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Yu X, Song Y, Dong T, Ouyang W, Quan C, Shao L, Barasa L, Thompson PR, Zhang M, Ma J, Kurabayashi K, Li Y. Citrullination of NF-κB p65 by PAD2 as a Novel Therapeutic Target for Modulating Macrophage Polarization in Acute Lung Injury. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2025; 12:e2413253. [PMID: 40087815 PMCID: PMC12079445 DOI: 10.1002/advs.202413253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Revised: 02/11/2025] [Indexed: 03/17/2025]
Abstract
Mediating protein citrullination, peptidyl arginine deiminase 2 (PAD2) has recently been reported to influence macrophage phenotypes. However, the mechanisms of PAD2 on macrophage function in Pseudomonas aeruginosa (PA)-induced acute lung injury syndrome (ALI) remains unclear. Utilizing single-cell RNA sequencing and mass spectrometry-based proteomics, a new citrullination site at arginine 171 (R171) is discovered within nuclear factor- κB (NF-κB) p65 catalyzed by PAD2, which modulates PAD2-NF-κB p65-importin α3 pathway and its downstream M1/M2 macrophage polarization. Building on these findings, a cell-specific targeted therapeutic strategy using gold nanoparticles (AuNPs) conjugated with a novel PAD2 inhibitor, AFM41a, and an intercellular adhesion molecule-1 (ICAM-1) antibody is developed. This approach enables the selective delivery of the inhibitor to M1-polarized macrophages in the PA-infected alveolar niche. In vivo, this nanomedicine reduces excessive inflammation and promotes M1-to-M2 polarization to inhibit ALI. This study highlights the role of PAD2-mediated citrullination in macrophage polarization and introduces a promising nanoparticle-based therapy for PA-induced ALI.
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Affiliation(s)
- Xin Yu
- Department of SurgeryUniversity of Michigan Health SystemAnn ArborMI48109USA
- Department of Emergency MedicineSecond Affiliated HospitalZhejiang University School of MedicineNo.88 Jiefang RoadHangzhouZhejiang310009China
| | - Yujing Song
- Department of Mechanical and Aerospace EngineeringNew York University Tandon School of EngineeringBrooklynNY11201USA
- Department of Mechanical EngineeringUniversity of MichiganAnn ArborMI48109USA
| | - Tao Dong
- Department of SurgeryUniversity of Michigan Health SystemAnn ArborMI48109USA
- Department of PhysiologyXuzhou Medical UniversityXu ZhouJiangsu221002China
| | - Wenlu Ouyang
- Department of SurgeryUniversity of Michigan Health SystemAnn ArborMI48109USA
- Department of Metabolism and EndocrinologyThe Second Xiangya HospitalChangsha410011China
| | - Chao Quan
- Department of SurgeryUniversity of Michigan Health SystemAnn ArborMI48109USA
- Department of UrologyThe Xiangya HospitalChangsha410013China
| | - Liujiazi Shao
- Department of SurgeryUniversity of Michigan Health SystemAnn ArborMI48109USA
- Department of AnesthesiologyBeijing Friendship HospitalCapital Medical UniversityNo.95 Yong‐an Road, Xicheng DistrictBeijing100050China
| | - Leonard Barasa
- Program in Chemical Biology, Department of Biochemistry and Molecular BiotechnologyUniversity of Massachusetts Chan Medical SchoolWorcesterMA01605USA
| | - Paul R. Thompson
- Program in Chemical Biology, Department of Biochemistry and Molecular BiotechnologyUniversity of Massachusetts Chan Medical SchoolWorcesterMA01605USA
| | - Mao Zhang
- Department of Emergency MedicineSecond Affiliated HospitalZhejiang University School of MedicineNo.88 Jiefang RoadHangzhouZhejiang310009China
| | - Jianjie Ma
- Department of SurgeryDivision of Surgical ScienceUniversity of VirginiaCharlottesvilleVA22903USA
| | - Katsuo Kurabayashi
- Department of Mechanical and Aerospace EngineeringNew York University Tandon School of EngineeringBrooklynNY11201USA
- Department of Chemical and Biomolecular EngineeringNew York University Tandon School of EngineeringBrooklynNY11201USA
| | - Yongqing Li
- Department of SurgeryUniversity of Michigan Health SystemAnn ArborMI48109USA
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Atif M, Dilawaiz, Akhtar H, Imran M, Ullah MZ, Andaleeb H, Hussain MA. In Vitro Hydroxyapatite Nucleation in Cationically Cured Epoxy Composites with Pulverized Date Seed. Polymers (Basel) 2024; 16:3463. [PMID: 39771316 PMCID: PMC11728756 DOI: 10.3390/polym16243463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Revised: 11/29/2024] [Accepted: 12/07/2024] [Indexed: 01/16/2025] Open
Abstract
Recently, driven by a growing focus on environmental sustainability and cost-effectiveness, researchers have shown a keen interest in creating useful materials from bio-wastes, particularly for their potential applications in the biomedical field. Current research has been conducted on the impact of date seed powder (DSP) on hydroxyapatite (HA) formation, specifically in relation to the promotion of bone health and regeneration. HA is an essential component of bone tissue and plays a crucial role in maintaining bone strength and structure. Date seed (DS) was used in two forms i.e., grains and powder, with unmodified and modified surface chemistries. Prepared composites were tested in vitro by soaking them in simulated body fluid (SBF). X-ray Diffraction (XRD) and Fourier Transform Infra-Red (FTIR) confirmed HA formation in all soaked samples. Thermogravimetric analysis (TGA) results indicated an improvement in thermal stability after soaking, suggesting a higher concentration of HA. Unsoaked samples were observed to have higher heat flow than soaked samples. The high gel content (GCs) over 90% and low hydrophilicity (less than 5%) of DSP-based composites were proven to be beneficial in HA nucleation. Antibacterial activity showed that the addition of DS filler yielded superior results compared to the pristine sample. Additionally, the modified samples demonstrated better antibacterial results than the unmodified ones.
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Affiliation(s)
- Muhammad Atif
- Chemistry Department, University of Education Lahore, Vehari Campus, Vehari 61100, Pakistan
| | - Dilawaiz
- Chemistry Department, University of Education Lahore, Vehari Campus, Vehari 61100, Pakistan
| | - Hafsah Akhtar
- Interdisciplinary Research Centre in Biomedical Materials (IRCBM), COMSATS University Islamabad (CUI), Lahore Campus, Lahore 54000, Pakistan
| | - Muhammad Imran
- Research Center for Advanced Material Science, Chemistry Department, Faculty of Science, King Khalid University, P.O. Box 9004, Abha 61413, Saudi Arabia
| | - Muhammad Zafar Ullah
- Chemistry Department, University of Education Lahore, Vehari Campus, Vehari 61100, Pakistan
| | - Hina Andaleeb
- Department of Biochemistry, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Muhammad Asif Hussain
- Institute of Metallurgy and Materials Engineering, University of the Punjab, Lahore 54000, Pakistan
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Zdero R, Brzozowski P, Schemitsch EH. Material Properties and Engineering Performance of Bone Fracture Plates Made from Plant Fiber Reinforced Composites: A Review. ACS Biomater Sci Eng 2024; 10:5439-5453. [PMID: 39155744 DOI: 10.1021/acsbiomaterials.4c00178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Bone fracture plates are usually made from titanium alloy or stainless steel, which are much stiffer than bone. However, overly stiff plates can restrict axial interfragmentary motion at the fracture leading to delayed callus formation and healing, as well as causing bone "stress shielding" under the plate leading to bone atrophy, bone resorption, and plate loosening. Consequently, there have been many prior efforts to develop nonmetallic bone fracture plates with customized material properties using synthetic fibers (e.g., aramid, carbon, glass) in polymer resin. Even so, plant fibers (e.g., flax, roselle, sisal) offer additional advantages over synthetic fibers, such as availability, biodegradability, less toxicity during processing, lower financial cost, and recyclability. As such, there is an emerging interest in using plant fibers alone, or combined with synthetic fibers, to reinforce polymers for various applications. Thus, this is the first review article on the material properties and engineering performance of innovative bone fracture plates made from composite materials reinforced by plant fibers alone or supplemented using synthetic fibers. This article presents material-level fiber properties (e.g., elastic modulus, ultimate strength), material-level plate properties (e.g., fatigue strength, impact toughness), and bone-plate engineering performance (e.g., overall stiffness, plate stress), as well as discussing general findings, study quality, and future work. This article may help engineers and surgeons to design, fabricate, analyze, and utilize novel bone fracture plates.
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Affiliation(s)
- Radovan Zdero
- Orthopaedic Biomechanics Lab, Victoria Hospital, London, Ontario N6A 5W9, Canada
| | - Pawel Brzozowski
- Orthopaedic Biomechanics Lab, Victoria Hospital, London, Ontario N6A 5W9, Canada
| | - Emil H Schemitsch
- Orthopaedic Biomechanics Lab, Victoria Hospital, London, Ontario N6A 5W9, Canada
- Division of Orthopaedic Surgery, Western University, London, Ontario N6A 3K7, Canada
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Zdero R, Brzozowski P, Schemitsch EH. Biomechanical stress analysis using thermography: A review. J Biomech 2023; 160:111822. [PMID: 37793203 DOI: 10.1016/j.jbiomech.2023.111822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/08/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
Biomechanics investigators are interested in experimentally measuring stresses experienced by dental structures, whole bones, joint replacements, soft tissues, normal limbs, etc. To do so, various experimental methods have been used that are based on acoustic, optical, piezo-resistive, or other principles, like digital image correlation, fiber optic sensors, photo-elasticity, strain gages, ultrasound, etc. Several biomechanical review papers have surveyed these research technologies, but they do not mention thermography. Thermography can identify temperature anomalies indicating low- or high-stress areas on a bone, implant, prosthesis, etc., which may need to be repaired, replaced, or redesigned to avoid damage, degradation, or failure. In addition, thermography can accurately predict a structure's cyclic fatigue strength. Consequently, this article gives an up-to-date survey of the scientific literature on thermography for biomechanical stress analysis. This review (i) describes the basic physics of thermography, thermo-elastic properties of biomaterials, experimental protocols for thermography, advantages, and disadvantages, (ii) surveys published studies on various applications that used thermography for biomechanical stress measurements, and (iii) discusses general findings and future work. This article is intended to inform biomechanics investigators about the potential of thermography for stress analysis.
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Affiliation(s)
- Radovan Zdero
- Orthopaedic Biomechanics Lab, Victoria Hospital, London, ON, Canada.
| | - Pawel Brzozowski
- Orthopaedic Biomechanics Lab, Victoria Hospital, London, ON, Canada.
| | - Emil H Schemitsch
- Orthopaedic Biomechanics Lab, Victoria Hospital, London, ON, Canada; Division of Orthopaedic Surgery, Western University, London, ON, Canada.
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Long Y, Qi Y, Zuo G, Zhang Q, Liu Z, Wang W. Femoral periprosthetic fracture treatment using the Ortho-Bridge System: a biomechanical study. J Orthop Surg Res 2022; 17:301. [PMID: 35659004 PMCID: PMC9166506 DOI: 10.1186/s13018-022-03154-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We undertook a comparative biomechanical study of type B1 fractures around femoral prostheses following cemented hip arthroplasty using the Ortho-Bridge System (OBS) and a locking compression plate/locking attachment plate structure (LCP + LAP). We aimed to investigate the biomechanical characteristics and advantages of the OBS compared with LCP + LAP when treating this fracture type. METHODS An OBS fixation model was designed based on OBS and LCP + LAP fixation characteristics. The LCP + LAP combination (Group A) and three different OBS combinations (Groups B, C, and D) were used to fix a B1 fracture model with a femoral periprosthetic fracture. Axial compression and torsion experiments were then performed using simple and comminuted fracture models. The axial compression failure experiment was carried out, and the model stiffness during axial compression, torsion angle in torsion test, and vertical load in the final failure test were collected. RESULTS When simulating simple oblique fractures, no significant difference was found among the four groups in terms of stiffness in the axial compression experiment (P = 0.257). The torsion angle of the LCP + LAP system was significantly higher compared with the OBS system (P < 0.05). When simulating a comminuted fracture, the experimental data for axial compression showed that the rigidity measurements of the three combinations of the OBS system were higher compared with the LCP + LAP system (P = 0.000) and that the torsion angles of three combinations of the OBS system were smaller compared with the LCP + LAP system (P < 0.05). In the axial compression failure test, the fixed failure mode of the LCP + LAP system was the destruction of the contact cortex at the fracture site, whereas the failure modes in the three OBS combinations involved fracture around the screws above the osteotomy and destruction of the contact cortex at the fracture site. CONCLUSIONS The findings revealed that the OBS produced superior biomechanical outcomes compared with LCP + LAP, especially for the bridging two-rod dual cortex. According to the performance observed after model axial compression destruction, the OBS was fixed and provided greater stress dispersion, which might make it more suitable for facilitating early functional movement and avoiding the failure of internal fixation.
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Affiliation(s)
- Yuntao Long
- Shandong First Medical University & Shandong Academy Medical Sciences, Jinan, 250117, Shandong, China
| | - Yubin Qi
- Department of Orthopaedics, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong, China
| | - Guilai Zuo
- Department of Orthopaedics, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong, China
| | - Qingjie Zhang
- Newton Laboratories, Tianjin Weiman Biomaterials Co., Ltd, Tianjin, 301600, China
| | - Zhenlin Liu
- Newton Laboratories, Tianjin Weiman Biomaterials Co., Ltd, Tianjin, 301600, China
| | - Wen Wang
- Department of Orthopaedics, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong, China.
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Islam M, Lantada AD, Mager D, Korvink JG. Carbon-Based Materials for Articular Tissue Engineering: From Innovative Scaffolding Materials toward Engineered Living Carbon. Adv Healthc Mater 2022; 11:e2101834. [PMID: 34601815 PMCID: PMC11469261 DOI: 10.1002/adhm.202101834] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 12/14/2022]
Abstract
Carbon materials constitute a growing family of high-performance materials immersed in ongoing scientific technological revolutions. Their biochemical properties are interesting for a wide set of healthcare applications and their biomechanical performance, which can be modulated to mimic most human tissues, make them remarkable candidates for tissue repair and regeneration, especially for articular problems and osteochondral defects involving diverse tissues with very different morphologies and properties. However, more systematic approaches to the engineering design of carbon-based cell niches and scaffolds are needed and relevant challenges should still be overcome through extensive and collaborative research. In consequence, this study presents a comprehensive description of carbon materials and an explanation of their benefits for regenerative medicine, focusing on their rising impact in the area of osteochondral and articular repair and regeneration. Once the state-of-the-art is illustrated, innovative design and fabrication strategies for artificially recreating the cellular microenvironment within complex articular structures are discussed. Together with these modern design and fabrication approaches, current challenges, and research trends for reaching patients and creating social and economic impacts are examined. In a closing perspective, the engineering of living carbon materials is also presented for the first time and the related fundamental breakthroughs ahead are clarified.
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Affiliation(s)
- Monsur Islam
- Karlsruhe Institute of TechnologyInstitute of Microstructure TechnologyHermann‐von‐Helmholtz‐Platz 1Eggenstein‐Leopoldshafen76344Germany
| | - Andrés Díaz Lantada
- Department of Mechanical EngineeringUniversidad Politécnica de MadridJosé Gutiérrez Abascal 2Madrid28006Spain
| | - Dario Mager
- Karlsruhe Institute of TechnologyInstitute of Microstructure TechnologyHermann‐von‐Helmholtz‐Platz 1Eggenstein‐Leopoldshafen76344Germany
| | - Jan G. Korvink
- Karlsruhe Institute of TechnologyInstitute of Microstructure TechnologyHermann‐von‐Helmholtz‐Platz 1Eggenstein‐Leopoldshafen76344Germany
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A Comparative Study of Fatigue Energy Dissipation of Additive Manufactured and Cast AlSi10Mg Alloy. METALS 2021. [DOI: 10.3390/met11081274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this paper, the fatigue energy dissipation of Gravity Casting (GC) and Laser-based Powder Bed Fusion (LPBF) AlSi10Mg alloys under cyclic loading are investigated. The increase in surface temperature related to the energy dissipation effect is decoupled and used to predict the fatigue limits of GC and LPBF AlSi10Mg alloys as being 55.8% UTS and 33.9% UTS, respectively. The energy dissipation rate is obtained by solving the one-dimensional thermal diffusion problem. This energy dissipation is separated into related and unrelated fatigue damage using polynomial function fitting. The energy dissipation related to fatigue damage for LPBF specimens is observed to be higher than that of GC specimens, which indicates worse fatigue performance. The fatigue damage entropy is employed to predict the fatigue life of both GC and LPBF AlSi10Mg alloys, which has a good agreement with the results of a traditional fatigue experiment.
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A new porous fixation plate design using the topology optimization. Med Eng Phys 2021; 92:18-24. [PMID: 34167707 DOI: 10.1016/j.medengphy.2021.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 11/23/2022]
Abstract
Fixation plates are used to accelerate the biological healing process in the damaged area by providing mechanical stabilization for fractured bones. However, they may cause mechanical and biological complications such as aseptic loosening, stress shielding effect and necrosis during the treatment process. The aim of this study, therefore, was to reduce mechanical and biological complications observed in conventional plate models. For this purpose, an optimum plate geometry was obtained using the finite element based topology optimization approach. An optimum and functionally graded porous model were obtained for the plates used for transverse fractures of diaphysis in long bones. This model was combined with a functional graded porous cage structure, and thus a new generation porous implant model was proposed for fixation plates. In order to determine the performance of the optimum plate model, it was produced by additive manufacturing. Three models; i.e. conventional, optimum and porous fixation plates were statically tested, and they were compared experimentally and numerically using the finite element analysis (FEA). The porous model can be considered as the most suitable option since it requires less invasive inputs, and might lead minimum necrosis formation due to having lesser contact surface with the bone.
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Zargar Kharazi A, Fathi MH, Manshaei M, Razavi SM. In-vivo evaluation of a partially resorbable poly l-lactic acid/ braided bioactive glass fibers reinforced composite for load bearing fracture fixation. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2020; 31:57. [PMID: 32596771 DOI: 10.1007/s10856-020-06394-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Our previous studies have been focused on the design, optimization and manufacture of a partially resorbable composite bone plate consisting of a poly l-lactic acid matrix reinforced with braided fabrics bioactive glass fibers (PLLA/BG). In the present study, the response of the composite samples, the degradation rate, the inflammatory response, fibrous capsule formation and tissue-implant bonding to the in-vivo environment were assessed via implantation in the rabbit subcutaneous tissue. Despite the presence of both enzymatic degradation and hydrolysis processes within the body, the rate of the molecular weight loss as an indicator of degradation did not show a significant difference with the in-vitro conditions. It was predicted that strength loss would show the same trend since it was a consequence of molecular chain disruption and the loss of molecular weight. Inexistence of chronic inflammation, as confirmed by our previous results on the controlled degradation rate, also showed the maintenance of the physiological pH in the peripheral environment of the implant. Moreover, lack of the fibrous capsule tissue around the implant indicated that the implant was bioactive. In addition, given the composition of the bioactive glass fibers, that could be bonded to soft and hard tissues, tissue bonding with the PLLA/BG composite samples was also observed, thereby confirming the bioactivity and biocompatibility of the proposed bone plate.
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Affiliation(s)
- Anousheh Zargar Kharazi
- Biomaterials Nanotechnology and Tissue Engineering faculty, School of Advanced Medical Technology, Isfahan University of Medical Sciences, Isfahan, 8174673461, Iran.
| | - Mohammad Hossein Fathi
- Biomaterials Group, Department of Materials Engineering, Isfahan University of Technology, Isfahan, 84156-83111, Iran
| | - Maziar Manshaei
- School of Dentistry, Isfahan UnIversity of Medical Sciences, Isfahan, Iran
- Department of Surgery, Islamic Azade University Shahrekord Branch, sharekord, Iran
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Samiezadeh S, Schemitsch EH, Zdero R, Bougherara H. Biomechanical Response under Stress-Controlled Tension-Tension Fatigue of a Novel Carbon Fiber/Epoxy Intramedullary Nail for Femur Fractures. Med Eng Phys 2020; 80:26-32. [PMID: 32430231 DOI: 10.1016/j.medengphy.2020.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/02/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
Abstract
Metallic intramedullary nails are the "gold standard" implant for repairing femur shaft fractures. However, their rigidity may eliminate axial micromotion at the fracture (causing delayed healing) and they may carry too much load relative to the femur (causing "stress shielding"). Consequently, some researchers have proposed fiber-reinforced composite nails, but only one evaluated cyclic fatigue performance. Therefore, this study assessed the cyclic fatigue response of a carbon fiber/epoxy nail with a novel ply stacking sequence of [02/-45/452/-45/0/-45/452/-452/452/-45/902] previously developed by the present authors. Nails were cyclically loaded in tension-tension at 5 Hz with a stress ratio of R=0.1 from 30% - 85% of the material's ultimate tensile strength (UTS). Thermographic stress analysis, rather than conventional fatigue testing, was used to obtain high cycle fatigue strength (HCFS), below which the nail can be cyclically loaded indefinitely without damage. Also, the mechanical test machine's built-in load cell and an extensometer were used to create stress-strain curves, from which the change in static EO and dynamic E* moduli were obtained. Results showed that HCFS was 70.3% of UTS (or about 283 MPa), while EO and E* remained at 42 GPa without any dRegradation during testing. The current nail shows potential for clinical use.
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Affiliation(s)
- Saeid Samiezadeh
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON, Canada, M5B2K3.
| | - Emil H Schemitsch
- Division of Orthopaedic Surgery, Western University, London, ON, Canada N6A4V2.
| | - Radovan Zdero
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON, Canada, M5B2K3; Division of Orthopaedic Surgery, Western University, London, ON, Canada N6A4V2; Department of Mechanical and Materials Engineering, Western University, London, ON, Canada, N6A5B9.
| | - Habiba Bougherara
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON, Canada, M5B2K3.
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Kim T, See CW, Li X, Zhu D. Orthopedic implants and devices for bone fractures and defects: Past, present and perspective. ENGINEERED REGENERATION 2020. [DOI: 10.1016/j.engreg.2020.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Carbon/PEEK nails: a case-control study of 22 cases. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2019; 30:643-651. [PMID: 31865455 DOI: 10.1007/s00590-019-02602-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 12/13/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Interest around carbon/PEEK plates and nails has been raising. The elastic modulus close to the bone, the high load-carrying capacity and radiolucency make CFR/PEEK materials a potential breakthrough. In the literature, there are abundant data about CFR/PEEK plates in the treatment of proximal humerus, distal radius and distal fibula fractures. In patients affected by bone metastasis, CFR/PEEK nails were proved effective and safe with 12 months of follow-up. Very little is known about performances of CFR/PEEK nails in patients affected by other pathologies. PURPOSES The aim of the study was to evaluate safety and efficacy of CFR/PEEK nails in the treatment of various pathological conditions. It was also investigated whatever radiolucency of this nails could lead to a more objective evaluation of bone callus or disease site. PATIENTS AND METHODS In the study group were included 20 patients (22 bone segments) who underwent CFR/PEEK nail implantation (eight humerus, one tibia, nine femur and four knee arthrodesis). They were affected by pathological fractures, and in four cases, they required an arthrodesis of the knee. They were retrospectively evaluated considering nail failures and bone callus or disease progression (RUSH scores). Mean follow-up time was 11 months (min 6.8-max 20.3). In the control group were included patients treated with titanium nails in the same institution for the same pathologies. An interclass correlation coefficient (ICC) analysis was performed in both groups considering RUSH scores by two expert surgeon from two institution to assess whether radiolucency could lead to a more objective evaluation of disease or bone callus site. RESULTS The ICC of mean values between RUSH scores was 0.882 (IC 95%: 0.702-0.953) in the CFR/PEEK group, while it was 0.778 (IC 95%: 0.41-0.91) in the titanium group. Observers' evaluation showed a significantly higher obscuration by titanium nails than by CFR/PEEK nails. No osteosynthesis failures were reported in both groups. CONCLUSIONS Our results confirm the safety of CFR/PEEK nails in the short-medium term. The radiolucency of these materials led our observers to perform more objective evaluations of bone callus formation or disease progression compared to the titanium group given the higher ICC. LEVEL OF EVIDENCE III Case-control therapeutic study.
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Manteghi S, Sarwar A, Fawaz Z, Zdero R, Bougherara H. Mechanical characterization of the static and fatigue compressive properties of a new glass/flax/epoxy composite material using digital image correlation, thermographic stress analysis, and conventional mechanical testing. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 99:940-950. [PMID: 30889768 DOI: 10.1016/j.msec.2019.02.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/13/2019] [Accepted: 02/13/2019] [Indexed: 11/16/2022]
Abstract
This study characterized the static and fatigue compressive properties of a new hybrid composite material made of synthetic and natural fibers with an epoxy matrix. The glass/flax/epoxy composite material was manufactured as a "sandwich structure" with a Type A configuration (i.e. [0G2/0F12/0G2] using unidirectional glass (G) and flax (F) fibers) and Type B configuration (i.e. [0G2/±45F12/0G2] using unidirectional glass (G) and ±45° oblique flax (F) fibers). Digital image correlation was used to obtain the static properties of compressive elastic modulus (Type A, 24.4 GPa; Type B, 14.7 GPa), ultimate compressive strength (Type A, 261.7 MPa; Type B, 231.9 MPa), and Poisson's ratio (Type A, 0.37; Type B, 0.58). Thermographic stress analysis was used to measure a high cycle fatigue strength (HCFS) of 53% (Type A and B) of ultimate compressive strength. Conventional experimental fatigue methods (i.e. stress vs. number of cycles to failure) yielded a HCFS of 56-61% (Type A) and 51-56% (Type B), as well as almost constant dynamic compressive moduli of 15 GPa (Type A) and 10 GPa (Type B) over the entire loading regime. This new composite material may have various potential applications, such as aerospace, automotive, biomechanics, sports, etc., based on the compressive properties measured.
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Affiliation(s)
- Saeed Manteghi
- Dept. of Mechanical and Industrial Engineering, Ryerson University, 350 Victoria Street, Toronto, ON M5B2K3, Canada
| | - Ahmed Sarwar
- Dept. of Mechanical and Industrial Engineering, Ryerson University, 350 Victoria Street, Toronto, ON M5B2K3, Canada
| | - Zouheir Fawaz
- Dept. of Aerospace Engineering, Ryerson University, 350 Victoria Street, Toronto, ON M5B2K3, Canada
| | - Radovan Zdero
- Dept. of Mechanical and Industrial Engineering, Ryerson University, 350 Victoria Street, Toronto, ON M5B2K3, Canada; Dept. of Mechanical and Materials Engineering, Western University, 1151 Richmond Street North, London, ON N6A5B9, Canada; Orthopaedic Biomechanics Lab, Victoria Hospital, 800 Commissioners Road, London, ON N6A5A5, Canada
| | - Habiba Bougherara
- Dept. of Mechanical and Industrial Engineering, Ryerson University, 350 Victoria Street, Toronto, ON M5B2K3, Canada.
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14
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Aisyah HA, Paridah MT, Khalina A, Sapuan SM, Wahab MS, Berkalp OB, Lee CH, Lee SH. Effects of Fabric Counts and Weave Designs on the Properties of Laminated Woven Kenaf/Carbon Fibre Reinforced Epoxy Hybrid Composites. Polymers (Basel) 2018; 10:E1320. [PMID: 30961245 PMCID: PMC6401800 DOI: 10.3390/polym10121320] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 11/24/2018] [Accepted: 11/26/2018] [Indexed: 11/25/2022] Open
Abstract
The effects of different fabric materials namely weave designs (plain and satin) and fabric counts (5 × 5 and 6 × 6) on the properties of laminated woven kenaf/carbon fibre reinforced epoxy hybrid composites were evaluated. The hybrid composites were fabricated from two types of fabric, i.e., woven kenaf that was made from a yarn of 500tex and carbon fibre, by using vacuum infusion technique and epoxy resin as matrix. The panels were tested for tensile, flexural, and impact strengths. The results have revealed that plain fabric is more suitable than satin fabric for obtaining high tensile and impact strengths. Using a fabric count of 5 × 5 has generated composites that are significantly higher in flexural modulus as compared to 6 × 6 which may be attributed to their structure and design. The scanned electron micrographs of the fractured surfaces of the composites demonstrated that plain woven fabric composites had better adhesion properties than satin woven fabric composites, as indicated by the presence of notably lower amount of fibre pull out.
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Affiliation(s)
- H A Aisyah
- Institute of Tropical Forestry and Forest Products (INTROP), Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia.
| | - M T Paridah
- Institute of Tropical Forestry and Forest Products (INTROP), Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia.
| | - A Khalina
- Institute of Tropical Forestry and Forest Products (INTROP), Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia.
- Faculty of Engineering, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia.
| | - S M Sapuan
- Institute of Tropical Forestry and Forest Products (INTROP), Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia.
- Faculty of Engineering, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia.
| | - M S Wahab
- Faculty of Mechanical Engineering, Universiti Tun Hussien Onn Malaysia (UTHM), 86400 Batu Pahat, Johor, Malaysia.
| | - O B Berkalp
- Faculty of Textile Technology and Design, Istanbul Technical University, İnönü Caddesi. No.: 65, Gumussuyu, Beyoglu, 34437 Istanbul, Turkey.
| | - C H Lee
- Institute of Tropical Forestry and Forest Products (INTROP), Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia.
| | - S H Lee
- Institute of Tropical Forestry and Forest Products (INTROP), Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia.
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15
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Early Comparative Outcomes of Carbon Fiber-Reinforced Polymer Plate in the Fixation of Distal Femur Fractures. J Orthop Trauma 2018; 32:386-390. [PMID: 29781944 DOI: 10.1097/bot.0000000000001223] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the early clinical results of distal femur fractures treated with carbon fiber-reinforced polyetheretherketone (CFR-PEEK) plates compared with stainless steel (SS) lateral locking plates. DESIGN Retrospective comparative cohort study. SETTING ACS Level I trauma center. PATIENTS/PARTICIPANTS Twenty-two patients (11 SS, 11 CFR-PEEK) with closed distal femur fractures treated by a single surgeon over a 6-year period. MAIN OUTCOME MEASUREMENTS Nonunion, hardware failure, reoperation, time to full weight-bearing, and time union were assessed. RESULTS The CFR-PEEK cohort was on average older (71 vs. 57 years, P = 0.03) and more likely to have diabetes (P = 0.02). Nonunion was diagnosed in 4/11 (36%) patients in the SS group and 1/11 (9%) patients in the CFR-PEEK group (P = 0.12). Hardware failure occurred in 2 SS patients (18%) compared with none in the CFR-PEEK group (P = 0.14). Time to full weight-bearing was similar between groups, occurring at 9.9 and 12.4 weeks in the CFR-PEEK and SS groups, respectively (P = 0.23). Time to radiographic union averaged 12.4 weeks in the SS group and 18.7 weeks in the CFR-PEEK group (P = 0.26). There were 4 reoperations in the SS group and 1 in the CFR-PEEK group (P = 0.12). CONCLUSIONS CFR-PEEK plates show encouraging short-term results in the treatment of distal femur fractures with a comparable nonunion, reoperation, and hardware failure rates to those treated with SS plates. This data suggest that CFR-PEEK plates may be a viable alternative to SS plates in fixation of these fractures. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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16
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Heimbach B, Grassie K, Shaw MT, Olson JR, Wei M. Effect of hydroxyapatite concentration on high-modulus composite for biodegradable bone-fixation devices. J Biomed Mater Res B Appl Biomater 2016; 105:1963-1971. [PMID: 27300308 DOI: 10.1002/jbm.b.33713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/27/2016] [Accepted: 05/01/2016] [Indexed: 11/06/2022]
Abstract
There are over 3 million bone fractures in the United States annually; over 30% of which require internal mechanical fixation devices to aid in the healing process. The current standard material used is a metal plate that is implanted onto the bone. However, metal fixation devices have many disadvantages, namely stress shielding and metal ion leaching. This study aims to fix these problems of metal implants by making a completely biodegradable material that will have a high modulus and exhibit great toughness. To accomplish this, long-fiber poly-l-lactic acid (PLLA) was utilized in combination with a matrix composed of polycaprolactone (PCL) and hydroxyapatite (HA) nano-rods. Through single fibril tensile tests, it was found that the PLLA fibers have a Young's modulus of 8.09 GPa. Synthesized HA nanorods have dimensions in the nanometer range with an aspect ratio over 6. By dip coating PLLA fibers in a suspension of PCL and HA and hot pressing the resulting coated fibers, dense fiber-reinforced samples were made having a flexural modulus up to 9.2 GPa and a flexural strength up to 187 MPa. The flexural modulus of cortical bone ranges from 7 to 25 GPa, so the modulus of the composite material falls into the range of bone. The typical flextural strength of bone is 130 MPa, and the samples here greatly exceed that with a strength of 187 MPa. After mechanical testing to failure the samples retained their shape, showing toughness with no catastrophic failure, indicating the possibility for use as a fixation material. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1963-1971, 2017.
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Affiliation(s)
- Bryant Heimbach
- Department of Biomedical Engineering, University of Connecticut, Connecticut
| | - Kevin Grassie
- Department of Biomedical Engineering, University of Connecticut, Connecticut
| | - Montgomery T Shaw
- Institute of Material Science (IMS), 97 North Eagleville Road, University of Connecticut, Storrs CT 06269-3136 Connecticut
| | - James R Olson
- Teleflex Medical, 1295 Main Street, Coventry, Connecticut, 06238
| | - Mei Wei
- Department of Biomedical Engineering, University of Connecticut, Connecticut.,Institute of Material Science (IMS), 97 North Eagleville Road, University of Connecticut, Storrs CT 06269-3136 Connecticut.,Department of Materials Science and Engineering, University of Connecticut, Storrs, Connecticut, 06269
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17
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Chakladar N, Harper L, Parsons A. Optimisation of composite bone plates for ulnar transverse fractures. J Mech Behav Biomed Mater 2016; 57:334-46. [DOI: 10.1016/j.jmbbm.2016.01.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 01/19/2016] [Accepted: 01/25/2016] [Indexed: 10/22/2022]
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18
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Bagheri ZS, Tavakkoli Avval P, Bougherara H, Aziz MSR, Schemitsch EH, Zdero R. Biomechanical analysis of a new carbon fiber/flax/epoxy bone fracture plate shows less stress shielding compared to a standard clinical metal plate. J Biomech Eng 2015; 136:091002. [PMID: 24828985 DOI: 10.1115/1.4027669] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 05/14/2014] [Indexed: 11/08/2022]
Abstract
Femur fracture at the tip of a total hip replacement (THR), commonly known as Vancouver B1 fracture, is mainly treated using rigid metallic bone plates which may result in "stress shielding" leading to bone resorption and implant loosening. To minimize stress shielding, a new carbon fiber (CF)/Flax/Epoxy composite plate has been developed and biomechanically compared to a standard clinical metal plate. For fatigue tests, experiments were done using six artificial femurs cyclically loaded through the femoral head in axial compression for four stages: Stage 1 (intact), stage 2 (after THR insertion), stage 3 (after plate fixation of a simulated Vancouver B1 femoral midshaft fracture gap), and stage 4 (after fracture gap healing). For fracture fixation, one group was fitted with the new CF/Flax/Epoxy plate (n = 3), whereas another group was repaired with a standard clinical metal plate (Zimmer, Warsaw, IN) (n = 3). In addition to axial stiffness measurements, infrared thermography technique was used to capture the femur and plate surface stresses during the testing. Moreover, finite element analysis (FEA) was performed to evaluate the composite plate's axial stiffness and surface stress field. Experimental results showed that the CF/Flax/Epoxy plated femur had comparable axial stiffness (fractured = 645 ± 67 N/mm; healed = 1731 ± 109 N/mm) to the metal-plated femur (fractured = 658 ± 69 N/mm; healed = 1751 ± 39 N/mm) (p = 1.00). However, the bone beneath the CF/Flax/Epoxy plate was the only area that had a significantly higher average surface stress (fractured = 2.10 ± 0.66 MPa; healed = 1.89 ± 0.39 MPa) compared to bone beneath the metal plate (fractured = 1.18 ± 0.93 MPa; healed = 0.71 ± 0.24 MPa) (p < 0.05). FEA bone surface stresses yielded peak of 13 MPa at distal epiphysis (stage 1), 16 MPa at distal epiphysis (stage 2), 85 MPa for composite and 129 MPa for metal-plated femurs at the vicinity of nearest screw just proximal to fracture (stage 3), 21 MPa for composite and 24 MPa for metal-plated femurs at the vicinity of screw farthest away distally from fracture (stage 4). These results confirm that the new CF/Flax/Epoxy material could be a potential candidate for bone fracture plate applications as it can simultaneously provide similar mechanical stiffness and lower stress shielding (i.e., higher bone stress) compared to a standard clinical metal bone plate.
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Samiezadeh S, Tavakkoli Avval P, Fawaz Z, Bougherara H. On optimization of a composite bone plate using the selective stress shielding approach. J Mech Behav Biomed Mater 2015; 42:138-53. [DOI: 10.1016/j.jmbbm.2014.11.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 11/08/2014] [Accepted: 11/17/2014] [Indexed: 10/24/2022]
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20
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Bagheri ZS, Giles E, El Sawi I, Amleh A, Schemitsch EH, Zdero R, Bougherara H. Osteogenesis and cytotoxicity of a new Carbon Fiber/Flax/Epoxy composite material for bone fracture plate applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 46:435-42. [PMID: 25492008 DOI: 10.1016/j.msec.2014.10.042] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 07/11/2014] [Accepted: 10/21/2014] [Indexed: 11/29/2022]
Abstract
This study is part of an ongoing program to develop a new CF/Flax/Epoxy bone fracture plate to be used in orthopedic trauma applications. The purpose was to determine this new plate's in-vitro effects on the level of bone formation genes, as well as cell viability in comparison with a medical grade metal (i.e. stainless steel) commonly employed for fabrication of bone plates (positive control). Cytotoxicity and osteogenesis induced by wear debris of the material were assessed using Methyl Tetrazolium (MTT) assay and reverse transcription polymerase chain reaction (RT-PCR) for 3 osteogenesis specific gene markers, including bone morphogenetic proteins (BMP2), runt-related transcription factor 2 (Runx2) and Osterix. Moreover, the Flax/Epoxy and CF/Epoxy composites were examined separately for their wettability properties by water absorption and contact angle (CA) tests using the sessile drop technique. The MTT results for indirect and direct assays indicated that the CF/Flax/Epoxy composite material showed comparable cell viability with no cytotoxicity at all incubation times to that of the metal group (p≥0.05). Osteogenesis test results showed that the expression level of Runx2 marker induced by CF/Flax/Epoxy were significantly higher than those induced by metal after 48 h (p=0.57). Also, the Flax/Epoxy composite revealed a hydrophilic character (CA=68.07°±2.05°) and absorbed more water up to 17.2% compared to CF/Epoxy, which reached 1.25% due to its hydrophobic character (CA=93.22°±1.95°) (p<0.001). Therefore, the new CF/Flax/Epoxy may be a potential candidate for medical applications as a bone fracture plate, as it showed similar cell viability with no negative effect on gene expression levels responsible for bone formation compared to medical grade stainless steel.
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Affiliation(s)
- Zahra S Bagheri
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON M5B-2K3, Canada; Martin Orthopaedic Biomechanics Lab, St. Michael's Hospital, Toronto, ON M5B-1W8, Canada
| | - Erica Giles
- Musculoskeletal Research Lab, St. Michael's Hospital, Toronto, ON M5B-1W8, Canada
| | - Ihab El Sawi
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON M5B-2K3, Canada
| | - Asma Amleh
- Department of Biology, The American University in Cairo (AUC), New Cairo 11835, Egypt
| | - Emil H Schemitsch
- Martin Orthopaedic Biomechanics Lab, St. Michael's Hospital, Toronto, ON M5B-1W8, Canada; Musculoskeletal Research Lab, St. Michael's Hospital, Toronto, ON M5B-1W8, Canada; Dept. of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON M5S-1A8, Canada
| | - Radovan Zdero
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON M5B-2K3, Canada; Martin Orthopaedic Biomechanics Lab, St. Michael's Hospital, Toronto, ON M5B-1W8, Canada; Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canada
| | - Habiba Bougherara
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON M5B-2K3, Canada.
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