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Nedorubova IA, Bukharova TB, Mokrousova VO, Khvorostina MA, Vasilyev AV, Nedorubov AA, Grigoriev TE, Zagoskin YD, Chvalun SN, Kutsev SI, Goldshtein DV. Comparative Efficiency of Gene-Activated Matrices Based on Chitosan Hydrogel and PRP Impregnated with BMP2 Polyplexes for Bone Regeneration. Int J Mol Sci 2022; 23:ijms232314720. [PMID: 36499056 PMCID: PMC9735524 DOI: 10.3390/ijms232314720] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/14/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
Gene therapy is one of the most promising approaches in regenerative medicine. Gene-activated matrices provide stable gene expression and the production of osteogenic proteins in situ to stimulate osteogenesis and bone repair. In this study, we developed new gene-activated matrices based on polylactide granules (PLA) impregnated with BMP2 polyplexes and included in chitosan hydrogel or PRP-based fibrin hydrogel. The matrices showed high biocompatibility both in vitro with mesenchymal stem cells and in vivo when implanted intramuscularly in rats. The use of porous PLA granules allowed the inclusion of a high concentration of polyplexes, and the introduction of the granules into hydrogel provided the gradual release of the plasmid constructs. All gene-activated matrices showed transfecting ability and ensured long-term gene expression and the production of target proteins in vitro. At the same time, the achieved concentration of BMP-2 was sufficient to induce osteogenic differentiation of MSCs. When implanted into critical-size calvarial defects in rats, all matrices with BMP2 polyplexes led to new bone formation. The most significant effect on osteoinduction was observed for the PLA/PRP matrices. Thus, the developed gene-activated matrices were shown to be safe and effective osteoplastic materials. PLA granules and PRP-based fibrin hydrogel containing BMP2 polyplexes were shown to be the most promising for future applications in bone regeneration.
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Affiliation(s)
| | | | - Viktoria Olegovna Mokrousova
- Research Centre for Medical Genetics, 115478 Moscow, Russia
- Central Research Institute of Dental and Maxillofacial Surgery, 119021 Moscow, Russia
| | - Maria Aleksandrovna Khvorostina
- Research Centre for Medical Genetics, 115478 Moscow, Russia
- Institute of Photon Technologies of Federal Scientific Research Centre “Crystallography and Photonics”, Russian Academy of Sciences, 108840 Moscow, Russia
| | - Andrey Vyacheslavovich Vasilyev
- Research Centre for Medical Genetics, 115478 Moscow, Russia
- Central Research Institute of Dental and Maxillofacial Surgery, 119021 Moscow, Russia
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Chang KE, Mesregah MK, Fresquez Z, Stanton EW, Buser Z, Wang JC. Use of graft materials and biologics in spine deformity surgery: a state-of-the-art review. Spine Deform 2022; 10:1217-1231. [PMID: 35733056 DOI: 10.1007/s43390-022-00529-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 05/21/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of the current review is to summarize the current evidence on graft materials used in fusion procedures for spinal deformity corrections. METHODS PubMed, Embase, and Cochrane Library were searched for relevant published observational studies and clinical trials using osteobiologics and biomaterials in spinal deformity surgery. RESULTS The use of autograft in deformity correction surgeries has been reported in a limited number of studies, with the harvest sites including iliac crest, ribs, and local bone. Various allografts and biologics have been used in the treatment of spinal deformities including idiopathic and degenerative scoliosis, either as stand alone or in combination with autograft. Limited number of studies reported no differences in fusion rates or outcomes. Use of rh-BMP2 in anterior, posterior or front/back approaches showed higher fusion rates than other graft materials in patients with spinal deformities. Due to the limited number of quality studies included in the review, as well as alternative factors, such as costs, availability, and surgeon expertise/preference, no definitive conclusion or recommendations can be made as to the ideal graft choice in spinal deformity surgery. CONCLUSIONS Most commonly used grafts included autograft, allograft and rh-BMP2, with new biologics and biomaterials constantly emerging in the market. Limited number of high-quality comparative studies and heterogeneity in study design prevented direct comparisons that can lead to meaningful recommendations. Further studies are needed to prove superiority of any single graft material and/or biologic that is also cost-effective and safe.
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Affiliation(s)
- Ki-Eun Chang
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo St., HC4, Suite 5400A, Los Angeles, CA, 90003, USA
| | - Mohamed Kamal Mesregah
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo St., HC4, Suite 5400A, Los Angeles, CA, 90003, USA
- Department of Orthopaedic Surgery, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Zoe Fresquez
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo St., HC4, Suite 5400A, Los Angeles, CA, 90003, USA
| | - Eloise W Stanton
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo St., HC4, Suite 5400A, Los Angeles, CA, 90003, USA
| | - Zorica Buser
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo St., HC4, Suite 5400A, Los Angeles, CA, 90003, USA.
| | - Jeffrey C Wang
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo St., HC4, Suite 5400A, Los Angeles, CA, 90003, USA
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REDDY HB, CRENA.M J, PSG P, SUBRAMANİAN S, APPUKUTTAN D. AN EXPLORATORY REVIEW OF CURRENT TRENDS IN NANODENTISTRY. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.974945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Zhao X, Li L, Chen M, Xu Y, Zhang S, Chen W, Liang W. Nanotechnology Assisted Targeted Drug Delivery for Bone Disorders: Potentials and Clinical Perspectives. Curr Top Med Chem 2020; 20:2801-2819. [PMID: 33076808 DOI: 10.2174/1568026620666201019110459] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 04/26/2020] [Accepted: 04/30/2020] [Indexed: 12/18/2022]
Abstract
Nanotechnology and its allied modalities have brought revolution in tissue engineering and bone healing. The research on translating the findings of the basic and preclinical research into clinical practice is ongoing. Advances in the synthesis and design of nanomaterials along with advances in genomics and proteomics, and tissue engineering have opened a bright future for bone healing and orthopedic technology. Studies have shown promising outcomes in the design and fabrication of porous implant substrates that can be exploited as bone defect augmentation and drug-carrier devices. However, there are dozens of applications in orthopedic traumatology and bone healing for nanometer-sized entities, structures, surfaces, and devices with characteristic lengths ranging from tens 10s of nanometers to a few micrometers. Nanotechnology has made promising advances in the synthesis of scaffolds, delivery mechanisms, controlled modification of surface topography and composition, and biomicroelectromechanical systems. This study reviews the basic and translational sciences and clinical implications of the nanotechnology in tissue engineering and bone diseases. Recent advances in NPs assisted osteogenic agents, nanocomposites, and scaffolds for bone disorders are discussed.
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Affiliation(s)
- Xiaofeng Zhao
- Department of Orthopaedics, Shaoxing People's Hospital, (Shaoxing Hospital, Zhejiang University School of Medicine), 568# Zhongxing North Road, Shaoxing 312000, Zhejiang Province, China
| | - Laifeng Li
- Department of Traumatic Orthopedics, Affiliated Jinan Third Hospital of Jining Medical University, Jinan 250132, Shandong Province, China
| | - Meikai Chen
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan 316000, Zhejiang Province, China
| | - Yifan Xu
- Department of Orthopaedics, Shaoxing People's Hospital, (Shaoxing Hospital, Zhejiang University School of Medicine), 568# Zhongxing North Road, Shaoxing 312000, Zhejiang Province, China
| | - Songou Zhang
- Department of Orthopaedics, Shaoxing People's Hospital, (Shaoxing Hospital, Zhejiang University School of Medicine), 568# Zhongxing North Road, Shaoxing 312000, Zhejiang Province, China
| | - Wangzhen Chen
- Department of Orthopaedics, Shaoxing People's Hospital, (Shaoxing Hospital, Zhejiang University School of Medicine), 568# Zhongxing North Road, Shaoxing 312000, Zhejiang Province, China
| | - Wenqing Liang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan 316000, Zhejiang Province, China
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Sun K, Lin H, Tang Y, Xiang S, Xue J, Yin W, Tan J, Peng H, Alexander PG, Tuan RS, Wang B. Injectable BMP-2 gene-activated scaffold for the repair of cranial bone defect in mice. Stem Cells Transl Med 2020; 9:1631-1642. [PMID: 32785966 PMCID: PMC7695643 DOI: 10.1002/sctm.19-0315] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 06/22/2020] [Accepted: 07/05/2020] [Indexed: 12/20/2022] Open
Abstract
Tissue engineering using adult human mesenchymal stem cells (MSCs) seeded within biomaterial scaffolds has shown the potential to enhance bone healing. Recently, we have developed an injectable, biodegradable methacrylated gelatin‐based hydrogel, which was especially effective in producing scaffolds in situ and allowed the delivery of high viable stem cells and gene vehicles. The well‐demonstrated benefits of recombinant adeno‐associated viral (rAAV) vector, including long‐term gene transfer efficiency and relative safety, combination of gene and cell therapies has been developed in both basic and translational research to support future bone tissue regeneration clinical trials. In this study, we have critically assessed the applicability of single‐step visible light (VL) photocrosslinking fabrication of gelatin scaffold to deliver rAAV encoding human bone morphogenetic protein‐2 (BMP‐2) gene to address the need for sustained BMP‐2 presence localized within scaffolds for the repair of cranial bone defect in mouse model. In this method, rAAV‐BMP‐2 and human bone marrow‐derived MSCs (hBMSCs) were simultaneously included into gelatin scaffolds during scaffold formation by VL illumination. We demonstrated that the subsequent release of rAAV‐BMP‐2 constructs from the scaffold matrix, which resulted in efficient in situ expression of BMP‐2 gene by hBMSCs seeded within the scaffolds, and thus induced their osteogenic differentiation without the supplement of exogenous BMP‐2. The reparative capacity of this novel stem cell‐seeded and gene‐activated scaffolds was further confirmed in the cranial defect in the severe combined immunodeficiency mice, revealed by imaging, histology, and immunohistochemistry at 6 weeks after cranial defect treatment.
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Affiliation(s)
- Kai Sun
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Hang Lin
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Ying Tang
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Shiqi Xiang
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jingwen Xue
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Weifeng Yin
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jian Tan
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | - Peter G Alexander
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rocky S Tuan
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Bing Wang
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Efficient in vivo bone formation by BMP-2 engineered human mesenchymal stem cells encapsulated in a projection stereolithographically fabricated hydrogel scaffold. Stem Cell Res Ther 2019; 10:254. [PMID: 31412905 PMCID: PMC6694509 DOI: 10.1186/s13287-019-1350-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/04/2019] [Accepted: 07/22/2019] [Indexed: 02/06/2023] Open
Abstract
Background Stem cell-based bone tissue engineering shows promise for bone repair but faces some challenges, such as insufficient osteogenesis and limited architecture flexibility of the cell-delivery scaffold. Methods In this study, we first used lentiviral constructs to transduce ex vivo human bone marrow-derived stem cells with human bone morphogenetic protein-2 (BMP-2) gene (BMP-hBMSCs). We then introduced these cells into a hydrogel scaffold using an advanced visible light-based projection stereolithography (VL-PSL) technology, which is compatible with concomitant cell encapsulation and amenable to computer-aided architectural design, to fabricate scaffolds fitting local physical and structural variations in different bones and defects. Results The results showed that the BMP-hBMSCs encapsulated within the scaffolds had high viability with sustained BMP-2 gene expression and differentiated toward an osteogenic lineage without the supplement of additional BMP-2 protein. In vivo bone formation efficacy was further assessed using an intramuscular implantation model in severe combined immunodeficiency (SCID) mice. Microcomputed tomography (micro-CT) imaging indicated rapid bone formation by the BMP-hBMSC-laden constructs as early as 14 days post-implantation. Histological examination revealed a mature trabecular bone structure with considerable vascularization. Through tracking of the implanted cells, we also found that BMP-hBMSC were directly involved in the new bone formation. Conclusions The robust, self-driven osteogenic capability and computer-designed architecture of the construct developed in this study should have potential applications for customized clinical repair of large bone defects or non-unions. Electronic supplementary material The online version of this article (10.1186/s13287-019-1350-6) contains supplementary material, which is available to authorized users.
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Grgurevic L, Oppermann H, Pecin M, Erjavec I, Capak H, Pauk M, Karlovic S, Kufner V, Lipar M, Bubic Spoljar J, Bordukalo-Niksic T, Maticic D, Peric M, Windhager R, Sampath TK, Vukicevic S. Recombinant Human Bone Morphogenetic Protein 6 Delivered Within Autologous Blood Coagulum Restores Critical Size Segmental Defects of Ulna in Rabbits. JBMR Plus 2018; 3:e10085. [PMID: 31131338 DOI: 10.1002/jbm4.10085] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/29/2018] [Accepted: 12/16/2018] [Indexed: 12/21/2022] Open
Abstract
BMP2 and BMP7, which use bovine Achilles tendon-derived absorbable collagen sponge and bovine bone collagen as scaffold, respectively, have been approved as bone graft substitutes for orthopedic and dental indications. Here, we describe an osteoinductive autologous bone graft substitute (ABGS) that contains recombinant human BMP6 (rhBMP6) dispersed within autologous blood coagulum (ABC) scaffold. The ABGS is created as an injectable or implantable coagulum gel with rhBMP6 binding tightly to plasma proteins within fibrin meshwork, as examined by dot-blot assays, and is released slowly as an intact protein over 6 to 8 days, as assessed by ELISA. The biological activity of ABGS was examined in vivo in rats (Rattus norvegicus) and rabbits (Oryctolagus cuniculus). In a rat subcutaneous implant assay, ABGS induced endochondral bone formation, as observed by histology and micro-CT analyses. In the rabbit ulna segmental defect model, a reproducible and robust bone formation with complete bridging and restoration of the defect was observed, which is dose dependent, as determined by radiographs, micro-CT, and histological analyses. In ABGS, ABC scaffold provides a permissive environment for bone induction and contributes to the use of lower doses of rhBMP6 compared with BMP7 in bovine bone collagen as scaffold. The newly formed bone undergoes remodeling and establishes cortices uniformly that is restricted to implant site by bridging with host bone. In summary, ABC carrier containing rhBMP6 may serve as an osteoinductive autologous bone graft substitute for several orthopedic applications that include delayed and nonunion fractures, anterior and posterior lumbar interbody fusion, trauma, and nonunions associated with neurofibromatosis type I.
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Affiliation(s)
- Lovorka Grgurevic
- Laboratory for Mineralized Tissues School of Medicine University of Zagreb Zagreb Croatia
| | | | - Marko Pecin
- Clinics for Surgery, Orthopedics, and Ophthalmology School of Veterinary Medicine University of Zagreb Zagreb Croatia
| | - Igor Erjavec
- Laboratory for Mineralized Tissues School of Medicine University of Zagreb Zagreb Croatia
| | - Hrvoje Capak
- Department of Radiology School of Veterinary Medicine University of Zagreb Zagreb Croatia
| | - Martina Pauk
- Laboratory for Mineralized Tissues School of Medicine University of Zagreb Zagreb Croatia
| | - Sven Karlovic
- Faculty of Food Technology and Biotechnology University of Zagreb Zagreb Croatia
| | - Vera Kufner
- Laboratory for Mineralized Tissues School of Medicine University of Zagreb Zagreb Croatia
| | - Marija Lipar
- Clinics for Surgery, Orthopedics, and Ophthalmology School of Veterinary Medicine University of Zagreb Zagreb Croatia
| | - Jadranka Bubic Spoljar
- Laboratory for Mineralized Tissues School of Medicine University of Zagreb Zagreb Croatia
| | | | - Drazen Maticic
- Clinics for Surgery, Orthopedics, and Ophthalmology School of Veterinary Medicine University of Zagreb Zagreb Croatia
| | - Mihaela Peric
- Laboratory for Mineralized Tissues School of Medicine University of Zagreb Zagreb Croatia
| | - Reinhard Windhager
- Department of Orthopedics and Trauma Surgery Medical University of Vienna Vienna Austria
| | | | - Slobodan Vukicevic
- Laboratory for Mineralized Tissues School of Medicine University of Zagreb Zagreb Croatia
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Salih SI, Al-Falahi NH, Saliem AH, Abedsalih AN. Effectiveness of platelet-rich fibrin matrix treated with silver nanoparticles in fracture healing in rabbit model. Vet World 2018; 11:944-952. [PMID: 30147264 PMCID: PMC6097570 DOI: 10.14202/vetworld.2018.944-952] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 06/04/2018] [Indexed: 12/04/2022] Open
Abstract
Aim: The current study was conducted to evaluate the effect of platelet-rich fibrin matrix (PRFM) treated with silver nanoparticles (AgNPs) on enhancing the healing of the experimentally induced bone gap in a rabbit model. Materials and Methods: Twenty healthy male local rabbits aged between 6 and 8 months, their weights between 1.5 and 2 kg were used in this study and divided randomly into four equal groups, under general anesthesia (1 cm), bone gap was induced in the tibia bone to create a critical bone defect and leave it without any treatment in the first group (control group). While in the second group the bone gap was filled with PRFM; in the third group, the gap was filled with 0.3 ml AgNPs; and in the fourth group, the gap was filled with PRFM treated with AgNPs. Results: There was no infection at the operation site in all experimental animals, and the radiograph images showed periosteal and endosteal reaction; the gaps were bridged faster in the fourth group as compared with the other groups. The histological examination showed lamellar bone with haversian canal completely filled the fracture gap and contact with old bone in the fourth group as compared to other groups. Conclusion: Using a combination of PRFM and single nucleotide polymorphisms together gave better acceleration in the bone healing process than using each one of them separately.
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Affiliation(s)
| | - Nadia H Al-Falahi
- Department of Surgery and Obstetrics, University of Baghdad, Baghdad, Iraq
| | - Ali H Saliem
- Department of Physiology, Biochemistry and Pharmacology, University of Baghdad, Baghdad, Iraq
| | - Ahmed N Abedsalih
- Department of Physiology, Biochemistry and Pharmacology, University of Baghdad, Baghdad, Iraq
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Xue J, Lin H, Bean A, Tang Y, Tan J, Tuan RS, Wang B. One-Step Fabrication of Bone Morphogenetic Protein-2 Gene-Activated Porous Poly-L-Lactide Scaffold for Bone Induction. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2017; 7:50-59. [PMID: 29018836 PMCID: PMC5626914 DOI: 10.1016/j.omtm.2017.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 08/31/2017] [Indexed: 01/18/2023]
Abstract
Bone morphogenetic protein 2 (BMP2) is an efficacious inducer for the osteogenesis of mesenchymal stem cells (MSCs). Conventional applications of BMP2 have involved either the direct incorporation of BMP2 protein or ex vivo BMP2 gene transfer into stem cells prior to their transplantation. These approaches are able to promote bone formation to some extent; however, they are hampered by either the lack of stability and sustainability of BMP2 protein or the time-consuming and cost-prohibitive in vitro cell culture procedure. To overcome these limitations, we have developed a gene-activated poly-L-lactide acid (PLLA) scaffold with the encapsulation of recombinant adeno-associated viral (AAV) vector encoding a full-length cDNA of human BMP2 using an ice-based microparticle porogenization method that was recently developed. Results showed continuous release of AAV particles from the micropores of scaffolds for up to 1 week, subsequently transducing embedded human MSCs and producing functional BMP2. MSCs within scaffolds underwent efficacious osteogenesis, on the basis of osteoinductive gene expression and osteogenic differentiation, which resulted in robust new bone formation in vivo at 4 weeks. These findings show the potential of the technology toward developing clinical applications of a rapid, cost-effective, and potentially point-of-care approach for the repair of bone defects.
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Affiliation(s)
- Jingwen Xue
- Center for Cellular and Molecular Engineering, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA.,Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA.,School of Medicine, Tsinghua University, Beijing, 100084, China
| | - Hang Lin
- Center for Cellular and Molecular Engineering, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA.,Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA
| | - Allison Bean
- Center for Cellular and Molecular Engineering, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA.,Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA
| | - Ying Tang
- Center for Cellular and Molecular Engineering, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA.,Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA
| | - Jian Tan
- Center for Cellular and Molecular Engineering, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA.,Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA
| | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA.,Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA
| | - Bing Wang
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219, USA
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Brannigan K, Griffin M. An Update into the Application of Nanotechnology in Bone Healing. Open Orthop J 2016; 10:808-823. [PMID: 28217207 PMCID: PMC5299556 DOI: 10.2174/1874325001610010808] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Bone differs from other organs in that it can regenerate and remodel without scar formation. There are instances of trauma, congenital bone disorder, bone disease and bone cancer where this is not possible. Without bone grafts and implants, deformity and disability would result. Human bone grafts are limited in their management of large or non-union fractures. In response, synthetic bone grafts and implants are available to the Orthopaedic Surgeon. Unfortunately these also have their limitations and associated complications. Nanotechnology involves the research, design and manufacture of materials with a grain size less than 100nm. Nano-phase materials follow the laws of quantum physics, not classical mechanics, resulting in novel behavioural differences compared to conventional counterparts. METHODS Past, present and future nanotechnology in bone healing literature is reviewed and discussed. The article highlights concepts which are likely to be instrumental to the future of nanotechnology in bone healing. RESULTS Nanotechnology in bone healing is an emerging field within Orthopaedic Surgery. There is a requirement for bone healing technologies which are biochemically and structurally similar to bone. Nanotechnology is a potential solution as the arrangement of bone includes nanoscopic collagen fibres and hydroxyapatite. This review centers on the novel field of nanotechnology in bone healing with discussion focusing on advances in bone grafts, implants, diagnostics and drug delivery. CONCLUSION The concept of nanotechnology was first introduced in 1959. Current nanoproducts for bone healing include nano-HA-paste-ostim and nano-beta-tricalcium phosphate-Vitoss. Nanophase technologies are considered to be superior bone healing solutions. Limited safety data and issues regarding cost and mass scale production require further research into this exciting field.
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Affiliation(s)
- K Brannigan
- Whiston Hospital, Warrington Road, Prescot, L35 5DR, Whiston, UK
| | - M Griffin
- Division of Surgery & Interventional Science, University College London, London, UK
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Fabrication and Characterization of Three-Dimensional Electrospun Scaffolds for Bone Tissue Engineering. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2015. [DOI: 10.1007/s40883-015-0004-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Objectives The major problem with repair of an articular cartilage injury
is the extensive difference in the structure and function of regenerated,
compared with normal cartilage. Our work investigates the feasibility
of repairing articular osteochondral defects in the canine knee
joint using a composite lamellar scaffold of nano-ß-tricalcium phosphate
(ß-TCP)/collagen (col) I and II with bone marrow stromal stem cells
(BMSCs) and assesses its biological compatibility. Methods The bone–cartilage scaffold was prepared as a laminated composite,
using hydroxyapatite nanoparticles (nano-HAP)/collagen I/copolymer
of polylactic acid–hydroxyacetic acid as the bony scaffold, and
sodium hyaluronate/poly(lactic-co-glycolic acid) as the cartilaginous
scaffold. Ten-to 12-month-old hybrid canines were randomly divided
into an experimental group and a control group. BMSCs were obtained
from the iliac crest of each animal, and only those of the third
generation were used in experiments. An articular osteochondral
defect was created in the right knee of dogs in both groups. Those
in the experimental group were treated by implanting the composites
consisting of the lamellar scaffold of ß-TCP/col I/col II/BMSCs.
Those in the control group were left untreated. Results After 12 weeks of implantation, defects in the experimental group
were filled with white semi-translucent tissue, protruding slightly
over the peripheral cartilage surface. After 24 weeks, the defect
space in the experimental group was filled with new cartilage tissues, finely
integrated into surrounding normal cartilage. The lamellar scaffold
of ß-TCP/col I/col II was gradually degraded and absorbed, while
new cartilage tissue formed. In the control group, the defects were
not repaired. Conclusion This method can be used as a suitable scaffold material for the
tissue-engineered repair of articular cartilage defects. Cite this article: Bone Joint Res 2015;4:56–64
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Affiliation(s)
- Y M Lv
- The Affiliated Hospital of Guangzhou Medical College, Guangzhou, China
| | - Q S Yu
- China-Japan Friendship Hospital, Beijing 100029, China
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Kulkova J, Moritz N, Suokas EO, Strandberg N, Leino KA, Laitio TT, Aro HT. Osteointegration of PLGA implants with nanostructured or microsized β-TCP particles in a minipig model. J Mech Behav Biomed Mater 2014; 40:190-200. [DOI: 10.1016/j.jmbbm.2014.08.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 08/28/2014] [Accepted: 08/31/2014] [Indexed: 01/05/2023]
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Zang S, Zhuo Q, Chang X, Qiu G, Wu Z, Yang G. Study of osteogenic differentiation of human adipose-derived stem cells (HASCs) on bacterial cellulose. Carbohydr Polym 2014; 104:158-65. [DOI: 10.1016/j.carbpol.2014.01.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 10/23/2013] [Accepted: 01/06/2014] [Indexed: 01/22/2023]
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15
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Zhang N, Molenda JA, Mankoci S, Zhou X, Murphy WL, Sahai N. Crystal structures of CaSiO 3 polymorphs control growth and osteogenic differentiation of human mesenchymal stem cells on bioceramic surfaces. Biomater Sci 2013; 1:1101-1110. [PMID: 26550475 DOI: 10.1039/c3bm60034c] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The repair and replacement of damaged or diseased human bone tissue requires a stable interface between the orthopedic implant and living tissue. The ideal material should be both osteoconductive (promote bonding to bone) and osteoinductive (induce osteogenic differentiation of cells and generate new bone). Partially resorbable bioceramic materials with both properties are developed by expensive trial-and-error methods. Structure-reactivity relationships for predicting the osteoinductive properties of ceramics would significantly increase the efficiency of developing materials for bone tissue engineering. Here we propose the novel hypothesis that the crystal structure of a bioceramic controls the release rates, subsequent surface modifications due to precipitation of new phases, and thus, the concentrations of soluble factors, and ultimately, the attachment, viability and osteogenic differentiation of human Mesenchymal Stem Cells (hMSCs). To illustrate our hypothesis, we used two CaSiO3 polymorphs, pseudo-wollastonite (psw, β-CaSiO3) and wollastonite (wol, α-CaSiO3) as scaffolds for hMSC culture. Polymorphs are materials which have identical chemical composition and stoichiometry, but different crystal structures. We combined the results of detailed surface characterizations, including environmental Scanning Electron Microscopy (SEM) back-scattered imaging, and spot-analysis and 2D elemental mapping by SEM-Energy Dispersive X-ray (SEM-EDX), High Resolution Transmission Electron Microscopy (HRTEM) and surface roughness analysis; culture medium solution analyses; and molecular/genetic assays from cell culture. Our results confirmed the hypothesis that the psw polymorph, which has a strained silicate ring structure, is more osteoinductive than the wol polymorph, which has a more stable, open silicate chain structure. The observations could be attributed to easier dissolution (resorption) of psw compared to wol, which resulted in concentration profiles that were more osteoinductive for the former. Thus, we showed that crystal structure is a fundamental parameter to be considered in the intelligent design of pro-osteogenic, partially resorbable bioceramics.
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Affiliation(s)
- Nianli Zhang
- Materials Science Program, University of Wisconsin, Madison, WI53706, USA ; Department of Biologic and Materials Science, 1011 N. University Avenue, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - James A Molenda
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI 53706, USA
| | - Steven Mankoci
- Department of Polymer Science, 170 University Avenue, Akron, OH 44325, USA. Tel: +1 330-972-5795
| | - Xianfeng Zhou
- Department of Polymer Science, 170 University Avenue, Akron, OH 44325, USA. Tel: +1 330-972-5795
| | - William L Murphy
- Materials Science Program, University of Wisconsin, Madison, WI53706, USA ; Department of Biomedical Engineering, University of Wisconsin, Madison, WI 53706, USA ; Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, WI 53706, USA ; Department of Pharmacology, University of Wisconsin, Madison, WI 53706, USA
| | - Nita Sahai
- Department of Polymer Science, 170 University Avenue, Akron, OH 44325, USA. Tel: +1 330-972-5795
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16
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Musib M, Saha S. Nanostructured materials for bone tissue replacement. Nanomedicine (Lond) 2012. [DOI: 10.1533/9780857096449.4.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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17
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Bacterial cellulose-based materials and medical devices: current state and perspectives. Appl Microbiol Biotechnol 2011; 91:1277-86. [PMID: 21744133 DOI: 10.1007/s00253-011-3432-y] [Citation(s) in RCA: 272] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 05/09/2011] [Accepted: 06/02/2011] [Indexed: 10/18/2022]
Abstract
Bacterial cellulose (BC) is a unique and promising material for use as implants and scaffolds in tissue engineering. It is composed of a pure cellulose nanofiber mesh spun by bacteria. It is remarkable for its strength and its ability to be engineered structurally and chemically at nano-, micro-, and macroscales. Its high water content and purity make the material biocompatible for multiple medical applications. Its biocompatibility, mechanical strength, chemical and morphologic controllability make it a natural choice for use in the body in biomedical devices with broader application than has yet been utilized. This paper reviews the current state of understanding of bacterial cellulose, known methods for controlling its physical and chemical structure (e.g., porosity, fiber alignment, etc.), biomedical applications for which it is currently being used, or investigated for use, challenges yet to be overcome, and future possibilities for BC.
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18
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Treatment of long bone non-unions with polytherapy: indications and clinical results. Injury 2011; 42:587-90. [PMID: 21524745 DOI: 10.1016/j.injury.2011.03.046] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Accepted: 03/21/2011] [Indexed: 02/02/2023]
Abstract
The incidence of long bone non-unions has been estimated to range between 5 and 10%. Autologous bone graft usually harvested from the iliac crest continues to be the gold standard for biological enhancement of atrophic non-unions. However, its use has been hampered by minor and major donor site complications. Moreover despite possessing the properties of osteogenecity, osteoconductivity and some osteoinductivity the overall results of treatment have not been consistent with disappointing success rates at times. The concept of polytherapy for the treatment of non-unions, namely the simultaneous application of the three fundamental elements of the diamond concept, osteoprogenitor cells, growth factor and osteoconductive scaffold, appears to be an attractive alternative but more studies are desirable to validate this strategy.
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Saito N, Aoki K, Usui Y, Shimizu M, Hara K, Narita N, Ogihara N, Nakamura K, Ishigaki N, Kato H, Haniu H, Taruta S, Kim YA, Endo M. Application of carbon fibers to biomaterials: a new era of nano-level control of carbon fibers after 30-years of development. Chem Soc Rev 2011; 40:3824-34. [PMID: 21487627 DOI: 10.1039/c0cs00120a] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Carbon fibers are state-of-the-art materials with properties that include being light weight, high strength, and chemically stable, and are applied in various fields including aeronautical science and space science. Investigation of applications of carbon fibers to biomaterials was started 30 or more years ago, and various products have been developed. Because the latest technological progress has realized nano-level control of carbon fibers, applications to biomaterials have also progressed to the age of nano-size. Carbon fibers with diameters in the nano-scale (carbon nanofibers) dramatically improve the functions of conventional biomaterials and make the development of new composite materials possible. Carbon nanofibers also open possibilities for new applications in regenerative medicine and cancer treatment. The first three-dimensional constructions with carbon nanofibers have been realized, and it has been found that the materials could be used as excellent scaffolding for bone tissue regeneration. In this critical review, we summarize the history of carbon fiber application to the biomaterials and describe future perspectives in the new age of nano-level control of carbon fibers (122 references).
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Affiliation(s)
- Naoto Saito
- Department of Applied Physical Therapy, Shinshu University School of Health Sciences, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan.
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20
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Lu Z, Roohani-Esfahani SI, Kwok PCL, Zreiqat H. Osteoblasts on rod shaped hydroxyapatite nanoparticles incorporated PCL film provide an optimal osteogenic niche for stem cell differentiation. Tissue Eng Part A 2011; 17:1651-61. [PMID: 21306280 DOI: 10.1089/ten.tea.2010.0567] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
After the clinical insertion of a bone biomaterial, the surrounding osteoblasts would migrate and attach to the implant surface and foster a microenvironment that largely determines the differentiation fate of the comigrated mesenchymal stem cells. Whether the fostered microenvironment is suitable for osteogenic differentiation of mesenchymal stem cells is critical for the subsequent osseointegration. In this study, we determined (1) how the spherical or rod-shaped hydroxyapatite nanoparticles (nHA) incorporated poly(ɛ-caprolactone) (PCL) films (PCL-spherical nHA, PCL-rod nHA) interact with primary human osteoblasts (HOBs); (2) how the microenvironment rendered by their interaction affects osteogenic differentiation of adipose tissue-derived mesenchymal stem cells (ASCs). HOBs were seeded on PCL, PCL-spherical nHA, and PCL-rod nHA films, respectively. When cultured alone, the HOBs on PCL-rod nHA films showed most efficient osteoblastic differentiation compared with those on PCL or PCL-spherical nHA films. When cocultured with ASCs in an indirect coculture system, only the HOBs on PCL-rod nHA films up-regulated the gene expression of Runx2, bone sialoprotein, and osteocalcin of ASCs. Additionally, the HOBs on PCL-rod nHA films showed significant up-regulation of bone morphogenic protein 2 gene and protein expression and induced highest phosphorylated Smad1/5 protein level in ASCs. Treatment of the coculture medium with bone morphogenic protein 2 inhibitor (Noggin) largely abolished the osteogenic differentiation of the ASCs induced by the HOBs on PCL-rod nHA films. In conclusion, HOBs can not only best display their osteoblastic phenotype by culturing on PCL-rod nHA films but also render an optimal osteogenic niche for the differentiation of stem cells.
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Affiliation(s)
- ZuFu Lu
- Biomaterials and Tissue Engineering Research Unit, School of AMME, The University of Sydney, Sydney, Australia
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21
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Johnson EO, Troupis T, Soucacos PN. Tissue-engineered vascularized bone grafts: Basic science and clinical relevance to trauma and reconstructive microsurgery. Microsurgery 2011; 31:176-82. [DOI: 10.1002/micr.20821] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 06/21/2010] [Indexed: 01/21/2023]
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22
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Ma L, Zheng LW, Sham MH, Cheung LK. Uncoupled angiogenesis and osteogenesis in nicotine-compromised bone healing. J Bone Miner Res 2010; 25:1305-13. [PMID: 20200934 DOI: 10.1002/jbmr.19] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Nicotine is the main chemical component responsible for tobacco addiction. This study aimed to evaluate the influence of nicotine on angiogenesis and osteogenesis and the associated expression of angiogenic and osteogenic mediators during bone healing. Forty-eight adult New Zealand White rabbits were randomly assigned to a nicotine group and a control group. Nicotine pellets (1.5 g, 60-day time release) or placebo pellets were implanted in the neck subcutaneous tissue. The nicotine or placebo exposure time for all the animals was 7 weeks. Unilateral mandibular distraction osteogenesis was performed. Eight animals in each group were euthanized on day 5, day 11 of active distraction, and week 1 of consolidation, respectively. The mandibular samples were subjected to radiographic, histologic, immunohistochemical, and real-time reverse-transcriptase polymerase chain reaction examinations. Nicotine exposure upregulated the expression of hypoxia inducible factor 1alpha and vascular endothelial growth factor and enhanced angiogenesis but inhibited the expression of bone morphogenetic protein 2 and impaired bone healing. The results indicate that nicotine decouples angiogenesis and osteogenesis in this rabbit model of distraction osteogenesis, and the enhanced angiogenesis cannot compensate for the adverse effects of nicotine on bone healing.
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Affiliation(s)
- Li Ma
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
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23
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Flores Sánchez X, Guerra Farfan E, Corona Pérez-Cardona P, Amat Mateu C, Nardi Vilardaga J. Cirugía reconstructiva del aparato locomotor, nuevas técnicas y opciones terapéuticas. Rev Esp Cir Ortop Traumatol (Engl Ed) 2010. [DOI: 10.1016/s1888-4415(10)70006-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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24
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Abstract
Nanotechnology and its attendant techniques have yet to make a significant impact on the science of bone healing. However, the potential benefits are immediately obvious with the result that hundreds of researchers and firms are performing the basic research needed to mature this nascent, yet soon to be fruitful niche. Together with genomics and proteomics, and combined with tissue engineering, this is the new face of orthopaedic technology. The concepts that orthopaedic surgeons recognize are fabrication processes that have resulted in porous implant substrates as bone defect augmentation and medication-carrier devices. However, there are dozens of applications in orthopaedic traumatology and bone healing for nanometer-sized entities, structures, surfaces, and devices with characteristic lengths ranging from 10s of nanometers to a few micrometers. Examples include scaffolds, delivery mechanisms, controlled modification of surface topography and composition, and biomicroelectromechanical systems. We review the basic science, clinical implications, and early applications of the nanotechnology revolution and emphasize the rich possibilities that exist at the crossover region between micro- and nanotechnology for developing new treatments for bone healing.
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Abstract
Ongoing research at the molecular level has expanded our understanding of the physiological processes that regulate the complex phenomena of fracture healing and bone regeneration. A number of key molecules have been identified and shown to facilitate the progression of healing from one stage to another, leading to an uneventful outcome. Among these candidate molecules, bone morphogenetic proteins (BMPs) possess potent osteoinductive properties. They interact with osteoprogenitor cells, regulating both mitogenesis and differentiation potential. Since the discovery of BMPs, a number of experimental and clinical trials have supported their safety and efficacy of their use in therapy. Nonetheless, at times their efficacy falls short of expectations. Several factors have been identified as contributing to this result. It is anticipated that, as our knowledge expands and we understand better the complex pathways and cascades of molecular events attributable to BMPs, the application of these molecules in the clinical setting will continue to increase and to show more favourable outcomes.
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27
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Huh JE, Kwon NH, Baek YH, Lee JD, Choi DY, Jingushi S, Kim KI, Park DS. Formononetin promotes early fracture healing through stimulating angiogenesis by up-regulating VEGFR-2/Flk-1 in a rat fracture model. Int Immunopharmacol 2009; 9:1357-65. [DOI: 10.1016/j.intimp.2009.08.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 08/07/2009] [Accepted: 08/07/2009] [Indexed: 11/29/2022]
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28
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29
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Aoki K, Usui Y, Narita N, Ogiwara N, Iashigaki N, Nakamura K, Kato H, Sano K, Ogiwara N, Kametani K, Kim C, Taruta S, Kim YA, Endo M, Saito N. A thin carbon-fiber web as a scaffold for bone-tissue regeneration. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2009; 5:1540-1546. [PMID: 19334009 DOI: 10.1002/smll.200801610] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Due to the rapid progress being made in tissue regeneration therapy, biomaterials used as scaffolds are expected to play an important role in future clinical application. We report the development of a 3D web (sheet) consisting of high-purity carbon fibers in a nanoscale structure. When the thin carbon-fiber web (TCFW) and recombinant human bone morphogenetic protein 2 (rhBMP-2) composite is implanted in the murine back muscle, new ectopic bone is formed, and the values of the bone mineral content and bone mineral density are significantly higher than those obtained with a collagen sheet. Observation of the interface between the carbon fibers and bone matrix reveal that the fibers are directly integrated into the bone matrix, indicating high bone-tissue compatibility. Further, the rhBMP-2/TCFW composite repairs a critical-size bone defect within a short time period. These results suggest that the TCFW functions as an effective scaffold material and will play an important role in tissue regeneration in the future.
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Affiliation(s)
- Kaoru Aoki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan
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30
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Scheiner S, Sinibaldi R, Pichler B, Komlev V, Renghini C, Vitale-Brovarone C, Rustichelli F, Hellmich C. Micromechanics of bone tissue-engineering scaffolds, based on resolution error-cleared computer tomography. Biomaterials 2009; 30:2411-9. [DOI: 10.1016/j.biomaterials.2008.12.048] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Accepted: 12/19/2008] [Indexed: 11/16/2022]
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31
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Abstract
The past 10 years have witnessed many advances in craniofacial surgery. Advances in surgical techniques, such as distraction osteogenesis and endoscopic procedures, combined with refinements in surgical equipment, such as resorbable plating and distractors, have improved surgical outcomes, while minimizing morbidity. Technological advances in 3-dimensional imaging, computer simulation, and intraoperative navigation facilitate diagnosis, preoperative planning, and surgical execution. Rising cases of deformational plagiocephaly owing to increased supine infant sleep positioning necessitated the development of appropriate diagnosis and treatment and the avoidance of unnecessary surgery. A greater understanding of the genetic basis of craniofacial disorders has allowed better preoperative assessment and counseling. Finally, efforts to develop better bone graft substitutes with gene therapy and nanotechnology are ongoing.
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Affiliation(s)
- Sherard A Tatum
- Central New York Cleft and Craniofacial Center, Division of Facial Plastic and Reconstructive Surgery, State University of New York, Upstate Medical University, 750 E Adams St, Syracuse, NY 13210, USA.
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32
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Tran PA, Sarin L, Hurt RH, Webster TJ. Opportunities for nanotechnology-enabled bioactive bone implants. ACTA ACUST UNITED AC 2009. [DOI: 10.1039/b814334j] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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33
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Terra J, Dourado ER, Eon JG, Ellis DE, Gonzalez G, Rossi AM. The structure of strontium-doped hydroxyapatite: an experimental and theoretical study. Phys Chem Chem Phys 2009; 11:568-77. [DOI: 10.1039/b802841a] [Citation(s) in RCA: 157] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Bone loss from trauma, neoplasia, reconstructive surgery and congenital defects remains a major health problem, making the development of effective bone regeneration therapies a primary priority. The long-term clinical goal is to reconstruct bony tissue in an anatomically functional three-dimensional morphology. Today, the science of bone regeneration is in its infancy with current and emerging therapies still having significant limitations. In addition to bone grafting, current bone regeneration strategies include the application of different bioactive factors, cell types, biologic or artificial scaffolds, alone or in various combinations. Recently, efforts are focused more on understanding the normal bone regenerative process where multiple factors interact in a defined temporal and spatial cascade of events. Bone biology has benefited over the last decade from an explosion of information regarding the molecular mechanisms underlying bone formation and resorption, as well as the feedback signals controlling these complex homeostatic mechanisms. New insights in the complexity of the homeostatic mechanisms regulating bone remodeling have uncovered potential therapeutic strategies for bone repair.
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Affiliation(s)
- Panayotis N Soucacos
- Department of Orthopaedic Surgery, University of Athens, School of Medicine, Athens, Greece.
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35
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Keramaris NC, Calori GM, Nikolaou VS, Schemitsch EH, Giannoudis PV. Fracture vascularity and bone healing: a systematic review of the role of VEGF. Injury 2008; 39 Suppl 2:S45-57. [PMID: 18804573 DOI: 10.1016/s0020-1383(08)70015-9] [Citation(s) in RCA: 217] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Fracture healing constitutes a complex and delicate physiological process. Local vascularity at the site of the fracture has been identified as one of the most significant parameters influencing the healing procedure. VEGF is the most important component of the regeneration of the vascular system at the fracture site. The aim of this review is to determine the evidence supporting the direct role of VEGF in the enhancement of fracture healing and the possible clinical use of VEGF for non-unions. The literature search was performed via the internet using the Medline. The key words which were searched in the abstracts were the terms "VEGF", "angiogenesis", "fracture", "bone" and "healing". Twenty-five articles were relevant to the topic of interest. A total of 11 articles were excluded from our research due to non conformity of their content to the inclusion criteria. Evidence retrieved suggests that VEGF could be extremely valuable for the treatment of critical size bone defects and that VEGF could have a direct effect on osteoprogenitor cells, mainly by promoting the differentiation of osteoblasts and by increasing the mineralisation of the regenerated bone. The former observation could have very interesting repercussions for the field of non-unions and the latter for the field of osteoporosis.
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Affiliation(s)
- N C Keramaris
- Academic Dept of Trauma & Orthopaedics, Leeds Teaching Hospitals, University of Leeds, Leeds, UK
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36
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Abstract
In the Trauma and Orthopaedic discipline, tissue engineering attempts to convert scientific knowledge into new products and methods of treatment in order to advance the repair, replacement, or regeneration of tissues such as bone, cartilage, tendon and ligament. Currently, tissue engineering strategies are based mainly on cell and tissue-based approaches. We have previously reported that the standard tissue engineering approach to provide solutions for impaired fracture healing, bone restoration and regeneration must include the utilisation of growth factors, scaffolds, mesenchymal stem cells and an optimal mechanical environment (diamond concept). These strategies are already benefiting patients, but as our understanding of the physiological processes increases, a number of questions come up requiring clarification and answers. In this article, important issues which continue to remain obscured are discussed.
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Affiliation(s)
- Peter V Giannoudis
- Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals, University of Leeds, UK.
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Abstract
Over the years giant steps have been made in the evolution of fracture fixation and the overall clinical care of patients. Better understanding of the physiological response to injury, bone biology, biomechanics and implants has led to early mobilisation of patients. A significant reduction in complications during the pre-operative and post-operative phases has also been observed, producing better functional results. A number of innovations have contributed to these improved outcomes and this article reports on the advances made in osteosynthesis and fracture care.
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Giannoudis PV, Stengel D. Clinical research in trauma and orthopaedic surgery--call for action. Injury 2008; 39:627-30. [PMID: 18508056 DOI: 10.1016/j.injury.2008.01.052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 01/24/2008] [Indexed: 02/02/2023]
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39
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40
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Giannoudis PV, Einhorn TA, Marsh D. Fracture healing: a harmony of optimal biology and optimal fixation? Injury 2007; 38 Suppl 4:S1-2. [PMID: 18224730 DOI: 10.1016/s0020-1383(08)70002-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Peter V Giannoudis
- Academic Dept of Trauma & Orthopaedics, Leeds Teaching Hospitals, University of Leeds, UK.
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Abstract
Fracture healing is a complex physiological process. With the latest advances made in molecular biology and genetics it is now known that it involves the spatial and temporal coordinated action of several different cell types, proteins and the expression of hundreds of genes working towards restoring its structural integrity without scar formation. The standard tissue engineering approach to provide solutions for impaired fracture healing, bone restoration and regeneration includes the utilisation of growth factors, scaffolds and mesenchymal stem cells (triangular concept). However, although the mechanical environment is discussed and is considered as an important element in bone regeneration, its importance is often underestimated and it is not always given the necessary attention. The available scientific evidence supports the view that all the 4 known factors contributing to bone restoration should be given an equal acknowledgment and recognition. The traditional discussed triangular concept therefore should be reconsidered and be accepted as the 'diamond concept'.
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