetics' (4DB) Research Group, Federal University of ABC (UFABC), Santo André, Brazil
| | - Qiyin Fang
- Department of Engineering Physics, McMaster University, Hamilton, ON, Canada
| | - Gregory R Wohl
- Department of Mechanical Engineering, McMaster University, Hamilton, ON, Canada; School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada; Brockhouse Institute for Materials Research, McMaster University, Hamilton, ON, Canada
| | - Feilong Deng
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Kathryn Grandfield
- Department of Materials Science and Engineering, McMaster University, Hamilton, ON, Canada; School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada; Brockhouse Institute for Materials Research, McMaster University, Hamilton, ON, Canada.
| | - Mohamed A Elbestawi
- Department of Mechanical Engineering, McMaster University, Hamilton, ON, Canada.
| | - Jianyu Chen
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
13
|
Kechagias S, Theodoridis K, Broomfield J, Malpartida-Cardenas K, Reid R, Georgiou P, van Arkel RJ, Jeffers JRT. The effect of nodal connectivity and strut density within stochastic titanium scaffolds on osteogenesis. Front Bioeng Biotechnol 2023; 11:1305936. [PMID: 38107615 PMCID: PMC10721980 DOI: 10.3389/fbioe.2023.1305936] [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: 10/02/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
Modern orthopaedic implants use lattice structures that act as 3D scaffolds to enhance bone growth into and around implants. Stochastic scaffolds are of particular interest as they mimic the architecture of trabecular bone and can combine isotropic properties and adjustable structure. The existing research mainly concentrates on controlling the mechanical and biological performance of periodic lattices by adjusting pore size and shape. Still, less is known on how we can control the performance of stochastic lattices through their design parameters: nodal connectivity, strut density and strut thickness. To elucidate this, four lattice structures were evaluated with varied strut densities and connectivity, hence different local geometry and mechanical properties: low apparent modulus, high apparent modulus, and two with near-identical modulus. Pre-osteoblast murine cells were seeded on scaffolds and cultured in vitro for 28 days. Cell adhesion, proliferation and differentiation were evaluated. Additionally, the expression levels of key osteogenic biomarkers were used to assess the effect of each design parameter on the quality of newly formed tissue. The main finding was that increasing connectivity increased the rate of osteoblast maturation, tissue formation and mineralisation. In detail, doubling the connectivity, over fixed strut density, increased collagen type-I by 140%, increased osteopontin by 130% and osteocalcin by 110%. This was attributed to the increased number of acute angles formed by the numerous connected struts, which facilitated the organization of cells and accelerated the cell cycle. Overall, increasing connectivity and adjusting strut density is a novel technique to design stochastic structures which combine a broad range of biomimetic properties and rapid ossification.
Collapse
Affiliation(s)
- Stylianos Kechagias
- Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | | | - Joseph Broomfield
- Centre for Bio Inspired Technology, Department of Electrical and Electronic Engineering, Imperial College London, London, United Kingdom
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Kenny Malpartida-Cardenas
- Centre for Bio Inspired Technology, Department of Electrical and Electronic Engineering, Imperial College London, London, United Kingdom
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Ruth Reid
- Centre for Bio Inspired Technology, Department of Electrical and Electronic Engineering, Imperial College London, London, United Kingdom
| | - Pantelis Georgiou
- Centre for Bio Inspired Technology, Department of Electrical and Electronic Engineering, Imperial College London, London, United Kingdom
| | - Richard J. van Arkel
- Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | | |
Collapse
|
14
|
Singh S, Zhou Y, Farris AL, Whitehead EC, Nyberg EL, O'Sullivan AN, Zhang NY, Rindone AN, Achebe CC, Zbijewski W, Grundy W, Garlick D, Jackson ND, Kraitchman D, Izzi JM, Lopez J, Grant MP, Grayson WL. Geometric Mismatch Promotes Anatomic Repair in Periorbital Bony Defects in Skeletally Mature Yucatan Minipigs. Adv Healthc Mater 2023; 12:e2301944. [PMID: 37565378 PMCID: PMC10840722 DOI: 10.1002/adhm.202301944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/04/2023] [Indexed: 08/12/2023]
Abstract
Porous tissue-engineered 3D-printed scaffolds are a compelling alternative to autografts for the treatment of large periorbital bone defects. Matching the defect-specific geometry has long been considered an optimal strategy to restore pre-injury anatomy. However, studies in large animal models have revealed that biomaterial-induced bone formation largely occurs around the scaffold periphery. Such ectopic bone formation in the periorbital region can affect vision and cause disfigurement. To enhance anatomic reconstruction, geometric mismatches are introduced in the scaffolds used to treat full thickness zygomatic defects created bilaterally in adult Yucatan minipigs. 3D-printed, anatomically-mirrored scaffolds are used in combination with autologous stromal vascular fraction of cells (SVF) for treatment. An advanced image-registration workflow is developed to quantify the post-surgical geometric mismatch and correlate it with the spatial pattern of the regenerating bone. Osteoconductive bone growth on the dorsal and ventral aspect of the defect enhances scaffold integration with the native bone while medio-lateral bone growth leads to failure of the scaffolds to integrate. A strong positive correlation is found between geometric mismatch and orthotopic bone deposition at the defect site. The data suggest that strategic mismatch >20% could improve bone scaffold design to promote enhanced regeneration, osseointegration, and long-term scaffold survivability.
Collapse
Affiliation(s)
- Srujan Singh
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
| | - Yuxiao Zhou
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Ashley L Farris
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Emma C Whitehead
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Ethan L Nyberg
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Aine N O'Sullivan
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Nicholas Y Zhang
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Alexandra N Rindone
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Chukwuebuka C Achebe
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Wojciech Zbijewski
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Will Grundy
- StageBio Company, Mount Jackson, VA, 22842, USA
| | | | | | - Dara Kraitchman
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Jessica M Izzi
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Joseph Lopez
- Pediatric Plastic and Reconstructive Surgery, Pediatric Head and Neck Surgery, AdventHealth for Children, Orlando, FL, 32803, USA
| | - Michael P Grant
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Warren L Grayson
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
- Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
- Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, 21218, USA
| |
Collapse
|
15
|
刘 鑫, 罗 翼, 何 宣, 王 杰, 李 壮, 张 瑀, 虎 鑫, 卢 敏, 唐 凡, 周 勇, 闵 理, 屠 重. [Three-dimensional-printed hemi-pelvic prosthesis for revision of aseptic loosening or screw fracture of modular hemi-pelvic prosthesis]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2023; 37:1183-1189. [PMID: 37848311 PMCID: PMC10581870 DOI: 10.7507/1002-1892.202306073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 10/19/2023]
Abstract
Objective To investigate the effectiveness of three-dimensional (3D)-printed hemi-pelvic prosthesis for revision of aseptic loosening or screw fracture of modular hemi-pelvic prosthesis. Methods Between February 2017 and January 2020, 11 patients with aseptic loosening or screw fracture of modular hemi-pelvic prosthesis were revised using 3D-printed hemi-pelvic prostheses. There were 7 males and 4 females with an average age of 44 years (range, 25-60 years). In the first operation, all patients underwent total tumor resection, modular hemi-pelvic prosthesis reconstruction, and autologous femoral head transplantation. According to the Enneking pelvic partition system, 8 cases were resected in zones Ⅰ+Ⅱ and 3 cases in zones Ⅰ+Ⅱ+Ⅲ. The interval from the initial operation to this revision ranged from 14.3-66.2 months, with an average of 35.8 months. The operation time, the amount of intraoperative bleeding, and the occurrence of complications were recorded. At 6 months after the first operation, before revision, and at last follow-up, the American Musculoskeletal Tumor Society (MSTS) score and Harris score were used to evaluate the recovery of lower limb function. The pain-free walking distance of patients without brace assistance was recorded at last follow-up. X-ray films were taken at 1 month after the first operation, before revision, and at 1 month after revision, the acetabulum position was assessed by the differences in weight arm and cup height between bilateral hip joints. At last follow-up, the digital X-ray tomography was taken to evaluate the prosthesis-bone integration and the occurrence of aseptic loosening. Results The operation time was 182.6-238.0 minutes (mean, 197.4 minutes). The amount of intraoperative bleeding was 400-860 mL (mean, 550.0 mL). All incisions healed by first intention with no infection, hip dislocation, nerve damage, or vascular-related adverse events. The MSTS score and Harris score at last follow-up were significantly higher than those at 6 months after the first operation and before revision ( P<0.05), while the score before revision was significantly lower than that at 6 months after the first operation ( P<0.05). At last follow-up, the patients were able to walk more than 1 000 meters painlessly without brace assistance. Imaging review showed that the difference of cup height at 1 month after revision was significantly lower than that at 1 month after the first operation and before revision, and at 1 month after the first operation than before revision operation, and the differences were significant ( P<0.05). There was no significant difference in the difference of weight arm among three time points ( P>0.05). All prostheses were well integrated, and no aseptic loosening of the prosthesis or screw fracture occurred. Conclusion Revision with 3D-printed hemi-pelvic prostheses benefited in reconstructing stable pelvic ring and natural bodyweight transmission for patients encountering the aseptic loosening or screw fracture of modular hemi-pelvic prosthesis. Early postoperative rehabilitation training can maximize the recovery of patient limb function, reduce pain during walking, and reduce the incidence of complications.
Collapse
Affiliation(s)
- 鑫 刘
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 翼 罗
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 宣虹 何
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 杰 王
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 壮壮 李
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 瑀琦 张
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 鑫 虎
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 敏勋 卢
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 凡 唐
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 勇 周
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 理 闵
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| | - 重棋 屠
- 四川大学华西医院骨科 骨科研究所(成都 610041)Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,P. R. China
| |
Collapse
|
16
|
Asbai-Ghoudan R, Nasello G, Pérez MÁ, Verbruggen SW, Ruiz de Galarreta S, Rodriguez-Florez N. In silico assessment of the bone regeneration potential of complex porous scaffolds. Comput Biol Med 2023; 165:107381. [PMID: 37611419 DOI: 10.1016/j.compbiomed.2023.107381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/21/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
Mechanical environment plays a crucial role in regulating bone regeneration in bone defects. Assessing the mechanobiological behavior of patient-specific orthopedic scaffolds in-silico could help guide optimal scaffold designs, as well as intra- and post-operative strategies to enhance bone regeneration and improve implant longevity. Additively manufactured porous scaffolds, and specifically triply periodic minimal surfaces (TPMS), have shown promising structural properties to act as bone substitutes, yet their ability to induce mechanobiologially-driven bone regeneration has not been elucidated. The aim of this study is to i) explore the bone regeneration potential of TPMS scaffolds made of different stiffness biocompatible materials, to ii) analyze the influence of pre-seeding the scaffolds and increasing the post-operative resting period, and to iii) assess the influence of patient-specific parameters, such as age and mechanosensitivity, on outcomes. To perform this study, an in silico model of a goat tibia is used. The bone ingrowth within the scaffold pores was simulated with a mechano-driven model of bone regeneration. Results showed that the scaffold's architectural properties affect cellular diffusion and strain distribution, resulting in variations in the regenerated bone volume and distribution. The softer material improved the bone ingrowth. An initial resting period improved the bone ingrowth but not enough to reach the scaffold's core. However, this was achieved with the implantation of a pre-seeded scaffold. Physiological parameters like age and health of the patient also influence the bone regeneration outcome, though to a lesser extent than the scaffold design. This analysis demonstrates the importance of the scaffold's geometry and its material, and highlights the potential of using mechanobiological patient-specific models in the design process for bone substitutes.
Collapse
Affiliation(s)
- Reduan Asbai-Ghoudan
- Department of Mechanical Engineering and Materials, Universidad de Navarra, TECNUN Escuela de Ingenieros, Paseo Manuel de Lardizabal, 13, 20018, San Sebastian, Spain.
| | - Gabriele Nasello
- Prometheus Division of Skeletal Tissue Engineering, KU Leuven, O&N1, Herestraat 49, PB 813, 3000, Leuven, Belgium
| | - María Ángeles Pérez
- Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, 50018, Zaragoza, Spain
| | - Stefaan W Verbruggen
- Centre for Bioengineering, School of Engineering and Materials Science, Queen Mary University of London, London, E1 4NS, UK; Department of Mechanical Engineering and INSIGNEO Institute for in Silico Medicine, University of Sheffield, Sheffield, S1 3JD, UK
| | - Sergio Ruiz de Galarreta
- Department of Mechanical Engineering and Materials, Universidad de Navarra, TECNUN Escuela de Ingenieros, Paseo Manuel de Lardizabal, 13, 20018, San Sebastian, Spain
| | - Naiara Rodriguez-Florez
- Department of Mechanical Engineering and Materials, Universidad de Navarra, TECNUN Escuela de Ingenieros, Paseo Manuel de Lardizabal, 13, 20018, San Sebastian, Spain; IKERBASQUE, Basque Foundation for Science, Plaza Euskadi 5, 48009, Bilbao, Spain
| |
Collapse
|
17
|
Titanium Lattice Structures Produced via Additive Manufacturing for a Bone Scaffold: A Review. J Funct Biomater 2023; 14:jfb14030125. [PMID: 36976049 PMCID: PMC10059040 DOI: 10.3390/jfb14030125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/08/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
The progress in additive manufacturing has remarkably increased the application of lattice materials in the biomedical field for the fabrication of scaffolds used as bone substitutes. Ti6Al4V alloy is widely adopted for bone implant application as it combines both biological and mechanical properties. Recent breakthroughs in biomaterials and tissue engineering have allowed the regeneration of massive bone defects, which require external intervention to be bridged. However, the repair of such critical bone defects remains a challenge. The present review collected the most significant findings in the literature of the last ten years on Ti6Al4V porous scaffolds to provide a comprehensive summary of the mechanical and morphological requirements for the osteointegration process. Particular attention was given on the effects of pore size, surface roughness and the elastic modulus on bone scaffold performances. The application of the Gibson–Ashby model allowed for a comparison of the mechanical performance of the lattice materials with that of human bone. This allows for an evaluation of the suitability of different lattice materials for biomedical applications.
Collapse
|
18
|
Yan Z, Hu Y, Shi H, Wang P, Liu Z, Tian Y, Zhuang Z. Experimentally characterizing the spatially varying anisotropic mechanical property of cancellous bone via a Bayesian calibration method. J Mech Behav Biomed Mater 2023; 138:105643. [PMID: 36603525 DOI: 10.1016/j.jmbbm.2022.105643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/07/2022] [Accepted: 12/25/2022] [Indexed: 12/29/2022]
Abstract
Traditional experimental tests for characterizing bone's mechanical properties usually hypothesize a uniaxial stress condition without quantitatively evaluating the influence of spatially varying principal material orientations, which cannot accurately predict the mechanical properties distribution of bones in vivo environment. In this study, a Bayesian calibrating procedure was developed using quantified multiaxial stress to investigate cancellous bone's local anisotropic elastic performance around joints as the spatial variation of main bearing orientations. First, the bone cube specimens from the distal femur of sheep are prepared using traditional anatomical axes. The multiaxial stress state of each bone specimen is calibrated using the actual principal material orientations derived from fabric tensor at different anatomical locations. Based on the calibrated multiaxial stress state, the process of identifying mechanical properties is described as an inverse problem. Then, a Bayesian calibration procedure based on a surrogate constitutive model was developed via multiaxial stress correction to identify the anisotropic material parameters. Finally, a comparison between the experiment and simulation results is discussed by applying the optimal model parameters obtained from the Bayesian probability distribution. Compared to traditional uniaxial methods, our results prove that the calibration based on the spatial variation of the main bearing orientations can significantly improve the accuracy of characterizing regional anisotropic mechanical responses. Moreover, we determine that the actual mechanical property distribution is influenced by complicated mechanical stimulation. This study provides a novel method to evaluate the spatially varying mechanical properties of bone tissues enduring complex mechanical loading accurately and effectively. It is expected to provide more realistic mechanical design targets in vivo for a personalized artificial bone prosthesis in clinical treatment.
Collapse
Affiliation(s)
- Ziming Yan
- Applied Mechanics Laboratory, Department of Engineering Mechanics, School of Aerospace, Tsinghua University, Beijing, 100084, China
| | - Yuanyu Hu
- Department of Orthopedics, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China; Engineering Research Center of Bone and Joint Precision Medicine, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Huibin Shi
- Applied Mechanics Laboratory, Department of Engineering Mechanics, School of Aerospace, Tsinghua University, Beijing, 100084, China
| | - Peng Wang
- Applied Mechanics Laboratory, Department of Engineering Mechanics, School of Aerospace, Tsinghua University, Beijing, 100084, China
| | - Zhanli Liu
- Applied Mechanics Laboratory, Department of Engineering Mechanics, School of Aerospace, Tsinghua University, Beijing, 100084, China.
| | - Yun Tian
- Department of Orthopedics, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China; Engineering Research Center of Bone and Joint Precision Medicine, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Zhuo Zhuang
- Applied Mechanics Laboratory, Department of Engineering Mechanics, School of Aerospace, Tsinghua University, Beijing, 100084, China
| |
Collapse
|
19
|
Mechanical behaviour of a novel biomimetic lattice structure for bone scaffold. J Mech Behav Biomed Mater 2023; 138:105656. [PMID: 36623402 DOI: 10.1016/j.jmbbm.2023.105656] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 12/26/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
In this research, a new lattice structure based on the octagonal geometry and produced by Additive Manufacturing (AM) technique was proposed. Eight octagons with the same dimensions are combined to each other forming a ring. To obtain an isotropic lattice structure, cubic symmetry was imposed; thus, the unit cell is made of three rings mutually perpendicular, one ring for each principal direction. The aim of this study is the morphological and mechanical characterization of the novel unit cell to check its suitability to the biomechanical field, along with its comparison with other lattice structures currently used as bone scaffold. Electron Beam Melting (EBM) technique was used to produce Ti6Al4V ELI alloy specimens of the novel unit cell and of the truncated octahedron (Kelvin) cell. Three different unit cell sizes were selected to investigate the effect of cell dimensions on the mechanical properties. Morphological analysis was performed through a scanning electron microscope (SEM), to compare the actual structures to the designed ones. On the whole, the new lattice structure provided adequate mechanical properties to be considered as a bone substitute; further tests will be focused on its osteointegration capability.
Collapse
|
20
|
Shum JM, Gadomski BC, Tredinnick SJ, Fok W, Fernandez J, Nelson B, Palmer RH, McGilvray KC, Hooper GJ, Puttlitz C, Easley J, Woodfield TBF. Enhanced bone formation in locally-optimised, low-stiffness additive manufactured titanium implants: An in silico and in vivo tibial advancement study. Acta Biomater 2023; 156:202-213. [PMID: 35413478 DOI: 10.1016/j.actbio.2022.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 01/18/2023]
Abstract
A tibial tuberosity advancement (TTA), used to treat lameness in the canine stifle, provides a framework to investigate implant performance within an uneven loading environment due to the dominating patellar tendon. The purpose of this study was to reassess how we design orthopaedic implants in a load-bearing model to investigate potential for improved osseointegration capacity of fully-scaffolded mechanically-matched additive manufactured (AM) implants. While the mechanobiological nature of bone is well known, we have identified a lower limit in the literature where investigation into exceedingly soft scaffolds relative to trabecular bone ceases due to the trade-off in mechanical strength. We developed a finite element model of the sheep stifle to assess the stresses and strains of homogeneous and locally-optimised TTA implant designs. Using additive manufacturing, we printed three different low-stiffness Ti-6Al-4 V TTA implants: 0.8 GPa (Ti1), 0.6 GPa (Ti2) and an optimised design with a 0.3 GPa cortex and 0.1 GPa centre (Ti3), for implantation in a 12-week in vivo ovine pilot study. Static histomorphometry demonstrated uniform bone ingrowth in optimised low-modulus Ti3 samples compared to homogeneous designs (Ti1 and Ti2), and greater bone-implant contact. Mineralising surfaces were apparent in all implants, though mineral apposition rate was only consistent throughout Ti3. The greatest bone formation scores were seen in Ti3, followed by Ti2 and Ti1. Results from our study suggest lower stiffnesses and higher strain ranges improve early bone formation, and that by accounting for loading environments through rational design, implants can be optimised to improve uniform osseointegration. STATEMENT OF SIGNIFICANCE: The effect of different strain ranges on bone healing has been traditionally investigated and characterised through computational models, with much of the literature suggesting higher strain ranges being favourable. However, little has been done to incorporate strain-optimisation into porous orthopaedic implants due to the trade-off in mechanical strength required to induce these microenvironments. In this study, we used finite element analysis to optimise the design of additive manufactured (AM) titanium orthopaedic implants for different strain ranges, using a clinically-relevant surgical model. Our research suggests that there is potential for locally-optimised AM scaffolds in the use of orthopaedic devices to induce higher strains, which in turn encourages de novo bone formation and uniform osseointegration.
Collapse
Affiliation(s)
- Josephine M Shum
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedic Surgery & Musculoskeletal Medicine, Centre for Bioengineering & Nanomedicine, University of Otago, Christchurch, New Zealand
| | - Benjamin C Gadomski
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, CO, United States
| | - Seamus J Tredinnick
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedic Surgery & Musculoskeletal Medicine, Centre for Bioengineering & Nanomedicine, University of Otago, Christchurch, New Zealand
| | - Wilson Fok
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Justin Fernandez
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Bradley Nelson
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, CO, United States
| | - Ross H Palmer
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, CO, United States
| | - Kirk C McGilvray
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, CO, United States
| | - Gary J Hooper
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedic Surgery & Musculoskeletal Medicine, Centre for Bioengineering & Nanomedicine, University of Otago, Christchurch, New Zealand
| | - Christian Puttlitz
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, CO, United States
| | - Jeremiah Easley
- Orthopaedic Bioengineering Research Laboratory, Colorado State University, Fort Collins, CO, United States
| | - Tim B F Woodfield
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE) Group, Department of Orthopaedic Surgery & Musculoskeletal Medicine, Centre for Bioengineering & Nanomedicine, University of Otago, Christchurch, New Zealand.
| |
Collapse
|
21
|
Kohli N, Theodoridis K, Hall TAG, Sanz-Pena I, Gaboriau DCA, van Arkel RJ. Bioreactor analyses of tissue ingrowth, ongrowth and remodelling around implants: An alternative to live animal testing. Front Bioeng Biotechnol 2023; 11:1054391. [PMID: 36890911 PMCID: PMC9986429 DOI: 10.3389/fbioe.2023.1054391] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/06/2023] [Indexed: 02/22/2023] Open
Abstract
Introduction: Preclinical assessment of bone remodelling onto, into or around novel implant technologies is underpinned by a large live animal testing burden. The aim of this study was to explore whether a lab-based bioreactor model could provide similar insight. Method: Twelve ex vivo trabecular bone cylinders were extracted from porcine femora and were implanted with additively manufactured stochastic porous titanium implants. Half were cultured dynamically, in a bioreactor with continuous fluid flow and daily cyclic loading, and half in static well plates. Tissue ongrowth, ingrowth and remodelling around the implants were evaluated with imaging and mechanical testing. Results: For both culture conditions, scanning electron microscopy (SEM) revealed bone ongrowth; widefield, backscatter SEM, micro computed tomography scanning, and histology revealed mineralisation inside the implant pores; and histology revealed woven bone formation and bone resorption around the implant. The imaging evidence of this tissue ongrowth, ingrowth and remodelling around the implant was greater for the dynamically cultured samples, and the mechanical testing revealed that the dynamically cultured samples had approximately three times greater push-through fixation strength (p < 0.05). Discussion: Ex vivo bone models enable the analysis of tissue remodelling onto, into and around porous implants in the lab. While static culture conditions exhibited some characteristics of bony adaptation to implantation, simulating physiological conditions with a bioreactor led to an accelerated response.
Collapse
Affiliation(s)
- Nupur Kohli
- Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - Konstantinos Theodoridis
- Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - Thomas A G Hall
- Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - Inigo Sanz-Pena
- Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | - David C A Gaboriau
- FILM, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Richard J van Arkel
- Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| |
Collapse
|
22
|
Alaña M, Lopez-Arancibia A, Ghouse S, Rodriguez-Florez N, Ruiz de Galarreta S. Additively manufactured lattice structures with controlled transverse isotropy for orthopedic porous implants. Comput Biol Med 2022; 150:105761. [PMID: 36126355 DOI: 10.1016/j.compbiomed.2022.105761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/31/2022] [Accepted: 06/18/2022] [Indexed: 11/26/2022]
Abstract
Additively manufactured lattice structures enable the design of tissue scaffolds with tailored mechanical properties, which can be implemented in porous biomaterials. The adaptation of bone to physiological loads results in anisotropic bone tissue properties which are optimized for site-specific loads; therefore, some bone sites are stiffer and stronger along the principal load direction compared to other orientations. In this work, a semi-analytical model was developed for the design of transversely isotropic lattice structures that can mimic the anisotropy characteristics of different types of bone tissue. Several design possibilities were explored, and a particular unit cell, which was best suited for additive manufacturing was further analyzed. The design of the unit cell was parameterized and in-silico analysis was performed via Finite Element Analysis. The structures were manufactured additively in metal and tested under compressive loads in different orientations. Finite element analysis showed good correlation with the semi-analytical model, especially for elastic constants with low relative densities. The anisotropy measured experimentally showed a variable accuracy, highlighting the deviations from designs to additively manufactured parts. Overall, the proposed model enables to exploit the anisotropy of lattice structures to design lighter scaffolds with higher porosity and increased permeability by aligning the scaffold with the principal direction of the load.
Collapse
Affiliation(s)
- Markel Alaña
- Department of Mechanical Engineering and Materials, Universidad de Navarra, TECNUN Escuela de Ingenieros, Paseo Manuel de Lardizabal, 13, 20018 San Sebastian, Spain.
| | - Aitziber Lopez-Arancibia
- Department of Mechanical Engineering and Materials, Universidad de Navarra, TECNUN Escuela de Ingenieros, Paseo Manuel de Lardizabal, 13, 20018 San Sebastian, Spain
| | - Shaaz Ghouse
- Department of Mechanical Engineering, Imperial College London, South Kensington London SW7 2AZ, UK
| | - Naiara Rodriguez-Florez
- Department of Mechanical Engineering and Materials, Universidad de Navarra, TECNUN Escuela de Ingenieros, Paseo Manuel de Lardizabal, 13, 20018 San Sebastian, Spain; IKERBASQUE, Basque Foundation for Science, Plaza Euskadi 5, 48009, Bilbao, Spain
| | - Sergio Ruiz de Galarreta
- Department of Mechanical Engineering and Materials, Universidad de Navarra, TECNUN Escuela de Ingenieros, Paseo Manuel de Lardizabal, 13, 20018 San Sebastian, Spain
| |
Collapse
|
23
|
Davoodi E, Montazerian H, Mirhakimi AS, Zhianmanesh M, Ibhadode O, Shahabad SI, Esmaeilizadeh R, Sarikhani E, Toorandaz S, Sarabi SA, Nasiri R, Zhu Y, Kadkhodapour J, Li B, Khademhosseini A, Toyserkani E. Additively manufactured metallic biomaterials. Bioact Mater 2022; 15:214-249. [PMID: 35386359 PMCID: PMC8941217 DOI: 10.1016/j.bioactmat.2021.12.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 02/06/2023] Open
Abstract
Metal additive manufacturing (AM) has led to an evolution in the design and fabrication of hard tissue substitutes, enabling personalized implants to address each patient's specific needs. In addition, internal pore architectures integrated within additively manufactured scaffolds, have provided an opportunity to further develop and engineer functional implants for better tissue integration, and long-term durability. In this review, the latest advances in different aspects of the design and manufacturing of additively manufactured metallic biomaterials are highlighted. After introducing metal AM processes, biocompatible metals adapted for integration with AM machines are presented. Then, we elaborate on the tools and approaches undertaken for the design of porous scaffold with engineered internal architecture including, topology optimization techniques, as well as unit cell patterns based on lattice networks, and triply periodic minimal surface. Here, the new possibilities brought by the functionally gradient porous structures to meet the conflicting scaffold design requirements are thoroughly discussed. Subsequently, the design constraints and physical characteristics of the additively manufactured constructs are reviewed in terms of input parameters such as design features and AM processing parameters. We assess the proposed applications of additively manufactured implants for regeneration of different tissue types and the efforts made towards their clinical translation. Finally, we conclude the review with the emerging directions and perspectives for further development of AM in the medical industry.
Collapse
Affiliation(s)
- Elham Davoodi
- Multi-Scale Additive Manufacturing (MSAM) Laboratory, Mechanical and Mechatronics Engineering Department, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
- Department of Bioengineering, University of California, Los Angeles, California 90095, United States
- California NanoSystems Institute (CNSI), University of California, Los Angeles, California 90095, United States
- Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Hossein Montazerian
- Department of Bioengineering, University of California, Los Angeles, California 90095, United States
- California NanoSystems Institute (CNSI), University of California, Los Angeles, California 90095, United States
- Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Anooshe Sadat Mirhakimi
- Department of Mechanical Engineering, Isfahan University of Technology, Isfahan, Isfahan 84156-83111, Iran
| | - Masoud Zhianmanesh
- School of Biomedical Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Osezua Ibhadode
- Multi-Scale Additive Manufacturing (MSAM) Laboratory, Mechanical and Mechatronics Engineering Department, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| | - Shahriar Imani Shahabad
- Multi-Scale Additive Manufacturing (MSAM) Laboratory, Mechanical and Mechatronics Engineering Department, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| | - Reza Esmaeilizadeh
- Multi-Scale Additive Manufacturing (MSAM) Laboratory, Mechanical and Mechatronics Engineering Department, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| | - Einollah Sarikhani
- Department of Nanoengineering, Jacobs School of Engineering, University of California, San Diego, California 92093, United States
| | - Sahar Toorandaz
- Multi-Scale Additive Manufacturing (MSAM) Laboratory, Mechanical and Mechatronics Engineering Department, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| | - Shima A. Sarabi
- Mechanical and Aerospace Engineering Department, University of California, Los Angeles, California 90095, United States
| | - Rohollah Nasiri
- Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Yangzhi Zhu
- Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Javad Kadkhodapour
- Department of Mechanical Engineering, Shahid Rajaee Teacher Training University, Tehran, Tehran 16785-163, Iran
- Institute for Materials Testing, Materials Science and Strength of Materials, University of Stuttgart, Stuttgart 70569, Germany
| | - Bingbing Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
- Department of Manufacturing Systems Engineering and Management, California State University, Northridge, California 91330, United States
| | - Ali Khademhosseini
- Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Ehsan Toyserkani
- Multi-Scale Additive Manufacturing (MSAM) Laboratory, Mechanical and Mechatronics Engineering Department, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| |
Collapse
|
24
|
Burge TA, Jeffers J, Myant C. Performance and Sensitivity Analysis of an Automated X-Ray Based Total Knee Replacement Mass-Customization Pipeline. J Med Device 2022. [DOI: 10.1115/1.4055000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
A proof-of-concept, fully automated, mass-customization pipeline for knee replacement surgery is outlined. The pipeline aims to address the limitations of currently available customization solutions by removing the need for 3D imaging and manual design, minimizing lead times, and reducing costs, whilst enabling improved patient outcomes.
The dataflow of the pipeline and methods for assessing performance are detailed. A digitally reconstructed radiograph method was adopted in the analysis to remove errors stemming from poor X-ray alignment and calibration, and to enable the influence of specific attributes to be evaluated. A sensitivity study was performed to quantify the impact of X-ray alignment and calibration.
The analysis found better results were achieved for the tibia over the femur in terms of clinically significant component over/under-hang (9% vs 18%). The pipeline was sensitive to subject ethnicity, but this was likely due to limited diversity in the training data. Arthritis severity was found to impact performance, suggesting further work is required to confirm suitability for use with more severe cases. X-ray alignment and dimensional calibration were shown to be paramount for accurate results. The pipeline performance was demonstrated to be superior to results reported for off-the-shelf implants, but customization solutions based on 3D imaging could afford marginally better results.
In summary, the study validated the pipeline for a broad range of subjects, highlighted its potential advantages over both off-the-shelf and other customization alternatives, and outlined the potential challenges of adopting such a tool.
Collapse
Affiliation(s)
- Thomas A Burge
- Dyson School of Design Engineering, Imperial College , London, UK, SW7 2BU
| | - Jonathan Jeffers
- Department of Mechanical Engineering, Imperial College , London, UK, SW7 2BU
| | - Connor Myant
- Dyson School of Design Engineering, Imperial College , London, UK, SW7 2BU
| |
Collapse
|
25
|
Design and Analysis of Biomedical Scaffolds Using TPMS-Based Porous Structures Inspired from Additive Manufacturing. COATINGS 2022. [DOI: 10.3390/coatings12060839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Gyroid (G) and primitive (P) porous structures have multiple application areas, ranging from thermal to mechanical, and fall in the complex triply periodic minimal surface (TPMS) category. Such intricate bioinspired constructs are gaining attention because they meet both biological and mechanical requirements for osseous reconstruction. The study aimed to develop G and P structures with varying porosity levels from 40% to 80% by modulating the strut thickness to proportionally resemble the stiffness of host tissue. The performance characteristics were evaluated using Ti6Al4V and important relationships between feature dimension, strut thickness, porosity, and stiffness were established. Numerical results showed that the studied porous structures could decrease stiffness from 107 GPa (stiffness of Ti6Al4V) to the range between 4.21 GPa to 29.63 GPa of varying porosities, which matches the human bone stiffness range. Furthermore, using this foundation, a subject-specific scaffold (made of P unit cells with an 80% porosity) was developed to reconstruct segmental bone defect (SBD) of the human femur, demonstrating a significant decrease in the stress shielding effect. Stress transfer on the bone surrounded by a P scaffold was compared with a solid implant which showed a net increase of stress transfer of 76% with the use of P scaffold. In the conclusion, future concerns and recommendations are suggested.
Collapse
|
26
|
Trueba P, Navarro C, Giner M, Rodríguez-Ortiz JA, Montoya-García MJ, Delgado-Pujol EJ, Rodríguez-Albelo LM, Torres Y. Approach to the Fatigue and Cellular Behavior of Superficially Modified Porous Titanium Dental Implants. MATERIALS 2022; 15:ma15113903. [PMID: 35683200 PMCID: PMC9182243 DOI: 10.3390/ma15113903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 12/04/2022]
Abstract
In this work, the fatigue and cellular performance of novel superficially treated porous titanium dental implants made up using conventional powder metallurgy and space-holder techniques (30 vol.% and 50 vol.%, both with a spacer size range of 100–200 µm) are evaluated. Before the sintering stage, a specific stage of CNC milling of the screw thread of the implant is used. After the consolidation processing, different surface modifications are performed: chemical etching and bioactive coatings (BG 45S5 and BG 1393). The results are discussed in terms of the effect of the porosity, as well as the surface roughness, chemical composition, and adherence of the coatings on the fatigue resistance and the osteoblast cells’ behavior for the proposed implants. Macro-pores are preferential sites of the nucleation of cracks and bone cell adhesion, and they increase the cellular activity of the implants, but decrease the fatigue life. In conclusion, SH 30 vol.% dental implant chemical etching presents the best bio-functional (in vitro osseointegration) and bio-mechanical (stiffness, yield strength and fatigue life) balance, which could ensure the required characteristics of cortical bone tissue.
Collapse
Affiliation(s)
- Paloma Trueba
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Universidad de Sevilla, 41011 Seville, Spain; (P.T.); (J.A.R.-O.); (E.J.D.-P.); (L.M.R.-A.); (Y.T.)
| | - Carlos Navarro
- Departamento de Ingeniería Mecánica y Fabricación, Escuela Técnica Superior de Ingeniería, Universidad de Sevilla, 41092 Seville, Spain;
| | - Mercè Giner
- Departamento de Citología e Histología Normal y Patológica, Universidad de Sevilla, 41009 Sevilla, Spain
- Correspondence: ; Tel.: +34-(9)-54551796
| | - José A. Rodríguez-Ortiz
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Universidad de Sevilla, 41011 Seville, Spain; (P.T.); (J.A.R.-O.); (E.J.D.-P.); (L.M.R.-A.); (Y.T.)
| | | | - Ernesto J. Delgado-Pujol
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Universidad de Sevilla, 41011 Seville, Spain; (P.T.); (J.A.R.-O.); (E.J.D.-P.); (L.M.R.-A.); (Y.T.)
| | - Luisa M. Rodríguez-Albelo
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Universidad de Sevilla, 41011 Seville, Spain; (P.T.); (J.A.R.-O.); (E.J.D.-P.); (L.M.R.-A.); (Y.T.)
| | - Yadir Torres
- Departamento de Ingeniería y Ciencia de los Materiales y del Transporte, Escuela Politécnica Superior, Universidad de Sevilla, 41011 Seville, Spain; (P.T.); (J.A.R.-O.); (E.J.D.-P.); (L.M.R.-A.); (Y.T.)
| |
Collapse
|
27
|
Munford MJ, Xiao D, Jeffers JRT. Lattice implants that generate homeostatic and remodeling strains in bone. J Orthop Res 2022; 40:871-877. [PMID: 34086355 DOI: 10.1002/jor.25114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/16/2021] [Accepted: 05/31/2021] [Indexed: 02/04/2023]
Abstract
Bone remodeling is mediated by several factors including strain. An increase in strain between 1% and 10% compared to homeostasis can trigger bone formation. We aim to create an orthopedic implant using clinically established imaging and manufacturing methods that induces this strain control in human bone. Titanium scaffolds were manufactured with multiaxial apparent modulus tailored to the mechanical properties of bone defined from computed tomography scans of cadaver human tibiae. Five bone cubes were tested with corresponding titanium scaffolds by loading under compression, which is similar to the implanted tibia loading condition. Bone strain was precisely controlled by varying the scaffold modulus, from 0% to 15% bone strain increase. This strain increase is the magnitude reported to invoke bone's positive remodeling. Axial modulus was closely matched between titanium scaffolds and bone, ranging from 48-728 and 81-800 MPa, respectively, whereby scaffold axial modulus was within 2% of nominal target values. Fine control of multiaxial moduli resulted in transverse modulus that matched bone well; ranging from 42-648 and 47-585 MPa in scaffolds and bone respectively. The scaffold manufacturing material and method are already used in the orthopedic industry. This study has significant clinical implications as it enables the design of implants which positively harness bone's natural mechanoresponse and respect bone's mechanical anisotropy and heterogeneity.
Collapse
Affiliation(s)
- Maxwell J Munford
- Department of Mechanical Engineering, Imperial College London, South Kensington, London, UK
| | - Dannier Xiao
- Department of Mechanical Engineering, Imperial College London, South Kensington, London, UK
| | - Jonathan R T Jeffers
- Department of Mechanical Engineering, Imperial College London, South Kensington, London, UK
| |
Collapse
|
28
|
Craniofacial Reconstruction with Personalized Lightweight Scaffold Fabricated Using Electron-Beam Additive Manufacturing. METALS 2022. [DOI: 10.3390/met12040552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Implants are the most popular option for restoring the facial anatomy in the event of a mishap. The commercially available craniofacial implants are of standard shapes, which need to be tailored and shaped to accurately fit the patient’s anatomy. The manual shaping of the implant to match the bone contours is conducted during surgical operation, and is a cumbersome and inaccurate process. Recent breakthroughs in computer-aided design, analysis, and additive manufacturing (AM) have allowed the precise and rapid manufacture of bespoke scaffolds for difficult anatomical restoration. The goal of this research is to investigate the use of scaffolds for craniofacial reconstruction and their fabrication using electron-beam additive manufacturing (EBAM). Personalized cheekbone scaffolds are additively fabricated using Ti6Al4V and subjected to compression testing. Finally, the scaffold design with the highest compressive strength is subjected to biomechanical analysis. The biomechanical analysis results indicate that the maximum Von Mises stress (40 MPa) and equivalent strain (0.4 µm) are significantly low in magnitude, thus providing a desirable implant that is both flexible and stable. The custom-designed cheekbone scaffold manufactured with AM technology not only aids in bone-implant ingrowth but also helps in reducing implant weight and ensuring implant stability and long-term effectiveness.
Collapse
|
29
|
You Q, Lu M, Min L, Zhang Y, Wang J, Wang Y, Zheng C, Zhou Y, Tu C. Hip-Preserved Reconstruction Using a Customized Cementless Intercalary Endoprosthesis With an Intra-Neck Curved Stem in Patients With an Ultrashort Proximal Femur: Midterm Follow-Up Outcomes. Front Bioeng Biotechnol 2022; 10:795485. [PMID: 35295648 PMCID: PMC8918842 DOI: 10.3389/fbioe.2022.795485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/21/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Hemiarthroplasty is widely used for proximal femoral reconstruction after tumor resection. However, complications of hemiarthroplasty include infection, hip dislocation, and acetabular wear. This study aimed to: (1) evaluate the reliability and validity of a customized cementless intercalary endoprosthesis (CCIE) with an intra-neck curved stem (INCS) to reconstruct femoral diaphyseal defects with an ultrashort proximal femur (UPF); (2) assess the lower extremity function after reconstruction with this endoprosthesis; and (3) identify the postoperative complications associated with the use of this endoprosthesis. Methods: Between October 2015 and May 2019, 13 patients underwent reconstruction with a CCIE with an INCS. The distance from the center of the femoral head to the midline of the body and the apex of the acetabulum was measured preoperatively. Additionally, the distance from the tip of the INCS to the midline of the body and the apex of the acetabulum was measured postoperatively. The femoral neck–shaft angle was also measured pre- and postoperatively. After an average follow-up duration of 46 months, the radiological outcomes of the CCIE with an INCS were analyzed. Function was evaluated with the Musculoskeletal Tumor Society (MSTS) score. Pain was measured using a paper visual analog scale (VAS) pre- and postoperatively, and complications were recorded. Results: Compared with our preoperative design, we found no significant difference in the postoperative distance from the tip of the INCS to the body midline (p = 0.187) and the apex of the acetabulum (p = 0.159), or in the postoperative femoral neck–shaft angle (p = 0.793). Thus, the INCS positions were deemed accurate. The average MSTS score was 26 (range: 24–28), and the VAS score was significantly decreased postoperatively compared with preoperatively (p < 0.0001). No patients developed aseptic loosening, infection, periprosthetic fracture, or prosthetic fracture as of the last follow-up. Conclusion: The CCIE with an INCS was a valid and reliable method for reconstructing femoral diaphyseal defects with a UPF following malignant tumor resection. Postoperative lower extremity function was acceptable, with an appropriate individualized rehabilitation program, and the incidence of complications was low.
Collapse
Affiliation(s)
- Qi You
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Minxun Lu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Li Min
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Yuqi Zhang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Wang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Yitian Wang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Chuanxi Zheng
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Zhou
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Chongqi Tu, ; Yong Zhou,
| | - Chongqi Tu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Chongqi Tu, ; Yong Zhou,
| |
Collapse
|
30
|
Polakova D, Capek L, Bartos M, Kejzlar P, Rysova M, Martinova L, Sevcu A. The stiffness variability of a silk fibroin scaffold during bone cell proliferation. Proc Inst Mech Eng H 2022; 236:9544119211070345. [PMID: 35125026 DOI: 10.1177/09544119211070345] [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: 02/21/2024]
Abstract
Complex assessment of gradual changes in scaffold morphology and stiffness is an essential step in bone filler development. Current approach, however, does not reflect long term cell proliferation effect as the mechanical tests are usually conducted on pristine materials without cells or cell influence on material stiffness is evaluated after one time period only. Here, biocompatible silk fibroin (SF) porous scaffolds envisioned for bone defect filling were prepared by dissolving of fibroin fibers, followed by dialysis, freeze-drying and final stabilization. Particular attention was devoted to the influence of bone cell proliferation up to 2 months on the stiffness of the material. The morphology of the material was studied in terms of its inner structure and the overall changes in the surface characteristics due to proliferation of MG 63 bone cell line. The SF scaffold stiffness significantly increased during first month followed by its decline during second month due to bone cell seeding. After 2 months, the SF scaffold was completely colonized, which resulted in a gradual decay of its structure. The length of degradation due to bone cell proliferation and mechanical behavior corresponded to the requirements set for reasonable filler material indicating that porous SF scaffolds comprise a promising biomaterial for bone regeneration.
Collapse
Affiliation(s)
- Dagmar Polakova
- Institute for Nanomaterials, Advanced Technologies and Innovation, Technical University of Liberec, Liberec 1, Czech Republic
- Faculty of Mechatronics, Informatics and Interdisciplinary Studies, Technical University of Liberec, Liberec 1, Czech Republic
| | - Lukas Capek
- Faculty of Textile Engineering, Technical University of Liberec, Liberec 1, Czech Republic
| | - Martin Bartos
- Institute of Dental Medicine, First Faculty of Medicine, Charles University and General Hospital in Prague, Prague 2, Czech Republic
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague 2, Czech Republic
| | - Pavel Kejzlar
- Institute for Nanomaterials, Advanced Technologies and Innovation, Technical University of Liberec, Liberec 1, Czech Republic
| | - Miroslava Rysova
- Institute for Nanomaterials, Advanced Technologies and Innovation, Technical University of Liberec, Liberec 1, Czech Republic
| | - Lenka Martinova
- Faculty of Textile Engineering, Technical University of Liberec, Liberec 1, Czech Republic
| | - Alena Sevcu
- Institute for Nanomaterials, Advanced Technologies and Innovation, Technical University of Liberec, Liberec 1, Czech Republic
| |
Collapse
|
31
|
Munford MJ, Stoddart JC, Liddle AD, Cobb JP, Jeffers JRT. Total and partial knee arthroplasty implants that maintain native load transfer in the tibia. Bone Joint Res 2022; 11:91-101. [PMID: 35168367 PMCID: PMC8882327 DOI: 10.1302/2046-3758.112.bjr-2021-0304.r1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Unicompartmental and total knee arthroplasty (UKA and TKA) are successful treatments for osteoarthritis, but the solid metal implants disrupt the natural distribution of stress and strain which can lead to bone loss over time. This generates problems if the implant needs to be revised. This study investigates whether titanium lattice UKA and TKA implants can maintain natural load transfer in the proximal tibia. METHODS In a cadaveric model, UKA and TKA procedures were performed on eight fresh-frozen knee specimens, using conventional (solid) and titanium lattice tibial implants. Stress at the bone-implant interfaces were measured and compared to the native knee. RESULTS Titanium lattice implants were able to restore the mechanical environment of the native tibia for both UKA and TKA designs. Maximum stress at the bone-implant interface ranged from 1.2 MPa to 3.3 MPa compared with 1.3 MPa to 2.7 MPa for the native tibia. The conventional solid UKA and TKA implants reduced the maximum stress in the bone by a factor of 10 and caused > 70% of bone surface area to be underloaded compared to the native tibia. CONCLUSION Titanium lattice implants maintained the natural mechanical loading in the proximal tibia after UKA and TKA, but conventional solid implants did not. This is an exciting first step towards implants that maintain bone health, but such implants also have to meet fatigue and micromotion criteria to be clinically viable. Cite this article: Bone Joint Res 2022;11(2):91-101.
Collapse
Affiliation(s)
- Maxwell J. Munford
- The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, UK
| | - Jennifer C. Stoddart
- The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, UK
| | - Alexander D. Liddle
- The MSk Lab, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Justin P. Cobb
- The MSk Lab, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Jonathan R. T. Jeffers
- The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, UK
| |
Collapse
|
32
|
Inchingolo F, Hazballa D, Inchingolo AD, Malcangi G, Marinelli G, Mancini A, Maggiore ME, Bordea IR, Scarano A, Farronato M, Tartaglia GM, Lorusso F, Inchingolo AM, Dipalma G. Innovative Concepts and Recent Breakthrough for Engineered Graft and Constructs for Bone Regeneration: A Literature Systematic Review. MATERIALS (BASEL, SWITZERLAND) 2022; 15:1120. [PMID: 35161065 PMCID: PMC8839672 DOI: 10.3390/ma15031120] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND For decades, regenerative medicine and dentistry have been improved with new therapies and innovative clinical protocols. The aim of the present investigation was to evaluate through a critical review the recent innovations in the field of bone regeneration with a focus on the healing potentials and clinical protocols of bone substitutes combined with engineered constructs, growth factors and photobiomodulation applications. METHODS A Boolean systematic search was conducted by PubMed/Medline, PubMed/Central, Web of Science and Google scholar databases according to the PRISMA guidelines. RESULTS After the initial screening, a total of 304 papers were considered eligible for the qualitative synthesis. The articles included were categorized according to the main topics: alloplastic bone substitutes, autologous teeth derived substitutes, xenografts, platelet-derived concentrates, laser therapy, microbiota and bone metabolism and mesenchymal cells construct. CONCLUSIONS The effectiveness of the present investigation showed that the use of biocompatible and bio-resorbable bone substitutes are related to the high-predictability of the bone regeneration protocols, while the oral microbiota and systemic health of the patient produce a clinical advantage for the long-term success of the regeneration procedures and implant-supported restorations. The use of growth factors is able to reduce the co-morbidity of the regenerative procedure ameliorating the post-operative healing phase. The LLLT is an adjuvant protocol to improve the soft and hard tissues response for bone regeneration treatment protocols.
Collapse
Affiliation(s)
- Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Maria Elena Maggiore
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Farronato
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| |
Collapse
|
33
|
Shape optimization of orthopedic porous scaffolds to enhance mechanical performance. J Mech Behav Biomed Mater 2022; 128:105098. [DOI: 10.1016/j.jmbbm.2022.105098] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/02/2021] [Accepted: 01/17/2022] [Indexed: 11/19/2022]
|
34
|
Cao C, Huang P, Prasopthum A, Parsons AJ, Ai F, Yang J. Characterisation of bone regeneration in 3D printed ductile PCL/PEG/hydroxyapatite scaffolds with high ceramic microparticle concentrations. Biomater Sci 2021; 10:138-152. [PMID: 34806738 DOI: 10.1039/d1bm01645h] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
3D printed bioactive glass or bioceramic particle reinforced composite scaffolds for bone tissue engineering currently suffer from low particle concentration (<50 wt%) hence low osteoconductivity. Meanwhile, composites with very high inorganic particle concentrations are very brittle. Scaffolds combining high particle content and ductility are urgently required for bone tissue engineering. Herein, 3D printed PCL/hydroxyapatite (HA) scaffolds with high ceramic concentration (up to 90 wt%) are made ductile (>100% breaking strain) by adding poly(ethylene glycol) which is biocompatible and FDA approved. The scaffolds require no post-printing washing to remove hazardous components. More exposure of HA microparticles on strut surfaces is enabled by incorporating higher HA concentrations. Compared to scaffolds with 72 wt% HA, scaffolds with higher HA content (90 wt%) enhance matrix formation but not new bone volume after 12 weeks implantation in rat calvarial defects. Histological analyses demonstrate that bone regeneration within the 3D printed scaffolds is via intramembranous ossification and starts in the central region of pores. Fibrous tissue that resembles non-union tissue within bone fractures is formed within pores that do not have new bone. The amount of blood vessels is similar between scaffolds with mainly fibrous tissue and those with more bone tissue, suggesting vascularization is not a deciding factor for determining the type of tissues regenerated within the pores of 3D printed scaffolds. Multinucleated immune cells are commonly present in all scaffolds surrounding the struts, suggesting a role of managing inflammation in bone regeneration within 3D printed scaffolds.
Collapse
Affiliation(s)
- Chuanliang Cao
- School of Mechatronic Engineering, Nanchang University, Nanchang, Jiangxi, China 330031.
| | - Pengren Huang
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China 330006
| | - Aruna Prasopthum
- Biodiscovery Institute, University of Nottingham, Nottingham, UK NG7 2RD.
| | - Andrew J Parsons
- Composites Research Group, Faculty of Engineering, University of Nottingham, Nottingham, UK NG7 2RD
| | - Fanrong Ai
- School of Mechatronic Engineering, Nanchang University, Nanchang, Jiangxi, China 330031.
| | - Jing Yang
- Biodiscovery Institute, University of Nottingham, Nottingham, UK NG7 2RD.
| |
Collapse
|
35
|
McGregor M, Patel S, McLachlin S, Vlasea M. Data related to architectural bone parameters and the relationship to Ti lattice design for powder bed fusion additive manufacturing. Data Brief 2021; 39:107633. [PMID: 34917699 PMCID: PMC8646123 DOI: 10.1016/j.dib.2021.107633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022] Open
Abstract
The data included in this article provides additional supporting information on our publication (McGregor et al. [1]) on the review of the natural lattice architecture in human bone and its implication towards titanium (Ti) lattice design for laser powder bed fusion and electron beam powder bed fusion. For this work, X-ray computed tomography was deployed to understand and visualize a Ti-6Al-4V lattice structure manufactured by laser powder bed fusion. This manuscript includes details about the manufacturing of the lattice structure using laser powder bed fusion and computed tomography methods used for analyzing the lattice structure. Additionally, a comprehensive literature review was conducted to understand how lattice parameters are controlled in additively manufactured Ti and Ti-alloy parts aimed at replacing or augmenting human bone. From this literature review, lattice design information was collected and is summarized in tabular form in this manuscript.
Collapse
Affiliation(s)
- Martine McGregor
- University of Waterloo, Department of Mechanical and Mechatronics Engineering, Waterloo, ON N2L 3G1, Canada
| | - Sagar Patel
- University of Waterloo, Department of Mechanical and Mechatronics Engineering, Waterloo, ON N2L 3G1, Canada
| | - Stewart McLachlin
- University of Waterloo, Department of Mechanical and Mechatronics Engineering, Waterloo, ON N2L 3G1, Canada
| | - Mihaela Vlasea
- University of Waterloo, Department of Mechanical and Mechatronics Engineering, Waterloo, ON N2L 3G1, Canada
| |
Collapse
|
36
|
Tan N, van Arkel RJ. Topology Optimisation for Compliant Hip Implant Design and Reduced Strain Shielding. MATERIALS (BASEL, SWITZERLAND) 2021; 14:7184. [PMID: 34885337 PMCID: PMC8658148 DOI: 10.3390/ma14237184] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/01/2021] [Accepted: 11/22/2021] [Indexed: 01/12/2023]
Abstract
Stiff total hip arthroplasty implants can lead to strain shielding, bone loss and complex revision surgery. The aim of this study was to develop topology optimisation techniques for more compliant hip implant design. The Solid Isotropic Material with Penalisation (SIMP) method was adapted, and two hip stems were designed and additive manufactured: (1) a stem based on a stochastic porous structure, and (2) a selectively hollowed approach. Finite element analyses and experimental measurements were conducted to measure stem stiffness and predict the reduction in stress shielding. The selectively hollowed implant increased peri-implanted femur surface strains by up to 25 percentage points compared to a solid implant without compromising predicted strength. Despite the stark differences in design, the experimentally measured stiffness results were near identical for the two optimised stems, with 39% and 40% reductions in the equivalent stiffness for the porous and selectively hollowed implants, respectively, compared to the solid implant. The selectively hollowed implant's internal structure had a striking resemblance to the trabecular bone structures found in the femur, hinting at intrinsic congruency between nature's design process and topology optimisation. The developed topology optimisation process enables compliant hip implant design for more natural load transfer, reduced strain shielding and improved implant survivorship.
Collapse
Affiliation(s)
| | - Richard J. van Arkel
- Department of Mechanical Engineering, Imperial College London, London SW7 2AZ, UK;
| |
Collapse
|
37
|
Hydrogel, Electrospun and Composite Materials for Bone/Cartilage and Neural Tissue Engineering. MATERIALS 2021; 14:ma14226899. [PMID: 34832300 PMCID: PMC8624846 DOI: 10.3390/ma14226899] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 12/15/2022]
Abstract
Injuries of the bone/cartilage and central nervous system are still a serious socio-economic problem. They are an effect of diversified, difficult-to-access tissue structures as well as complex regeneration mechanisms. Currently, commercially available materials partially solve this problem, but they do not fulfill all of the bone/cartilage and neural tissue engineering requirements such as mechanical properties, biochemical cues or adequate biodegradation. There are still many things to do to provide complete restoration of injured tissues. Recent reports in bone/cartilage and neural tissue engineering give high hopes in designing scaffolds for complete tissue regeneration. This review thoroughly discusses the advantages and disadvantages of currently available commercial scaffolds and sheds new light on the designing of novel polymeric scaffolds composed of hydrogels, electrospun nanofibers, or hydrogels loaded with nano-additives.
Collapse
|
38
|
Hossain U, Ghouse S, Nai K, Jeffers JR. Mechanical and morphological properties of additively manufactured SS316L and Ti6Al4V micro-struts as a function of build angle. ADDITIVE MANUFACTURING 2021; 46:None. [PMID: 34603974 PMCID: PMC8448581 DOI: 10.1016/j.addma.2021.102050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 06/13/2023]
Abstract
Additive manufacturing methods such as laser powder bed fusion (PBF) can produce micro-lattice structures which consist of 'micro-struts', which have properties that differ from the bulk metal and that can vary depending on the orientation of the strut to the build direction (the strut build angle). Characterizing these mechanical and morphological changes would help explain macro-scale lattice behavior. Individual stainless steel (SS316L) and titanium alloy (Ti6Al4V) laser PBF struts were built at 20°, 40°, 70° and 90° to the build platform, with 3 designed diameters and tested in uniaxial tension (n = 5). Micro-CT was used to quantify changes in surface roughness, eccentricity and cross-section. Average elastic modulus was 61.5 GPa and 37.5 GPa for SS316L and Ti6Al4V respectively, less than the bulk material. Yield strength was uniform over build angle for SS316L, but for Ti6Al4V varied from 40% to 98% of the bulk value from 20° to 90° build angles. All lower angle struts had worse morphology, with higher roughness and less circular cross-sections. These data should help inform micro-lattice design, especially in safety critical applications where lower mechanical performance must be compensated for.
Collapse
Affiliation(s)
- Umar Hossain
- Department of Mechanical Engineering, Imperial College London, South Kensington, London SW7 2AZ, UK
| | - Shaaz Ghouse
- Department of Mechanical Engineering, Imperial College London, South Kensington, London SW7 2AZ, UK
| | - Kenneth Nai
- Renishaw PLC, New Mills, Wotton-under-Edge, Gloucestershire GL12 8JR, UK
| | - Jonathan R.T. Jeffers
- Department of Mechanical Engineering, Imperial College London, South Kensington, London SW7 2AZ, UK
| |
Collapse
|
39
|
García-Aznar JM, Nasello G, Hervas-Raluy S, Pérez MÁ, Gómez-Benito MJ. Multiscale modeling of bone tissue mechanobiology. Bone 2021; 151:116032. [PMID: 34118446 DOI: 10.1016/j.bone.2021.116032] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/25/2021] [Accepted: 06/02/2021] [Indexed: 02/07/2023]
Abstract
Mechanical environment has a crucial role in our organism at the different levels, ranging from cells to tissues and our own organs. This regulatory role is especially relevant for bones, given their importance as load-transmitting elements that allow the movement of our body as well as the protection of vital organs from load impacts. Therefore bone, as living tissue, is continuously adapting its properties, shape and repairing itself, being the mechanical loads one of the main regulatory stimuli that modulate this adaptive behavior. Here we review some key results of bone mechanobiology from computational models, describing the effect that changes associated to the mechanical environment induce in bone response, implant design and scaffold-driven bone regeneration.
Collapse
Affiliation(s)
- José Manuel García-Aznar
- Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain.
| | - Gabriele Nasello
- Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain; Biomechanics Section, KU Leuven, Leuven, Belgium
| | - Silvia Hervas-Raluy
- Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - María Ángeles Pérez
- Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - María José Gómez-Benito
- Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| |
Collapse
|
40
|
Zheng J, Zhao H, Dong E, Kang J, Liu C, Sun C, Li D, Wang L. Additively-manufactured PEEK/HA porous scaffolds with highly-controllable mechanical properties and excellent biocompatibility. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 128:112333. [PMID: 34474884 DOI: 10.1016/j.msec.2021.112333] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/28/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
Polyetheretherketone (PEEK) was widely applied into fabricating of orthopaedic implants, benefitting its excellent biocompatibility and similar mechanical properties to native bones. However, the inertness of PEEK hinders its integration with the surrounding bone tissue. Here PEEK scaffolds with a series of hydroxyapatite (HA) contents in gradient were manufactured via fused filament fabrication (FFF) 3D printing techniques. The influence of the pore size, HA content and printing direction on the mechanical properties of the PEEK/HA scaffolds was systematically evaluated. By adjusting the pore size and HA contents, the elastic modulus of the PEEK/HA scaffolds can be widely tuned in the range of 624.7-50.6 MPa, similar to the variation range of natural cancellous bone. Meanwhile, the scaffolds exhibited higher Young's modulus and lower compressive strength along Z printing direction. The mapping relationship among geometric parameters, HA content, printing direction and mechanical properties was established, which gave more accurate predictions and controllability of the modulus and strength of scaffolds. The PEEK/HA scaffolds with the micro-structured surface could promote cell attachment and mineralization in vitro. Therefore, the FFF-printed PEEK/HA composites scaffolds can be a good candidate for bone grafting and tissue engineering.
Collapse
Affiliation(s)
- Jibao Zheng
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China
| | - Huiyu Zhao
- Academy of Orthopedics, Guangdong Province, Orthopaedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510665, People's Republic of China
| | - Enchun Dong
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China
| | | | - Chaozong Liu
- Institute of Orthopaedic & Musculoskeletal, University College London, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, UK
| | - Changning Sun
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China
| | - Dichen Li
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China.
| | - Ling Wang
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China.
| |
Collapse
|
41
|
Ruiz de Galarreta S, Doyle RJ, Jeffers J, Ghouse S. Laser powder bed fusion of porous graded structures: A comparison between computational and experimental analysis. J Mech Behav Biomed Mater 2021; 123:104784. [PMID: 34419887 DOI: 10.1016/j.jmbbm.2021.104784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/02/2021] [Accepted: 08/13/2021] [Indexed: 10/20/2022]
Abstract
Functionally graded porous structures (FGPSs) are gaining interest in the biomedical sector, specifically for orthopaedic implants. In this study, the compressive behaviour of seven different FGPSs comprised of Face Centred Cubic (FCC) and the Octet truss unit cells (OCT) were analysed. The porosity of the structures were graded in different directions (radially, longitudinally, laterally and longitudinally & radially) by varying the strut diameters or by combining the two types of unit cells. The structures were manufactured by laser power bed fusion and compression tests were performed. Radially and laterally porous graded structures were found to outperform uniform porous structures with an increase in stiffness of 13.7% and 21.1% respectively. The experimental and finite element analysis (FEA) results were in good agreement with differences in elastic modulus of 9.4% and yield strength of 15.8%. A new FEA beam model is proposed in this study to analyse this type of structures with accurate results and the consequent reduction of computational time. The accuracy of the Kelvin-Voight model and the rule of mixtures for predicting the mechanical behaviour of different FGPSs was also investigated. The results demonstrate the adequacy of the analytical models specifically for hybrid structures and for structures with smooth diameter transitions.
Collapse
Affiliation(s)
- Sergio Ruiz de Galarreta
- Department of Mechanical Engineering and Materials, Universidad de Navarra, TECNUN Escuela de Ingenieros, Paseo Manuel de Lardizabal, 13, 20018, San Sebastian, Spain.
| | - Ruben J Doyle
- Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
| | - Jonathan Jeffers
- Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
| | - Shaaz Ghouse
- Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
| |
Collapse
|
42
|
Contemporary Approach to the Porosity of Dental Materials and Methods of Its Measurement. Int J Mol Sci 2021; 22:ijms22168903. [PMID: 34445606 PMCID: PMC8396236 DOI: 10.3390/ijms22168903] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/11/2021] [Accepted: 08/15/2021] [Indexed: 01/05/2023] Open
Abstract
Porosity is an important parameter for characterizing the microstructure of solids that corresponds to the volume of the void space, which may contain fluid or air, over the total volume of the material. Many materials of natural and technically manufactured origin have a large number of voids in their internal structure, relatively small in size, compared to the characteristic dimensions of the body itself. Thus, porosity is an important feature of industrial materials, but also of biological ones. The porous structure affects a number of material properties, such as sorption capacity, as well as mechanical, thermal, and electrical properties. Porosity of materials is an important factor in research on biomaterials. The most popular materials used to rebuild damaged tooth tissues are composites and ceramics, whilst titanium alloys are used in the production of implants that replace the tooth root. Research indicates that the most comprehensive approach to examining such materials should involve an analysis using several complementary methods covering the widest possible range of pore sizes. In addition to the constantly observed increase in the resolution capabilities of devices, the development of computational models and algorithms improving the quality of the measurement signal remains a big challenge.
Collapse
|
43
|
Wang J, Min L, Lu M, Zhang Y, Lin J, Luo Y, Zhou Y, Tu C. Three-dimensional-printed custom-made hemipelvic endoprosthesis for the revision of the aseptic loosening and fracture of modular hemipelvic endoprosthesis: a pilot study. BMC Surg 2021; 21:262. [PMID: 34039325 PMCID: PMC8157625 DOI: 10.1186/s12893-021-01257-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/18/2021] [Indexed: 02/08/2023] Open
Abstract
Background The aims of this pilot study were (1) to assess the efficacy of 3D-printed custom-made hemipelvic endoprosthesis in restoring the natural location of acetabulum for normal bodyweight transmission; (2) to evaluate the short-term function of the revision with this endoprosthesis and (3) to identify short-term complications associated with the use of this endoprosthesis. Methods Between February 2017 and December 2017, seven patients received revision with 3D-printed custom-made hemipelvic endoprosthesis. The body weight moment arm (BWMA) and cup height discrepancy (CHD) after primary and revisional surgery were analyzed to assess acetabulum location with plain radiography. After a median follow-up duration of 29 months (range 24–34), the function was evaluated with the Musculoskeletal Tumor Society (MSTS-93) score and Harris hip score (HHS). Complications were recorded by chart review. Results The acetabulum locations were deemed reasonable, as evaluated by median BWMA (primary vs. revision, 10 cm vs. 10 cm) and median CHD (primary vs. revision, 10 mm vs. 8 mm). The median MSTS-93 score and HHS score were 21 (range 18–23) and 78 (range 75–82) after the revision. No short or mid-term complication was observed in the follow-up of this series. Conclusions Revision with 3D-printed custom-made hemipelvic endoprostheses benefited in reconstructing stable pelvic ring and natural bodyweight transmission for patients encountering the aseptic loosening and fracture of modular hemipelvic endoprosthesis. The revision surgery and appropriate rehabilitation program improved patients’ function to a median MSTS score of 22 and pain-free ambulation. The incidence of the complications was low via this individualized workflow.
Collapse
Affiliation(s)
- Jie Wang
- Department of Orthopaedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, People's Republic of China.,Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Li Min
- Department of Orthopaedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, People's Republic of China.,Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Minxun Lu
- Department of Orthopaedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, People's Republic of China.,Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yuqi Zhang
- Department of Orthopaedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, People's Republic of China.,Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jingqi Lin
- Department of Orthopaedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, People's Republic of China
| | - Yi Luo
- Department of Orthopaedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, People's Republic of China.,Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yong Zhou
- Department of Orthopaedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, People's Republic of China.,Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Chongqi Tu
- Department of Orthopaedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, People's Republic of China. .,Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| |
Collapse
|
44
|
Zhu G, Zhang T, Chen M, Yao K, Huang X, Zhang B, Li Y, Liu J, Wang Y, Zhao Z. Bone physiological microenvironment and healing mechanism: Basis for future bone-tissue engineering scaffolds. Bioact Mater 2021; 6:4110-4140. [PMID: 33997497 PMCID: PMC8091181 DOI: 10.1016/j.bioactmat.2021.03.043] [Citation(s) in RCA: 158] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/19/2021] [Accepted: 03/28/2021] [Indexed: 02/06/2023] Open
Abstract
Bone-tissue defects affect millions of people worldwide. Despite being common treatment approaches, autologous and allogeneic bone grafting have not achieved the ideal therapeutic effect. This has prompted researchers to explore novel bone-regeneration methods. In recent decades, the development of bone tissue engineering (BTE) scaffolds has been leading the forefront of this field. As researchers have provided deep insights into bone physiology and the bone-healing mechanism, various biomimicking and bioinspired BTE scaffolds have been reported. Now it is necessary to review the progress of natural bone physiology and bone healing mechanism, which will provide more valuable enlightenments for researchers in this field. This work details the physiological microenvironment of the natural bone tissue, bone-healing process, and various biomolecules involved therein. Next, according to the bone physiological microenvironment and the delivery of bioactive factors based on the bone-healing mechanism, it elaborates the biomimetic design of a scaffold, highlighting the designing of BTE scaffolds according to bone biology and providing the rationale for designing next-generation BTE scaffolds that conform to natural bone healing and regeneration.
Collapse
Affiliation(s)
- Guanyin Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Tianxu Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Miao Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Ke Yao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Xinqi Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Bo Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Yazhen Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Jun Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Yunbing Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610041, PR China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| |
Collapse
|
45
|
Zhang Z, Li Y, He P, Liu F, Li L, Zhang H, Ji P, Yang S. Nanotube-decorated hierarchical tantalum scaffold promoted early osseointegration. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2021; 35:102390. [PMID: 33857685 DOI: 10.1016/j.nano.2021.102390] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/24/2021] [Accepted: 03/16/2021] [Indexed: 01/28/2023]
Abstract
This study aimed to fabricate a hierarchical tantalum scaffold mimicking natural bone structure to enhance osseointegration. Porous tantalum scaffolds (p-Ta) with microgradients were fabricated by selective laser melting according to a computer-aided design model. Electrochemical anodization produced nanotubes on the p-Ta surface (p-Ta-nt). SEM verified the construction of a unique nanostructure on p-Ta-nt. Contact angle and protein adsorption measurements demonstrated that p-Ta-nt have enhanced hydrophilicity and protein absorption. MC3T3-E1 preosteoblasts showed increased filamentous pseudopods and comparable cell proliferation when cultured on p-Ta-nt. Osteogenic marker gene (Osterix, Runx2, COL-I) transcription was significantly upregulated in MC3T3-E1 cells cultured on p-Ta-nt after 7 days. After implantation into the femurs of New Zealand white rabbits for 2 weeks, histological examination found improved early osseointegration in the p-Ta-nt group. This study showed that a hierarchical tantalum structure could enhance early osteogenic effects in vitro and in vivo.
Collapse
Affiliation(s)
- Zhiyi Zhang
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yuzhou Li
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Ping He
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Fengyi Liu
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lingjie Li
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - He Zhang
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Ping Ji
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Sheng Yang
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| |
Collapse
|
46
|
Alsheghri A, Reznikov N, Piché N, McKee MD, Tamimi F, Song J. Optimization of 3D network topology for bioinspired design of stiff and lightweight bone-like structures. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 123:112010. [PMID: 33812629 DOI: 10.1016/j.msec.2021.112010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 01/17/2023]
Abstract
A truly bioinspired approach to design optimization should follow the energetically favorable natural paradigm of "minimum inventory with maximum diversity". This study was inspired by constructive regression of trabecular bone - a natural process of network connectivity optimization occurring early in skeletal development. During trabecular network optimization, the original excessively connected network undergoes incremental pruning of redundant elements, resulting in a functional and adaptable structure operating at lowest metabolic cost. We have recapitulated this biological network topology optimization algorithm by first designing in silico an excessively connected network in which elements are dimension-independent linear connections among nodes. Based on bioinspired regression principles, least-loaded connections were iteratively pruned upon simulated loading. Evolved networks were produced along this optimization trajectory when pre-set convergence criteria were met. These biomimetic networks were compared to each other, and to the reference network derived from mature trabecular bone. Our results replicated the natural network optimization algorithm in uniaxial compressive loading. However, following triaxial loading, the optimization algorithm resulted in lattice networks that were more stretch-dominated than the reference network, and more capable of uniform load distribution. As assessed by 3D printing and mechanical testing, our heuristic network optimization procedure opens new possibilities for parametric design.
Collapse
Affiliation(s)
- Ammar Alsheghri
- Department of Mining and Materials Engineering, McGill University, Montréal, Québec, Canada
| | | | - Nicolas Piché
- Object Research Systems Inc., Montréal, Québec, Canada
| | - Marc D McKee
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada; Department of Anatomy and Cell Biology, McGill University, Montréal, Québec, Canada
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada
| | - Jun Song
- Department of Mining and Materials Engineering, McGill University, Montréal, Québec, Canada.
| |
Collapse
|
47
|
Nasello G, Vautrin A, Pitocchi J, Wesseling M, Kuiper JH, Pérez MÁ, García-Aznar JM. Mechano-driven regeneration predicts response variations in large animal model based on scaffold implantation site and individual mechano-sensitivity. Bone 2021; 144:115769. [PMID: 33276152 DOI: 10.1016/j.bone.2020.115769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 11/02/2020] [Accepted: 11/20/2020] [Indexed: 02/02/2023]
Abstract
It is well founded that the mechanical environment may regulate bone regeneration in orthopedic applications. The purpose of this study is to investigate the mechanical contributions of the scaffold and the host to bone regeneration, in terms of subject specificity, implantation site and sensitivity to the mechanical environment. Using a computational approach to model mechano-driven regeneration, bone ingrowth in porous titanium scaffolds was simulated in the distal femur and proximal tibia of three goats and compared to experimental results. The results showed that bone ingrowth shifted from a homogeneous distribution pattern, when scaffolds were in contact with trabecular bone (max local ingrowth 12.47%), to a localized bone ingrowth when scaffolds were implanted in a diaphyseal location (max local ingrowth 20.64%). The bone formation dynamics revealed an apposition rate of 0.37±0.28%/day in the first three weeks after implantation, followed by limited increase in bone ingrowth until the end of the experiment (12 weeks). According to in vivo data, we identified one animal whose sensitivity to mechanical stimulation was higher than the other two. Moreover, we found that the stimulus initiating bone formation was consistently higher in the femur than in the tibia for all the individuals. Overall, the dependence of the osteogenic response on the host biomechanics means that, from a mechanical perspective, the regenerative potential depends on both the scaffold and the host environment. Therefore, this work provides insights on how the mechanical conditions of both the recipient and the scaffold contribute to meet patient and location-specific characteristics.
Collapse
Affiliation(s)
- Gabriele Nasello
- Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain; Biomechanics Section, KU Leuven, Leuven, Belgium
| | - Antoine Vautrin
- Ecole Nationale d'Ingénieurs de Metz, University of Lorraine, Metz, France
| | - Jonathan Pitocchi
- Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain; Biomechanics Section, KU Leuven, Leuven, Belgium; Materialise NV, Leuven, Belgium
| | | | - Jan Herman Kuiper
- Institute for Science and Technology in Medicine, Keele University, Keele, UK; The Robert Jones and Agnes Hunt Orthopaedic Hospital, NHS Foundation Trust, Oswestry, UK
| | - María Ángeles Pérez
- Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - José Manuel García-Aznar
- Multiscale in Mechanical and Biological Engineering, Instituto de Investigación en Ingeniería de Aragón (I3A), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain.
| |
Collapse
|
48
|
Entezari A, Swain MV, Gooding JJ, Roohani I, Li Q. A modular design strategy to integrate mechanotransduction concepts in scaffold-based bone tissue engineering. Acta Biomater 2020; 118:100-112. [PMID: 33059100 DOI: 10.1016/j.actbio.2020.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/01/2020] [Accepted: 10/08/2020] [Indexed: 12/19/2022]
Abstract
Repair or regeneration of load-bearing bones has long been an incentive for the tissue engineering community to develop a plethora of synthetic bone scaffolds. Despite the key role of physical forces and the mechanical environment in bone regeneration, the mechanotransduction concept has rarely been incorporated in structural design of bone tissue scaffolds, particularly those made of bioactive materials such as hydrogels and bioceramics. Herein, we introduce a modular design strategy to fabricate a load bearing device that can support a wide range of hydrogel- and ceramic-based scaffolds against complex in-vivo loading conditions to induce desirable mechanical strains for bone regeneration within the scaffolds. The device is comprised of a fenestrated polymeric shell and ceramic structural pillars arranged in a sophisticated configuration to provide ample internal space for the scaffold, also enabling it to purposely regulate the levels of strains and stresses within the scaffolds. Utilizing this top-down design approach, we demonstrate that the failure load of alginate hydrogels increases 3200-fold in compression, 300-fold in shear and 75-fold in impact, achieving the values that enable them to withstand physiological loads in weight-bearing sites, while allowing generation of osteoinductive strains (i.e., 0.2-0.4%) in the hydrogel. This modular design approach opens a broad range of opportunities to utilize various bioactive but mechanically weak scaffolds for the treatment of load-bearing defects and exploiting mechanobiology strategies to improve bone regeneration.
Collapse
|
49
|
Clark JN, Heyraud A, Tavana S, Al-Jabri T, Tallia F, Clark B, Blunn GW, Cobb JP, Hansen U, Jones JR, Jeffers JRT. Exploratory Full-Field Mechanical Analysis across the Osteochondral Tissue-Biomaterial Interface in an Ovine Model. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E3911. [PMID: 32899671 PMCID: PMC7559087 DOI: 10.3390/ma13183911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 11/26/2022]
Abstract
Osteochondral injuries are increasingly prevalent, yet success in articular cartilage regeneration remains elusive, necessitating the development of new surgical interventions and novel medical devices. As part of device development, animal models are an important milestone in illustrating functionality of novel implants. Inspection of the tissue-biomaterial system is vital to understand and predict load-sharing capacity, fixation mechanics and micromotion, none of which are directly captured by traditional post-mortem techniques. This study aims to characterize the localised mechanics of an ex vivo ovine osteochondral tissue-biomaterial system extracted following six weeks in vivo testing, utilising laboratory micro-computed tomography, in situ loading and digital volume correlation. Herein, the full-field displacement and strain distributions were visualised across the interface of the system components, including newly formed tissue. The results from this exploratory study suggest that implant micromotion in respect to the surrounding tissue could be visualised in 3D across multiple loading steps. The methodology provides a non-destructive means to assess device performance holistically, informing device design to improve osteochondral regeneration strategies.
Collapse
Affiliation(s)
- Jeffrey N. Clark
- Department of Mechanical Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (J.N.C.); (S.T.); (U.H.)
- Department of Materials, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (A.H.); (F.T.); (J.R.J.)
| | - Agathe Heyraud
- Department of Materials, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (A.H.); (F.T.); (J.R.J.)
| | - Saman Tavana
- Department of Mechanical Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (J.N.C.); (S.T.); (U.H.)
| | - Talal Al-Jabri
- Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK; (T.A.-J.); (J.P.C.)
| | - Francesca Tallia
- Department of Materials, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (A.H.); (F.T.); (J.R.J.)
| | - Brett Clark
- Imaging and Analysis Centre, Natural History Museum London, London SW7 5BD, UK;
| | - Gordon W. Blunn
- School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth PO1 2DT, UK;
| | - Justin P. Cobb
- Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK; (T.A.-J.); (J.P.C.)
| | - Ulrich Hansen
- Department of Mechanical Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (J.N.C.); (S.T.); (U.H.)
| | - Julian R. Jones
- Department of Materials, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (A.H.); (F.T.); (J.R.J.)
| | - Jonathan R. T. Jeffers
- Department of Mechanical Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (J.N.C.); (S.T.); (U.H.)
| |
Collapse
|
50
|
Arjunan A, Demetriou M, Baroutaji A, Wang C. Mechanical performance of highly permeable laser melted Ti6Al4V bone scaffolds. J Mech Behav Biomed Mater 2019; 102:103517. [PMID: 31877520 DOI: 10.1016/j.jmbbm.2019.103517] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/08/2019] [Accepted: 10/31/2019] [Indexed: 01/05/2023]
Abstract
Critically engineered stiffness and strength of a scaffold are crucial for managing maladapted stress concentration and reducing stress shielding. At the same time, suitable porosity and permeability are key to facilitate biological activities associated with bone growth and nutrient delivery. A systematic balance of all these parameters are required for the development of an effective bone scaffold. Traditionally, the approach has been to study each of these parameters in isolation without considering their interdependence to achieve specific properties at a certain porosity. The purpose of this study is to undertake a holistic investigation considering the stiffness, strength, permeability, and stress concentration of six scaffold architectures featuring a 68.46-90.98% porosity. With an initial target of a tibial host segment, the permeability was characterised using Computational Fluid Dynamics (CFD) in conjunction with Darcy's law. Following this, Ashby's criterion, experimental tests, and Finite Element Method (FEM) were employed to study the mechanical behaviour and their interdependencies under uniaxial compression. The FE model was validated and further extended to study the influence of stress concentration on both the stiffness and strength of the scaffolds. The results showed that the pore shape can influence permeability, stiffness, strength, and the stress concentration factor of Ti6Al4V bone scaffolds. Furthermore, the numerical results demonstrate the effect to which structural performance of highly porous scaffolds deviate, as a result of the Selective Laser Melting (SLM) process. In addition, the study demonstrates that stiffness and strength of bone scaffold at a targeted porosity is linked to the pore shape and the associated stress concentration allowing to exploit the design freedom associated with SLM.
Collapse
Affiliation(s)
- Arun Arjunan
- School of Engineering, University of Wolverhampton, Telford, TF2 9NT, UK.
| | - Marios Demetriou
- School of Engineering, University of Wolverhampton, Telford, TF2 9NT, UK
| | - Ahmad Baroutaji
- School of Engineering, University of Wolverhampton, Telford, TF2 9NT, UK
| | - Chang Wang
- Department of Engineering and Design, University of Sussex, Brighton, BN1 9RH, UK
| |
Collapse
|