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用于修复关节周围骨缺损的高温氧化处理3D打印解剖型WE43合金支架:及研究

High temperature oxidation treated 3D printed anatomical WE43 alloy scaffolds for repairing periarticular bone defects: and studies.

作者信息

Liu Bingchuan, Liu Jinge, Wang Chaoxin, Wang Zhengguang, Min Shuyuan, Wang Caimei, Zheng Yufeng, Wen Peng, Tian Yun

机构信息

Department of Orthopaedics, Peking University Third Hospital, Beijing, 100191, China.

Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China.

出版信息

Bioact Mater. 2023 Oct 11;32:177-189. doi: 10.1016/j.bioactmat.2023.09.016. eCollection 2024 Feb.

Abstract

Reconstruction of subarticular bone defects is an intractable challenge in orthopedics. The simultaneous repair of cancellous defects, fractures, and cartilage damage is an ideal surgical outcome. 3D printed porous anatomical WE43 (magnesium with 4 wt% yttrium and 3 wt% rare earths) scaffolds have many advantages for repairing such bone defects, including good biocompatibility, appropriate mechanical strength, customizable shape and structure, and biodegradability. In a previous investigation, we successfully enhanced the corrosion resistance of WE43 samples via high temperature oxidation (HTO). In the present study, we explored the feasibility and effectiveness of HTO-treated 3D printed porous anatomical WE43 scaffolds for repairing the cancellous bone defects accompanied by split fractures via in vitro and experiments. After HTO treatment, a dense oxidation layer mainly composed of YO and NdO formed on the surface of scaffolds. In addition, the majority of the grains were equiaxed, with an average grain size of 7.4 μm. Cell and rabbit experiments confirmed the non-cytotoxicity and biocompatibility of the HTO-treated WE43 scaffolds. After the implantation of scaffolds inside bone defects, their porous structures could be maintained for more than 12 weeks without penetration and for more than 6 weeks with penetration. During the postoperative follow-up period for up to 48 weeks, radiographic examinations and histological analysis revealed that abundant bone gradually regenerated along with scaffold degradation, and stable osseointegration formed between new bone and scaffold residues. MRI images further demonstrated no evidence of any obvious damage to the cartilage, ligaments, or menisci, confirming the absence of traumatic osteoarthritis. Moreover, finite element analysis and biomechanical tests further verified that the scaffolds was conducive to a uniform mechanical distribution. In conclusion, applying the HTO-treated 3D printed porous anatomical WE43 scaffolds exhibited favorable repairing effects for subarticular cancellous bone defects, possessing great potential for clinical application.

摘要

关节下骨缺损的重建是骨科领域一项棘手的挑战。同时修复松质骨缺损、骨折和软骨损伤是理想的手术结果。3D打印多孔解剖型WE43(含4 wt%钇和3 wt%稀土的镁)支架在修复此类骨缺损方面具有诸多优势,包括良好的生物相容性、合适的机械强度、可定制的形状和结构以及生物可降解性。在先前的一项研究中,我们通过高温氧化(HTO)成功提高了WE43样品的耐腐蚀性。在本研究中,我们通过体外和体内实验探索了HTO处理的3D打印多孔解剖型WE43支架修复伴有劈裂骨折的松质骨缺损的可行性和有效性。经过HTO处理后,支架表面形成了主要由YO和NdO组成的致密氧化层。此外,大多数晶粒呈等轴状,平均晶粒尺寸为7.4μm。细胞和兔子实验证实了HTO处理的WE43支架无细胞毒性和生物相容性。将支架植入骨缺损后,其多孔结构可维持12周以上无穿透,6周以上有穿透。在长达48周的术后随访期间,影像学检查和组织学分析显示,随着支架降解,大量骨逐渐再生,新骨与支架残余物之间形成了稳定的骨整合。MRI图像进一步表明,软骨、韧带或半月板没有明显损伤的迹象,证实没有创伤性骨关节炎。此外,有限元分析和生物力学测试进一步验证了支架有利于机械分布均匀。总之,应用HTO处理的3D打印多孔解剖型WE43支架对关节下松质骨缺损具有良好的修复效果,具有很大的临床应用潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f740/10582357/774ac43fb2b8/ga1.jpg

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