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Sui P, Yu T, Sun S, Chao B, Qin C, Wang J, Wang E, Zheng C. Advances in materials used for minimally invasive treatment of vertebral compression fractures. Front Bioeng Biotechnol 2023; 11:1303678. [PMID: 37954022 PMCID: PMC10634476 DOI: 10.3389/fbioe.2023.1303678] [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: 09/28/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023] Open
Abstract
Vertebral compression fractures are becoming increasingly common with aging of the population; minimally invasive materials play an essential role in treating these fractures. However, the unacceptable processing-performance relationships of materials and their poor osteoinductive performance have limited their clinical application. In this review, we describe the advances in materials used for minimally invasive treatment of vertebral compression fractures and enumerate the types of bone cement commonly used in current practice. We also discuss the limitations of the materials themselves, and summarize the approaches for improving the characteristics of bone cement. Finally, we review the types and clinical efficacy of new vertebral implants. This review may provide valuable insights into newer strategies and methods for future research; it may also improve understanding on the application of minimally invasive materials for the treatment of vertebral compression fractures.
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Affiliation(s)
| | | | | | | | | | | | | | - Changjun Zheng
- Orthopaedic Medical Center, Second Hospital of Jilin University, Changchun, China
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2
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Quan Q, Gongping X, Ruisi N, Shiwen L. New Research Progress of Modified Bone Cement Applied to Vertebroplasty. World Neurosurg 2023; 176:10-18. [PMID: 37087028 DOI: 10.1016/j.wneu.2023.04.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/24/2023]
Abstract
Percutaneous vertebroplasty and percutaneous kyphoplasty are effective methods to treat acute osteoporotic vertebral compression fractures that can quickly provide patients with pain relief, prevent further height loss of the vertebral body, and help correct kyphosis. Many clinical studies have investigated the characteristics of bone cement. Bone cement is a biomaterial injected into the vertebral body that must have good biocompatibility and biosafety. The optimization of the characteristics of bone cement has become of great interest. Bone cement can be mainly divided into 3 types: polymethyl methacrylate, calcium phosphate cement, and calcium sulfate cement. Each type of cement has its own advantages and disadvantages. In the past 10 years, the performance of bone cement has been greatly improved via different methods. The aim of our review is to provide an overview of the current progress in the types of modified bone cement and summarize the key clinical findings.
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Affiliation(s)
- Qi Quan
- Department of Spine Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xu Gongping
- Department of Spine Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Na Ruisi
- Department of Gastrointestinal Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Li Shiwen
- Department of Spine Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, China.
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3
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Wei Y, Baskaran N, Wang HY, Su YC, Nabilla SC, Chung RJ. Study of polymethylmethacrylate/tricalcium silicate composite cement for orthopedic application. Biomed J 2022; 46:100540. [DOI: 10.1016/j.bj.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 05/13/2022] [Accepted: 05/23/2022] [Indexed: 11/02/2022] Open
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4
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Khan A, Khan GH, Mirza EH, Chandio A, Mohsin M, Hassan M, Naushad M, Jafri AR. Development and Characterization of Acrylic Based Bone Cements. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.2933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Bone tissue engineering has emerged as a multidisciplinary field in recent times with an aim to expedite the process of regeneration of damaged or diseased tissues. This study is an attempt to fabricate and characterize Tricalcium Phosphate (TCP) and Chitosan incorporated Polymethylmethacrylate
(PMMA) based bone cement. In total two experimental PMMA based bone cements were fabricated that were differentiated by presence and absence of Chitosan. In both groups (10 and 30 wt.%) TCP were incorporated into Methyl methacrylate (MMA) monomer. PMMA was used as a control. The physical,
mechanical and thermal properties of the composites were assessed. Morphological changes of PMMA after the introduction of TCP and Chitosan were observed by means of X-ray diffraction (XRD). Major peak shifts in Fourier transform Infrared spectroscopy (FTIR) spectra demonstrated the strong
bonding of PMMA with incorporated materials. PMMA incorporated with 10% TCP showed the maximum wettability in absence of Chitosan. Hardness of the tested specimens decreased with increasing content of TCP which in turns enhanced ductility. It was also observed that neither of the samples showed
significant degradation. The incorporation of additives enhance the physical and chemical properties of PMMA as bone cement.
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Affiliation(s)
- Aqsa Khan
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, 74800, Pakistan
| | - Ghazna Hassan Khan
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, 74800, Pakistan
| | - Eraj Humayun Mirza
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, 74800, Pakistan
| | - Alidad Chandio
- Department of Metallurgical Engineering, NED University of Engineering & Technology, Karachi, 75270, Pakistan
| | - Maliha Mohsin
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, 74800, Pakistan
| | - Mahnoor Hassan
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, 74800, Pakistan
| | - Manal Naushad
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, 74800, Pakistan
| | - Ali Raza Jafri
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, 74800, Pakistan
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Injectable bioactive polymethyl methacrylate–hydrogel hybrid bone cement loaded with BMP-2 to improve osteogenesis for percutaneous vertebroplasty and kyphoplasty. Biodes Manuf 2022. [DOI: 10.1007/s42242-021-00172-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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6
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Chiang CC, Hsieh MK, Wang CY, Tuan WH, Lai PL. Cytotoxicity and cell response of preosteoblast in calcium sulfate-augmented PMMA bone cement. Biomed Mater 2021; 16. [PMID: 34410226 DOI: 10.1088/1748-605x/ac1ab5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 08/04/2021] [Indexed: 12/25/2022]
Abstract
Poly(methyl methacrylate) (PMMA) has been widely used in orthopedic applications, but bone ingrowth and toxic monomer release are drawback of this material. Particle reinforcement with osteoconductive substitute, such as calcium sulfate (CaSO4), is one of the solutions used to modify PMMA bone cement. The current study investigated the mechanical, chemical and biological properties of CaSO4-augmented bone cement. Mechanical strength was measured by a material testing machine. The concentration of methyl methacrylate (MMA) monomer from the various formulations of PMMA mixed with CaSO4was measured by ultra-performance liquid chromatography (UPLC). CCK-8 assay and ALP assay were performed to evaluate cytotoxicity of released MMA monomer and cell differentiation. The attachment of cells to CaSO4-augmented bone cement discs was observed by confocal and scanning electron microscopy, and surface topography was also evaluated by atomic force microscopy. The results revealed that increased CaSO4weight ratios led to compromised mechanical strength and increased MMA monomer release. Cell density and cell differentiation on CaSO4-augmented bone cement discs were decreased at CaSO4weight ratios above 10%. In addition, the presence of micropores on the surface and surface roughness were both increased for PMMA composite discs containing higher levels of CaSO4. These results demonstrated that fewer MC3T3-E1 cells on the surface of CaSO4-PMMA composites was correlated to increased MMA monomer release, micropore number and surface roughness. In summary, the augmentation of a higher proportion of CaSO4(>10 wt. %) to PMMA did not promote the biological properties of traditional PMMA bone cement.
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Affiliation(s)
- Ching-Chien Chiang
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ming-Kai Hsieh
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chi-Yun Wang
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wei-Hsing Tuan
- Department of Materials Science and Engineering, National Taiwan University, Taipei, Taiwan
| | - Po-Liang Lai
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Yang J, Qin H, Chai Y, zhang P, Chen Y, Yang K, Qin M, Zhang Y, Xia H, Ren L, Yu B. Molecular mechanisms of osteogenesis and antibacterial activity of Cu-bearing Ti alloy in a bone defect model with infection in vivo. J Orthop Translat 2021; 27:77-89. [PMID: 33437640 PMCID: PMC7779545 DOI: 10.1016/j.jot.2020.10.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/03/2020] [Accepted: 10/08/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE The antibacterial activity of copper (Cu)-alloy biomaterials has shown a great potential in clinical application. Here, we evaluated the osteogenesis and antibacterial effects of Ti6Al4V-6.5wt%Cu alloy in an in vivo model of infected bone defects and determine their responsible proteins and pathways using proteomics. METHODS After bone defects were filled with Ti6Al4V and Ti6Al4V-6.5wt%Cu implants for 6 week, the tissue and bone samples around the implants were harvested for radiographic, micro-CT, histological, and bone-related gene expression analyses. An iTRAQ-based protein identification/quantification approach was used to analyze the osteogenic and antibacterial effects of Ti6Al4V-6.5wt%Cu alloy. RESULTS Imaging and histological results showed Ti6Al4V alloy induced a stronger inflammatory response than Ti6Al4V-6.5wt%Cu alloy; imaging results and osteogenic protein levels showed Ti6Al4V-6.5wt%Cu alloy exerted a stronger osteogenic effect. In vitro experiment, we found the Ti6Al4V-6.5wt%Cu had significant antibacterial effects and inhibited the activity of Staphylococcus aureus in the early stage. In addition, the bacterial biofilm formed in Ti6Al4V-6.5wt%Cu group was significantly lower than that in Ti6Al4V group. Proteomic screening of 4279 proteins resulted in 35 differentially expressed proteins for further examination which were mainly associated with the cellular process, metabolic process, stimulus response, and cellular component organization. In further exploration of the mechanism of osteogenic mineralization of Ti6Al4V-6.5wt%Cu alloy, we found out SDC4 and AGRN were the top two target proteins associated with osteogenic differentiation and bone mineralization. CONCLUSION Ti6Al4V-6.5wt%Cu alloy shows a great potential as a bone implant material due to its positive effects against bacterial infection and on bone formation. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE At present, titanium alloys and other non-antibacterial metal materials are used in orthopedic internal fixation operations. Our study demonstrates that Ti6Al4V-6.5wt%Cu alloy has good antibacterial and osteogenic effects in vivo and in vitro. This means that Ti6Al4V-6.5wt%Cu alloy may become a new kind of antimicrobial metallic material as internal fixation material to continuously exert its antimicrobial effects and reduce the infection rate after clinical internal fixation.
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Key Words
- AGRN, Agrin
- ALP, alkaline phosphatase
- Antibacterial
- BV, bone volume
- Bone defect
- DEPs, differentially expressed proteins
- EDTA, Ethylene Diamine Tetraacetic Acid
- ESI, Electrospray Ionization
- LC, Liquid Chromatography
- OCN, osteocalcin
- OPN, osteopontin
- Osteogenesis
- PPI, protein-to-protein interacting
- S. Aureus, staphylococcus aureus
- SCX, Strong Cation Exchange
- SDC4, Syndecan 4
- SEM, scanning electron microscope
- TV, tissue volume
- Tb.N, trabecular number
- Tb.Sp, trabecular separation
- Tb.Th, trabecular thickness
- Ti6Al4V-6.5wt%Cu alloy
- UV, ultraviolet
- XRD, X-Ray Diffraction
- cfu, colony-forming unit
- hBMSCs, human bone marrow stromal cells
- iTRAQ, isobaric Tags for Relative and Absolute Quantitation
- isobaric tags for relative and absolute quantification(iTRAQ) analysis
- micro-CT, microcomputed tomography
- pAGC, predictive Automatic Gain Control
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Affiliation(s)
- Jun Yang
- Department of Orthopaedics, Nanfang Hospital, Southern Medical University; Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
- Department of Orthopaedics, Guangzhou General Hospital of Guangzhou Military Command of PLA, Guangdong Key Lab of Orthopaedic Technology and Implant Materials, Key Laboratory of Trauma & Tissue Repair of Tropical Area of PLA, Guangzhou 510010, China
| | - Hanjun Qin
- Department of Orthopaedics, Nanfang Hospital, Southern Medical University; Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yu Chai
- Department of Orthopaedics, Nanfang Hospital, Southern Medical University; Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Ping zhang
- Department of Orthopaedics, Nanfang Hospital, Southern Medical University; Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yirong Chen
- Department of Orthopaedics, Nanfang Hospital, Southern Medical University; Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Ke Yang
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Min Qin
- School of Public Health, Experimental Teaching Center of Preventive Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yifang Zhang
- Editorial Office, Chinese Journal of Orthopaedic Trauma, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Hong Xia
- Department of Orthopaedics, Guangzhou General Hospital of Guangzhou Military Command of PLA, Guangdong Key Lab of Orthopaedic Technology and Implant Materials, Key Laboratory of Trauma & Tissue Repair of Tropical Area of PLA, Guangzhou 510010, China
| | - Ling Ren
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Bin Yu
- Department of Orthopaedics, Nanfang Hospital, Southern Medical University; Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
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8
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Yousefi AM. A review of calcium phosphate cements and acrylic bone cements as injectable materials for bone repair and implant fixation. J Appl Biomater Funct Mater 2020; 17:2280800019872594. [PMID: 31718388 DOI: 10.1177/2280800019872594] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Treatment of bone defects caused by trauma or disease is a major burden on human healthcare systems. Although autologous bone grafts are considered as the gold standard, they are limited in availability and are associated with post-operative complications. Minimally invasive alternatives using injectable bone cements are currently used in certain clinical procedures, such as vertebroplasty and balloon kyphoplasty. Nevertheless, given the high incidence of fractures and pathologies that result in bone voids, there is an unmet need for injectable materials with desired properties for minimally invasive procedures. This paper provides an overview of the most common injectable bone cement materials for clinical use. The emphasis has been placed on calcium phosphate cements and acrylic bone cements, while enabling the readers to compare the opportunities and challenges for these two classes of bone cements. This paper also briefly reviews antibiotic-loaded bone cements used in bone repair and implant fixation, including their efficacy and cost for healthcare systems. A summary of the current challenges and recommendations for future directions has been brought in the concluding section of this paper.
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Affiliation(s)
- Azizeh-Mitra Yousefi
- Department of Chemical, Paper and Biomedical Engineering, Miami University, Oxford, OH, USA
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9
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Ahangar P, Aziz M, Rosenzweig DH, Weber MH. Advances in personalized treatment of metastatic spine disease. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:223. [PMID: 31297388 DOI: 10.21037/atm.2019.04.41] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The spine is one of the most common sites of bony metastases, and its involvement leads to significant patient morbidity. Surgical management in these patients is aimed at improving quality of life and functional status throughout the course of the disease. Resection of metastases often leads to critical size bone defects, presenting a challenge to achieving adequate bone regeneration to fill the void. Current treatment options for repairing these defects are bone grafting and commercial bone cements; however, each has associated limitations. Additionally, tumor recurrence and tumor-induced bone loss make bone regeneration particularly difficult. Systemic therapeutic delivery, such as bisphosphonates, have become standard of care to combat bone loss despite unfavorable systemic side-effects and lack of local efficacy. Developments from tissue engineering have introduced novel materials with osteoinductive and osteoconductive properties which also act as structural support scaffolds for bone regeneration. These new materials can also act as a therapeutic reservoir to sustainably release drugs locally as an alternative to systemic therapy. In this review, we outline recent advancements in tissue engineering and the role of translational research in developing implants that can fully repair bone defects while also delivering local therapeutics to curb tumor recurrence and improve patient quality of life.
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Affiliation(s)
- Pouyan Ahangar
- Division of Orthopedic Surgery, McGill University, Montreal, QC, Canada.,The Research Institute of the McGill University Health Centre, Injury, Repair and Recovery Program, Montreal, QC, Canada.,Montreal General Hospital C10.148.6, Montreal, QC, Canada
| | - Mina Aziz
- Division of Orthopedic Surgery, McGill University, Montreal, QC, Canada.,The Research Institute of the McGill University Health Centre, Injury, Repair and Recovery Program, Montreal, QC, Canada.,Montreal General Hospital C10.148.6, Montreal, QC, Canada.,Clinical Investigator Program, McGill University, Montreal, QC, Canada
| | - Derek H Rosenzweig
- Division of Orthopedic Surgery, McGill University, Montreal, QC, Canada.,The Research Institute of the McGill University Health Centre, Injury, Repair and Recovery Program, Montreal, QC, Canada.,Montreal General Hospital C10.148.6, Montreal, QC, Canada
| | - Michael H Weber
- Division of Orthopedic Surgery, McGill University, Montreal, QC, Canada.,The Research Institute of the McGill University Health Centre, Injury, Repair and Recovery Program, Montreal, QC, Canada.,Montreal General Hospital C10.148.6, Montreal, QC, Canada
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10
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Ji X, Xu F, Dong G, Jia C, Jia P, Chen H, Tang H. Loading necrostatin-1 composite bone cement inhibits necroptosis of bone tissue in rabbit. Regen Biomater 2019; 6:113-119. [PMID: 30967966 PMCID: PMC6447002 DOI: 10.1093/rb/rbz004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/19/2018] [Accepted: 01/01/2019] [Indexed: 01/16/2023] Open
Abstract
Bone necrosis after injecting of polymethylmethacrylate (PMMA) bone cement will lead to re-fracture of bone tissue. As a new type of necrosis, there is little research related to the necroptosis of surrounding bone tissue near the bone cement. The purpose of our study was to (i) investigate the presence of necroptosis in vivo and, (ii) established as a new type of bone cement containing PMMA, calcium phosphate cement (CPC) and Necrostatin-1 (Nec-1) to inhibit necroptosis of bone tissue. A total of 12 Japanese rabbits were used to establish the animal model and randomly divided into 4 groups signed as a control group, PMMA group, PMMA-CPC group and PMMA-CPC-Nec-1 group, respectively. We used scanning electron microscope to observe the structure of the samples, used HE staining to detect the necrosis, and used western blotting as well as ELISA test to examine the iconic molecule receptor interacting protein kinase-3 (RIP 3) protein and tumor necrosis factor α (TNF-α). After analyzing the results of our study, we found that the structure in both PMMA bone cement group and composite bone cement group was damaged and there was an evidence of necrosis, but it was absent in control group. Through molecule detection, the RIP 3 protein expression was decreased in PMMA-CPC-Nec-1 (P < 0.05). TNF-α expression was increased in bone cement groups with and without CPC (P < 0.05), but was inhibited in PMMA-CPC-Nec-1 group. We have concluded that the necroptosis could be confirmed in bone tissue necrosis induced by TNF-α after bone cement injection and also could be inhibited by composite bone cement with Nec-1.
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Affiliation(s)
- Xiang Ji
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing, China
| | - Feng Xu
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing, China
| | - Guoling Dong
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing, China
| | - Chongzhe Jia
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing, China
| | - Pu Jia
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing, China
| | - Hao Chen
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing, China
| | - Hai Tang
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing, China
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A Case of Osteomyelitis after Calcaneal Fracture Treated by Antibiotic-Containing Calcium Phosphate Cements. Case Rep Orthop 2018; 2018:9321830. [PMID: 30009068 PMCID: PMC6020476 DOI: 10.1155/2018/9321830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/10/2018] [Indexed: 12/17/2022] Open
Abstract
Calcaneal osteomyelitis (CO) is considered to be difficult to cure when it turned into a chronic phase. We report one case of calcaneal osteomyelitis which arises after the operation of calcaneal fracture. Remission was obtained by performing curettage of the infected cancellous bone of the calcaneal body and filling antibiotic-containing calcium phosphate cements (CPC) within its bone defect. This one-stage surgery is useful to treat calcaneal osteomyelitis.
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12
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Healing potentials of polymethylmethacrylate bone cement combined with platelet gel in the critical-sized radial bone defect of rats. PLoS One 2018; 13:e0194751. [PMID: 29608574 PMCID: PMC5880368 DOI: 10.1371/journal.pone.0194751] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 03/08/2018] [Indexed: 11/24/2022] Open
Abstract
Polymethylmethacrylate (PMMA) is the most commonly used filler material that lacks biological properties and osteoconductivity or osteoinductivity. Platelet gel (PG) is a typical source of growth factors, cytokines and molecules efficient for bone formation and remodeling. The aim of this study was to evaluate bone healing and regeneration of bone defect in rat model by combining PMMA with PG. A total of 50 defects were created in the diaphysis of the radii of 25 male Sprague-Dawley rats. These defects were randomly divided into five groups (n = 10 defects for each group) and treated by autograft, plain PMMA, PG and PMMA-PG or left untreated. The rats were examined clinically and radiologically during the experiment and also after euthanasia at the 8th post-operative week, the healed defects were evaluated by gross morphology, histopathology, histomorphometry, computed tomography, scanning electron microscopy and biomechanical testing. PG could function as efficiently as autograft in promoting bone healing of the radial bones. Additionally, bone formation, and densities of cartilaginous and osseous tissues in the defects treated with autograft, PG and PMMA-PG were more satisfactory than the untreated and PMMA treated defects. Compared with the PMMA-PG implant, more PMMA residuals remained in the defect area and induced more intense inflammatory reaction. In conclusion, addition of PG could improve the bone regenerative properties of PMMA bone cement compared with PMMA alone in vivo. Therefore, the PG-PMMA can be proposed as a promising option to increase regenerative potential of PMMA, particularly when it is used as fixator, filler or adhesive in the dentistry, neurosurgery and bone tissue engineering applications.
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13
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Yang Z, Chen L, Hao Y, Zang Y, Zhao X, Shi L, Zhang Y, Feng Y, Xu C, Wang F, Wang X, Wang B, Liu C, Tang Y, Wu Z, Lei W. Synthesis and Characterization of an Injectable and Hydrophilous Expandable Bone Cement Based on Poly(methyl methacrylate). ACS APPLIED MATERIALS & INTERFACES 2017; 9:40846-40856. [PMID: 29099164 DOI: 10.1021/acsami.7b12983] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Poly(methyl methacrylate) (PMMA), the most common bone cement, has been used as a graft substitute in orthopedic surgeries such as vertebroplasty. However, an undesirable minor crack in the bone-cement interface provoked by shrinkage during polymerization and high elastic modulus of conventional PMMA bone cement dramatically increases the risk of vertebral body refracture postsurgery. Thus, herein, a hydrophilous expandable bone cement was synthesized based on a PMMA commercial cement (Mendec Spine Resin), acrylic acid (AA), and styrene (St). The two synthesized cements (PMMA-PAA, PMMA-PAA-PSt) showed excellent volumetric swelling in vitro and cohesive bone-cement contact in rabbit femur cavity defect. The elastic modulus and compressive strength of the new cements were lower than PMMA. Furthermore, the in vitro analysis indicated that the new cements had lower cytotoxicity than PMMA, including superior proliferation and lower apoptotic rates of Sprague-Dawly rat-derived osteoblasts. Western blotting for protein expression and RT-PCR analysis of osteogenesis-specific genes were conducted on SD rat-derived osteoblasts from both PMMA and new cements films; the results showed that new cements enhanced the expression of osteogenesis-specific genes. Scanning electron microscopy demonstrated improved morphology and attachment of osteoblast on new cement discs compared to the PMMA discs. Additionally, the histological morphologies of the bone-cement interface from the rabbit medial femoral condyle cavity defect model revealed direct and cohesive contact with the bone in the new cement groups in contrast to a minor crack in the PMMA cement group. The sign of a new bone growing into the cement has been found in the new cements after 12 weeks, thereby indicating the osteogenic capacity in vivo. In conclusion, the synthesized hydrophilous expandable bone cements based on PMMA and poly(acrylic acid) (PAA) are promising candidates for vertebroplasty.
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Affiliation(s)
- Zhao Yang
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Lei Chen
- School of Materials Science and Engineering, Xi'an University of Technology , No. 5 Jinhua South Road, Xi'an, Shaanxi province 710048, P.R. China
| | - Yuxin Hao
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Yuan Zang
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences Beijing, Beijing Institute of Lifeomics , Beijing, 102206, P.R. China
| | - Xiong Zhao
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Lei Shi
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Yang Zhang
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Yafei Feng
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Chao Xu
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Faqi Wang
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Xinli Wang
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Bowen Wang
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Chenxin Liu
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Yufei Tang
- School of Materials Science and Engineering, Xi'an University of Technology , No. 5 Jinhua South Road, Xi'an, Shaanxi province 710048, P.R. China
| | - Zixiang Wu
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Wei Lei
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
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