Reconstruction Of Bone Defects Research Articles

Hemi-Gastrocnemius Hemi-Soleus Bi-pedicled Muscle Flap and Bone Transport in Reconstruction of Bone and Soft Tissue Defects in an Open Fracture Tibia Gustilo Type IIIc

Hemi-Gastrocnemius Hemi-Soleus Bi-pedicled Muscle Flap and Bone Transport in Reconstruction of Bone and Soft Tissue Defects in an Open Fracture Tibia Gustilo Type IIIc

Finely controlled bioceramic granules and sonoporation for osteogenic bone defect repair and reconstruction

Osteoporotic fractures caused by imbalance in bone homeostasis like chemotherapy, loss of ovarian function，glucocorticoid use and aging require special surgical procedure to treat and restore anatomical function. However, due to escalating bone weakness and impairment, it remains a clinical challenge to treat these types of fracture defects through conventional means. Herein, we fabricated a novel calcium silicate‑strontium (CS-Sr35) bioceramic granules with high biological properties and combined it with ultrasound aided sonoporation (sono) in augmenting osteoporotic critical-sized bone defect. The use of sonoporation mediated by microbubble was to influence efficient response for tissue permeability and delivery of bioactive ions from the bioceramic scaffold. The graded robust granule with adjustable microstructure exhibited physiochemical and biointegration properties favorable for ion release in vitro and osteogenic related activities in vivo. Herein, we compared the treatment of bone defect repair using (i) no scaffold (ii) CS-Sr35 only and (iii) CS-Sr35 + sono. The gradual bone repair process was elucidated by X-ray, histology and micro-CT analyses. Overall, our results showed that the CS-Sr35 + sono exhibited a tailored biodissolution behavior with complete defect repair and reconstruction. Meanwhile, the group with only CS-Sr35 granules had less osteoblastic healing while the blank group showed inadequate critical-sized defect repair throughout the study. Our study suggests that, the synergistic technique of combining bioceramic granule with sonoporation significantly optimizes osteogenic activity and biomineralization ability of the bioceramic granule for new bone growth in osteoporotic pathology and also this tailored technique provides versatile approach for improving the biological effect for next generation reconstruction and repair of diseased bone defect.

Clinical efficacy on the reconstruction of bone defects using modular hemipelvic prosthesis in patients with pelvic tumors

ObjectiveTo evaluate the clinical efficacy of modular hemipelvic prosthesis replacement in the treatment of pelvic tumors and the relationship between postoperative functional recovery and the position deviation of the hip rotation center.MethodsA retrospective research was conducted involving 56 patients who underwent surgical resection of pelvic tumors followed by modular hemipelvic prosthesis reconstruction between 2010 and 2016. Comprehensive data encompassing preoperative conditions, intraoperative and postoperative follow-up information were systematically collected. Limb function was evaluated at 1, 3, 6, and 12 months postoperatively using the Musculoskeletal Tumor Society Scores (MSTS). The positional deviation of the hip joint’s rotational center was quantified. Statistical analyses were performed utilizing SPSS 26.0 software.ResultsAll surgical interventions were successful, with an average operation time of 268.82 ± 42.17 min and mean intraoperative blood loss of 1086.64 ± 538.28 ml. Postoperative complications were noted in 26.79% of patients, predominantly comprising incision-related issues. Hip dislocation was documented in 5.4% of cases, while seven patients experienced prosthesis loosening or fracture during follow-up. A statistically significant improvement in MSTS scores was observed, increasing from an average of 14.3 at 1 month to 21.1 at 12 months postoperatively. The recorded minor deviations in the position of the prosthetic hip joint’s rotational center did not exhibit a significant correlation with functional outcomes. The observed survival rates were 94.64%, 83.93%, 73.21%, and 48.21% at 1, 2, 3, and 5 years, respectively.ConclusionsThe modular hemipelvic prosthesis serves as an effective reconstructive solution for bone defects resulting from pelvic tumor resection, facilitating early functional rehabilitation. The prosthesis demonstrates commendable adaptability and mechanical properties, with a low incidence of complications such as hip dislocation and wound-related issues, thereby contributing to favorable functional recovery of the affected limb.

3D printed polyhydroxyalkanoate scaffold for bone defect reconstruction

3D printed polyhydroxyalkanoate scaffold for bone defect reconstruction

Viability Test of Osteoblast Cells After Application of Hydroxyapatite Nanoparticle from Unam Snail’s Shells In-vitro Examination

The bone defect reconstruction process can use hydroxyapatite is osteoconductive and can retain the original biocompatible shape to enhance hydroxyapatite with osteogenic proteins. To analyze the most appropriate concentration of hydroxyapatite nanoparticles using the MTT Assay method and to test the viability of osteoblast cells after being given hydroxyapatite nanoparticle (nHA) derived from unam snail shells. The fabrication of hydroxyapatite nanoparticles from unam snail shells using a mechanical-chemical combination method. Osteoblast cells are obtained from Calvaria rats after being cultured in DMEM. Viability tests of osteoblast cells were done using the MTT Assay method and repeated three times, and then results were measured using an Elisa reader. Viability of osteoblast cells in nHA 1,25 mg/ml (164,60 % ± 0,096), nHA 1,5 mg/ml (151,72 % ± 0,176), nHA 1,75 mg/ml (90,55 % ± 0,243), nHA 2 mg/ml (74,23 % ± 0,301) respectively. ANOVA test shows p < 0,05. IC50 value of hydroxyapatite nanoparticle from the unam snail’s shells to viability osteoblast cells is 2,23 mg/ml. Less concentration of hydroxyapatite nanoparticles tends to increase the viability of osteoblast cells. 1,75 mg/ml and below hydroxyapatite nanoparticles derived from unam snail shells are not toxic to osteoblast cells.

Application and evaluation of carbonate apatite granules for mandibular bone defect reconstruction after jawbone cyst enucleation-a retrospective case series.

To evaluate the effectiveness of CO3Ap granules in the mandibular bone defects by using computed tomography (CT) images. This study was retrospective case series of mandibular bone defect reconstruction using CO3Ap granules. Six patients with jawbone cysts treated by simultaneous grafting CO3Ap granules after cyst enucleation were enrolled. Patients without grafting CO3Ap granules were excluded. Mandibular bone height including buccolingual bone height, the change of perpendicular distance between the buccolingual line to the alveolar ridge, and the three-dimensional volume of remaining CO3Ap granules were analyzed using CT images obtained at 3, 6, 12, 18, and 24 months postoperatively. Postoperative CT images showed that cortical and cancellous bone-like structures were formed on the grafting area periphery and inside the defect, respectively, with gradual resorption of the CO3Ap granules. Furthermore, there was no evidence of leaving bone defect even at the center of the lesion when the defect was successfully reconstructed by filling it with CO3Ap granules. The percentage volume of remaining CO3Ap granules to the volume at 3 months postoperatively were 76.1 ± 13.1%, 35.8 ± 22.5%, 25.0 ± 13.0%, and 9.9 ± 6.4% at 6, 12, 18, and 24 months postoperatively, and the volume reduction rate increased significantly within 12 months postoperatively. Grafting CO3Ap granules after the enucleation of a jawbone cyst is a good reconstructive treatment option for postoperative prosthetic treatment because CO3Ap granules are gradually replaced by new bone while preserving the contour of the mandibular bone. Not applicable.

Dental pulp stem cell‑derived extracellular vesicles loaded with hydrogels promote osteogenesis in rats with alveolar bone defects.

Alveolar bone defects caused by inflammation, trauma and tumors adversely affect periodontal health, causing tooth loosening or dentition defects, thus affecting denture or implant repair. Advancements in tissue engineering technology and stem cell biology have significantly improved the regenerative reconstruction of alveolar bone defects. The multiple trophic activities of extracellular vesicles (EVs) produced by mesenchymal stem cells play important roles in exerting their therapeutic effects. Several studies have reported the role of dental pulp stem cells (DPSCs) in bone regeneration, but the regenerative effects of DPSC‑EVs on alveolar bone defects are unclear. In the present study, the osteogenic effects of DPSC‑EVs on Hertwig's epithelial root sheath (HERS) cells in vitro and their osteoinductive effects in an alveolar bone defect rat model were investigated. The results showed that DPSC‑EVs significantly promoted the expression of osteogenic genes, such as runt‑related transcription factor 2 and alkaline phosphatase, and increased the osteogenic differentiation capability of HERS. These findings suggested that transforming growth factor β1 inhibition decreased DPSC‑EV‑induced Smad, MAPK and ERK phosphorylation in HERS. In vivo, DPSC‑EV‑loaded hydrogels were transplanted into the alveolar sockets of Sprague‑Dawley rats and observed for eight weeks. The new bone grew concentrically in the DPSC‑EV or DPSC‑EV‑loaded hydrogel group, with greater bone mass than that in the control group, and the bone volume/total volume increased notably. The results confirmed the osteogenic and osteoinductive effects of DPSC‑EVs and DPSC‑Exo‑loaded hydrogels on alveolar bone defects. Due to their low immunogenicity, high stability, good biocompatibility and osteogenic propensity, DPSC‑EV‑loaded hydrogels are a safe cell‑free therapeutic approach for defective alveolar bone regeneration.

3D-Printed Bioceramic Scaffolds Reinforced by the In Situ Oriented Growth of Grains for Supercritical Bone Defect Reconstruction.

Porous calcium phosphate ceramics have attracted widespread attention owing to their excellent bioactivity. However, their poor mechanical properties severely limit their clinical applications. Significantly improving the mechanical strength of porous CaP ceramics while maintaining their bioactivity remains a major challenge. To address this issue, calcium sulfate is used to regulate the directional growth of hydroxyapatite grains during ceramic sintering. The in situ oriented grains can not only alleviate the stress concentration but also strengthen the bonding force between the ceramic grain boundaries. Calcium sulfate improves the release of active calcium ions from calcium phosphate ceramics, further enhancing their bioactivity and osteoinductivity in vivo. Transcriptome and proteome sequencing reveals that the in situ whisker-reinforced ceramics increase the expression of proteins related to calcium ion binding and promote the expression of osteogenesis-related proteins. In the supercritical bone defect repair model, repair of the defect is achieved within 3 months, with mechanical recovery reaching more than 70% of the autologous bone.

3D-Printed Bifunctional Scaffold for Treatment of Critical Bone Defects Based on Osteoimmune Microenvironment Regulation and Osteogenetic Effects.

The critical-sized bone defect resulting from trauma, tumor resection, and congenital deformity fails to undergo spontaneous healing due to its substantial size, while the ensuing inflammatory process and hypoxic environment further impede the regenerative process. Therefore, it has consistently presented a significant clinical challenge. In the present study, we incorporate a glycyrrhizic acid (GA)-functionalized hydrogel onto the surface of a Hydroxyapatite (Hap)-modified Polycaprolactone (PCL) scaffold to fabricate a composite scaffold. The composed scaffold showed favorable anti-inflammatory and antioxidative capabilities by modulating macrophage polarization and scavenging reactive oxygen species (ROS); the modification of Hap enhanced its osteogenic ability. An in vivo rat skull defect model confirmed that the composed scaffold efficiently promotes bone regeneration. In general, the composed scaffold with the ability of osteoimmune microenvironment regulation can effectively repair critical-sized bone defects. This strategy provides a promising method for the reconstruction of large segmental bone defects.

Is intercalary frozen autograft augmented with intramedullary cement and bridging plates fixation a durable reconstruction?

AimsWe analysed the survival, complications, and function of frozen autograft augmented with intramedullary cement and bridging plates fixation for intercalary bone defect reconstruction in primary bone sarcomas.Patients and MethodsA retrospective cohort study was conducted on 72 patients with primary bone sarcomas (34 males, 38 females) between January 2016 and June 2023. The average age was 22.0 ± 13.6 years (6 to 61 years) and the pathological type included osteosarcoma (55), followed by adamantinoma (5), Ewing’s sarcoma (4), undifferentiated pleomorphic sarcoma (4), chondrosarcoma (3), and malignant tenosynovial giant cell tumor (1). The oncological outcomes included local control, metastasis, progression-free survival and overall survival. The functional outcomes were evaluated by the Musculoskeletal Tumor Society Score (MSTS-93), the Toronto Extremity Salvage Score (TESS), and the motion of the joint.ResultsThe mean follow-up time was 50.0 ± 27.4 months (12 to 99 months). 10 patients died of the disease, 9 patients were alive with disease and 53 patients were alive with no evidence of disease. The average 5-year overall survival of autograft was 85.8% (95% CI, 72.1-93.1%). The average MSTS-93 score was 96% ( 67–100%) and the average TESS score was 98% (74–100%). Twenty-four patients (33.3%) had at least one complication in the follow-up period. The most common complications were nonunion (9.7%, 7/72) and local recurrence (9.7%, 7/72), followed by leg length discrepancy (6.9%, 5/72), infection (5.6%, 4/72), implant failure (4.2%, 3/72), delayed union (2.8%, 2/72), and graft fractures (1.4%, 1/72). Tumor site was an independent risk factor for bone nonunion (OR, 22.23; p = 0.006).ConclusionsWe presented a large technique series for preventing autograft-related complications (especially for autograft fractures) of intercalary frozen autograft reconstruction. This method showed promising functional outcomes and provided durable reconstruction.Level of evidencelevel IV therapeutic study.

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.

GelMA-based moldable and rapid-curable osteogenic paste inspired by ceramic craft for alveolar bone defect regeneration

Alveolar bone defects pose a significant challenge in oral clinical treatments, impacting procedures such as dental implants, orthodontics, and oral restoration. Despite their frequent occurrence due to various causes, the effective restoration and reconstruction of alveolar bone defects remain a significant clinical challenge in dentistry. Existing treatments often rely on intrinsic blood coagulation to stabilize bone grafts, but they present limitations such as gradual clotting and reduced effectiveness in patients with coagulation dysfunction. Injectable gel holds promise as an alternative to coagulation-dependent bone graft matrices, but it also faces challenges, including low initial viscosity and dependence on the natural formation of the defect area during the curing process. Here, we present a ceramic-craft-inspired osteogenic (CIO) hydrogel, designed to achieve moldable and curable properties for bone defect regeneration. This injectable paste, composed of gelatin methacrylate (GelMA), nanoclay, and bone grafts, allows for local injection and manual shaping without the need for molds. The shaped hydrogel rapidly crosslinks within 15 s under UV irradiation, providing malleability, strength, and coagulation-independent bone graft stabilization. This approach offers a potential breakthrough in addressing the persistent clinical challenge of alveolar bone defect restoration.

Challenging frontiers in neuroplastic cranial reconstruction: addressing neurosurgical wound healing complications through interdisciplinary collaboration – an observational study

Background and objectivesAlthough rare, complications like skin dehiscence and necrosis after neurosurgery pose significant challenges by increasing the risk of infections spreading to the epidural, subdural, or intracerebral spaces. This retrospective, single-center study aims to assess the prior clinical courses, neuroplastic repair, and outcomes of patients with skin defects following cranial neurosurgical procedures, and to outline our interdisciplinary reconstructive protocol.MethodsA retrospective analysis was performed on cranial surgeries conducted at the Department of Neurosurgery, spanning from 2017 to 2023. Patients with skin defects requiring the combined expertise of neurosurgery and plastic surgery for effective treatment were included. The sizes of the skin defects were measured using intraoperative photographs analyzed with the freeware ImageJ software, version 2018. All patients provided informed consent for the surgeries. If informed consent was not possible due to neurological deterioration, consent was sought from adult representatives or next of kin except for acute circumstances. All patients admitted to our hospital agree to the pseudonymized use of their medical data and tissue specimens for research purposes in their treatment contract.ResultsA cohort of 24 patients experiencing wound healing complications after neurosurgical procedures underwent a total of 29 interdisciplinary surgeries for the reconstruction of skin, dural, and bone defects. After the neuroplastic surgery, 8 out of 24 patients (33.3%) developed surgical complications, with 6 of these requiring revision surgeries due to persistent cranial infection. In all cases, permanent wound closure was successfully achieved following adherence to the proposed treatment algorithm.ConclusionsOur study underscores the necessity of an integrated neurosurgical and plastic surgical approach to effectively manage wound healing complications in a single stage surgery. Key interventions include differentiation between necrosis and gaping lesions, alongside precise management of neurosurgical issues like cerebrospinal fluid fistulas and hydrocephalus. Plastic surgical expertise in assessing the possibilities and limitations of both local and free flap surgeries is essential.

Porous titanium/hydroxyapatite interpenetrating phase composites with optimal mechanical and biological properties for personalized bone repair

This study introduces the first fabrication of porous titanium/hydroxyapatite interpenetrating phase composites through an innovative processing method. The approach combines additive manufacturing of a customized titanium skeleton with the infiltration of an injectable hydroxyapatite foam, followed by in situ foam hardening at physiological temperature. This biomimetic process circumvents ceramic sintering and metal casting, effectively avoiding the formation of secondary phases that can impair mechanical performance. Hydroxyapatite foams, prepared using two foaming agents (polysorbate 80 and gelatine), significantly reinforce the titanium skeleton while preserving the microstructural characteristics essential for osteoinductive properties. The strengthening mechanisms rely on the conformation of the foams to the titanium surface, thereby enabling stable mechanical interlocking and effective interfacial stress transfer. This, combined with the mechanical constriction of phases, enhances damage tolerance and mechanical reliability of the interpenetrating phase composites. In addition, the interpenetrating phase composites feature a network of concave pores with an optimal size for bone repair, support human osteoblast proliferation, and exhibit mechanical properties compatible with bone, offering a promising solution for the efficient and personalized reconstruction of large bone defects. The results demonstrate a significant advancement in composite fabrication, integrating the benefits of additive manufacturing for bone repair with the osteogenic capacity of calcium phosphate ceramics.

Management of chronic septic nonunion of the femur associated with an extended drug resistant nosocomial germ: a case report

Introduction and Importance: Septic nonunion of long bones poses significant treatment challenges, often necessitating extended hospital stays and multiple surgical interventions. This report details a chronic septic nonunion of the femur, complicated by drug-resistant pathogens, managed through an integrated surgical approach. Case Presentation: A 32-year-old male with a history of infected nonunion and multiple failed surgeries presented with a vast bone defect and osteomyelitis. Treatment involved single-session debridement, bone resection, intramedullary fixation, and trifocal segment bone transport using the Limb Reconstruction System (LRS) and Masquelet technique. After eight months, the patient achieved radiologic and clinical bone healing, regained full ambulation, and resumed work without re-infection over an 18-months follow-up. Clinical Discussion: The management of septic nonunion, particularly with drug-resistant infections, requires a multifaceted approach. This case exemplifies the efficacy of combining radical bone resection, targeted debridement, and advanced reconstructive techniques. The use of antibiotic-impregnated cement beads and bone transport procedures played pivotal roles in the successful outcome. While such procedures can be complex and necessitate vigilant monitoring, they are crucial for improving treatment success and functional recovery. Conclusion: Septic nonunion caused by extended drug-resistant germs of the lower extremity long bones can be managed in a single-session bone resection and debridement, local antibiotic administration, and later bone defect reconstruction.

Research progress in repair and reconstruction of tumor-related bone defects in proximal femur

To review the repair and reconstruction methods for large segmental femoral proximal bone defects caused by tumors, and to explore their clinical application effects, advantages, and disadvantages, and future research directions. A comprehensive search of Chinese and foreign databases was conducted to select basic and clinical research literature related to the repair and reconstruction of femoral proximal bone defects caused by tumors. The studies were classified and analyzed based on two main strategies: hip-preserving reconstruction and non-hip-preserving reconstruction. In hip-preserving reconstruction, traditional methods such as allograft transplantation and vascularized autograft transplantation are common but have risks of poor bone integration and bone resorption. The clinical application of inactivated tumor segment reimplantation and distraction osteogenesis techniques is limited. In recent years, three-dimensional printing technology has become increasingly mature, with personalized prostheses and precise surgeries becoming development trends. Non-hip-preserving reconstruction primarily includes allograft prosthesis composite and total femoral replacement. The former focuses on improving the survival rate and bone integration efficiency of the allograft, while the latter requires the simultaneous reconstruction of hip and knee joint stability. Significant progress has been made in repairing and reconstructing proximal femoral bone defects caused by tumors, but many challenges remain. The integration of three-dimensional printing technology and digital design offers potential for precise bone defect repair. Future efforts should focus on new concepts, technologies, and materials through multidisciplinary approaches to provide personalized and precise solutions, thereby improving patient quality of life.

Distraction osteogenesis application in bone defect caused by osteomyelitis following mandibular fracture surgery: a case report and literature review

BackgroundOsteomyelitis secondary to mandibular fracture surgery is rare and complete surgical debridement of necrotic infected tissues is an optimal treatment for it. Subsequent reconstruction is required for bone defect caused by operation. Autogenous, allograft and synthetic bone graft substitutes have become widespread in bone defect treatment. Distraction osteogenesis (DO) was also applied in bone defect reconstruction, even it wasn’t conventional therapy in jaw.Case presentationHere we report a case of a 40-year-old aged man who presented with chronic swelling and pain on the right mandibular masseteric region after mandibular angle and Le Fort II fracture surgery. In six weeks after surgery, CBCT images showed that the fracture ends hadn’t heal and the fracture gap had widened significantly. The clinical diagnosis of the patient was right mandibular angle osteomyelitis. After controlling the symptoms of pain and infection with local rinses and systemic antibiotic therapy, the patient underwent segmental resection of the infected bone and DO reconstruction for bone defect simultaneously. Encouragingly, well bone healing and normal occlusion restoration was observed finally.ConclusionsDO could be a valuable alternative therapy to bone grafts for bone defect, even in the case of infection.

Histodynamics of calcium phosphate coating on the osseointegration of medical-grade polycaprolactone β-tricalcium phosphate scaffolds

Bone formation on implant surfaces occurs via distance and contact osteogenesis, with osseointegration influenced by the implant’s surface topography and coating. However, the traditional mechanisms of osseointegration around metal implant surfaces may not fully encompass the ultimate outcomes of using medical-grade polycaprolactone β-tricalcium phosphate calcium phosphate coated (mPCL-TCP-CaP) scaffolds for the reconstruction of large bone defects. Using histology, immunohistochemical (IHC) and scanning electron microscopy (SEM) analyses our studies on large bone defects using mPCL-TCP-CaP scaffolds show osteogenic cells forming a fibrous connective matrix around these scaffolds. Despite extensive research, the in vivo mechanisms of osseointegration of CaP-coated mPCL-TCP-CaP scaffolds remain unclear. This study investigates the structural details and spatial organization of the mPCL-TCP-CaP scaffold’s interface, providing insights into the histodynamic processes involved in their osseointegration with CaP coatings.

Hierarchical Integration of Curcumin-Loaded CaCO3 Nanoparticles and Black Phosphorus Nanosheets in Core/Shell Nanofiber for Cranial Defect Repair.

Reconstruction and healing of large craniofacial bone defects are major clinical challenges due to high risk of chronic inflammation and reduced cell mineralization levels. Herein, a core-shell nanofiber-based implant with significant pro-osteogenesis capability for treating skull defects is reported, which is hierarchically integrated with curcumin-loaded calcium carbonate nanoparticles (CaCO3@Cur NPs) in the outer layers and black phosphorus nanosheets (BPNSs) in the core compartments. The radical alignment of the integrated nanocomponents allows the sequential in situ release of the therapeutic agents in a controlled manner after implantation. Curcumin can repolarize M1 macrophages into M2 phenotypes for anti-inflammation purposes. Meanwhile, the released calcium and phosphate ions can promote the biomineralization of hydroxyapatite at the defect site and facilitate bone regeneration. Evaluations on cranial defect-bearing rat models demonstrated that the electrospun fibers in the present study substantially promoted restoration of the damaged skulls and inhibited inflammation in the wound bed. This strategy provides a new idea for the treatment of skull defects in the clinic.

Nicorandil-based hydrogel promotes bone defect reconstruction by targeting Hmox1

BackgroundThe local use of drugs to promote bone healing is still difficult to apply clinically. We aimed to construct a nicorandil-based hydrogel to promote local bone healing by promoting angiogenesis and inhibiting osteoclastogenesis. ResultsIn this study, we constructed a nicorandil-based hydrogel and used it to intervene in bone repair during bone defect reconstruction. The results showed that the nicorandil-based hydrogel significantly inhibited osteoclast differentiation and promoted angiogenesis in vitro. Furthermore, bone formation was significantly promoted by the use of a nicorandil-based hydrogel. Mechanistically, Hmox1 was directly targeted by nicorandil, and overexpression of Hmox1 was found to promote bone defect reconstruction. ConclusionOur study provides a fresh perspective and a potential therapeutic approach for the use of local nicorandil-based hydrogels to improve bone defect reconstruction.