Shan Jianyang, Yu Yaling, Liu Xiaohan, Chai Yimin, Wang Xing, Wen Gen
Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, National Center for Orthopaedic Medicine, Shanghai, 200233, China.
Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China.
Heliyon. 2024 Sep 7;10(19):e37431. doi: 10.1016/j.heliyon.2024.e37431. eCollection 2024 Oct 15.
Bone defects, stemming from trauma, tumors, infections, and congenital conditions, pose significant challenges in orthopedics. Although the body possesses innate mechanisms for bone self-repairing, factors such as aging, disease, and injury can impair these processes, jeopardizing skeletal integrity. Addressing substantial bone defects remains a global orthopedic concern, with variables like gender, lifestyle and preexisting conditions influencing fracture risk and complication rates. Traditional repair methods, mainly bone transplantation including autografts, allografts and xenografts, have shown effectiveness but also present limitations. Autologous bone grafts, highly valued for their osteogenic properties, require additional surgeries with extended hospitalization, and carry risks associated with the donor site. The development of advanced biomaterials offers promising new avenues for bone repair. An ideal material should exhibit a combination of biocompatibility, biodegradability, bone conduction, porosity, strength, and the ability to stimulate bone formation. Chitosan (CS), derived from chitin, stands out due to its biocompatibility, biodegradability, low immunogenicity, non-toxicity, and a wide range of biological activities, including antioxidant, anti-tumor, anti-inflammatory, antimicrobial, and immunomodulatory properties. Notably, CS has shown the properties to promote bone regeneration, increase bone density, and accelerate fracture healing. This review provides a comprehensive examination of CS-based hydrogels for bone repair aiming to inspire researchers by presenting new ideas for innovative CS-based solutions, thereby advancing their potential applications in the field of bone repair.
由创伤、肿瘤、感染和先天性疾病引起的骨缺损给骨科带来了重大挑战。尽管身体具有骨自我修复的内在机制，但衰老、疾病和损伤等因素会损害这些过程，危及骨骼完整性。解决大面积骨缺损仍然是全球骨科关注的问题，性别、生活方式和既往疾病等变量会影响骨折风险和并发症发生率。传统的修复方法主要是骨移植，包括自体骨移植、异体骨移植和异种骨移植，已显示出有效性，但也存在局限性。自体骨移植因其成骨特性而备受重视，但需要额外的手术和更长的住院时间，并且存在供体部位相关的风险。先进生物材料的发展为骨修复提供了有前景的新途径。理想的材料应具备生物相容性、生物可降解性、骨传导性、孔隙率、强度以及刺激骨形成的能力等多种特性。壳聚糖（CS）由甲壳素衍生而来，因其生物相容性、生物可降解性、低免疫原性、无毒以及广泛的生物活性（包括抗氧化、抗肿瘤、抗炎、抗菌和免疫调节特性）而脱颖而出。值得注意的是，CS已显示出促进骨再生、增加骨密度和加速骨折愈合的特性。本综述全面考察了用于骨修复的基于壳聚糖的水凝胶，旨在通过提出基于壳聚糖的创新解决方案的新思路来启发研究人员，从而推动其在骨修复领域的潜在应用。
