Biomaterials for Adhesion in Orthopedic Applications: A Review

A particle-filled hydrogel based on alginate and calcium phosphate nanoparticles as bone adhesive

The clinical need for bone adhesives as an alternative to osteosynthesis is evident. However, this is a challenging problem due to the moist environment in surgical sites with bone surfaces covered with blood and biomolecules like lipids or proteins. A nanoparticle-loaded hydrogel that is based on a freeze-dried powder of silica-coated calcium phosphate/carboxymethyl cellulose nanoparticles (CaP/CMC/SiO2) and an aqueous solution of sodium alginate (2 wt%) was developed and optimized with respect to the gluing ability in air and in water. The final paste was crosslinked within about one minute by calcium ions released from the calcium phosphate nanoparticles and contained about 20 wt% nanoparticles and 80 wt% water. The mechanical properties of the hydrogel were determined by extensive rheological tests. The thixotropic pasty hydrogel can be applied with a syringe. The adhesion strength was about 84 kPa between moist bone fragments in air. The hydrogel kept fragments of cortical bone well connected for >3 months during complete submersion in water. Besides water, the material consists only of biocompatible and biodegradable components (calcium phosphate, CMC, alginate). It carries only a very low dose of these materials into the bone site (mainly calcium phosphate nanoparticles). In-vitro cell culture with hMSCs that differentiated to osteoblasts confirmed a good biocompatibility of the bone adhesive formulation.

Polysaccharide Hydroxyapatite (Nano)composites and Their Biomedical Applications: An Overview of Recent Years

Hydroxyapatite can combine with polysaccharide originating biomaterials with special applications in the biomedical field. In this review, the synthesis of (nano)composites is discussed, focusing on natural polysaccharides such as alginate, chitosan, and pectin. In this way, advances in recent years in the development of preparing materials are revised and discussed. Therefore, an overview of the recent synthesis and applications of polyssacharides@hydroxyapatites is presented. Several studies based on chitosan@hydroxyapatite combined with other inorganic matrices are highlighted, while pectin@hydroxyapatite is present in a smaller number of reports. Biomedical applications as drug carriers, adsorbents, and bone implants are discussed, combining their dependence with the nature of interactions on the molecular scale and the type of polysaccharides used, which is a relevant aspect to be explored.

Fabrication and Characterization of a Bioscaffold Using Hydroxyapatite and Unsaturated Polyester Resin

Outstanding biodegradability and biocompatibility are attributes associated with particular polyester substances that make this group useful in specific biomedical fields. To assess the potential as a biomaterial, a novel composite consisting of hydroxyapatite (HAp) and unsaturated polyester resin (UPR) was developed in this work. Using a hand-lay-up technique, various percentages (50, 40, 30, 20, and 10%) of HAp were reinforced into the UPR matrix to fabricate composite materials out of glass sheets. Prior to processing of the composite samples, hydroxyapatite was chemically synthesized in a wet chemical manner. Using a universal testing machine (UTM), Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and thermo-gravimetric analysis (TGA), the fabricated samples were characterized. The crystallographic parameters of synthesized hydroxyapatite (HAp) were also estimated through a range of formulas. The optimal amount for hydroxyapatite was 40% according to the findings of the tensile strength (TS), tensile modulus (TM), percentage of elongation at break (EB), bending strength (BS), and bending modulus (BM). Improvements in TS, TM, BS, and BM for the ideal combination were 39.39, 9.21, 912.05, and 259.96%, in each case, over the controlled one. Thermogravimetric analysis (TGA) has been implemented to determine the degradation temperature of the fabricated composites up to 600 °C.

The characterization of collagen-based scaffolds modified with phenolic acids for tissue engineering application

The aim of the experiment was to study the morphology of collagen-based scaffolds modified by caffeic acid, ferulic acid, and gallic acid, their swelling, and degradation rate, as well as the biological properties of scaffolds, such as antioxidant activity, hemo- and cytocompatibility, histological observation, and antibacterial properties. Scaffolds based on collagen with phenolic acid showed higher swelling rate and enzymatic stability compared to scaffolds based on pure collagen, and the radical scavenging activity was in the range 85-91%. All scaffolds were non-hemolytic and compatible with surrounding tissues. Collagen modified by ferulic acid showed potentially negative effects on hFOB cells as a significantly increased LDH release was found, but all of the studied materials had antimicrobial activity against Staphylococcus aureus and Escherichia coli. It may be assumed that phenolic acids, such as caffeic, ferulic, and gallic acid, are modifiers and provide novel biological properties of collagen-based scaffolds. This paper provides the summarization and comparison of the biological properties of scaffolds based on collagen modified with three different phenolic acids.

Bone adhesive materials: From bench to bedside

Biodegradable bone adhesives represent a highly sought-after type of biomaterial which would enable replacement of traditional metallic devices for fixation of bone. However, these biomaterials should fulfil an extremely large number of requirements. As a consequence, bone-adhesive biomaterials which meet all of these requirements are not yet commercially available. Therefore, this comprehensive review provides an extensive overview of the development of bone adhesives from a translational perspective. First, the definition, classification, and chemistry of various types of bone adhesives are highlighted to provide a detailed overview of this emerging class of biomaterials. In this review we particularly focused studies which describe the use of materials that are capable of gluing two pieces of bone together within a time frame of minutes to days. Second, this review critically reflects on i) the experimental conditions of commonly employed adhesion tests to assess bone adhesion and ii) the current state-of-the-art regarding their preclinical and clinical applicability.

A Review on Three-Dimensional Printed Silicate-Based Bioactive Glass/Biodegradable Medical Synthetic Polymer Composite Scaffolds

In recent years, tissue engineering scaffolds have turned into the preferred option for the clinical treatment of pathological and traumatic bone defects. In this field, silicate-based bioactive glasses (SBGs) and biodegradable medical synthetic polymers (BMSPs) have attracted a great deal of attention owing to their shared exceptional advantages, like excellent biocompatibility, good biodegradability, and outstanding osteogenesis. Three-dimensional (3D) printed SBG/BMSP scaffolds can not only replicate the mechanical properties and microstructure of natural bone but also degrade in situ after service and end up being replaced by regenerated bone tissue in vivo. This review first consolidates the research efforts in 3D printed SBG/BMSP scaffolds, and then focuses on their composite mechanism. This review may help to provide a fresh perspective for SBG/BMSP composite system in bone regeneration.

Responsive and self-healing structural color supramolecular hydrogel patch for diabetic wound treatment

The treatment of diabetic wounds remains a great challenge for medical community. Here, we present a novel structural color supramolecular hydrogel patch for diabetic wound treatment. This hydrogel patch was created by using N-acryloyl glycinamide (NAGA) and 1-vinyl-1,2,4-triazole (VTZ) mixed supramolecular hydrogel as the inverse opal scaffold, and temperature responsive poly(N-isopropylacrylamide) (PNIPAM) hydrogel loaded with vascular endothelial cell growth factor (VEGF) as a filler. Supramolecular hydrogel renders hydrogel patch with superior mechanical properties, in which NAGA and VTZ also provide self-healing and antibacterial properties, respectively. Besides, as the existence of PNIPAM, the hydrogel patch was endowed with thermal-responsiveness property, which could release actives in response to temperature stimulus. Given these excellent performances, we have demonstrated that the supramolecular hydrogel patch could significantly enhance the wound healing process in diabetes rats by downregulating the expression of inflammatory factors, promoting collagen deposition and angiogenesis. Attractively, due to responsive optical property of inverse opal scaffold, the hydrogel patch could display color-sensing behavior that was suitable for the wound monitoring and management as well as guidance of clinical treatment. These distinctive features indicate that the presented hydrogel patches have huge potential values in biomedical fields.

Phenol-Hyaluronic Acid Conjugates: Correlation of Oxidative Crosslinking Pathway and Adhesiveness

Hyaluronic acid (HA) is a natural polysaccharide with great biocompatibility for a variety of biomedical applications, such as tissue scaffolds, dermal fillers, and drug-delivery carriers. Despite the medical impact of HA, its poor adhesiveness and short-term in vivo stability limit its therapeutic efficacy. To overcome these shortcomings, a versatile modification strategy for the HA backbone has been developed. This strategy involves tethering phenol moieties on HA to provide both robust adhesiveness and intermolecular cohesion and can be used for oxidative crosslinking of the polymeric chain. However, a lack of knowledge still exists regarding the interchangeable phenolic adhesion and cohesion depending on the type of oxidizing agent used. Here, we reveal the correlation between phenolic adhesion and cohesion upon gelation of two different HA–phenol conjugates, HA–tyramine and HA–catechol, depending on the oxidant. For covalent/non-covalent crosslinking of HA, oxidizing agents, horseradish peroxidase/hydrogen peroxide, chemical oxidants (e.g., base, sodium periodate), and metal ions, were utilized. As a result, HA–catechol showed stronger adhesion properties, whereas HA–tyramine showed higher cohesion properties. In addition, covalent bonds allowed better adhesion compared to that of non-covalent bonds. Our findings are promising for designing adhesive and mechanically robust biomaterials based on phenol chemistry.

Adhesive Tissue Engineered Scaffolds: Mechanisms and Applications

A variety of suture and bioglue techniques are conventionally used to secure engineered scaffold systems onto the target tissues. These techniques, however, confront several obstacles including secondary damages, cytotoxicity, insufficient adhesion strength, improper degradation rate, and possible allergic reactions. Adhesive tissue engineering scaffolds (ATESs) can circumvent these limitations by introducing their intrinsic tissue adhesion ability. This article highlights the significance of ATESs, reviews their key characteristics and requirements, and explores various mechanisms of action to secure the scaffold onto the tissue. We discuss the current applications of advanced ATES products in various fields of tissue engineering, together with some of the key challenges for each specific field. Strategies for qualitative and quantitative assessment of adhesive properties of scaffolds are presented. Furthermore, we highlight the future prospective in the development of advanced ATES systems for regenerative medicine therapies.