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Perez JR, Kouroupis D, Li DJ, Best TM, Kaplan L, Correa D. Tissue Engineering and Cell-Based Therapies for Fractures and Bone Defects. Front Bioeng Biotechnol 2018; 6:105. [PMID: 30109228 PMCID: PMC6079270 DOI: 10.3389/fbioe.2018.00105] [Citation(s) in RCA: 207] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 07/09/2018] [Indexed: 12/25/2022] Open
Abstract
Bone fractures and segmental bone defects are a significant source of patient morbidity and place a staggering economic burden on the healthcare system. The annual cost of treating bone defects in the US has been estimated to be $5 billion, while enormous costs are spent on bone grafts for bone injuries, tumors, and other pathologies associated with defective fracture healing. Autologous bone grafts represent the gold standard for the treatment of bone defects. However, they are associated with variable clinical outcomes, postsurgical morbidity, especially at the donor site, and increased surgical costs. In an effort to circumvent these limitations, tissue engineering and cell-based therapies have been proposed as alternatives to induce and promote bone repair. This review focuses on the recent advances in bone tissue engineering (BTE), specifically looking at its role in treating delayed fracture healing (non-unions) and the resulting segmental bone defects. Herein we discuss: (1) the processes of endochondral and intramembranous bone formation; (2) the role of stem cells, looking specifically at mesenchymal (MSC), embryonic (ESC), and induced pluripotent (iPSC) stem cells as viable building blocks to engineer bone implants; (3) the biomaterials used to direct tissue growth, with a focus on ceramic, biodegradable polymers, and composite materials; (4) the growth factors and molecular signals used to induce differentiation of stem cells into the osteoblastic lineage, which ultimately leads to active bone formation; and (5) the mechanical stimulation protocols used to maintain the integrity of the bone repair and their role in successful cell engraftment. Finally, a couple clinical scenarios are presented (non-unions and avascular necrosis—AVN), to illustrate how novel cell-based therapy approaches can be used. A thorough understanding of tissue engineering and cell-based therapies may allow for better incorporation of these potential therapeutic approaches in bone defects allowing for proper bone repair and regeneration.
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Affiliation(s)
- Jose R Perez
- Department of Orthopedics, UHealth Sports Medicine Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Dimitrios Kouroupis
- Department of Orthopedics, UHealth Sports Medicine Institute, Miller School of Medicine, University of Miami, Miami, FL, United States.,Diabetes Research Institute & Cell Transplant Center, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Deborah J Li
- Department of Orthopedics, UHealth Sports Medicine Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Thomas M Best
- Department of Orthopedics, UHealth Sports Medicine Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Lee Kaplan
- Department of Orthopedics, UHealth Sports Medicine Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Diego Correa
- Department of Orthopedics, UHealth Sports Medicine Institute, Miller School of Medicine, University of Miami, Miami, FL, United States.,Diabetes Research Institute & Cell Transplant Center, Miller School of Medicine, University of Miami, Miami, FL, United States
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Gao X, Chen M, Yang X, Harper L, Ahmed I, Lu J. Simulating damage onset and evolution in fully bio-resorbable composite under three-point bending. J Mech Behav Biomed Mater 2018; 81:72-82. [PMID: 29500980 DOI: 10.1016/j.jmbbm.2018.02.022] [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: 12/11/2017] [Revised: 02/10/2018] [Accepted: 02/17/2018] [Indexed: 10/18/2022]
Abstract
This paper presents a strain-based damage model to predict the stress-strain relationship and investigate the damage onset and evolution of the fibre and matrix of a fully bio-resorbable phosphate glass fibre reinforced composite under three-point bending. The flexural properties of the composite are crucial, particularly when it is employed as implant for long bone fracture. In the model, the 3D case of the strain and stress was used and the response of the undamaged material was assumed to be linearly elastic. The onset of damage was indicated by two damage variables for the fibre and matrix, respectively. The damage evolution law was based on the damage variable and the facture energy of the fibre and matrix, individually. A finite element (FE) model was created to implement the constitutive model and conduct numerical tests. An auto-adaptive algorithm is integrated in the FE model to improve the convergence. The FE model was capable of predicting the flexural modulus with around 3% relative error, and the flexural strength within 2% relative error in comparison with the experimental data. The numerical indices showed that the top surface of the sample was the most vulnerable under three-point bending. It was also found that the damage initiated in the fibre, was the primary driver for composite failure under three-point bending.
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Affiliation(s)
- Xi Gao
- International Doctoral Innovation Centre, University of Nottingham Ningbo China, 315100, China
| | - Menghao Chen
- Faculty of Engineering, University of Nottingham, NG7 2RD, United Kingdom
| | - Xiaogang Yang
- International Doctoral Innovation Centre, University of Nottingham Ningbo China, 315100, China
| | - Lee Harper
- Faculty of Engineering, University of Nottingham, NG7 2RD, United Kingdom
| | - Ifty Ahmed
- Faculty of Engineering, University of Nottingham, NG7 2RD, United Kingdom
| | - Jiawa Lu
- International Doctoral Innovation Centre, University of Nottingham Ningbo China, 315100, China.
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Biodegradable Materials for Bone Repair and Tissue Engineering Applications. MATERIALS 2015; 8:5744-5794. [PMID: 28793533 PMCID: PMC5512653 DOI: 10.3390/ma8095273] [Citation(s) in RCA: 354] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 08/09/2015] [Accepted: 08/24/2015] [Indexed: 12/21/2022]
Abstract
This review discusses and summarizes the recent developments and advances in the use of biodegradable materials for bone repair purposes. The choice between using degradable and non-degradable devices for orthopedic and maxillofacial applications must be carefully weighed. Traditional biodegradable devices for osteosynthesis have been successful in low or mild load bearing applications. However, continuing research and recent developments in the field of material science has resulted in development of biomaterials with improved strength and mechanical properties. For this purpose, biodegradable materials, including polymers, ceramics and magnesium alloys have attracted much attention for osteologic repair and applications. The next generation of biodegradable materials would benefit from recent knowledge gained regarding cell material interactions, with better control of interfacing between the material and the surrounding bone tissue. The next generations of biodegradable materials for bone repair and regeneration applications require better control of interfacing between the material and the surrounding bone tissue. Also, the mechanical properties and degradation/resorption profiles of these materials require further improvement to broaden their use and achieve better clinical results.
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Zhou J, Huang W, Li Q, She Z, Chen F, Li L. A novel multilayer model with controllable mechanical properties for magnesium-based bone plates. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:164. [PMID: 25791460 DOI: 10.1007/s10856-015-5504-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 02/23/2015] [Indexed: 06/04/2023]
Abstract
Proper mechanical properties are essential for the clinical application of magnesium-based implants. In the present work, a novel multilayer model composed of three layers with desirable features was developed. The modulus of the multilayer model can be adjusted by changing the thickness of each layer. To combine three layers and improve the corrosion resistance of the whole multilayer model, the polycaprolactone coating was employed. In the immersion test, pH values, the concentration of released magnesium ions, and weight loss indicate that the corrosion rate of multilayer models is considerable lower than that of the one-layer bare substrate. The three-point bending test, which is used to examine models' mechanical properties, shows that the flexural modulus of multilayer models is reduced effectively. In addition, the mechanical degradation of multilayer models is more stable, compared to the one-layer substrate.
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Affiliation(s)
- Juncen Zhou
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
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Liu X, Hasan MS, Grant DM, Harper LT, Parsons AJ, Palmer G, Rudd CD, Ahmed I. Mechanical, degradation and cytocompatibility properties of magnesium coated phosphate glass fibre reinforced polycaprolactone composites. J Biomater Appl 2014; 29:675-87. [DOI: 10.1177/0885328214541302] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Retention of mechanical properties of phosphate glass fibre reinforced degradable polyesters such as polycaprolactone and polylactic acid in aqueous media has been shown to be strongly influenced by the integrity of the fibre/polymer interface. A previous study utilising ‘single fibre’ fragmentation tests found that coating with magnesium improved the fibre and matrix interfacial shear strength. Therefore, the aim of this study was to investigate the effects of a magnesium coating on the manufacture and characterisation of a random chopped fibre reinforced polycaprolactone composite. Short chopped strand non-woven phosphate glass fibre mats were sputter coated with degradable magnesium to manufacture phosphate glass fibre/polycaprolactone composites. The degradation behaviour (water uptake, mass loss and pH change of the media) of these polycaprolactone composites as well as of pure polycaprolactone was investigated in phosphate buffered saline. The Mg coated fibre reinforced composites revealed less water uptake and mass loss during degradation compared to the non-coated composites. The cations released were also explored and a lower ion release profile for all three cations investigated (namely Na+, Mg2+ and Ca2+) was seen for the Mg coated composite samples. An increase of 17% in tensile strength and 47% in tensile modulus was obtained for the Mg coated composite samples. Both flexural and tensile properties were investigated and a higher retention of mechanical properties was obtained for the Mg coated fibre reinforced composite samples up to 10 days immersion in PBS. Cytocompatibility study showed both composite samples (coated and non-coated) had good cytocompatibility with human osteosarcoma cell line.
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Affiliation(s)
- Xiaoling Liu
- Division of Materials, Mechanics and Structures, Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Muhammad S Hasan
- Division of Materials, Mechanics and Structures, Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - David M Grant
- Division of Materials, Mechanics and Structures, Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Lee T Harper
- Division of Materials, Mechanics and Structures, Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Andrew J Parsons
- Division of Materials, Mechanics and Structures, Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Graham Palmer
- Biomaterials and Tissue Engineering, Eastman Dental Institute, University College London, London, UK
| | - Chris D Rudd
- Division of Materials, Mechanics and Structures, Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Ifty Ahmed
- Division of Materials, Mechanics and Structures, Faculty of Engineering, University of Nottingham, Nottingham, UK
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