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Garot C, Schoffit S, Monfoulet C, Machillot P, Deroy C, Roques S, Vial J, Vollaire J, Renard M, Ghanem H, El-Hafci H, Decambron A, Josserand V, Bordenave L, Bettega G, Durand M, Manassero M, Viateau V, Logeart-Avramoglou D, Picart C. 3D-Printed Osteoinductive Polymeric Scaffolds with Optimized Architecture to Repair a Sheep Metatarsal Critical-Size Bone Defect. Adv Healthc Mater 2023; 12:e2301692. [PMID: 37655491 DOI: 10.1002/adhm.202301692] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/10/2023] [Indexed: 09/02/2023]
Abstract
The reconstruction of critical-size bone defects in long bones remains a challenge for clinicians. A new osteoinductive medical device is developed here for long bone repair by combining a 3D-printed architectured cylindrical scaffold made of clinical-grade polylactic acid (PLA) with a polyelectrolyte film coating delivering the osteogenic bone morphogenetic protein 2 (BMP-2). This film-coated scaffold is used to repair a sheep metatarsal 25-mm long critical-size bone defect. In vitro and in vivo biocompatibility of the film-coated PLA material is proved according to ISO standards. Scaffold geometry is found to influence BMP-2 incorporation. Bone regeneration is followed using X-ray scans, µCT scans, and histology. It is shown that scaffold internal geometry, notably pore shape, influenced bone regeneration, which is homogenous longitudinally. Scaffolds with cubic pores of ≈870 µm and a low BMP-2 dose of ≈120 µg cm-3 induce the best bone regeneration without any adverse effects. The visual score given by clinicians during animal follow-up is found to be an easy way to predict bone regeneration. This work opens perspectives for a clinical application in personalized bone regeneration.
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Affiliation(s)
- Charlotte Garot
- CNRS EMR 5000 Biomimetism and Regenerative Medicine (BRM), INSERM U1292 Biosanté, CEA, Université Grenoble Alpes, 17 avenue des Martyrs, Grenoble, F-38054, France
| | - Sarah Schoffit
- Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, F-94704, France
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Cécile Monfoulet
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Paul Machillot
- CNRS EMR 5000 Biomimetism and Regenerative Medicine (BRM), INSERM U1292 Biosanté, CEA, Université Grenoble Alpes, 17 avenue des Martyrs, Grenoble, F-38054, France
| | - Claire Deroy
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Samantha Roques
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Julie Vial
- Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, F-94704, France
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Julien Vollaire
- INSERM U1209, Institute of Advanced Biosciences, Grenoble, F-38000, France
- Institute of Advanced Biosciences, Université Grenoble Alpes, Grenoble, F-38000, France
| | - Martine Renard
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Hasan Ghanem
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Hanane El-Hafci
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Adeline Decambron
- Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, F-94704, France
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Véronique Josserand
- INSERM U1209, Institute of Advanced Biosciences, Grenoble, F-38000, France
- Institute of Advanced Biosciences, Université Grenoble Alpes, Grenoble, F-38000, France
| | - Laurence Bordenave
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Georges Bettega
- INSERM U1209, Institute of Advanced Biosciences, Grenoble, F-38000, France
- Service de Chirurgie Maxillo-Faciale, Centre Hospitalier Annecy Genevois, 1 avenue de l'hôpital, Epagny Metz-Tessy, F-74370, France
| | - Marlène Durand
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Mathieu Manassero
- Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, F-94704, France
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Véronique Viateau
- Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, F-94704, France
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | | | - Catherine Picart
- CNRS EMR 5000 Biomimetism and Regenerative Medicine (BRM), INSERM U1292 Biosanté, CEA, Université Grenoble Alpes, 17 avenue des Martyrs, Grenoble, F-38054, France
- Institut Universitaire de France (IUF), 1 rue Descartes, Paris CEDEX 05, 75231, France
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2
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Labus KM, Wolynski J, Easley J, Stewart HL, Ilic M, Notaros B, Zagrocki T, Puttlitz CM, McGilvray KC. Employing direct electromagnetic coupling to assess acute fracture healing: An ovine model assessment. Injury 2023; 54:111080. [PMID: 37802738 PMCID: PMC10843464 DOI: 10.1016/j.injury.2023.111080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVES This study explored the efficacy of collecting temporal fracture site compliance data via an advanced direct electromagnetic coupling (DEC) system equipped with a Vivaldi-type antenna, novel calibration technique, and multi-antenna setup (termed maDEC) as an approach to monitor acute fracture healing progress in a translational large animal model. The overarching goal of this approach was to provide insights into the acute healing dynamics, offering a promising avenue for optimizing fracture management strategies. METHODS A sample of twelve sheep, subjected to ostectomies and intramedullary nail fixations, was divided into two groups, simulating normal and impaired healing scenarios. Sequential maDEC compliance or stiffness measurements and radiographs were taken from the surgery until euthanasia at four or eight weeks and were subsequently compared with post-sacrifice biomechanical, micro-CT, and histological findings. RESULTS The results showed that the maDEC system offered straightforward quantification of fracture site compliance via a multiantenna array. Notably, the rate of change in the maDEC-measured bending stiffness significantly varied between normal and impaired healing groups during both the 4-week (p = 0.04) and 8-week (p = 0.02) periods. In contrast, radiographically derived mRUST healing measurements displayed no significant differences between the groups (p = 0.46). Moreover, the cumulative normalized stiffness maDEC data significantly correlated with post-sacrifice mechanical strength (r2 = 0.80, p < 0.001), micro-CT measurements of bone volume fraction (r2 = 0.60, p = 0.003), and density (r2 = 0.60, p = 0.003), and histomorphometric measurements of new bone area fraction (r2 = 0.61, p = 0.003) and new bone area (r2 = 0.60, p < 0.001). CONCLUSIONS These data indicate that the enhanced maDEC system provides a non-invasive, accurate method to monitor fracture healing during the acute healing phase, showing distinct stiffness profiles between normal and impaired healing groups and offering critical insights into the healing process's progress and efficiency.
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Affiliation(s)
- Kevin M Labus
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Jakob Wolynski
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Jeremiah Easley
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Holly L Stewart
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Milan Ilic
- University of Belgrade, School of Electrical Engineering, Belgrade, Serbia
| | - Branislav Notaros
- Electromagnetic Laboratory, Department of Electrical and Computer Engineering, Colorado State University, Fort Collins, Colorado, USA
| | - Taylor Zagrocki
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Christian M Puttlitz
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Kirk C McGilvray
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA.
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Lin S, Maekawa H, Moeinzadeh S, Lui E, Alizadeh HV, Li J, Kim S, Poland M, Gadomski BC, Easley JT, Young J, Gardner M, Mohler D, Maloney WJ, Yang YP. An osteoinductive and biodegradable intramedullary implant accelerates bone healing and mitigates complications of bone transport in male rats. Nat Commun 2023; 14:4455. [PMID: 37488113 PMCID: PMC10366099 DOI: 10.1038/s41467-023-40149-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
Bone transport is a surgery-driven procedure for the treatment of large bone defects. However, challenging complications include prolonged consolidation, docking site nonunion and pin tract infection. Here, we develop an osteoinductive and biodegradable intramedullary implant by a hybrid tissue engineering construct technique to enable sustained delivery of bone morphogenetic protein-2 as an adjunctive therapy. In a male rat bone transport model, the eluting bone morphogenetic protein-2 from the implants accelerates bone formation and remodeling, leading to early bony fusion as shown by imaging, mechanical testing, histological analysis, and microarray assays. Moreover, no pin tract infection but tight osseointegration are observed. In contrast, conventional treatments show higher proportion of docking site nonunion and pin tract infection. The findings of this study demonstrate that the novel intramedullary implant holds great promise for advancing bone transport techniques by promoting bone regeneration and reducing complications in the treatment of bone defects.
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Affiliation(s)
- Sien Lin
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Hirotsugu Maekawa
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Seyedsina Moeinzadeh
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Elaine Lui
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
- Department of Mechanical Engineering, School of Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Hossein Vahid Alizadeh
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Jiannan Li
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Sungwoo Kim
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Michael Poland
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, 80523, USA
| | - Benjamin C Gadomski
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, 80523, USA
| | - Jeremiah T Easley
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
| | - Jeffrey Young
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Michael Gardner
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - David Mohler
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - William J Maloney
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Yunzhi Peter Yang
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA.
- Department of Materials Science and Engineering, School of Engineering, Stanford University, Stanford, CA, 94305, USA.
- Department of Bioengineering, School of Medicine, Stanford University, Stanford, CA, 94305, USA.
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4
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Baumer V, Gunn E, Riegle V, Bailey C, Shonkwiler C, Prawel D. Robocasting of Ceramic Fischer-Koch S Scaffolds for Bone Tissue Engineering. J Funct Biomater 2023; 14:jfb14050251. [PMID: 37233361 DOI: 10.3390/jfb14050251] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
Triply Periodic Minimal Surfaces (TPMS) are promising structures for bone tissue engineering scaffolds due to their relatively high mechanical energy absorption, smoothly interconnected porous structure, scalable unit cell topology, and relatively high surface area per volume. Calcium phosphate-based materials, such as hydroxyapatite and tricalcium phosphate, are very popular scaffold biomaterials due to their biocompatibility, bioactivity, compositional similarities to bone mineral, non-immunogenicity, and tunable biodegradation. Their brittle nature can be partially mitigated by 3D printing them in TPMS topologies such as gyroids, which are widely studied for bone regeneration, as evidenced by their presence in popular 3D-printing slicers, modeling systems, and topology optimization tools. Although structural and flow simulations have predicted promising properties of other TPMS scaffolds, such as Fischer-Koch S (FKS), to the best of our knowledge, no one has explored these possibilities for bone regeneration in the laboratory. One reason for this is that fabrication of the FKS scaffolds, such as by 3D printing, is challenged by a lack of algorithms to model and slice this topology for use by low-cost biomaterial printers. This paper presents an open-source software algorithm that we developed to create 3D-printable FKS and gyroid scaffold cubes, with a framework that can accept any continuous differentiable implicit function. We also report on our successful 3D printing of hydroxyapatite FKS scaffolds using a low-cost method that combines robocasting with layer-wise photopolymerization. Dimensional accuracy, internal microstructure, and porosity characteristics are also presented, demonstrating promising potential for the 3D printing of TPMS ceramic scaffolds for bone regeneration.
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Affiliation(s)
- Vail Baumer
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA
| | - Erin Gunn
- Department of Computer Science, Colorado State University, Fort Collins, CO 80523, USA
| | - Valerie Riegle
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523, USA
| | - Claire Bailey
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523, USA
| | - Clayton Shonkwiler
- Department of Mathematics, Colorado State University, Fort Collins, CO 80523, USA
| | - David Prawel
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523, USA
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5
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Khandaker M, Lane R, Yeakley S, Alizereej H, Nikfarjam S, Ait Moussa A, Vaughan MB, Haleem AM. Evaluation of a Bioabsorbable Scaffold and Interlocked Nail System for Segmental Bone Defect. J Funct Biomater 2023; 14:jfb14040183. [PMID: 37103273 PMCID: PMC10141685 DOI: 10.3390/jfb14040183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
In the current study, we designed and manufactured a scaffold and fixation system for the reconstruction of long-bone segmental defects in a rabbit tibia model. We used biocompatible and biodegradable materials, polycaprolactone (PCL) and PCL soaked with sodium alginate (PCL-Alg) to manufacture the scaffold, interlocking nail and screws using a phase separation casing method. Degradation and mechanical tests on the PCL and PCL-Alg scaffolds indicated that both were suitable for faster degradation and early weight-bearing capacity. PCL scaffold surface porosity facilitated the infiltration of alginate hydrogel through the scaffold. Cell viability results showed that the number of cells increased on Day 7 and decreased marginally by Day 14. For accurate placement of the scaffold and fixation system, a surgical jig was designed and 3D-printed using biocompatible resin in a stereolithography (SLA) 3D printer, then cured with UV light for increased strength. Our cadaver tests using New Zealand White rabbit confirmed our novel jigs’ potential for accurate placement of the bone scaffold, intramedullary nail and the alignment of the fixation screws in future reconstructive surgeries on rabbit long-bone segmental defects. Additionally, the cadaver tests confirmed that our designed nails and screws were strong enough to carry the surgical insertion force. Therefore, our designed prototype has the potential for further clinical translational study using the rabbit tibia model.
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Affiliation(s)
- Morshed Khandaker
- School of Engineering, University of Central Oklahoma, Edmond, OK 73034, USA
- Correspondence: ; Tel.: +1-405-974-5935; Fax: +1-405-974-3812
| | - Reuben Lane
- School of Engineering, University of Central Oklahoma, Edmond, OK 73034, USA
| | - Shannon Yeakley
- School of Engineering, University of Central Oklahoma, Edmond, OK 73034, USA
| | - Hussein Alizereej
- School of Engineering, University of Central Oklahoma, Edmond, OK 73034, USA
| | - Sadegh Nikfarjam
- Department of Biology, University of Central Oklahoma, Edmond, OK 73034, USA
| | - Abdellah Ait Moussa
- School of Engineering, University of Central Oklahoma, Edmond, OK 73034, USA
| | - Melville B. Vaughan
- Department of Biology, University of Central Oklahoma, Edmond, OK 73034, USA
| | - Amgad M. Haleem
- Department of Orthopedics, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
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6
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Steward SKT, Brodin E, Gadomski B, Nelson B, Easley J. Mechanical comparison of application of locking intramedullary nail to locking compression plate in the ovine metatarsus. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:191. [PMID: 37007576 PMCID: PMC10061473 DOI: 10.21037/atm-22-2746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 01/08/2023] [Indexed: 02/23/2023]
Abstract
Background The metatarsal bone is commonly utilized in preclinical fracture models in sheep. A majority of studies achieve fracture stabilization with bone plating, but more recently intramedullary interlocking nails (IMN) have been utilized. The mechanical properties of this unique surgical technique utilizing an IMN has not yet been fully elucidated or compared to the traditional locking compression plating (LCP) technique. We hypothesize that a mid-diaphysis metatarsal critical-sized osteotomy stabilized with an IMN will provide equivalent mechanical stability to LCP with less variance of mechanical properties across specimens. Methods Sixteen ovine hind limbs were transected at the mid tibia with soft tissue intact and utilized for implantation. A 3-cm osteotomy was created in the mid-diaphysis of all metatarsi. For the IMN group, a 147 mm × 8 mm IMN was implanted from distal to proximal through the sagittal septum of the distal metatarsus and the bolts locked in place using an IMN guide system. For the LCP group, a 3.5-mm 9-hole LCP was secured to the lateral aspect of the metatarsus with three locking screws in the proximal and distal holes leaving the central three holes empty. All metatarsal constructs were fitted with three strain gages on proximal and distal metaphyses and the lateral aspect of the IMN or LCP at the osteotomy site. Non-destructive mechanical testing was performed in compression, torsion, and four-point bending. Results The IMN constructs showed overall greater construct stiffness with less variance in strain between constructs than the LCP constructs in 4-point bending, compression, and torsion. Conclusions IMN constructs may provide superior mechanical properties for a critical-sized osteotomy model of the ovine metatarsus when compared to lateral LCP constructs. Further in vivo investigation comparing characteristics of fracture healing between IMN and LCP is warranted.
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Affiliation(s)
| | - Erik Brodin
- Colorado State University College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, USA
| | - Ben Gadomski
- Colorado State University College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, USA
| | - Bradley Nelson
- Colorado State University College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, USA
| | - Jeremiah Easley
- Colorado State University College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, USA
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7
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Schulze F, Lang A, Schoon J, Wassilew GI, Reichert J. Scaffold Guided Bone Regeneration for the Treatment of Large Segmental Defects in Long Bones. Biomedicines 2023; 11:biomedicines11020325. [PMID: 36830862 PMCID: PMC9953456 DOI: 10.3390/biomedicines11020325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Bone generally displays a high intrinsic capacity to regenerate. Nonetheless, large osseous defects sometimes fail to heal. The treatment of such large segmental defects still represents a considerable clinical challenge. The regeneration of large bone defects often proves difficult, since it relies on the formation of large amounts of bone within an environment impedimental to osteogenesis, characterized by soft tissue damage and hampered vascularization. Consequently, research efforts have concentrated on tissue engineering and regenerative medical strategies to resolve this multifaceted challenge. In this review, we summarize, critically evaluate, and discuss present approaches in light of their clinical relevance; we also present future advanced techniques for bone tissue engineering, outlining the steps to realize for their translation from bench to bedside. The discussion includes the physiology of bone healing, requirements and properties of natural and synthetic biomaterials for bone reconstruction, their use in conjunction with cellular components and suitable growth factors, and strategies to improve vascularization and the translation of these regenerative concepts to in vivo applications. We conclude that the ideal all-purpose material for scaffold-guided bone regeneration is currently not available. It seems that a variety of different solutions will be employed, according to the clinical treatment necessary.
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Affiliation(s)
- Frank Schulze
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Annemarie Lang
- Departments of Orthopaedic Surgery & Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Janosch Schoon
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Georgi I. Wassilew
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Johannes Reichert
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
- Correspondence: ; Tel.: +49-3834-86-22530
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8
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Herczeg CK, Song J. Sterilization of Polymeric Implants: Challenges and Opportunities. ACS APPLIED BIO MATERIALS 2022; 5:5077-5088. [PMID: 36318175 PMCID: PMC9691608 DOI: 10.1021/acsabm.2c00793] [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] [Indexed: 11/22/2022]
Abstract
Degradable and environmentally responsive polymers have been actively developed for drug delivery and regenerative medicine applications, yet inadequate consideration of their compatibility with terminal sterilization presents notable barriers to clinical translation. This Review discusses industry-established terminal sterilization methods and aseptic processing and contrasts them with innovative approaches aimed at preserving the integrity of polymeric implants. Regulatory guidelines, fiscal considerations, and potential pitfalls are discussed to encourage early integration of sterility regulatory considerations in material designs.
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Affiliation(s)
- Chloe K Herczeg
- Department of Orthopedics and Physical Rehabilitation, Department of Biochemistry and Molecular Biotechnology, UMass Chan Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, United States
| | - Jie Song
- Department of Orthopedics and Physical Rehabilitation, Department of Biochemistry and Molecular Biotechnology, UMass Chan Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, United States
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9
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Liu J, Wu S, Ma J, Liu C, Dai T, Wu X, Zhao H, Zhou D. Polycaprolactone/Gelatin/Hydroxyapatite Electrospun Nanomembrane Materials Incorporated with Different Proportions of Attapulgite Synergistically Promote Bone Formation. Int J Nanomedicine 2022; 17:4087-4103. [PMID: 36105619 PMCID: PMC9467850 DOI: 10.2147/ijn.s372247] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/31/2022] [Indexed: 12/28/2022] Open
Abstract
Purpose To enhance the osteoinductive effect of Hydroxyapatite (HA) in bone tissue engineering, this study manufactured polycaprolactone (PCL)/gelatin (GEL)/HA nanofibrous scaffolds incorporated with different ratios of attapulgite (ATP): HA (0:3, 0:0, 1:1, 2:1 and 3:0) by high-voltage electrospinning. The synergistic effect exerted by ATP and HA on bone formation was explored both in vivo and in vitro. Methods and Results First, we determined the group composition and crystal structure of the nanosheets by Fourier transform infrared (FTIR) and X-ray diffraction (XRD) analyses. Then, the physical properties of the scaffolds, including the modulus of elasticity, porosity and water absorption were evaluated. Moreover, the surface microstructure of the nanofibrous scaffolds was captured by Scanning electron microscopy (SEM) and Transmission Electron Microscope (TEM). The biocompatibility of the fabricated scaffolds represented by cell counting kit 8 (CCK-8) and phalloidin staining was also assessed. Next, in vitro osteogenesis was evaluated. Real-time PCR, alkaline phosphatase (ALP) staining and Alizarin red S (ARS) staining results showed that the materials incorporated with HA and ATP at a ratio of 2:1 synergistically promoted more osteoblastic differentiation and extracellular mineralization than scaffolds doped with HA and ATP alone. Last, in vivo, Hematoxylin-Eosin staining (HE staining) and Masson staining showed that groups treated with HA and ATP acquired optimal patterns of bone regeneration. Conclusion This study clarified for the first time that the combination of HA and ATP orchestrated biomaterial-induced osseointegration, and the synergistic effect was more significant when the ratio of ATP/HA was 2:1. This conclusion also provides new ideas and a scientific basis for the development of functionalized nanomaterials in bone tissue engineering.
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Affiliation(s)
- Jun Liu
- Medical Research Centre, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, 213164, People's Republic of China.,Dalian Medical University, Dalian, 116044, People's Republic of China
| | - Siyu Wu
- Medical Research Centre, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, 213164, People's Republic of China.,Dalian Medical University, Dalian, 116044, People's Republic of China
| | - Jiayi Ma
- Medical Research Centre, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, 213164, People's Republic of China.,Dalian Medical University, Dalian, 116044, People's Republic of China
| | - Chun Liu
- Medical Research Centre, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, 213164, People's Republic of China
| | - Ting Dai
- Medical Research Centre, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, 213164, People's Republic of China
| | - Xiaoyu Wu
- Medical Research Centre, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, 213164, People's Republic of China
| | - Hongbin Zhao
- Medical Research Centre, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, 213164, People's Republic of China
| | - Dong Zhou
- Medical Research Centre, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, 213164, People's Republic of China
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10
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Hao D, Lopez JM, Chen J, Iavorovschi AM, Lelivelt NM, Wang A. Engineering Extracellular Microenvironment for Tissue Regeneration. Bioengineering (Basel) 2022; 9:bioengineering9050202. [PMID: 35621480 PMCID: PMC9137730 DOI: 10.3390/bioengineering9050202] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/23/2022] [Accepted: 05/04/2022] [Indexed: 12/12/2022] Open
Abstract
The extracellular microenvironment is a highly dynamic network of biophysical and biochemical elements, which surrounds cells and transmits molecular signals. Extracellular microenvironment controls are of crucial importance for the ability to direct cell behavior and tissue regeneration. In this review, we focus on the different components of the extracellular microenvironment, such as extracellular matrix (ECM), extracellular vesicles (EVs) and growth factors (GFs), and introduce engineering approaches for these components, which can be used to achieve a higher degree of control over cellular activities and behaviors for tissue regeneration. Furthermore, we review the technologies established to engineer native-mimicking artificial components of the extracellular microenvironment for improved regenerative applications. This review presents a thorough analysis of the current research in extracellular microenvironment engineering and monitoring, which will facilitate the development of innovative tissue engineering strategies by utilizing different components of the extracellular microenvironment for regenerative medicine in the future.
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Affiliation(s)
- Dake Hao
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA; (D.H.); (J.-M.L.); (J.C.); (A.M.I.); (N.M.L.)
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA 95817, USA
| | - Juan-Maria Lopez
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA; (D.H.); (J.-M.L.); (J.C.); (A.M.I.); (N.M.L.)
| | - Jianing Chen
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA; (D.H.); (J.-M.L.); (J.C.); (A.M.I.); (N.M.L.)
| | - Alexandra Maria Iavorovschi
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA; (D.H.); (J.-M.L.); (J.C.); (A.M.I.); (N.M.L.)
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA 95817, USA
| | - Nora Marlene Lelivelt
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA; (D.H.); (J.-M.L.); (J.C.); (A.M.I.); (N.M.L.)
| | - Aijun Wang
- Department of Surgery, School of Medicine, University of California Davis, Sacramento, CA 95817, USA; (D.H.); (J.-M.L.); (J.C.); (A.M.I.); (N.M.L.)
- Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA 95817, USA
- Department of Biomedical Engineering, University of California Davis, Davis, CA 95616, USA
- Correspondence:
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11
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Stahl A, Park YB, Park SH, Lin S, Pan C, Kim S, Yang Y. Probing the role of methyl methacrylate release from spacer materials in induced membrane bone healing. J Orthop Res 2022; 40:1065-1074. [PMID: 34314063 PMCID: PMC8792109 DOI: 10.1002/jor.25147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/30/2021] [Accepted: 07/14/2021] [Indexed: 02/06/2023]
Abstract
In the induced membrane (IM) technique for bone reconstruction, a poly(methyl methacrylate) (PMMA) spacer is implanted to induce formation of a foreign body membrane around the defect site. Membrane development is essential for later bone grafting success, yet the mechanism by which the IM promotes bone regeneration remains unknown, as are the ways that spacer composition plays a role in the membrane's healing potential. This study investigated the impact of leached methyl methacrylate (MMA)-the major monomeric component of PMMA-on IM development. In vitro cell culture found that MMA elution did not impact endothelial cell or mesenchymal stem cell proliferation. For in vivo analysis, we advanced a streamlined rat femoral model to efficiently study the influence of spacer properties on IM characteristics. Comparison of membrane formation around polycaprolactone (PCL), MMA-eluting PCL (high-dose PCL-MMA and low-dose PCL-MMA), and surgical PMMA revealed robust membranes enveloped all groups after 4 weeks in vivo, with elevated expression of osteogenic bone morphogenetic protein-2 and angiogenic vascular endothelial growth factor compared with the surrounding muscle and bone tissues. Growth factor quantitation in IM tissue found no statistically significant difference between groups. New bone growth, vascularization, and CD163+ macrophage populations surrounding the polymer implants were also quantified; and blood vessel formation around high-dose PCL-MMA was found to be significantly decreased compared with PCL alone. To the best of our knowledge, these findings represent the first time that results have been obtained about the characteristics of membranes formed around PCL in the IM setting.
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Affiliation(s)
- A. Stahl
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA 94304, USA
- Department of Chemistry, Stanford University, 121 Mudd Building, CA 94305, USA
| | - YB. Park
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA 94304, USA
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul 120-752, Korea
| | - SH. Park
- Osong Research Institute, TaeWoong Medical Co., Ltd, 55-7, Osongsaengmyeong 2-ro, Korea
| | - S. Lin
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA 94304, USA
| | - C.C. Pan
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA 94304, USA
- Department of Mechanical Engineering, Stanford University, 440 Escondido Mall, Stanford, CA94305, USA
| | - S. Kim
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA 94304, USA
| | - Y.P. Yang
- Department of Orthopaedic Surgery, Stanford University, 240 Pasteur Drive, Stanford, CA 94304, USA
- Department of Materials Science and Engineering, Stanford University, 496 Lomita Mall, Stanford, CA94305, USA
- Department of Bioengineering, Stanford University, 443 Via Ortega, Stanford, CA94305, USA
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12
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Liang W, Dong Y, Shen H, Shao R, Wu X, Huang X, Sun B, Zeng B, Zhang S, Xu F. Materials science and design principles of therapeutic materials in orthopedic and bone tissue engineering. POLYM ADVAN TECHNOL 2021. [DOI: 10.1002/pat.5445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Wenqing Liang
- Department of Orthopedics Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University Zhoushan China
| | - Yongqiang Dong
- Department of Orthopedics Xinchang People's Hospital Shaoxing China
| | - Hailiang Shen
- Department of Orthopedics Affiliated Hospital of Shaoxing University Shaoxing China
| | - Ruyi Shao
- Department of Orthopedics Zhuji People's Hospital Shaoxing China
| | - Xudong Wu
- Department of Orthopedics Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University Zhoushan China
| | - Xiaogang Huang
- Department of Orthopedics Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University Zhoushan China
| | - Bin Sun
- Department of Orthopedics Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University Zhoushan China
| | - Bin Zeng
- Department of Orthopedics Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University Zhoushan China
| | - Songou Zhang
- College of Medicine Shaoxing University Shaoxing China
| | - Fangming Xu
- Department of Orthopedics Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University Zhoushan China
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13
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Karimzadeh Bardeei L, Seyedjafari E, Hossein G, Nabiuni M, Majles Ara MH, Salber J. Regeneration of Bone Defects in a Rabbit Femoral Osteonecrosis Model Using 3D-Printed Poly (Epsilon-Caprolactone)/Nanoparticulate Willemite Composite Scaffolds. Int J Mol Sci 2021; 22:10332. [PMID: 34638673 PMCID: PMC8508893 DOI: 10.3390/ijms221910332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 01/12/2023] Open
Abstract
Steroid-associated osteonecrosis (SAON) is a chronic disease that leads to the destruction and collapse of bone near the joint that is subjected to weight bearing, ultimately resulting in a loss of hip and knee function. Zn2+ ions, as an essential trace element, have functional roles in improving the immunophysiological cellular environment, accelerating bone regeneration, and inhibiting biofilm formation. In this study, we reconstruct SAON lesions with a three-dimensional (3D)-a printed composite made of poly (epsilon-caprolactone) (PCL) and nanoparticulate Willemite (npW). Rabbit bone marrow stem cells were used to evaluate the cytocompatibility and osteogenic differentiation capability of the PCL/npW composite scaffolds. The 2-month bone regeneration was assessed by a Micro-computed tomography (micro-CT) scan and the expression of bone regeneration proteins by Western blot. Compared with the neat PCL group, PCL/npW scaffolds exhibited significantly increased cytocompatibility and osteogenic activity. This finding reveals a new concept for the design of a 3D-printed PCL/npW composite-based bone substitute for the early treatment of osteonecrosis defects.
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Affiliation(s)
- Latifeh Karimzadeh Bardeei
- Developmental Biology Laboratory, Animal Biology Department, School of Biology, College of Science, University of Tehran, Tehran 1417935840, Iran;
| | - Ehsan Seyedjafari
- Department of Biotechnology, College of Science, University of Tehran, Tehran 1417935840, Iran
| | - Ghamartaj Hossein
- Developmental Biology Laboratory, Animal Biology Department, School of Biology, College of Science, University of Tehran, Tehran 1417935840, Iran;
| | - Mohammad Nabiuni
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran 15719-14911, Iran;
| | - Mohammad Hosein Majles Ara
- Photonics Laboratory, Physics Department, Kharazmi University, Tehran 15719-14911, Iran;
- Applied Science Research Centre, Kharazmi University, Tehran 15719-14911, Iran
| | - Jochen Salber
- Salber Laboratory, Centre for Clinical Research, Department of Experimental Surgery, Ruhr-Universität Bochum, 44780 Bochum, Germany;
- Department of Surgery, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, 44892 Bochum, Germany
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