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Niu X, Xiao S, Huang R, Huang D, Aifantis KE, Yu H, Xue C, Yin L, Dunne N, Li X. ZIF-8-modified hydrogel sequentially delivers angiogenic and osteogenic growth factors to accelerate vascularized bone regeneration. J Control Release 2024; 374:154-170. [PMID: 39127448 DOI: 10.1016/j.jconrel.2024.08.011] [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: 06/25/2024] [Revised: 08/05/2024] [Accepted: 08/07/2024] [Indexed: 08/12/2024]
Abstract
To realize high-quality vascularized bone regeneration, we developed a multifunctional hydrogel (SHPP-ZB) by incorporating BMP-2@ZIF-8/PEG-NH2 nanoparticles (NPs) into a sodium alginate/hydroxyapatite/polyvinyl alcohol hydrogel loaded with PDGF-BB, allowing for the sequential release of angiogenic and osteogenic growth factors (GFs) during bone repair. ZIF-8 served as a protective host for BMP-2 from degradation, ensuring high encapsulation efficiency and long-term bioactivity. The SHPP-ZB hydrogel exhibited enhanced mechanical strength and injectability, making it suitable for complex bone defects. It provided a swelling interface for tissue interlocking and the early release of Zn2+ and tannin acid (TA) to exert antioxidant and antibacterial effects, followed by the sequential release of angiogenic and osteogenic GFs to promote high-quality vascularized bone regeneration. In vitro experiments demonstrated the superior angiogenic and osteogenic properties of SHPP-ZB compared to other groups. In vivo experiments indicated that the sequential delivery of GFs via SHPP-ZB hydrogel could improve vascularized bone regeneration. Further, RNA sequencing analysis of regenerative bone tissue revealed that SHPP-ZB hydrogel promoted vascularized bone regeneration by regulating JUN, MAPK, Wnt, and calcium signaling pathways in vivo. This study presented a promising approach for efficient vascularized bone regeneration in large-scale bone defects.
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Affiliation(s)
- Xiaolian Niu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Shengzhao Xiao
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai 200011, China.
| | - Ruoyu Huang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Di Huang
- Department of Biomedical Engineering, Research Center for Nano-Biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Katerina E Aifantis
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Han Yu
- Senior Department of Orthopedics, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Chao Xue
- Senior Department of Orthopedics, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Lan Yin
- Key Laboratory of Advanced Materials of Ministry of Education, Tsinghua University, Beijing 100084, China
| | - Nicholas Dunne
- Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Stokes Building, Collins Avenue, Dublin 9, Ireland
| | - Xiaoming Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China.
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Huang S, Yang J, Li X, Tang X, Ji T. A novel non-invasive electromagnetic extendable intercalary endoprosthesis: a proof-of-concept study. Front Bioeng Biotechnol 2024; 12:1400428. [PMID: 39091970 PMCID: PMC11291365 DOI: 10.3389/fbioe.2024.1400428] [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: 03/13/2024] [Accepted: 06/26/2024] [Indexed: 08/04/2024] Open
Abstract
Introduction: Femur and tibia are the most commonly affected sites for primary malignant bone tumors in children. The wide resection of the tumor frequently requires the physis to be resected. The normal growth of the unaffected limb will result in a significant limb length discrepancy at skeletal maturity. To compensate for this resulting LLD, different generations of extendible endoprostheses have been developed. Non-invasive extendable prostheses eliminate the need for surgical procedures and general anesthesia, enabling gradual and painless lengthening. Currently available non-invasive extendable prostheses focus on joint reconstruction, and no case series analysis of intercalary non-invasive extendable prosthesis has been reported. Therefore, we have designed a novel non-invasive electromagnetic extendable intercalary endoprosthesis. Methods: In vitro mechanical experiments and in vivo animal experiments were conducted. Results: In vitro experiments have confirmed that the prosthetics can extend at a constant rate, increasing by 4.4 mm every 10 min. The average maximum extension force during prosthetic elongation can reach 1306N. In animal in vivo experiments, the extension process is smooth and non-invasive, and the sheep is in a comfortable state. Discussion: The in vitro and in vivo animal studies provide evidence to support the extension reliability, laying the foundation for future large-scale validation experiments.
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Affiliation(s)
- Siyi Huang
- Musculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, China
- Beijing Key Laboratory of Musculoskeletal Tumor, Beijing, China
| | - Jiake Yang
- Musculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, China
- Beijing Key Laboratory of Musculoskeletal Tumor, Beijing, China
| | - Xinyu Li
- Beijing AK Medical Co., Ltd., Beijing, China
| | - Xiaodong Tang
- Musculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, China
- Beijing Key Laboratory of Musculoskeletal Tumor, Beijing, China
| | - Tao Ji
- Musculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, China
- Beijing Key Laboratory of Musculoskeletal Tumor, Beijing, China
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Wei J, Chen X, Xu Y, Shi L, Zhang M, Nie M, Liu X. Significance and considerations of establishing standardized critical values for critical size defects in animal models of bone tissue regeneration. Heliyon 2024; 10:e33768. [PMID: 39071581 PMCID: PMC11283167 DOI: 10.1016/j.heliyon.2024.e33768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
Establishing animal models with critical size defects (CSDs) is critical for conducting experimental investigations engineering of bone tissue regeneration. Currently, a standardised protocol for establishing an animal CSDs model has not been developed. Furthermore, a consensus has not been reached regarding the critical values of CSDs. Successful establishment of animal models for CSDs is a complex process that requires researchers to meticulously consider a variety of factors such as age, species, bone defect size and anatomic location. The specific numerical values for CSDs in small animal models vary, and a clear definition of the critical value for large animal CSDs models in the literature is still lacking. This review consolidates the advancements in critical bone defects animal models by outlining the research landscape across variables, including animal species, age groups, bone defect sites, and sizes, to offer valuable guidance and a theoretical framework for the establishment of pertinent experimental animal models.
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Affiliation(s)
- Jian Wei
- Department of Periodontics & Oral Mucosal Diseases, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China
- Institute of Stomatology, Southwest Medical University, Luzhou, 646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou, 646000, China
| | - Xiao Chen
- Department of Oral Medical Technology, Sichuan College of Traditional Chinese Medicine, Mianyang, 621000, China
- Department of Orthodontics, Mianyang Stomatological Hospital, Mianyang, 621000, China
| | - Yingjiao Xu
- Department of Periodontics & Oral Mucosal Diseases, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China
- Institute of Stomatology, Southwest Medical University, Luzhou, 646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou, 646000, China
| | - Lijuan Shi
- Department of Periodontics & Oral Mucosal Diseases, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China
- Institute of Stomatology, Southwest Medical University, Luzhou, 646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou, 646000, China
| | - Menglian Zhang
- Department of Periodontics & Oral Mucosal Diseases, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China
- Institute of Stomatology, Southwest Medical University, Luzhou, 646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou, 646000, China
| | - Minhai Nie
- Department of Periodontics & Oral Mucosal Diseases, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China
- Institute of Stomatology, Southwest Medical University, Luzhou, 646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou, 646000, China
| | - Xuqian Liu
- Department of Basic Medicine of Stomatology, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China
- Institute of Stomatology, Southwest Medical University, Luzhou, 646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou, 646000, China
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Liu X, Deng S, Li X, Liu H, Li Z, Wu Y, Luo P, Zhong X, Huang R, Liu R, Wu X, Huang B, Chen Z, Chen Z, Chen S. A Standardized Rat Model to Study Peri-implantitis of Transmucosal Osseointegrated Implants. Biomater Res 2024; 28:0021. [PMID: 38828365 PMCID: PMC11142924 DOI: 10.34133/bmr.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/19/2024] [Indexed: 06/05/2024] Open
Abstract
With the high incidence rate, distinctive implant characteristic and unique infection pattern, peri-implantitis (PI) requires a specially designed implant animal model for the researches on the pathogenesis and treatments. Previous small-animal PI models exhibit variability in implant site selection, design, and surgical procedures resulting in unnecessary tissue damage and less effectivity. Herein, a quantitative-analysis-based standardized rat model for transmucosal PI-related research was proposed. After dissecting the anatomic structures of the rat maxilla, we determined that placing the implant anterior to the molars in the rat maxilla streamlined the experimental period and enhanced animal welfare. We standardized the model by controlling the rat strain, gender, and size. The customized implant and a series of matched surgical instruments were appropriately designed. A clear, step-by-step surgical process was established. These designs ensured the success rate, stability, and replicability of the model. Each validation method confirmed the successful construction of the model. This study proposed a quantitative-analysis-based standardized transmucosal PI rat model with improved animal welfare and reliable procedures. This model could provide efficient in vivo insights to study the pathogenesis and treatments of PI and preliminary screening data for further large-animal and clinical trials.
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Affiliation(s)
- Xingchen Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Shudan Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xiyan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Haiwen Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
- Department of Stomatology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Zhixin Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - You Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Pu Luo
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xinyi Zhong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Ruoxuan Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Runheng Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xiayi Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Baoxin Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Zetao Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Zhuofan Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Shoucheng Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
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Bowers KM, Anderson DE. Delayed Union and Nonunion: Current Concepts, Prevention, and Correction: A Review. Bioengineering (Basel) 2024; 11:525. [PMID: 38927761 PMCID: PMC11201148 DOI: 10.3390/bioengineering11060525] [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: 03/29/2024] [Revised: 05/12/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024] Open
Abstract
Surgical management of fractures has advanced with the incorporation of advanced technology, surgical techniques, and regenerative therapies, but delayed bone healing remains a clinical challenge and the prevalence of long bone nonunion ranges from 10 to 15% of surgically managed fractures. Delayed bone healing arises from a combination of mechanical, biological, and systemic factors acting on the site of tissue remodeling, and careful consideration of each case's injury-related, patient-dependent, surgical, and mechanical risk factors is key to successful bone union. In this review, we describe the biology and biomechanics of delayed bone healing, outline the known risk factors for nonunion development, and introduce modern preventative and corrective therapies targeting fracture nonunion.
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Affiliation(s)
| | - David E. Anderson
- Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, 2407 River Dr., Knoxville, TN 37996-4550, USA;
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6
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Zhen C, Shi Y, Wang W, Zhou G, Li H, Lin G, Wang F, Tang B, Li X. Advancements in gradient bone scaffolds: enhancing bone regeneration in the treatment of various bone disorders. Biofabrication 2024; 16:032004. [PMID: 38688259 DOI: 10.1088/1758-5090/ad4595] [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: 11/28/2023] [Accepted: 04/30/2024] [Indexed: 05/02/2024]
Abstract
Bone scaffolds are widely employed for treating various bone disorders, including defects, fractures, and accidents. Gradient bone scaffolds present a promising approach by incorporating gradients in shape, porosity, density, and other properties, mimicking the natural human body structure. This design offers several advantages over traditional scaffolds. A key advantage is the enhanced matching of human tissue properties, facilitating cell adhesion and migration. Furthermore, the gradient structure fosters a smooth transition between scaffold and surrounding tissue, minimizing the risk of inflammation or rejection. Mechanical stability is also improved, providing better support for bone regeneration. Additionally, gradient bone scaffolds can integrate drug delivery systems, enabling controlled release of drugs or growth factors to promote specific cellular activities during the healing process. This comprehensive review examines the design aspects of gradient bone scaffolds, encompassing structure and drug delivery capabilities. By optimizing the scaffold's inherent advantages through gradient design, bone regeneration outcomes can be improved. The insights presented in this article contribute to the academic understanding of gradient bone scaffolds and their applications in bone tissue engineering.
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Affiliation(s)
- Chengdong Zhen
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, People's Republic of China
- Shandong Institute of Mechanical Design and Research, Jinan 250031, People's Republic of China
| | - Yanbin Shi
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, People's Republic of China
- Shandong Institute of Mechanical Design and Research, Jinan 250031, People's Republic of China
- School of Arts and Design, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, People's Republic of China
| | - Wenguang Wang
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, People's Republic of China
- Shandong Institute of Mechanical Design and Research, Jinan 250031, People's Republic of China
| | - Guangzhen Zhou
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, People's Republic of China
- Shandong Institute of Mechanical Design and Research, Jinan 250031, People's Republic of China
| | - Heng Li
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, People's Republic of China
- Shandong Institute of Mechanical Design and Research, Jinan 250031, People's Republic of China
| | - Guimei Lin
- School of Pharmaceutical Science, Shandong University, Jinan 250012, People's Republic of China
| | - Fei Wang
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, People's Republic of China
- Shandong Institute of Mechanical Design and Research, Jinan 250031, People's Republic of China
| | - Bingtao Tang
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, People's Republic of China
- Shandong Institute of Mechanical Design and Research, Jinan 250031, People's Republic of China
| | - Xuelin Li
- School of Arts and Design, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, People's Republic of China
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García-Lamas L, Lozano D, Jiménez-Díaz V, Bravo-Giménez B, Sánchez-Salcedo S, Jiménez-Holguín J, Abella M, Desco M, Vallet-Regi M, Cecilia-López D, Salinas AJ. Enriched mesoporous bioactive glass scaffolds as bone substitutes in critical diaphyseal bone defects in rabbits. Acta Biomater 2024; 180:104-114. [PMID: 38583750 DOI: 10.1016/j.actbio.2024.04.005] [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: 11/27/2023] [Revised: 03/23/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
In the field of orthopedic surgery, there is an increasing need for the development of bone replacement materials for the treatment of bone defects. One of the main focuses of biomaterials engineering are advanced bioceramics like mesoporous bioactive glasses (MBG´s). The present study compared the new bone formation after 12 weeks of implantation of MBG scaffolds with composition 82,5SiO2-10CaO-5P2O5-x 2.5SrO alone (MBGA), enriched with osteostatin, an osteoinductive peptide, (MBGO) or enriched with bone marrow aspirate (MBGB) in a long bone critical defect in radius bone of adult New Zealand rabbits. New bone formation from the MBG scaffold groups was compared to the gold standard defect filled with iliac crest autograft and to the unfilled defect. Radiographic follow-up was performed at 2, 6, and 12 weeks, and microCT and histologic examination were performed at 12 weeks. X-Ray study showed the highest bone formation scores in the group with the defect filled with autograft, followed by the MBGB group, in addition, the microCT study showed that bone within defect scores (BV/TV) were higher in the MBGO group. This difference could be explained by the higher density of newly formed bone in the osteostatin enriched MBG scaffold group. Therefore, MBG scaffold alone and enriched with osteostatin or bone marrow aspirate increase bone formation compared to defect unfilled, being higher in the osteostatin group. The present results showed the potential to treat critical bone defects by combining MBGs with osteogenic peptides such as osteostatin, with good prospects for translation into clinical practice. STATEMENT OF SIGNIFICANCE: Treatment of bone defects without the capacity for self-repair is a global problem in the field of Orthopedic Surgery, as evidenced by the fact that in the U.S alone it affects approximately 100,000 patients per year. The gold standard of treatment in these cases is the autograft, but its use has limitations both in the amount of graft to be obtained and in the morbidity produced in the donor site. In the field of materials engineering, there is a growing interest in the development of a bone substitute equivalent. Mesoporous bioactive glass (MBG´s) scaffolds with three-dimensional architecture have shown great potential for use as a bone substitutes. The osteostatin-enriched Sr-MBG used in this long bone defect in rabbit radius bone in vivo study showed an increase in bone formation close to autograft, which makes us think that it may be an option to consider as bone substitute.
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Affiliation(s)
- Lorena García-Lamas
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre, Madrid, España; Instituto de Investigación I+12, Madrid, España.
| | - Daniel Lozano
- Instituto de Investigación I+12, Madrid, España; Departamento de Química en Ciencias Farmacéuticas, Universidad Complutense de Madrid, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, España
| | - Verónica Jiménez-Díaz
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre, Madrid, España; Instituto de Investigación I+12, Madrid, España
| | - Beatriz Bravo-Giménez
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre, Madrid, España; Instituto de Investigación I+12, Madrid, España
| | - Sandra Sánchez-Salcedo
- Instituto de Investigación I+12, Madrid, España; Departamento de Química en Ciencias Farmacéuticas, Universidad Complutense de Madrid, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, España
| | - Javier Jiménez-Holguín
- Instituto de Investigación I+12, Madrid, España; Departamento de Química en Ciencias Farmacéuticas, Universidad Complutense de Madrid, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, España
| | - Mónica Abella
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España
| | - Manuel Desco
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España
| | - María Vallet-Regi
- Instituto de Investigación I+12, Madrid, España; Departamento de Química en Ciencias Farmacéuticas, Universidad Complutense de Madrid, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, España
| | - David Cecilia-López
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre, Madrid, España; Instituto de Investigación I+12, Madrid, España
| | - Antonio Jesús Salinas
- Instituto de Investigación I+12, Madrid, España; Departamento de Química en Ciencias Farmacéuticas, Universidad Complutense de Madrid, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, España.
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8
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Shanbhag S, Kampleitner C, Sanz-Esporrin J, Lie SA, Gruber R, Mustafa K, Sanz M. Regeneration of alveolar bone defects in the experimental pig model: A systematic review and meta-analysis. Clin Oral Implants Res 2024; 35:467-486. [PMID: 38450852 DOI: 10.1111/clr.14253] [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: 12/05/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Pigs are emerging as a preferred experimental in vivo model for bone regeneration. The study objective was to answer the focused PEO question: in the pig model (P), what is the capacity of experimental alveolar bone defects (E) for spontaneous regeneration in terms of new bone formation (O)? METHODS Following PRISMA guidelines, electronic databases were searched for studies reporting experimental bone defects or extraction socket healing in the maxillae or mandibles of pigs. The main inclusion criteria were the presence of a control group of untreated defects/sockets and the assessment of regeneration via 3D tomography [radiographic defect fill (RDF)] or 2D histomorphometry [new bone formation (NBF)]. Random effects meta-analyses were performed for the outcomes RDF and NBF. RESULTS Overall, 45 studies were included reporting on alveolar bone defects or extraction sockets, most frequently in the mandibles of minipigs. Based on morphology, defects were broadly classified as 'box-defects' (BD) or 'cylinder-defects' (CD) with a wide range of healing times (10 days to 52 weeks). Meta-analyses revealed pooled estimates (with 95% confidence intervals) of 50% RDF (36.87%-63.15%) and 43.74% NBF (30.47%-57%) in BD, and 44% RDF (16.48%-71.61%) and 39.67% NBF (31.53%-47.81%) in CD, which were similar to estimates of socket-healing [48.74% RDF (40.35%-57.13%) and 38.73% NBF (28.57%-48.89%)]. Heterogeneity in the meta-analysis was high (I2 > 90%). CONCLUSION A substantial body of literature revealed a high capacity for spontaneous regeneration in experimental alveolar bone defects of (mini)pigs, which should be considered in future studies of bone regeneration in this animal model.
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Affiliation(s)
- Siddharth Shanbhag
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Carina Kampleitner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, The Research Center in Cooperation with AUVA, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Javier Sanz-Esporrin
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Stein-Atle Lie
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Reinhard Gruber
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Kamal Mustafa
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Mariano Sanz
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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Yang J, Chen Z, Gao C, Liu J, Liu K, Wang X, Pan X, Wang G, Sang H, Pan H, Liu W, Ruan C. A mechanical-assisted post-bioprinting strategy for challenging bone defects repair. Nat Commun 2024; 15:3565. [PMID: 38670999 PMCID: PMC11053166 DOI: 10.1038/s41467-024-48023-8] [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: 07/26/2023] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Bioprinting that can synchronously deposit cells and biomaterials has lent fresh impetus to the field of tissue regeneration. However, the unavoidable occurrence of cell damage during fabrication process and intrinsically poor mechanical stability of bioprinted cell-laden scaffolds severely restrict their utilization. As such, on basis of heart-inspired hollow hydrogel-based scaffolds (HHSs), a mechanical-assisted post-bioprinting strategy is proposed to load cells into HHSs in a rapid, uniform, precise and friendly manner. HHSs show mechanical responsiveness to load cells within 4 s, a 13-fold increase in cell number, and partitioned loading of two types of cells compared with those under static conditions. As a proof of concept, HHSs with the loading cells show an enhanced regenerative capability in repair of the critical-sized segmental and osteoporotic bone defects in vivo. We expect that this post-bioprinting strategy can provide a universal, efficient, and promising way to promote cell-based regenerative therapy.
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Affiliation(s)
- Jirong Yang
- Research Center for Human Tissue and Organ Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhigang Chen
- Research Center for Human Tissue and Organ Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chongjian Gao
- Research Center for Human Tissue and Organ Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Juan Liu
- Research Center for Human Tissue and Organ Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Kaizheng Liu
- Research Center for Human Tissue and Organ Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xiao Wang
- Research Center for Human Tissue and Organ Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Shenzhen Hospital, Southern Medical University, Shenzhen, 518000, China
| | - Xiaoling Pan
- Research Center for Human Tissue and Organ Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Shenzhen Hospital, Southern Medical University, Shenzhen, 518000, China
| | - Guocheng Wang
- Research Center for Human Tissue and Organ Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Hongxun Sang
- Shenzhen Hospital, Southern Medical University, Shenzhen, 518000, China
| | - Haobo Pan
- Research Center for Human Tissue and Organ Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
- The Key Laboratory of Biomedical Imaging Science and System, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Wenguang Liu
- School of Materials Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, China
| | - Changshun Ruan
- Research Center for Human Tissue and Organ Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- The Key Laboratory of Biomedical Imaging Science and System, Chinese Academy of Sciences, Shenzhen, 518055, China.
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10
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Takatsu Y, Ohnishi H, Tateyama T, Miyati T. Usefulness of fat-containing agents: an initial study on estimating fat content for magnetic resonance imaging. Phys Eng Sci Med 2024; 47:339-350. [PMID: 38379016 DOI: 10.1007/s13246-023-01372-y] [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: 04/24/2023] [Accepted: 12/11/2023] [Indexed: 02/22/2024]
Abstract
This initial study aimed at testing whether fat-containing agents can be used for the fat mass estimation methods using magnetic resonance imaging (MRI). As an example for clinical application, fat-containing agents (based on soybean oil, 10% and 20%), 100% soybean oil, and saline as reference substances were placed outside the proximal femurs obtained from 14 participants and analyzed by 0.3 T MRI. Fat content was the estimated fat fraction (FF) based on signal intensity (SIeFF, %). The SIeFF values of the femoral bone marrow, including the femoral head, neck, shaft, and trochanter area, were measured. MRI data were compared in terms of bone mineral content (BMC) and bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) in the proximal femur. Twelve pig femurs were also used to confirm the correlation between FF by the DIXON method and SIeFF. According to Pearson's correlation coefficient, the SIeFF and total BMC and BMD data revealed strong and moderate negative correlations in the femoral head (r < - 0.74) and other sites (r = - 0.66 to - 0.45). FF and SIeFF showed a strong correlation (r = 0.96). This study was an initial investigation of a method for estimating fat mass with fat-containing agents and showed the potential for use in MRI. SIeFF and FF showed a strong correlation, and SIeFF and BMD and BMC showed correlation; however, further studies are needed to use SIeFF as a substitute for DXA.
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Affiliation(s)
- Yasuo Takatsu
- Molecular Imaging, School of Medical Sciences, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan.
- Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan.
| | - Hiroshi Ohnishi
- Department of Radiology, Geisei Ortho Clinic, 1495-1, Wajikikou, Geisei-Mura, Aki-Gun, Kochi, 781-5701, Japan
| | - Tomoko Tateyama
- Department of Intelligent Information Engineering, School of Medical Sciences, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan
| | - Tosiaki Miyati
- Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan
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11
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Wang S, Shao C, Zhao X, Guo Y, Song H, Shen L, Zhou Z, Li Z. Application of Three-Dimension Printing Nano-Carbonated-Hydroxylapatite to the Repair of Defects in Rabbit Bone. Int J Nanomedicine 2024; 19:1667-1681. [PMID: 38406604 PMCID: PMC10894707 DOI: 10.2147/ijn.s439775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction Hydroxylapatite (HAp) is a biodegradable bone graft material with high biocompatibility. However, the clinical application of HAp has been limited due to the poor absorption rate in vivo. Methods In this study, carbonated hydroxylapatite (CHAp) with a chemical composition similar to natural bone was synthesized. HAp and CHAp scaffolds were fabricated by 3D printing. Each material was designed by two types of scaffold model with a maximum width of 8 mm and a thickness of 2 mm, ie, structure I (round shape) and structure II (grid shape). Then, the HAp scaffolds were loaded with lutein. These scaffolds were implanted into the 8 mm bone defect on the top of the rabbit skull within 3 hours in the morning. The curative effects of the scaffolds were assessed two months after implantation. Results The 3D printed scaffolds did not cause severe inflammation or rejection after implantation. It showed that the porous structures allow bone cells to enter into the scaffolds. Furthermore, CHAp scaffolds were more biocompatible than HAp scaffolds, and showed a higher level of degradation and new bone formation after implantation. Structure II scaffolds with a smaller mineral content degraded faster than structure I, while structure I had better osteoconductive properties than structure II. Besides, the addition of lutein significantly enhanced the rate of new bone formation. Discussion The uniqueness of this study lies in the synthesis of 3D printed CHAp scaffolds and the implantation of CHAp in rabbit bone defects. The incorporation of suitable carbonate and lutein into HAp can enhance the osteoinductivity of the graft, and CHAp has a faster degradation rate in vivo, all of which provide a new reference for the research and application of apatite-based composites.
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Affiliation(s)
- Shujie Wang
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, People’s Republic of China
- College of Animal Science and Technology & College of Veterinary Medicine, Zhejiang Agriculture and Forestry University, Hangzhou, Zhejiang, 311300, People’s Republic of China
| | - Chunyan Shao
- College of Animal Science and Technology & College of Veterinary Medicine, Zhejiang Agriculture and Forestry University, Hangzhou, Zhejiang, 311300, People’s Republic of China
| | - Xingkai Zhao
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, People’s Republic of China
| | - Yizhe Guo
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, People’s Republic of China
| | - Houhui Song
- College of Animal Science and Technology & College of Veterinary Medicine, Zhejiang Agriculture and Forestry University, Hangzhou, Zhejiang, 311300, People’s Republic of China
| | - Lida Shen
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, 210016, People’s Republic of China
| | - Zhenlei Zhou
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, People’s Republic of China
| | - Zhen Li
- College of Resources and Environmental Sciences, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, People’s Republic of China
- State Key Laboratory of Palaeobiology and Stratigraphy, Nanjing Institute of Geology and Palaeontology and Center for Excellence in Life and Paleoenvironment, Chinese Academy of Sciences, Nanjing, Jiangsu, 210008, People’s Republic of China
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12
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García-Lamas L, Peña J, Roman J, Cabañas V, Bravo-Giménez B, Jiménez-Díaz V, Sánchez-Salcedo S, Jiménez-Holguín J, Abella M, Desco M, Lozano D, Cecilia-López D, Salinas A. In vivo behavior in rabbit radius bone defect of scaffolds based on nanocarbonate hydroxyapatite. J Biomed Mater Res B Appl Biomater 2024; 112:e35391. [PMID: 38348754 DOI: 10.1002/jbm.b.35391] [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: 09/09/2023] [Revised: 01/08/2024] [Accepted: 01/27/2024] [Indexed: 02/15/2024]
Abstract
Bone defects treatment may require the use of biomaterials that behave as a support and promote bone regeneration. Limitations associated with the use of autografts and allografts make it necessary to design new synthetic bone substitutes. Some of the most promising biomaterials currently under investigation are based on nanocarbonate hydroxyapatite (nCHA). In this study, we studied the bone-inducing capacity of nCHA-based scaffolds alone (SAG) and enriched with osteostatin (SAGO) or with bone marrow aspirate(SAGB) after implantation for 12 weeks in a 15-mm long critical defect performed in the radius of New Zealand rabbits. Bone formation obtained was compared with a group with the unfilled defect (CE), as control group, and other with the defect filed with iliac crest autograft (GS), as gold standard. X-ray follow-up was performed at 2, 4, 6 and 12 weeks and μCT and histological studies at 12 weeks. The radiological results showed a greater increment in bone formation in the GS group (75%-100%), followed by the SAG and SAGB groups (50%-75%). μCT results showed an increase of bone volume/tissue volume values in GS group followed by SAG and SAGB groups (0.53, 0.40, and 0.31 respectively) compared with CE group (0.26). Histological results showed limited resorption of the nCHA scaffolds and partial osseointegration in the SAG and SAGB groups. However, in the SAGO group, the presence of connective tissue encapsulating the scaffold was detected. In SAG, SAGB, and increase of bone formation were observed compared with CE group, but less than the GS group. Thus, the investigated materials represent a significant advance in the design of synthetic materials for bone grafting, but further studies are needed to bring their in vivo behavior closer to autograft, the gold standard.
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Affiliation(s)
- Lorena García-Lamas
- Department of Orthopedic Surgery, University Hospital 12 de Octubre, Madrid, Spain
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
| | - Juan Peña
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid, Madrid, Spain
| | - Jesús Roman
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid, Madrid, Spain
| | - Victoria Cabañas
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid, Madrid, Spain
| | - Beatriz Bravo-Giménez
- Department of Orthopedic Surgery, University Hospital 12 de Octubre, Madrid, Spain
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
| | - Verónica Jiménez-Díaz
- Department of Orthopedic Surgery, University Hospital 12 de Octubre, Madrid, Spain
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
| | - Sandra Sánchez-Salcedo
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid, Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Carlos III Health Institute, Madrid, Spain
| | - Javier Jiménez-Holguín
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid, Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Carlos III Health Institute, Madrid, Spain
| | - Monica Abella
- Departamento de Bioingeniería, Universidad Carlos III, Madrid, Spain
| | - Manuel Desco
- Departamento de Bioingeniería, Universidad Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañon, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Daniel Lozano
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid, Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Carlos III Health Institute, Madrid, Spain
| | - David Cecilia-López
- Department of Orthopedic Surgery, University Hospital 12 de Octubre, Madrid, Spain
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
| | - Antonio Salinas
- Research institute imas 12, University Hospital 12 de Octubre, Madrid, Spain
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid, Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Carlos III Health Institute, Madrid, Spain
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13
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Knorr IJ, Tix L, Liu W, Talbot SR, Schulz M, Bell L, Kögel B, Tolba R, Ernst L. Refinement in Post-Operative Care for Orthopaedic Models: Implementing a Sheep Walking Cast (SWC) for Effective Tibial Fracture Management. Biomedicines 2024; 12:343. [PMID: 38397945 PMCID: PMC10886840 DOI: 10.3390/biomedicines12020343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 02/25/2024] Open
Abstract
In the healthcare system, lower leg fractures remain relevant, incurring costs related to surgical treatment, hospitalization, and rehabilitation. The duration of treatment may vary depending on the individual case and its severity. Casting as a post-surgical fracture treatment is a common method in human and experimental veterinary medicine. Despite the high importance of sheep in preclinical testing materials for osteosynthesis, there is no standardised cast system ensuring proper stabilisation and functionality of hind limbs during the healing of tibia fractures or defects. Existing treatment approaches for tibial osteosynthesis in laboratory animal science include sling hanging, external fixators, or former Achilles tendon incision. These methods restrict animal movement for 4-6 weeks, limit species-typical behaviour, and impact social interactions. Our pilot study introduces a Standardised Walking Cast (SWC) for sheep, enabling immediate physiological movement post surgery. Seven Rhone sheep (female, 63.5 kg ± 6.45 kg) each with a single tibia defect (6 mm mechanical drilled defect) underwent SWC application for 4 weeks after plate osteosynthesis. The animals bore weight on their operated leg from day one, exhibiting slight lameness (grade 1-2 out of 5). Individual step lengths showed good uniformity (average deviation: 0.89 cm). Group housing successfully started on day three after surgery. Weekly X-rays and cast changes ensured proper placement, depicting the healing process. This study demonstrates the feasibility of using an SWC for up to 72 kg of body weight without sling hanging via ceiling mounting or external fixation techniques. Allowing species-typical movement and social behaviour can significantly improve the physiological behaviour of sheep in experiments, contributing to refinement.
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Affiliation(s)
- Ivonne Jeanette Knorr
- Institute for Laboratory Animal Science and Experimental Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; (I.J.K.); (L.T.); (W.L.); (M.S.); (B.K.); (R.T.)
| | - Leonie Tix
- Institute for Laboratory Animal Science and Experimental Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; (I.J.K.); (L.T.); (W.L.); (M.S.); (B.K.); (R.T.)
| | - Wenjia Liu
- Institute for Laboratory Animal Science and Experimental Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; (I.J.K.); (L.T.); (W.L.); (M.S.); (B.K.); (R.T.)
| | - Steven R. Talbot
- Institute for Laboratory Animal Science and Central Animal Facility, Hannover Medical School, 30625 Hannover, Germany;
| | - Mareike Schulz
- Institute for Laboratory Animal Science and Experimental Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; (I.J.K.); (L.T.); (W.L.); (M.S.); (B.K.); (R.T.)
| | - Laura Bell
- Audiovisual Media Center, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany;
| | - Babette Kögel
- Institute for Laboratory Animal Science and Experimental Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; (I.J.K.); (L.T.); (W.L.); (M.S.); (B.K.); (R.T.)
| | - Rene Tolba
- Institute for Laboratory Animal Science and Experimental Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; (I.J.K.); (L.T.); (W.L.); (M.S.); (B.K.); (R.T.)
| | - Lisa Ernst
- Institute for Laboratory Animal Science and Experimental Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; (I.J.K.); (L.T.); (W.L.); (M.S.); (B.K.); (R.T.)
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14
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Luengo-Alonso G, Bravo-Gimenez B, Lozano D, Heras C, Sanchez-Salcedo S, Benito-Garzón L, Abella M, Vallet-Regi M, Cecilia-Lopez D, Salinas AJ. Osteogenic Potential of a Biomaterial Enriched with Osteostatin and Mesenchymal Stem Cells in Osteoporotic Rabbits. Biomolecules 2024; 14:143. [PMID: 38397380 PMCID: PMC10887093 DOI: 10.3390/biom14020143] [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: 12/18/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 02/25/2024] Open
Abstract
Mesoporous bioactive glasses (MBGs) of the SiO2-CaO-P2O5 system are biocompatible materials with a quick and effective in vitro and in vivo bioactive response. MBGs can be enhanced by including therapeutically active ions in their composition, by hosting osteogenic molecules within their mesopores, or by decorating their surfaces with mesenchymal stem cells (MSCs). In previous studies, our group showed that MBGs, ZnO-enriched and loaded with the osteogenic peptide osteostatin (OST), and MSCs exhibited osteogenic features under in vitro conditions. The aim of the present study was to evaluate bone repair capability after large bone defect treatment in distal femur osteoporotic rabbits using MBGs (76%SiO2-15%CaO-5%P2O5-4%ZnO (mol-%)) before and after loading with OST and MSCs from a donor rabbit. MSCs presence and/or OST in scaffolds significantly improved bone repair capacity at 6 and 12 weeks, as confirmed by variations observed in trabecular and cortical bone parameters obtained by micro-CT as well as histological analysis results. A greater effect was observed when OST and MSCs were combined. These findings may indicate the great potential for treating critical bone defects by combining MBGs with MSCs and osteogenic peptides such as OST, with good prospects for translation to clinical practice.
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Affiliation(s)
- Gonzalo Luengo-Alonso
- Orthopaedics and Traumatology Service, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain;
- Orthopedics and Traumatology Service, Hospital Universitario 12 de Octubre & Imas12, 28041 Madrid, Spain;
| | - Beatriz Bravo-Gimenez
- Orthopedics and Traumatology Service, Hospital Universitario 12 de Octubre & Imas12, 28041 Madrid, Spain;
| | - Daniel Lozano
- Department of Chemistry in Pharmaceutical Sciences, Universidad Complutense & Imas12, 28040 Madrid, Spain; (D.L.); (C.H.); (S.S.-S.); (M.V.-R.)
- Networking Research Center on Bioengineering, Biomaterials, Nanomedicine, CIBER-BBN, 28040 Madrid, Spain
| | - Clara Heras
- Department of Chemistry in Pharmaceutical Sciences, Universidad Complutense & Imas12, 28040 Madrid, Spain; (D.L.); (C.H.); (S.S.-S.); (M.V.-R.)
| | - Sandra Sanchez-Salcedo
- Department of Chemistry in Pharmaceutical Sciences, Universidad Complutense & Imas12, 28040 Madrid, Spain; (D.L.); (C.H.); (S.S.-S.); (M.V.-R.)
- Networking Research Center on Bioengineering, Biomaterials, Nanomedicine, CIBER-BBN, 28040 Madrid, Spain
| | - Lorena Benito-Garzón
- Department of Human Anatomy and Histology, Facultad de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain;
| | - Monica Abella
- Department of Bioengineering, Universidad Carlos III de Madrid, 28911 Madrid, Spain;
| | - María Vallet-Regi
- Department of Chemistry in Pharmaceutical Sciences, Universidad Complutense & Imas12, 28040 Madrid, Spain; (D.L.); (C.H.); (S.S.-S.); (M.V.-R.)
- Networking Research Center on Bioengineering, Biomaterials, Nanomedicine, CIBER-BBN, 28040 Madrid, Spain
| | - David Cecilia-Lopez
- Orthopedics and Traumatology Service, Hospital Universitario 12 de Octubre & Imas12, 28041 Madrid, Spain;
| | - Antonio J. Salinas
- Department of Chemistry in Pharmaceutical Sciences, Universidad Complutense & Imas12, 28040 Madrid, Spain; (D.L.); (C.H.); (S.S.-S.); (M.V.-R.)
- Networking Research Center on Bioengineering, Biomaterials, Nanomedicine, CIBER-BBN, 28040 Madrid, Spain
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15
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Toosi S, Javid-Naderi MJ, Tamayol A, Ebrahimzadeh MH, Yaghoubian S, Mousavi Shaegh SA. Additively manufactured porous scaffolds by design for treatment of bone defects. Front Bioeng Biotechnol 2024; 11:1252636. [PMID: 38312510 PMCID: PMC10834686 DOI: 10.3389/fbioe.2023.1252636] [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: 07/04/2023] [Accepted: 12/20/2023] [Indexed: 02/06/2024] Open
Abstract
There has been increasing attention to produce porous scaffolds that mimic human bone properties for enhancement of tissue ingrowth, regeneration, and integration. Additive manufacturing (AM) technologies, i.e., three dimensional (3D) printing, have played a substantial role in engineering porous scaffolds for clinical applications owing to their high level of design and fabrication flexibility. To this end, this review article attempts to provide a detailed overview on the main design considerations of porous scaffolds such as permeability, adhesion, vascularisation, and interfacial features and their interplay to affect bone regeneration and osseointegration. Physiology of bone regeneration was initially explained that was followed by analysing the impacts of porosity, pore size, permeability and surface chemistry of porous scaffolds on bone regeneration in defects. Importantly, major 3D printing methods employed for fabrication of porous bone substitutes were also discussed. Advancements of MA technologies have allowed for the production of bone scaffolds with complex geometries in polymers, composites and metals with well-tailored architectural, mechanical, and mass transport features. In this way, a particular attention was devoted to reviewing 3D printed scaffolds with triply periodic minimal surface (TPMS) geometries that mimic the hierarchical structure of human bones. In overall, this review enlighten a design pathway to produce patient-specific 3D-printed bone substitutions with high regeneration and osseointegration capacity for repairing large bone defects.
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Affiliation(s)
- Shirin Toosi
- Stem Cell and Regenerative Medicine Center, Mashhad University of Medical Science, Mashhad, Iran
| | - Mohammad Javad Javid-Naderi
- Department of Medical Biotechnology and Nanotechnology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Ali Tamayol
- Department of Biomedical Engineering, University of Connecticut Health Center, Farmington, CT, United States
| | | | - Sima Yaghoubian
- Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Ali Mousavi Shaegh
- Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Laboratory for Microfluidics and Medical Microsystems, BuAli Research Institute, Mashhad University of Medical Science, Mashhad, Iran
- Clinical Research Unit, Ghaem Hospital, Mashhad University of Medical Science, Mashhad, Iran
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16
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Slavin BV, Nayak VV, Boczar D, Bergamo ET, Slavin BR, Yarholar LM, Torroni A, Coelho PG, Witek L. Bone Tissue Engineering (BTE) of the Craniofacial Skeleton, Part II: Translational Potential of 3D-Printed Scaffolds for Defect Repair. J Craniofac Surg 2024; 35:261-267. [PMID: 37622526 PMCID: PMC10836599 DOI: 10.1097/scs.0000000000009635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/06/2023] [Indexed: 08/26/2023] Open
Abstract
Computer-aided design/computer-aided manufacturing and 3-dimensional (3D) printing techniques have revolutionized the approach to bone tissue engineering for the repair of craniomaxillofacial skeletal defects. Ample research has been performed to gain a fundamental understanding of the optimal 3D-printed scaffold design and composition to facilitate appropriate bone formation and healing. Benchtop and preclinical, small animal model testing of 3D-printed bioactive ceramic scaffolds augmented with pharmacological/biological agents have yielded promising results given their potential combined osteogenic and osteoinductive capacity. However, other factors must be evaluated before newly developed constructs may be considered analogous alternatives to the "gold standard" autologous graft for defect repair. More specifically, the 3D-printed bioactive ceramic scaffold's long-term safety profile, biocompatibility, and resorption kinetics must be studied. The ultimate goal is to successfully regenerate bone that is comparable in volume, density, histologic composition, and mechanical strength to that of native bone. In vivo studies of these newly developed bone tissue engineering in translational animal models continue to make strides toward addressing regulatory and clinically relevant topics. These include the use of skeletally immature animal models to address the challenges posed by craniomaxillofacial defect repair in pediatric patients. This manuscript reviews the most recent preclinical animal studies seeking to assess 3D-printed ceramic scaffolds for improved repair of critical-sized craniofacial bony defects.
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Affiliation(s)
| | - Vasudev V Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL
| | - Daniel Boczar
- Department of Surgery, University of Washington, Seattle, WA
| | - Edmara Tp Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
- Biomaterials Division, NYU College of Dentistry, New York, NY
| | - Benjamin R Slavin
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Lauren M Yarholar
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Lukasz Witek
- Biomaterials Division, NYU College of Dentistry, New York, NY
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY
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El-Kady AM, Mahmoud EM, Sayed M, Kamel SM, Naga SM. In-vitro and in-vivo evaluation for the bio-natural Alginate/nano-Hydroxyapatite (Alg/n-HA) injectable hydrogel for critical size bone substitution. Int J Biol Macromol 2023; 253:126618. [PMID: 37659491 DOI: 10.1016/j.ijbiomac.2023.126618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
Currently, bio-natural injectable hydrogels are receiving a lot of attention due to their ability to control, adjust, and adapt to random bone defects, in addition, to their ability to mimic the composition of natural bones. From such a viewpoint, this study goal is to prepare and characterize the injectable hydrogels paste based on the natural alginate (Alg) derived from brown sea algae as a polysaccharide polymer, which coupled with nano biogenic-hydroxyapatite (n-HA) prepared from eggshells and enriched with valuable trace elements. The viscosity and mechanical properties of the paste were investigated. As well as the in-vitro study in terms of water absorption and biodegradability in the PBS, biocompatibility and the capability of the injectable Alginate/n-Hydroxyapatite (Alg/n-HA) to regenerate bone for the most suitable injectable form. The injectable hydrogel (BP -B sample) was chosen for the study as it had an appropriate setting time for injecting (13 mins), and suitable compressive strength reached 6.3 MPa. The in vivo study was also carried out including a post-surgery follow-up test of the newly formed bone (NB) in the defect area after 10 and 20 weeks using different techniques such as (SEM/EDX) and histological analysis, the density of the newly formed bone by Dual x-ray absorptiometry (DEXA), blood biochemistry and the radiology test. The results proved that the injectable hydrogels Alginate/n-Hydroxyapatite (Alg/n-HA) had an appreciated biodegradability and bioactivity, which allow the progress of angiogenesis, endochondral ossification, and osteogenesis throughout the defect area, which positively impacts the healing time and ensures the full restoration for the well-mature bone tissue that similar to the natural bone.
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Affiliation(s)
- Abeer M El-Kady
- Glass Research Department, National Research Centre, El-Bohous Str., 12622 Cairo, Egypt
| | - E M Mahmoud
- Ceramics Department, National Research Centre, El-Bohous Str., 12622 Cairo, Egypt.
| | - M Sayed
- Ceramics Department, National Research Centre, El-Bohous Str., 12622 Cairo, Egypt
| | - S M Kamel
- Oral Biology Department, MSA University, Egypt
| | - S M Naga
- Ceramics Department, National Research Centre, El-Bohous Str., 12622 Cairo, Egypt
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Blázquez-Carmona P, Mora-Macías J, Morgaz J, Granados MDM, Domínguez J, Reina-Romo E. Gait analysis: An effective tool to mechanically monitor the bone regeneration of critical-sized defects in tissue engineering applications. PLoS One 2023; 18:e0296510. [PMID: 38157369 PMCID: PMC10756556 DOI: 10.1371/journal.pone.0296510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION Tissue engineering has emerged as an innovative approach to treat critical-size bone defects using biocompatible scaffolds, thus avoiding complex distraction surgeries or limited stock grafts. Continuous regeneration monitoring is essential in critical-size cases due to the frequent appearance of non-unions. This work evaluates the potential clinical use of gait analysis for the mechanical assessment of a tissue engineering regeneration as an alternative to the traditional and hardly conclusive manual or radiological follow-up. MATERIALS AND METHODS The 15-mm metatarsal fragment of eight female merino sheep was surgically replaced by a bioceramic scaffold stabilized with an external fixator. Gait tests were performed weekly by making the sheep walk on an instrumented gangway. The evolution of different kinematic and dynamic parameters was analyzed for all the animal's limbs, as well as asymmetries between limbs. Finally, potential correlation in the recovery of the gait parameters was evaluated through the linear regression models. RESULTS After surgery, the operated limb has an altered way of carrying body weight while walking. Its loading capacity was significantly reduced as the stance phases were shorter and less impulsive. The non-operated limbs compensated for this mobility deficit. All parameters were normalizing during the consolidation phase while the bone callus was simultaneously mineralizing. The results also showed high levels of asymmetry between the operated limb and its contralateral, which exceeded 150% when analyzing the impulse after surgery. Gait recovery significantly correlated between symmetrical limbs. CONCLUSIONS Gait analysis was presented as an effective, low-cost tool capable of mechanically predicting the regeneration of critical-size defects treated by tissue engineering, as comparing regeneration processes or novel scaffolds. Despite the progressive normalization as the callus mineralized, the bearing capacity reduction and the asymmetry of the operated limb were more significant than in other orthopedic alternatives.
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Affiliation(s)
- Pablo Blázquez-Carmona
- Department of Mechanical and Manufacturing Engineering, Escuela Técnica Superior de Ingeniería, Universidad de Sevilla, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), University of Seville, Seville, Spain
| | - Juan Mora-Macías
- Instituto de Biomedicina de Sevilla (IBiS), University of Seville, Seville, Spain
- Department of Mining, Mechanical, Energy and Building Engineering, Escuela Técnica Superior de Ingeniería, University of Huelva, Huelva, Spain
| | - Juan Morgaz
- Department of Animal Medicine and Surgery, Universidad de Córdoba, Campus Universitario de Rabanales, Córdoba, Spain
| | - María del Mar Granados
- Department of Animal Medicine and Surgery, Universidad de Córdoba, Campus Universitario de Rabanales, Córdoba, Spain
| | - Jaime Domínguez
- Department of Mechanical and Manufacturing Engineering, Escuela Técnica Superior de Ingeniería, Universidad de Sevilla, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), University of Seville, Seville, Spain
| | - Esther Reina-Romo
- Department of Mechanical and Manufacturing Engineering, Escuela Técnica Superior de Ingeniería, Universidad de Sevilla, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), University of Seville, Seville, Spain
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Caffrey JM, Thomas PK, Appt SE, Burkart HB, Weaver CM, Kleinberger M, Gayzik FS. Contrast enhanced computed tomography of small ruminants: Caprine and ovine. PLoS One 2023; 18:e0287529. [PMID: 38127918 PMCID: PMC10735035 DOI: 10.1371/journal.pone.0287529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 06/07/2023] [Indexed: 12/23/2023] Open
Abstract
The use of small ruminants, mainly sheep and goats, is increasing in biomedical research. Small ruminants are a desirable animal model due to their human-like anatomy and physiology. However, the large variability between studies and lack of baseline data on these animals creates a barrier to further research. This knowledge gap includes a lack of computed tomography (CT) scans for healthy subjects. Full body, contrast enhanced CT scans of caprine and ovine subjects were acquired for subsequent modeling studies. Scans were acquired from an ovine specimen (male, Khatadin, 30-35 kg) and caprine specimen (female, Nubian 30-35 kg). Scans were acquired with and without contrast. Contrast enhanced scans utilized 1.7 mL/kg of contrast administered at 2 mL/s and scans were acquired 20 seconds, 80 seconds, and 5 minutes post-contrast. Scans were taken at 100 kV and 400 mA. Each scan was reconstructed using a bone window and a soft tissue window. Sixteen full body image data sets are presented (2 specimens by 4 contrast levels by 2 reconstruction windows) and are available for download through the form located at: https://redcap.link/COScanData. Scans showed that the post-contrast timing and scan reconstruction method affected structural visualization. The data are intended for further biomedical research on ruminants related to computational model development, device prototyping, comparative diagnostics, intervention planning, and other forms of translational research.
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Affiliation(s)
- Juliette M. Caffrey
- Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Patricia K. Thomas
- Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Susan E. Appt
- Pathology–Comparative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Heather B. Burkart
- Pathology–Comparative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Caitlin M. Weaver
- Army Research Directorate, DEVCOM Army Research Laboratory, Aberdeen Proving Ground, MD, United States of America
| | - Michael Kleinberger
- Army Research Directorate, DEVCOM Army Research Laboratory, Aberdeen Proving Ground, MD, United States of America
| | - F. Scott Gayzik
- Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
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Sasanuma H, Takahashi T, Kawai S, Saitsu A, Kurashina W, Iijima Y, Saito T, Takeshita K. Morphological and histological evaluation of the tendon-bone junction in porcine shoulders to create a rotator cuff tear and repair model. J Orthop Sci 2023:S0949-2658(23)00325-1. [PMID: 38007298 DOI: 10.1016/j.jos.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 10/30/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND This study aimed to morphologically and histologically examine whether pig is useful as models for rotator cuff tear (RCT). METHODS The morphology of the scapula and humerus bones was evaluated by taking X-ray and three-dimensional computed tomography (3D CT) scans of the right shoulders of five female pigs (age: 4 months). The rotator cuff (RC) footprint at the humeral insertion of these was observed and its shape was measured. Next, they underwent general anesthesia and an acute rotator cuff tear/rotator cuff repair (RCT/RCR) model was created using a deltoid split approach. Four weeks after surgery, the animals were euthanized, the shoulder joints were harvested, and the repaired RC was evaluated by hematoxylin and eosin staining and toluidine blue staining. RESULTS The scapula of the pig had a vestigial acromion, in contrast to that in humans. The supraspinatus and infraspinatus tendons were connected so as to overlap each other and attached to the postero-superior part of the greater tuberosity. These tendons were located extra-articularly, separate from the joint capsule. The average antero-posterior length of the foot print was 17.4 ± 0.7 mm on the medial margin and 19.1 ± 2.2 mm on the lateral margin. The maximum medial-to-lateral width of it was 5.1 ± 0.5 mm. In all RCT/RCR models at 4 weeks after surgery, the repaired RC compound tendon was visually confirmed to be continuous with the footprint. Histologically, it was confirmed that regeneration of the four-layer structure of the bone-tendon junction had occurred. CONCLUSION Porcine supraspinatus and infraspinatus attachment to the greater tuberosity have a structure similar to that of sheep and dogs, which is advantageous for creating the RCT/RCR model. It might be used for future in vivo studies of shoulder joint diseases. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE Pigs could potentially serve as a viable model for rotator cuff tears.
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Affiliation(s)
- Hideyuki Sasanuma
- Jichi Medical University Hospital, Graduate School of Medicine, Department of Orthopaedics, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
| | - Tsuneari Takahashi
- Jichi Medical University Hospital, Graduate School of Medicine, Department of Orthopaedics, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Shigeo Kawai
- Tochigi Medical Center Shimotsuga, Department of Diagnostic Pathology, 420-1, Ohira, Tochigi, 329-4498, Japan
| | - Akihiro Saitsu
- Jichi Medical University Hospital, Graduate School of Medicine, Department of Orthopaedics, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Wataru Kurashina
- Jichi Medical University Hospital, Graduate School of Medicine, Department of Orthopaedics, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Yuki Iijima
- Jichi Medical University Hospital, Graduate School of Medicine, Department of Orthopaedics, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Tomohiro Saito
- Jichi Medical University Hospital, Graduate School of Medicine, Department of Orthopaedics, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Katsushi Takeshita
- Jichi Medical University Hospital, Graduate School of Medicine, Department of Orthopaedics, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
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21
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Mirulla AI, Brogi C, Barone G, Secciani N, Sansom W, Bartalucci L, Ridolfi A, Allotta B, Bragonzoni L. External devices increasing bone quality in animals: A systematic review. Heliyon 2023; 9:e22379. [PMID: 38027551 PMCID: PMC10679491 DOI: 10.1016/j.heliyon.2023.e22379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/28/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background: Osteoporosis can reduce bone quality and increase the risk of fractures. In addition to pharmacological approaches, physical activity, and implanted devices, external devices can also be detected in the literature as a technique to strengthen bones. This type of intervention arises to be particularly promising because it minimizes the invasiveness of therapy. Methods: A systematic review of the technologies involved in such devices was carried out to identify the most fruitful ones in improving bone quality. This review, according to the PRISMA Statement, focuses on studies involving animals, and excludes pharmaceutical approaches. Findings: The animal models and devices used, their settings, interventions, outcomes measured, and consequent effect on bone quality are reported for each detected technology. Ultrasound and laser arose to be the most studied technologies in the literature, even if they have yet to be proved to have a significant effect on bone quality. Interpretation: External devices for bone quality improvement offer a non-invasive approach that causes minimum discomfort to the patient. This review aimed to detect which technologies reported in the literature significantly affect bone quality. The results showed that several technologies are currently used to improve bone quality. However, each study measures different outcomes and uses different measurement methods, device settings, and interventions. This lack of standardization and the reduced number of articles found do not allow for proper quantitative comparisons.
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Affiliation(s)
- Agostino Igor Mirulla
- Department for Life Quality Studies, University of Bologna, Corso d'Augusto 237, 47921, Rimini, Italy
| | - Chiara Brogi
- Department of Industrial Engineering, University of Florence, Via di Santa Marta 3, 50139, Firenze, Italy
| | - Giuseppe Barone
- Department for Life Quality Studies, University of Bologna, Corso d'Augusto 237, 47921, Rimini, Italy
| | - Nicola Secciani
- Department of Industrial Engineering, University of Florence, Via di Santa Marta 3, 50139, Firenze, Italy
| | - William Sansom
- Department for Life Quality Studies, University of Bologna, Corso d'Augusto 237, 47921, Rimini, Italy
| | - Lorenzo Bartalucci
- Department of Industrial Engineering, University of Florence, Via di Santa Marta 3, 50139, Firenze, Italy
| | - Alessandro Ridolfi
- Department of Industrial Engineering, University of Florence, Via di Santa Marta 3, 50139, Firenze, Italy
| | - Benedetto Allotta
- Department of Industrial Engineering, University of Florence, Via di Santa Marta 3, 50139, Firenze, Italy
| | - Laura Bragonzoni
- Department for Life Quality Studies, University of Bologna, Corso d'Augusto 237, 47921, Rimini, Italy
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22
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Park JJ, Rochlin DH, Parsaei Y, Shetye PR, Witek L, Leucht P, Rabbani PS, Flores RL. Bone Tissue Engineering Strategies for Alveolar Cleft: Review of Preclinical Results and Guidelines for Future Studies. Cleft Palate Craniofac J 2023; 60:1450-1461. [PMID: 35678607 DOI: 10.1177/10556656221104954] [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: 11/22/2022] Open
Abstract
The current standard of care for an alveolar cleft defect is an autogenous bone graft, typically from the iliac crest. Given the limitations of alveolar bone graft surgery, such as limited supply, donor site morbidity, graft failure, and need for secondary surgery, there has been growing interest in regenerative medicine strategies to supplement and replace traditional alveolar bone grafts. Though there have been preliminary clinical studies investigating bone tissue engineering methods in human subjects, lack of consistent results as well as limitations in study design make it difficult to determine the efficacy of these interventions. As the field of bone tissue engineering is rapidly advancing, reconstructive surgeons should be aware of the preclinical studies informing these regenerative strategies. We review preclinical studies investigating bone tissue engineering strategies in large animal maxillary or mandibular defects and provide an overview of scaffolds, stem cells, and osteogenic agents applicable to tissue engineering of the alveolar cleft. An electronic search conducted in the PubMed database up to December 2021 resulted in 35 studies for inclusion in our review. Most studies showed increased bone growth with a tissue engineering construct compared to negative control. However, heterogeneity in the length of follow up, method of bone growth analysis, and inconsistent use of positive control groups make comparisons across studies difficult. Future studies should incorporate a pediatric study model specific to alveolar cleft with long-term follow up to fully characterize volumetric defect filling, cellular ingrowth, bone strength, tooth movement, and implant support.
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Affiliation(s)
- Jenn J Park
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Danielle H Rochlin
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Yassmin Parsaei
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Pradip R Shetye
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Lukasz Witek
- New York University College of Dentistry, New York, NY, USA
| | - Philipp Leucht
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Piul S Rabbani
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Roberto L Flores
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
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23
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Gu J, Liu X, Cui P, Yi X. Multifunctional bioactive glasses with spontaneous degradation for simultaneous osteosarcoma therapy and bone regeneration. BIOMATERIALS ADVANCES 2023; 154:213626. [PMID: 37722164 DOI: 10.1016/j.bioadv.2023.213626] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 08/31/2023] [Accepted: 09/12/2023] [Indexed: 09/20/2023]
Abstract
For the treatment of tumor-related bone defects resulting from surgical resection, simultaneous eradication of residual tumor cells and repair of bone defects represent a challenge. To date, photothermal therapy based on photothermal materials is used to remove residual tumor cells under near infrared light. However, most of photothermal materials have no function for bone repair, and even if combined with bioactive materials to enhance osteogenesis, they still cause potential harm to the body due to inability to degrade or poor degradability. Herein, multifunctional bioactive glasses (PGFe5-1100, PGCu5-1100) based on phosphate glass doped with transition metal elements were prepared for photothermal ablation, bone regeneration, and controllable degradation. The glasses exhibited excellent photothermal effect, which was derived from the electron in-band transition after light absorption due to energy level splitting of doped transition metal element and the subsequent electron nonradiative relaxation. The photothermal performance can be controlled by laser power density, element doping content and glass melting temperature. Moreover, the hyperthermia induced by the glasses can effectively kill tumor cells in vitro. In addition, the glasses degraded over time, and the released P, Ca, Na, Fe could promote bone cell proliferation and osteogenic differentiation. Therefore, these results successfully demonstrated that transition metal element-doped phosphate glasses have multifunctional abilities of tumor elimination, bone regeneration, and spontaneous degradation simultaneously with better biosecurity and bioactivity, which is believed to pave the way for the design of novel biomaterials for osteosarcoma treatment.
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Affiliation(s)
- Jiafei Gu
- New Materials Institute, University of Nottingham Ningbo China, Ningbo 315100, China
| | - Xiaoling Liu
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo 315100, China.
| | - Ping Cui
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo 315100, China
| | - Xiaosu Yi
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo 315100, China
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24
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de Silva L, Longoni A, Staubli F, Nurmohamed S, Duits A, Rosenberg AJWP, Gawlitta D. Bone Regeneration in a Large Animal Model Featuring a Modular Off-the-Shelf Soft Callus Mimetic. Adv Healthc Mater 2023; 12:e2301717. [PMID: 37580174 DOI: 10.1002/adhm.202301717] [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: 05/30/2023] [Revised: 07/31/2023] [Indexed: 08/16/2023]
Abstract
Implantation of engineered cartilage with soft callus features triggers remodeling to bone tissue via endochondral bone regeneration (EBR). Thus far, EBR has not progressed to the level of large animals on the axis of clinical translation. Herein, the feasibility of EBR is aimed for a critical-sized defect in a large animal model. Chondrogenesis is first induced in goat-derived multipotent mesenchymal stromal cells (MSCs) by fine-tuning the cellular differentiation process. Through a unique devitalization process, two off-the-shelf constructs aimed to recapitulate the different stages of the transient cartilaginous soft callus template in EBR are generated. To evaluate bone regeneration, the materials are implanted in an adapted bilateral iliac crest defect model in goats, featuring a novel titanium star-shaped spacer. After 3 months, the group at the more advanced differentiation stage shows remarkable regenerative capacity, with comparable amounts of bone regeneration as the autograft group. In contrast, while the biomaterial mimicking the earlier stages of chondrogenesis shows improved regeneration compared to the negative controls, this is subpar compared to the more advanced material. Concluding, EBR is attainable in large animals with a soft callus mimetic material that leads to fast conversion into centimeter-scale bone, which prospects successful implementation in the human clinics.
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Affiliation(s)
- Leanne de Silva
- Department of Oral and Maxillofacial Surgery & Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, GA, 3508, The Netherlands
- Regenerative Medicine Center Utrecht, Utrecht, CT, 3584, The Netherlands
| | - Alessia Longoni
- Regenerative Medicine Center Utrecht, Utrecht, CT, 3584, The Netherlands
- Department of Orthopedics, University Medical Center Utrecht, Utrecht University, Utrecht, GA, 3508, The Netherlands
| | - Flurina Staubli
- Department of Oral and Maxillofacial Surgery & Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, GA, 3508, The Netherlands
- Regenerative Medicine Center Utrecht, Utrecht, CT, 3584, The Netherlands
| | - Silke Nurmohamed
- Department of Oral and Maxillofacial Surgery & Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, GA, 3508, The Netherlands
| | - Anneli Duits
- Regenerative Medicine Center Utrecht, Utrecht, CT, 3584, The Netherlands
- Department of Orthopedics, University Medical Center Utrecht, Utrecht University, Utrecht, GA, 3508, The Netherlands
| | - Antoine J W P Rosenberg
- Department of Oral and Maxillofacial Surgery & Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, GA, 3508, The Netherlands
| | - Debby Gawlitta
- Department of Oral and Maxillofacial Surgery & Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, GA, 3508, The Netherlands
- Regenerative Medicine Center Utrecht, Utrecht, CT, 3584, The Netherlands
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25
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Li Z, He D, Guo B, Wang Z, Yu H, Wang Y, Jin S, Yu M, Zhu L, Chen L, Ding C, Wu X, Wu T, Gong S, Mao J, Zhou Y, Luo D, Liu Y. Self-promoted electroactive biomimetic mineralized scaffolds for bacteria-infected bone regeneration. Nat Commun 2023; 14:6963. [PMID: 37907455 PMCID: PMC10618168 DOI: 10.1038/s41467-023-42598-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
Infected bone defects are a major challenge in orthopedic treatment. Native bone tissue possesses an endogenous electroactive interface that induces stem cell differentiation and inhibits bacterial adhesion and activity. However, traditional bone substitutes have difficulty in reconstructing the electrical environment of bone. In this study, we develop a self-promoted electroactive mineralized scaffold (sp-EMS) that generates weak currents via spontaneous electrochemical reactions to activate voltage-gated Ca2+ channels, enhance adenosine triphosphate-induced actin remodeling, and ultimately achieve osteogenic differentiation of mesenchymal stem cells by activating the BMP2/Smad5 pathway. Furthermore, we show that the electroactive interface provided by the sp-EMS inhibits bacterial adhesion and activity via electrochemical products and concomitantly generated reactive oxygen species. We find that the osteogenic and antibacterial dual functions of the sp-EMS depend on its self-promoting electrical stimulation. We demonstrate that in vivo, the sp-EMS achieves complete or nearly complete in situ infected bone healing, from a rat calvarial defect model with single bacterial infection, to a rabbit open alveolar bone defect model and a beagle dog vertical bone defect model with the complex oral bacterial microenvironment. This translational study demonstrates that the electroactive bone graft presents a promising therapeutic platform for complex defect repair.
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Affiliation(s)
- Zixin Li
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 101400, PR China
- Department of Stomatology, Peking University People's Hospital, Beijing, 100044, PR China
| | - Danqing He
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China
| | - Bowen Guo
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 101400, PR China
| | - Zekun Wang
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 101400, PR China
| | - Huajie Yu
- Fourth Clinical Division, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
| | - Yu Wang
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China
| | - Shanshan Jin
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China
| | - Min Yu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China
| | - Lisha Zhu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China
| | - Liyuan Chen
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China
| | - Chengye Ding
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China
| | - Xiaolan Wu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China
| | - Tianhao Wu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China
| | - Shiqiang Gong
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Huazhong University of Science and Technology, Wuhan, 430030, PR China
| | - Jing Mao
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Huazhong University of Science and Technology, Wuhan, 430030, PR China
| | - Yanheng Zhou
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China
| | - Dan Luo
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 101400, PR China.
| | - Yan Liu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & Translational Research Center for Orocraniofacial Stem Cells and Systemic Health, Beijing, 100081, PR China.
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26
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Finze R, Laubach M, Russo Serafini M, Kneser U, Medeiros Savi F. Histological and Immunohistochemical Characterization of Osteoimmunological Processes in Scaffold-Guided Bone Regeneration in an Ovine Large Segmental Defect Model. Biomedicines 2023; 11:2781. [PMID: 37893154 PMCID: PMC10604530 DOI: 10.3390/biomedicines11102781] [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: 08/21/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Large-volume bone defect regeneration is complex and demands time to complete. Several regeneration phases with unique characteristics, including immune responses, follow, overlap, and interdepend on each other and, if successful, lead to the regeneration of the organ bone's form and function. However, during traumatic, infectious, or neoplastic clinical cases, the intrinsic bone regeneration capacity may exceed, and surgical intervention is indicated. Scaffold-guided bone regeneration (SGBR) has recently shown efficacy in preclinical and clinical studies. To investigate different SGBR strategies over periods of up to three years, we have established a well-characterized ovine large segmental tibial bone defect model, for which we have developed and optimized immunohistochemistry (IHC) protocols. We present an overview of the immunohistochemical characterization of different experimental groups, in which all ovine segmental defects were treated with a bone grafting technique combined with an additively manufactured medical-grade polycaprolactone/tricalcium phosphate (mPCL-TCP) scaffold. The qualitative dataset was based on osteoimmunological findings gained from IHC analyses of over 350 sheep surgeries over the past two decades. Our systematic and standardized IHC protocols enabled us to gain further insight into the complex and long-drawn-out bone regeneration processes, which ultimately proved to be a critical element for successful translational research.
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Affiliation(s)
- Ronja Finze
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (R.F.)
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany;
| | - Markus Laubach
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (R.F.)
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, 81377 Munich, Germany
| | - Mairim Russo Serafini
- Department of Pharmacy, Universidade Federal de Sergipe, Sao Cristovao 49100-000, Brazil;
| | - Ulrich Kneser
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany;
| | - Flavia Medeiros Savi
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (R.F.)
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Max Planck Queensland Center for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD 4059, Australia
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27
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Rossi N, Hadad H, Bejar-Chapa M, Peretti GM, Randolph MA, Redmond RW, Guastaldi FPS. Bone Marrow Stem Cells with Tissue-Engineered Scaffolds for Large Bone Segmental Defects: A Systematic Review. TISSUE ENGINEERING. PART B, REVIEWS 2023; 29:457-472. [PMID: 36905366 DOI: 10.1089/ten.teb.2022.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Critical-sized bone defects (CSBDs) represent a significant clinical challenge, stimulating researchers to seek new methods for successful bone reconstruction. The aim of this systematic review is to assess whether bone marrow stem cells (BMSCs) combined with tissue-engineered scaffolds have demonstrated improved bone regeneration in the treatment of CSBD in large preclinical animal models. A search of electronic databases (PubMed, Embase, Web of Science, and Cochrane Library) focused on in vivo large animal studies identified 10 articles according to the following inclusion criteria: (1) in vivo large animal models with segmental bone defects; (2) treatment with tissue-engineered scaffolds combined with BMSCs; (3) the presence of a control group; and (4) a minimum of a histological analysis outcome. Animal research: reporting of in Vivo Experiments guidelines were used for quality assessment, and Systematic Review Center for Laboratory animal Experimentation's risk of bias tool was used to define internal validity. The results demonstrated that tissue-engineered scaffolds, either from autografts or allografts, when combined with BMSCs provide improved bone mineralization and bone formation, including a critical role in the remodeling phase of bone healing. BMSC-seeded scaffolds showed improved biomechanical properties and microarchitecture properties of the regenerated bone when compared with untreated and scaffold-alone groups. This review highlights the efficacy of tissue engineering strategies for the repair of extensive bone defects in preclinical large-animal models. In particular, the use of mesenchymal stem cells, combined with bioscaffolds, seems to be a successful method in comparison to cell-free scaffolds.
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Affiliation(s)
- Nicolò Rossi
- Wellman Center for Photomedicine and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Henrique Hadad
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Maria Bejar-Chapa
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Giuseppe M Peretti
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Mark A Randolph
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert W Redmond
- Wellman Center for Photomedicine and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Fernando P S Guastaldi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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28
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Lv S, Yuan X, Xiao J, Jiang X. Hemostasis-osteogenesis integrated Janus carboxymethyl chitin/hydroxyapatite porous membrane for bone defect repair. Carbohydr Polym 2023; 313:120888. [PMID: 37182974 DOI: 10.1016/j.carbpol.2023.120888] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/21/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023]
Abstract
Barrier membranes with osteogenesis are desirable for promoting bone repair. Janus membrane, which has a bilayered structure with different properties on each side, could meet the osteogenesis/barrier dual functions of guided bone regeneration. In this work, new biodegradable Janus carboxymethyl chitin membrane with asymmetric pore structure was prepared based on thermosensitive carboxymethyl chitin without using any crosslinkers. Nano-hydroxyapatites were cast on single-sided membrane. The obtained carboxymethyl chitin/nano-hydroxyapatite Janus membrane showed dual biofunctions: the dense layer of the Janus membrane could act as a barrier to prevent connective tissue cells from invading the bone defects, while the porous layer (with pore size 100-200 μm) containing nano-hydroxyapatite could guide bone regeneration. After implanted on the rat critical-sized calvarial defect 8 weeks, carboxymethyl chitin/nano-hydroxyapatite membrane showed the most newly formed bone tissue with the highest bone volume/total volume ratio (10.03 ± 1.81 %, analyzed by micro CT), which was significantly better than the commercial collagen membrane GTR® (5.05 ± 0.76 %). Meanwhile, this Janus membrane possessed good hemostatic ability. These results suggest a facile strategy to construct hemostasis-osteogenesis integrated Janus carboxymethyl chitin/hydroxyapatite membrane for guided bone regeneration.
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Affiliation(s)
- Siyao Lv
- Key Laboratory of Biomedical Polymers of Ministry of Education, Department of Chemistry, Wuhan University, Wuhan 430072, PR China; Shandong Laboratory of Yantai Advanced Materials and Green Manufacturing, Yantai 264005, PR China.
| | - Xi Yuan
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China
| | - Jun Xiao
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China.
| | - Xulin Jiang
- Key Laboratory of Biomedical Polymers of Ministry of Education, Department of Chemistry, Wuhan University, Wuhan 430072, PR China.
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29
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García-Lamas L, Sánchez-Salcedo S, Jiménez-Díaz V, Bravo-Giménez B, Cabañas MV, Peña J, Román J, Jiménez-Holguín J, Abella M, Desco M, Lozano D, Cecilia-López D, Salinas AJ. Desing and comparison of bone substitutes. Study of in vivo behavior in a rabbit model. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:324-333. [PMID: 36646252 DOI: 10.1016/j.recot.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 01/15/2023] Open
Abstract
AIM Compare bone formation capacity in vivo of two types of biomaterials designed as bone substitutes with respect to iliac crest autograft, one based on carbonate hydroxyapatites and the other one on bioactive mesoporous glass. MATERIALS AND METHODS Experimental study consisting on 14 adult female New Zeland rabbits where a critical defect was made in the rabbit radius bone. The sample was divided into four groups: defect without material, with iliac crest autograft, with carbonatehydroxyapatite support, and with bioactive mesoporous glass support. Serial X-ray studies were carried out at 2, 4, 6 and 12 weeks and a microCT study at euthanasia at 6 and 12 weeks. RESULTS In the X-ray study, autograft group showed the highest bone formation scores. Both groups of biomaterials presented bone formation similar and greater than the defect without material, but always less than in the autograft group. The results of the microCT study showed the largest bone volume in the study area in the autograft group. The groups with bone substitutes presented greater bone volume than the group without material but always less than in the autograft group. CONCLUSION Both supports seem to promote bone formation but are not capable of reproducing the characteristics of autograft. Due to their different macroscopic characteristics, each one could be suitable for a different type of defect.
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Affiliation(s)
- L García-Lamas
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre; Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España.
| | - S Sánchez-Salcedo
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España; CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, España
| | - V Jiménez-Díaz
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre; Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España
| | - B Bravo-Giménez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre; Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España
| | - M V Cabañas
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España
| | - J Peña
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España
| | - J Román
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España
| | - J Jiménez-Holguín
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España
| | - M Abella
- Instituto de Investigación Sanitaria Gregorio Marañón, Departamento de Bioingeniería, Universidad Carlos III de Madrid, Madrid, España
| | - M Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Departamento de Bioingeniería, Universidad Carlos III de Madrid, Madrid, España
| | - D Lozano
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España; CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, España
| | - D Cecilia-López
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre; Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España
| | - A J Salinas
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, España; CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, España
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30
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García-Lamas L, Sánchez-Salcedo S, Jiménez-Díaz V, Bravo-Giménez B, Cabañas MV, Peña J, Román J, Jiménez-Holguín J, Abella M, Desco M, Lozano D, Cecilia-López D, Salinas AJ. [Translated article] Design and comparison of bone substitutes. Study of in vivo behaviour in a rabbit model. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:T324-T333. [PMID: 36940846 DOI: 10.1016/j.recot.2023.03.011] [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: 11/28/2022] [Accepted: 12/03/2022] [Indexed: 03/23/2023] Open
Abstract
AIM To compare the in vivo bone formation capacity of of biomaterials designed as bone substitutes with respect to iliac crest autograft, one based on carbonate hydroxiapatite and the other one on bioactive mesoporous glass. MATERIALS AND METHODS Experimental study consisting on 14 adult female New Zeland rabbits where a critical defect was made in the rabbit radius bone. The sample was divided into four groups: defect without material, with iliac crest autograft, with carbonatehydroxyapatite scaffold, and with bioactive mesoporous glass scaffold. Serial X-ray studies were carried out at 2, 4, 6 and 12 weeks and a microCT study at euthanasia at 6 and 12 weeks. RESULTS In the X-ray study, autograft group showed the highest bone formation scores. Both groups of biomaterials presented bone formation similar and greater than the defect without material, but always less than in the autograft group. The results of the microCT study showed the largest bone volume in the study area in the autograft group. The groups with bone substitutes presented greater bone volume than the group without material but always less than the autograft group. CONCLUSION Both scaffolds seem to promote bone formation but are not capable of reproducing the characteristics of autograft. Due to their different macroscopic characteristics, each one could be suitable for a different type of defect.
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Affiliation(s)
- L García-Lamas
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain.
| | - S Sánchez-Salcedo
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - V Jiménez-Díaz
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain
| | - B Bravo-Giménez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain
| | - M V Cabañas
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain
| | - J Peña
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain
| | - J Román
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain
| | - J Jiménez-Holguín
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain
| | - M Abella
- Instituto de Investigación Sanitaria Gregorio Marañón, Departamento de Bioingeniería, Universidad Carlos III de Madrid, Madrid, Spain
| | - M Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Departamento de Bioingeniería, Universidad Carlos III de Madrid, Madrid, Spain
| | - D Lozano
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - D Cecilia-López
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain
| | - A J Salinas
- Departamento de Química en Ciencias Farmaceúticas, Universidad Complutense de Madrid (UCM), Instituto de Investigación Hospital 12 de Octubre, imas12, Madrid, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
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31
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Laubach M, Hildebrand F, Suresh S, Wagels M, Kobbe P, Gilbert F, Kneser U, Holzapfel BM, Hutmacher DW. The Concept of Scaffold-Guided Bone Regeneration for the Treatment of Long Bone Defects: Current Clinical Application and Future Perspective. J Funct Biomater 2023; 14:341. [PMID: 37504836 PMCID: PMC10381286 DOI: 10.3390/jfb14070341] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
The treatment of bone defects remains a challenging clinical problem with high reintervention rates, morbidity, and resulting significant healthcare costs. Surgical techniques are constantly evolving, but outcomes can be influenced by several parameters, including the patient's age, comorbidities, systemic disorders, the anatomical location of the defect, and the surgeon's preference and experience. The most used therapeutic modalities for the regeneration of long bone defects include distraction osteogenesis (bone transport), free vascularized fibular grafts, the Masquelet technique, allograft, and (arthroplasty with) mega-prostheses. Over the past 25 years, three-dimensional (3D) printing, a breakthrough layer-by-layer manufacturing technology that produces final parts directly from 3D model data, has taken off and transformed the treatment of bone defects by enabling personalized therapies with highly porous 3D-printed implants tailored to the patient. Therefore, to reduce the morbidities and complications associated with current treatment regimens, efforts have been made in translational research toward 3D-printed scaffolds to facilitate bone regeneration. Three-dimensional printed scaffolds should not only provide osteoconductive surfaces for cell attachment and subsequent bone formation but also provide physical support and containment of bone graft material during the regeneration process, enhancing bone ingrowth, while simultaneously, orthopaedic implants supply mechanical strength with rigid, stable external and/or internal fixation. In this perspective review, we focus on elaborating on the history of bone defect treatment methods and assessing current treatment approaches as well as recent developments, including existing evidence on the advantages and disadvantages of 3D-printed scaffolds for bone defect regeneration. Furthermore, it is evident that the regulatory framework and organization and financing of evidence-based clinical trials remains very complex, and new challenges for non-biodegradable and biodegradable 3D-printed scaffolds for bone regeneration are emerging that have not yet been sufficiently addressed, such as guideline development for specific surgical indications, clinically feasible design concepts for needed multicentre international preclinical and clinical trials, the current medico-legal status, and reimbursement. These challenges underscore the need for intensive exchange and open and honest debate among leaders in the field. This goal can be addressed in a well-planned and focused stakeholder workshop on the topic of patient-specific 3D-printed scaffolds for long bone defect regeneration, as proposed in this perspective review.
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Affiliation(s)
- Markus Laubach
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Sinduja Suresh
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Michael Wagels
- Department of Plastic Surgery, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia;
- The Herston Biofabrication Institute, The University of Queensland, Herston, QLD 4006, Australia
- Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, QLD 4102, Australia
- Department of Plastic and Reconstructive Surgery, Queensland Children’s Hospital, South Brisbane, QLD 4101, Australia
- The Australian Centre for Complex Integrated Surgical Solutions, Woolloongabba, QLD 4102, Australia
| | - Philipp Kobbe
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Fabian Gilbert
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Boris M. Holzapfel
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Dietmar W. Hutmacher
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD 4000, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies (CTET), Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
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Jin L, Shan J, Hao Y, Wang Y, Liu L. Enhanced bone regeneration by low-intensity pulsed ultrasound and lipid microbubbles on PLGA/TCP 3D-printed scaffolds. BMC Biotechnol 2023; 23:13. [PMID: 37280578 DOI: 10.1186/s12896-023-00783-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 05/23/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND To investigate the effect of low-intensity pulsed ultrasound (LIPUS) combined with lipid microbubbles on the proliferation and bone regeneration of bone marrow mesenchymal stem cells (BMSCs) in poly (lactic-glycolic acid copolymer) (PLGA)/α-tricalcium phosphate (TCP) 3D-printed scaffolds. METHODS BMSCs were irradiated with different LIPUS parameters and microbubble concentrations, and the best acoustic excitation parameters were selected. The expression of type I collagen and the activity of alkaline phosphatase were detected. Alizarin red staining was used to evaluate the calcium salt production during osteogenic differentiation. RESULTS BMSCs proliferation was the most significant under the condition of 0.5% (v/v) lipid microbubble concentration, 2.0 MHz frequency, 0.3 W/cm2 sound intensity and 20% duty cycle. After 14 days, the type I collagen expression and alkaline phosphatase activity in the scaffold increased significantly compared to those in the control group, and alizarin red staining showed more calcium salt production during osteogenic differentiation. After 21 days, scanning electron microscopy experiments showed that osteogenesis was obvious in the PLGA/TCP scaffolds. CONCLUSION LIPUS combined with lipid microbubbles on PLGA/TCP scaffolds can promote BMSCs growth and bone differentiation, which is expected to provide a new and effective method for the treatment of bone regeneration in tissue engineering.
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Affiliation(s)
- Lin Jin
- Department of Ultrasound, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, China
- Department of Ultrasound, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200052, China
| | - Jiali Shan
- Department of Ultrasound, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, China
| | - Yanhong Hao
- Department of Ultrasound, First Hospital of Shanxi Medical University, No. 85, Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Yingchun Wang
- Department of Ultrasound, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, China
| | - Liping Liu
- Department of Ultrasound, First Hospital of Shanxi Medical University, No. 85, Jiefang South Road, Taiyuan, 030001, Shanxi, China.
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Bowers KM, Wright EM, Terrones LD, Sun X, Rifkin R, Grzeskowiak R, Croy E, Seddighi R, Kleine S, Hampton C, Hecht S, Adair HS, Anderson DE, Mulon PY. In vitro analysis and in vivo assessment of fracture complications associated with use of locking plate constructs for stabilization of caprine tibial segmental defects. J Exp Orthop 2023; 10:38. [PMID: 37010659 PMCID: PMC10070588 DOI: 10.1186/s40634-023-00598-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/15/2023] [Indexed: 04/04/2023] Open
Abstract
PURPOSE Locking plate fixation of caprine tibial segmental defects is widely utilized for translational modeling of human osteopathology, and it is a useful research model in tissue engineering and orthopedic biomaterials research due to its inherent stability while maintaining unobstructed visualization of the gap defect and associated healing. However, research regarding surgical technique and long-term complications associated with this fixation method are lacking. The goal of this study was to assess the effects of surgeon-selected factors including locking plate length, plate positioning, and relative extent of tibial coverage on fixation failure, in the form of postoperative fracture. METHODS In vitro, the effect of plate length was evaluated using single cycle compressive load to failure mechanical testing of locking plate fixations of caprine tibial gap defects. In vivo, effects of plate length, positioning, and relative tibial coverage were evaluated using data from a population of goats enrolled in ongoing orthopedic research which utilized locking plate fixation of 2 cm tibial diaphyseal segmental defects to evaluate bone healing over 3, 6, 9, and 12 months. RESULTS In vitro, no significant differences in maximum compressive load or total strain were noted between fixations using 14 cm locking plates and 18 cm locking plates. In vivo, both plate length and tibial coverage ratio were significantly associated with postoperative fixation failure. The incidence of any cortical fracture in goats stabilized with a 14 cm plate was 57%, as compared with 3% in goats stabilized with an 18 cm plate. Craniocaudal and mediolateral angular positioning variables were not significantly associated with fixation failure. Decreasing distance between the gap defect and the proximal screw of the distal bone segment was associated with increased incidence of fracture, suggesting an effect on proximodistal positioning on overall fixation stability. CONCLUSIONS This study emphasizes the differences between in vitro modeling and in vivo application of surgical fixation methods, and, based on the in vivo results, maximization of plate-to-tibia coverage is recommended when using locking plate fixation of the goat tibial segmental defect as a model in orthopedic research.
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Affiliation(s)
- Kristin M Bowers
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA.
| | - Ellis M Wright
- Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - Lori D Terrones
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - Xiaocun Sun
- Office of Information Technology, University of Tennessee, Knoxville, USA
| | - Rebecca Rifkin
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - Remi Grzeskowiak
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - Elizabeth Croy
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - Reza Seddighi
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - Stephanie Kleine
- Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - Chiara Hampton
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - Silke Hecht
- Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - Henry S Adair
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - David E Anderson
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
| | - Pierre-Yves Mulon
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, USA
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Kaya O, Mirioglu A, Ozkan C, Bicer OS, Deveci MA, Tekin M, Ates KE. Reconstruction of critical size segmental femoral diaphyseal defects of New Zealand rabbits by using combined titanium mesh cage and induced membrane technique. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023; 33:629-637. [PMID: 35852612 DOI: 10.1007/s00590-022-03330-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/27/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Long bone defects due to fractures resulting from high-energy trauma, infections and tumor resections are problems that orthopedic surgeons commonly face. We investigated the effects of a titanium mesh cage on bone healing with an induced membrane technique. METHODS Three groups, each composed of eight rabbits, were formed. Extraarticular diaphyseal bone defects were created. Femora of the first group were fixed with an empty titanium mesh cage and two K-wires. After formation of the defect, polymethylmethacrylate was inserted and fixed with a K-wire in the second group. At the third week, the cement was removed, a sterilized cancellous graft-filled titanium mesh cage was placed into the defect, and the membrane that was previously formed over the cement was placed on the cage and repaired. In the third group, sterilized cancellous grafts were filled into the titanium mesh cage, and the titanium mesh cage was fitted into the bone defect area. RESULTS At the end of the third month, all subjects were killed. Radiological data revealed that the healing of the bone in the second and third groups was significantly better than that in the first group. There was no difference between the second and third groups. A histological evaluation of the healing status, such as fibrous tissue, cartilage tissue and mature or immature bone formation, was performed. Histological healing in the second and third groups was also significantly better than that in the first group. CONCLUSION We concluded that the combination of membrane-induced bone healing and graft-filled titanium mesh cages expedites osteogenesis in extraarticular bone defects.
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Affiliation(s)
- Onur Kaya
- Department of Orthopaedic and Traumatology, Abdulkadir Yüksel State Hospital, 27100, Gaziantep, Turkey.
| | - Akif Mirioglu
- Department of Orthopaedic and Traumatology, Medicine Faculty, Cukurova University, Çukurova University Balcalı Kampüs, 01330, Sarıçam, Adana, Turkey
| | - Cenk Ozkan
- Department of Orthopaedic and Traumatology, Medicine Faculty, Cukurova University, Çukurova University Balcalı Kampüs, 01330, Sarıçam, Adana, Turkey
| | - Omer Sunkar Bicer
- Department of Orthopaedic and Traumatology, Medicine Faculty, Cukurova University, Çukurova University Balcalı Kampüs, 01330, Sarıçam, Adana, Turkey
| | - Mehmet Ali Deveci
- Department of Orthopaedic and Traumatology, Koc University Medicine Faculty, Topkapı, Koç Üniversitesi Hastanesi, Davutpaşa Cd. No:4, 34010, Zeytinburnu, Istanbul, Turkey
| | - Mustafa Tekin
- Department of Orthopaedic and Traumatology, Medicine Faculty, Cukurova University, Çukurova University Balcalı Kampüs, 01330, Sarıçam, Adana, Turkey
| | - Kivilcim Eren Ates
- Department of Pathology, Medicine Faculty, Cukurova University, Çukurova University Balcalı Kampüs, 01330, Sarıçam, Adana, Turkey
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Regenerative Potential of Hydroxyapatite-Based Ceramic Biomaterial on Mandibular Cortical Bone: An In Vivo Study. Biomedicines 2023; 11:biomedicines11030877. [PMID: 36979856 PMCID: PMC10045626 DOI: 10.3390/biomedicines11030877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/19/2023] [Accepted: 03/08/2023] [Indexed: 03/15/2023] Open
Abstract
Reconstruction of bone defects and maintaining the continuity of the mandible is still a challenge in the maxillofacial surgery. Nowadays, the biomedical research within bone defect treatment is focussed on the therapy of using innovative biomaterials with specific characteristics consisting of the body’s own substances. Hydroxyapatite ceramic scaffolds have fully acceptable phase compositions, microstructures and compressive strengths for their use in regenerative medicine. The innovative hydroxyapatite ceramics used by us were prepared using the tape-casting method, which allows variation in the shape of samples after packing hydroxyapatite paste to 3D-printed plastic form. The purpose of our qualitative study was to evaluate the regenerative potential of the innovative ceramic biomaterial prepared using this method in the therapy of the cortical bone of the lower jaw in four mature pigs. The mandible bone defects were evaluated after different periods of time (after 3, 4, 5 and 6 months) and compared with the control sample (healthy cortical bone from the opposite side of the mandible). The results of the morphological, clinical and radiological investigation and hardness examination confirmed the positive regenerative potential of ceramic implants after treatment of the mandible bone defects in the porcine mandible model.
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Vancomycin-Loaded, Nanohydroxyapatite-Based Scaffold for Osteomyelitis Treatment: In Vivo Rabbit Toxicological Tests and In Vivo Efficacy Tests in a Sheep Model. Bioengineering (Basel) 2023; 10:bioengineering10020206. [PMID: 36829700 PMCID: PMC9952702 DOI: 10.3390/bioengineering10020206] [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: 12/27/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
The treatment for osteomyelitis consists of surgical debridement, filling of the dead space, soft tissue coverage, and intravenous administration of antimicrobial (AM) agents for long periods. Biomaterials for local delivery of AM agents, while providing controllable antibiotic release rates and simultaneously acting as a bone scaffold, may be a valuable alternative; thus, avoiding systemic AM side effects. V-HEPHAPC is a heparinized nanohydroxyapatite (nHA)/collagen biocomposite loaded with vancomycin that has been previously studied and tested in vitro. It enables a vancomycin-releasing profile with an intense initial burst, followed by a sustained release with concentrations above the Minimum Inhibitory Concentration (MIC) for MRSA. In vitro results have also shown that cellular viability is not compromised, suggesting that V-HEPHAPC granules may be a promising alternative device for the treatment of osteomyelitis. In the present study, V-HEPHAPC (HEPHAPC with vancomycin) granules were used as a vancomycin carrier to treat MRSA osteomyelitis. First, in vivo Good Laboratory Practice (GLP) toxicological tests were performed in a rabbit model, assuring that HEPHAPC and V-HEPHAPC have no relevant side effects. Second, V-HEPHAPC proved to be an efficient drug carrier and bone substitute to control MRSA infection and simultaneously reconstruct the bone cavity in a sheep model.
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Bow AJ, Rifkin RE, Priester C, Christopher CJ, Grzeskowiak RM, Hecht S, Adair SH, Mulon PY, Castro HF, Campagna SR, Anderson DE. Temporal metabolic profiling of bone healing in a caprine tibia segmental defect model. Front Vet Sci 2023; 9:1023650. [PMID: 36733424 PMCID: PMC9886884 DOI: 10.3389/fvets.2022.1023650] [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: 08/20/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023] Open
Abstract
Bone tissue engineering is an emerging field of regenerative medicine, with a wide array of biomaterial technologies and therapeutics employed. However, it is difficult to objectively compare these various treatments during various stages of tissue response. Metabolomics is rapidly emerging as a powerful analytical tool to establish broad-spectrum metabolic signatures for a target biological system. Developing an effective biomarker panel for bone repair from small molecule data would provide an objective metric to readily assess the efficacy of novel therapeutics in relation to natural healing mechanisms. In this study we utilized a large segmental bone defect in goats to reflect trauma resulting in substantial volumetric bone loss. Characterization of the native repair capacity was then conducted over a period of 12 months through the combination of standard (radiography, computed tomography, histology, biomechanics) data and ultra-high-performance liquid chromatography-high resolution mass spectrometry (UHPLC-HRMS) metabolic profiling. Standard metrics demonstrated that samples formed soft callus structures that later mineralized. Small molecule profiles showed distinct temporal patterns associated with the bone tissue repair process. Specifically, increased lactate and amino acid levels at early time points indicated an environment conducive to osteoblast differentiation and extracellular matrix formation. Citrate and pyruvate abundances increased at later time points indicating increasing mineral content within the defect region. Taurine, shikimate, and pantothenate distribution profiles appeared to represent a shift toward a more homeostatic remodeling environment with the differentiation and activity of osteoclasts offsetting the earlier deposition phases of bone repair. The generation of a comprehensive metabolic reference portfolio offers a potent mechanism for examining novel biomaterials and can serve as guide for the development of new targeted therapeutics to improve the rate, magnitude, and quality of bone regeneration.
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Affiliation(s)
- Austin J. Bow
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States,*Correspondence: Austin J. Bow ✉
| | - Rebecca E. Rifkin
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Caitlin Priester
- Department of Animal Science, University of Tennessee, Knoxville, Knoxville, TN, United States
| | | | - Remigiusz M. Grzeskowiak
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Steve H. Adair
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Pierre-Yves Mulon
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Hector F. Castro
- Department of Chemistry, University of Tennessee, Knoxville, Knoxville, TN, United States,Biological and Small Molecule Mass Spectrometry Core and the Department of Chemistry, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Shawn R. Campagna
- Department of Chemistry, University of Tennessee, Knoxville, Knoxville, TN, United States,Biological and Small Molecule Mass Spectrometry Core and the Department of Chemistry, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - David E. Anderson
- University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States,David E. Anderson ✉
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Chae S, Cho DW. Biomaterial-based 3D bioprinting strategy for orthopedic tissue engineering. Acta Biomater 2023; 156:4-20. [PMID: 35963520 DOI: 10.1016/j.actbio.2022.08.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/05/2022] [Accepted: 08/02/2022] [Indexed: 02/02/2023]
Abstract
The advent of three-dimensional (3D) bioprinting has enabled impressive progress in the development of 3D cellular constructs to mimic the structural and functional characteristics of natural tissues. Bioprinting has considerable translational potential in tissue engineering and regenerative medicine. This review highlights the rational design and biofabrication strategies of diverse 3D bioprinted tissue constructs for orthopedic tissue engineering applications. First, we elucidate the fundamentals of 3D bioprinting techniques and biomaterial inks and discuss the basic design principles of bioprinted tissue constructs. Next, we describe the rationale and key considerations in 3D bioprinting of tissues in many different aspects. Thereafter, we outline the recent advances in 3D bioprinting technology for orthopedic tissue engineering applications, along with detailed strategies of the engineering methods and materials used, and discuss the possibilities and limitations of different 3D bioprinted tissue products. Finally, we summarize the current challenges and future directions of 3D bioprinting technology in orthopedic tissue engineering and regenerative medicine. This review not only delineates the representative 3D bioprinting strategies and their tissue engineering applications, but also provides new insights for the clinical translation of 3D bioprinted tissues to aid in prompting the future development of orthopedic implants. STATEMENT OF SIGNIFICANCE: 3D bioprinting has driven major innovations in the field of tissue engineering and regenerative medicine; aiming to develop a functional viable tissue construct that provides an alternative regenerative therapy for musculoskeletal tissue regeneration. 3D bioprinting-based biofabrication strategies could open new clinical possibilities for creating equivalent tissue substitutes with the ability to customize them to meet patient demands. In this review, we summarize the significance and recent advances in 3D bioprinting technology and advanced bioinks. We highlight the rationale for biofabrication strategies using 3D bioprinting for orthopedic tissue engineering applications. Furthermore, we offer ample perspective and new insights into the current challenges and future direction of orthopedic bioprinting translation research.
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Affiliation(s)
- Suhun Chae
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-ro, Nam-gu, Gyeongsangbuk-do, Pohang 37673, South Korea; EDmicBio Inc., 111 Hoegi-ro, Dongdaemun-gu, Seoul 02445, South Korea
| | - Dong-Woo Cho
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-ro, Nam-gu, Gyeongsangbuk-do, Pohang 37673, South Korea; Institute for Convergence Research and Education in Advanced Technology, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
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Baumgartner D, Schramel JP, Kau S, Unger E, Oberoi G, Peham C, Eberspächer-Schweda M. 3D printed plates based on generative design biomechanically outperform manual digital fitting and conventional systems printed in photopolymers in bridging mandibular bone defects of critical size in dogs. Front Vet Sci 2023; 10:1165689. [PMID: 37065217 PMCID: PMC10098091 DOI: 10.3389/fvets.2023.1165689] [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: 02/14/2023] [Accepted: 03/16/2023] [Indexed: 04/18/2023] Open
Abstract
Conventional plate osteosynthesis of critical-sized bone defects in canine mandibles can fail to restore former functionality and stability due to adaption limits. Three-dimensional (3D) printed patient-specific implants are becoming increasingly popular as these can be customized to avoid critical structures, achieve perfect alignment to individual bone contours, and may provide better stability. Using a 3D surface model for the mandible, four plate designs were created and evaluated for their properties to stabilize a defined 30 mm critical-size bone defect. Design-1 was manually designed, and further shape optimized using Autodesk ® Fusion 360 (ADF360) and finite element analysis (FE) to generate Design-2. Design-4 was created with the generative design (GD) function from ADF360 using preplaced screw terminals and loading conditions as boundaries. A 12-hole reconstruction titanium locking plate (LP) (2.4/3.0 mm) was also tested, which was scanned, converted to a STL file and 3D printed (Design-3). Each design was 3D printed from a photopolymer resin (VPW) and a photopolymer resin in combination with a thermoplastic elastomer (VPWT) and loaded in cantilever bending using a customized servo-hydraulic mechanical testing system; n = 5 repetitions each. No material defects pre- or post-failure testing were found in the printed mandibles and screws. Plate fractures were most often observed in similar locations, depending on the design. Design-4 has 2.8-3.6 times ultimate strength compared to other plates, even though only 40% more volume was used. Maximum load capacities did not differ significantly from those of the other three designs. All plate types, except D3, were 35% stronger when made of VPW, compared to VPWT. VPWT D3 plates were only 6% stronger. Generative design is faster and easier to handle than optimizing manually designed plates using FE to create customized implants with maximum load-bearing capacity and minimum material requirements. Although guidelines for selecting appropriate outcomes and subsequent refinements to the optimized design are still needed, this may represent a straightforward approach to implementing additive manufacturing in individualized surgical care. The aim of this work is to analyze different design techniques, which can later be used for the development of implants made of biocompatible materials.
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Affiliation(s)
- Doris Baumgartner
- Movement Science Group, University Equine Hospital, Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
- Small Animals Surgery Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
- *Correspondence: Doris Baumgartner
| | - Johannes Peter Schramel
- Movement Science Group, University Equine Hospital, Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Silvio Kau
- Department of Pathobiology, Institute of Morphology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Gunpreet Oberoi
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Christian Peham
- Movement Science Group, University Equine Hospital, Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Matthias Eberspächer-Schweda
- Small Animals Surgery Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
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Zhu L, Kong W, Ma J, Zhang R, Qin C, Liu H, Pan S. Applications of carbon dots and its modified carbon dots in bone defect repair. J Biol Eng 2022; 16:32. [PMID: 36419160 PMCID: PMC9682789 DOI: 10.1186/s13036-022-00311-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
Bone defect repair is a continual and complicated process driven by a variety of variables. Because of its bright multicolor luminescence, superior biocompatibility, water dispersibility, and simplicity of synthesis from diverse carbon sources, carbon dots (CDs) have received a lot of interest. It has a broad variety of potential biological uses, including bone defect repair, spinal cord injury, and wound healing. Materials including CDs as the matrix or major component have shown considerable benefits in enabling bone defect healing in recent years. By altering the carbon dots or mixing them with other wound healing-promoting agents or materials, the repair effect may be boosted even further. The report also shows and discusses the use of CDs to heal bone abnormalities. The study first presents the fundamental features of CDs in bone defect healing, then provides CDs manufacturing techniques that should be employed in bone defect repair, and lastly examines their development in the area of bioengineering, particularly in bone defect repair. In this work, we look at how carbon dots and their alteration products may help with bone defect healing by being antibacterial, anti-infective, osteogenic differentiation-promoting, and gene-regulating.
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Affiliation(s)
- Longchuan Zhu
- grid.452829.00000000417660726Department of Orthopedic Surgery, Second Hospital Jilin University, Ziqiang St 218, 130041 Changchun, People’s Republic of China
| | - Weijian Kong
- grid.452829.00000000417660726Department of Orthopedic Surgery, Second Hospital Jilin University, Ziqiang St 218, 130041 Changchun, People’s Republic of China
| | - Jijun Ma
- Department of Orthopedic Surgery, Baicheng Hospital Traditional Chinese Medicine, Jilin, People’s Republic of China
| | - Renfeng Zhang
- grid.452829.00000000417660726Department of Orthopedic Surgery, Second Hospital Jilin University, Ziqiang St 218, 130041 Changchun, People’s Republic of China
| | - Cheng Qin
- grid.452829.00000000417660726Department of Orthopedic Surgery, Second Hospital Jilin University, Ziqiang St 218, 130041 Changchun, People’s Republic of China
| | - Hao Liu
- grid.452829.00000000417660726Department of Orthopedic Surgery, Second Hospital Jilin University, Ziqiang St 218, 130041 Changchun, People’s Republic of China
| | - Su Pan
- grid.452829.00000000417660726Department of Orthopedic Surgery, Second Hospital Jilin University, Ziqiang St 218, 130041 Changchun, People’s Republic of China
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Gareb B, van Bakelen NB, Driessen L, Buma P, Kuipers J, Grijpma DW, Vissink A, Bos RR, van Minnen B. Biocompatibility and degradation comparisons of four biodegradable copolymeric osteosynthesis systems used in maxillofacial surgery: A goat model with four years follow-up. Bioact Mater 2022; 17:439-456. [PMID: 35386449 PMCID: PMC8961280 DOI: 10.1016/j.bioactmat.2022.01.015] [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: 09/08/2021] [Revised: 12/10/2021] [Accepted: 01/08/2022] [Indexed: 01/15/2023] Open
Abstract
Applying biodegradable osteosyntheses avoids the disadvantages of titanium osteosyntheses. However, foreign-body reactions remain a major concern and evidence of complete resorption is lacking. This study compared the physico-chemical properties, histological response and radiographs of four copolymeric biodegradable osteosynthesis systems in a goat model with 48-months follow-up. The systems were implanted subperiosteally in both tibia and radius of 12 Dutch White goats. The BioSorb FX [poly(70LLA-co-30DLLA)], Inion CPS [poly([70–78.5]LLA-co-[16–24]DLLA-co-4TMC)], SonicWeld Rx [poly(DLLA)], LactoSorb [poly(82LLA-co-18GA)] systems and a negative control were randomly implanted in each extremity. Samples were assessed at 6-, 12-, 18-, 24-, 36-, and 48-month follow-up. Surface topography was performed using scanning electron microscopy (SEM). Differential scanning calorimetry and gel permeation chromatography were performed on initial and explanted samples. Histological sections were systematically assessed by two blinded researchers using (polarized) light microscopy, SEM and energy-dispersive X-ray analysis. The SonicWeld Rx system was amorphous while the others were semi-crystalline. Foreign-body reactions were not observed during the complete follow-up. The SonicWeld Rx and LactoSorb systems reached bone percentages of negative controls after 18 months while the BioSorb Fx and Inion CPS systems reached these levels after 36 months. The SonicWeld Rx system showed the most predictable degradation profile. All the biodegradable systems were safe to use and well-tolerated (i.e., complete implant replacement by bone, no clinical or histological foreign body reactions, no [sterile] abscess formation, no re-interventions needed), but nanoscale residual polymeric fragments were observed at every system's assessment. Foreign-body reactions are a major concern of biodegradable osteosyntheses. Amorphous poly(DLLA) showed the most predictable degradation profile. Nanoscale residual polymeric fragments could still be observed after 4 years.
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Black C, Gibbs D, McEwan J, Kanczler J, Fernández MP, Tozzi G, Dawson J, Oreffo R. Comparison of bone formation mediated by bone morphogenetic protein delivered by nanoclay gels with clinical techniques (autograft and InductOs ®) in an ovine bone model. J Tissue Eng 2022; 13:20417314221113746. [PMID: 36147728 PMCID: PMC9486279 DOI: 10.1177/20417314221113746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/29/2022] [Indexed: 01/12/2023] Open
Abstract
Development of a growth factor delivery vehicle providing appropriate temporal-spatial release together with an appropriate preclinical large animal model to evaluate bone formation is critical in the development of delivery strategies for bone tissue regeneration. Smectite nanoclays such as LAPONITE™ possess unique thixotropic and protein retention properties offering promise for use in growth factor delivery in bone repair and regeneration. This study has examined bone formation mediated by a clinically approved growth factor delivery system (InductOs®) in combination with Laponite gel in an aged female ovine femoral condyle defect preclinical model (10 weeks). Two different designs, one containing a low volume of Laponite gel (LLG) in combination with the InductOs® absorbable collagen sponge (ACS), the other in which Laponite gel formed the implant (HLG), were compared against InductOs® alone and an autograft positive control. Thus, five groups: (i) empty defect, (ii) autograft, (iii) BMP2 + ACS, (iv) BMP2 + ACS + LLG and (v) BMP2 + HLG + ACS were examined in 9 mm × 12 mm defects performed bilaterally in the medial femoral condyles of 24 aged (>5 years) sheep. Bone formation within the defect was assessed using micro-computed tomography (micro-CT), digital volume correlation (DVC) for biomechanical characterisation as well as histology. The autograft and InductOs® mediated enhanced bone formation (p < 0001) compared to blank controls, while no significant differences were observed between the Laponite/Collagen/BMP delivery vehicles. However, the current study illustrated the excellent biocompatibility of Laponite and its ability to deliver localised active BMP-2, with the opportunity for improved efficacy with further optimisation. Interestingly, DVC-computed strain distributions indicated that the regenerated bone structure is mechanically adapted to bear external loads from the early remodelling stages of the bone reparation cascade. The current studies of selected nanoclay delivery platforms for BMP, assessed in a clinically relevant large animal model auger well for the development of bone fracture therapeutics for an ageing population.
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Affiliation(s)
- Cameron Black
- Bone & Joint Research Group, Centre
for Human Development, Stem Cells and Regeneration, Human Development & Health,
Institute of Developmental Sciences, University of Southampton, Southampton,
UK
| | - David Gibbs
- Bone & Joint Research Group, Centre
for Human Development, Stem Cells and Regeneration, Human Development & Health,
Institute of Developmental Sciences, University of Southampton, Southampton,
UK
| | - Josephine McEwan
- Bone & Joint Research Group, Centre
for Human Development, Stem Cells and Regeneration, Human Development & Health,
Institute of Developmental Sciences, University of Southampton, Southampton,
UK
| | - Janos Kanczler
- Bone & Joint Research Group, Centre
for Human Development, Stem Cells and Regeneration, Human Development & Health,
Institute of Developmental Sciences, University of Southampton, Southampton,
UK
| | - Marta Peña Fernández
- Institute of Mechanical, Process and
Engineering, School of Engineering and Physical Sciences, Heriot Watt University,
Edinburgh, UK
| | - Gianluca Tozzi
- Zeiss Global Centre, School of
Mechanical and Design Engineering, University of Portsmouth, Portsmouth, UK
| | - Jonathan Dawson
- Bone & Joint Research Group, Centre
for Human Development, Stem Cells and Regeneration, Human Development & Health,
Institute of Developmental Sciences, University of Southampton, Southampton,
UK
| | - Richard Oreffo
- Bone & Joint Research Group, Centre
for Human Development, Stem Cells and Regeneration, Human Development & Health,
Institute of Developmental Sciences, University of Southampton, Southampton,
UK,College of Biomedical Engineering,
China Medical University, Taichung, Taiwan,Richard Oreffo, Bone & Joint Research
Group, Centre for Human Development, Stem Cells and Regeneration, Human
Development & Health, Institute of Developmental Sciences, University of
Southampton, Southampton General Hospital, Southampton SO16 6YD, UK.
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Gharacheh H, Guvendiren M. Cell-Laden Composite Hydrogel Bioinks with Human Bone Allograft Particles to Enhance Stem Cell Osteogenesis. Polymers (Basel) 2022; 14:polym14183788. [PMID: 36145933 PMCID: PMC9503810 DOI: 10.3390/polym14183788] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/01/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
There is a growing demand for bone graft substitutes that mimic the extracellular matrix properties of the native bone tissue to enhance stem cell osteogenesis. Composite hydrogels containing human bone allograft particles are particularly interesting due to inherent bioactivity of the allograft tissue. Here, we report a novel photocurable composite hydrogel bioink for bone tissue engineering. Our composite bioink is formulated by incorporating human allograft bone particles in a methacrylated alginate formulation to enhance adult human mesenchymal stem cell (hMSC) osteogenesis. Detailed rheology and printability studies confirm suitability of our composite bioinks for extrusion-based 3D bioprinting technology. In vitro studies reveal high cell viability (~90%) for hMSCs up to 28 days of culture within 3D bioprinted composite scaffolds. When cultured within bioprinted composite scaffolds, hMSCs show significantly enhanced osteogenic differentiation as compared to neat scaffolds based on alkaline phosphatase activity, calcium deposition, and osteocalcin expression.
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Affiliation(s)
- Hadis Gharacheh
- Otto H. York Department of Chemical and Materials Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
| | - Murat Guvendiren
- Otto H. York Department of Chemical and Materials Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
- Correspondence:
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Nik Md Noordin Kahar NNF, Ahmad N, Mariatti M, Yahaya BH, Sulaiman AR, Abdul Hamid ZA. A review on bioceramics scaffolds for bone defect in different types of animal models: HA and β -TCP. Biomed Phys Eng Express 2022; 8. [PMID: 35921834 DOI: 10.1088/2057-1976/ac867f] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/03/2022] [Indexed: 11/12/2022]
Abstract
Increased life expectancy has led to an increase in the use of bone substitutes in numerous nations, with over two million bone-grafting surgeries performed worldwide each year. A bone defect can be caused by trauma, infections, and tissue resections which can self-heal due to the osteoconductive nature of the native extracellular matrix components. However, natural self-healing is time-consuming, and new bone regeneration is slow, especially for large bone defects. It also remains a clinical challenge for surgeons to have a suitable bone substitute. To date, there are numerous potential treatments for bone grafting, including gold-standard autografts, allograft implantation, xenografts, or bone graft substitutes. Tricalcium phosphate (TCP) and hydroxyapatite (HA) are the most extensively used and studied bone substitutes due to their similar chemical composition to bone. The scaffolds should be testedin vivoandin vitrousing suitable animal models to ensure that the biomaterials work effectively as implants. Hence, this article aims to familiarize readers with the most frequently used animal models for biomaterials testing and highlight the available literature for in vivo studies using small and large animal models. This review summarizes the bio ceramic materials, particularly HA and β-TCP scaffolds, for bone defects in small and large animal models. Besides, the design considerations for the pre-clinical animal model selection for bone defect implants are emphasized and presented.
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Affiliation(s)
- Nik Nur Farisha Nik Md Noordin Kahar
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia - Kampus Kejuruteraan Seri Ampangan, Transkrian, Nibong Tebal, Seberang Perai Selatan, Nibong Tebal, Pulau Pinang, 14300, MALAYSIA
| | - Nurazreena Ahmad
- Biomaterials Niche Group, School of Materials & Mineral Resources Engineering, Universiti Sains Malaysia - Kampus Kejuruteraan Seri Ampangan, Engineering Campus, Universiti Sains Malaysia, Nibong Tebal 14300 Penang, Malaysia, Nibong Tebal, Pulau Pinang, 14300, MALAYSIA
| | - M Mariatti
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia - Kampus Kejuruteraan Seri Ampangan, Engineering Campus, Universiti Sains Malaysia, 14300 NibongTebal,, Nibong Tebal, Pulau Pinang, 14300, MALAYSIA
| | - Badrul Hisham Yahaya
- Cluster of Regenerative Medicine, Universiti Sains Malaysia Institut Perubatan dan Pengigian Termaju, Bertam, Kepala Batas, Pulau Pinang, 13200, MALAYSIA
| | - Abdul Razak Sulaiman
- Department of Orthopaedics, School of Medical Science, Universiti Sains Malaysia - Kampus Kesihatan, 16150, Kota Bharu, Kelantan, MALAYSIA, Kubang Kerian, Kelantan, 16150, MALAYSIA
| | - Zuratul Ain Abdul Hamid
- School of Materials & Mineral Resources Engineering, Universiti Sains Malayisa, Universiti Sains Malaysia - Engineering Campus Seri Ampangan, Universiti Sains Malaysia, Engineering Campus, Universiti Sains Malaysia, Engineering Campus, Nibong Tebal, 14300, MALAYSIA
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Wang C, Wang H, Chen Q, Gang H, Zhou Y, Gu S, Liu X, Xu W, Zhang B, Yang H. Polylactic acid scaffold with directional porous structure for large-segment bone repair. Int J Biol Macromol 2022; 216:810-819. [PMID: 35908680 DOI: 10.1016/j.ijbiomac.2022.07.207] [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: 06/22/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 11/24/2022]
Abstract
Biodegradable porous scaffolds with different structure, porosity, and strength play a critical role in the repair and regeneration of defects in bone tissue engineering by changing the proliferation condition for cell. In this study, polylactic acid (PLA) scaffold with directional porous structure is designed and fabricated using the method of ice template and phase inversion for speeding up bone repair by promoting the growth and proliferation of bone cells. The morphology, mechanical properties, hydrophilicity, and wicking properties of PLA scaffolds were characterized by scanning electron microscope, universal testing machine, contact angle tester and wicking rate test, respectively. In vitro biocompatibility has been investigated through measuring cell adhesion, proliferation, and viability on PLA scaffold with directional porous structure. Prepared PLA scaffold was implanted into animals to observe the repair mechanism of large-sized bone defects. This study proposes a novel bioporous scaffold design to induce osteocyte growth at the rat calvaria with a directional pore structure, and the scaffold edges were integrated with the calvaria at week 12, effectively promoting the repair and regeneration of defective bone tissue.
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Affiliation(s)
- Chaorong Wang
- College of Materials Science and Engineering, Wuhan Textile University, Wuhan 430200, China
| | - Han Wang
- Key Laboratory of Green Processing and Functional New Textile Materials of Ministry of Education, Wuhan Textile University, Wuhan 430200, China; Institute for Frontier Materials, Deakin University, Geelong, Victoria 3216, Australia
| | - Qingqing Chen
- College of Materials Science and Engineering, Wuhan Textile University, Wuhan 430200, China
| | - Hanlin Gang
- Key Laboratory of Green Processing and Functional New Textile Materials of Ministry of Education, Wuhan Textile University, Wuhan 430200, China
| | - Yingshan Zhou
- College of Materials Science and Engineering, Wuhan Textile University, Wuhan 430200, China
| | - Shaojin Gu
- College of Materials Science and Engineering, Wuhan Textile University, Wuhan 430200, China
| | - Xin Liu
- College of Materials Science and Engineering, Wuhan Textile University, Wuhan 430200, China
| | - Weilin Xu
- Key Laboratory of Green Processing and Functional New Textile Materials of Ministry of Education, Wuhan Textile University, Wuhan 430200, China
| | - Baocheng Zhang
- Department of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan 430070, China.
| | - Hongjun Yang
- College of Materials Science and Engineering, Wuhan Textile University, Wuhan 430200, China; Key Laboratory of Green Processing and Functional New Textile Materials of Ministry of Education, Wuhan Textile University, Wuhan 430200, China.
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Won JE, Kim WJ, Ryu JJ, Shim JS. Guided Bone Regeneration with a Nitric-Oxide Releasing Polymer Inducing Angiogenesis and Osteogenesis in Critical-Sized Bone Defects. Macromol Biosci 2022; 22:e2200162. [PMID: 35895972 DOI: 10.1002/mabi.202200162] [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: 04/25/2022] [Revised: 06/09/2022] [Indexed: 11/07/2022]
Abstract
Synthetic scaffolds, as bone grafts, provide a favorable environment for the repair and growth of new bone tissue at defect sites. However, the lack of angio- and osteo-induction limits the usefulness of artificial scaffolds for bone regeneration. Nitric oxide (NO) performs essential roles in healing processes, such as regulating inflammation and addressing incomplete revascularization. In this study, we developed a polymer capable of controlled NO release to promote the osteogenic capacity in artificial scaffolds. The biological efficiency of the NO compound was assessed by its effect on pre-osteoblasts and macrophages in vitro and the extent of vascularization and bone formation in the calvaria defect model in vivo. The compound did not inhibit cell adhesion or proliferation. NO treatment significantly increased both alkaline phosphatase activity and mineralization in pre-osteoblasts. Macrophages treated with NO secreted high levels of anti-inflammatory factors and adopted the pro-regenerative M2 phenotype. In the critical-sized defect model, the collagen scaffold containing the NO compound enhanced neovascularization and bone formation. The developed NO-releasing system promoted osteogenesis and regeneration of damaged bone tissue. As the multiple functions of NO involve macrophage modulation and angiogenesis, such release systems may be valuable for guiding bone regeneration in critical-sized defects. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jong-Eun Won
- Institute for Clinical Dental Research, Department of Dentistry, Korea University Guro Hospital, Seoul, 08308, Republic of Korea
| | - Won Jong Kim
- Department of Chemistry, Pohang University of Science and Technology (POSTECH), Pohang-si, 37673, Republic of Korea
| | - Jae Jun Ryu
- Department of Dentistry, Korea University Anam Hospital, Seoul, 02841, Republic of Korea
| | - Ji Suk Shim
- Institute for Clinical Dental Research, Department of Dentistry, Korea University Guro Hospital, Seoul, 08308, Republic of Korea
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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.
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Union, complication, reintervention and failure rates of surgical techniques for large diaphyseal defects: a systematic review and meta-analysis. Sci Rep 2022; 12:9098. [PMID: 35650218 PMCID: PMC9160061 DOI: 10.1038/s41598-022-12140-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/25/2022] [Indexed: 12/20/2022] Open
Abstract
To understand the potential and limitations of the different available surgical techniques used to treat large, long-bone diaphyseal defects by focusing on union, complication, re-intervention, and failure rates, summarizing the pros and cons of each technique. A literature search was performed on PubMed, Web of Science, and Cochrane databases up to March 16th, 2022; Inclusion criteria were clinical studies written in English, of any level of evidence, with more than five patients, describing the treatment of diaphyseal bone defects. The primary outcome was the analysis of results in terms of primary union, complication, reintervention, and failure rate of the four major groups of techniques: bone allograft and autograft, bone transport, vascularized and non-vascularized fibular graft, and endoprosthesis. The statistical analysis was carried out according to Neyeloff et al., and the Mantel–Haenszel method was used to provide pooled rates across the studies. The influence of the various techniques on union rates, complication rates, and reintervention rates was assessed by a z test on the pooled rates with their corresponding 95% CIs. Assessment of risk of bias and quality of evidence was based on Downs and Black’s “Checklist for Measuring Quality” and Rob 2.0 tool. Certainty of yielded evidence was evaluated with the GRADE system. Seventy-four articles were included on 1781 patients treated for the reconstruction of diaphyseal bone defects, 1496 cases in the inferior limb, and 285 in the upper limb, with trauma being the main cause of bone defect. The meta-analysis identified different outcomes in terms of results and risks. Primary union, complications, and reinterventions were 75%, 26% and 23% for bone allografts and autografts, 91%, 62% and 19% for the bone transport group, and 78%, 38% and 23% for fibular grafts; mean time to union was between 7.8 and 8.9 months in all these groups. Results varied according to the different aetiologies, endoprosthesis was the best solution for tumour, although with a 22% failure rate, while trauma presented a more composite outcome, with fibular grafts providing a faster time to union (6.9 months), while cancellous and cortical-cancellous grafts caused less complications, reinterventions, and failures. The literature about this topic has overall limited quality. However, important conclusions can be made: Many options are available to treat critical-size defects of the diaphysis, but no one appears to be an optimal solution in terms of a safe, satisfactory, and long-lasting outcome. Regardless of the bone defect cause, bone transport techniques showed a better primary union rate, but bone allograft and autograft had fewer complication, reintervention, and failure rates than the other techniques. The specific lesion aetiology represents a critical aspect influencing potential and limitations and therefore the choice of the most suitable technique to address the challenging large diaphyseal defects.
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49
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Ho CK, Gimarc D, Carroll HF, Clay M, Schowinsky J, Jesse MK, Crawford AM, Marshall CB. Evaluating bone biopsy quality by technique in an animal model. RESEARCH IN DIAGNOSTIC AND INTERVENTIONAL IMAGING 2022; 2:100008. [PMID: 39076835 PMCID: PMC11265185 DOI: 10.1016/j.redii.2022.100008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/10/2022] [Indexed: 07/31/2024]
Abstract
Rationale and Objectives Powered bone biopsy technique is popular due to its ease of use. However, there is conflicting evidence regarding the diagnostic quality of the samples. The purpose of this study is to evaluate the diagnostic adequacy of different bone biopsy devices and techniques as it relates to the frequency of sample artifacts. Materials and Methods Bone biopsy was performed on same-day processed lamb femora using the following techniques: manual, pulsed powered and full powered. Ten samples were collected using each method by a single musculoskeletal-trained radiologist and were reviewed by 3 blinded pathologists. Samples were compared across multiple categories: length, bone dust, thermal/crush artifact, cellular morphology, fragmentation, and diagnostic acceptability. Bayesian Multilevel Nonlinear Regression models were performed assessing the association between the techniques across the categories. Results Statistical analysis revealed that the manual technique outperformed any powered technique across all categories: decreased thermal/crush artifact (P = 0.014), decreased bone dust (p<0.001), better cellular morphology (P = 0.005), less fragmentation (P < 0.0001) and better diagnostic acceptability (P < 0.0001). Conclusion Manually obtained bone biopsy samples generally produce a more diagnostic sample as compared to powered techniques in an animal model. Given these results, manual bone biopsy methods should be encouraged after consideration for lesion composition, difficulty of access and the patient's overall condition.
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Affiliation(s)
- Corey K Ho
- University of Colorado – Anschutz Medical Campus, Department of Radiology, 12401 E 17th Ave, Aurora, CO 80045, USA
| | - David Gimarc
- University of Colorado – Anschutz Medical Campus, Department of Radiology, 12401 E 17th Ave, Aurora, CO 80045, USA
| | - Hsieng-Feng Carroll
- University of Colorado – Anschutz Medical Campus, Department of Radiology, 12401 E 17th Ave, Aurora, CO 80045, USA
| | - Michael Clay
- University of Colorado – Anschutz Medical Campus, Department of Pathology, 12401 E 17th Ave, Aurora, CO 80045, USA
| | - Jeffrey Schowinsky
- University of Colorado – Anschutz Medical Campus, Department of Pathology, 12401 E 17th Ave, Aurora, CO 80045, USA
| | - MK Jesse
- University of Colorado – Anschutz Medical Campus, Department of Radiology, 12401 E 17th Ave, Aurora, CO 80045, USA
| | - Amanda M Crawford
- University of Utah – Department of Radiology and Imaging Sciences, University of Utah Hospital, 50 2030 E, Salt Lake City, UT 84132, USA
| | - Carrie B Marshall
- University of Colorado – Anschutz Medical Campus, Department of Pathology, 12401 E 17th Ave, Aurora, CO 80045, USA
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50
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Abulaiti A, Liu Y, Cai F, Liu K, Abula A, Maimaiti X, Ren P, Yusufu A. Bone Defects in Tibia Managed by the Bifocal vs. Trifocal Bone Transport Technique: A Retrospective Comparative Study. Front Surg 2022; 9:858240. [PMID: 36034365 PMCID: PMC9406520 DOI: 10.3389/fsurg.2022.858240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background The purpose of this study is to evaluate the clinical effectiveness and determine the differences, if any, between the trifocal bone transport (TFT) technique and the bifocal bone transport (BFT) technique in the reconstruction of long segmental tibial bone defects caused by infection using a monolateral rail external fixator. Methods A total of 53 consecutive patients with long segmental tibial bone defects caused by infection and treated by monolateral rail external fixator in our department were retrospectively collected and analyzed from the period January 2013 to April 2019, including 39 males and 14 females with an average age of 38.8 ± 12.4 years (range 19–65 years). Out of these, 32 patients were treated by the BFT technique, and the remaining 21 patients were managed by the TFT technique. The demographic data, operation duration (OD), docking time (DT), external fixation time (EFT), and external fixation index (EFI) were documented and analyzed. Difficulties that occur during the treatment were classified according to Paley. The clinical outcomes were evaluated by following the Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria at the last clinical visit. Results All patients achieved an infection-free union finally, and there was no significant difference between the two groups in terms of demographic data and both ASAMI bone and functional scores (p > 0.05). The mean defect size and OD in TFT (9.4 ± 1.5 cm, 161.9 ± 8.9 min) were larger than that in BFT (7.8 ± 1.8 cm, 122.5 ± 11.2 min) (p < 0.05). The mean DT, EFT, and EFI in TFT (65.9 ± 10.8 days, 328.0 ± 57.2 days, 34.8 ± 2.1 days/cm) were all less than those in BFT (96.8 ± 22.6 days, 474.5 ± 103.2 days, 60.8 ± 1.9 days/cm) (p < 0.05). Difficulties and complications were more prevalent in the BFT group than in the TFT group (p < 0.05). Conclusion Both the trifocal and BFT techniques achieve satisfactory clinical outcomes in the reconstruction of long segmental tibial bone defects caused by infection using a monolateral rail external fixator. The TFT technique can significantly decrease the DT, EFT, EFI, difficulties, and complications compared with the BFT technique.
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