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Aydınoğlu A. Enhancing orthopedic outcomes: A comparative analysis of gentamicin sulphate and nanosilver in bone cement. Heliyon 2024; 10:e35189. [PMID: 39157348 PMCID: PMC11328090 DOI: 10.1016/j.heliyon.2024.e35189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 08/20/2024] Open
Abstract
Background Orthopedic surgeries frequently utilize bone cement, which can increase the risk of postoperative infections. Addressing this challenge, this study aims to enhance the mechanical, physical, and handling properties of bone cement by integrating gentamicin sulfate (GS) and nanosilver (nAg). The objective is to evaluate and compare the effects of these additives on properties such as compressive strength, flexural strength, doughing time, working time, setting time, and exothermic temperature. By doing so, the study seeks to identify a safer and more effective alternative to traditional antibiotics in bone cement formulations, thereby improving clinical outcomes in orthopedic procedures. Methods This research involved a comparative analysis of modified cements against standard cements, focusing on compressive strength, flexural strength, doughing time, working time, setting time, and exothermic temperature. Various bone cement samples with GS and nAg additives were prepared and tested in accordance with international standards (ISO 5833:2002 and ASTM F451). Statistical analysis, including one-way and two-way ANOVA tests, was used to assess the significance of the results. Results nAg-loaded cements exhibit mechanical and physical properties on par with or supe-rior to those of GS-loaded and standard cements. Notably, nAg incorporation leads to significantly lower exothermic temperatures, reducing the risk of thermal bone tissue damage. This finding highlights that nAg-loaded cement is a safer alternative. Alongside unaltered or enhanced strength, nAgs demonstrate promise for orthopedic applications, particularly in primary arthroplasty. Additionally, nAgs reduce doughing time, enhancing the practicality of these methods in surgical settings. Conclusions In conclusion, this study underscores the potential advantages of incorporating GSs and nAgs into bone cement. nAg-loaded cement offers improved properties and reduced infection risk, making it a valuable choice for orthopedic procedures. It enhances both mechanical performance and safety, addressing crucial concerns in orthopedic surgery.
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Affiliation(s)
- Aysu Aydınoğlu
- Yıldız Technical University, Faculty of Chemistry and Metallurgy, Department of Metallurgy and Materials Engineering, Istanbul, 34349, Turkiye
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Liu D, Li H, Yang Y, Xu S, Zheng X, Liu J, Miyazaki T, Zhu Y. Preparation and characterizations of antibacterial poly(methyl methacrylate) bone cement via copolymerization with a quaternary ammonium monomer of dimethylaminotriclosan methacrylate. J Mech Behav Biomed Mater 2024; 151:106367. [PMID: 38194787 DOI: 10.1016/j.jmbbm.2023.106367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/30/2023] [Accepted: 12/31/2023] [Indexed: 01/11/2024]
Abstract
Poly (methyl methacrylate) (PMMA) bone cement relies on the loaded antibiotic to realize the antibacterial purpose. But the exothermic behavior during setting often makes temperature-sensitive antibiotics inactivated. It is necessary to develop new material candidates to replace antibiotics. In this study, a new quaternary ammonium methacrylate (QAM) monomer called dimethylaminetriclosan methacrylate (DMATCM) was designed by the quaternization between 2-(Dimethylamino)ethyl methacrylate and triclosan, then employed as the modifier to explore the feasibility of equipping bone cement with antibacterial activity, and to investigate the variations on the physical and biological performances brought by the substitution ratio of DMATCM to MMA. Results showed that DMATCM opened its C=C bonding to participate in the MMA polymerization, and the quaternary ammonium group helped it to perform broad-spectrum antibacterial property against both Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. With an increased substitution ratio of DMATCM to MMA, the glass transition temperatures, the maximum exothermic temperatures, and the contact angles of bone cements declined, but the residual monomer contents, the fluid uptakes, and the setting times under Vical indentation increased. Long-term soaking made almost no changes to the weight loss and the mechanical properties of DMATCM-modified cements with lower substitution ratios of 0∼20%, and the activation rather enhanced the strengths of uncured AMBC-4 and AMBC-5 samples. Owing to more DMATCM exposed on the cement surface, the inhibition ring diameter produced by modified cement was improved to a maximum of 28.09 mm, and MC3T3-E1 cells performed the cell viabilities all beyond 70% and healthy adhesion after 72 h co-culturing. Taking all measured properties and ISO standards into account, the antibacterial bone cement under the ratio of 10% performed better, besides its good bactericidal effect, the other properties satisfied the requirements for clinical application.
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Affiliation(s)
- Dong Liu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Haoyang Li
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Yunping Yang
- Spine Surgery Department, Affiliated Hospital of Yunnan University, No.176 Qingnian Road, Wuhua District, Kunming, Yunnan, 650021, China.
| | - Shan Xu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Xihao Zheng
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Jinkun Liu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Toshiki Miyazaki
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, 2-4, Hibikino, Wakamatsu-ku, Kitakyushu-shi, 808-0196, Japan.
| | - Yan Zhu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
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Zhang M, Xu F, Cao J, Dou Q, Wang J, Wang J, Yang L, Chen W. Research advances of nanomaterials for the acceleration of fracture healing. Bioact Mater 2024; 31:368-394. [PMID: 37663621 PMCID: PMC10474571 DOI: 10.1016/j.bioactmat.2023.08.016] [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: 06/16/2023] [Revised: 08/15/2023] [Accepted: 08/15/2023] [Indexed: 09/05/2023] Open
Abstract
The bone fracture cases have been increasing yearly, accompanied by the increased number of patients experiencing non-union or delayed union after their bone fracture. Although clinical materials facilitate fracture healing (e.g., metallic and composite materials), they cannot fulfill the requirements due to the slow degradation rate, limited osteogenic activity, inadequate osseointegration ability, and suboptimal mechanical properties. Since early 2000, nanomaterials successfully mimic the nanoscale features of bones and offer unique properties, receiving extensive attention. This paper reviews the achievements of nanomaterials in treating bone fracture (e.g., the intrinsic properties of nanomaterials, nanomaterials for bone defect filling, and nanoscale drug delivery systems in treating fracture delayed union). Furthermore, we discuss the perspectives on the challenges and future directions of developing nanomaterials to accelerate fracture healing.
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Affiliation(s)
- Mo Zhang
- School of Pharmacy, Key Laboratory of Innovative Drug Development and Evaluation, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Fan Xu
- School of Pharmacy, Key Laboratory of Innovative Drug Development and Evaluation, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Jingcheng Cao
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, PR China
- Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang, 050051, PR China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, PR China
| | - Qingqing Dou
- School of Pharmacy, Key Laboratory of Innovative Drug Development and Evaluation, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Juan Wang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, PR China
- Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang, 050051, PR China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, PR China
| | - Jing Wang
- School of Pharmacy, Key Laboratory of Innovative Drug Development and Evaluation, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Lei Yang
- Center for Health Sciences and Engineering, Hebei Key Laboratory of Biomaterials and Smart Theranostics, School of Health Sciences and Biomedical Engineering, Hebei University of Technology, Tianjin, 300131, PR China
| | - Wei Chen
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, PR China
- Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang, 050051, PR China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, PR China
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Cherednichenko K, Sayfutdinova A, Rimashevskiy D, Malik B, Panchenko A, Kopitsyna M, Ragnaev S, Vinokurov V, Voronin D, Kopitsyn D. Composite Bone Cements with Enhanced Drug Elution. Polymers (Basel) 2023; 15:3757. [PMID: 37765611 PMCID: PMC10535863 DOI: 10.3390/polym15183757] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Antibiotic-loaded bone cement (ALBC) has become an indispensable material in orthopedic surgery in recent decades, owing to the possibility of drugs delivery to the surgical site. It is applied for both infection prophylaxis (e.g., in primary joint arthroplasty) and infection treatment (e.g., in periprosthetic infection). However, the introduction of antibiotic to the polymer matrix diminishes the mechanical strength of the latter. Moreover, the majority of the loaded antibiotic remains embedded in polymer and does not participate in drug elution. Incorporation of the various additives to ALBC can help to overcome these issues. In this paper, four different natural micro/nanoscale materials (halloysite, nanocrystalline cellulose, micro- and nanofibrillated cellulose) were tested as additives to commercial Simplex P bone cement preloaded with vancomycin. The influence of all four materials on the polymerization process was comprehensively studied, including the investigation of the maximum temperature of polymerization, setting time, and monomer leaching. The introduction of the natural additives led to a considerable enhancement of drug elution and microhardness in the composite bone cements compared to ALBC. The best combination of the polymerization rate, monomer leaching, antibiotic release, and microhardness was observed for the sample containing nanofibrillated cellulose (NFC).
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Affiliation(s)
- Kirill Cherednichenko
- Department of Physical and Colloid Chemistry, Faculty of Chemical and Environmental Engineering, National University of Oil and Gas “Gubkin University”, Moscow 119991, Russia; (K.C.)
| | - Adeliya Sayfutdinova
- Department of Physical and Colloid Chemistry, Faculty of Chemical and Environmental Engineering, National University of Oil and Gas “Gubkin University”, Moscow 119991, Russia; (K.C.)
| | - Denis Rimashevskiy
- Department of Physical and Colloid Chemistry, Faculty of Chemical and Environmental Engineering, National University of Oil and Gas “Gubkin University”, Moscow 119991, Russia; (K.C.)
- Department of Traumatology and Orthopedics, Peoples’ Friendship University of Russia, Moscow 117198, Russia
| | - Birzhan Malik
- Astana Medical University, Beybitshilik Street 49a, Astana 010000, Kazakhstan
| | - Andrey Panchenko
- Department of Physical and Colloid Chemistry, Faculty of Chemical and Environmental Engineering, National University of Oil and Gas “Gubkin University”, Moscow 119991, Russia; (K.C.)
| | - Maria Kopitsyna
- Russian Institute for Scientific and Technical Information “VINITI RAS”, Moscow 125190, Russia
| | - Stanislav Ragnaev
- Multidisciplinary Hospital Named after Professor Kh.Zh. Makazhanov, Karaganda 100000, Kazakhstan
| | - Vladimir Vinokurov
- Department of Physical and Colloid Chemistry, Faculty of Chemical and Environmental Engineering, National University of Oil and Gas “Gubkin University”, Moscow 119991, Russia; (K.C.)
| | - Denis Voronin
- Department of Physical and Colloid Chemistry, Faculty of Chemical and Environmental Engineering, National University of Oil and Gas “Gubkin University”, Moscow 119991, Russia; (K.C.)
| | - Dmitry Kopitsyn
- Department of Physical and Colloid Chemistry, Faculty of Chemical and Environmental Engineering, National University of Oil and Gas “Gubkin University”, Moscow 119991, Russia; (K.C.)
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Tseng TH, Chang CH, Chen CL, Chiang H, Hsieh HY, Wang JH, Young TH. A simple method to improve the antibiotic elution profiles from polymethylmethacrylate bone cement spacers by using rapid absorbable sutures. BMC Musculoskelet Disord 2022; 23:916. [PMID: 36242041 PMCID: PMC9563514 DOI: 10.1186/s12891-022-05870-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/05/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Antibiotic-loaded bone cement beads and spacers have been widely used for orthopaedic infection. Poor antibiotic elution is not capable of eradicating microbial pathogens and could lead to treatment failure. The elution profiles differ among different cement formulations. Although Simplex P cement has the least release amount, it is widely used due to its ready availability. Previous methods aiming to improve the elution profiles were not translated well to clinical practice. We sought to address this by using easily available materials to improve the elution profile of antibiotics from PMMA, which allows clinicians to implement the method intraoperatively. METHODS Vancomycin was mixed with Simplex P cement. We used Vicryl Rapide sutures to fabricate sustained-release cement beads by repetitively passing the sutures through the beads and/or mixing suture segments into the cement formulation. Vancomycin elution was measured for 49 days. The mechanism of antibiotic release was observed with gross appearance and scanning electron microscopic images. The antimicrobial activities against MRSA were tested using an agar disk diffusion bioassay. RESULTS Passing Vicryl Rapide sutures through cement beads significantly improved the elution profiles in the 7-week period. The increased ratios were 9.0% on the first day and 118.0% from the 2nd day to the 49th day. Addition of suture segments did not increase release amount. The Vicryl Rapide sutures completely degraded at the periphery and partially degraded at the center. The antibiotic particles were released around the suture, while antibiotic particles kept densely entrapped in the control group. The antimicrobial activities were stronger in passing suture groups. CONCLUSION Passing fast absorbable sutures through PMMA cement is a feasible method to fabricate sustained-release antibiotic bone cement. Intra-cement tunnels can be formed, and the effect can last for at least 7 weeks. It is suitable for a temporary spacer between two stages of a revision surgery.
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Affiliation(s)
- Tzu-Hao Tseng
- Department of Biomedical Engineering, National Taiwan University, No.1 Jen Ai road section 1, 10002, Taipei, Taiwan.,Department of Orthopaedic Surgery, National Taiwan University Hospital, 7 Chungsan South Road, 10002, Taipei, Taiwan
| | - Chih-Hao Chang
- Department of Orthopaedic Surgery, National Taiwan University Hospital, 7 Chungsan South Road, 10002, Taipei, Taiwan.,Department of Orthopaedic Surgery, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan
| | - Chien-Lin Chen
- Department of Biomedical Engineering, National Taiwan University, No.1 Jen Ai road section 1, 10002, Taipei, Taiwan
| | - Hongsen Chiang
- Department of Orthopaedic Surgery, National Taiwan University Hospital, 7 Chungsan South Road, 10002, Taipei, Taiwan.,Department of Biomedical Engineering, National Taiwan University Hospital, Taipei City, Taiwan
| | - Hao-Ying Hsieh
- Department of Biomedical Engineering, National Taiwan University, No.1 Jen Ai road section 1, 10002, Taipei, Taiwan
| | - Jyh-Horng Wang
- Department of Orthopaedic Surgery, National Taiwan University Hospital, 7 Chungsan South Road, 10002, Taipei, Taiwan.
| | - Tai-Horng Young
- Department of Biomedical Engineering, National Taiwan University, No.1 Jen Ai road section 1, 10002, Taipei, Taiwan.
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Liu S, Chen X, Yu M, Li J, Liu J, Xie Z, Gao F, Liu Y. Applications of Titanium Dioxide Nanostructure in Stomatology. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27123881. [PMID: 35745007 PMCID: PMC9229536 DOI: 10.3390/molecules27123881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022]
Abstract
Breakthroughs in the field of nanotechnology, especially in nanochemistry and nanofabrication technologies, have been attracting much attention, and various nanomaterials have recently been developed for biomedical applications. Among these nanomaterials, nanoscale titanium dioxide (nano-TiO2) has been widely valued in stomatology due to the fact of its excellent biocompatibility, antibacterial activity, and photocatalytic activity as well as its potential use for applications such as dental implant surface modification, tissue engineering and regenerative medicine, drug delivery carrier, dental material additives, and oral tumor diagnosis and treatment. However, the biosafety of nano-TiO2 is controversial and has become a key constraint in the development of nano-TiO2 applications in stomatology. Therefore, in this review, we summarize recent research regarding the applications of nano-TiO2 in stomatology, with an emphasis on its performance characteristics in different fields, and evaluations of the biological security of nano-TiO2 applications. In addition, we discuss the challenges, prospects, and future research directions regarding applications of nano-TiO2 in stomatology that are significant and worthy of further exploration.
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Affiliation(s)
- Shuang Liu
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun 130000, China; (S.L.); (X.C.); (M.Y.); (J.L.); (J.L.); (Z.X.)
| | - Xingzhu Chen
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun 130000, China; (S.L.); (X.C.); (M.Y.); (J.L.); (J.L.); (Z.X.)
| | - Mingyue Yu
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun 130000, China; (S.L.); (X.C.); (M.Y.); (J.L.); (J.L.); (Z.X.)
| | - Jianing Li
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun 130000, China; (S.L.); (X.C.); (M.Y.); (J.L.); (J.L.); (Z.X.)
| | - Jinyao Liu
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun 130000, China; (S.L.); (X.C.); (M.Y.); (J.L.); (J.L.); (Z.X.)
| | - Zunxuan Xie
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun 130000, China; (S.L.); (X.C.); (M.Y.); (J.L.); (J.L.); (Z.X.)
| | - Fengxiang Gao
- Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130000, China
- Correspondence: (F.G.); (Y.L.); Tel.: +86-13756189633 (F.G.); +86-13756466950 (Y.L.)
| | - Yuyan Liu
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun 130000, China; (S.L.); (X.C.); (M.Y.); (J.L.); (J.L.); (Z.X.)
- Correspondence: (F.G.); (Y.L.); Tel.: +86-13756189633 (F.G.); +86-13756466950 (Y.L.)
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Kroczek K, Turek P, Mazur D, Szczygielski J, Filip D, Brodowski R, Balawender K, Przeszłowski Ł, Lewandowski B, Orkisz S, Mazur A, Budzik G, Cebulski J, Oleksy M. Characterisation of Selected Materials in Medical Applications. Polymers (Basel) 2022; 14:1526. [PMID: 35458276 PMCID: PMC9027145 DOI: 10.3390/polym14081526] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 11/19/2022] Open
Abstract
Tissue engineering is an interdisciplinary field of science that has developed very intensively in recent years. The first part of this review describes materials with medical and dental applications from the following groups: metals, polymers, ceramics, and composites. Both positive and negative sides of their application are presented from the point of view of medical application and mechanical properties. A variety of techniques for the manufacture of biomedical components are presented in this review. The main focus of this work is on additive manufacturing and 3D printing, as these modern techniques have been evaluated to be the best methods for the manufacture of medical and dental devices. The second part presents devices for skull bone reconstruction. The materials from which they are made and the possibilities offered by 3D printing in this field are also described. The last part concerns dental transitional implants (scaffolds) for guided bone regeneration, focusing on polylactide-hydroxyapatite nanocomposite due to its unique properties. This section summarises the current knowledge of scaffolds, focusing on the material, mechanical and biological requirements, the effects of these devices on the human body, and their great potential for applications.
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Affiliation(s)
- Kacper Kroczek
- Doctoral School of Engineering and Technical Sciences, Rzeszow University of Technology, 35-959 Rzeszow, Poland;
| | - Paweł Turek
- Faculty of Mechanical Engineering and Aeronautics, Rzeszow University of Technology, 35-959 Rzeszow, Poland; (Ł.P.); (G.B.)
| | - Damian Mazur
- Faculty of Electrical and Computer Engineering, Rzeszow University of Technology, 35-959 Rzeszow, Poland
| | - Jacek Szczygielski
- Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland; (J.S.); (K.B.); (B.L.); (S.O.); (A.M.)
- Department of Neurosurgery, Faculty of Medicine, Saarland University, 66123 Saarbrücken, Germany
| | - Damian Filip
- Institute of Medical Science, University of Rzeszow, 35-959 Rzeszow, Poland;
| | - Robert Brodowski
- Department of Maxillofacial Surgery, Fryderyk Chopin Clinical Voivodeship Hospital No.1 in Rzeszow, 35-055 Rzeszow, Poland;
| | - Krzysztof Balawender
- Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland; (J.S.); (K.B.); (B.L.); (S.O.); (A.M.)
| | - Łukasz Przeszłowski
- Faculty of Mechanical Engineering and Aeronautics, Rzeszow University of Technology, 35-959 Rzeszow, Poland; (Ł.P.); (G.B.)
| | - Bogumił Lewandowski
- Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland; (J.S.); (K.B.); (B.L.); (S.O.); (A.M.)
- Department of Maxillofacial Surgery, Fryderyk Chopin Clinical Voivodeship Hospital No.1 in Rzeszow, 35-055 Rzeszow, Poland;
| | - Stanisław Orkisz
- Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland; (J.S.); (K.B.); (B.L.); (S.O.); (A.M.)
| | - Artur Mazur
- Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland; (J.S.); (K.B.); (B.L.); (S.O.); (A.M.)
| | - Grzegorz Budzik
- Faculty of Mechanical Engineering and Aeronautics, Rzeszow University of Technology, 35-959 Rzeszow, Poland; (Ł.P.); (G.B.)
| | - Józef Cebulski
- Institute of Physics, University of Rzeszow, 35-959 Rzeszow, Poland;
| | - Mariusz Oleksy
- Faculty of Chemistry, Rzeszow University of Technology, 35-959 Rzeszow, Poland;
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Influence of Different Nanometals Implemented in PMMA Bone Cement on Biological and Mechanical Properties. NANOMATERIALS 2022; 12:nano12050732. [PMID: 35269220 PMCID: PMC8911740 DOI: 10.3390/nano12050732] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/15/2021] [Accepted: 02/11/2022] [Indexed: 01/27/2023]
Abstract
Cemented arthroplasty is a common process to fix prostheses when a patient becomes older and his/her bone quality deteriorates. The applied cements are biocompatible, can transfer loads, and dampen vibrations, but do not provide antibacterial protection. The present work is aimed at the development of cement with antibacterial effectivity achieved with the implementation of nanoparticles of different metals. The powders of Ag, Cu with particles size in a range of 10–30 nm (Cu10) and 70–100 nm (Cu70), AgCu, and Ni were added to PMMA cement. Their influence on compression strength, wettability, and antibacterial properties of cement was assessed. The surface topography of samples was examined with biological and scanning electron microscopy. The mechanical properties were determined by compression tests. A contact angle was observed with a goniometer. The biological tests included an assessment of cytotoxicity (XTT test on human cells Saos-2 line) and bacteria viability exposure (6 months). The cements with Ag and Cu nanopowders were free of bacteria. For AgCu and Ni nanoparticles, the bacterial solution became denser over time and, after 6 months, the bacteria clustered into conglomerates, creating a biofilm. All metal powders in their native form in direct contact reduce the number of eukaryotic cells. Cell viability is the least limited by Ag and Cu particles of smaller size. All samples demonstrated hydrophobic nature in the wettability test. The mechanical strength was not significantly affected by the additions of metal powders. The nanometal particles incorporated in PMMA-based bone cement can introduce long-term resistance against bacteria, not resulting in any serious deterioration of compression strength.
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Wang P, Lin H. [Research progress of nanomaterials in osteomyelitis treatment]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2021; 35:648-655. [PMID: 33998221 DOI: 10.7507/1002-1892.202012044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To review the related studies on the application of nanomaterials in the treatment of osteomyelitis, and to provide new ideas for the research and clinical treatment of osteomyelitis. Methods The literature about the treatment of osteomyelitis with nanomaterials at home and abroad in recent years was reviewed and analyzed. Results At present, surgical treatment and antibiotic application are the main treatment options for osteomyelitis. But there are many defects such as antibiotic resistance, residual bone defect, and low effective concentration of local drugs. The application of nanomaterials can make up for the above defects. In recent years, nanomaterials play an important role in the treatment of osteomyelitis by filling bone defects, establishing local drug delivery system, and self-antibacterial properties. Conclusion It will provide a new idea and an important research direction for the treatment of osteomyelitis to fully study the related characteristics of nanomaterials and select beneficial materials to make drug delivery system or substitute drugs.
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Affiliation(s)
- Peilin Wang
- Department of Orthopaedics, Shanghai General Hospital, Shanghai, 200080, P.R.China
| | - Haodong Lin
- Department of Orthopaedics, Shanghai General Hospital, Shanghai, 200080, P.R.China
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10
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Tuncer K, Gür B, Şenol O, Aydın MR, Gündoğdu Ö. New bone cements with Pluronic®F127 for prophylaxis and treatment of periprosthetic joint infections. J Mech Behav Biomed Mater 2021; 119:104496. [PMID: 33812290 DOI: 10.1016/j.jmbbm.2021.104496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022]
Abstract
In line with the increase in orthopedic prosthetic surgeries, there has been a significant rise in periprosthetic joint infections (PJI) due to Methicillin-Resistant Staphylococcus Aureus (MRSA) bacteria. In case of infection, antibiotic-added spacers are temporarily placed into the periprosthetic region. With the release of antibiotics usually failing to work in fighting off infection, recent studies have centered around developing more effective approaches. New polymethylmethacrylate (PMMA) cement mixtures were prepared for this study with Pluronic®F127, bicarbonate, and citric acid addition. Optimal solutions were searched by monitoring vancomycin release on consecutive days with HPLC in in-vitro. The strengths of the samples were measured via four-point bending tests. Compared to conventional PMMA, strength values were observed to have improved by about 20% with 1.0 g of Pluronic®F127. According to HPLC studies, the highest increase for the area under the curve value was obtained for Pluronic®F127 doped mixture with a value of about 20%. It is understood from SEM and BET studies that addition of Pluronic®F127 helps increase porosity. The present study concludes that the optimum concentration of Pluronic®F127 could improve the strength and drug-releasing capacity of the spacer by increasing its porosity.
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Affiliation(s)
- Kutsi Tuncer
- Department of Orthopedics and Traumatology, Faculty of Medicine, Ataturk University, 25240, Erzurum, Turkey; Anesthesiology, Clinical Research Office, Atatürk University, 25240, Erzurum, Turkey
| | - Bahri Gür
- Department of Biochemistry, Faculty of Sciences and Arts, Iğdır University, 76000, Iğdır, Turkey.
| | - Onur Şenol
- Department of Analytical Chemistry, Faculty of Pharmacy, Atatürk University, 25240, Erzurum, Turkey
| | - Muhammet Raci Aydın
- Department of Mechanical Engineering, Faculty of Engineering, Iğdır University, 76000, Iğdır, Turkey.
| | - Ömer Gündoğdu
- Department of Mechanical Engineering, Faculty of Engineering, Iğdır University, 76000, Iğdır, Turkey; Department of Mechanical Engineering, Faculty of Engineering, Atatürk University, 25240, Erzurum, Turkey
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11
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Rabiei M, Kashanian S, Samavati SS, Derakhshankhah H, Jamasb S, McInnes SJ. Nanotechnology application in drug delivery to osteoarthritis (OA), rheumatoid arthritis (RA), and osteoporosis (OSP). J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.102011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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12
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Soleymani Eil Bakhtiari S, Bakhsheshi‐Rad HR, Karbasi S, Tavakoli M, Hassanzadeh Tabrizi SA, Ismail AF, Seifalian A, RamaKrishna S, Berto F. Poly(methyl methacrylate) bone cement, its rise, growth, downfall and future. POLYM INT 2020. [DOI: 10.1002/pi.6136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Sanaz Soleymani Eil Bakhtiari
- Advanced Materials Research Center, Department of Materials Engineering Najafabad Branch, Islamic Azad University Najafabad Iran
| | - Hamid Reza Bakhsheshi‐Rad
- Advanced Materials Research Center, Department of Materials Engineering Najafabad Branch, Islamic Azad University Najafabad Iran
| | - Saeed Karbasi
- Biomaterials and Tissue Engineering Department, School of Advanced Technologies in Medicine Isfahan University of Medical Sciences Isfahan 81746‐73461 Iran
| | - Mohamadreza Tavakoli
- Department of Materials Engineering Isfahan University of Technology Isfahan 84156‐83111 Iran
| | - Sayed Ali Hassanzadeh Tabrizi
- Advanced Materials Research Center, Department of Materials Engineering Najafabad Branch, Islamic Azad University Najafabad Iran
| | - Ahmad Fauzi Ismail
- Advanced Membrane Technology Research Center (AMTEC) Universiti Teknologi Malaysia Skudai, Johor Bahru Johor 81310 Malaysia
| | - Alexander Seifalian
- Nanotechnology and Regenerative Medicine Commercialisation Centre (NanoRegMed Ltd) London Biosciences Innovation Centre 2 Royal College Street London NW1 0NH U.K
| | - Seeram RamaKrishna
- Department of Mechanical Engineering National University of Singapore 9 Engineering Drive 1 Singapore 117576 Singapore
| | - Filippo Berto
- Department of Mechanical and Industrial Engineering Norwegian University of Science and Technology 7491 Trondheim Norway
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13
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Xu YM, Peng HM, Feng B, Weng XS. Progress of antibiotic-loaded bone cement in joint arthroplasty. Chin Med J (Engl) 2020; 133:2486-2494. [PMID: 32960839 PMCID: PMC7575178 DOI: 10.1097/cm9.0000000000001093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Indexed: 11/26/2022] Open
Abstract
Bone cement, consisting of polymethyl methacrylate, is a bioinert material used for prothesis fixation in joint arthroplasty. To treat orthopedic infections, such as periprosthetic joint infection, antibiotic-loaded bone cement (ALBC) was introduced into clinical practice. Recent studies have revealed the limitations of the antibacterial effect of ALBC. Moreover, with the increase in high infection risk patients and highly resistant microbes, more researches and modification of ALBC are required. This paper reviewed latest findings about ALBC for most popular and destructive pathogens, summarized the influence of antibiotic kind, drug dosage, application method, and environment towards characteristic of ALBC. Subsequently, new cement additives and clinical applications of ALBC in joint arthroplasty were also discussed.
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Affiliation(s)
- Yi-Ming Xu
- Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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14
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Pan C, Hu Y, Gong Z, Yang Y, Liu S, Quan L, Yang Z, Wei Y, Ye W. Improved Blood Compatibility and Endothelialization of Titanium Oxide Nanotube Arrays on Titanium Surface by Zinc Doping. ACS Biomater Sci Eng 2020; 6:2072-2083. [PMID: 33455341 DOI: 10.1021/acsbiomaterials.0c00187] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Titanium dioxide nanotube arrays are widely used in biomaterials due to their unique tubular structure and tunable biocompatibility. In the present study, titanium oxide nanotube arrays with different diameters were prepared on the titanium surface by anodization, followed by zinc doping using hydrothermal treatment to enhance the biocompatibility. Both the nanotube dimensions and zinc doping had obvious influences on the hydrophilicity, protein adsorption, blood compatibility, and endothelial cell behaviors of the titanium surface. The increase of the diameter and zinc doping can improve the hydrophilicity of the titanium surface. The increase of nanotube diameter could reduce the albumin adsorption while increasing the fibrinogen adsorption. However, zinc doping can simultaneously promote the adsorption of albumin and fibrinogen, and the effect was more obvious for albumin. Zinc doping can significantly improve the blood compatibility of the titanium oxide nanotubes because it cannot only increase the activity of cyclophosphate guanylate (cGMP) but also significantly reduce the platelets adhesion and hemolysis rate. Moreover, it was also found that both the smaller diameter and zinc doping nanotubes can enhance the endothelial cell adhesion and proliferation as well as up-regulate the expression of NO and VEGF. Therefore, the zinc doped titanium dioxide nanotube array can be used to simultaneously improve the blood compatibility and promote endothelialization of the titanium-based biomaterials and implants, such as intravascular stents.
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Affiliation(s)
- Changjiang Pan
- Faculty of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huai'an 223003, China
| | - Youdong Hu
- Department of Geriatrics, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223003, China
| | - Zhihao Gong
- Faculty of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huai'an 223003, China
| | - Ya Yang
- Department of Geriatrics, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an 223003, China
| | - Sen Liu
- Faculty of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huai'an 223003, China
| | - Li Quan
- Faculty of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huai'an 223003, China
| | - Zhongmei Yang
- Faculty of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huai'an 223003, China
| | - Yanchun Wei
- Faculty of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huai'an 223003, China
| | - Wei Ye
- Faculty of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huai'an 223003, China
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15
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Ayatollahi MR, Ghouli S, Bahrami B. Experimental and theoretical fracture analyses for three biomaterials with dental applications. J Mech Behav Biomed Mater 2020; 103:103612. [PMID: 32090937 DOI: 10.1016/j.jmbbm.2019.103612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/30/2019] [Accepted: 12/31/2019] [Indexed: 01/24/2023]
Abstract
Dental materials are known as efficient tools to revive the functionality and integrity of decayed/missing tooth structure. Being frequently subjected to different mixtures of tensile and shear loads accompanied by temperature changes and suffering from pre-existing voids and imperfect interfaces at the same time, dental restorations and prostheses are found to be susceptible to crack initiation and growth. In this paper, fracture properties of three dental biomaterials namely polymethylmethacrylate (PMMA), 75Sr and 75Sr10 undergoing mixed tensile-shear loads are investigated. The PMMA used in this study has application as a cold-cured acrylic resin for repairing dental prostheses, while 75Sr and 75Sr10 are dental restorative materials. Fracture growth angle and onset of crack propagation are evaluated experimentally using shortened semi-circular bend specimens made from PMMA. In addition, the generalized maximum tangential strain (GMTSN) criterion is applied to theoretically predict the fracture behavior of the tested PMMA, as well as two other dental bio-composites reported in the literature viz 75Sr and 75Sr10. Good agreement is met between theory and practice when comparing fracture curves extracted from the GMTSN criterion and the experimental data points. Further, it is found that conventional stress- and strain-based fracture models fail to provide suitable estimates of crack growth behavior.
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Affiliation(s)
- Majid R Ayatollahi
- Fatigue and Fracture Laboratory, School of Mechanical Engineering, Center of Excellence in Experimental Solid Mechanics and Dynamics, Iran University of Science and Technology, Narmak, Tehran, 16846, Iran.
| | - Saeid Ghouli
- Fatigue and Fracture Laboratory, School of Mechanical Engineering, Center of Excellence in Experimental Solid Mechanics and Dynamics, Iran University of Science and Technology, Narmak, Tehran, 16846, Iran.
| | - Bahador Bahrami
- Fatigue and Fracture Laboratory, School of Mechanical Engineering, Center of Excellence in Experimental Solid Mechanics and Dynamics, Iran University of Science and Technology, Narmak, Tehran, 16846, Iran.
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Bistolfi A, Ferracini R, Albanese C, Vernè E, Miola M. PMMA-Based Bone Cements and the Problem of Joint Arthroplasty Infections: Status and New Perspectives. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E4002. [PMID: 31810305 PMCID: PMC6926619 DOI: 10.3390/ma12234002] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/14/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023]
Abstract
Polymethyl methacrylate (PMMA)-based bone cement is a biomaterial that has been used over the last 50 years to stabilize hip and knee implants or as a bone filler. Although PMMA-based bone cement is widely used and allows a fast-primary fixation to the bone, it does not guarantee a mechanically and biologically stable interface with bone, and most of all it is prone to bacteria adhesion and infection development. In the 1970s, antibiotic-loaded bone cements were introduced to reduce the infection rate in arthroplasty; however, the efficiency of antibiotic-containing bone cement is still a debated issue. For these reasons, in recent years, the scientific community has investigated new approaches to impart antibacterial properties to PMMA bone cement. The aim of this review is to summarize the current status regarding antibiotic-loaded PMMA-based bone cements, fill the gap regarding the lack of data on antibacterial bone cement, and explore the progress of antibacterial bone cement formulations, focusing attention on the new perspectives. In particular, this review highlights the innovative study of composite bone cements containing inorganic antibacterial and bioactive phases, which are a fascinating alternative that can impart both osteointegration and antibacterial properties to PMMA-based bone cement.
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Affiliation(s)
- Alessandro Bistolfi
- AO Citta’ della Salute e della Scienza. CTO Hospital, Department of Orthopedics. Via Zuretti 29, 10126 Turin, Italy; (A.B.); (C.A.)
| | - Riccardo Ferracini
- IRCCS Ospedale Policlinico San Martino, Department of Surgical Sciences and Integrated Diagnostics, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy;
| | - Carlo Albanese
- AO Citta’ della Salute e della Scienza. CTO Hospital, Department of Orthopedics. Via Zuretti 29, 10126 Turin, Italy; (A.B.); (C.A.)
| | - Enrica Vernè
- Department of Applied Science and Technology, PolitoBIOMed Lab, Politecnico di Torino, C.so Duca Degli Abruzzi 24, 10129 Torino, Italy;
| | - Marta Miola
- Department of Applied Science and Technology, PolitoBIOMed Lab, Politecnico di Torino, C.so Duca Degli Abruzzi 24, 10129 Torino, Italy;
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Chen L, Tang Y, Zhao K, Zha X, Liu J, Bai H, Wu Z. Fabrication of the antibiotic-releasing gelatin/PMMA bone cement. Colloids Surf B Biointerfaces 2019; 183:110448. [DOI: 10.1016/j.colsurfb.2019.110448] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/10/2019] [Accepted: 08/20/2019] [Indexed: 12/11/2022]
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Wekwejt M, Michno A, Truchan K, Pałubicka A, Świeczko-Żurek B, Osyczka AM, Zieliński A. Antibacterial Activity and Cytocompatibility of Bone Cement Enriched with Antibiotic, Nanosilver, and Nanocopper for Bone Regeneration. NANOMATERIALS (BASEL, SWITZERLAND) 2019; 9:E1114. [PMID: 31382557 PMCID: PMC6722923 DOI: 10.3390/nano9081114] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 12/11/2022]
Abstract
Bacterial infections due to bone replacement surgeries require modifications of bone cement with antibacterial components. This study aimed to investigate whether the incorporation of gentamicin or nanometals into bone cement may reduce and to what extent bacterial growth without the loss of overall cytocompatibility and adverse effects in vitro. The bone cement Cemex was used as the base material, modified either with gentamicin sulfate or nanometals: Silver or copper. The inhibition of bacterial adhesion and growth was examined against five different bacterial strains along with integrity of erythrocytes, viability of blood platelets, and dental pulp stem cells. Bone cement modified with nanoAg or nanoCu revealed greater bactericidal effects and prevented the biofilm formation better compared to antibiotic-loaded bone cement. The cement containing nanoAg displayed good cytocompatibility without noticeable hemolysis of erythrocytes or blood platelet disfunction and good viability of dental pulp stem cells (DPSC). On the contrary, the nanoCu cement enhanced hemolysis of erythrocytes, reduced the platelets aggregation, and decreased DPSC viability. Based on these studies, we suggest the modification of bone cement with nanoAg may be a good strategy to provide improved implant fixative for bone regeneration purposes.
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Affiliation(s)
- Marcin Wekwejt
- Biomaterials Division, Department of Materials Engineering and Bonding, Gdańsk University of Technology, 80-233 Gdańsk, Poland.
| | - Anna Michno
- Chair of Clinical Biochemistry, Department of Laboratory Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Karolina Truchan
- Department of Biology and Cell Imaging, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University, 30-387 Kraków, Poland
| | - Anna Pałubicka
- Department of Laboratory Diagnostics and Microbiology with Blood Bank, Specialist Hospital in Kościerzyna, 83-400 Kościerzyna, Poland
- Department of Surgical Oncologic, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Beata Świeczko-Żurek
- Biomaterials Division, Department of Materials Engineering and Bonding, Gdańsk University of Technology, 80-233 Gdańsk, Poland
| | - Anna Maria Osyczka
- Department of Biology and Cell Imaging, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University, 30-387 Kraków, Poland
| | - Andrzej Zieliński
- Biomaterials Division, Department of Materials Engineering and Bonding, Gdańsk University of Technology, 80-233 Gdańsk, Poland
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