Tensile and compressive properties of cancellous bone

Compressive mechanical properties of dry antler cortical bone cylinders from different cervidae species

Antlers are bony structures composed predominantly of primary osteons with unique mechanical properties due to their specific use by deer as weapon and shield. Antler bone fracture resistance has attracted prior scrutiny through experimental tests and theoretical models. To characterize antler mechanical properties, compression of cubes, or bending or tensioning of rectangular bars have been performed in the literature with variations in the protocols precluding comparisons of the data. Compression testing is a widely used experimental technique for determining the mechanical properties of specimens excised from cortical or cancellous regions of bone. However, the recommended geometry for compression tests is the cylinder, being more representative of the real performances of the material. The purpose of research was to report data for compressive strength and stiffness of antler cortical bone following current guidelines. Cylinders (n = 296) of dry antler cortical bone from either the main beam or the tines of Cervus elaphus, Rangifer tarandus, Cervus nippon and Damadama were tested. This study highlights the fact that compression of antler cortical bone cylinders following current guidelines is feasible but not applicable in all species. Standardization of the testing protocols could help to compare data from the literature. This study also confirms that sample localization has no effect on the mechanical properties, that sample density has a significant impact and allows enriching the knowledge of the mechanical properties of dry antler cortical bone.

Can we achieve biomimetic electrospun scaffolds with gelatin alone?

Introduction: Gelatin is a natural polymer commonly used in biomedical applications in combination with other materials due to its high biocompatibility, biodegradability, and similarity to collagen, principal protein of the extracellular matrix (ECM). The aim of this study was to evaluate the suitability of gelatin as the sole material to manufacture tissue engineering scaffolds by electrospinning. Methods: Gelatin was electrospun in nine different concentrations onto a rotating collector and the resulting scaffold's mechanical properties, morphology and topography were assessed using mechanical testing, scanning electron microscopy and white light interferometry, respectively. After characterizing the scaffolds, the effects of the concentration of the solvents and crosslinking agent were statistically evaluated with multivariate analysis of variance and linear regressions. Results: Fiber diameter and inter-fiber separation increased significantly when the concentration of the solvents, acetic acid (HAc) and dimethyl sulfoxide (DMSO), increased. The roughness of the scaffolds decreased as the concentration of dimethyl sulfoxide increased. The mechanical properties were significantly affected by the DMSO concentration. Immersed crosslinked scaffolds did not degrade until day 28. The manufactured gelatin-based electrospun scaffolds presented comparable mechanical properties to many human tissues such as trabecular bone, gingiva, nasal periosteum, oesophagus and liver tissue. Discussion: This study revealed for the first time that biomimetic electrospun scaffolds with gelatin alone can be produced for a significant number of human tissues by appropriately setting up the levels of factors and their interactions. These findings also extend statistical relationships to a form that would be an excellent starting point for future research that could optimize factors and interactions using both traditional statistics and machine learning techniques to further develop specific human tissue.

An Investigation into the Potential of Turning Induced Deformation Technique for Developing Porous Magnesium and Mg-SiO2 Nanocomposite

A new and novel method of synthesising porous Mg materials has been explored utilising a variant of a processing method previously used for the synthesis of dense Mg materials, namely the turning-induced deformation (TID) method combined with sintering. It was found that the Mg materials synthesised possessed comparable properties to previously-synthesised porous Mg materials in the literature while subsequent sintering resulted in a more consistent mechanical response, with microwave sintering showing the most promise. The materials were also found to possess mechanical response within the range of the human cancellous bone, and when reinforced with biocompatible silica nanoparticles, presented the most optimal combination of mechanical properties for potential use as biodegradable implants due to most similarity with cancellous bone properties.

Biomechanical properties and clinical significance of cancellous bone in proximal femur: A review

Trabecular bone plays an important role in the load-bearing capacity of the femur. Understanding the structural characteristics, biomechanics, and mechanical conduction of the trabecular bone is of great value in studying the mechanism of fractures and formulating surgical plans. The past decade has witnessed unprecedented progress in imaging, biomechanics and finite element analysis techniques, translating into a better understanding of trabecular bone. This article reviews the research progress achieved over the years regarding femoral trabecular bone, especially on factors influencing the strength of the proximal femoral cancellous bone and cancellous bone microfractures and provides a comprehensive overview of the latest findings on proximal femoral trabecular bone and their clinical significance.

A review on bioceramics scaffolds for bone defect in different types of animal models: HA and β -TCP

Increased life expectancy has led to an increase in the use of bone substitutes in numerous nations, with over two million bone-grafting surgeries performed worldwide each year. A bone defect can be caused by trauma, infections, and tissue resections which can self-heal due to the osteoconductive nature of the native extracellular matrix components. However, natural self-healing is time-consuming, and new bone regeneration is slow, especially for large bone defects. It also remains a clinical challenge for surgeons to have a suitable bone substitute. To date, there are numerous potential treatments for bone grafting, including gold-standard autografts, allograft implantation, xenografts, or bone graft substitutes. Tricalcium phosphate (TCP) and hydroxyapatite (HA) are the most extensively used and studied bone substitutes due to their similar chemical composition to bone. The scaffolds should be testedin vivoandin vitrousing suitable animal models to ensure that the biomaterials work effectively as implants. Hence, this article aims to familiarize readers with the most frequently used animal models for biomaterials testing and highlight the available literature for in vivo studies using small and large animal models. This review summarizes the bio ceramic materials, particularly HA and β-TCP scaffolds, for bone defects in small and large animal models. Besides, the design considerations for the pre-clinical animal model selection for bone defect implants are emphasized and presented.

Influence of alumina substrates open porosity on calcium phosphates formation produced by the biomimetic method

We evaluated the influence of the open porosity of alumina (Al₂O₃) substrates on the phase formation of calcium phosphates deposited onto it surface. The Al₂O₃ substrates were prepared with different porosities by the foam-gelcasting method associated with different amounts of polyethylene beads. The substrates were coated biomimetically for 14 and 21 days of incubation in a simulated body fluid (SBF). Scanning electron microscopy characterisation and X-ray computed microtomography showed that the increase in the number of beads provided an increase in the open porosity. The X-ray diffraction and infrared spectroscopy showed that the biomimetic method was able to form different phases of calcium phosphates. It was observed that the increase in the porosity favoured the formation of β-tricalcium phosphate for both incubation periods. The incubation period and the porosity of the substrates can influence the phases and the amount of calcium phosphates formed. Thus, it is possible to target the best application for the biomaterial produced.

Nano-Hydroxyapatite Bone Scaffolds with Different Porous Structures Processed by Digital Light Processing 3D Printing

The morphologies and structures of the scaffold have a significant influence on their mechanical and biological properties. In this work, different types of porous structures: Triply periodic minimal surface-Schwarz primitive (P), body-centered cubic, and cubic pore-shaped (CPS) hydroxyapatite scaffolds with ~70% porosity were fabricated through digital light processing (DLP) 3D printing technology. The compressive properties and in vitro cell evaluations such as cell proliferation and attachment morphology of these scaffolds were systematically compared. The results showed that the CPS scaffolds exhibited the highest compressive strength (~22.5 MPa) and modulus (~400 MPa). In addition, the CPS scaffolds also performed the most active cell metabolisms as compared to other two structures, which may account for the larger pore size and smaller curvature of the substrate. This study provides a general guidance for the fabrication and selection of porous bone scaffolds processed by DLP 3D printing.

Vertebral trabecular bone mechanical properties vary among functional groups of cetaceans

Since their appearance in the fossil record 34 million years ago, modern cetaceans (dolphins, whales, and porpoises) have radiated into diverse habitats circumglobally, developing vast phenotypic variations among species. Traits such as skeletal morphology and ecologically linked behaviors denote swimming activity; trade-offs in flexibility and rigidity along the vertebral column determine patterns of caudal oscillation. Here, we categorized 10 species of cetaceans (families Delphinidae and Kogiidae; N = 21 animals) into functional groups based on vertebral centra morphology, swimming speeds, diving behavior, and inferred swimming patterns. We quantified trabecular bone mechanical properties (yield strength, apparent stiffness, and resilience) among functional groups and regions of the vertebral column (thoracic, lumbar, and caudal). We extracted 6 mm³ samples from vertebral bodies and tested them in compression in 3 orientations (rostrocaudal, dorsoventral, and mediolateral) at 2 mm min⁻¹. Overall, bone from the pre-fluke/fluke boundary had the greatest yield strength and resilience, indicating that the greatest forces are translated to the tail during caudal oscillatory swimming. Group 1, composed of 5 shallow-diving delphinid species, had the greatest vertebral trabecular bone yield strength, apparent stiffness, and resilience of all functional groups. Conversely, Group 3, composed of 2 deep-diving kogiid species, had the least strong, stiff, and resilient bone, while Group 2 (3 deep-diving delphinid species) exhibited intermediate values. These data suggest that species that incorporate prolonged glides during deep descents in the water column actively swim less, and place relatively smaller loads on their vertebral columns, compared with species that execute shallower dives. We found that cetacean vertebral trabecular bone properties differed from the properties of terrestrial mammals; for every given bone strength, cetacean bone was less stiff by comparison. This relative lack of material rigidity within vertebral bone may be attributed to the non-weight-bearing locomotor modes of fully aquatic mammals.

Effect of captivity on the vertebral bone microstructure of xenarthran mammals

Captive specimens in museum collections facilitate study of rare taxa, but the lifestyles, diets, and lifespans of captive animals differ from their wild counterparts. Trabecular bone architecture adapts to in vivo forces, and may reflect interspecific variation in ecology and behavior as well as intraspecific variation between captive and wild specimens. We compared trunk vertebrae bone microstructure in captive and wild xenarthran mammals to test the effects of ecology and captivity. We collected μCT scans of the last six presacral vertebrae in 13 fossorial, terrestrial, and suspensorial xenarthran species (body mass: 120 g to 35 kg). For each vertebra, we measured centrum length; bone volume fraction (BV.TV); trabecular number and mean thickness (Tb.Th); global compactness (GC); cross-sectional area; mean intercept length; star length distribution; and connectivity and connectivity density. Wild specimens have more robust trabeculae, but this varies with species, ecology, and pathology. Wild specimens of fossorial taxa (Dasypus) have more robust trabeculae than captives, but there is no clear difference in bone microstructure between wild and captive specimens of suspensorial taxa (Bradypus, Choloepus), suggesting that locomotor ecology influences the degree to which captivity affects bone microstructure. Captive Tamandua and Myrmecophaga have higher BV.TV, Tb.Th, and GC than their wild counterparts due to captivity-caused bone pathologies. Our results add to the understanding of variation in mammalian bone microstructure, suggest caution when including captive specimens in bone microstructure research, and indicate the need to better replicate the habitats, diets, and behavior of animals in captivity.

Personalized Baghdadite scaffolds: stereolithography, mechanics and in vivo testing

An ongoing challenge in the field of orthopedics is to produce a clinically relevant synthetic ceramic scaffold for the treatment of 'critical-sized' bone defects, which cannot heal without intervention. We had developed a bioactive ceramic (baghdadite, Ca₃ZrSi₂O₉) and demonstrated its outstanding bioactivity using traditional manufacturing techniques. Here, we report on the development of a versatile stereolithography printing technology that enabled fabrication of anatomically-shaped and -sized Baghdadite scaffolds. We assessed the in vivo bioactivity of these scaffolds in co-delivering of bone morphogenetic protein-2 (BMP2) and zoledronic acid (ZA) through bioresorbable coatings to induce bone formation and increase retention in a rat model of heterotopic ossification. Micro-computed tomography, histology, mechanical tests pre- and post-implantation, and mechanical modelling were used to assess bone ingrowth and its effects on the mechanics of the scaffolds. Bone ingrowth and the consequent mechanical properties of the scaffolds improved with increasing BMP2 dose. Co-delivery of ZA with BMP2 further improved this outcome. The significant bone formation within the scaffolds functionalized with 10 µg BMP2 and 2 µg ZA made them 2.3 × stiffer and 2.7 × stronger post-implantation and turned these inherently brittle scaffolds into a tough and deformable material. The effects of bone ingrowth on the mechanical properties of scaffolds were captured in a mechanical model that can be used in future clinical studies for non-destructive evaluation of scaffold's stiffness and strength as new bone forms. These results support the practical utilization of our versatile stereolithographic printing methods and BMP2/ZA functionalization to create fit-for-purpose personalized implants for clinical trials. STATEMENT OF SIGNIFICANCE: In this study, we addressed a long-standing challenge of developing a ceramic printing technology that enables fabrication of customizable anatomically-shaped and -sized bioceramic scaffolds with precise internal architectures using an inexpensive desktop printer. We also addressed another challenge related to delivery of pharmaceuticals. BMP2, currently available as a bone-inducing bioactive protein, is clinically administered in a collagen scaffold that has limited moldability and poor mechanical properties. The comparably stiffer and stronger 3D printed personalized Baghdadite scaffolds developed here can be readily functionalized with bioresorbable coatings containing BMP2 ± ZA. These innovations considerably improve on the prior art and are scalable for use in human surgery.

Application of textile technology in tissue engineering: A review

One of the key elements in tissue engineering is to design and fabricate scaffolds with tissue-like properties. Among various scaffold fabrication methods, textile technology has shown its unique advantages in mimicking human tissues' properties such as hierarchical, anisotropic, and strain-stiffening properties. As essential components in textile technology, textile patterns affect the porosity, architecture, and mechanical properties of textile-based scaffolds. However, the potential of various textile patterns has not been fully explored when fabricating textile-based scaffolds, and the effect of different textile patterns on scaffold properties has not been thoroughly investigated. This review summarizes textile technology development and highlights its application in tissue engineering to facilitate the broader application of textile technology, especially various textile patterns in tissue engineering. The potential of using different textile methods such as weaving, knitting, and braiding to mimic properties of human tissues is discussed, and the effect of process parameters in these methods on fabric properties is summarized. Finally, perspectives on future directions for explorations are presented. STATEMENT OF SIGNIFICANCE: Recently, biomedical engineers have applied textile technology to fabricate scaffolds for tissue engineering applications. Various textile methods, especially weaving, knitting, and braiding, enables engineers to customize the physical, mechanical, and biological properties of scaffolds. However, most textile-based scaffolds only use simple textile patterns, and the effect of different textile patterns on scaffold properties has not been thoroughly investigated. In this review, we cover for the first time the effect of process parameters in different textile methods on fabric properties, exploring the potential of using different textile methods to mimic properties of human tissues. Previous advances in textile technology are presented, and future directions for explorations are presented, hoping to facilitate new breakthroughs of textile-based tissue engineering.

Risk assessment of vertebral compressive fracture using bone mass index and strength predicted by computed tomography image based finite element analysis

BACKGROUND

A main purpose of osteoporosis diagnosis is to evaluate the bone fracture risk. Some bone mass indices evaluated using bone mineral density has been utilized clinically to assess the degree of osteoporosis. On the other hand, Computed tomography image based finite element analysis has been developed to evaluate bone strength of vertebral bodies. The strength of a vertebra is defined as the load at the onset of compressive fracture. The objective of this study was therefore to propose a new feasible method to combine the advantages of the two osteoporotic indices such as the bone mass index and the bone strength.

METHODS

Three-dimensional finite element models of 246 vertebral bodies from 88 patients were constructed using the computed tomography images. Finite element analysis was then conducted to evaluate their strength values. The Pearson's correlation analysis was also conducted between the vertebral strength and bone mass indices.

FINDINGS

It was found that relatively weak positive correlations existed between the strength and the bone mass indices. A new assessment method was then proposed by combining the strength and the bone mass index. "high risk zone" corresponding to low strength with normal bone mass was found from the assessment method.

INTERPRETATION

Singe bone mass index cannot predict the fracture risk with high standard. The results of fracture risk assessment conducted by the new method clearly indicated the necessity and effectiveness to take both the strength and the bone mass index into account.

Effects of autoclaving on compressive strength of bovine bones and their use as chewing agents for dogs

This study aimed to evaluate the effect of autoclave processing on compressive stress of spongy and cortical bones, and the effect of autoclaved bones as chewing agents to reduce dental calculus in adult dogs. Spongy and cortical bones were autoclaved (1 ATM, 30 min, and 120°C) and compressive strength was evaluated in autoclaved and raw bone specimens. Autoclaved bones were offered to ten Beagle dogs divided into two groups of 5 dogs each: Group 1 – received a portion of the autoclaved bovine cortical bone (ACB) and Group 2 – received a portion of the autoclaved bovine spongy bone (ASB). Prior to the experimental period (1-d) and every two days thereafter, oral photographs were taken on both sides of the dental arch to evaluate dental calculus reduction over time. The vestibular surface of the canines, premolars, and molars teeth was evaluated using integration software to measure the proportion between the area covered by calculus and the total teeth area. The effect of bone type, treatment (raw vs. autoclaved), and their interaction were evaluated using the PROC GLIMMIX procedure of SAS (version 9.4). Linear equations were generated to estimate calculus reduction over time for ACB and ASB. Compressive strength was higher (P < 0.05) in cortical bones compared to spongy bones. However, the autoclaving procedure did not affect (P > 0.05) compressive strength, regardless of the bone type. The teeth area covered by calculus of dogs that were offered ACB reduced from 41% to 32% in 5 days, and at the end of 15 days a reduction of 62.2% was observed, resulting in a remaining of 15.5% of teeth area covered by calculus. In this group, the dental calculus area reduced by 57.7% after 5 days, and at the end of the trial, only 5.4% of teeth were still covered by calculus, which represents a reduction of 81%. The linear regression analysis revealed no significant difference between the slopes for the ACB and ASB equations (P > 0.05). No health complications such as tooth fracture, intestinal obstructions, and oral lesions were observed throughout the study. Our results demonstrated that the autoclave processing did not impair compressive strength of spongy and cortical bones. This corroborates with the results observed in vivo, which suggests that autoclaved bones are chewing agents for adult dogs with additional benefits of lower risk of bacterial contamination.

Bioactive Cellulose Nanocrystal-Poly(ε-Caprolactone) Nanocomposites for Bone Tissue Engineering Applications

3D-printed bone scaffolds hold great promise for the individualized treatment of critical-size bone defects. Among the resorbable polymers available for use as 3D-printable scaffold materials, poly(ε-caprolactone) (PCL) has many benefits. However, its relatively low stiffness and lack of bioactivity limit its use in load-bearing bone scaffolds. This study tests the hypothesis that surface-oxidized cellulose nanocrystals (SO-CNCs), decorated with carboxyl groups, can act as multi-functional scaffold additives that (1) improve the mechanical properties of PCL and (2) induce biomineral formation upon PCL resorption. To this end, an in vitro biomineralization study was performed to assess the ability of SO-CNCs to induce the formation of calcium phosphate minerals. In addition, PCL nanocomposites containing different amounts of SO-CNCs (1, 2, 3, 5, and 10 wt%) were prepared using melt compounding extrusion and characterized in terms of Young's modulus, ultimate tensile strength, crystallinity, thermal transitions, and water contact angle. Neither sulfuric acid-hydrolyzed CNCs (SH-CNCs) nor SO-CNCs were toxic to MC3T3 preosteoblasts during a 24 h exposure at concentrations ranging from 0.25 to 3.0 mg/mL. SO-CNCs were more effective at inducing mineral formation than SH-CNCs in simulated body fluid (1x). An SO-CNC content of 10 wt% in the PCL matrix caused a more than 2-fold increase in Young's modulus (stiffness) and a more than 60% increase in ultimate tensile strength. The matrix glass transition and melting temperatures were not affected by the SO-CNCs but the crystallization temperature increased by about 5.5°C upon addition of 10 wt% SO-CNCs, the matrix crystallinity decreased from about 43 to about 40%, and the water contact angle decreased from 87 to 82.6°. The abilities of SO-CNCs to induce calcium phosphate mineral formation and increase the Young's modulus of PCL render them attractive for applications as multi-functional nanoscale additives in PCL-based bone scaffolds.

A Review on Recent Advances in the Constitutive Modeling of Bone Tissue

PURPOSE OF REVIEW

Image-based finite element analysis (FEA) to predict and understand the biomechanical response has become an essential methodology in musculoskeletal research. An important part of such simulation models is the constitutive material model of which recent advances are summarized in this review.

RECENT FINDINGS

The review shows that existing models from other fields were introduced, such as cohesion zone (cortical bone) or phase-field models (trabecular bone). Some progress has been made in describing cortical bone involving physical mechanisms such as microcracks. Problems with validations at different length scales remain a problem. The improvement of recent constitutive models is partially obscured by uncertainties that affect overall predictions, such as image quality and calibration or boundary conditions. Nevertheless, in vivo CT-based FEA simulations based on a sophisticated constitutive behavior are a very valuable tool for clinical-related osteoporosis research.

Human metabolite-derived alkylsuccinate/dilinoleate copolymers: from synthesis to application

The advances in polymer chemistry have allowed the preparation of biomedical polymers using human metabolites as monomers that can hold unique properties beyond the required biodegradability and biocompatibility. Herein, we demonstrate the use of endogenous human metabolites (succinic and dilinoleic acids) as monomeric building blocks to develop a new series of renewable resource-based biodegradable and biocompatible copolyesters. The novel copolyesters were characterized in detail employing several standard techniques, namely 1H NMR, 13C NMR, and FTIR spectroscopy and SEC, followed by an in-depth thermomechanical and surface characterization of their resulting thin films (DSC, TGA, DMTA, tensile tests, AFM, and contact angle measurements). Also, their anti-fungal biofilm properties were assessed via an anti-fungal biofilm assay and the biological properties were evaluated in vitro using relevant human-derived cells (human mesenchymal stem cells and normal human dermal fibroblasts). These novel highly biocompatible polymers are simple and cheap to prepare, and their synthesis can be easily scaled-up. They presented good mechanical, thermal and anti-fungal biofilm properties while also promoting cell attachment and proliferation, outperforming well-known polymers used for biomedical applications (e.g. PVC, PLGA, and PCL). Moreover, they induced morphological changes in the cells, which were dependent on the structural characteristics of the polymers. In addition, the obtained physicochemical and biological properties can be design-tuned by the synthesis of homo- and -copolymers through the selection of the diol moiety (ES, PS, or BS) and by the addition of a co-monomer, DLA. Consequently, the copolyesters presented herein have high application potential as renewable and cost-effective biopolymers for various biomedical applications.

Fabrication of polylactic acid (PLA)-based porous scaffold through the combination of traditional bio-fabrication and 3D printing technology for bone regeneration

Artificial bone grafts possess the advantages of good biodegradability, customizable dimensions, and sufficient mechanical properties, which can promote cell proliferation and differentiation in bone tissue regeneration. 3D printing is a delicate approach that endows the scaffolds with excellent controllability and repeatability when compared with conventional bio-fabrication methods. However, the limitation of printing resolution somehow makes it difficult to prepare bone defect substitution with high porosity and hierarchical construct. In this study, we utilized polylactic acid (PLA) as printing materials and developed a smart strategy to combine 3D printing technology with bio-fabrication methods. A porous planar scaffold was printed and then rolled up into a spiral structure with adjustable pore size and porosity. The topographic features and morphology of the artificial scaffolds were examined through stereomicroscope and SEM, respectively. The porous spiral scaffold presented good mechanical properties in a set of mechanical testing. Later, the human fetal osteoblasts (hFOB) were cultured on the porous spiral scaffold and its control groups for a total of 28 days. The MTS analysis, alkaline phosphatase (ALP) assay, and alizarin red S (ARS) staining were used to analyze the cell proliferation, osteogenic differentiation, and mineral deposition after a certain period of time. The results indicated that compared with the other two scaffolds, the porous spiral scaffold with larger surface area and better interconnections between internal porous networks could significantly improve the spatial cell compartment and promote cell growth and differentiation. The porous spiral scaffold may see versatile applications in large-volume bone defects regeneration.

Tough magnesium phosphate-based 3D-printed implants induce bone regeneration in an equine defect model

One of the important challenges in bone tissue engineering is the development of biodegradable bone substitutes with appropriate mechanical and biological properties for the treatment of larger defects and those with complex shapes. Recently, magnesium phosphate (MgP) doped with biologically active ions like strontium (Sr²⁺) have shown to significantly enhance bone formation when compared with the standard calcium phosphate-based ceramics. However, such materials can hardly be shaped into large and complex geometries and more importantly lack the adequate mechanical properties for the treatment of load-bearing bone defects. In this study, we have fabricated bone implants through extrusion assisted three-dimensional (3D) printing of MgP ceramics modified with Sr²⁺ ions (MgPSr) and a medical-grade polycaprolactone (PCL) polymer phase. MgPSr with 30 wt% PCL (MgPSr-PCL30) allowed the printability of relevant size structures (>780 mm³) at room temperature with an interconnected macroporosity of approximately 40%. The printing resulted in implants with a compressive strength of 4.3 MPa, which were able to support up to 50 cycles of loading without plastic deformation. Notably, MgPSr-PCL30 scaffolds were able to promote in vitro bone formation in medium without the supplementation with osteo-inducing components. In addition, long-term in vivo performance of the 3D printed scaffolds was investigated in an equine tuber coxae model over 6 months. The micro-CT and histological analysis showed that implantation of MgPSr-PCL30 induced bone regeneration, while no bone formation was observed in the empty defects. Overall, the novel polymer-modified MgP ceramic material and extrusion-based 3D printing process presented here greatly improved the shape ability and load-bearing properties of MgP-based ceramics with simultaneous induction of new bone formation.

Prediction of failure in cancellous bone using extended finite element method

The objective of our study is to develop extended finite element method models of cancellous bone specimens that are capable of accurately predicting the onset and propagation of cracks under mechanical loading. In order to do so, previously published three-point bending test results of a single trabecula were replicated using two different extended finite element method approaches, namely, elastic-plastic-fracture and elastic-fracture that considered different configurations of the elasto-plastic properties of bone from which the best approach to fit the experimental data was identified. The behavior of a single trabecula was then used in 2D extended finite element method models to quantify the strength of the trabecular tissue of the forearm along three perpendicular anatomical axes. The results revealed that the elastic-plastic-fracture model better represented the experimental data in the model of a single trabecula. Considering the 2D trabecular specimens, the elastic fracture model predicted higher strength than the elastic-plastic-fracture model and there was no difference in stiffness between the two models. In general, the specimens exhibited higher failure strain and more ductile behavior in compression than in tension. In addition, strength and stiffness were found to be higher in tension than compression on average. It can be concluded that with proper parameters, extended finite element method is capable of simulating the ductile behavior of cancellous bone. The models are able to quantify the tensile strength of trabecular tissue in the various anatomical directions reporting an increased strength in the longitudinal direction of forearm cancellous bone tissue. Extended finite element method of cancellous bone proves to be a valuable tool to predict the mechanical characteristics of cancellous bones as a function of the microstructure.

Polymer-Bioactive Glass Composite Filaments for 3D Scaffold Manufacturing by Fused Deposition Modeling: Fabrication and Characterization

Critical size bone defects are regularly treated by auto- and allograft transplantation. However, such treatments require to harvest bone from patient donor sites, with often limited tissue availability or risk of donor site morbidity. Not requiring bone donation, three-dimensionally (3D) printed implants and biomaterial-based tissue engineering (TE) strategies promise to be the next generation therapies for bone regeneration. We present here polylactic acid (PLA)-bioactive glass (BG) composite scaffolds manufactured by fused deposition modeling (FDM), involving the fabrication of PLA-BG composite filaments which are used to 3D print controlled open-porous and osteoinductive scaffolds. We demonstrated the printability of PLA-BG filaments as well as the bioactivity and cytocompatibility of PLA-BG scaffolds using pre-osteoblast MC3T3E1 cells. Gene expression analyses indicated the beneficial impact of BG inclusions in FDM scaffolds regarding osteoinduction, as BG inclusions lead to increased osteogenic differentiation of human adipose-derived stem cells in comparison to pristine PLA. Our findings confirm that FDM is a convenient additive manufacturing technology to develop PLA-BG composite scaffolds suitable for bone tissue engineering.

Empirical relationships between bone density and ultimate strength: A literature review

INTRODUCTION

Ultimate strength-density relationships for bone have been reported with widely varying results. Reliable bone strength predictions are crucial for many applications that aim to assess bone failure. Bone density and bone morphology have been proposed to explain most of the variance in measured bone strength. If this holds true, it could lead to the derivation of a single ultimate strength-density-morphology relationship for all anatomical sites.

METHODS

All relevant literature was reviewed. Ultimate strength-density relationships derived from mechanical testing of human bone tissue were included. The reported relationships were translated to ultimate strength-apparent density relationships and normalized with respect to strain rate. Results were grouped based on bone tissue type (cancellous or cortical), anatomical site, and loading mode (tension vs. compression). When possible, the relationships were compared to existing ultimate strength-density-morphology relationships.

RESULTS

Relationships that considered bone density and morphology covered the full spectrum of eight-fold inter-study difference in reported compressive ultimate strength-density relationships for trabecular bone. This was true for studies that tested specimens in different loading direction and tissue from different anatomical sites. Sparse data was found for ultimate strength-density relationships in tension and for cortical bone properties transverse to the main loading axis of the bone.

CONCLUSIONS

Ultimate strength-density-morphology relationships could explain measured strength across anatomical sites and loading directions. We recommend testing of bone specimens in other directions than along the main trabecular alignment and to include bone morphology in studies that investigate bone material properties. The lack of tensile strength data did not allow for drawing conclusions on ultimate strength-density-morphology relationships. Further studies are needed. Ideally, these studies would investigate both tensile and compressive strength-density relationships, including morphology, to close this gap and lead to more accurate evaluation of bone failure.

Accelerating bone defects healing in calvarial defect model using 3D cultured bone marrow-derived mesenchymal stem cells on demineralized bone particle scaffold

Bone defects are usually difficult to be regenerated due to pathological states or the size of the injury. Researchers are focusing on tissue engineering approaches in order to drive the regenerative events, using stem cells to regenerate bone. The purpose of this study is to evaluate the osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs) on biologically derived Gallus gallus domesticus-derived demineralized bone particle (GDD) sponge. The sponges were prepared by freeze-drying method using 1, 2, and 3 wt% GDD and cross-linked with glutaraldehyde. The GDD sponge was characterized using scanning electron microscopy, compressive strength, porosity, and Fourier transform infrared. The potential bioactivity of the sponge was evaluated by osteogenic differentiation of BMSCs using 3(4, dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay and quantifying alkaline phosphatase (ALP) activity. in vivo experiments were evaluated through a micro-computerized tomography (μ-CT) and histological assays. The analysis confirmed that an increase in the concentration of the GDD in the sponge leads to a higher bone formation and deposition in rat calvarial defects. Histological assay results were in line with μ-CT. The results reported in this study demonstrated the potential application of GDD sponges as osteoinductor in bone tissue engineering in pathological or nonunion bone defects.

Three-dimensional distribution of cystic lesions in osteonecrosis of the femoral head

Purpose

The aim of this study was to investigate the location characteristics of cystic lesions in a three-dimensional context and discuss the mechanism of formation.

Methods

A total of 155 femoral head computed tomography images from 94 patients diagnosed with stage II and III osteonecrosis of the femoral head were retrospectively reviewed. Three-dimensional structures of the femoral head including the cystic lesions and necrotic area were reconstructed. We divided each femoral head into eight regions to observe the positional relationship of the cystic lesions, normal areas, and necrotic areas.

Results

The regional distribution revealed 14 (13%), 35 (32%), 9 (8%), 25 (23%), 6 (6%), 15 (14%), 4 (4%), and 0 (0%) cystic lesions in regions Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ, Ⅵ, Ⅶ, and Ⅷ, respectively. The anteromedial zone, A (Ⅰ ​+ ​Ⅲ), contained 22% of the lesions, anterolateral zone, B (Ⅱ ​+ ​Ⅳ), contained 54%, posteromedial zone, C (Ⅴ +Ⅶ), contained 9% of the lesions, and posterolateral zone, D (Ⅵ ​+ ​Ⅷ), contained 15% of the lesions. Most of the cystic lesions (78%) were located between the normal and necrotic areas; 18% of cystic lesions were in the necrotic area ​and 4% were in the normal area.

Conclusions

Cystic lesions most often occur at the junction of the necrotic ​and normal areas and are most commonly located in the anterolateral femoral head, which is similar to the distribution of the stress concentration region.

The translational potential of this article

The study showed the location characteristics of cystic lesions in osteonecrosis of femoral head, which suggested that the formation of cystic lesions may be related to stress and could accelerate the collapse of femoral head. The results can support further research on cystic lesions and provide a reference for doctors' treatment strategies for patients with osteonecrosis of femoral head.

Symptomatic stress reaction of the humerus in a professional cricketer

A symptomatic bone stress reaction is an early pathological feature, which can lead to stress fractures. It typically affects bones of the lower limbs in response to unaccustomed disproportional compressive loading. Professional sportspeople are susceptible to both bone stress reaction and stress fractures, where training regimes and competition predispose to overuse injuries. We discuss a unique case of a professional cricketer developing pain in the throwing arm due to bone stress reaction in the distal humerus, as confirmed on MRI. Modification of the patient's training regime, presented in this case, facilitated complete recovery within 6 weeks. The positive response to modified training suggests a biomechanical origin of the pain. This case illustrates that tensile stress associated with throwing activities can result in a symptomatic bone stress reaction of the humerus in elite cricketers.

Preparation of electrospun nanofibers with desired microstructures using a programmed three-dimensional (3D) nanofiber collector

The traditional electrospinning process produces dense two-dimensional (2D) nanofiber (NF) sheets that limit cell infiltration and proliferation. Our previous study demonstrated that 3D NF sheets could be formed on an NF collector surface mounted with multiple movable needles through the corona discharge. In this study, we developed a programmed electrospun 3D NF collector. It can precisely control the moving speed of NF collector during electrospinning; thereby fabricating 3D NFs with desired microstructures (pore size, pore volume, and interconnectivity). Four types of polycaprolactone (PCL) 3D NF matrices with different microstructures can be obtained concurrently on the NF collector surface, which are set by different forward moving speed of the NF collector device: NF-zero (no move, as control), NF-low (0.085 mm/min), NF-mid (0.158 mm/min) and NF-high (0.232 mm/min). A linear increase of the NF sheet thickness (from 0.21 mm to 0.91 mm) was recorded with accelerating collector movement. Quantitative analysis using scanning electron microscopy (SEM), micro-computed tomography (μ-CT), and confocal laser scanning microscopy (CLSM) showed a monotonic increase of pore size and porosity with the increase of collector moving speeds. The collector movement also impacted the crystallinity and mechanical properties of the NFs. When prepared at high collector speed, the NFs showed improved proliferation and differentiation (p < .05) of pre-osteoblastic MC3T3 cells compared to the NFs from the static collector. A programmed NF collector device allows for the reproducible, precise and continuous fabrication of 3D NFs with tailorable geometry and microstructures. This simple, controllable, one-step process could promote the clinical translation of electrospun NFs in tissue engineering and regenerative medicine.

Modulating matrix-multicellular response using polysucrose-blended with poly-L-lactide or polydioxanone in electrospun scaffolds for skin tissue regeneration

Polysucrose (PSuc) is hydrophilic, has excellent biocompatibility with cells as a density gradient and is resistant to enzymes. Its use in electrospun mats for tissue engineering applications has not been investigated due to its amorphous nature. For spinnability and robustness, polysucrose was blended with poly-L-lactide (PLLA) and polydioxanone (PDX) respectively and electrospun into nanofibrous mats. Interaction with cells was assessed using L929 mouse fibroblasts and HaCaT keratinocytes separately and in co-culture. Effect of parameters such as porosity, fiber diameter, surface wettability and mechanical properties of mats on cell-scaffold interactions was studied. Depending on nature and composition of mats, fibroblasts showed dendritic, spindle or round cell morphologies along with the formation of lamellipodia, filopodia, fibrillar or fiber-like projections of 100 nm and 200-300 nm in diameter respectively from the periphery or center of cells. Granular extracellular matrix was formed on both PLLA-PSuc and PDX-PSuc 50-50 seeded with keratinocytes. Growth of keratinocytes was enhanced in co-culture with fibroblasts with the formation of a skin-like layer. Both cells showed the ability to form multilayer structures. The mats maintained their physical integrity during the period of study. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 3275-3291, 2018.

The Multi-Axial Failure Response of Porcine Trabecular Skull Bone Estimated Using Microstructural Simulations

The development of a multi-axial failure criterion for trabecular skull bone has many clinical and biological implications. This failure criterion would allow for modeling of bone under daily loading scenarios that typically are multi-axial in nature. Some yield criteria have been developed to evaluate the failure of trabecular bone, but there is a little consensus among them. To help gain deeper understanding of multi-axial failure response of trabecular skull bone, we developed 30 microstructural finite element models of porous porcine skull bone and subjected them to multi-axial displacement loading simulations that spanned three-dimensional (3D) stress and strain space. High-resolution microcomputed tomography (microCT) scans of porcine trabecular bone were obtained and used to develop the meshes used for finite element simulations. In total, 376 unique multi-axial loading cases were simulated for each of the 30 microstructure models. Then, results from the total of 11,280 simulations (approximately 135,360 central processing unit-hours) were used to develop a mathematical expression, which describes the average three-dimensional yield surface in strain space. Our results indicate that the yield strain of porcine trabecular bone under multi-axial loading is nearly isotropic and despite a spread of yielding points between the 30 different microstructures, no significant relationship between the yield strain and bone volume fraction is observed. The proposed yield equation has simple format and it can be implemented into a macroscopic model for the prediction of failure of whole bones.

Standardizing compression testing for measuring the stiffness of human bone

Objectives

The ability to determine human bone stiffness is of clinical relevance in many fields, including bone quality assessment and orthopaedic prosthesis design. Stiffness can be measured using compression testing, an experimental technique commonly used to test bone specimens in vitro. This systematic review aims to determine how best to perform compression testing of human bone.

Methods

A keyword search of all English language articles up until December 2017 of compression testing of bone was undertaken in Medline, Embase, PubMed, and Scopus databases. Studies using bulk tissue, animal tissue, whole bone, or testing techniques other than compression testing were excluded.

Results

A total of 4712 abstracts were retrieved, with 177 papers included in the analysis; 20 studies directly analyzed the compression testing technique to improve the accuracy of testing. Several influencing factors should be considered when testing bone samples in compression. These include the method of data analysis, specimen storage, specimen preparation, testing configuration, and loading protocol.

Conclusion

Compression testing is a widely used technique for measuring the stiffness of bone but there is a great deal of inter-study variation in experimental techniques across the literature. Based on best evidence from the literature, suggestions for bone compression testing are made in this review, although further studies are needed to establish standardized bone testing techniques in order to increase the comparability and reliability of bone stiffness studies.

Cite this article: S. Zhao, M. Arnold, S. Ma, R. L. Abel, J. P. Cobb, U. Hansen, O. Boughton. Standardizing compression testing for measuring the stiffness of human bone. Bone Joint Res 2018;7:524–538. DOI: 10.1302/2046-3758.78.BJR-2018-0025.R1.

The challenges of promoting osteogenesis in segmental bone defects and osteoporosis

Conventional clinical management of complex bone healing scenarios continues to result in 5-10% of fractures forming non-unions. Additionally, the aging population and prevalence of osteoporosis-related fractures necessitate the further exploration of novel ways to augment osteogenesis in this special population. This review focuses on the current clinical modalities available, and the ongoing clinical and pre-clinical research to promote osteogenesis in segmental bone defects, delayed unions, and osteoporosis. In summary, animal models of fracture repair are often small animals as historically significant large animal models, like the dog, continue to gain favor as companion animals. Small rodents have well-documented limitations in comparing to fracture repair in humans, and few similarities exist. Study design, number of studies, and availability of funding continue to limit large animal studies. Osteoinduction with rhBMP-2 results in robust bone formation, although long-term quality is scrutinized due to poor bone mineral quality. PTH 1-34 is the only FDA approved osteo-anabolic treatment to prevent osteoporotic fractures. Limited to 2 years of clinical use, PTH 1-34 has further been plagued by dose-related ambiguities and inconsistent results when applied to pathologic fractures in systematic human clinical studies. There is limited animal data of PTH 1-34 applied locally to bone defects. Gene therapy continues to gain popularity among researchers to augment bone healing. Non-integrating viral vectors and targeted apoptosis of genetically modified therapeutic cells is an ongoing area of research. Finally, progenitor cell therapies and the content variation of patient-side treatments (e.g., PRP and BMAC) are being studied. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1559-1572, 2018.

Biodegradation and mechanical behavior of an advanced bioceramic-containing Mg matrix composite synthesized through in-situ solid-state oxidation

Recent studies have shown great potential of Mg matrix composites for biodegradable orthopedic devices. However, the poor structural integrity of these composites, which results in excessive localized corrosion and premature mechanical failure, has hindered their widespread applications. In this research, an in-situ Powder Metallurgy (PM) method was used to fabricate a novel biodegradable Mg-bredigite composite and to achieve enhanced chemical interfacial locking between the constituents by triggering a solid-state thermochemical reaction between Mg and bredigite particles. The reaction resulted in a highly densified and integrated microstructure, which prevented corrosion pits from propagating when the composite was immersed in a physiological solution. In addition, chemical interlocking between the constituents prohibited interparticle fracture and subsequent surface delamination during compression testing, enabling the composite to withstand larger plastic deformation before mechanical failure. Furthermore, the composite was proven to be biocompatible and capable of maintaining its ultimate compressive strength in the strength range of cortical bone after 25-day immersion in DMEM. The research provided the necessary information to guide further research towards the development of a next generation of biodegradable Mg matrix composites with enhanced chemical interlocking.

Fabrication of Trabecular Bone-Templated Tissue-Engineered Constructs by 3D Inkjet Printing

3D printing enables the creation of scaffolds with precisely controlled morphometric properties for multiple tissue types, including musculoskeletal tissues such as cartilage and bone. Computed tomography (CT) imaging has been combined with 3D printing to fabricate anatomically scaled patient-specific scaffolds for bone regeneration. However, anatomically scaled scaffolds typically lack sufficient resolution to recapitulate the <100 micrometer-scale trabecular architecture essential for investigating the cellular response to the morphometric properties of bone. In this study, it is hypothesized that the architecture of trabecular bone regulates osteoblast differentiation and mineralization. To test this hypothesis, human bone-templated 3D constructs are fabricated via a new micro-CT/3D inkjet printing process. It is shown that this process reproducibly fabricates bone-templated constructs that recapitulate the anatomic site-specific morphometric properties of trabecular bone. A significant correlation is observed between the structure model index (a morphometric parameter related to surface curvature) and the degree of mineralization of human mesenchymal stem cells, with more concave surfaces promoting more extensive osteoblast differentiation and mineralization compared to predominately convex surfaces. These findings highlight the significant effects of trabecular architecture on osteoblast function.

A self-organising biomimetic collagen/nano-hydroxyapatite-glycosaminoglycan scaffold for spinal fusion

The use of spinal fusion surgery as a treatment for degenerative spinal conditions and chronic back pain is increasing. However, this technique requires use of a bone grafting material to fuse the vertebrae, traditionally autologous bone, which consists of an optimal combination of osteogenic cell precursors, extracellular matrix proteins and mineral components. To date, this remains the 'gold standard' material but its supply is limited and is associated with a number of clinical and ethical difficulties; consequently, various combinations of cells with biological scaffold materials have been tested but have failed to achieve fusion rates even comparable to autologous bone. We successfully fabricated a novel collagen-based scaffold using self-organising atelocollagen combined with nano-hydroxyapatite and chondroitin sulphate, cross-linked by microbial transglutaminase. The scaffold was characterised using a range of imaging, chemical composition and thermal analysis techniques. It was found to exhibit appropriate stiffness and suitable pore size for the adhesion, growth and differentiation of MSCs. The low toxicity makes it suitable for clinical application, and its slow degradation profile would enable the scaffold to promote bone growth over an extended period. This material therefore shows promise for clinical use in spinal fusion and other procedures requiring the use of bone grafts.

Nano/Micro-Manufacturing of Bioinspired Materials: a Review of Methods to Mimic Natural Structures

Through billions of years of evolution and natural selection, biological systems have developed strategies to achieve advantageous unification between structure and bulk properties. The discovery of these fascinating properties and phenomena has triggered increasing interest in identifying characteristics of biological materials, through modern characterization and modeling techniques. In an effort to produce better engineered materials, scientists and engineers have developed new methods and approaches to construct artificial advanced materials that resemble natural architecture and function. A brief review of typical naturally occurring materials is presented here, with a focus on chemical composition, nano-structure, and architecture. The critical mechanisms underlying their properties are summarized, with a particular emphasis on the role of material architecture. A review of recent progress on the nano/micro-manufacturing of bio-inspired hybrid materials is then presented in detail. In this case, the focus is on nacre and bone-inspired structural materials, petals and gecko foot-inspired adhesive films, lotus and mosquito eye inspired superhydrophobic materials, brittlestar and Morpho butterfly-inspired photonic structured coatings. Finally, some applications, current challenges and future directions with regard to manufacturing bio-inspired hybrid materials are provided.

Reducing Escherichia coli growth on a composite biomaterial by a surface immobilized antimicrobial peptide

A new composite bioceramic consisting of calcium aluminum oxide (CaAlO) and hydroxyapatite (HA) was functionalized with the synthetic antimicrobial peptide Inverso-CysHHC10. CaAlO is a bioceramic that can be mold cast easily and quickly at room temperature. Improved functionality was previously achieved through surface reactions. Here, composites containing 0-5% HA (by mass) were prepared and the elastic modulus and modulus of rupture were mechanically similar to non-load bearing bone. The addition of hydroxyapatite resulted in increased osteoblast attachment (>180%) and proliferation (>140%) on all composites compared to 100% CaAlO. Antimicrobial peptide (AMP) immobilization was achieved using an interfacial alkene-thiol click reaction. The linked AMP persisted on the composite (>99.6% after 24h) and retained its activity against Escherichia coli based on N-phenylnaphthylamine uptake and bacterial turbidity tests. Overall, this simple scaffold system improves osteoblast activity and reduces bacterial activity.

Modeling the Mechanical Consequences of Age-Related Trabecular Bone Loss by XFEM Simulation

The elderly are more likely to suffer from fracture because of age-related trabecular bone loss. Different bone loss locations and patterns have different effects on bone mechanical properties. Extended finite element method (XFEM) can simulate fracture process and was suited to investigate the effects of bone loss on trabecular bone. Age-related bone loss is indicated by trabecular thinning and loss and may occur at low-strain locations or other random sites. Accordingly, several ideal normal and aged trabecular bone models were created based on different bone loss locations and patterns; then, fracture processes from crack initiation to complete failure of these models were observed by XFEM; finally, the effects of different locations and patterns on trabecular bone were compared. Results indicated that bone loss occurring at low-strain locations was more detrimental to trabecular bone than that occurring at other random sites; meanwhile, the decrease in bone strength caused by trabecular loss was higher than that caused by trabecular thinning, and the effects of vertical trabecular loss on mechanical properties were more severe than horizontal trabecular loss. This study provided a numerical method to simulate trabecular bone fracture and distinguished different effects of the possible occurrence of bone loss locations and patterns on trabecular bone.

Strength reliability and in vitro degradation of three-dimensional powder printed strontium-substituted magnesium phosphate scaffolds

Strontium ions (Sr(2+)) are known to prevent osteoporosis and also encourage bone formation. Such twin requirements have motivated researchers to develop Sr-substituted biomaterials for orthopaedic applications. The present study demonstrates a new concept of developing Sr-substituted Mg3(PO4)2 - based biodegradable scaffolds. In particular, this work reports the fabrication, mechanical properties with an emphasis on strength reliability as well as in vitro degradation of highly biodegradable strontium-incorporated magnesium phosphate cements. These implantable scaffolds were fabricated using three-dimensional powder printing, followed by high temperature sintering and/or chemical conversion, a technique adaptable to develop patient-specific implants. A moderate combination of strength properties of 36.7MPa (compression), 24.2MPa (bending) and 10.7MPa (tension) were measured. A reasonably modest Weibull modulus of up to 8.8 was recorded after uniaxial compression or diametral tensile tests on 3D printed scaffolds. A comparison among scaffolds with varying compositions or among sintered or chemically hardened scaffolds reveals that the strength reliability is not compromised in Sr-substituted scaffolds compared to baseline Mg3(PO4)2. The micro-computed tomography analysis reveals the presence of highly interconnected porous architecture in three-dimension with lognormal pore size distribution having median in the range of 17.74-26.29μm for the investigated scaffolds. The results of extensive in vitro ion release study revealed passive degradation with a reduced Mg(2+) release and slow but sustained release of Sr(2+) from strontium-substituted magnesium phosphate scaffolds. Taken together, the present study unequivocally illustrates that the newly designed Sr-substituted magnesium phosphate scaffolds with good strength reliability could be used for biomedical applications requiring consistent Sr(2+)- release, while the scaffold degrades in physiological medium.

STATEMENT OF SIGNIFICANCE

The study investigates the additive manufacturing of scaffolds based on different strontium-substituted magnesium phosphate bone cements by means of three-dimensional powder printing technique (3DPP). Magnesium phosphates were chosen due to their higher biodegradability compared to calcium phosphates, which is due to both a higher solubility as well as the absence of phase changes (to low soluble hydroxyapatite) in vivo. Since strontium ions are known to promote bone formation by stimulating osteoblast growth, we aimed to establish such a highly degradable magnesium phosphate ceramic with an enhanced bioactivity for new bone ingrowth. After post-processing, mechanical strengths of up to 36.7MPa (compression), 24.2MPa (bending) and 10.7MPa (tension) could be achieved. Simultaneously, the failure reliability of those bioceramic implant materials, measured by Weibull modulus calculations, were in the range of 4.3-8.8. Passive dissolution studies in vitro proved an ion release of Mg(2+) and PO4(3-) as well as Sr(2+), which is fundamental for in vivo degradation and a bone growth promoting effect. In our opinion, this work broadens the range of bioceramic bone replacement materials suitable for additive manufacturing processing. The high biodegradability of MPC ceramics together with the anticipated promoting effect on osseointegration opens up the way for a patient-specific treatment with the prospect of a fast and complete healing of bone fractures.

Chitosan based biocomposite scaffolds for bone tissue engineering

The clinical demand for scaffolds and the diversity of available polymers provide freedom in the fabrication of scaffolds to achieve successful progress in bone tissue engineering (BTE). Chitosan (CS) has drawn much of the attention in recent years for its use as graft material either as alone or in a combination with other materials in BTE. The scaffolds should possess a number of properties like porosity, biocompatibility, water retention, protein adsorption, mechanical strength, biomineralization and biodegradability suited for BTE applications. In this review, CS and its properties, and the role of CS along with other polymeric and ceramic materials as scaffolds for bone tissue repair applications are highlighted.