Bao Zijian, Yang Ran, Chen Binggang, Luan Shifang
State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China.
School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei 230026, China.
Fundam Res. 2024 Feb 29;5(2):782-795. doi: 10.1016/j.fmre.2023.11.023. eCollection 2025 Mar.
Highly comminuted fractures and bone defects pose a significant challenge for orthopedic surgery. Current surgical procedures commonly rely on metal implants (such as bone plates, nails and pins) for fracture internal and external fixations, but they are likely to result in problems, such as stress shielding and poor bone healing. Bone adhesive represents an attractive alternative for the treatment of fracture. The ideal bone adhesive should satisfy several performance requirements, including high adhesion strength for bone tissues, rapid in-situ curing in a physiological environment, good biocompatibility with no toxicity, degradability, and good stability . Among these requirements, degradability is a crucial characteristic of bone adhesives. This property enables the material to be easily removed without the need for surgery at a later stage, ensuring the regeneration of bone tissue without any hindrance. The degradation rate of bone adhesive varies depending on the application scenarios and tissues, ranging from weeks to years. Many bone adhesives are unable to guarantee degradability while achieving other necessary performances. Therefore, this article provides a detailed overview of the strategies to fabricate biodegradable polymer bone adhesives that can maintain high bulk and adhesion strength, biocompatibility and other properties. Finally, the current challenges in the clinical translation of bone adhesives and their future development directions are discussed.
高度粉碎性骨折和骨缺损给骨科手术带来了重大挑战。目前的外科手术通常依靠金属植入物（如骨板、髓内钉和钢针）进行骨折的内固定和外固定，但它们可能会导致诸如应力遮挡和骨愈合不良等问题。骨粘合剂是治疗骨折的一种有吸引力的替代方法。理想的骨粘合剂应满足多项性能要求，包括对骨组织的高粘附强度、在生理环境中快速原位固化、良好的生物相容性且无毒、可降解性以及良好的稳定性。在这些要求中，可降解性是骨粘合剂的一个关键特性。这一特性使材料能够在后期无需手术即可轻松移除，确保骨组织的再生不受任何阻碍。骨粘合剂的降解速率因应用场景和组织而异，从数周到数年不等。许多骨粘合剂在实现其他必要性能的同时无法保证可降解性。因此，本文详细概述了制备可生物降解聚合物骨粘合剂的策略，这些骨粘合剂能够保持较高的本体强度和粘附强度、生物相容性及其他性能。最后，讨论了骨粘合剂临床转化目前面临的挑战及其未来的发展方向。
