Strong and bioactive bioinspired biomaterials, next generation of bone adhesives

Hydrogel adhesives for tissue recovery

Hydrogel adhesives (HAs) are promising and rewarding tools for improving tissue therapy management. Such HAs had excellent properties and potential applications in biological tissues, such as suture replacement, long-term administration, and hemostatic sealing. In this review, the common designs and the latest progress of HAs based on various methodologies are systematically concluded. Thereafter, how to deal with interfacial water to form a robust wet adhesion and how to balance the adhesion and non-adhesion are underlined. This review also provides a brief description of gelation strategies and raw materials. Finally, the potentials of wound healing, hemostatic sealing, controlled drug delivery, and the current applications in dermal, dental, ocular, cardiac, stomach, and bone tissues are discussed. The comprehensive insight in this review will inspire more novel and practical HAs in the future.

A magnesium calcium phosphate-based cement as a bone adhesive: characterization and biomechanical evaluation

BACKGROUND

Usually, comminuted fractures contain fragments that are too small for fixation with Kirschner (K)-wires or screws. For those bony or osteochondral fragments, a bone adhesive would be desirable to, for example, enable easy anatomic reduction, avoid discarding of the fragments, and enable temporary fixation to visualize reduction before definitive osteosynthesis is performed. Most of the currently available bone adhesives have shortcomings, such as cytotoxicity, lack of resorbability, and inadequate mechanical properties. Thus, there is room for improved bone adhesives. The present work involves synthesis, characterization, and biomechanical evaluation of three variants of a novel magnesium calcium phostphate-based cement that may be used as a bone adhesive.

METHODS

Three novel experimental formulations of a magnesium calcium phosphate-based cement and a commercially-available cyanoacrylate bone adhesive (Glubran® 2) were used. The formulations were a magnesium phosphate (Mg3PO4 + MgO + phytic acid) (MPC_25), a magnesium calcium phosphate (Mg2.75Ca0.25PO4 + MgO + phytic acid) (MPCa_22.5), and a magnesium phosphate that had undergone modified temperature stages during sintering (Mg3O8P2 * x H2O) (HT-MPC). In vitro quasi-static compression tests were conducted using cuboid specimens. Split fractures of the lateral tibial plateau were created in dissected porcine tibiae. The lateral fracture fragments were glued onto the condyles. Load was applied on the glued fracture fragments via the femoral component of a knee hemiarthroplasty. Cyclic loading tests with increasing load levels, load-to-failure tests, and torque tests were conducted using this biomechanical model.

RESULTS

Among the experimental cement formulations, HT-MPC had the highest compressive strength (26.8 ± 9.5 MPa), MPCa_22.5 had the highest cyclic increasing load-to-failure (162 ± 40 N) and the highest load-to-failure (295 ± 84 N), while the highest calculated shear strength was obtained with both MPC_25 and MPCa_22.5 (0.27 ± 0.12 and 0.26 ± 0.06 MPa, respectively), and the highest torque-to-failure was obtained with both MPCa_22.5 and HT-MPC (2.2 ± 0.8 and 2.1 ± 1.2 Nm, respectively). The calculated shear strength for the experimental cement formulations (0.13-0.38 MPa) is above the minimum that has been suggested to be required for a bone adhesive to be used in clinical practice (0.2 MPa). Relative to the experimental cement formulations, the compressive strength of Glubran® 2 was significantly lower, but for each of the other four biomechanical parameters, values were significantly higher.

CONCLUSIONS

Each of the synthesized novel magnesium calcium phosphate-based cement formulations has adequate compressive strength, shear strength and resistance to fatigue failure. Thus, each merits further study for use in intraoperative fixation of small bone fragments.

Wet adhesives for hard tissues

The development of wet adhesives capable of bonding in aqueous environments, particularly for hard tissues such as bone, tooth, and cartilage, remains a significant challenge in material chemistry and biomedical research. Currently available hard tissue adhesives in clinical practice lack well-defined wet adhesion properties. Nature offers valuable inspiration through the adhesive mechanisms of marine organisms, advancing the design of bioinspired wet adhesives. Beyond biomimetic approaches, alternative strategies have emerged for the design of wet adhesives. This review systematically summarizes the current design strategies for wet adhesives, focusing on their applications to hard tissues. Then, the unique chemical, physical, mechanical, and biological requirements for wet adhesives applied to hard tissues are also discussed. The importance of understanding natural adhesion mechanisms and the need for high-performance materials that can meet the complex demands of hard tissue adhesion in a complex and delicate physiological microenvironment are highlighted. Finally, this review clarifies the future research directions that can further facilitate the clinical application of wet adhesives for hard tissues. STATEMENT OF SIGNIFICANCE: The significance of this review lies in its comprehensive analysis of wet adhesives for hard tissues, a field that has been largely overlooked despite its critical importance in biomedical applications. The insights gained from studying natural adhesives and the translation of these mechanisms into synthetic materials have the potential to revolutionize medical procedures involving hard tissue repair and regeneration. This review meticulously addresses the distinct challenges and specific requirements of hard tissue adhesives, providing an exhaustive roadmap for researchers striving to develop wet adhesives that can endure the demanding physiological conditions inside the human body. In doing so, it aims to facilitate the transition from laboratory findings to practical clinical applications.

Biomaterials for Corneal Regeneration

Corneal blindness is a significant reason for visual impairment globally. Researchers have been investigating several methods for corneal regeneration in order to cure these patients. Biomaterials are favored due to their biocompatibility and capacity to promote cell adhesion. A variety of natural and synthetic biomaterials, along with decellularized cornea, have been employed in corneal wound healing. Commonly utilized natural biomaterials encompass proteins such as collagen, gelatin, and silk fibroin (SF), as well as polysaccharides including alginate, chitosan (CS), hyaluronic acid (HA), and cellulose. Synthetic biomaterials primarily consist of polyvinyl alcohol (PVA), poly(ε-caprolactone) (PCL), and poly (lactic-co-glycolic acid) (PLGA). Bio-based materials and their composites are primarily utilized as hydrogels, films, scaffolds, patches, nanocapsules, and other formats for the treatment of blinding ocular conditions, including corneal wounds, corneal ulcers, corneal endothelium, and stromal defects. This review attempts to summarize in vitro, preclinical, and clinical trial studies relevant to corneal regeneration using biomaterials within the last five years, and expect that these experiences and outcomes will inspire and provide practical strategies for the future development of biomaterials for corneal regeneration. Furthermore, potential improvements and difficulties for these biomaterials are discussed.

Design and Improvement of Bone Adhesive in response to Clinical Needs

Fracture represents one of the most common diagnoses in contemporary medical practice, with the majority of cases traditionally addressed through metallic device fixation. However, this approach is marred by several drawbacks, including prolonged operative durations, considerable expenses, suboptimal applicability to comminuted fractures, increased infection risks, and the inevitable requirement for secondary surgery. The inherent advantages of bone adhesives in these fields have garnered the attention of orthopedic surgeons, who have commenced utilizing biocompatible and biodegradable bone adhesives to bond and stabilize bone fragments. Regrettably, the current bone adhesives generally exhibit insufficient adhesive strength in vivo environments, and it is desirable for them to possess effective osteogenesis to facilitate fracture healing. Consequently, aligning bone adhesives with practical clinical demands remains a significant hurdle, which has catalyzed a surge in research endeavors. Within this review, the conceptual framework, characteristics, and design ideas of bone adhesives based on clinical needs are delineated. Recent advancements in this domain, specifically focusing on the enhancement of two pivotal characteristics-adhesive strength and osteogenic potential are also reviewed. Finally, a prospective analysis of the future advancements in bone adhesives, offering new insights into solutions for diverse clinical problems is presented.

Application of adhesives in the treatment of cartilage repair

From degeneration causing intervertebral disc issues to trauma‐induced meniscus tears, diverse factors can injure the different types of cartilage. This review highlights adhesives as a promising and rapidly implemented repair strategy. Compared to traditional techniques such as sutures and wires, adhesives offer several advantages. Importantly, they seamlessly connect with the injured tissue, deliver bioactive substances directly to the repair site, and potentially alleviate secondary problems like inflammation or degeneration. This review delves into the cutting‐edge advancements in adhesive technology, specifically focusing on their effectiveness in cartilage injury treatment and their underlying mechanisms. We begin by exploring the material characteristics of adhesives used in cartilage tissue, focusing on essential aspects like adhesion, biocompatibility, and degradability. Subsequently, we investigate the various types of adhesives currently employed in this context. Our discussion then moves to the unique role adhesives play in addressing different cartilage injuries. Finally, we acknowledge the challenges currently faced by this promising technology.

Bioengineering Approaches and Novel Biomaterials to Enhance Sternal Wound Healing after Cardiac Surgery: A Crosstalk between Innovation and Surgical Practice

Median sternotomy and steel wires for sternal closure are the standard approach for cardiac surgery. An incomplete repair associated with chest wall motion, especially in the presence of predisposing factors, can lead to life-threatening deep sternal wound infection, also known as mediastinitis, in 2-5% of cases. Despite current antibiotic and surgical treatments, mediastinitis is associated with a 10-40% mortality rate and a significant increase in morbidity and hospital stay. High mortality and difficult treatment appear to be due to bacterial biofilm, a self-produced extracellular polymeric product that incorporates host tissue and is responsible for the failure of immune defenses and standard antimicrobial therapies. Nanostructures are an effective strategy to enhance the healing process, as they establish a favorable environment for the neosynthesis of the extracellular matrix, supporting tissue development. Synthetic polymers have been proven to exhibit suitable biodegradable and mechanical properties, and their biofunctionalization to enhance cell attachment and interaction with the extracellular matrix is being widely investigated. The use of antibiotic treatments suspended in poly-D,L-lactide and polyethylene oxide and electrospun into nanofibers, or in sponges, has been shown to inhibit bacterial biofilm production. Additionally, growth factors can be incorporated into 3D bioresorbable scaffolds with the aim of constituting a structural and biological framework to organize and expedite the healing process. Therefore, these combined approaches may change the treatment of mediastinitis in the near future.

Polyacrylic acid-reinforced organic-inorganic composite bone adhesives with enhanced mechanical properties and controlled degradability

Bone adhesives, as alternatives to traditional bone fracture treatment methods, have great benefits in achieving effective fixation and healing of fractured bones. However, current available bone adhesives have limitations in terms of weak mechanical properties, low adhesion strength, and inappropriate degradability, hindering their clinical applications. The development of bone adhesives with strong mechanical properties, adhesion strength, and appropriate degradability remains a great challenge. In this study, polyacrylic acid was incorporated with tetracalcium phosphate and O-phospho-L-serine to form a new bone adhesive via coordination and ionic interactions to achieve exceptional mechanical properties, adhesion strength, and degradability. The bone adhesive could achieve an initial adhesion strength of approximately 3.26 MPa and 0.86 MPa on titanium alloys and bones after 15 min of curing, respectively, and it increased to 5.59 MPa and 2.73 MPa, after 24 h of incubation in water or simulated body fluid (SBF). The compressive strength of the adhesive increased from 10.06 MPa to 72.64 MPa over two weeks, which provided sufficient support for the fractured bone. Importantly, the adhesive started to degrade after 6 to 8 weeks of incubation in SBF, which is beneficial to cell ingrowth and the bone healing process. In addition, the bone adhesives exhibited favorable mineralization capability, biocompatibility, and osteogenic activity. In vivo experiments showed that it has a better bone-healing effect compared with the traditional polymethyl methacrylate bone cement. These results demonstrate that the bone adhesive has great potential in the treatment of bone fractures.

Engineering Wet-Resistant and Osteogenic Nanocomposite Adhesive to Control Bleeding and Infection after Median Sternotomy

Median sternotomy surgery stands as one of the prevailing strategies in cardiac surgery. In this study, the cutting-edge bone adhesive is designed, inspired by the impressive adhesive properties found in mussels and sandcastle worms. This work has created an osteogenic nanocomposite coacervate adhesive by integrating a cellulose-polyphosphodopamide interpenetrating network, quaternized chitosan, and zinc, gallium-doped hydroxyapatite nanoparticles. This adhesive is characterized by robust catechol-metal coordination which effectively adheres to both hard and soft tissues with a maximum adhesive strength of 900 ± 38 kPa on the sheep sternum bone, surpassing that of commercial bone adhesives. The release of zinc and gallium cations from nanocomposite adhesives and quaternized chitosan matrix imparts remarkable antibacterial properties and promotes rapid blood coagulation, in vitro and ex vivo. It is also proved that this nanocomposite adhesive exhibits significant in vitro bioactivity, stable degradability, biocompatibility, and osteogenic ability. Furthermore, the capacity of nanocomposite coacervate to adhere to bone tissue and support osteogenesis contributes to the successful healing of a sternum bone defect in a rabbit model in vivo. In summary, these nanocomposite coacervate adhesives with promising characteristics are expected to provide solutions to clinical issues faced during median sternotomy surgery.

In Situ Photo-Crosslinkable Protein Bioadhesive for Bone Graft Fixation

Bone grafting is a fundamental dental surgery procedure widely used for implant placement and periodontal disease management treatments. Despite its broad applications, vertical bone augmentation presents unique challenges, including the risk of graft displacement due to gravitational and masticatory forces. Traditional physical stabilization methods introduce additional complexities and risks, underscoring the need for innovative fixation technologies. This study aimed to develop an in situ photo-crosslinkable bioadhesive hydrogel (iPBAH) as a multifunctional bone graft binder to enhance the process of bone reconstruction. The bioadhesive is composed of mussel-derived adhesive protein (MAP) fused with the cell-adhesive peptide RGD. The numerous tyrosine residues in MAP facilitate rapid photo-crosslinking, enabling efficient hydrogel formation using visible blue light. Subsequently, iPBAH underwent comprehensive characterization to evaluate its suitability as a multifunctional bone graft binder. iPBAH efficiently underwent in situ crosslinking through harmless exposure to visible light within minutes and displayed several exceptional properties, including a microporous structure, underwater adhesion, extended durability, high compressive strength, and biocompatibility. In vivo assessments, using male Sprague-Dawley rats, demonstrated that iPBAH binder significantly enhanced bone regeneration in a rat calvarial bone defect model. The in situ crosslinking of the iPBAH binder during bone graft transplantation can effectively fill irregular and complex defect shapes while simultaneously preventing graft material leakage. The improved physical attributes of the bound graft material can enhance its resistance to external forces, thereby ensuring sustained retention over time. Moreover, the interaction between iPBAH and surrounding tissues promotes adhesion and integration of the graft material with host tissues in the defect area. In addition, the included RGD peptide in iPBAH can augment inherent cell recruitment, adhesion, and growth, consequently expediting osteogenesis.

Silk fibroin hydrogel adhesive enables sealed-tight reconstruction of meniscus tears

Despite orientationally variant tears of the meniscus, suture repair is the current clinical gold treatment. However, inaccessible tears in company with re-tears susceptibility remain unresolved. To extend meniscal repair tools from the perspective of adhesion and regeneration, we design a dual functional biologic-released bioadhesive (S-PIL10) comprised of methacrylated silk fibroin crosslinked with phenylboronic acid-ionic liquid loading with growth factor TGF-β1, which integrates chemo-mechanical restoration with inner meniscal regeneration. Supramolecular interactions of β-sheets and hydrogen bonds richened by phenylboronic acid-ionic liquid (PIL) result in enhanced wet adhesion, swelling resistance, and anti-fatigue capabilities, compared to neat silk fibroin gel. Besides, elimination of reactive oxygen species (ROS) by S-PIL10 further fortifies localized meniscus tear repair by affecting inflammatory microenvironment with dynamic borate ester bonds, and S-PIL10 continuously releases TGF-β1 for cell recruitment and bridging of defect edge. In vivo rabbit models functionally evidence the seamless and dense reconstruction of torn meniscus, verifying that the concept of meniscus adhesive is feasible and providing a promising revolutionary strategy for preclinical research to repair meniscus tears.

Degradable Nanohydroxyapatite-Reinforced Superglue for Rapid Bone Fixation and Promoted Osteogenesis

Bone glue with robust adhesion is crucial for treating complicated bone fractures, but it remains a formidable challenge to develop a "true" bone glue with high adhesion strength, degradability, bioactivity, and satisfactory operation time in clinical scenarios. Herein, inspired by the hydroxyapatite and collagen matrix composition of natural bone, we constructed a nanohydroxyapatite (nHAP) reinforced osteogenic backbone-degradable superglue (O-BDSG) by in situ radical ring-opening polymerization. nHAP significantly enhances adhesive cohesion by synergistically acting as noncovalent connectors between polymer chains and increasing the molecular weight of the polymer matrix. Moreover, nHAP endows the glue with bioactivity to promote osteogenesis. The as-prepared glue presented a 9.79 MPa flexural adhesion strength for bone, 4.7 times that without nHAP, and significantly surpassed commercial cyanoacrylate (0.64 MPa). O-BDSG exhibited degradability with 51% mass loss after 6 months of implantation. In vivo critical defect and tibia fracture models demonstrated the promoted osteogenesis of the O-BDSG, with a regenerated bone volume of 75% and mechanical function restoration to 94% of the native tibia after 8 weeks. The glue can be flexibly adapted to clinical scenarios with a curing time window of about 3 min. This work shows promising prospects for clinical application in orthopedic surgery and may inspire the design and development of bone adhesives.

Lobster-Inspired Chitosan-Derived Adhesives with a Biomimetic Design

Polysaccharide-based adhesives, especially chitosan (CS)-derived adhesives, serve as promising sustainable alternatives to traditional adhesives. However, most demonstrate a poor adhesive strength. Inspired by the inherent layered structure of marine arthropods (lobsters), a core-shell structure (SiO2-NH2@OPG) with amine-functionalized silica (SiO2-NH2) as the core and oxidized pyrogallol (OPG) as the shell is prepared in this study. The compound is blended with CS to produce a structural biomimetic wood adhesive (SiO2-NH2@OPG/CS) with excellent performance. In addition to thermocompressive curing, this adhesive exhibits a water-evaporation-induced curing behavior at room temperature. With reference to the design mechanism of the lobster cuticle, this microphase-separated structure consists of clustered nanofibers with varying amounts of SiO2-NH2@OPG particles between the fibers. This intriguing microphase structure and its mechanical effects could offer a powerful solution for improving the functional modification of wood composites.

Overcoming the Dilemma of In Vivo Stable Adhesion and Sustained Degradation by the Molecular Design of Polyurethane Adhesives for Bone Fracture Repair

Bone adhesive is a promising candidate to revolutionize the clinical treatment of bone repairs. However, several drawbacks have limited its further clinical application, such as unreliable wet adhesive performance leading to fixation failure and poor biodegradability inhibiting bone tissue growth. By incorporating catechol groups and disulfide bonds into polyurethane (PU) molecules, an injectable and porous PU adhesive is developed with both superior wet adhesion and biodegradability to facilitate the reduction and fixation of comminuted fractures and the subsequent regeneration of bone tissue. The bone adhesive can be cured within a reasonable time acceptable to a surgeon, and then the wet bone adhesive strength is near 1.30 MPa in 1 h. Finally, the wet adhesive strength to the cortical bone will achieve about 1.70 MPa, which is also five times more than nonresorbable poly(methyl methacrylate) bone cement. Besides, the cell culture experiments also indicate that the adhesives show excellent biocompatibility and osteogenic ability in vitro. Especially, it can degrade in vivo gradually and promote fracture healing in the rabbit iliac fracture model. These results demonstrate that this ingenious bone adhesive exhibits great potential in the treatment of comminuted fractures, providing fresh insights into the development of clinically applicable bone adhesives.

Double-Cross-Linked Hydrogel with Long-Lasting Underwater Adhesion: Enhancement of Maxillofacial In Situ and Onlay Bone Retention

Bone retention is a usual clinical problem existing in a lot of maxillofacial surgeries involving bone reconstruction and bone transplantation, which puts forward the requirements for bone adhesives that are stable, durable, biosafe, and biodegradable in wet environment. To relieve the suffering of patients during maxillofacial surgery with one-step operation and satisfying repair, herein, we developed a double-cross-linked A-O hydrogel named by its two components: [(3-Aminopropyl) methacrylamide]-co-{[Tris(hydroxymethyl) methyl] acrylamide} and oxidated methylcellulose. With excellent bone adhesion ability, it can maintain long-lasting stable underwater bone adhesion for over 14 days, holding a maximum adhesion strength of 2.32 MPa. Schiff-base reaction and high-density hydrogen bonds endow the hydrogel with strong cohesion and adhesion performance as well as maneuverable properties such as easy formation and injectability. A-O hydrogel not only presents rarely reported long-lasting underwater adhesion of hard tissue but also owns inherent biocompatibility and biodegradation properties with a porous structure that facilitates the survival of bone graft. Compared to the commercial cyanoacrylate adhesive (3 M Vetbond Tissue Adhesive), the A-O hydrogel is confirmed to be safer, more stable, and more effective in calvarial in situ bone retention model and onlay bone retention model of rat, providing a practical solution for the everyday scenario of clinical bone retention.

A Review on Polymers for Biomedical Applications on Hard and Soft Tissues and Prosthetic Limbs

In the past decades, there has been a significant increase in the use of polymers for biomedical applications. The global medical polymer market size was valued at USD 19.92 billion in 2022 and is expected to grow at a CAGR of 8.0% from 2023 to 2030 despite some limitations, such as cost (financial limitation), strength compared to metal plates for bone fracture, design optimization and incorporation of reinforcement. Recently, this increase has been more pronounced due to important advances in synthesis and modification techniques for the design of novel biomaterials and their behavior in vitro and in vivo. Also, modern medicine allows the use of less invasive surgeries and faster surgical sutures. Besides their use in the human body, polymer biomedical materials must have desired physical, chemical, biological, biomechanical, and degradation properties. This review summarizes the use of polymers for biomedical applications, mainly focusing on hard and soft tissues, prosthetic limbs, dental applications, and bone fracture repair. The main properties, gaps, and trends are discussed.

Biodegradable Implants for Internal Fixation of Fractures and Accelerated Bone Regeneration

Bone fractures have always been a burden to patients due to their common occurrence and severe complications. Traditionally, operative treatments have been widely used in the clinic for implanting, despite the fact that they can only achieve bone fixation with limited stability and pose no effect on promoting tissue growth. In addition, the nondegradable implants usually need a secondary surgery for implant removal, otherwise they may block the regeneration of bones resulting in bone nonunion. To overcome the low degradability of implants and avoid multiple surgeries, tissue engineers have investigated various biodegradable materials for bone regeneration, whereas the significance of stability of long-term bone fixation tends to be neglected during this process. Combining the traditional orthopedic implantation surgeries and emerging tissue engineering, we believe that both bone fixation and bone regeneration are indispensable factors for a successful bone repair. Herein, we define such a novel idea as bone regenerative fixation (BRF), which should be the main future development trend of biodegradable materials.

Marine collagen-chitosan-fucoidan/chondroitin sulfate cryo-biomaterials loaded with primary human cells envisaging cartilage tissue engineering

Cartilage repair after a trauma or a degenerative disease like osteoarthritis (OA) continues to be a big challenge in current medicine due to the limited self-regenerative capacity of the articular cartilage tissues. To overcome the current limitations, tissue engineering and regenerative medicine (TERM) and adjacent areas have focused their efforts on new therapeutical procedures and materials capable of restoring normal tissue functionalities through polymeric scaffolding and stem cell engineering approaches. For this, the sustainable exploration of marine origin materials has emerged in the last years as a natural alternative to mammal sources, benefiting from their biological properties (e.g., biocompatibility, biodegradability, no toxicity, among others) for the development of several types of scaffolds. In this study, marine collagen(jCOL)-chitosan(sCHT)-fucoidan(aFUC)/chondroitin sulfate(aCS) were cryo-processed (-20 °C, -80 °C, and -196 °C) and a chemical-free crosslinking approach was explored to establish cohesive and stable cryogel materials. The cryogels were intensively characterized to assess their oscillatory behavior, thermal structural stability, thixotropic properties (around 45 % for the best formulations), injectability, and surface structural organization. Additionally, the cryogels demonstrate an interesting microenvironment in in vitro studies using human adipose-derived stem cells (hASCs), supporting their viability and proliferation. In both physic-chemical and in vitro studies, the systems that contain fucoidan in their formulations, i.e., C1 (jCOL, sCHT, aFUC) and C3 (jCOL, sCHT, aFUC, aCS), submitted at -80 °C, are those that demonstrated most promising results for future application in articular cartilage tissues.

C- and N-Phosphorylated Enamines-An Avenue to Heterocycles: NMR Spectroscopy

The review presents extensive data (from the works of the author and literature) on the structure of C- and N-chlorophosphorylated enamines and the related heterocycles obtained by multipulse multinuclear ¹H, ¹³C, and ³¹P NMR spectroscopy. The use of phosphorus pentachloride as a phosphorylating agent for functional enamines enables the synthesis of various C- and N-phosphorylated products that are heterocyclized to form various promising nitrogen- and phosphorus-containing heterocyclic systems. ³¹P NMR spectroscopy is the most convenient, reliable and unambiguous method for the study and identification of organophosphorus compounds with different coordination numbers of the phosphorus atom, as well as for the determination of their Z- and E-isomeric forms. An alteration of the coordination number of the phosphorus atom in the phosphorylated compounds from 3 to 6 leads to a drastic screening of the ³¹P nucleus from about +200 to -300 ppm. The unique structural features of nitrogen-phosphorus-containing heterocyclic compounds are discussed.

Bone adhesive materials: From bench to bedside

Biodegradable bone adhesives represent a highly sought-after type of biomaterial which would enable replacement of traditional metallic devices for fixation of bone. However, these biomaterials should fulfil an extremely large number of requirements. As a consequence, bone-adhesive biomaterials which meet all of these requirements are not yet commercially available. Therefore, this comprehensive review provides an extensive overview of the development of bone adhesives from a translational perspective. First, the definition, classification, and chemistry of various types of bone adhesives are highlighted to provide a detailed overview of this emerging class of biomaterials. In this review we particularly focused studies which describe the use of materials that are capable of gluing two pieces of bone together within a time frame of minutes to days. Second, this review critically reflects on i) the experimental conditions of commonly employed adhesion tests to assess bone adhesion and ii) the current state-of-the-art regarding their preclinical and clinical applicability.

Multifunctional Bioinspired Bredigite-Modified Adhesive for Bone Fracture Healing

Despite recent advances in bone adhesives applied for full median sternotomy, the regeneration of bone defects has remained challenging since the healing process is hampered by poor adhesiveness, limited bioactivity, and lack of antibacterial functions. Bioinspired adhesives by marine organisms provide a novel concept to circumvent these problems. Herein, a dual cross-link strategy is employed in designing a multifaceted bioinspired adhesive consisting of a catechol amine-functionalized hyperbranched polymer (polydopamine-co-acrylate, PDA), bredigite (BR) nanoparticles, and Fe³⁺ ions. The hybrid adhesives exhibit strong adhesion to various substrates such as poly(methyl methacrylate), glass, bone, and skin tissues through synergy between irreversible covalent and reversible noncovalent cross-linking, depending on the BR content. Noticeably, the adhesion strength of hybrid adhesives containing 2 wt % BR nanoparticles to bone tissues is 2.3 ± 0.8 MPa, which is about 3 times higher than that of pure PDA adhesives. We also demonstrate that these hybrid adhesives not only are bioactive and accelerate in vitro bone-like apatite formation but also exhibit antibacterial properties against Staphylococcus aureus, depending on the BR concentration. Furthermore, the superior cellular responses in contact with hybrid adhesives, including improved human osteosarcoma MG63 cell spreading and osteogenic differentiation, are achieved owing to the appropriate ion release and flexibility of the cross-linked double-network adhesive. In summary, multifunctional hybrid PDA/BR adhesives with appreciable osteoconductive, mechanical, and antibacterial properties represent the potential applications for median sternotomy surgery as a bone tissue adhesive.

Mussel-Based Biomimetic Strategies in Musculoskeletal Disorder Treatment: From Synthesis Principles to Diverse Applications

Musculoskeletal disorders are the second leading cause of disability worldwide, posing a huge global burden to the public sanitation system. Currently, tissue engineering-based approaches act as effective strategies, which are, however, challenging in limited application scenarios. Mussel-based biomimetic materials, exhibit numerous unique properties such as intense adhesion, biocompatibility, moisture resistance, and injectability, to name only a few, and have attracted extensive research interest. In particular, featuring state-of-the-art properties, mussel-inspired biomaterials have been widely explored in innumerable musculoskeletal disorder treatments including osteochondral defects, osteosarcoma, osteoarthritis, ligament rupture, and osteoporosis. Nevertheless, a comprehensive and timely discussion of their applications in musculoskeletal disorders is insufficient. In this review, we emphasize on (1) the main categories and characteristics of mussel foot proteins and their fundamental mechanisms for the spectacular adhesion in mussels; (2) the diverse synthetic methods and modification of various polymers; and (3) the emerging applications of mussel-biomimetic materials, the future perspectives, and challenges, especially in the area of musculoskeletal disorder. We envision that this review will provide a unique and insightful perspective to improve the development of a new generation of mussel biomimetic strategies.

High Performance Marine and Terrestrial Bioadhesives and the Biomedical Applications They Have Inspired

This study has reviewed the naturally occurring bioadhesives produced in marine and freshwater aqueous environments and in the mucinous exudates of some terrestrial animals which have remarkable properties providing adhesion under difficult environmental conditions. These bioadhesives have inspired the development of medical bioadhesives with impressive properties that provide an effective alternative to suturing surgical wounds improving closure and healing of wounds in technically demanding tissues such as the heart, lung and soft tissues like the brain and intestinal mucosa. The Gecko has developed a dry-adhesive system of exceptional performance and has inspired the development of new generation re-usable tapes applicable to many medical procedures. The silk of spider webs has been equally inspiring to structural engineers and materials scientists and has revealed innovative properties which have led to new generation technologies in photonics, phononics and micro-electronics in the development of wearable biosensors. Man made products designed to emulate the performance of these natural bioadhesive molecules are improving wound closure and healing of problematic lesions such as diabetic foot ulcers which are notoriously painful and have also found application in many other areas in biomedicine. Armed with information on the mechanistic properties of these impressive biomolecules major advances are expected in biomedicine, micro-electronics, photonics, materials science, artificial intelligence and robotics technology.

Hydrophilic competent and enhanced wet-bond strength castor oil-based bioadhesive for bone repair

Bone adhesive has been proved to be a promising alternative in the clinical treatment of bone repairs. However, the problems of unsatisfying bone-bonding strength, especially the bonding of cortical bone in vivo, and blocked bone tissue recovery remain barriers to clinical reparation. Benefit from dopamine-modified castor oil synthesized by an epoxy-modification method, a porous and two-component polyurethane adhesive (PUA) was prepared to overcome the current challenges encountered. The tailored surface morphology and open porosity of the adhesive layer can be obtained to meet the requirements of bone repair by tuning the fraction of the formulation. Furthermore, the incorporation of nano-hydroxyapatite improved the mechanical properties and osteocompatibility of the material. Compared with PUA without catechol groups, the introduction of catechol groups not only increased the adhesive strength from 0.28 ± 0.05 MPa to 0.58 ± 0.06 MPa under wet conditions but also enabled the enrichment of Ca2+ on the adhesive surface to promote bone regeneration. Besides, the cell culture experiments also indicated that PUAs show good biocompatibility and excellent adhesion to stem cells. Given its excellent wet adhesive strength and biocompatibility, this system demonstrated potential applications in orthopedic treatment.