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Zhao Z, Wang C, Liu A, Bai N, Jiang B, Mao Y, Ying T, Dong D, Yi C, Li D. Multiple applications of metal-organic frameworks (MOFs) in the treatment of orthopedic diseases. Front Bioeng Biotechnol 2024; 12:1448010. [PMID: 39295846 PMCID: PMC11408336 DOI: 10.3389/fbioe.2024.1448010] [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: 06/12/2024] [Accepted: 08/27/2024] [Indexed: 09/21/2024] Open
Abstract
Pharmacologic treatment of orthopedic diseases is a common challenge for clinical orthopedic surgeons, and as an important step in the stepwise treatment of orthopedic diseases, it is often difficult to achieve satisfactory results with existing pharmacologic treatments. Therefore, it is increasingly important to find new ways to effectively improve the treatment pattern of orthopedic diseases as well as to enhance the therapeutic efficacy. It has been found that metal-organic frameworks (MOFs) possess the advantages of high specific surface area, high porosity, chemical stability, tunability of structure and biocompatibility. Therefore, MOFs are expected to improve the conventional traditional treatment modality for bone diseases. This manuscript reviewed the applications of MOFs in the treatment of common clinical bone diseases and look forward to its future development.
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Affiliation(s)
- Ziwen Zhao
- Department of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
- Department of Orthopedics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Chenxu Wang
- Department of Orthopedics, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Aiguo Liu
- Department of Orthopedics, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Ning Bai
- Department of Gastroenterology, Huaihe Hospital of Henan University, Kaifeng, China
| | - Bo Jiang
- The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Yuanfu Mao
- Department of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ting Ying
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Daming Dong
- Department of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chengqing Yi
- Department of Orthopedics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Dejian Li
- Department of Orthopedics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
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Tao YK, Tseng YW, Tzou KY, Kuo CY, Nguyen HT, Lu HT, Chuang AEY. Advancing teeth whitening efficacy via dual-phototherapeutic strategy incorporating molybdenum disulfide embedded in carrageenan hydrogel for dental healthcare. Int J Biol Macromol 2024; 276:133647. [PMID: 38964693 DOI: 10.1016/j.ijbiomac.2024.133647] [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: 03/29/2024] [Revised: 06/27/2024] [Accepted: 07/02/2024] [Indexed: 07/06/2024]
Abstract
Teeth discoloration poses a widespread challenge in dental health across various regions. Conventional teeth whitening methods often result in enamel deterioration and soft tissue harm due to the utilization of incompatible whitening agents and continuous intense light exposure. Here, we propose an effective phototherapy technique for teeth whitening, employing pathways of energy transition through intersystem crossing. The integration of MoS2 nanosheets into carrageenan gel (MoS2 NSs@Carr) facilitates both photothermal-hyperthermia and the generation of reactive oxygen species (ROS) through photocatalytic processes. The efficacy of ROS generation by the phototherapeutic MoS2 NSs@Carr on teeth whitening in the scenario. This approach ensures comprehensive teeth whitening by eliminating deep-seated stains on the teeth while preserving structural integrity and avoiding any tissue toxicity. This research highlights the efficacy of the phototherapeutic MoS2 NSs@Carr for dental whitening and underscores the potential of exploring nanostructures based on MoS2 NSs for managing dental healthcare issue.
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Affiliation(s)
- Yu-Kuang Tao
- Graduate Institute of Biomedical Materials and Tissue Engineering, International Ph.D. Program in Biomedical Engineering, Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan
| | - Yu-Wen Tseng
- Graduate Institute of Biomedical Materials and Tissue Engineering, International Ph.D. Program in Biomedical Engineering, Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan
| | - Kai-Yi Tzou
- Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Taipei Medical University Research Centre of Urology and Kidney, Taipei Medical University, Taipei, Taiwan
| | - Chun-Yuan Kuo
- Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, Taipei 110301, Taiwan; School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110301, Taiwan
| | - Hieu Trung Nguyen
- Department of Orthopedics and Trauma, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Viet Nam
| | - Hsien-Tsung Lu
- Department of Orthopedics and Trauma, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Viet Nam; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Andrew E-Y Chuang
- Graduate Institute of Biomedical Materials and Tissue Engineering, International Ph.D. Program in Biomedical Engineering, Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan; Cell Physiology and Molecular Image Research Center, Taipei Medical University, Wan Fang Hospital, Taipei 11696, Taiwan.
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Geng X, Li Y, Wang R, Jiang S, Liang Y, Li T, Li C, Tao J, Li Z. Enhanced High-Fructose Corn Syrup Production: Immobilizing Serratia marcescens Glucose Isomerase on MOF (Co)-525 Reduces Co 2+ Dependency in Glucose Isomerization to Fructose. Foods 2024; 13:527. [PMID: 38397503 PMCID: PMC10888103 DOI: 10.3390/foods13040527] [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: 01/12/2024] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
The escalating demand for processed foods has led to the widespread industrial use of glucose isomerase (GI) for high-fructose corn syrup (HFCS) production. This reliance on GIs necessitates continual Co2+ supplementation to sustain high catalytic activity across multiple reaction cycles. In this study, Serratia marcescens GI (SmGI) was immobilized onto surfaces of the metal-organic framework (MOF) material MOF (Co)-525 to generate MOF (Co)-525-GI for use in catalyzing glucose isomerization to generate fructose. Examination of MOF (Co)-525-GI structural features using scanning electron microscopy-energy dispersive spectroscopy, Fourier-transform infrared spectroscopy, and ultraviolet spectroscopy revealed no structural changes after SmGI immobilization and the addition of Co2+. Notably, MOF (Co)-525-GI exhibited optimal catalytic activity at pH 7.5 and 70 °C, with a maximum reaction rate (Vmax) of 37.24 ± 1.91 μM/min and Km value of 46.25 ± 3.03 mM observed. Remarkably, immobilized SmGI exhibited sustained high catalytic activity over multiple cycles without continuous Co2+ infusion, retaining its molecular structure and 96.38% of its initial activity after six reaction cycles. These results underscore the potential of MOF (Co)-525-GI to serve as a safer and more efficient immobilized enzyme technology compared to traditional GI-based food-processing technologies.
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Affiliation(s)
- Xu Geng
- Key Laboratory for Molecular Enzymology and Engineering of the Ministry of Education, College of Life Sciences, Jilin University, Changchun 130012, China; (X.G.); (S.J.); (T.L.)
| | - Yi Li
- National Engineering Research Center for Corn Deep Processing, Jilin COFCO Biochemical Co., Ltd., Changchun 130033, China; (Y.L.); (Y.L.)
| | - Ruizhe Wang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China; (R.W.); (C.L.)
| | - Song Jiang
- Key Laboratory for Molecular Enzymology and Engineering of the Ministry of Education, College of Life Sciences, Jilin University, Changchun 130012, China; (X.G.); (S.J.); (T.L.)
| | - Yingchao Liang
- National Engineering Research Center for Corn Deep Processing, Jilin COFCO Biochemical Co., Ltd., Changchun 130033, China; (Y.L.); (Y.L.)
| | - Tao Li
- Key Laboratory for Molecular Enzymology and Engineering of the Ministry of Education, College of Life Sciences, Jilin University, Changchun 130012, China; (X.G.); (S.J.); (T.L.)
| | - Chen Li
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China; (R.W.); (C.L.)
| | - Jin Tao
- National Engineering Research Center for Corn Deep Processing, Jilin COFCO Biochemical Co., Ltd., Changchun 130033, China; (Y.L.); (Y.L.)
| | - Zhengqiang Li
- Key Laboratory for Molecular Enzymology and Engineering of the Ministry of Education, College of Life Sciences, Jilin University, Changchun 130012, China; (X.G.); (S.J.); (T.L.)
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Wang Z, Geest ICMVD, Leeuwenburgh SCG, van den Beucken JJJP. Bifunctional bone substitute materials for bone defect treatment after bone tumor resection. Mater Today Bio 2023; 23:100889. [PMID: 38149015 PMCID: PMC10749907 DOI: 10.1016/j.mtbio.2023.100889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/27/2023] [Accepted: 11/27/2023] [Indexed: 12/28/2023] Open
Abstract
Aggressive benign, malignant and metastatic bone tumors can greatly decrease the quality of patients' lives and even lead to substantial mortality. Several clinical therapeutic strategies have been developed to treat bone tumors, including preoperative chemotherapy, surgical resection of the tumor tissue, and subsequent systemic chemo- or radiotherapy. However, those strategies are associated with inevitable drawbacks, such as severe side effects, substantial local tumor recurrence, and difficult-to-treat bone defects after tumor resection. To overcome these shortcomings and achieve satisfactory clinical outcomes, advanced bifunctional biomaterials which simultaneously promote bone regeneration and combat bone tumor growth are increasingly advocated. These bifunctional bone substitute materials fill bone defects following bone tumor resection and subsequently exert local anticancer effects. Here we describe various types of the most prevalent bone tumors and provide an overview of common treatment options. Subsequently, we review current progress regarding the development of bifunctional bone substitute materials combining osteogenic and anticancer efficacy. To this end, we categorize these biomaterials based on their anticancer mechanism deriving from i) intrinsic biomaterial properties, ii) local drug release of anticancer agents, and iii) oxidative stress-inducing and iv) hyperthermia-inducing biomaterials. Consequently, this review offers researchers, surgeons and oncologists an up-to-date overview of our current knowledge on bone tumors, their treatment options, and design of advanced bifunctional biomaterials with strong potential for clinical application in oncological orthopedics.
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Affiliation(s)
- Zhule Wang
- Radboud University Medical Center, Department of Dentistry – Regenerative Biomaterials, Nijmegen, the Netherlands
- Research Institute for Medical Innovation, Radboudumc, Nijmegen, the Netherlands
| | - Ingrid CM van der Geest
- Research Institute for Medical Innovation, Radboudumc, Nijmegen, the Netherlands
- Radboud University Medical Center, Department of Orthopedics, Nijmegen, the Netherlands
| | - Sander CG. Leeuwenburgh
- Radboud University Medical Center, Department of Dentistry – Regenerative Biomaterials, Nijmegen, the Netherlands
- Research Institute for Medical Innovation, Radboudumc, Nijmegen, the Netherlands
| | - Jeroen JJP. van den Beucken
- Radboud University Medical Center, Department of Dentistry – Regenerative Biomaterials, Nijmegen, the Netherlands
- Research Institute for Medical Innovation, Radboudumc, Nijmegen, the Netherlands
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5
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Chao B, Jiao J, Yang L, Wang Y, Jiang W, Yu T, Wang L, Liu H, Zhang H, Wang Z, Wu M. Application of advanced biomaterials in photothermal therapy for malignant bone tumors. Biomater Res 2023; 27:116. [PMID: 37968707 PMCID: PMC10652612 DOI: 10.1186/s40824-023-00453-z] [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: 07/19/2023] [Accepted: 10/21/2023] [Indexed: 11/17/2023] Open
Abstract
Malignant bone tumors are characterized by severe disability rate, mortality rate, and heavy recurrence rate owing to the complex pathogenesis and insidious disease progression, which seriously affect the terminal quality of patients' lives. Photothermal therapy (PTT) has emerged as an attractive adjunctive treatment offering prominent hyperthermal therapeutic effects to enhance the effectiveness of surgical treatment and avoid recurrence. Simultaneously, various advanced biomaterials with photothermal capacity are currently created to address malignant bone tumors, performing distinctive biological functions, including nanomaterials, bioceramics (BC), polymers, and hydrogels et al. Furthermore, PTT-related combination therapeutic strategies can provide more significant curative benefits by reducing drug toxicity, improving tumor-killing efficiency, stimulating anti-cancer immunity, and improving immune sensitivity relative to monotherapy, even in complex tumor microenvironments (TME). This review summarizes the current advanced biomaterials applicable in PTT and relevant combination therapies on malignant bone tumors for the first time. The multiple choices of advanced biomaterials, treatment methods, and new prospects for future research in treating malignant bone tumors with PTT are generalized to provide guidance. Malignant bone tumors seriously affect the terminal quality of patients' lives. Photothermal therapy (PTT) has emerged as an attractive adjunctive treatment enhancing the effectiveness of surgical treatment and avoiding recurrence. In this review, advanced biomaterials applicable in the PTT of malignant bone tumors and their distinctive biological functions are comprehensively summarized for the first time. Simultaneously, multiple PTT-related combination therapeutic strategies are classified to optimize practical clinical issues, contributing to the selection of biomaterials, therapeutic alternatives, and research perspectives for the adjuvant treatment of malignant bone tumors with PTT in the future.
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Affiliation(s)
- Bo Chao
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China
| | - Jianhang Jiao
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China
| | - Lili Yang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China
| | - Yang Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China
| | - Weibo Jiang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China
| | - Tong Yu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China
| | - Linfeng Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China
| | - Han Zhang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China.
| | - Minfei Wu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China.
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6
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Yu X, Han F, Feng X, Wang X, Zhu Y, Ye C, Ji M, Chen Z, Tao R, Zhou Z, Wan F. Sea Cucumber-Inspired Aerogel for Ultrafast Hemostasis of Open Fracture. Adv Healthc Mater 2023; 12:e2300817. [PMID: 37340763 DOI: 10.1002/adhm.202300817] [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: 03/15/2023] [Revised: 05/29/2023] [Indexed: 06/22/2023]
Abstract
The symptomatic management of hemorrhagic shock complicated by open fractures is a great challenge, because it is also complicated by complex wound bleeding, bacterial infection, and bone defects. Inspired by the water absorption and cross-sectional microstructure of sea cucumbers, in this study, a new sea cucumber-like aerogel (GCG) is proposed. Its aligned porous structure and composition can stop bleeding rapidly and effectively with a blood clotting index of 3.73 ± 1.8%. More importantly, the data of in vivo hemostasis test in an amputating rat tail hemostatic model (15.69 ± 2.45 s, 26.95 ± 8.43 mg) and liver puncture bleeding model (23.77 ± 2.68 s, 36.22 ± 16.92 mg) also indicate the excellent hemostatic performance of GCG. In addition, GCG also shows a significant inhibitory effect on S. aureus and E. coli, which can prevent the occurrence of postoperative osteomyelitis. Not only that, after filling in the bone defect, it is shown that this GCG aerogel completely degrades eight weeks after surgery and induces new bone ingrowth, achieving functional regeneration after hemostasis of an open fracture defect. Generally, because of its combination of hemostatic, antibacterial, and osteogenic activities, this new aerogel is a promising option for open fractures treatment.
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Affiliation(s)
- Xinyu Yu
- Department of Orthopeadic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Fei Han
- Department of Orthopeadic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Xian Feng
- Department of Orthopeadic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Xin Wang
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Yang Zhu
- Department of Orthopeadic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Cong Ye
- Department of Orthopeadic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Minrui Ji
- Department of Orthopeadic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Zhichao Chen
- Department of Orthopeadic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Ran Tao
- Department of Orthopeadic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Zhenyu Zhou
- Department of Orthopeadic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Fuyin Wan
- Department of Orthopeadic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, China
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Zhao C, Shu C, Yu J, Zhu Y. Metal-organic frameworks functionalized biomaterials for promoting bone repair. Mater Today Bio 2023; 21:100717. [PMID: 37545559 PMCID: PMC10401359 DOI: 10.1016/j.mtbio.2023.100717] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Bone defects induced by bone trauma, tumors and osteoarthritis greatly affect the life quality and health of patients. The biomaterials with numerous advantages are becoming the most preferred options for repairing bone defects and treating orthopedic diseases. However, their repairing effects remains unsatisfactory, especially in bone defects suffering from tumor, inflammation, and/or bacterial infection. There are several strategies to functionalize biomaterials, but a more general and efficient method is essential for accomplishing the functionalization of biomaterials. Possessing high specific surface, high porosity, controlled degradability and variable composition, metal-organic frameworks (MOFs) materials are inherently advantageous for functionalizing biomaterials, with tremendous improvements having been achieved. This review summarizes recent progresses in MOFs functionalized biomaterials for promoting bone repair and therapeutic effects. In specific, by utilizing various properties of diverse MOFs materials, integrated MOFs functionalized biomaterials achieve enhanced bone regeneration, antibacterial, anti-inflammatory and anti-tumor functions. Finally, the summary and prospects of on the development of MOFs-functionalized biomaterials for promoting bone repair were discussed.
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Affiliation(s)
- Chaoqian Zhao
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, PR China
| | - Chaoqin Shu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, PR China
| | - Jiangming Yu
- Department of Orthopaedics, Tongren Hospital, Shanghai Jiaotong University, Shanghai, 200336, PR China
| | - Yufang Zhu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, PR China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, PR China
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Bosch-Rué È, Díez-Tercero L, Buitrago JO, Castro E, Pérez RA. Angiogenic and immunomodulation role of ions for initial stages of bone tissue regeneration. Acta Biomater 2023; 166:14-41. [PMID: 37302735 DOI: 10.1016/j.actbio.2023.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/10/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
It is widely known that bone has intrinsic capacity to self-regenerate after injury. However, the physiological regeneration process can be impaired when there is an extensive damage. One of the main reasons is due to the inability to establish a new vascular network that ensures oxygen and nutrient diffusion, leading to a necrotic core and non-junction of bone. Initially, bone tissue engineering (BTE) emerged to use inert biomaterials to just fill bone defects, but it eventually evolved to mimic bone extracellular matrix and even stimulate bone physiological regeneration process. In this regard, the stimulation of osteogenesis has gained a lot of attention especially in the proper stimulation of angiogenesis, being critical to achieve a successful osteogenesis for bone regeneration. Besides, the immunomodulation of a pro-inflammatory environment towards an anti-inflammatory one upon scaffold implantation has been considered another key process for a proper tissue restoration. To stimulate these phases, growth factors and cytokines have been extensively used. Nonetheless, they present some drawbacks such as low stability and safety concerns. Alternatively, the use of inorganic ions has attracted higher attention due to their higher stability and therapeutic effects with low side effects. This review will first focus in giving fundamental aspects of initial bone regeneration phases, focusing mainly on inflammatory and angiogenic ones. Then, it will describe the role of different inorganic ions in modulating the immune response upon biomaterial implantation towards a restorative environment and their ability to stimulate angiogenic response for a proper scaffold vascularization and successful bone tissue restoration. STATEMENT OF SIGNIFICANCE: The impairment of bone tissue regeneration when there is excessive damage has led to different tissue engineered strategies to promote bone healing. Significant importance has been given in the immunomodulation towards an anti-inflammatory environment together with proper angiogenesis stimulation in order to achieve successful bone regeneration rather than stimulating only the osteogenic differentiation. Ions have been considered potential candidates to stimulate these events due to their high stability and therapeutic effects with low side effects compared to growth factors. However, up to now, no review has been published assembling all this information together, describing individual effects of ions on immunomodulation and angiogenic stimulation, as well as their multifunctionality or synergistic effects when combined together.
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Affiliation(s)
- Èlia Bosch-Rué
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Josep Trueta, s/n, Sant Cugat del Vallès, Barcelona 08195, Spain; Basic Sciences Department, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Leire Díez-Tercero
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Josep Trueta, s/n, Sant Cugat del Vallès, Barcelona 08195, Spain; Basic Sciences Department, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Jenifer Olmos Buitrago
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Josep Trueta, s/n, Sant Cugat del Vallès, Barcelona 08195, Spain; Basic Sciences Department, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Emilio Castro
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Josep Trueta, s/n, Sant Cugat del Vallès, Barcelona 08195, Spain; Basic Sciences Department, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Roman A Pérez
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Josep Trueta, s/n, Sant Cugat del Vallès, Barcelona 08195, Spain; Basic Sciences Department, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Barcelona 08195, Spain.
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Li D, Dai D, Xiong G, Lan S, Zhang C. Composite Nanocoatings of Biomedical Magnesium Alloy Implants: Advantages, Mechanisms, and Design Strategies. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2300658. [PMID: 37097626 PMCID: PMC10288271 DOI: 10.1002/advs.202300658] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/25/2023] [Indexed: 06/19/2023]
Abstract
The rapid degradation of magnesium (Mg) alloy implants erodes mechanical performance and interfacial bioactivity, thereby limiting their clinical utility. Surface modification is among the solutions to improve corrosion resistance and bioefficacy of Mg alloys. Novel composite coatings that incorporate nanostructures create new opportunities for their expanded use. Particle size dominance and impermeability may increase corrosion resistance and thereby prolong implant service time. Nanoparticles with specific biological effects may be released into the peri-implant microenvironment during the degradation of coatings to promote healing. Composite nanocoatings provide nanoscale surfaces to promote cell adhesion and proliferation. Nanoparticles may activate cellular signaling pathways, while those with porous or core-shell structures may carry antibacterial or immunomodulatory drugs. Composite nanocoatings may promote vascular reendothelialization and osteogenesis, attenuate inflammation, and inhibit bacterial growth, thus increasing their applicability in complex clinical microenvironments such as those of atherosclerosis and open fractures. This review combines the physicochemical properties and biological efficiency of Mg-based alloy biomedical implants to summarize the advantages of composite nanocoatings, analyzes their mechanisms of action, and proposes design and construction strategies, with the purpose of providing a reference for promoting the clinical application of Mg alloy implants and to further the design of nanocoatings.
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Affiliation(s)
- Dan Li
- Stomatological HospitalSchool of StomatologySouthern Medical UniversityGuangzhou510280China
| | - Danni Dai
- Stomatological HospitalSchool of StomatologySouthern Medical UniversityGuangzhou510280China
| | - Gege Xiong
- Stomatological HospitalSchool of StomatologySouthern Medical UniversityGuangzhou510280China
| | - Shuquan Lan
- Stomatological HospitalSchool of StomatologySouthern Medical UniversityGuangzhou510280China
| | - Chao Zhang
- Stomatological HospitalSchool of StomatologySouthern Medical UniversityGuangzhou510280China
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Song Y, Zhao L, Niu B, Zhao H, Hu Y, Wei Y, Huang D, Wang T, Lian X. The study of self-regulating α-TCP based composite by micro/nano scaled silk fibroin and α-CSH on physicochemical and biological properties of bone cement. J Biomater Appl 2023; 37:1801-1812. [PMID: 37121598 DOI: 10.1177/08853282231172855] [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: 05/02/2023]
Abstract
A novel self-hardening α-tricalcium phosphate (α-TCP) bone cement complexed with different content of α-calcium sulfate hemihydrate (α-CSH) and micrometer hydroxyapatite mineralized silk fibroin (HA-SF) using micro/SF as curing liquid has been investigated in this work, which was capable of tunable setting time, degradation, mechanical property and ability to anti-washout. After addition 0 ∼ 25% α-CSH to the α-TCP cement with SFFs as curing liquid, it shortened the setting time of the modified composite to 10 ∼ 30 min. Furthermore, the addition of SFFs improved the compressive strength of the composite from 5.41 MPa to 9.44 MPa. The composites with both Na2HPO4 and SFFs as curing liquid showed good anti-collapse performance. The weight loss ratio of bone cement was -0.18 ∼ 12.08% in 4 weeks when the content of α-CSH in α-TCP/α-CSH was between 0 ∼ 25 wt%. During the degradation of α-CSH, the amorphous α-TCP were deposited as hydroxyapatite to formed a plate-like products on the surface of composite. Compared to the composite with Na2HPO4 solution as the curing liquid, alkaline phosphatase (ALP) activity of the composites using SFFs as curing liquid were maintained at high levels on the 14th day especially when the Ca/P ratio was 1.7. This study provides a theoretical basis for the regeneration of bone defects guided by bone cement materials.
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Affiliation(s)
- Yaping Song
- Department of Biomedical Engineering, Research Center for Nano-Biomaterials and Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Liqin Zhao
- Department of Biomedical Engineering, Research Center for Nano-Biomaterials and Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
- Shanxi key Laboratory of material strength and structure impact, Institute of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, PR China
| | - Baolong Niu
- College of Materials Science and Engineering, Taiyuan University of Technology, Taiyuan, PR China
| | - Hongyun Zhao
- Department of Biomedical Engineering, Research Center for Nano-Biomaterials and Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Yinchun Hu
- Department of Biomedical Engineering, Research Center for Nano-Biomaterials and Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
- Shanxi key Laboratory of material strength and structure impact, Institute of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, PR China
| | - Yan Wei
- Department of Biomedical Engineering, Research Center for Nano-Biomaterials and Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
- Shanxi key Laboratory of material strength and structure impact, Institute of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, PR China
| | - Di Huang
- Department of Biomedical Engineering, Research Center for Nano-Biomaterials and Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
- Shanxi key Laboratory of material strength and structure impact, Institute of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, PR China
| | - Tongxin Wang
- College of Dentistry, Howard University, Washington, DC 20059, United State
| | - XiaoJie Lian
- Department of Biomedical Engineering, Research Center for Nano-Biomaterials and Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
- Shanxi key Laboratory of material strength and structure impact, Institute of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, PR China
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11
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Calcium phosphate bone cements as local drug delivery systems for bone cancer treatment. BIOMATERIALS ADVANCES 2023; 148:213367. [PMID: 36921461 DOI: 10.1016/j.bioadv.2023.213367] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/18/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
Bone cancer is usually a metastatic disease, affecting people of all ages. Its effective therapy requires a targeted drug administration locally at the cancer site so that the surrounding healthy organs and tissues stay unharmed. Upon a thorough literature search, a tremendous number of published articles are reporting on development of calcium phosphate cements (CPCs) for the treatment of a variety of diseases, such as osteoporosis, osteoarthritis, osteomyelitis, and other musculoskeletal disorders. However, just a limited number of research employs CPCs specifically for bone cancer treatment. In this review article, we study the factors influencing the local drug release from CPCs and particularly focus on bone cancer therapy. Finally, we locate the deficiencies in the literature regarding this specific topic and propose which other perspectives should be considered and discussed in future articles.
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12
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Yu H, Liu H, Shen Y, Ao Q. Synthetic biodegradable polymer materials in the repair of tumor-associated bone defects. Front Bioeng Biotechnol 2023; 11:1096525. [PMID: 36873359 PMCID: PMC9978220 DOI: 10.3389/fbioe.2023.1096525] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/20/2023] [Indexed: 02/18/2023] Open
Abstract
The repair and reconstruction of bone defects and the inhibition of local tumor recurrence are two common problems in bone surgery. The rapid development of biomedicine, clinical medicine, and material science has promoted the research and development of synthetic degradable polymer anti-tumor bone repair materials. Compared with natural polymer materials, synthetic polymer materials have machinable mechanical properties, highly controllable degradation properties, and uniform structure, which has attracted more attention from researchers. In addition, adopting new technologies is an effective strategy for developing new bone repair materials. The application of nanotechnology, 3D printing technology, and genetic engineering technology is beneficial to modify the performance of materials. Photothermal therapy, magnetothermal therapy, and anti-tumor drug delivery may provide new directions for the research and development of anti-tumor bone repair materials. This review focuses on recent advances in synthetic biodegradable polymer bone repair materials and their antitumor properties.
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Affiliation(s)
- Honghao Yu
- Departments of Spine Surgery, Shengjing Hospital of China Medical University, Shenyang, China.,Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Haifeng Liu
- Departments of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuan Shen
- Departments of Spine Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qiang Ao
- Department of Tissue Engineering, China Medical University, Shenyang, China.,NMPA Key Laboratory for Quality Research and Control of Tissue Regenerative Biomaterial and Institute of Regulatory Science for Medical Device and National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
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13
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Xie Y, Wang M, Sun Q, Wang D, Li C. Recent Advances in Tetrakis (4‐Carboxyphenyl) Porphyrin‐Based Nanocomposites for Tumor Therapy. ADVANCED NANOBIOMED RESEARCH 2022. [DOI: 10.1002/anbr.202200136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Yulin Xie
- Institute of Molecular Sciences and Engineering Institute of Frontier and Interdisciplinary Science Shandong University Qingdao 266237 P.R. China
| | - Man Wang
- Institute of Molecular Sciences and Engineering Institute of Frontier and Interdisciplinary Science Shandong University Qingdao 266237 P.R. China
| | - Qianqian Sun
- Institute of Molecular Sciences and Engineering Institute of Frontier and Interdisciplinary Science Shandong University Qingdao 266237 P.R. China
| | - Dongmei Wang
- Key Laboratory of the Ministry of Education for Advanced Catalysis Materials College of Chemistry and Life Sciences Zhejiang Normal University Jinhua 321004 P.R. China
| | - Chunxia Li
- Institute of Molecular Sciences and Engineering Institute of Frontier and Interdisciplinary Science Shandong University Qingdao 266237 P.R. China
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14
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Xu C, Guan S, Hou W, Dong X, Qi M. Magnesium-organic framework modified biodegradable electrospun scaffolds for promoting osteogenic differentiation and bone regeneration. Eur Polym J 2022. [DOI: 10.1016/j.eurpolymj.2022.111692] [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]
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15
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Tan X, Liao D, Rao C, Zhou L, Tan Z, Pan Y, Singh A, Kumar A, Liu J, Li B. Recent advances in nano-architectonics of metal-organic frameworks for chemodynamic therapy. J SOLID STATE CHEM 2022. [DOI: 10.1016/j.jssc.2022.123352] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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16
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Xu N, Zhang X, Qi T, Wu Y, Xie X, Chen F, Shao D, Liao J. Biomedical applications and prospects of temperature‐orchestrated photothermal therapy. MEDCOMM – BIOMATERIALS AND APPLICATIONS 2022; 1. [DOI: 10.1002/mba2.25] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/10/2022] [Indexed: 01/06/2025]
Abstract
AbstractPhotothermal therapy (PTT) has been regarded as a promising strategy considering its advantages of high inherent specificity and a lower invasive burden. Since the photothermal killing of cells/bacteria showed different patterns of death depending on the varying temperature in PTT, the temperature change of PTT is vital to cell/tissue response in scientific research and clinical application. On one hand, mild PTT has received substantial attention in the treatment of cancer and soft/hard tissue repair. On the other hand, the high temperature induced by PTT is capable of antibacterial capacity, which is better than conventional antibiotic therapy with drug resistance. Herein, we summarize the recent developments in the application of temperature‐dependent photothermal biomaterials, mainly covering the temperature ranges of 40–42°C, 43–50°C, and over 50°C. We highlight the biological mechanism of PTT and the latest progress in the treatment of different diseases. Finally, we conclude by discussing the challenges and perspectives of biomaterials in addressing temperature‐orchestrated PTT. Given a deep understanding of the interaction between temperature and biology, rationally designed biomaterials with sophisticated photothermal responsiveness will benefit the outcomes of personalized PTT toward various diseases.
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Affiliation(s)
- Nuo Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu China
| | - Xu Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu China
| | - Tingting Qi
- Department of Pharmacy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China Chengdu China
| | - Yongzhi Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu China
| | - Xi Xie
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu China
| | - Fangman Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences University of Macau Macau China
| | - Dan Shao
- School of Medicine South China University of Technology Guangzhou Guangdong China
| | - Jinfeng Liao
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu China
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17
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Li M, Yin S, Lin M, Chen X, Pan Y, Peng Y, Sun J, Kumar A, Liu J. Current status and prospects of metal-organic frameworks for bone therapy and bone repair. J Mater Chem B 2022; 10:5105-5128. [PMID: 35766423 DOI: 10.1039/d2tb00742h] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
With the development of society, traumatic bone defects caused by accidents, diseases and surgeries have become common, eventually resulting in an increase in bone defects. The treatment of bone defects is characterized by a long period of treatment, high cost and uncontrollable outcomes. Also, it results in complications such as infection and bone discontinuity. Hence, due to this situation, the physical, mental and financial aspects of the patient are severely affected. What's more, such outcomes pose a challenge to orthopaedic surgeons. As a result, bone therapy and bone repair have become a hot topic of interest. In repairing bone defects, materials other than autogenous bone are still unable to provide good biocompatibility, osteogenesis, osteoconductivity and osteoinduction properties at the same time. In addition, the scarcity of autologous bone sources has forced the search for new autologous bone replacement materials. Metal organic frameworks (MOFs) are a new class of developed functional materials that have been widely used in the biomedical field during the recent years due to their porous nature, large specific surface area and diverse structures. With the progress in the investigation into bone treatment and repair, more and more investigators are using MOFs in bone therapy and bone repair. With these viewpoints, in the present perspective, the use of MOFs in bone therapy and bone repair has been summarized, and an insight into the future of MOFs in bone therapy and bone repair has been provided.
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Affiliation(s)
- Minmin Li
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China. .,Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
| | - Shihai Yin
- Hand Surgery Department, Liaobu Hospital of Guangdong Medical University, Dongguan, China
| | - Mingzi Lin
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
| | - Xuelin Chen
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
| | - Ying Pan
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
| | - Yanqiong Peng
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China.
| | - Jianbo Sun
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China.
| | - Abhinav Kumar
- Department of Chemistry, Faculty of Science, University of Lucknow, Lucknow 226 007, India.
| | - Jianqiang Liu
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China. .,Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
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18
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Sun J, Xing F, Braun J, Traub F, Rommens PM, Xiang Z, Ritz U. Progress of Phototherapy Applications in the Treatment of Bone Cancer. Int J Mol Sci 2021; 22:ijms222111354. [PMID: 34768789 PMCID: PMC8584114 DOI: 10.3390/ijms222111354] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 02/05/2023] Open
Abstract
Bone cancer including primary bone cancer and metastatic bone cancer, remains a challenge claiming millions of lives and affecting the life quality of survivors. Conventional treatments of bone cancer include wide surgical resection, radiotherapy, and chemotherapy. However, some bone cancer cells may remain or recur in the local area after resection, some are highly resistant to chemotherapy, and some are insensitive to radiotherapy. Phototherapy (PT) including photodynamic therapy (PDT) and photothermal therapy (PTT), is a clinically approved, minimally invasive, and highly selective treatment, and has been widely reported for cancer therapy. Under the irradiation of light of a specific wavelength, the photosensitizer (PS) in PDT can cause the increase of intracellular ROS and the photothermal agent (PTA) in PTT can induce photothermal conversion, leading to the tumoricidal effects. In this review, the progress of PT applications in the treatment of bone cancer has been outlined and summarized, and some envisioned challenges and future perspectives have been mentioned. This review provides the current state of the art regarding PDT and PTT in bone cancer and inspiration for future studies on PT.
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Affiliation(s)
- Jiachen Sun
- Biomatics Group, Department of Orthopaedics and Traumatology, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany; (J.S.); (J.B.); (F.T.); (P.M.R.)
- Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, China;
| | - Fei Xing
- Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, China;
| | - Joy Braun
- Biomatics Group, Department of Orthopaedics and Traumatology, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany; (J.S.); (J.B.); (F.T.); (P.M.R.)
| | - Frank Traub
- Biomatics Group, Department of Orthopaedics and Traumatology, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany; (J.S.); (J.B.); (F.T.); (P.M.R.)
| | - Pol Maria Rommens
- Biomatics Group, Department of Orthopaedics and Traumatology, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany; (J.S.); (J.B.); (F.T.); (P.M.R.)
| | - Zhou Xiang
- Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, China;
- Correspondence: (Z.X.); (U.R.)
| | - Ulrike Ritz
- Biomatics Group, Department of Orthopaedics and Traumatology, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany; (J.S.); (J.B.); (F.T.); (P.M.R.)
- Correspondence: (Z.X.); (U.R.)
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