Analysis of a biodegradable composite for bone healing

Osteogenesis Improvement of Gelatin-Based Nanocomposite Scaffold by Loading Zoledronic Acid

Bisphosphonates (BPs) such as Zoledronic acid (ZA) are a subset of synthetic small molecules, which are now marketed as the main drugs to stimulate the growth and differentiation of osteoblast cells, thereby increasing bone formation as well as preventing bone loss. Also, Halloysite Nanotubes (HNTs)-polymer composites have attracted a lot of attention due to their high surface-to-volume ratio, low density, and high hydrophilicity, and are easily dispersed in hydrophilic biopolymers. In addition, their ability to carry enough amounts of drugs and the ability to control release has been demonstrated. Based on studies, the Gelatin-based scaffold with Halloysite nanotube (HNT) has the capacity as a drug carrier and Zoledronic acid (ZA) sustains release. Previous studies show that using ZA intravenously has some severe side effects and limitations. But by attention to the advantages of its osteogenesis, the current study has been done in order to reduce the side effects of local delivery of it. The 3-dimensional scaffolds were prepared by the Freeze-drying method. Characterization methods such as FE-SEM, FTIR, XRD, and release behavior of the scaffold has been performed to evaluate the features of the scaffolds. In fact, as-prepared Gel-HNT/ZA release 49% ZA in Phosphate Buffered Saline (PBS) within 21 days. The mechanical properties have been increased after adding HNTs and ZA from 10.27 to 26.18 MPa. Also, the water absorption has been increased after adding HNTs and ZA from 1.67 to 5.02 (g/g). Seeded human Adipose stem cells (hASCs) on the prepared scaffolds showed that the ZA effectively elevated the proliferation of the hASCs and also the MTT results proved the non-toxicity of all prepared scaffolds by high cell viability (˃80%). The osteogenic differentiation has been accelerated as displayed by ALP and Ca assay. The results propose that the HNTs-loaded Gelatin scaffold could control the releasing of ZA and its localized delivery at the defect site, simultaneously promoting the mechanical and osteogenesis ability of gelatin-based scaffolds.

The Use of Mussel Shell as a Bio-Additive for Poly(Lactic Acid) Based Green Composites

Mussel shell is one of the most hazardous aquaculture wastes and its powder was used as an additive for bio-degradable poly (lactic acid) in this current study. Bio-composites were fabricated via conventional melt mixing technique followed by an injection moulding process. The effects of mussel shell powder inclusion on mechanical, melt-flow, water uptake and morphological performance of poly (lactic acid)-based green composites were reported.

In vitro Apatite Mineralization, Degradability, Cytocompatibility and in vivo New Bone Formation and Vascularization of Bioactive Scaffold of Polybutylene Succinate/Magnesium Phosphate/Wheat Protein Ternary Composite

Purpose

A bioactive and degradable scaffold of ternary composite with good biocompatibility and osteogenesis was developed for bone tissue repair.

Materials and Methods

Polybutylene succinate (PS:50 wt%), magnesium phosphate (MP:40 wt%) and wheat protein (WP:10 wt%) composite (PMWC) scaffold was fabricated, and the biological performances of PMWC were evaluated both in vitro and vivo in this study.

Results

PMWC scaffold possessed not only interconnected macropores (400 μm to 600 μm) but also micropores (10 μm ~20 μm) on the walls of macropores. Incorporation of MP into composite improved the apatite mineralization (bioactivity) of PMWC scaffold in simulated body fluid (SBF), and addition of WP into composite further enhanced the degradability of PMWC in PBS compared with the scaffold of PS (50 wt%)/MP (50 wt%) composite (PMC) and PS alone. In addition, the PMWC scaffold containing MP and WP significantly promoted the proliferation and differentiation of mouse pre-osteoblastic cell line (MC3T3-E1) cells. Moreover, the images from synchrotron radiation microcomputed tomography (SRmCT) and histological sections of the in vivo implantation suggested that the PMWC scaffold containing MP and WP prominently improved the new bone formation and ingrowth compared with PMC and PS. Furthermore, the immunohistochemical analysis further confirmed that the PMWC scaffold obviously promoted osteogenesis and vascularization in vivo compared with PMC and PS.

Conclusion

This study demonstrated that the biocompatible PMWC scaffold with improved bioactivity and degradability significantly promoted the osteogenesis and vascularization in vivo, which would have a great potential to be applied for bone tissue repair.

Feasibility of a Three-Dimensional Porous Uncalcined and Unsintered Hydroxyapatite/poly-d/l-lactide Composite as a Regenerative Biomaterial in Maxillofacial Surgery

This study evaluated the feasibility of a novel three-dimensional (3D) porous composite of uncalcined and unsintered hydroxyapatite (u-HA) and poly-d/l-lactide (PDLLA) (3D-HA/PDLLA) for the bony regenerative biomaterial in maxillofacial surgery, focusing on cellular activities and osteoconductivity properties in vitro and in vivo. In the in vitro study, we assessed the proliferation and ingrowth of preosteoblastic cells (MC3T3-E1 cells) in 3D-HA/PDLLA biomaterials using 3D cell culture, and the results indicated enhanced bioactive proliferation. After osteogenic differentiation of those cells on 3D-HA/PDLLA, the osteogenesis marker genes runt-related transcription factor-2 (Runx2), and Sp7 (Osterix) were upregulated. For the in vivo study, we evaluated the utility of 3D-HA/PDLLA biomaterials compared to the conventional bone substitute of beta-tricalcium phosphate (β-TCP) in rats with critical mandibular bony defects. The implantation of 3D-HA/PDLLA biomaterials resulted in enhanced bone regeneration, by inducing high osteoconductivity as well as higher β-TCP levels. Our study thus showed that the novel composite, 3D-HA/PDLLA, is an excellent bioactive/bioresorbable biomaterial for use as a cellular scaffold, both in vitro and in vivo, and has utility in bone regenerative therapy, such as for patients with irregular maxillofacial bone defects.

Recent advances in the synthesis, functionalization and biomedical applications of hydroxyapatite: a review

Hydroxyapatite (HA) is a member of the Ca apatite family.

Biodegradable Materials for Bone Repair and Tissue Engineering Applications

This review discusses and summarizes the recent developments and advances in the use of biodegradable materials for bone repair purposes. The choice between using degradable and non-degradable devices for orthopedic and maxillofacial applications must be carefully weighed. Traditional biodegradable devices for osteosynthesis have been successful in low or mild load bearing applications. However, continuing research and recent developments in the field of material science has resulted in development of biomaterials with improved strength and mechanical properties. For this purpose, biodegradable materials, including polymers, ceramics and magnesium alloys have attracted much attention for osteologic repair and applications. The next generation of biodegradable materials would benefit from recent knowledge gained regarding cell material interactions, with better control of interfacing between the material and the surrounding bone tissue. The next generations of biodegradable materials for bone repair and regeneration applications require better control of interfacing between the material and the surrounding bone tissue. Also, the mechanical properties and degradation/resorption profiles of these materials require further improvement to broaden their use and achieve better clinical results.

Biological performance of a new β-TCP/PLLA composite material for applications in spine surgery:In vitro andin vivo studies

The objective of this research was to carry out an in vitro and in vivo study of the biological performance of PLLA/beta-TCP composite materials, to estimate the scope of their potential applications in bone surgery. Samples with increasing beta-TCP (0-60% w/w) contents were processed by injection molding. The in vitro study consisted of an evaluation of inflammatory potential by assaying the IL-1alpha secreted by monocytes, and then cell proliferation (counting) and phenotype expression (PAL and I collagen) in human osteogenous cells. The in vivo study was carried out using cylindrical implants of composite materials composed of composite materials containing 0 or 60% beta-TCP and pure beta-TCP, respectively. The implants were inserted in femoral sites in rabbits, using the Kathagen protocol. Each animal received a 60% implant, with either a 0 or a 100% implant in the contralateral femur, so that the materials could be compared with one another. Five animals were examined for each material and implantation period, giving a total of 30 animals. This study showed that adding increasing percentages of beta-TCP to a lactic acid polymer matrix stimulated the proliferation of human osteogenous cells and synthesis of the extracellular bone matrix in a dose-dependent manner. In vivo results indicate that, in comparison with pure PLA, tricalcium phosphate-containing composite materials had faster degradation kinetics, caused less inflammatory reaction, and promoted contact osteogenesis. The composite material containing 60% beta-TCP demonstrated a similar performance to pure tricalcium phosphate bone grafts in terms of osteogenesis, and is apparently compatible with the production of intra-osseous implants for situations representing high levels of mechanical strain.

The development and identification of constructing tissue engineered bone by seeding osteoblasts from differentiated rat marrow stromal stem cells onto three-dimensional porous nano-hydroxylapatite bone matrix in vitro

The purposes of this study were to develop a new cultural method for the rat bone marrow stromal cells (MSCs) to differentiate into osteoblasts well in vitro, and to investigate the feasibility of using MSCs as seed cells and three-dimensional porous nano-hydroxylapatite as scaffolds for constructing tissue-engineered bone. MSCs of rats were isolated, cultured, induced to differentiate into osteoblasts, and then observed with inverted microscopy. Histochemical staining and radio-immunological analysis were applied for identifying MSCs. Whereafter MSCs were seeded onto three-dimensional porous nano-hydroxylapatite scaffolds, and scanning electron microscopy was applied to evaluate their growth on scaffolds. Results showed that MSCs were typical fibroblast-like and possessed a better proliferating capability; the activity of alkaline phosphatase (ALP) and the secretion of osteocalcin of MSCs were produced gradually and increased continuously; the cells seeded on three-dimensional porous nano-hydroxylapatite scaffolds adhered, proliferated and differentiated well. These results demonstrated that the new improved culture method had the advantages of short isolating time, less risk of contamination and higher efficiency and accordingly was conducive to MSCs proliferating and differentiating into osteoblasts, and that it was advantageous to constructing tissue-engineered bone using MSCs as seed cells and three-dimensional porous nano-hydroxylapatite as scaffolds.

A biomechanical and histological evaluation of a bioresorbable lumbar interbody fusion cage

Novel spinal interbody fusion cages made of bioactive and bioresorbable composites by a unique forging process were developed. Previous in vitro study demonstrated that these cages marked excellent biomechanical values. The purpose of the present in vivo study was to evaluate the viability and advantage of this forged composite of uncalcined hydroxyapatite/poly L-Lactide (F-u-HA/PLLA) cage radiographically, biomechanically, and histologically, when compared to conventional autologous iliac bone (AIB) and carbon fiber cage (CFC). Twenty-five mature sheep underwent posterior lumbar interbody fusion at L2-3 level with pedicle screws system made of titanium. Three types of interbody fusion implants were grafted: AIB (n = 7), CFCs (n = 9), F-u-HA/PLLA cages (n = 9). Two types of cages were packed with autologous fragmented cancellous bone harvested locally. All animals were euthanized at 120 days after surgery. The fusion scoring using the coronal view CT scans was designed to three-dimensionally evaluate fusion quality within and around cages. The mean CT scores of three groups were 33.3 points, 35.0 points, and 33.6 points in AIB, CFC, and F-u-HA/PLLA cage groups, respectively (full-score: 56 points). Statistical differences were not detected among the three groups. The mean range of motion values among fused groups had no significant difference under all pure loadings. The range of motion showed strong and significant correlation with the CT fusion scores. Histologic results demonstrated that F-u-HA/PLLA cages contacted with the surrounding bone directly, and CFC was encircled with thick fibrous tissue layers without any sign of inflammation around cages. The fusion quality of fused spinal segment using F-u-HA/PLLA cages was equal to that of AIB or CFCs both radiographically and biomechanically. In the histological observation, biocompatibility of F-u-HA/PLLA cage was obviously superior to CFC. It has been confirmed that the novel bioactive and bioresorbable cages had valuable advantages over existing CFC for use in spinal reconstructive surgery.

Synthesis and characterization of a novel polymer-ceramic system for biodegradable composite applications

The objective of this study was to develop a biodegradable polymer resin that could be used for the fabrication of an interpenetrating phase composite (IPC) made of porous calcium polyphosphate (CPP) and an organic polymer resin. The resin was synthesized from a polycarbonate-based divinyl oligomer and monomers containing ionic groups. The physical and chemical properties of the polymer resin and polycarbonate-based divinyl oligomer were characterized by gel permeation chromatography, Fourier transform infrared spectroscopy, and swelling studies. The in vitro degradation of the polymer resins was assessed using cholesterol esterase in a buffer solution at 37 degrees C for 3 weeks. Scanning electron microscopy of the degraded samples indicated that the hydrolysis of the resin was catalyzed by the enzyme. The relative interfacial shear strength between the polymer resin and the CPP ceramic was studied using a microbond test. The addition of ionic groups into the polymer resin chains appeared to improve the chemical bonding between the polymer and the CPP. Preliminary mechanical properties of the IPC were investigated by determining bending strength using a three point bending test. The data showed a sevenfold increase in strength over that of the monolithic CPP, and the addition of more ionic groups into the resin led to a higher bending strength for the newly formed CPP/polycarbonate resin system. Sample cross sections of the IPC examined using scanning electron microscopy suggested that the resin had infiltrated almost all of the pores of the CPP. The results of this study indicate that the IPC could potentially be used for fabricating novel biodegradable load-bearing implants.

Long-term study of high-strength hydroxyapatite/poly(L-lactide) composite rods for the internal fixation of bone fractures: a 2-4-year follow-up study in rabbits

Biodegradation of hydroxyapatite (HA)/poly(L-lactide)(PLLA) composite bone implant rods was studied with the use of two types of HA particles as reinforcing fillers: uncalcined HA (u-HA) or calcined HA (c-HA). Composite rods of u-HA/PLLA and c-HA/PLLA containing 30 or 40% (w/w) HA were implanted in the distal femur of 21 rabbits, and specimens were examined by light microscopy, scanning-electron microscopy (SEM), and transmission-electron microscopy (TEM) 2-4 years later. For u-HA/PLLA, trabecular bone bonding directly onto the rod was maintained for up to 2 years. By 3 years, surface collapse had begun, and the implants were shrinking. By 4 years, they had shrunk further, with complete bone encapsulation. The u-HA particles were small and needle shaped in the peripheries, and TEM confirmed their resorption. The cross-sectional area after 4 years decreased by 23.3+/-8.4%. The mean ratio of bony ingrowth to the initial cross-sectional area around the shrunken rods was 6.7+/-1.3 %. The viscosity molecular weight of PLLA reduced from 2 x 10(5) to less than 1 x 10(3). Thus, most of the PLLA had released from the rods. The c-HA/PLLA implants also showed good osteoconductivity, but shrinkage and infiltration of histiocytes were less. No osteolytic or osteoarthritic changes were found.

Juniper wood as a possible implant material

Natural materials, such as wood and bone, possess structures fulfilling the requirements of support and transport of nutrients. Similarity in function and properties provides inspiration for investigating the possible use of wood as an implant material. Juniperus communis wood is dense, durable, and strong and has naturally impregnated essential oils that display antiseptic properties. This study investigated the toxicity of the oil, the effect of sterilization on the mechanical properties of the wood, and bone attachment with animal studies. The possible toxicity of the oil was determined orally and by intravenous injection. At low concentrations, the dose that would be released by the wood in the body could be tolerated without any detrimental effects. Sterilization of the wood in boiling water lowered the elastic modulus and modulus of rupture to a level at which the elastic modulus could be better matched to bone. Wood shaped into the form of femoral implants were implanted into rabbits and displayed good acceptance by the body up to a period of 3 years, indicating bone apposition, abutment into pores, and growth into drilled cavities.

In vivo investigations on composites made of resorbable ceramics and poly(lactide) used as bone graft substitutes

Porous composites made of poly(L, DL-lactide) (PLA) and alpha-tricalcium phosphate (alpha-TCP) or the glass ceramic, GB14N, respectively, were investigated in a loaded implant model in sheep. Six, 12 and 24 months after implantation histological and biomechanical evaluation were performed and compared to autogenous bone transplants. No significant differences were observed between the composites. After 6 months, the interconnecting pores of the alpha-TCP-composite and the GB14N-composite were filled with newly formed bone (14 +/- 5% or 29 +/-15% of the implant, respectively) and soft tissue (30 +/-9% or 21 +/-12% of the implant, respectively). Only a mild inflammatory response was observed. The reaction was similar after 12 months. However, after 24 months a strong inflammatory reaction was seen. The newly formed bone was partly osteolytic. The adverse reaction occurred simultaneously to a significant reduction of the PLA component. The histological results were reflected by the biomechanical outcomes. Both composites showed compression strengths in the range of the autologous bone graft until 12 months of implantation. After 2 years, however, the strengths were significantly decreased. It is concluded that the new composites cannot yet be used for clinical application. An improvement in biocompatibility might be reached by a better coordination of the degradation times of the polymer and the ceramic component.

Composites made of rapidly resorbable ceramics and poly(lactide) show adequate mechanical properties for use as bone substitute materials

Porous composite materials made of poly(L, DL-lactide) and a ceramic component, alpha-tricalcium phosphate (alpha-TCP) or one of the rapidly resorbable glass ceramics, GB9N or GB14N, respectively, were developed to be used as bone substitutes. The present article describes the mechanical properties and the in vitro degradation characteristic of the different composite materials. The yield strength, the elastic modulus, and the molecular weight were measured after in vitro degradation up to 78 weeks. The initial strengths of the alpha-TCP composite (12.5 +/- 0.7 MPa) was higher than that of the GB9N and GB14N composites (8.3 +/- 0.2 MPa and 10.9 +/- 0.2 MPa, respectively). The initial elastic moduli of the composites were between 450 and 650 MPa. The mechanical properties remained constant until a degradation period of 26 weeks. Then they decreased continuously until they were completely lost at week 52. The molecular weight (M(w)) decreased steadily from 91,000 D in the case of the alpha-TCP composite and 78,000 D and 85,000 D in the case of the GB9N or GB14N composites, respectively, to about 10,000 D at week 78. It was concluded that the composites show adequate mechanical properties in the range of cancellous bone and a suitable degradation characteristic to be used as bone substitute materials.

Preparation and properties of poly(L-lactide)/hydroxyapatite composites

In this study, two different viscosity-average molecular weight (eta = 4.0 and 7.8) poly(L-lactide) (PLLA) were synthesized by ring-opening polymerization and the poly(L-lactide)/hydroxyapatite composites (PLLA/HA) were prepared by blending HA particles (size range: 25-45 microm and Ca/P = 1.69) with a content of 10, 30, and 50 wt% in PLLA solution with further evaporation of the solvent. The plain PLLA polymers and PLLA/HA composites were compression-molded and machined to yield 25 x 3 x 2 mm3 specimens. The molar mass of resulting specimens was decreased drastically due to the hydrolytic and thermal degradation of ester bonds. Scanning electron microscopy and thermal gravimetric results indicated that the compositions of HA in PLLA were well dispersed. With increasing HA content, the crystallinity of PLLA/HA composites are slightly increased due to the effect of HA as a nucleating agent. The dynamic mechanical analysis is useful in studying the viscoelastic behaviour of the PLLA/HA composites and no secondary relaxation was observed below the glass-to-rubber transition (60 degrees C). The mechanical properties of the PLLA/HA composites were found to vary with HA content. Increased levels of HA resulted in increased bending modulus and strength.

Bone bonding ability of a new biodegradable composite for internal fixation of bone fractures

Hydroxyapatite particles and poly(L-lactide) composites for internal fixation of bone fractures have been developed based on the hypothesis that incorporation of hydroxyapatite particles in a poly(L-lactide) matrix might enhance bone bonding. This study evaluated the bone bonding ability of these biodegradable composites. Two types of hydroxyapatite and poly(L-lactide) composite were used in this study: calcined hydroxyapatite/poly(L-lactide) and uncalcined hydroxyapatite/poly(L-lactide). Rectangular plates (2 x 10 x 15 mm) of each composite or poly(L-lactide) were implanted into the metaphysis of the tibiae of 33 male rabbits, and the failure load was measured by conducting a detaching test 8, 16, and 25 weeks after implantation. The failure loads of calcined hydroxyapatite/poly(L-lactide), uncalcined hydroxyapatite/poly(L-lactide), and poly(L-lactide), respectively, were 13.60, 13.95, and 0.46 N at 8 weeks; 29.84, 24.09, and 2.86 N at 16 weeks; and 25.50, 29.67, and 2.43 N at 25 weeks. Histologic observation revealed that the composites formed direct contact with the bone. The results in this study indicate that the composites improved the strength of the interface between bone and plate. This improved interfacial strength lead to a substantial decrease in the frequency of implant loosening in the treatment of fractured bones by internal fixation.

Calcium-deficient hydroxyapatite-PLGA composites: mechanical and microstructural investigation

The microstructural and mechanical properties of composites composed of calcium deficient hydroxyapatite (CDHAp) and poly(lactide-co-glycolide) (PLGA) have been investigated. The composites were formed by hydrolysis of alpha-tricalcium phosphate (alpha-TCP) to CDHAp in pressed precomposite compacts of alpha-TCP-PLGA-NaCl. The differences in hydrolysis of alpha-TCP-PLGA-NaCl for two compositions of 80:10:10 wt % and 60:20:20 wt %. were monitored by isothermal calorimetry and X-ray diffraction. The microstructural evolution and variance in final composite microstructure after hydrolysis at 37 degrees C, 45 degrees C, and 56 degrees C were examined by scanning electron microscopy. HAp-PLGA composite formed from the alpha-TCP-PLGA-NaCl (80:10:10) precomposites at 37 degrees C developed a tensile strength of 13.3 +/- 0.9 MPa, a flexural strength of 24.8 +/- 1.7 MPa, and Young's modulus of 2.8 +/- 0.3 GPa. These values were 12.00 +/- 0.2 MPa, 36.1 +/- 2.1 MPa, and 5.5 +/- 0.8 GPa for the precomposite composition 60:20:20. All these mechanical properties showed a variation with hydrolysis temperature and composition. The differences in mechanical properties were related to the final microstructures of the composites, which are governed by the morphological changes in the polymer structure at its glass transition temperature and the extent of cement-type formation of CDHAp by hydrolysis of alpha-TCP.

Histomorphometric study on high-strength hydroxyapatite/poly(L-lactide) composite rods for internal fixation of bone fractures

The purpose of this study was to investigate the bone-implant interface of high-strength hydroxyapatite (HA)/poly(L-lactide) (PLLA) composite rods. As reinforcing particles, two types of HA particles-calcined HA (c-HA) and uncalcined HA (u-HA)-were applied to allow comparison of their suitability as bioactive fillers. Four types of composites (c-HA30, c-HA40, u-HA30, and u-HA40), which contained 30 or 40% by weight of each HA particle, were used. Unfilled PLLA rods were used as controls. A hole was drilled in the distal femora of 50 rabbits, and a composite or unfilled PLLA rod was implanted in a press-fit manner. Two, 4, 8, and 25 weeks after implantation, the samples were examined histologically by light microscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). An image analyzer was used for histomorphometric analysis of the bone-implant interface. An affinity index was calculated for each material; this was the length of bone directly apposed to the rods expressed as a percentage of the total length of the rod surface. In all the composites, histologic examination showed new bone formation at 2 weeks after implantation. The bone gradually grew along the composite surface. SEM showed direct bone contact with the composites without intervening fibrous tissue. During follow-up, the affinity indices of all the composite rods were significantly higher than those of the unfilled PLLA rods (p < 0.01; two-way ANOVA). The maximum affinity index (41%) was attained at 4 weeks in c-HA40 rods. In contrast, little bone contact was seen in unfilled PLLA rods. The only significant difference in affinity indices among the composites was that c-HA40 had a higher affinity index than u-HA40 (p < 0.05 at 4 weeks). No disintegration of rods or polymer debris, which could elicit inflammatory tissue reactions, was observed even at 25 weeks. Our results indicate that osteoconductive bone formation on composites could enhance the stability between bone and implant in fracture repair.

Biodegradation behavior of ultra-high-strength hydroxyapatite/poly (L-lactide) composite rods for internal fixation of bone fractures

The purpose of this study was to investigate the biodegradation behavior of the ultra-high-strength hydroxyapatite/poly(L-lactide) (HA/PLLA) composite rods for fracture repair. Two kinds of composite materials were used in this study: u-HA/PLLA. which contained 30% by weight of uncalcined HA as reinforcing particles, and c-HA/PLLA, which contained 30% by weight of calcined HA as reinforcing particles. These composite rods were implanted in the subcutis and in the medullary cavities of rabbits. The specimens were removed at specific intervals between 2 and 52 weeks and the mechanical strength was measured for the rods in the subcutis, and the molecular weight and crystallinity were measured for the rods in both the subcutis and medullary cavities. The rod surfaces were examined using a scanning electron microscope (SEM). The specimens were examined histologically by light microscopy. The bending strength of the composites implanted in the subcutis was maintained at more than 200 M Pa at 25 weeks and at 150 MPa at 52 weeks. The molecular weight dropped to 45% of the initial values at 8 weeks and to approximately 10% at 52 weeks. Significant differences in the molecular weight were seen between c-HA/PLLA and u-HA/PLLA, with u-HA/PLLA showing a faster rate of decrease than c-HA/PLLA after 8 weeks. SEM demonstrated that HA particles disappeared increasingly from the rod surfaces over time and that the spaces left by these HA particles formed many pores in the composite surfaces at 52 weeks. Histologically, a fibrous tissue layer was formed around the composite rod from 4 weeks in the subcutis and in the diaphyseal area of the medullary canal. This became more mature over time. Bony tissue contact to the composites without fibrous tissue layers was seen in the metaphyseal area of the medullary canal. During the experimental period, there were no inflammatory cells such as mono- or multi-nuclear phagocytes. Although further long-term studies for degradation are needed, the composites have promising mechanical strength and no adverse tissue reaction for use as fracture-fixation devices during the experimental periods.

Poly(alpha-hydroxyl acids)/hydroxyapatite porous composites for bone-tissue engineering. I. Preparation and morphology

Tissue engineering has shown great promise for creating biological alternatives for implants. In this approach, scaffolding plays a pivotal role. Hydroxyapatite mimics the natural bone mineral and has shown good bone-bonding properties. This paper describes the preparation and morphologies of three-dimensional porous composites from poly(L-lactic acid) (PLLA) or poly(D,L-lactic acid-co-glycolic acid) (PLGA) solution and hydroxyapatite (HAP). A thermally induced phase separation technique was used to create the highly porous composite scaffolds for bone-tissue engineering. Freeze drying of the phase-separated polymer/HAP/solvent mixtures produced hard and tough foams with a co-continuous structure of interconnected pores and a polymer/HAP composite skeleton. The microstructure of the pores and the walls was controlled by varying the polymer concentration, HAP content, quenching temperature, polymer, and solvent utilized. The porosity increased with decreasing polymer concentration and HAP content. Foams with porosity as high as 95% were achieved. Pore sizes ranging from several microns to a few hundred microns were obtained. The composite foams showed a significant improvement in mechanical properties over pure polymer foams. They are promising scaffolds for bone-tissue engineering.

Evaluation of bovine-derived bone protein with a natural coral carrier as a bone-graft substitute in a canine segmental defect model

The efficacy of a bone-graft substitute (bovine-derived bone protein in a carrier of natural coral) in the healing of a segmental defect of a weight-bearing long bone was evaluated. Twenty dogs, divided into two groups, underwent bilateral radial osteotomies with creation of a 2.5 cm defect. On one side of each dog, the defect was filled with autogenous cancellous bone graft. Contralateral defects received, in a blinded randomized fashion, cylindrical implants consisting of natural coral (calcium carbonate) or calcium carbonate enhanced with a standard dose of bovine-derived bone protein (3.0 mg/implant; 0.68 mg bone protein/cm3). The limbs were stabilized with external fixators, and all animals underwent monthly radiographs. They were killed at 12 (group 1) or 24 (group 2) weeks, and regenerated bone was studied by biomechanical testing and histology. Radiographic union developed in all 20 radii with autogenous cancellous bone grafts and in all 10 of the radii with the composite implants. None of the radii with implants of calcium carbonate alone showed radiographic evidence of union. This represented a statistically significant difference between implant types. In addition, calcium carbonate implants both with and without bone protein demonstrated radiographic evidence of near total resorption of the radiodense carrier by 12 weeks. This resorption facilitated radiographic evaluation of healing. Mean values for biomechanical parameters of radii with the composite implants exceeded those for the contralateral controls at 12 and 24 weeks; the difference was statistically significant at 12 weeks. Histology revealed scant residual calcium carbonate carrier at either time in the defects with calcium carbonate implants; however, a moderate amount was present in defects with the composite implants. In these specimens, the residual carrier was completely surrounded by newly formed bone that may have insulated the calcium carbonate from further degradation. The present study used a carrier of granular calcium carbonate reconstituted with bovine type-I collagen to deliver an osteoinductive protein to the defect site. This carrier is of nonhuman origin (eliminating the risk of disease transmission or antigenicity) and resorbs rapidly. In this model, bovine-derived bone protein in a natural coral carrier performed consistently better than the gold standard autogenous cancellous bone graft in terms of the amount of bone formation and strength of the healed defect. This may have implications for removal of hardware or resumption of weight-bearing in certain clinical situations. These data also indicate that coralline calcium carbonate alone represents a poor option as a bone-graft substitute in this critical-sized segmental defect model.