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Foppiani JA, Taritsa IC, Foster L, Patel A, Hernandez Alvarez A, Lee D, Lin GJ, Lee TC, Gavlasova D, Escobar-Domingo MJ, Kaplan DL, Lin SJ. Redefining Surgical Materials: Applications of Silk Fibroin in Osteofixation and Fracture Repair. Biomimetics (Basel) 2024; 9:286. [PMID: 38786496 PMCID: PMC11118403 DOI: 10.3390/biomimetics9050286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 05/25/2024] Open
Abstract
Silk and silk derivatives have emerged as a possible alternative in surgical device development, offering mechanical strength, biocompatibility, and environmental sustainability. Through a systematic review following PRISMA guidelines, this study evaluated silk fibroin's application across pre-clinical and clinical settings, focusing on its role as screws and plates for osteofixation. A comprehensive search yielded 245 studies, with 33 subjected to full-text review and 15 ultimately included for qualitative analysis. The findings underscore silk fibroin's superior properties, including its tunable degradation rates and ability to be functionalized with therapeutic agents. In vivo and in vitro studies demonstrated its efficacy in enhancing bone healing, offering improved outcomes in osteofixation, particularly for craniofacial defects. Silk fibroin's remarkable attributes in biodegradation and drug release capabilities underscore its potential to enhance patient care. Ultimately, silk fibroin's integration into surgical practices promises a revolution in patient outcomes and environmental sustainability. Its versatility, coupled with the continuous progress in fabrication techniques, signals a promising horizon for its widespread acceptance in the medical field, potentially establishing a new benchmark in surgical treatment. Further research is expected to solidify the transition of silk products from basic science to patient care, paving the way for widespread use in various surgical applications.
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Affiliation(s)
- Jose A. Foppiani
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; (J.A.F.); (D.L.)
| | - Iulianna C. Taritsa
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; (J.A.F.); (D.L.)
| | - Lacey Foster
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Armaan Patel
- Department of Biomedical Engineering, Tufts University, Boston, MA 02155, USA; (A.P.)
| | - Angelica Hernandez Alvarez
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; (J.A.F.); (D.L.)
| | - Daniela Lee
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; (J.A.F.); (D.L.)
| | - Gavin J. Lin
- Nobles and Greenough School, Dedham, MA 02026, USA
| | | | - Dominika Gavlasova
- Institute of Clinical and Experimental Medicine, 140 21 Prague, Czech Republic
| | - Maria J. Escobar-Domingo
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; (J.A.F.); (D.L.)
| | - David L. Kaplan
- Department of Biomedical Engineering, Tufts University, Boston, MA 02155, USA; (A.P.)
| | - Samuel J. Lin
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; (J.A.F.); (D.L.)
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Delemeester M, Pawelec KM, Hix JML, Siegenthaler JR, Lissy M, Douek P, Houmeau A, Si-Mohamed S, Shapiro EM. Device Design and Diagnostic Imaging of Radiopaque 3D Printed Tissue Engineering Scaffolds. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.26.582070. [PMID: 38464166 PMCID: PMC10925229 DOI: 10.1101/2024.02.26.582070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
3D printed biomaterial implants are revolutionizing personalized medicine for tissue repair, especially in orthopedics. In this study, a radiopaque Bi 2 O 3 doped polycaprolactone ( PCL ) composite is developed and implemented to enable the use of diagnostic X-ray technologies, especially photon counting X-ray computed tomography ( PCCT ), for comprehensive in vivo device monitoring. PCL filament with homogeneous Bi 2 O 3 nanoparticle ( NP ) dispersion (0.8 to 11.7 wt%) are first fabricated. Tissue engineered scaffolds ( TES ) are then 3D printed with the composite filament, optimizing printing parameters for small feature size and severely overhung geometries. These composite TES are characterized via micro-computed tomography ( µ CT ), tensile testing, and a cytocompatibility study, with Bi 2 O 3 mass fractions as low as 2 wt% providing excellent radiographic distinguishability, improved tensile properties, and equivalent cytocompatibility of neat PCL. The excellent radiographic distinguishability is validated in situ by imaging 4 and 7 wt% TES in a mouse model with µCT, showing excellent agreement with in vitro measurements. Subsequently, CT image-derived swine menisci are 3D printed with composite filament and re-implanted in their corresponding swine legs ex vivo . Re-imaging the swine legs via clinical CT allows facile identification of device location and alignment. Finally, the emergent technology of PCCT unambiguously distinguishes implanted menisci in situ.
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Lifka S, Rehberger Y, Pastl K, Rofner-Moretti A, Reichkendler M, Baumgartner W. The Development and Biomechanical Analysis of an Allograft Interference Screw for Anterior Cruciate Ligament Reconstruction. Bioengineering (Basel) 2023; 10:1174. [PMID: 37892904 PMCID: PMC10604633 DOI: 10.3390/bioengineering10101174] [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: 09/21/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
Graft fixation during cruciate ligament reconstruction using interference screws is a common and frequently used surgical technique. These interference screws are usually made of metal or bioabsorbable materials. This paper describes the development of an allograft interference screw from cortical human bone. During the design of the screw, particular attention was paid to the choice of the screw drive and the screw shape, as well as the thread shape. Based on these parameters, a prototype was designed and manufactured. Subsequently, the first biomechanical tests using a bovine model were performed. The test procedure comprised a torsion test to determine the ultimate failure torque of the screw and the insertion torque during graft fixation, as well as a pull-out test to asses the ultimate failure load of the graft fixation. The results of the biomechanical analysis showed that the mean value of the ultimate failure torque was 2633 Nmm, whereas the mean occurring insertion torque during graft fixation was only 1125 Nmm. The mean ultimate failure load of the graft fixation was approximately 235 N. The results of this work show a good overall performance of the allograft screw compared to conventional screws, and should serve as a starting point for further detailed investigations and studies.
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Affiliation(s)
- Sebastian Lifka
- Institute of Biomedical Mechatronics, Johannes Kepler University Linz, 4040 Linz, Austria
| | | | | | | | - Markus Reichkendler
- Department of Orthopedic and Trauma Surgery, District Hospital Schwaz, 6130 Schwaz, Austria
| | - Werner Baumgartner
- Institute of Biomedical Mechatronics, Johannes Kepler University Linz, 4040 Linz, Austria
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Terzopoulou Z, Zamboulis A, Koumentakou I, Michailidou G, Noordam MJ, Bikiaris DN. Biocompatible Synthetic Polymers for Tissue Engineering Purposes. Biomacromolecules 2022; 23:1841-1863. [PMID: 35438479 DOI: 10.1021/acs.biomac.2c00047] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Synthetic polymers have been an integral part of modern society since the early 1960s. Besides their most well-known applications to the public, such as packaging, construction, textiles and electronics, synthetic polymers have also revolutionized the field of medicine. Starting with the first plastic syringe developed in 1955 to the complex polymeric materials used in the regeneration of tissues, their contributions have never been more prominent. Decades of research on polymeric materials, stem cells, and three-dimensional printing contributed to the rapid progress of tissue engineering and regenerative medicine that envisages the potential future of organ transplantations. This perspective discusses the role of synthetic polymers in tissue engineering, their design and properties in relation to each type of application. Additionally, selected recent achievements of tissue engineering using synthetic polymers are outlined to provide insight into how they will contribute to the advancement of the field in the near future. In this way, we aim to provide a guide that will help scientists with synthetic polymer design and selection for different tissue engineering applications.
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Affiliation(s)
- Zoi Terzopoulou
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
| | - Alexandra Zamboulis
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
| | - Ioanna Koumentakou
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
| | - Georgia Michailidou
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
| | - Michiel Jan Noordam
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
| | - Dimitrios N Bikiaris
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
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Lifka S, Baumgartner W. A Novel Screw Drive for Allogenic Headless Position Screws for Use in Osteosynthesis-A Finite-Element Analysis. Bioengineering (Basel) 2021; 8:136. [PMID: 34677209 PMCID: PMC8533393 DOI: 10.3390/bioengineering8100136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/28/2021] [Indexed: 11/25/2022] Open
Abstract
Due to their osteoconductive properties, allogenic bone screws made of human cortical bone have advantages regarding rehabilitation compared to other materials such as stainless steel or titanium. Since conventional screw drives like hexagonal or hexalobular drives are difficult to manufacture in headless allogenic screws, an easy-to-manufacture screw drive is needed. In this paper, we present a simple drive for headless allogenic bone screws that allows the screw to be fully inserted. Since the screw drive is completely internal, no threads are removed. In order to prove the mechanical strength, we performed simulations of the new drive using the Finite-Element method (FEM), validated the simulations with a prototype screw, tested the novel screw drive experimentally and compared the simulations with conventional drives. The validation with the prototype showed that our simulations provided valid results. Furthermore, the simulations of the new screw drive showed good performance in terms of mechanical strength in allogenic screws compared to conventional screw drives. The presented screw drive is simple and easy to manufacture and is therefore suitable for headless allogenic bone screws where conventional drives are difficult to manufacture.
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Affiliation(s)
- Sebastian Lifka
- Institute of Biomedical Mechatronics, Johannes Kepler University Linz, 4040 Linz, Austria;
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Lei T, Qian H, Nan J, Hu Y, Lei P. The optimization of pepsin processing time to balance the mechanical and biological properties of xenogeneic bone. J Biomed Mater Res B Appl Biomater 2021; 110:403-411. [PMID: 34309189 DOI: 10.1002/jbm.b.34916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 11/07/2022]
Abstract
Xenogeneic bone showed great prospects to treat large bone defects due to its bionic composition and structure, but the immunogenicity limited its wide applications. Previously, we developed a pepsin treating method to eliminate the immunogenicity of xenogeneic bone. In this study, we further investigated the effect of pepsin processing time on the biological and mechanical properties. The results indicated that increased pepsin treating time impaired the mechanical properties of xenogeneic bone. And MC3T3-E1 cells showed enhanced adhesion ability, as well as increased production of alkaline phosphatase and calcium nodulus production on the xenogeneic bone processed by pepsin for 24 hr (P24), as compared with xenogeneic bone processed by pepsin for 30 hr (P30) and 36 hr (P36). In addition, we found no significant inflammatory responses after implanting different xenogeneic bone into the intermuscular site of rats. These results suggested that xenogeneic bone processed by pepsin for 24 hr may be a preferable choice when using the xenogeneic bone as biomaterials for further researches.
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Affiliation(s)
- Ting Lei
- Department of Orthopeadic Surgery, Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital Central South University
| | - Hu Qian
- Department of Orthopeadic Surgery, Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital Central South University
| | - Jiangyu Nan
- Department of Orthopeadic Surgery, Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital Central South University
| | - Yihe Hu
- Department of Orthopeadic Surgery, Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital Central South University.,Department of Sports Medicine, Xiangya Hospital Central South University
| | - Pengfei Lei
- Department of Orthopeadic Surgery, Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital Central South University
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Silk: A Promising Biomaterial Opening New Vistas Towards Affordable Healthcare Solutions. J Indian Inst Sci 2019. [DOI: 10.1007/s41745-019-00114-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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