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Zhang C, Cai X, Li M, Peng J, Mei J, Wang F, Zhang R, Zhou Y, Fang S, Xia D, Zhao J. Preclinical Evaluation of Bioactive Small Intestinal Submucosa-PMMA Bone Cement for Vertebral Augmentation. ACS Biomater Sci Eng 2024; 10:2398-2413. [PMID: 38477550 PMCID: PMC11005825 DOI: 10.1021/acsbiomaterials.3c01629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/25/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
In vertebroplasty and kyphoplasty, bioinert poly(methyl methacrylate) (PMMA) bone cement is a conventional filler employed for quick stabilization of osteoporotic vertebral compression fractures (OVCFs). However, because of the poor osteointegration, excessive stiffness, and high curing temperature of PMMA, the implant loosens, the adjacent vertebrae refracture, and thermal necrosis of the surrounding tissue occurs frequently. This investigation addressed these issues by incorporating the small intestinal submucosa (SIS) into PMMA (SIS-PMMA). In vitro analyses revealed that this new SIS-PMMA bone cement had improved porous structure, as well as reduced compressive modulus and polymerization temperature compared with the original PMMA. Furthermore, the handling properties of SIS-PMMA bone cement were not significantly different from PMMA. The in vitro effect of PMMA and SIS-PMMA was investigated on MC3T3-E1 cells via the Transwell insert model to mimic the clinical condition or directly by culturing cells on the bone cement samples. The results indicated that SIS addition substantially enhanced the proliferation and osteogenic differentiation of MC3T3-E1 cells. Additionally, the bone cement's biomechanical properties were also assessed in a decalcified goat vertebrae model with a compression fracture, which indicated the SIS-PMMA had markedly increased compressive strength than PMMA. Furthermore, it was proved that the novel bone cement had good biosafety and efficacy based on the International Standards and guidelines. After 12 weeks of implantation, SIS-PMMA indicated significantly more osteointegration and new bone formation ability than PMMA. In addition, vertebral bodies with cement were also extracted for the uniaxial compression test, and it was revealed that compared with the PMMA-implanted vertebrae, the SIS-PMMA-implanted vertebrae had greatly enhanced maximum strength. Overall, these findings indicate the potential of SIS to induce efficient fixation between the modified cement surface and the host bone, thereby providing evidence that the SIS-PMMA bone cement is a promising filler for clinical vertebral augmentation.
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Affiliation(s)
- Chi Zhang
- Department
of Orthopaedic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo 315010, China
- Zhejiang
Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Xiongxiong Cai
- Department
of Orthopaedic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo 315010, China
| | - Mei Li
- Key
Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang
Province, The First Affiliated Hospital
of Ningbo University, Ningbo 315010, China
| | - Jing Peng
- Zhejiang
Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
| | - Jin Mei
- Institute
of Biomaterials, The First Affiliated Hospital
of Ningbo University, Ningbo 315010, China
| | - Fangfang Wang
- Institute
of Biomaterials, The First Affiliated Hospital
of Ningbo University, Ningbo 315010, China
| | - Rui Zhang
- Institute
of Biomaterials, The First Affiliated Hospital
of Ningbo University, Ningbo 315010, China
| | - Yingjie Zhou
- Institute
of Biomaterials, The First Affiliated Hospital
of Ningbo University, Ningbo 315010, China
| | - Shuyu Fang
- Department
of Clinical Laboratory, The First Affiliated
Hospital of Ningbo University, Ningbo 315010, China
| | - Dongdong Xia
- Department
of Orthopaedic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo University, Ningbo 315010, China
| | - Jiyuan Zhao
- Zhejiang
Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315211, China
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2
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Dong L, Li Y, Cong H, Yu B, Shen Y. A review of chitosan in gene therapy: Developments and challenges. Carbohydr Polym 2024; 324:121562. [PMID: 37985064 DOI: 10.1016/j.carbpol.2023.121562] [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: 08/18/2023] [Revised: 10/14/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023]
Abstract
Gene therapy, as a revolutionary treatment, has been gaining more and more attention. The key to gene therapy is the selection of suitable vectors for protection of exogenous nucleic acid molecules and enabling their specific release in target cells. While viral vectors have been widely used in researches, non-viral vectors are receiving more attention due to its advantages. Chitosan (CS) has been widely used as non-viral organic gene carrier because of its good biocompatibility and its ability to load large amounts of nucleic acids. This paper summarizes and evaluates the potential of chitosan and its derivatives as gene delivery vector materials, along with factors influencing transfection efficiency, performance evaluation, ways to optimize infectious efficiency, and the current main research development directions. Additionally, it provides an outlook on its future prospects.
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Affiliation(s)
- Liang Dong
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China
| | - Yanan Li
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China
| | - Hailin Cong
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China; School of Materials Science and Engineering, Shandong University of Technology, Zibo 255000, China.
| | - Bing Yu
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China.
| | - Youqing Shen
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; Key Laboratory of Biomass Chemical Engineering of Ministry of Education, Center for Bionanoengineering, Department of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China
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3
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Quan Q, Gongping X, Ruisi N, Shiwen L. New Research Progress of Modified Bone Cement Applied to Vertebroplasty. World Neurosurg 2023; 176:10-18. [PMID: 37087028 DOI: 10.1016/j.wneu.2023.04.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/24/2023]
Abstract
Percutaneous vertebroplasty and percutaneous kyphoplasty are effective methods to treat acute osteoporotic vertebral compression fractures that can quickly provide patients with pain relief, prevent further height loss of the vertebral body, and help correct kyphosis. Many clinical studies have investigated the characteristics of bone cement. Bone cement is a biomaterial injected into the vertebral body that must have good biocompatibility and biosafety. The optimization of the characteristics of bone cement has become of great interest. Bone cement can be mainly divided into 3 types: polymethyl methacrylate, calcium phosphate cement, and calcium sulfate cement. Each type of cement has its own advantages and disadvantages. In the past 10 years, the performance of bone cement has been greatly improved via different methods. The aim of our review is to provide an overview of the current progress in the types of modified bone cement and summarize the key clinical findings.
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Affiliation(s)
- Qi Quan
- Department of Spine Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xu Gongping
- Department of Spine Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Na Ruisi
- Department of Gastrointestinal Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Li Shiwen
- Department of Spine Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, China.
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4
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Wilson BJ, Philipose Pampadykandathil L. Novel Bone Void Filling Cement Compositions Based on Shell Nacre and Siloxane Methacrylate Resin: Development and Characterization. Bioengineering (Basel) 2023; 10:752. [PMID: 37508779 PMCID: PMC10376770 DOI: 10.3390/bioengineering10070752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/09/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023] Open
Abstract
Shell nacre from Pinctada species has been extensively researched for managing bone defects. However, there is a gap in the research regarding using shell nacre powder as a cement with improved biological and physicochemical properties. To address this, bone void filling cement was formulated by incorporating shell nacre powder and an organically modified ceramic resin (ormocer). The shell nacre powder was specifically processed from the shells of Pinctada fucata and analysed using thermogravimetric analysis (TGA), X-ray diffraction spectroscopy, Fourier transform infrared (FTIR), and Raman spectroscopy, confirming the presence of organic constituents and inorganic aragonite. Trace element analysis confirmed the eligibility of shell nacre powder for biomedical applications. Next, the ormocer SNLSM2 was synthesized through a modified sol-gel method. FTIR, Raman, TGA, and transmission electron microscopy studies revealed the presence of a ladder-structured siloxane backbone and methacrylate side chain. To develop chemical curable composite shell nacre cement (SNC), different amounts of shell nacre (24%, 48%, and 72%) were added to the SNLSM2 resin, and the impact on the physicochemical properties of the cement was studied. Among the compositions, SNC 72 exhibited significantly lower linear polymerization shrinkage (0.4%) and higher compressive (>100 MPa) and flexural strength (>35 MPa). SNC 72 was radiopaque, and the exotherm generated during the cement curing was minimal. Cytotoxicity studies with L929 cells revealed the non-cytotoxic nature of the cement. Overall, the findings of this study prove that the shell nacre cement is a promising candidate for managing bone voids.
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Affiliation(s)
- Bridget Jeyatha Wilson
- Division of Dental Products, Department of Biomaterial Science and Technology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695 012, India
| | - Lizymol Philipose Pampadykandathil
- Division of Dental Products, Department of Biomaterial Science and Technology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695 012, India
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Wang T, Liu K, Wang J, Xiang G, Hu X, Bai H, Lei W, Tao TH, Feng Y. Spatiotemporal Regulation of Injectable Heterogeneous Silk Gel Scaffolds for Accelerating Guided Vertebral Repair. Adv Healthc Mater 2023; 12:e2202210. [PMID: 36465008 DOI: 10.1002/adhm.202202210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/27/2022] [Indexed: 12/12/2022]
Abstract
Osteoporotic vertebral fracture is jeopardizing the health of the aged population around the world, while the hypoxia microenvironment and oxidative damage of bone defect make it difficult to perform effective tissue regeneration. The balance of oxidative stress and the coupling of vessel and bone ingrowth are critical for bone regeneration. In this study, an injectable heterogeneous silk gel scaffold which can spatiotemporally and sustainedly release bone mesenchymal stem cell-derived small extracellular vesicles, HIF-1α pathway activator, and inhibitor is developed for bone repair and vertebral reinforcement. The initial enhancement of HIF-1α upregulates the expression of VEGF to promote angiogenesis, and the balance of reactive oxygen species level is regulated to effectively eliminate oxidative damage and abnormal microenvironment. The subsequent inhibition of HIF-1α avoids the overexpression of VEGF and vascular overgrowth. Meanwhile, complex macroporous structures and suitable mechanical support can be obtained within the silk gel scaffolds, which will promote in situ bone regeneration. These findings provide a new clinical translation strategy for osteoporotic vertebral augmentation on basis of hypoxia microenvironment improvement.
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Affiliation(s)
- Tianji Wang
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, China
| | - Keyin Liu
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai, 200050, China
| | - Jing Wang
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, China
| | - Geng Xiang
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, China
| | - Xiaofan Hu
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, China
| | - Hao Bai
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, China
| | - Wei Lei
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, China
| | - Tiger H Tao
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai, 200050, China.,Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China.,School of Physical Science and Technology, ShanghaiTech University, Shanghai, 200031, China.,Institute of Brain-Intelligence Technology, Zhangjiang Laboratory, Shanghai, 200031, China.,Shanghai Research Center for Brain Science and Brain-Inspired Intelligence, Shanghai, 200031, China
| | - Yafei Feng
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, China
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6
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Zhao X, Ma H, Han H, Zhang L, Tian J, Lei B, Zhang Y. Precision medicine strategies for spinal degenerative diseases: Injectable biomaterials with in situ repair and regeneration. Mater Today Bio 2022; 16:100336. [PMID: 35799898 PMCID: PMC9254127 DOI: 10.1016/j.mtbio.2022.100336] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/16/2022] [Accepted: 06/18/2022] [Indexed: 11/23/2022]
Abstract
As the population ages, spinal degeneration seriously affects quality of life in middle-aged and elderly patients, and prevention and treatment remain challenging for clinical surgeons. In recent years, biomaterials-based injectable therapeutics have attracted much attention for spinal degeneration treatment due to their minimally invasive features and ability to perform precise repair of irregular defects. However, the precise design and functional control of bioactive injectable biomaterials for efficient spinal degeneration treatment remains a challenge. Although many injectable biomaterials have been reported for the treatment of spinal degeneration, there are few reviews on the advances and effects of injectable biomaterials for spinal degeneration treatment. This work reviews the current status of the design and fabrication of injectable biomaterials, including hydrogels, bone cements and scaffolds, microspheres and nanomaterials, and the current progress in applications for treating spinal degeneration. Additionally, registered clinical trials were also summarized and key challenges and clinical translational prospects for injectable materials for the treatment of spinal degenerative diseases are discussed.
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7
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Tan QC, Jiang XS, Chen L, Huang JF, Zhou QX, Wang J, Zhao Y, Zhang B, Sun YN, Wei M, Zhao X, Yang Z, Lei W, Tang YF, Wu ZX. Bioactive graphene oxide-functionalized self-expandable hydrophilic and osteogenic nanocomposite for orthopaedic applications. Mater Today Bio 2022; 18:100500. [DOI: 10.1016/j.mtbio.2022.100500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/30/2022] [Accepted: 11/18/2022] [Indexed: 11/26/2022] Open
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8
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Shokri M, Dalili F, Kharaziha M, Baghaban Eslaminejad M, Ahmadi Tafti H. Strong and bioactive bioinspired biomaterials, next generation of bone adhesives. Adv Colloid Interface Sci 2022; 305:102706. [PMID: 35623113 DOI: 10.1016/j.cis.2022.102706] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/20/2022] [Accepted: 05/15/2022] [Indexed: 12/29/2022]
Abstract
The bone adhesive is a clinical requirement for complicated bone fractures always articulated by surgeons. Applying glue is a quick and easy way to fix broken bones. Adhesives, unlike conventional fixation methods such as wires and sutures, improve healing conditions and reduce postoperative pain by creating a complete connection at the fractured joint. Despite many efforts in the field of bone adhesives, the creation of a successful adhesive with robust adhesion and appropriate bioactivity for the treatment of bone fractures is still in its infancy. Because of the resemblance of the body's humid environment to the underwater environment, in the latest decades, researchers have pursued inspiration from nature to develop strong bioactive adhesives for bone tissue. The aim of this review article is to discuss the recent state of the art in bone adhesives with a specific focus on biomimetic adhesives, their action mechanisms, and upcoming perspective. Firstly, the adhesive biomaterials with specific affinity to bone tissue are introduced and their rational design is studied. Consequently, various types of synthetic and natural bioadhesives for bone tissue are comprehensively overviewed. Then, bioinspired-adhesives are described, highlighting relevant structures and examples of biomimetic adhesives mainly made of DOPA and the complex coacervates inspired by proteins secreted in mussel and sandcastle worms, respectively. Finally, this article overviews the challenges of the current bioadhesives and the future research for the improvement of the properties of biomimetic adhesives for use as bone adhesives.
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Affiliation(s)
- Mahshid Shokri
- Department of Materials Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran
| | - Faezeh Dalili
- School of Metallurgy & Materials Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Mahshid Kharaziha
- Department of Materials Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran.
| | - Mohamadreza Baghaban Eslaminejad
- Department of Stem Cells and Developmental Biology, Cell Sciences Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
| | - Hossein Ahmadi Tafti
- Tehran Heart Hospital Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Yu X, Shen G, Shang Q, Zhang Z, Zhao W, Zhang P, Liang D, Ren H, Jiang X. A Naringin-loaded gelatin-microsphere/nano-hydroxyapatite/silk fibroin composite scaffold promoted healing of critical-size vertebral defects in ovariectomised rat. Int J Biol Macromol 2021; 193:510-518. [PMID: 34710477 DOI: 10.1016/j.ijbiomac.2021.10.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/28/2021] [Accepted: 10/06/2021] [Indexed: 01/08/2023]
Abstract
In this study, we investigated the effect of three-dimensional of naringin/gelatin microspheres/nano-hydroxyapatite/silk fibroin (NG/GMs/nHA/SF) scaffolds on repair of a critical-size bone defect of lumbar 6 in osteoporotic rats. In this work, a cell-free scaffold for bone-tissue engineering based on a silk fibroin (SF)/nano-hydroxyapatite (nHA) scaffold was developed. The scaffold was fabricated by lyophilization. Naringin (NG) was loaded into gelatin microspheres (GMs), which were encapsulated in the nHA/SF scaffolds. The materials were characterized using x ray diffraction, Fourier-transform infrared spectroscopy, scanning electron microscopy, transmission electron microscopy and thermogravimetric analysis. Moreover, the biomechanics, degradation, and drug-release profile of the scaffold were also evaluated. In vitro, the effect of the scaffold on the adhesion, proliferation, and osteogenic differentiation of rat bone marrow mesenchymal stem cells (BMSCs) was evaluated. In vivo, at 3 months after ovariectomy, a critical-size lumbar defect was indued in the rats to evaluate scaffold therapeutic potential. A 3-mm defect in L6 developed in 60 SD rats, which were randomly divided into SF scaffold, nHA/SF scaffold, NG/nHA/SF scaffold, NG/GMs/nHA/SF scaffold, and blank groups (n = 12 each). At 4, 8, 12, and 16 weeks postoperatively, osteogenesis was evaluated by X-ray, micro-computed tomography, hematoxylin-eosin staining, and fast green staining, and by analysis of BMP-2, Runx2, and Ocn protein levels at 16 weeks. In our results, NG/GM/nHA/SF scaffolds exhibited good biocompatibility, biomechanical strength, and promoted BMSC adhesion, proliferation, and calcium nodule formation in vitro. Moreover, NG/GMs/nHA/SF scaffolds showed greater osteogenic differentiation potential than the other scaffolds in vitro. In vivo, gradual new bone formation was observed, and bone defects recovered by 16 weeks in the experimental group. In the blank group, limited bone formation was observed, and the bone defect was obvious. In conclusion, NG/GMs/nHA/SF scaffolds promoted repair of a lumbar 6 defect in osteoporotic rats. Therefore, the NG/GMs/nHA/SF biocomposite scaffold has potential as a bone-defect-filling biomaterial for bone regeneration.
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Affiliation(s)
- Xiang Yu
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Gengyang Shen
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qi Shang
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhida Zhang
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenhua Zhao
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peng Zhang
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - De Liang
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hui Ren
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Xiaobing Jiang
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China; Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China..
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10
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Chen L, Tang Y, Zhao K, Liu J, Jiang X, Sun Y, Zhao Y, Tan Q, Yang Z, Wu Z. High water‐absorbent and fast‐expanding
PMMA
bone cement with double‐bridged structure. J Appl Polym Sci 2021. [DOI: 10.1002/app.50464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Lei Chen
- School of Materials Science and Engineering Xi'an University of Technology Xi'an China
| | - Yufei Tang
- School of Materials Science and Engineering Xi'an University of Technology Xi'an China
| | - Kang Zhao
- School of Materials Science and Engineering Xi'an University of Technology Xi'an China
| | - Jiaxin Liu
- School of Materials Science and Engineering Xi'an University of Technology Xi'an China
| | - Xiashu Jiang
- School of Materials Science and Engineering Xi'an University of Technology Xi'an China
| | - Yani Sun
- School of Materials Science and Engineering Xi'an University of Technology Xi'an China
| | - Yan Zhao
- Institute of Orthopaedics Xi'jing Hospital, Fourth Military Medical University Xi'an China
| | - Quanchang Tan
- Institute of Orthopaedics Xi'jing Hospital, Fourth Military Medical University Xi'an China
| | - Zhao Yang
- Institute of Orthopaedics Xi'jing Hospital, Fourth Military Medical University Xi'an China
| | - Zixiang Wu
- Institute of Orthopaedics Xi'jing Hospital, Fourth Military Medical University Xi'an China
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11
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Sun H, Ma X, Li Z, Liu J, Wang W, Qi X. Release characteristics of enoxaparin sodium-loaded polymethylmethacrylate bone cement. J Orthop Surg Res 2021; 16:108. [PMID: 33541384 PMCID: PMC7860616 DOI: 10.1186/s13018-021-02223-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/11/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND This study aimed to prepare the polymethylmethacrylate (PMMA) bone cement release system with different concentrations of enoxaparin sodium (ES) and to investigate the release characteristics of ES after loading into the PMMA bone cement. METHODS In the experimental group, 40 g Palacos®R PMMA bone cement was loaded with various amount of ES 4000, 8000, 12,000, 16,000, 20,000, and 24,000 AXaIU, respectively. The control group was not loaded with ES. Scanning electron microscopy (SEM) was used to observe the surface microstructure of the bone cement in the two groups. In the experiment group, the mold was extracted continuously with pH7.4 Tris-HCL buffer for 10 days. The extract solution was collected every day and the anti-FXa potency was measured. The experiment design and statistical analysis were conducted using a quantitative response parallel line method. RESULTS Under the SEM, it was observed that ES was filled in the pores of PMMA bone cement polymer structure and released from the pores after extraction. There was a burst effect of the release. The release amount of ES on the first day was 0.415, 0.858, 1.110, 1.564, 1.952, and 2.513, respectively, from the six groups with various ES loading amount of 4000, 8000, 12,000, 16,000, 20,000, and 24,000 AXaIU, all reaching the peak of release on the first day. The release decreased rapidly on the next day and entered the plateau phase on the fourth day. CONCLUSION The prepared ES-PMMA bone cement has high application potential in orthopedic surgery. ES-PMMA bone cement shows good drug release characteristics. The released enoxaparin sodium has a local anti-coagulant effect within 24 h after application, but it will not be released for a long time, which is complementary to postoperative anti-coagulation therapy.
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Affiliation(s)
- Hui Sun
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xinzhe Ma
- Department of Orthopaedic Surgery, Shijiazhuang Third Hospital, Shijiazhuang, China
| | - Zhiyong Li
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jianning Liu
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wei Wang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiangbei Qi
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
- Tiemenguan District of the Third Hospital of Hebei Medical University, Tiemenguan City, China.
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12
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Chen L, Tang Y, Zhao K, Zha X, Wei M, Tan Q, Wu Z. Sequential release of double drug (graded distribution) loaded gelatin microspheres/PMMA bone cement. J Mater Chem B 2021; 9:508-522. [PMID: 33305784 DOI: 10.1039/d0tb01452d] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Drugs are loaded into PMMA bone cement to reduce the risk of infection in freshly implanted prostheses or to promote the differentiation and growth of osteoblasts. However, the same method of loading of drugs in the bone cement cannot simultaneously achieve an effective antibacterial response and long-term treatment outcomes for osteoporosis based on a patient's clinical needs. In the present study, gentamicin sulfate (GS)/alendronate (ALN)-dual-loaded gelatin modified PMMA bone cement (GAPBC) was fabricated to provide rapid and continuous antibiotic release and long-term anti-osteoporotic therapy. Specifically, the gelatin microspheres were loaded with the drugs using separate methodologies, namely, ALN was loaded during fabrication of the gelatin microspheres after which GS was absorbed onto the gelatin from solution. The results demonstrate that sequential release of the GS and ALN was achieved, GS release playing a major role over the first 24 hours and ALN release dominant after 3 weeks of immersion in PBS, resulting from the graded distribution within the gelatin microspheres, and the final drug release ratio of GS (73.6%) and ALN (68.5%) from the modified bone cement was significantly higher than from PMMA bone cement. Therefore, GAPBC represents a potential drug carrier for future clinical applications.
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Affiliation(s)
- Lei Chen
- Department of Materials Science and Engineering, Xi'an University of Technology, Xi'an 710048, P. R. China.
| | - Yufei Tang
- Department of Materials Science and Engineering, Xi'an University of Technology, Xi'an 710048, P. R. China.
| | - Kang Zhao
- Department of Materials Science and Engineering, Xi'an University of Technology, Xi'an 710048, P. R. China.
| | - Xiang Zha
- Department of Materials Science and Engineering, Xi'an University of Technology, Xi'an 710048, P. R. China.
| | - Min Wei
- Department of Materials Science and Engineering, Xi'an University of Technology, Xi'an 710048, P. R. China.
| | - Quanchang Tan
- Institute of Orthopaedics, Xi'jing Hospital, Fourth Military Medical University, Xi'an 710032, P. R. China.
| | - Zixiang Wu
- Institute of Orthopaedics, Xi'jing Hospital, Fourth Military Medical University, Xi'an 710032, P. R. China.
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Xia X, Shi R, Huang J, Li Y, Zuo Y, Li J. Development of a phase change microcapsule to reduce the setting temperature of PMMA bone cement. J Appl Biomater Funct Mater 2020; 18:2280800020940279. [PMID: 33147094 DOI: 10.1177/2280800020940279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of the current study is to alleviate the adverse effect of the strongly exothermic polymerization of polymethyl methacrylate (PMMA) bone cement in clinical applications. In this study, paraffin/poly(methyl methacrylate-methylene bisacrylamide) (paraffin/P(MMA-MBA)) phase change microcapsules (MPn; n = 1, 2) were developed via the emulsion polymerization method. The reduction of the maximum temperature of polymerization (Tmax) and physicochemical properties were evaluated after doping commercial PMMA cement with MPn in specific proportions (10%, 20%, and 30%). The results reveal that the MPn-doped PMMA exhibited an effective reduction in Tmax, which can help alleviate the adverse effect of the strong exothermic reactions during PMMA setting. After doping with the MPn, the mechanical properties of the PMMA cement decrease and the values are close to that of body cancellous bone. The Tmax of the cement doped with 20 wt% MP1 is 37.6°C, which is close to body temperature. Significantly, the setting and compressive properties of the optimized group can still adhere to clinical requirements. The MPn doping PMMA technique holds much promise in clinical practice.
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Affiliation(s)
- Xue Xia
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Rui Shi
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jinhui Huang
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yubao Li
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yi Zuo
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jidong Li
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, Chengdu, Sichuan, People's Republic of China
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14
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Swelling behavior of expandable poly(methyl methacrylate‐acrylic acid)/polymethyl methacrylate bio‐composites with different crosslinking densities. J Appl Polym Sci 2020. [DOI: 10.1002/app.49567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Zhu J, Yang S, Cai K, Wang S, Qiu Z, Huang J, Jiang G, Wang X, Fang X. Bioactive poly (methyl methacrylate) bone cement for the treatment of osteoporotic vertebral compression fractures. Theranostics 2020; 10:6544-6560. [PMID: 32483469 PMCID: PMC7255031 DOI: 10.7150/thno.44428] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/05/2020] [Indexed: 12/14/2022] Open
Abstract
Rationale: Poly (methyl methacrylate) (PMMA) bone cement is one of the most commonly used biomaterials for augmenting/stabilizing osteoporosis-induced vertebral compression fractures (OVCFs), such as percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP). However, its clinical applications are limited by its poor performance in high compressive modulus and weak bonding to bone. To address these issues, a bioactive composite bone cement was developed for the treatment of osteoporotic vertebral compression fractures, in which mineralized collagen (MC) was incorporated into the PMMA bone cement (MC-PMMA). Methods: The in vitro properties of PMMA and MC-PMMA composite bone cement were determined, including setting time, compressive modulus, adherence, proliferation, and osteogenic differentiation of rat bone mesenchymal stem cells. The in vivo properties of both cements were evaluated in an animal study (36 osteoporotic New Zealand female rabbits divided equally between the two bone cement groups; PVP at L5) and a small-scale and short-term clinical study (12 patients in each of the two bone cement groups; follow-up: 2 years). Results: In terms of value for PMMA bone cement, the handling properties of MC-PMMA bone cement were not significantly different. However, both compressive strength and compressive modulus were found to be significantly lower. In the rabbit model study, at 8 and 12 weeks post-surgery, bone regeneration was more significant in MC-PMMA bone cement (cortical bone thickness, osteoblast area, new bone area, and bone ingrowth %; each significantly higher). In the clinical study, at a follow-up of 2 years, both the Visual Analogue Score and Oswestry Disability Index were significantly reduced when MC-PMMA cement was used. Conclusions: MC-PMMA bone cement demonstrated good adaptive mechanical properties and biocompatibility and may be a promising alternative to commercial PMMA bone cements for the treatment of osteoporotic vertebral fractures in clinical settings. While the present results for MC-PMMA bone cement are encouraging, further study of this cement is needed to explore its viability as an ideal alternative for use in PVP and BKP.
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Affiliation(s)
- Jinjin Zhu
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine & Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang, Hangzhou 310016, China
- Department of Spinal Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, China
| | - Shuhui Yang
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
| | - Kaiwen Cai
- Department of Spinal Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, China
| | - Shuo Wang
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
| | - Zhiye Qiu
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
| | - Junfei Huang
- Shimadzu (China) Co., Ltd. Shenzhen Branch, Shenzhen 518042, China
| | - Guoqiang Jiang
- Department of Spinal Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, China
| | - Xiumei Wang
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
| | - Xiangqian Fang
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine & Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang, Hangzhou 310016, China
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16
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Chen L, Tang Y, Zhao K, Liu J, Bai H, Wu Z. Absorptive and expansive behaviors of poly(methyl methacrylate-co-acrylic acid) bone cement. Colloids Surf B Biointerfaces 2020; 189:110848. [PMID: 32058255 DOI: 10.1016/j.colsurfb.2020.110848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/15/2020] [Accepted: 02/04/2020] [Indexed: 02/08/2023]
Abstract
Some additives had provided the expansion capacity to the polymethylmethacrylate (PMMA) bone cement and also reduced its maximum reaction temperature. However, the corresponding modified bone cement displayed inferior simulated body fluid (SBF) absorption capacity and expansion behavior, the mechanism of SBF absorption and the trend of expansion stress were ignored additionally. In this study, a homogeneous distribution of poly (methyl methacrylate-co-acrylic acid) [P(MMA-AA)] microspheres led to the formation of microchannels that favored the delivery of SBF to the interior, causing an increased absorption capacity and enhanced expansion behavior before solidification of the bone cement, with the maximum equilibrium absorption ratio and the expansion ratio reaching 27.3 % and 26.3 %, respectively, at an AA content of 50 %. In addition, the expansion stress induced by the expansion behavior experienced a gradual increase from the 0 s to 2590s, followed by a sharp climbed in a short period ranging from 2590s to 2900s, finally reaching maximum stress of 82.1 MPa. Furthermore, the expansion stress within the maximum value could be obtained by controlling the AA content in the P(MMA-AA) bone cement. With the above characteristics, the prepared P(MMA-AA) bone cement has potential applications as a filling and adhesive material in arthroplasties, vertebroplasties, joint replacements, bone screws, and dentistry.
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Affiliation(s)
- Lei Chen
- School of Materials Science and Engineering, Xi'an University of Technology, Xi'an, 710048, PR China
| | - Yufei Tang
- School of Materials Science and Engineering, Xi'an University of Technology, Xi'an, 710048, PR China.
| | - Kang Zhao
- School of Materials Science and Engineering, Xi'an University of Technology, Xi'an, 710048, PR China
| | - Jiaxin Liu
- School of Materials Science and Engineering, Xi'an University of Technology, Xi'an, 710048, PR China
| | - Hao Bai
- Institute of Orthopaedics, Xi'jing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China
| | - Zixiang Wu
- Institute of Orthopaedics, Xi'jing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China.
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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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