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Zhou S, Xiao C, Fan L, Yang J, Ge R, Cai M, Yuan K, Li C, Crawford RW, Xiao Y, Yu P, Deng C, Ning C, Zhou L, Wang Y. Injectable ultrasound-powered bone-adhesive nanocomposite hydrogel for electrically accelerated irregular bone defect healing. J Nanobiotechnology 2024; 22:54. [PMID: 38326903 PMCID: PMC10851493 DOI: 10.1186/s12951-024-02320-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024] Open
Abstract
The treatment of critical-size bone defects with irregular shapes remains a major challenge in the field of orthopedics. Bone implants with adaptability to complex morphological bone defects, bone-adhesive properties, and potent osteogenic capacity are necessary. Here, a shape-adaptive, highly bone-adhesive, and ultrasound-powered injectable nanocomposite hydrogel is developed via dynamic covalent crosslinking of amine-modified piezoelectric nanoparticles and biopolymer hydrogel networks for electrically accelerated bone healing. Depending on the inorganic-organic interaction between the amino-modified piezoelectric nanoparticles and the bio-adhesive hydrogel network, the bone adhesive strength of the prepared hydrogel exhibited an approximately 3-fold increase. In response to ultrasound radiation, the nanocomposite hydrogel could generate a controllable electrical output (-41.16 to 61.82 mV) to enhance the osteogenic effect in vitro and in vivo significantly. Rat critical-size calvarial defect repair validates accelerated bone healing. In addition, bioinformatics analysis reveals that the ultrasound-responsive nanocomposite hydrogel enhanced the osteogenic differentiation of bone mesenchymal stem cells by increasing calcium ion influx and up-regulating the PI3K/AKT and MEK/ERK signaling pathways. Overall, the present work reveals a novel wireless ultrasound-powered bone-adhesive nanocomposite hydrogel that broadens the therapeutic horizons for irregular bone defects.
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Affiliation(s)
- Shiqi Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Cairong Xiao
- School of Materials Science and Engineering, National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, 510641, China
| | - Lei Fan
- Department of Orthopedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Jinghong Yang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Ruihan Ge
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Min Cai
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Kaiting Yuan
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Changhao Li
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China
| | - Ross William Crawford
- Institute of Health and Biomedical Innovation & Australia-China Centre for Tissue Engineering and Regenerative Medicine, Centre for Biomedical Technologies, Queensland University of Technology, Queensland, 4059, Australia
| | - Yin Xiao
- School of Medicine and Dentistry & Menzies Health Institute Queensland, Griffith University, Queensland, 4111, Australia
| | - Peng Yu
- School of Materials Science and Engineering, National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, 510641, China
| | - Chunlin Deng
- School of Materials Science and Engineering, National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, 510641, China
| | - Chengyun Ning
- School of Materials Science and Engineering, National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, 510641, China.
| | - Lei Zhou
- Guangzhou Key Laboratory of Spine Disease Prevention and Treatment, Department of Spine Surgery, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510150, China.
| | - Yan Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, China.
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Yang Y, Su S, Liu S, Liu W, Yang Q, Tian L, Tan Z, Fan L, Yu B, Wang J, Hu Y. Triple-functional bone adhesive with enhanced internal fixation, bacteriostasis and osteoinductive properties for open fracture repair. Bioact Mater 2023; 25:273-290. [PMID: 36825223 PMCID: PMC9941416 DOI: 10.1016/j.bioactmat.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 02/11/2023] Open
Abstract
At present, effective fixation and anti-infection implant materials represent the mainstay for the treatment of open fractures. However, external fixation can cause nail tract infections and is ineffective for fixing small fracture fragments. Moreover, closed reduction and internal fixation during the early stage of injury can lead to potential bone infection, conducive to bone nonunion and delayed healing. Herein, we designed a bone adhesive with anti-infection, osteogenic and bone adhesion fixation properties to promote reduction and fixation of open fractures and subsequent soft tissue repair. It was prepared by the reaction of gelatin (Gel) and oxidized starch (OS) with vancomycin (VAN)-loaded mesoporous bioactive glass nanoparticles (MBGNs) covalently cross-linked with Schiff bases. Characterization and adhesion experiments were conducted to validate the successful preparation of the Gel-OS/VAN@MBGNs (GOVM-gel) adhesive. Meanwhile, in vitro cell experiments demonstrated its good antibacterial effects with the ability to stimulate bone marrow mesenchymal stem cell (BMSCs) proliferation, upregulate the expression of alkaline phosphatase (ALP) and osteogenic proteins (RunX2 and OPN) and enhance the deposition of calcium nodules. Additionally, we established a rat skull fracture model and a subcutaneous infection model. The histological analysis showed that bone adhesive enhanced osteogenesis, and in vivo experiments demonstrated that the number of inflammatory cells and bacteria was significantly reduced. Overall, the adhesive could promote early reduction of fractures and antibacterial and osteogenic effects, providing the foothold for treatment of this patient population.
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Affiliation(s)
- Yusheng Yang
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Shenghui Su
- Department of Orthopaedics, Ningde Municipal Hospital, Ningde Normal University, Ningde, Fujian Province, 352100, China
| | - Shencai Liu
- Division of Orthopaedics Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Weilu Liu
- Division of Orthopaedics Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Qinfeng Yang
- Division of Orthopaedics Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Liangjie Tian
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Zilin Tan
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Lei Fan
- Division of Orthopaedics Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Bin Yu
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China,Corresponding author.
| | - Jian Wang
- Division of Orthopaedics Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China,Corresponding author.
| | - Yanjun Hu
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China,Corresponding author.
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Liu X, Tang B, Li Q, Xiao W, Wang X, Xiao H, Zheng Z. Hydrophilic competent and enhanced wet-bond strength castor oil-based bioadhesive for bone repair. Colloids Surf B Biointerfaces 2022; 219:112835. [PMID: 36113225 DOI: 10.1016/j.colsurfb.2022.112835] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 10/31/2022]
Abstract
Bone adhesive has been proved to be a promising alternative in the clinical treatment of bone repairs. However, the problems of unsatisfying bone-bonding strength, especially the bonding of cortical bone in vivo, and blocked bone tissue recovery remain barriers to clinical reparation. Benefit from dopamine-modified castor oil synthesized by an epoxy-modification method, a porous and two-component polyurethane adhesive (PUA) was prepared to overcome the current challenges encountered. The tailored surface morphology and open porosity of the adhesive layer can be obtained to meet the requirements of bone repair by tuning the fraction of the formulation. Furthermore, the incorporation of nano-hydroxyapatite improved the mechanical properties and osteocompatibility of the material. Compared with PUA without catechol groups, the introduction of catechol groups not only increased the adhesive strength from 0.28 ± 0.05 MPa to 0.58 ± 0.06 MPa under wet conditions but also enabled the enrichment of Ca2+ on the adhesive surface to promote bone regeneration. Besides, the cell culture experiments also indicated that PUAs show good biocompatibility and excellent adhesion to stem cells. Given its excellent wet adhesive strength and biocompatibility, this system demonstrated potential applications in orthopedic treatment.
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Affiliation(s)
- Xinchang Liu
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Bo Tang
- The Third Clinical Medical College of Southern Medical University, Guangzhou 510630, China; Department of Orthopedics, Central Hospital of Fengxian District, Sixth People's Hospital of Shanghai, Shanghai 201400, China
| | - Qiang Li
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Wei Xiao
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xinling Wang
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Haijun Xiao
- The Third Clinical Medical College of Southern Medical University, Guangzhou 510630, China; Department of Orthopedics, Central Hospital of Fengxian District, Sixth People's Hospital of Shanghai, Shanghai 201400, China.
| | - Zhen Zheng
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
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Bojan AJ, Stadelmann VA, Wu D, Pujari-Palmer M, Insley G, Sundh D, Persson C, Engqvist H, Procter P. A new bone adhesive candidate- does it work in human bone? An ex-vivo preclinical evaluation in fresh human osteoporotic femoral head bone. Injury 2022; 53:1858-1866. [PMID: 35469636 DOI: 10.1016/j.injury.2022.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The fixation of small intraarticular bone fragments is clinically challenging and an obvious first orthopaedic indication for an effective bone adhesive. In the present study the feasibility of bonding freshly harvested human trabecular bone with OsSticR, a novel phosphoserine modified cement, was evaluated using a bone cylinder model pull-out test and compared with a commercial fibrin tissue adhesive. METHODS Femoral heads (n=13) were collected from hip fracture patients undergoing arthroplasty and stored refrigerated overnight in saline medium prior to testing. Cylindrical bone cores with a pre-inserted bone screw, were prepared using a coring tool. Each core was removed and glued back in place with either the bone adhesive (α-tricalcium phosphate, phosphoserine and 20% trisodium citrate solution) or the fibrin glue. All glued bones were stored in bone medium at 37°C. Tensile loading, using a universal testing machine (5 kN load cell), was applied to each core/head. For the bone adhesive, bone cores were tested at 2 (n=13) and 24 (n=11) hours. For the fibrin tissue adhesive control group (n=9), bone cores were tested exclusively at 2 hours. The femoral bone quality was evaluated with micro-CT. RESULTS The ultimate pull-out load for the bone adhesive at 2 hours ranged from 36 to 171 N (mean 94 N, SD 42 N). At 24 hours the pull-out strength was similar, 47 to 198 N (mean 123 N, SD 43 N). The adhesive failure usually occurred through the adhesive layer, however in two samples, at 167 N and 198 N the screw pulled out of the bone core. The fibrin tissue adhesive group reached a peak force of 8 N maximally at 2 hours (range 2.8-8 N, mean 5.4 N, SD 1.6 N). The mean BV/TV for femoral heads was 0.15 and indicates poor bone quality. CONCLUSION The bone adhesive successfully glued wet and fatty tissue of osteoporotic human bone cores. The mean ultimate pull-out force of 123 N at 24 hours corresponds to ∼ 300 kPa shear stress acting on the bone core. These first ex-vivo results in human bone are a promising step toward potential clinical application in osteochondral fragment fixation.
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Affiliation(s)
- Alicja J Bojan
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden.
| | - Vincent A Stadelmann
- Department of Teaching, Research, and Development, Schulthess Klinik, Zürich, Switzerland
| | - Dan Wu
- Department of Materials Science and Engineering, Uppsala University, Sweden
| | | | - Gerard Insley
- Department of Materials Science and Engineering, Uppsala University, Sweden
| | - Daniel Sundh
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Cecilia Persson
- Department of Materials Science and Engineering, Uppsala University, Sweden
| | - Håkan Engqvist
- Department of Materials Science and Engineering, Uppsala University, Sweden
| | - Philip Procter
- Department of Materials Science and Engineering, Uppsala University, Sweden
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Van Erk M, Van Luijk J, Yang F, Leeuwenburgh SCG, Sánchez‐Fernández MJ, Hermans E, Félix Lanao RP, Van Goor H. A systematic review and meta-analyses on animal models used in bone adhesive research. J Orthop Res 2022; 40:624-633. [PMID: 33871061 PMCID: PMC9290478 DOI: 10.1002/jor.25057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 01/19/2021] [Accepted: 04/12/2021] [Indexed: 02/04/2023]
Abstract
Currently, steel implants are used for osteosynthesis of (comminuted) fractures and intra-articular bone defects. These osteosyntheses can sometimes be complicated procedures and can have several drawbacks including stress shielding of the bone. A bone glue might be a safe and effective alternative to current materials. Despite numerous animal studies on bone adhesives, no such material is clinically applied yet. We have conducted a systematic review to summarize the evidence in experimental animal models used in research on bone adhesive materials for trauma and orthopedic surgery. Additionally, we analysed the efficacy of the different bone adhesives for different experimental designs. A heterogeneity in experimental parameters including animal species, defect types, and control measurements resulted in a wide variety in experimental models. In addition, no standard outcome measurements could be identified. Meta-analysis on bone regeneration between adhesive treatment and nonadhesive treatment showed a high heterogeneity and no statistically significant overall effect (M: -0.71, 95% confidence interval [CI]: -1.63-0.21, p = 0.13). Besides, currently there is not enough evidence to draw conclusions based on the effectiveness of the individual types of adhesives or experimental models. A positive statistically significant effect was found for the adhesive treatment in comparison with conventional osteosynthesis materials (M: 2.49, 95% CI: 1.20-3.79, p = 0.0002). To enhance progression in bone adhesive research and provide valuable evidence for clinical application, more standard experimental parameters and a higher reporting quality in animal studies are needed. Statement of Clinical Significance: Current materials restoring anatomical alignments of bones have several drawbacks. A (biodegradable) adhesive for fixating bone defects can be a treatment breakthrough. Although numerous bone adhesives have been researched, most seemed to fail at the preclinical stage. An overview in this field is missing. This systematic review highlights the relevant parameters for design of experimental bone adhesive studies. It demonstrates evidence regarding benefit of bone adhesives but also that the quality of reporting and the risk of bias in studies need to be improved. The results will aid in designing better quality animal studies for bone adhesive research with higher translational value.
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Affiliation(s)
- Machteld Van Erk
- Department of SurgeryRadboud University Medical CentreNijmegenThe Netherlands
| | - Judith Van Luijk
- Department for Health Evidence, SYstematic Review Centre for Laboratory Animal Experimentation (SYRCLE)Radboud University Medical CentreNijmegenThe Netherlands
| | - Fang Yang
- Department of Regenerative BiomaterialsRadboud University Medical CentreNijmegenThe Netherlands
| | | | | | - Erik Hermans
- Department of SurgeryRadboud University Medical CentreNijmegenThe Netherlands
| | - Rosa P. Félix Lanao
- Department of SurgeryRadboud University Medical CentreNijmegenThe Netherlands,GATT Technologies B.V.NijmegenThe Netherlands
| | - Harry Van Goor
- Department of SurgeryRadboud University Medical CentreNijmegenThe Netherlands
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Balcioglu S, Gurses C, Ozcan I, Yildiz A, Koytepe S, Parlakpinar H, Vardi N, Ates B. Photocrosslinkable gelatin/collagen based bioinspired polyurethane-acrylate bone adhesives with biocompatibility and biodegradability. Int J Biol Macromol 2021; 192:1344-1356. [PMID: 34536477 DOI: 10.1016/j.ijbiomac.2021.09.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 01/11/2023]
Abstract
Hard or soft tissue adhesives have been presented as a promising candidate to replace traditional wound closure methods. However, there are mechanical strength problems in biological adhesives and biocompatibility problems in synthetic-based adhesives. At this point, we aimed to remove all these disadvantages and produce a single adhesive that contains all the necessary features and acrylate functionalized UV-curable polyurethane formulations were produced with high crosslink density, high adhesion strength, biocompatibility and injectable property for easy application as potential biomedical adhesives. Aliphatic isophorone diisocyanate (IPDI) was used as the isocyanate source and β-cyclodextrin was used for host-guest relationship with gentamicin by crosslinking. Proteins (gelatin (GEL), collagen (COL)) and PEGs of various molecular weight ranges (P200, P400, P600) were selected as the polyol backbone for polyurethane synthesis due to their multiple biological activities such as biocompatibility, biodegradability, biomimetic property. Several techniques have been used to characterize the structural, thermal, morphological, and various other physicochemical properties of the adhesive formulations. Besides, the possibility of its use as a hard tissue adhesive was investigated by evaluating the tissue adhesion strength in vitro and ex vivo via a universal testing analyzer in tensile mode. Corresponding adhesive formulations were evaluated by in vitro and in vivo techniques for biocompatibility. The best adhesion strength results were obtained as 3821.0 ± 214.9, and 3722.2 ± 486.8 kPa, for IPDI-COL-P200 and IPDI-GEL-P200, respectively. Good antibacterial activity capability toward Escherichia coli Pseudomonas aeruginosa, and Staphylococcus aureus were confirmed using disc diffusion method. Moreover, cell viability assay demonstrated that the formulations have no significant cytotoxicity on the L929 fibroblast cells. Most importantly, we finally performed the in vivo biodegradability and in vivo biocompatibility evaluations of the adhesive formulations on rat model. Considering their excellent cell/tissue viability, fast curable, strong adhesion, high antibacterial character, and injectability, these adhesive formulations have significant potential for tissue engineering applications.
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Affiliation(s)
- Sevgi Balcioglu
- Sakarya University of Applied Sciences, Department of Medicinal Laboratory, Sakarya, Turkey.
| | - Canbolat Gurses
- İnönü University, Science Faculty, Department of Molecular Biology and Genetics, Malatya, Turkey
| | - Imren Ozcan
- İnönü University, Science Faculty, Department of Chemistry, Malatya, Turkey
| | - Azibe Yildiz
- İnönü University, Medical Faculty, Department of Histology and Embryology, Malatya, Turkey
| | - Suleyman Koytepe
- İnönü University, Science Faculty, Department of Chemistry, Malatya, Turkey
| | - Hakan Parlakpinar
- İnönü University, Medical Faculty, Department of Medicinal Pharmacology, Malatya, Turkey
| | - Nigar Vardi
- İnönü University, Medical Faculty, Department of Histology and Embryology, Malatya, Turkey
| | - Burhan Ates
- İnönü University, Science Faculty, Department of Chemistry, Malatya, Turkey.
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Procter P, Pujari-Palmer M, Hulsart-Billström G, Wenner D, Insley G, Larsson S, Engqvist H. A biomechanical test model for evaluating osseous and osteochondral tissue adhesives. BMC Biomed Eng 2019; 1:11. [PMID: 32903290 PMCID: PMC7422571 DOI: 10.1186/s42490-019-0011-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/31/2019] [Indexed: 01/01/2023] Open
Abstract
Background Currently there are no standard models with which to evaluate the biomechanical performance of calcified tissue adhesives, in vivo. We present, herein, a pre-clinical murine distal femoral bone model for evaluating tissue adhesives intended for use in both osseous and osteochondral tissue reconstruction. Results Cylindrical cores (diameter (Ø) 2 mm (mm) × 2 mm depth), containing both cancellous and cortical bone, were fractured out from the distal femur and then reattached using one of two tissue adhesives. The adhesiveness of fibrin glue (Tisseeltm), and a novel, biocompatible, calcium phosphate-based tissue adhesive (OsStictm) were evaluated by pullout testing, in which glued cores were extracted and the peak force at failure recorded. The results show that Tisseel weakly bonded the metaphyseal bone cores, while OsStic produced > 30-fold higher mean peak forces at failure (7.64 Newtons (N) vs. 0.21 N). The failure modes were consistently disparate, with Tisseel failing gradually, while OsStic failed abruptly, as would be expected with a calcium-based material. Imaging of the bone/adhesive interface with microcomputed tomography revealed that, for OsStic, failure occurred more often within cancellous bone (75% of tested samples) rather than at the adhesive interface. Conclusions Despite the challenges associated with biomechanical testing in small rodent models the preclinical ex-vivo test model presented herein is both sensitive and accurate. It enabled differences in tissue adhesive strength to be quantified even for very small osseous fragments (<Ø4mm). Importantly, this model can easily be scaled to larger animals and adapted to fracture fragment fixation in human bone. The present model is also compatible with other long-term in vivo evaluation methods (i.e. in vivo imaging, histological analysis, etc.).
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Affiliation(s)
- Philip Procter
- Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, Box 523, 75120 Uppsala, Sweden.,GPBio Ltd, Rathkeale, Ireland
| | - Michael Pujari-Palmer
- Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, Box 523, 75120 Uppsala, Sweden
| | - Gry Hulsart-Billström
- Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, Box 523, 75120 Uppsala, Sweden.,Department Surgical Sciences, Orthopaedics, Uppsala University Hospital, 75185 Uppsala, Sweden
| | - David Wenner
- Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, Box 523, 75120 Uppsala, Sweden
| | - Gerard Insley
- Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, Box 523, 75120 Uppsala, Sweden.,GPBio Ltd, Rathkeale, Ireland
| | - Sune Larsson
- Department Surgical Sciences, Orthopaedics, Uppsala University Hospital, 75185 Uppsala, Sweden
| | - Håkan Engqvist
- Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, Box 523, 75120 Uppsala, Sweden
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