| 摘要: | Background: It is estimated approximately that annually, more than 150,000 anterior cruciate ligament (ACL) reconstruction (surgery) occurs worldwide. ACL tear or rupture is a common injury in active people, and one of the most common knee injuries in sports. The healing response after ACL tear, into its anatomic or physiologic position is considered very poor and without surgical reconstruction, the ACL deficient knee mobility will be limited. Such deficiencies can lead to associated degenerative changes in knee joint. ACL tears are frequently treated with surgical reconstruction using grafts, in which interference screws (IFSs) are considered as the critical factor anchoring trauma implants for the healing process.
The criterion for bone replacing or anchoring trauma implants, besides resorption, includes functional ankylosis (osteointegration) at fixation point, osseous ingrowth onto implant surface (osteoconduction) and replacement by viable functional osteogenesis (neo-bone tissues). Resorbable IFSs, and conventional metallic IFSs are equally regarded as successful in graft fixation. However, drawbacks of metallic IFSs like graft irritation, potential revision procedures, and distortion of Magnetic Resonance Imaging (MRI) have led to the preference of resorbable IFSs that exhibits advantages like resorbability and imaging compatibility. Although, through out these years, the resorbable IFSs fixation armamentarium of clinicians, amplified with numerous options, lack of graft healing, poor tissue integration and inadequate neo- bone tissue replacement in fixation point even after extended implantation time, unstable degradation, tunnel enlargement, inflammatory or foreign body reactions, mechanical failures, and post-implantation complications raised concerns in its reliability and efficacy
Aim: To study the state-of-the-art developed IFSs bioresorbable bone-anchoring substitutes fabricated by Glass fiber-reinforced plastic (GFP) composites composing multiplexed network modifiers for regenerative medicine.
Materials and Methods: For the experimental studies, two groups of bioactive glass fiber-reinforced plastic (BGFP) composite having cladded, and non-cladded fiber micro-structures were fabricated with compositional variations. The hybrids of each group were formulated with same but varying concentration of multiplexed glass network modifier oxides with and without incorporation of niobicoxide. This BGFP composite hybrids have a novel microarchitecture of unidirectional and continuous bioactive glass fibers-reinforced in a matrix made up off thermosetting epoxy resin polymer using melt-drawing and microfabrication fabrication technology. This depicted method can structurally intricate compositionally variant GFP composites hybrids.
Furthermore, a 3D customized fiber braiding method is practiced facilitating advanced reinforcement interference bonding within the composite microstructures and to improve the biomechanical behavior at bone-implant interface. Micro-architectural structural bioactive glass fiber variants to enhance radiopacity in imaging are constructed using “fiber cladding technique”, which is also one of the highlights of the material construct in this study.
Results: Non-cladded fiber composing BGFP group hybrids (BGFPnb5 and BGFP5) and cladded fiber composing BGFP group hybrids (BGFPdnb12 and BGFPd12) comprising multiplexed elemental oxide components differentially influenced bioactivation mechanism and unique structural apatite layer formation as it encounters stimulated biological solutions. Furthermore, BGFP composite hybrids demonstrated dominant physico-chemical properties such as surface roughness characteristics, hydrophilic exposure in water contact, and pH balanced ionic dissolution mechanisms. Additionally, distinctive flexural strength kinetics was also expressed. In in-vitro, cellular assays, revealed high cellular biocompatibility and material influenced bone marrow-derived mesenchymal stem cells (BM-MSCs) proliferation, adherence, and migration.The composites showed antimicrobial activity against DH5-???? Escherichia coli (E-coli) growth in suspension culture. Moreover, demonstrated induced functional ankylosis (osteointegration), Osteoconduction, and periosteal actuation in in-vivo animal model implantation studies in rat and rabbit.
Conclusion: Therapeutic efficacy of Bioactive Glass fiber-reinforced plastic (BGFP) composite hybrid’s, exibits favourable material properties aiding in bone regeneration and restoration mechanisms that could contribute in developing BGFP as a pioneer next generation biomaterial for orthopedics/orthodontics based regenerative medicine. |
