Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, P. R. China.
Adv Sci (Weinh). 2022 Jun;9(17):e2200079. doi: 10.1002/advs.202200079. Epub 2022 Apr 11.
Lesion positioning therapy optimizes medical treatment by directly targeting lesions. However, strong physical barriers greatly hinder its wide use. Here, the Chinese acupuncture needles (CA-needles) with a screw-thread structure at the tip (ST-needle) and the hydrogel with the function of adhesive metal and loaded drug sustained-release structure are designed, through the minimally invasive and precise positioning of lesions by ST-needles, the dry-wet conversion of hydrogel with absorbing fluids and swelling, and the rotation back of ST-needles, the hydrogel is precisely positioned in the subchondral bone with physical barrier to achieve precise positioning therapy for lesions. In vitro experiments show that the ST-needle penetrates the physical barrier of cartilage and enters the subchondral bone. Simultaneously, the hydrogel transfer efficiency of the ST-needle (73.25%) is significantly higher than that of the CA-needle (29.92%) due to the protective effect of the screw-thread structure. In vivo experiments demonstrate that precise positioning in subchondral bone in osteoarthritis rats with ST-needles effectively inhibits abnormal subchondral bone remodeling, alleviating the degeneration and degradation of cartilage. Therefore, ST-needles achieve lesion positioning therapy through minimally invasive penetration of physical barriers, precisely positioning within lesions, and delivering hydrogel to release drugs.
病灶定位治疗通过直接针对病灶来优化治疗效果。然而，强大的物理屏障极大地阻碍了其广泛应用。在这里，设计了一种具有螺纹结构尖端（ST 针）的中国针灸针（CA 针）和具有粘合金属和负载药物持续释放结构的水凝胶，通过 ST 针对病灶进行微创和精确定位，水凝胶吸收液体和肿胀的干湿转换，以及 ST 针的反向旋转，水凝胶被精确地定位在具有物理屏障的软骨下骨中，从而实现对病灶的精确定位治疗。体外实验表明，ST 针穿透软骨的物理屏障并进入软骨下骨。同时，由于螺纹结构的保护作用，ST 针的水凝胶传递效率（73.25%）明显高于 CA 针（29.92%）。体内实验表明，ST 针在骨关节炎大鼠的软骨下骨中的精确定位有效地抑制了异常的软骨下骨重塑，缓解了软骨的退变和降解。因此，ST 针通过微创穿透物理屏障、在病灶内精确定位以及输送水凝胶释放药物来实现病灶定位治疗。
