Carbon nanostructures for orthopedic medical applications

Pioneering nanomedicine in orthopedic treatment care: a review of current research and practices

A developing use of nanotechnology in medicine involves using nanoparticles to administer drugs, genes, biologicals, or other materials to targeted cell types, such as cancer cells. In healthcare, nanotechnology has brought about revolutionary changes in the treatment of various medical and surgical conditions, including in orthopedic. Its clinical applications in surgery range from developing surgical instruments and suture materials to enhancing imaging techniques, targeted drug delivery, visualization methods, and wound healing procedures. Notably, nanotechnology plays a significant role in preventing, diagnosing, and treating orthopedic disorders, which is crucial for patients' functional rehabilitation. The integration of nanotechnology improves standards of patient care, fuels research endeavors, facilitates clinical trials, and eventually improves the patient's quality of life. Looking ahead, nanotechnology holds promise for achieving sustained success in numerous surgical disciplines, including orthopedic surgery, in the years to come. This review aims to focus on the application of nanotechnology in orthopedic surgery, highlighting the recent development and future perspective to bridge the bridge for clinical translation.

An update on the advances in the field of nanostructured drug delivery systems for a variety of orthopedic applications

Nanotechnology has made significant progress in various fields, including medicine, in recent times. The application of nanotechnology in drug delivery has sparked a lot of research interest, especially due to its potential to revolutionize the field. Researchers have been working on developing nanomaterials with distinctive characteristics that can be utilized in the improvement of drug delivery systems (DDS) for the local, targeted, and sustained release of drugs. This approach has shown great potential in managing diseases more effectively with reduced toxicity. In the medical field of orthopedics, the use of nanotechnology is also being explored, and there is extensive research being conducted to determine its potential benefits in treatment, diagnostics, and research. Specifically, nanophase drug delivery is a promising technique that has demonstrated the capability of delivering medications on a nanoscale for various orthopedic applications. In this article, we will explore current advancements in the area of nanostructured DDS for orthopedic use.

Bioactive Surface Modifications through Thermally Sprayed Hydroxyapatite Composite Coatings: A Review over Selective Reinforcements

Hydroxyapatite (HA) has been an excellent replacement for the natural bone in orthopedic applications, owing to its close resemblance; however, it is brittle and has low strength. Surface modification techniques...

Mesoporous silica coated carbon nanofibers reduce embryotoxicity via ERK and JNK pathways

Carbon nanofibers (CNFs) have been implicated in biomedical applications, yet, they are still considered as a potential hazard. Conversely, mesoporous silica is a biocompatible compound that has been used in various biomedical applications. In this regard, we recently reported that CNFs induce significant toxicity on the early stage of embryogenesis in addition to the inhibition of its angiogenesis. Thus, we herein use mesoporous silica coating of CNFs (MCNFs) in order to explore their outcome on normal development and angiogenesis using avian embryos at 3 days and its chorioallantoic membrane (CAM) at 6 days of incubation. Our data show that mesoporous silica coating of CNFs significantly reduces embryotoxicity provoked by CNFs. However, MCNFs exhibit slight increase in angiogenesis inhibition in comparison with CNFs. Further investigation revealed that MCNFs slightly deregulate the expression patterns of key controller genes involved in cell proliferation, survival, angiogenesis, and apoptosis as compared to CNFs. We confirmed these data using avian primary normal embryonic fibroblast cells established in our lab. Regarding the molecular pathways, we found that MCNFs downregulate the expression of ERK1/ERK2, p-ERK1/ERK2 and JNK1/JNK2/JNK3, thus indicating a protective role of MCNFs via ERK and JNK pathways. Our data suggest that coating CNFs with a layer of mesoporous silica can overcome their toxicity making them suitable for use in biomedical applications. Nevertheless, further investigations are required to evaluate the effects of MCNFs and their mechanisms using different in vitro and in vivo models.

Nanotechnology-based drug delivery systems in orthopedics

In recent years, nanotechnology has led to significant scientific and technological advances in diverse fields, specifically within the field of medicine. Owing to the revolutionary implications in drug delivery, nanotechnology-based drug delivery systems have gained an increasing research interest in the current medical field. A variety of nanomaterials with unique physical, chemical and biological properties have been engineered to develop new drug delivery systems for the local, sustained and targeted delivery of drugs with improved therapeutic efficiency and less or no toxicity, representing a very promising approach for the effective management of diseases. The utility of nanotechnology, particularly in the field of orthopedics, is a topic of extensive research. Nanotechnology has a great potential to revolutionize treatment, diagnostics, and research in the field of orthopedics. Nanophase drug delivery has shown great promise in their ability to deliver drugs at nanoscale for a variety of orthopedic applications. In this review, we discuss recent advances in the field of nanostructured drug delivery systems for orthopedic applications.

Synthesis of Carbon Nanomaterials from Biomass Utilizing Ionic Liquids for Potential Application in Solar Energy Conversion and Storage

Considering its availability, renewable character and abundance in nature, this review assesses the opportunity of the application of biomass as a precursor for the production of carbon-based nanostructured materials (CNMs). CNMs are exceptionally shaped nanomaterials that possess distinctive properties, with far-reaching applicability in a number of areas, including the fabrication of sustainable and efficient energy harnessing, conversion and storage devices. This review describes CNM synthesis, properties and modification, focusing on reports using biomass as starting material. Since biomass comprises 60-90% cellulose, the current review takes into account the properties of cellulose. Noting that highly crystalline cellulose poses a difficulty in dissolution, ionic liquids (ILs) are proposed as the solvent system to dissolve the cellulose-containing biomass in generating precursors for the synthesis of CNMs. Preliminary results with cellulose and sugarcane bagasse indicate that ILs can not only be used to make the biomass available in a liquefied form as required for the floating catalyst CVD technique but also to control the heteroatom content and composition in situ for the heteroatom doping of the materials.

Multifunctional Platforms Based on Graphene Oxide and Natural Products

Background and objectives: In the last few years, graphene oxide has attracted much attention in biomedical applications due to its unique physico-chemical properties and can be used as a carrier for both hydrophilic and/or hydrophobic biomolecules. The purpose of this paper was to synthesize graphene oxide and to obtain multifunctional platforms based on graphene oxide as a nanocarrier loaded with few biologically active substances with anticancer, antimicrobial or anti-inflammatory properties such as gallic acid, caffeic acid, limonene and nutmeg and cembra pine essential oils. Materials and Methods: Graphene oxide was obtained according to the method developed by Hummers and further loaded with biologically active agents. The obtained platforms were characterized using FTIR, HPLC, TGA, SEM, TEM and Raman spectroscopy. Results: Gallic acid released 80% within 10 days but all the other biologically active agents did not release because their affinity for the graphene oxide support was higher than that of the phosphate buffer solution. SEM characterization showed the formation of nanosheets and a slight increase in the degree of agglomeration of the particles. The ratio I2D/IG for all samples was between 0.18 for GO-cembra pine and 0.27 for GO-limonene, indicating that the GO materials were in the form of multilayers. The individual GO sheets were found to have less than 20 µm, the thickness of GO was estimated to be ~4 nm and an interlayer spacing of about 2.12 Å. Raman spectroscopy indicated that the bioactive substances were adsorbed on the surface and no degradation occurred during loading. Conclusions: These findings encourage this research to further explore, both in vitro and in vivo, the biological activities of bioactive agents for their use in medicine.

Cosmetic reconstruction in breast cancer patients: Opportunities for nanocomposite materials

The most common malignancy in women, breast cancer remains a major medical challenge that affects the life of thousands of patients every year. With recognized benefits to body image and self-esteem, the use of synthetic mammary implants for elective cosmetic augmentation and post-mastectomy reconstruction continues to increase. Higher breast implant use leads to an increased occurrence of implant-related complications associated with implant leakage and rupture, capsular contracture, necrosis and infections, which include delayed healing, pain, poor aesthetic outcomes and the need for revision surgeries. Along with the health status of the implant recipient and the skill of the surgeon, the properties of the implant determine the likelihood of implant-related complications and, in doing so, specific patient outcomes. This paper will review the challenges associated with the use of silicone, saline and "gummy bear" implants in view of their application in patients recovering from breast cancer-related mastectomy, and investigate the opportunities presented by advanced functional nanomaterials in meeting these challenges and potentially opening new dimensions for breast reconstruction. STATEMENT OF SIGNIFICANCE: Breast cancer is a significant cause of morbidity and mortality in women worldwide, which is difficult to prevent or predict, and its treatment carries long-term physiological and psychological consequences. Post-mastectomy breast reconstruction addresses the cosmetic aspect of cancer treatment. Yet, drawbacks of current implants contribute to the development of implant-associated complications, which may lead to prolonged patient care, pain and loss of function. Nanomaterials can help resolve the intrinsic biomechanical mismatch between implant and tissues, enhance mechanical properties of soft implantable materials, and provide an alternative avenue for controlled drug delivery. Here, we explore advances in the use of functionalized nanomaterials to enhance the properties of breast implants, with representative examples that highlight the utility of nanomaterials in addressing key challenges associated with breast reconstruction.

Carbon Nanofiber/Polycaprolactone/Mineralized Hydroxyapatite Nanofibrous Scaffolds for Potential Orthopedic Applications

Hydroxyapatite (Ca₁₀ (PO₄)₆(OH)₂, HAP), a multimineral substituted calcium phosphate is one of the most substantial bone mineral component that has been widely used as bone replacement materials because of its bioactive and biocompatible properties. However, the use of HAP as bone implants is restricted due to its brittle nature and poor mechanical properties. To overcome this defect and to generate suitable bone implant material, HAP is combined with biodegradable polymer (polycaprolactone, PCL). To enhance the mechanical property of the composite, carbon nanofibers (CNF) is incorporated to the composite, which has long been considered for hard and soft tissue implant due to its exceptional mechanical and structural properties. It is well-known that nanofibrous scaffold are the most-prominent material for the bone reconstruction. We have developed a new remarkable CNF/PCL/mineralized hydroxyapatite (M-HAP) nanofibrous scaffolds on titanium (Ti). The as-developed coatings were characterized by various techniques. The results indicate the formation and homogeneous distribution of components in the nanofibrous scaffolds. Incorporation of CNF into the PCL/M-HAP composite significantly improves the adhesion strength and elastic modulus of the scaffolds. Furthermore, the responses of human osteosarcoma (HOS MG63) cells cultured onto the scaffolds demonstrate that the viability of cells were considerably high for CNF-incorporated PCL/M-HAP than for PCL/M-HAP. In vivo analysis show the presence of soft fibrous tissue growth without any significant inflammatory signs, which suggests that incorporated CNF did not counteract the favorable biological roles of HAP. For load-bearing applications, research in various bone models is needed to substantiate the clinical availability. Thus, from the obtained results, we suggest that CNF/PCL/M-HAP nanofibrous scaffolds can be considered as potential candidates for orthopedic applications.

Effects of nanotopography on the in vitro hemocompatibility of nanocrystalline diamond coatings

Nanocrystalline diamond (NCD) coatings have been investigated for improved wear resistance and enhanced hemocompatibility of cardiovascular devices. The goal of this study was to evaluate the effects of NCD surface nanotopography on in vitro hemocompatibility. NCD coatings with small (NCD-S) and large (NCD-L) grain sizes were deposited using microwave plasma chemical vapor deposition and characterized using scanning electron microscopy, atomic force microscopy, contact angle testing, and Raman spectroscopy. NCD-S coatings exhibited average grain sizes of 50-80 nm (RMS 5.8 nm), while NCD-L coatings exhibited average grain sizes of 200-280 nm (RMS 23.1 nm). In vitro hemocompatibility testing using human blood included protein adsorption, hemolysis, nonactivated partial thromboplastin time, platelet adhesion, and platelet activation. Both NCD coatings demonstrated low protein adsorption, a nonhemolytic response, and minimal activation of the plasma coagulation cascade. Furthermore, the NCD coatings exhibited low thrombogenicity with minimal platelet adhesion and aggregation, and similar morphological changes to surface-bound platelets (i.e., activation) in comparison to the HDPE negative control material. For all assays, there were no significant differences in the blood-material interactions of NCD-S versus NCD-L. The two tested NCD coatings, regardless of nanotopography, had similar hemocompatibility profiles compared to the negative control material (HDPE) and should be further evaluated for use in blood-contacting medical devices. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 253-264, 2017.

Comparative facile methods for preparing graphene oxide-hydroxyapatite for bone tissue engineering

Motivated by the success of using graphene oxide (GO) as a nanofiller of composites, there is a drive to search for this new kind of carbon material as a bioactive component in ceramic materials. In the present study, biomineralized GO was prepared by two different approaches, represented by in situ sol-gel synthesis and biomimetic treatment. It was found that in the biocomposites obtained by the sol-gel approach, the spindle-like hydroxyapatite nanoparticles, with a diameter of ca. 5 ± 0.37 nm and a length of ca. 70 ± 2.5 nm, were presented randomly and strongly on the surface. The oxygen-containing functional groups, such as hydroxyl and carbonyl, present on the basal plane and edges of the GO sheets, play an important role in anchoring calcium ions, as demonstrated by FT-IR and TEM investigations. A different result was obtained for biocomposites after biomimetic treatment: an amorphous calcium phosphate on GO sheet was observed after 5 days of treatment. These different approaches resulted in a diverse effect on the proliferation and differentiation of osteogenic mesenchymal stem cells. In fact, in biocomposites prepared by the sol-gel approach the expression of an early marker of osteogenic differentiation, ALP, increases with the amount of GO in the first days of cell culture. Meanwhile, biomimetic materials sustain cell viability and proliferation, even if the expression of alkaline phosphatase activity in a basal medium is delayed. These findings may provide new prospects for utilizing GO-based hydroxyapatite biocomposites in bone repair, bone augmentation and coating of biomedical implants and broaden the application of GO sheets in biological areas. Copyright © 2016 John Wiley & Sons, Ltd.

Nanomedicine applications in orthopedic medicine: state of the art

The technological and clinical need for orthopedic replacement materials has led to significant advances in the field of nanomedicine, which embraces the breadth of nanotechnology from pharmacological agents and surface modification through to regulation and toxicology. A variety of nanostructures with unique chemical, physical, and biological properties have been engineered to improve the functionality and reliability of implantable medical devices. However, mimicking living bone tissue is still a challenge. The scope of this review is to highlight the most recent accomplishments and trends in designing nanomaterials and their applications in orthopedics with an outline on future directions and challenges.

Strontium eluting graphene hybrid nanoparticles augment osteogenesis in a 3D tissue scaffold

The objective of this work was to prepare hybrid nanoparticles of graphene sheets decorated with strontium metallic nanoparticles and demonstrate their advantages in bone tissue engineering. Strontium-decorated reduced graphene oxide (RGO_Sr) hybrid nanoparticles were synthesized by the facile reduction of graphene oxide and strontium nitrate. X-ray diffraction, transmission electron microscopy, and atomic force microscopy revealed that the hybrid particles were composed of RGO sheets decorated with 200-300 nm metallic strontium particles. Thermal gravimetric analysis further confirmed the composition of the hybrid particles as 22 wt% of strontium. Macroporous tissue scaffolds were prepared by incorporating RGO_Sr particles in poly(ε-caprolactone) (PCL). The PCL/RGO_Sr scaffolds were found to elute strontium ions in aqueous medium. Osteoblast proliferation and differentiation was significantly higher in the PCL scaffolds containing the RGO_Sr particles in contrast to neat PCL and PCL/RGO scaffolds. The increased biological activity can be attributed to the release of strontium ions from the hybrid nanoparticles. This study demonstrates that composites prepared using hybrid nanoparticles that elute strontium ions can be used to prepare multifunctional scaffolds with good mechanical and osteoinductive properties. These findings have important implications for designing the next generation of biomaterials for use in tissue regeneration.

The development, fabrication, and material characterization of polypropylene composites reinforced with carbon nanofiber and hydroxyapatite nanorod hybrid fillers

This study focuses on the design, fabrication, microstructural and property characterization, and biocompatibility evaluation of polypropylene (PP) reinforced with carbon nanofiber (CNF) and hydroxyapatite nanorod (HANR) fillers. The purpose is to develop advanced PP/CNF–HANR hybrids with good mechanical behavior, thermal stability, and excellent biocompatibility for use as craniofacial implants in orthopedics. Several material-examination techniques, including X-ray diffraction, Fourier-transform infrared spectroscopy, scanning electron microscopy, thermogravimetric analysis, differential scanning calorimetry, tensile tests, and impact measurement are used to characterize the microstructural, mechanical, and thermal properties of the hybrids. Furthermore, osteoblastic cell cultivation and colorimetric assay are also employed for assessing their viability on the composites. The CNF and HANR filler hybridization yields an improvement in Young’s modulus, impact strength, thermal stability, and biocompatibility of PP. The PP/2% CNF–20% HANR hybrid composite is found to exhibit the highest elastic modulus, tensile strength, thermal stability, and biocompatibility.

Growth and spontaneous differentiation of umbilical-cord stromal stem cells on activated carbon cloth

We have investigated the capacity of activated carbon cloth to support the growth and differentiation of human mesenchymal umbilical-cord stromal stem cells. Our results demonstrate that this scaffold provides suitable conditions for the development of cell-derived matrix proteins and facilitates the growth of undifferentiated stem cells with the ability to induce osteogenic and chondrogenic differentiation. Immunoflourescence staining revealed extensive expression of collagen in all the samples, and collagen type II and osteopontin within the samples cultivated in specific differentiation-inducing media. Cell growth and the formation of natural collagen, calcium-magnesium carbonate and hydroxyapatite crystals, together with the self-assemblage of collagen to produce suprafibrillar arrangements of fibrils all occur simultaneously and can be studied together ex vivo under physiological conditions. Furthermore, the spontaneous differentiation of stem cells cultured on activated carbon cloth with no osteogenic supplements opens up new possibilities for bone-tumour engineering and treatment of traumatic and degenerative bone diseases.

Hybrid composites made of multiwalled carbon nanotubes functionalized with Fe3O4 nanoparticles for tissue engineering applications

A straightforward technique for functionalization of multiwalled carbon nanotubes (MWCNTs) with magnetite (Fe(3)O(4)) nanoparticles was developed. Iron oxide nanoparticles were deposited on MWCNT surfaces by a deposition-precipitation method using Fe(3+)/Fe(2+) salts precursors in basic solution. The characterizations by HRTEM, XRD, SEM/EDX, AAS and TPR analyses confirmed the successful formation of magnetic iron oxide nanoparticles on the MWCNT surface. Fe(3)O(4)/MWCNT hybrid composites were analysed in vitro by incubation with mesenchymal stem cells for 1, 3 and 7 days, either in the presence or absence of a static magnetic field. Analysis of cell proliferation was performed by the MTT assay, quantification of cellular stress was performed by the Lactate Dehydrogenase assay and analysis of cell morphology was performed by actin immunofluorescence and scanning electron microscopy. Results demonstrate that the introduction of magnetite into the MWCNT structure increases biocompatibility of oxidized MWCNTs. In addition, the presence of a static magnetic field further increases Fe(3)O(4)/MWCNT influence on cell behaviour. These results demonstrate this novel Fe(3)O(4)/MWCNT hybrid composite has good potential for tissue engineering applications.