Zhang Weimin, Zhang Jiaxin, Liu He, Liu Yang, Sheng Xiao, Zhou Sixing, Pei Tiansen, Li Chen, Wang Jincheng
Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China.
Huzhou Central Hospital, Fifth school of Clinical Medical Universtiy, Wuxing, Huzhou, Zhejiang 313000, PR China.
Mater Today Bio. 2024 Dec 24;30:101422. doi: 10.1016/j.mtbio.2024.101422. eCollection 2025 Feb.
Titanium alloys are widely used in the manufacture of orthopedic prosthesis given their excellent mechanical properties and biocompatibility. However, the primary drawbacks of traditional titanium alloy prosthesis are their much higher elastic modulus than cancellous bone and poor interfacial adhesion, which lead to poor osseointegration. 3D-printed porous titanium alloys can partly address these issues, but their bio-inertness still requires modifications to adapt to different physiological and pathological microenvironments. Hydrogels composed of three-dimensional networks of hydrophilic polymers can effectively simulate the extracellular matrix of natural bone and are capable of loading bioactive molecules such as proteins, peptides, growths factors, polysaccharides, or nucleotides for localized release within the human body, by directly participating in biological processes. Combining 3D-printed porous titanium alloys with hydrogels to construct a bioactive composite system that regulates cellular adhesion, proliferation, migration, and differentiation in the local microenvironment is of great significance for enhancing the bioactivity of the prosthesis surface. In this review, we focus on three aspects of the bioactive composite system: (Ⅰ) strategies for constructing bioactive interfaces with hydrogels, and (Ⅱ) how bioactive composite systems regulate the microenvironment under different physiological and pathological conditions to enhance the osteointegration and bone regeneration capability of prostheses. Considering the current research status in this field, innovations in orthopedic prosthesis can be achieved through material optimization, personalized customization, and the development of multifunctional composite systems. These advancements provide essential references for the clinical translation of osseointegration and bone regeneration in various physiological and pathological microenvironments.
钛合金因其优异的力学性能和生物相容性而被广泛应用于骨科假体的制造。然而，传统钛合金假体的主要缺点是其弹性模量比松质骨高得多，且界面附着力差，这导致骨整合不良。3D打印多孔钛合金可以部分解决这些问题，但其生物惰性仍需要改进以适应不同的生理和病理微环境。由亲水性聚合物的三维网络组成的水凝胶可以有效地模拟天然骨的细胞外基质，并且能够负载蛋白质、肽、生长因子、多糖或核苷酸等生物活性分子，以便通过直接参与生物过程在人体内进行局部释放。将3D打印多孔钛合金与水凝胶结合，构建一个能在局部微环境中调节细胞黏附、增殖、迁移和分化的生物活性复合系统，对于提高假体表面的生物活性具有重要意义。在这篇综述中，我们聚焦于生物活性复合系统的三个方面：（Ⅰ）与水凝胶构建生物活性界面的策略，以及（Ⅱ）生物活性复合系统如何在不同生理和病理条件下调节微环境以增强假体的骨整合和骨再生能力。考虑到该领域的当前研究现状，通过材料优化、个性化定制以及多功能复合系统的开发，可以实现骨科假体的创新。这些进展为各种生理和病理微环境下骨整合和骨再生的临床转化提供了重要参考。
