Bone Defects Research Articles

The Effect of Implantoplasty on Fracture Resistance and Implant Surface Changes: An InVitro and Finite Element Analysis Study.

Implantoplasty can be performed on implants diagnosed with peri-implantitis to facilitate implant decontamination and improve access for oral home care. However, its effect on the mechanical strength of the implant is still uncertain. This study aimed to evaluate the effect of implantoplasty on the fracture resistance of dental implants with various degrees of bone loss, as well as its surface changes. Eighty 4.2 × 13 mm conical connection dental implants were allocated evenly into four groups based on the bone defect morphology: circumferential or semi-circumferential, and 3 or 5 mm vertical height. Half of the implants underwent implantoplasty with tungsten carbide finishing burs. Weight, volume, and surface roughness of the implants were recorded prior to and after instrumentation. All implants were subjected to static loading to failure or fracture and the implant surfaces were then analyzed using optical microscopy. Finite element analysis was carried out to assess the stress pattern on dental implants after implantoplasty. Implantoplasty significantly reduced the fracture resistance of implants with all defect morphologies, aside from those with 3 mm of circumferential bone loss. Implants with 5 mm of peri-implant bone loss also experienced significantly reduced fracture resistance compared to the 3 mm group. Significant decrease in fracture resistance was only observed between the circumferential and semi-circumferential groups with 5 mm of bone loss. Surface roughness was also significantly reduced following implantoplasty. The results from finite element analysis revealed a change in pattern of stress concentration in the implant after implantoplasty. Implantoplasty negatively impacted the fracture resistance of standard diameter dental implants in most scenarios. The increase in exposed implant length resulted in a decrease in fracture resistance. This increase in fracture risk should be considered prior to implantoplasty, especially in implants with more advanced bone loss.

Preparation and Characterization of Mechanical Properties of HAP/45S5 Bioglass Laminated Ceramic Composites via Spark Plasma Sintering

Hydroxyapatite (HAP) displays a high degree of similarity to the inorganic components that make up roughly 70% of human hard tissue, and it possesses exceptional biological activity and biocompatibility. It is currently internationally recognized as the most biologically active hard tissue implant material. However, its substandard mechanical properties have significantly limited the application of HAP in areas requiring load bearing or in the repair of large bone defects. In this study, HAP/45S5 bioglass laminated ceramic composites were consolidated using the spark plasma sintering (SPS) technique. The grain growth and phase transformation of HAP and 45S5 bioglass were examined at various sintering temperatures. The mechanical properties of the laminated composites were investigated. At 950 °C, the flexural strength and fracture work of the sintered body were (153.22 ± 7.7) MPa and (2049 ± 34) J·m−2, respectively. These results corresponded to the load–displacement curves and showed that the composites met the mechanical performance requirements of the support material.

Effect of Structure on Osteogenesis of Bone Scaffold: Simulation Analysis Based on Mechanobiology and Animal Experiment Verification

Porous scaffolds, whose mechanical and biological properties are greatly affected by structure, are new treatments for bone defects. Since bone repair is related to biomechanics, analyzing the osteogenesis in scaffolds based on mechanical stimulation may become a more effective method than traditional biological experiments. A tissue regeneration algorithm based on mechanical regulation theory was implemented in this study to evaluate the osteogenesis of classical scaffolds (Gyroid, I-WP, and Diamond). In vivo experiments were used to verify and supplement the simulation results. Different approaches to describing osteogenesis were discussed. Bone formation was more obvious inside the Gyroid scaffold and outside the I-WP scaffold, while the new bone was more sufficient and evenly distributed in the Diamond scaffold. The osteogenesis pattern of the bone scaffold in the simulation analysis was consistent with the results of animal experiments, and the bone volume calculated by the tissue fraction threshold method and the elastic modulus threshold method was very similar to the in vivo experiment. The mechanical responses mediated by structure affect the osteogenesis of bone scaffolds. This study provided and confirmed a simulation analysis method based on mechanical regulation theory, which is more efficient and economical for analyzing tissue healing in bioengineering.

The accuracy and efficiency of design and development of 3D printed integral anatomical acetabular prosthesis in total hip arthroplasty for Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip

Objective: To compare the accuracy and efficiency between the model development method and the software development method, which design and develop 3D printed integral anatomical acetabular prosthesis to be used in total hip arthroplasty(THA) for patients with Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip(DDH). Methods: Fifteen patients with end-stage hip osteoarthritis due to Crowe type Ⅱ and Ⅲ DDH who underwent THA in the Orthopedics Department of the First Affiliated Hospital of Bengbu Medical College between January 2015 and June 2023 were selected in this study retrospectively. There were 1 male (1 hip) and 14 females (17 hips) with a mean age of (55.1±9.1) years. There were 12 hips with Crowe type Ⅱ, 6 hips with Crowe type Ⅲ. The preoperative pelvis three-dimensional CT data in those patients were used to design integral anatomical acetabular prosthesis. The model development group used 3D printing technology to print life-size pelvis models. The acetabulum was reamed and the acetabulum cup was inserted into the socket according to conventional THA procedures. The bone defect above the acetabulum cup was filled with bone wax. The Mimics and 3-matic software were used to simulate the THA procedures, design and install the integrated anatomical acetabular prosthesis in the software development group. The operation time, the size of the acetabular cup, the volume and surface area of the acetabulum bone defect, the acetabular cup's inclination and anteversion, the horizontal distance and the vertical distance of hip rotation center were compared between the two methods. Results: The study in the two groups were all based on the data of 18 hips in the 15 patients. The horizontal and vertical distances of rotation center in the model development group and software development group was (32.08±1.80) mm, (32.17±2.40) mm and (14.36±1.53) mm, (15.11±1.45) mm, respectively (both P>0.05). The cup size in model development group was (48.56±1.15)mm, and it was (48.77±1.22) mm in the software group (P=0.160). The anteversion and inclination of the acetabular cup in the model and software groups were 23.79°±6.31°, 30.49°±11.03° and 15.17°±0.52°, 40.24°±0.58°, respectively (both P<0.01). The volume and surface area of the acetabulum bone defect in the model development group was (5.06±2.86) mm3 and (8.31±2.21) mm2, respectively, while it was (4.01±2.56)mm3 and (6.83±2.71) mm2, respectively, in the software development group (both P<0.05). The work time in the model development group was (24.43±0.68) h and (0.47±0.12) h in the software development group, respectively (P<0.001). Conclusion: Compared with the 3D printing model development method, the application of Mimics and 3-matic software to design and develop integrated anatomical acetabular prosthesis in total hip arthroplasty for Crowe type Ⅱ and Ⅲ DDH show advantages of convenience, high efficiency and more accuracy.

Implications of Biomaterials and Adipose-Derived Stem Cells in the Management of Calvarial Bone Defects

Implications of Biomaterials and Adipose-Derived Stem Cells in the Management of Calvarial Bone Defects

BIOMECHANICAL ASPECTS OF IMPACTION BONE GRAFTING IN THE ACETABULAR REVISION (EXPERIMENTAL AND CLINICAL WORK)

Introduction. The modern features of the revision hip arthroplasty are the increase of the number early revisions and young age of patients. Bone defect management in this category is especially relevant. The leading role in long-term survival using impaction bone grafting (IBG) is given to the mechanical properties of the graft. The purpose of the study is to explore the mechanical properties of osteoplastic material and determine the effect of cyclic loads on dynamic changes in the position of the acetabular component after revision hip arthroplasty using (IBG). Materials and methods. A single-cycle constrained compression experiment was carried out on morselized xenobone. Cyclic tests were carried out at the second stage of the study. Clinical interpretation of biomechanics was carried out on the radiographic data by changes in the acetabular position. Results. Stress-strain dependences and instantaneous elastic moduli were obtained. The increase of the instantaneous elastic modulus during cyclic tests was obtained by 2.6 times for a “dry” specimen and from 3.9 to 4.7 times with liquid. The shift of the center rotation cranially and laterally was noted in the first case is 2.4 and 1.5 mm, in the second is 14.9 and 9.5 mm, respectively. The change in the inclination was 18.7º in the first case and 19.8º in the second. The Hip Harris Score (HHS) was 97 points in the first case, 53 points in the second. Conclusions: 1. The material used for IBG is subject to deformation in the postoperative period. 2. Compression tests suggested that the deformation of impacted bone graft in the postoperative period gradually tends to reach a plateau, and with the completion of the deformation, migration of the acetabular component stops. 3. A change of the acetabular component position in the absence of a radiolucent line is not an absolute sign of loosening.

Sonification of Deproteinized Bovine Bone Functionalized with Genistein Enhances Bone Repair in Peri-Implant Bone Defects in Ovariectomized Rats

Estrogen deficiency is one of several contributing factors to catabolic changes in bone surrounding dental implants, impairing bone repair in defects requiring bone regeneration. Functionalizing bone substitutes is an alternative approach among various strategies to address this challenge. In this study, the aim was to evaluate the effect of functionalizing deproteinized bovine bone (Bio-Oss®, BO) with genistein via sonication on peri-implant bone defects in ovariectomized rats. The animals were randomly distributed according to the treatment into the following four groups (n = 10): BO sonicated with genistein (BOS + GEN), BO sonicated alone (BOS), untreated BO (BO), and blood clot only (CLOT). After twenty-eight days, implant removal torque was determined, and the peri-implant bone parameters were calculated based on computed microtomography. Additionally, the gene expression of bone turnover markers was evaluated. As a main result, the functionalization with genistein increased implant removal torque and the peri-implant bone volume in the BOS + GEN group compared to both BOS and BO groups (both p &lt; 0.05). These findings suggest that the sonification of deproteinized bovine bone functionalized with genistein improves bone repair in peri-implant bone defects in ovariectomized rats.

Are asymmetric designs of tibial components superior to their symmetric counterparts for constrained condylar total knee arthroplasty using metal block augmentation?

PurposeIn total knee arthroplasty (TKA), asymmetric tibial components have been developed alongside symmetric tibial components to enhance bony coverage at the tibia. In primary TKA and revision TKA for patients with significant bone defects, augmentation is employed to fill the bone defect. However, there have been no reports on bony coverage of the tibial component of the revision system in the cases of bone defects. Therefore, we simulated bone defects using CT and compared the bony coverage of asymmetric and symmetric tibial components in the revision TKA system.MethodsThis study included 45 patients (50 knees involved) with medial osteoarthritis. Preoperative CT scans were used to simulate placement using ZedKnee. Three models were evaluated: Persona Revision PCCK (Zimmer) for the asymmetric component, NexGen LCCK (Zimmer) for the symmetric component, and the ATTUNE revision system (Depuy-Synthes). A 130-mm stem extension was utilized. Augmentations of each thickness were placed to simulate bone defects of 5, 10, and 15 mm. The coverage, overhang, and underhang rates were measured for each slice and compared among the models.ResultsIn terms of coverage, the rate was greater for PCCK at 0 mm, and only ATTUNE exhibited a significantly lower coverage at 5 and 10 mm. There was no significant difference in coverage at 15 mm. At 0 mm, PCCK demonstrated less posterior underhangs. At 5 and 10 mm, PCCK showed less anterior overhang but more anterior underhang. At 15 mm, PCCK had a less anterior overhang, with an overhang in the posterior region but less underhang. When overhang and underhang were combined and compared, the asymmetric component generally yielded superior results.ConclusionIn the cases of bone defects, asymmetric components demonstrated reduced anterior overhang and decreased posterior underhang, resulting in greater bone coverage. This may contribute to improved long-term outcomes in the revision TKA system.

Biphasic Calcium Phosphate Ceramic Scaffold Composed of Zinc Doped β-Tricalcium Phosphate and Silicon Doped Hydroxyapatite for Bone Tissue Engineering.

The rapid repair of bone defects remains a significant clinical challenge to this day. To address this issue, a 3D-printed biphasic calcium phosphate (BCP) scaffold consisting of 40 wt % hydroxyapatite (HA) and 60 wt % β-tricalcium phosphate (β-TCP) was created. Silicon and zinc were incorporated into HA and β-TCP, respectively, to enhance the angiogenic and osteogenic properties of the BCP scaffold. The physicochemical properties, in vitro cell responses, and bone defect repair efficacy of the modified BCP scaffold were comprehensively investigated. Results showed that the fabricated scaffold possessed a 3D interconnected pore structure. Zinc doping enhanced the sintering of the BCP scaffold, increased its density and strength, but decreased its degradation rate. Conversely, silicon doping had the opposite effect. The modified scaffold was capable of a gradual release of zinc/silicon ions, which promoted the proliferation and differentiation of cells. Specifically, the scaffold doped with zinc significantly promoted the osteogenic differentiation of stem cells. Moreover, co-doping with silicon and zinc synergistically promoted in vitro angiogenesis, with BCP-3 (doped with 2.5 mol % zinc and 4 mol % silicon) exhibiting the best pro-angiogenic activity. BCP-3 significantly induced regeneration of blood vessels and bone tissue in vivo, indicating its potential to accelerate the process of bone defect repair.

Prediction of recurrence-free survival and risk factors of sinonasal inverted papilloma after surgery by machine learning models

ObjectivesOur research aims to construct machine learning prediction models to identify patients proned to recurrence after inverted papilloma (IP) surgery and guide their follow-up treatment.MethodsThis study collected 210 patients underwent IP resection surgery at a university hospital from January 2010 to December 2023. Six machine learning algorithms including ExtraSurvivalTrees (EST), GradientBoostingSurvivalAnalysis (GBSA), RandomSurvivalForest (RSF), SurvivalSVM, Coxnet and Coxph, were used to construct the prediction models. Shapley Additive Explanations (SHAP) values were used to explain the importance of various features in predicting IP recurrence.ResultsWe found that the recurrence rate of IP patients is 20.00%, with a median recurrence time of 35.5 months. Multivariate Cox regression analysis identified mild or moderate dysplasia as an independent risk factor for recurrence. The EST model performs the best in predicting postoperative recurrence of IP, with C-index of 0.968 and 0.878 in the training and testing sets. SHAP emphasizes five important predictive factors for recurrence, including bone defects, orbital involvement, smoking, no processing of tumor attachment sites and drinking.ConclusionsTo our knowledge, this is the first study to use multiple ML models to predict postoperative recurrence of IP. The EST model has the best predictive performance, with SHAP emphasizing several key predictive factors for IP recurrence. This study emphasizes the practicality of machine learning algorithms in predicting IP clinical outcomes, providing valuable insights into the potential for improving clinical decision-making.

Biological evaluation of ZrO2 composites modified with different ceramics additives

In this work, zirconia (ZrO2) composites modified with bioactive hydroxyapatite (HAp), hexagonal boron nitride (hBN), bioglass (BG), and bioglass with copper (BGCu) via the hydrothermal method were synthesized. The aim was to obtain highly bioactive and cytocompatible materials that could combine beneficial properties of inert and bioactive ceramics. Such materials could be applied as fillers for tooth extraction cavities, guaranteeing osseintegration without the need to introduce additional bone cements or other adhesives. It was proven that while all materials were favourable towards cells adhesion and growth, the HAp and BG-doped ones facilitated early adhesion, especially when compared to unmodified ZrO2. Only the HAp-doped materials showed satisfactory bioactivity results, with a well-developed apatite layer forming on their surfaces. This study confirms that the Hap-doped ZrO2 is suitable for treating bone defects.

Decellularized Extracellular Matrix Scaffolds: Recent Advances and Emerging Strategies in Bone Tissue Engineering.

Bone tissue engineering (BTE) is a complex biological process involving the repair of bone tissue with proper neuronal network and vasculature as well as bone surrounding soft tissue. Synthetic biomaterials used for BTE should be biocompatible, support bone tissue regeneration, and eventually be degraded in situ and replaced with the newly generated bone tissue. Recently, various forms of bone graft materials such as hydrogel, nanofiber scaffolds, and 3D printed composite scaffolds have been developed for BTE application. Decellularized extracellular matrix (DECM), a kind of natural biological material obtained from specific tissues and organs, has certain advantages over synthetic and exogenous biomaterial-derived bone grafts. Moreover, DECM can be developed from a wide range of biological sources and possesses strong molding abilities, natural 3D structures, and bioactive factors. Although DECM has shown robust osteogenic, proangiogenic, immunomodulatory, and bone defect healing potential, the rapid degradation and limited mechanical properties should be improved for bench-to-bed translation in BTE. This review summarizes the recent advances in DECM-based BTE and discusses emerging strategies of DECM-based BTE.

Incorporating Hydrogel (with Low Polymeric Content) into 3D-Printed PLGA Scaffolds for Local and Sustained Release of BMP2 in Repairing Large Segmental Bone Defects.

Treating large bone defects remains a considerable challenge for clinicians: bone repair requires scaffolds with mechanical properties and bioactivities. Herein, based on crosslinking o-phthalaldehyde (OPA) with amine groups, 4-arm polyethylene glycol (4armPEG)-OPA/Gelatin hydrogel loaded with bone morphogenetic protein 2 (BMP2) is prepared and a three dimensional (3D)-printed poly (lactic-co-glycolic acid) (PLGA) porous scaffold is filled with the hydrogel solution. The composite scaffold, with a compression modulus of 0.68 ±0.097GPa similar to the cancellous bone, has a porosity of 56.67 ± 4.72% and a pore size of about 380µm, promoting bone growth. The hydrogel forms a porous network at low concentrations, aiding protein release and cell migration. The hydrogel degrades in approximately three weeks, and the scaffold takes five months, matching bone repair timelines. BMP2 release experiment shows a sustained BMP2 release with a 72.4 ± 0.53% release ratio. The ALP activity test and alizarin red staining shows effective osteogenic promotion, while RT-PCR confirms BMP2@Gel enhanced COL-1 and OPN expression. Animal experiments further validate the composite scaffold's bone repair efficacy. This study demonstrates the effectiveness of the hydrogel in releasing BMP2 and the mechanical support of the 3D-printed PLGA porous scaffold, providing a new treatment for bone defects.

MBG/BSA Bone Grafts Immunomodulate Bone Regeneration by Releasing Bioactive Ions in Inflammatory Bone Defects.

Since the diseases that cause bone defects are mostly inflammatory diseases, the current bone grafts are unable to effectively regulate osteoimmune activity, leading to the impaired osteogenesis and unfavorable bone regeneration. In this study, inspired by bone composition, biomimetic mesoporous bioactive glass nanoparticle (MBG)/bovine serum albumin (BSA) bone grafts are designed for inflammatory bone defects. Systematically, MBG/BSA bone grafts are evaluated for characterization, bioactivity, anti-inflammatory, antioxidant activity, and osteogenic activity. MBG/BSA bone grafts are proved to be biocompatible and can release bioactive ions including calcium and silicon in a sustained manner. Furthermore, MBG/BSA reprograms the macrophage phenotype toward anti-inflammation that is beneficial for bone regeneration. The antioxidative activity is also validated under inflammation and the mechanism may be via the interleukin-4 (IL-4)/Signal transducer and activator of transcription 6 (STAT6)pathway. The osteogenic differentiation and mineralization are also facilitated due to the improved immunoregulation of MBG/BSA. Overall, this work suggests that the MBG/BSA bone grafts with improved immunomodulatory properties are an ideal material for inflammatory bone regeneration application.

Treatment of a patient with Ollier’s disease

The objective was to demonstrate a clinical case of an adult patient with Olier’s disease (enchondromatosis), severe hand deformity, and its treatment in orthopedic department. Patient K., 71 years old, was treated with severe deformation of the left hand due to Ollier’s disease in Ya. L. Tsiv’yan Novosibirsk Research Institute of Traumatology and Orthopedics in 2017. The patient underwent a one-stage multi-stage surgical intervention with removal of the endochondromas of the 1st, 2nd, 4th and 5th fingers, bone and tendon grafting of the defects.In 5 years after surgery, patient notes a high degree of satisfaction with the treatment. At the control visit, the preservation of the intraoperatively achieved result was established without signs of recurrence of the process or signs of malignancy. The achieved result led to the improvement of motor skills, restored a number of social self-service functions.Due to the high risks of recurrence and malignancy of the process, patients with Olier’s disease require close monitoring by clinicians. Surgical treatment of benign forms of the disease involves the implementation of an organ-preserving intervention with the reconstruction of bone and tendon ligament defects. The main goals of the intervention in this case were a removing of the pathological substrate and the improvement of hand function.

Plating after tumor curettage in human femora does not efficiently improve torsional stability ex vivo

BackgroundSurgical treatments of benign primary bone tumors of the femur face the challenge of limiting tissue damage and contamination while providing sufficient stabilization to avoid fracture. While no clear treatment guidelines exist, surgical treatment commonly consists of femoral fenestration and curettage with optional filling and plating of the defect. Mono- or bicortical plating of distal femoral defects aim to reduce fracture risk and have been shown to increase axial stability. However, it remains unclear whether plating increases torsional stability of the affected femur. Questions/purposesThis biomechanical study aimed to determine how much additional stability can be achieved by mono- or bicortical plating of femoral defects after fenestration. The following hypotheses were investigated: 1. Preventive plating of distal femur bone defects enhances torsional stability when compared to femoral fenestration alone. 2. A condition close to the intact (nonpathological) bone can be achieved by bone plating. 3. Defect shape influences torsional stability. Patients and methodsThiel embalmed human femora (n = 24) were left intact or subjected to the following surgical treatments (A) defect creation via fenestration, (B) defect with short monocortical plating, (C) defect with long bicortical plating. All femora were torsion tested in midstance position using pre-cycling and testing until failure. Quantitative computed tomography pre and post testing allowed bone mineral density calculation and crack path analysis. Finite element analysis provided insight into defect shape variations. ResultsTorsion experiments showed no relevant enhancement of torsional stability due to mono- or bicortical plating. There were no significant differences in maximum torque between unplated and plated femora with defect (defect: 35.38 ± 7.53 Nm, monocortical plating: 37.77 ± 9.82 Nm, bicortical plating: 50.27 ± 9.72 Nm, p > 0.05). Maximum torque for all treatment groups was significantly lower compared to intact femora (155–200 Nm, p < 0.001). Cracks originated predominantly from the proximal posterior corner of the defect and intersected with screw holes in plated femora. The influence of variations of the defect corner shapes had no significant influence on maximum torque and angle. ConclusionThis biomechanical study shows that mono- or bicortical plating is not an effective preventive treatment against torsional failure of femora with distal defects as the resulting maximum torque was drastically reduced compared to intact femora. Thus, the initial hypotheses have to be rejected. As habitual loading of the femur includes a combination of axial and torsional loading, the observed lack of prevention against torsional failure might help to explain the occurrence of fractures despite plating. Future research towards ameliorating clinical outcome should address the role of defect filling with bone cement or bone grafts regarding the improvement of torsional stability after primary bone tumor treatment in the femur.

Bone‐Induced Nanocomposite Coating with a “Sandwich” Structure

AbstractInfection‐induced bone defects present significant challenges in clinical bone regeneration, frequently leading to poor bone induction, recurring infections, and complications such as pain and chronic inflammation. This study introduces a novel Ti/Lignin‐Ag@PLL composite coating with a “sandwich” structure, designed to integrate pro‐adhesion, photothermal‐photodynamic antibacterial, and osteogenic properties. The Ti/Lignin‐Ag@PLL composite coating is fabricated using self‐assembly technology, in which Ag+ is reduced to silver nanoparticles (Ag‐NPs) by lignin, followed by Polylysine (PLL) grafting. Photothermal conversion efficiency is evaluated under near‐infrared (NIR) laser irradiation, while antibacterial activity is tested against E. coli and S. aureus. Biocompatibility is also assessed using vascular endothelial cells (VECs) and osteoblasts (OBs). The results indicate that the Ti/Lignin‐Ag@PLL coating demonstrates a 31% photothermal conversion efficiency and nearly 100% antibacterial efficacy against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) under NIR irradiation for 10 min. Without irradiation, the antibacterial rates are 85% and 94%, respectively, after 24 h. Additionally, the coating significantly promotes cell adhesion, proliferation, and osteogenesis, as evidenced by the upregulation of Runx2 and Collagen I. This study uniquely contributes to the development of a multifunctional composite coating that effectively combines robust antibacterial properties with enhanced osteogenic potential, offering a promising solution for bone tissue repair and infection prevention.

Mechanically enhanced biodegradable scaffold based on SF microfibers for repairing bone defects in the distal femur of rats

Silk-based biodegradable materials play an important role in tissue engineering, especially in the field of bone regeneration. However, while optimizing mechanical properties and bone regeneration characteristics, modified silk fibroin (SF)-based materials also increase the complexity of scaffold systems, which is not conducive to clinical translation. In this study, we first added synthetic biomimetic mineralized collagen (MC) particles to SF-based materials to improve the bone regeneration properties of the scaffolds and simultaneously regulated the degradation rate of the scaffolds to match the bone regeneration rate. Second, SF microfibers were prepared by hydrolysis with alkaline heating and added to SFMC scaffolds with excellent osteogenic stimulation ability to prepare SF microfiber (mf)-modified SFMC-mf scaffolds with excellent mechanical properties, whose compression modulus increased from 4.58±0.23 MPa to 14.63±0.88 MPa. Finally, the SFMC-mf scaffold was implanted into the weight-bearing bone defect area of the distal femur of rats, and the results showed that the SFMC-mf scaffold significantly promoted functional recovery of the affected limb and increased the amount of new bone in the defect area compared with those in the SFC-mf group and the blank control group. In addition, the RNA-seq results suggested that the genes with upregulated expression in the SFMC-mf scaffold group were mainly enriched in vascular regeneration. In conclusion, this SF microfiber modification method effectively improved the mechanical properties of SFMC scaffolds without moving the SF scaffold system in the direction of compositional complexity, providing new insights for the subsequent development of more effective bionic repair materials for bone defects and assisting in their clinical translation.

Harnessing Hydrogen Sulfide in Injectable Hydrogels That Guide the Immune Response and Osteoclastogenesis Balance for Osteoporosis Treatment

Elevated levels of oxidative stress, inflammation, and a dysregulated osteoclastogenesis balance frequently characterize the microenvironment of osteoporosis, which impedes the processes of healing and repair. Existing treatment approaches are limited in scope and rely primarily on factors and drugs. An injectable hydrogel designed for the ROS-responsive release of H2S gas is presented in this study. The first network of the hydrogel comprises sodium alginate (SA-SATO) chelated with S-aroylthiooxime (SATO) and an H2S-generating group, while the second network is composed of photocrosslinkable PEGDA. Through the integration of Cys-releasing microspheres that are reactive with ROS, a composite hydrogel was developed that exhibited advantageous mechanical characteristics and biosafety. The composite hydrogel effectively promoted osteogenic differentiation of mesenchymal stem cells, modulated macrophage polarization, decreased inflammatory responses, and halted cell apoptosis, as evidenced by in vitro experiments. Additionally, it released H2S gas and mitigated excess ROS in cells. The efficacy of the composite hydrogel in promoting bone defect repair and regeneration in an osteoporotic model was further validated by in vivo findings. In summary, the composite hydrogel exhibits potential as a viable approach to address osteoporotic bone defects by harmonizing osteogenesis and osteoclast activity, modulating the microenvironment of bone injuries, and reducing inflammation. Consequently, it presents a viable strategy for the efficient repair of bone defects.

Design and preparation of biomimetic "Hard-soft" functional scaffold with gradient irregular pore structure for bone repair

To treat critical-sized defects in long bones, a novel structure was proposed by introducing a Haversian biomimetic structure and trabecular-like irregular pore morphology (IPM) structure into functional gradient porous scaffolds (FGPS). The outer shell structure is a "hard" structure providing mechanical support, and the inner core is a "soft" structure with radial gradient distribution IPM structure to promote the ingrowth of bone tissue. In this study, different inner core continuous gradient FGPS (GIPM) and layered FGPS (IPM, and BCC structure), with different outer shell pore sizes (300, 500, and 700 μm) were designed and fabricated by selective laser melting. The results show the stiffness of those FGPS was between 20.0-28.7 kN/mm, which is similar to the native femur (with a stiffness ranging from 7.2-11.7 kN/mm) of similar size. The GIPM-500 has more uniform stress distribution and stress transfer, resulting in superior load-bearing efficiency. Moreover, GIPM-500 exhibited excellent fatigue durability, achieving excellent fatigue cycles of more than 1×106 cycles. Cell immunofluorescence shows that the GIPM-500 and IPM-500 are more suitable for cell attachment and growth due to the flexibility of the local porosity and curvature. Bone defect repair simulations showed that GIPM-500 can meet normal load-bearing requirements while having little impact on the normal stress-strain trajectory. This work provides a novel biomimetic scaffold design containing both cortical and trabecular bone components for repairing critical-size defects in long bones.