Design,fabrication,and structural safety validation of 3D-printable biporous bone augments

The use of commercial products such as a cup and liner for total hip arthroplasty for patients with severe bone defects has a high probability of failure.In these patients the cup alone cannot cover the bone defect,and thus,an additional augment or cage is required.In this study,we designed three-dimensional(3D)printable bone augments as an alternative to surgeries using reinforcement cages.Thirty-five sharp-edged bone augments of various sizes were 3D printed.A biporous structure was designed to reduce the weight of the augment and to facilitate bone ingrowth.Two types of frames were used to prevent damage to the augment’s porous structure and maintain its stability during printing.Furthermore,two types of holes were provided for easy augment fixation at various angles.Fatigue tests were performed on a combination of worst-case sizes derived using finite element analysis.The test results confirmed the structural stability of the specimens at a load of 5340 N.Although the porosity of the specimens was measured to be 63.70%,it cannot be said that the porous nature was uniformly distributed because porosity tests were performed locally and randomly.In summary,3D-printable biporous bone augments capable of bonding from various angles and bidirectionally through angulation and bottom-plane screw holes are proposed.The mechanical results with bone augments indicate good structural safety in patients.However,further research is necessary to study the clinical applications of the proposed bone augment.

EFFECTS OF ALENDRONATE ON STRUCTURAL PROPERTIES OF TRABECULAR BONE IN DOGS

Objective. To evaluate the effects of alendronate on the structural properties of trabecular bone.Methods. Alendronate was administered at a daily p. o. dose of 0. 5 mg/kg over a 12-week period in hound dogs (n = 8 for both the control and treated group), and the structural indices of the lumbar vertebral (LI and L2) trabecular bone were assessed directly from 3-D images.Results. Treatment with alendronate increased bone volume fraction by 9. 5% and 7. 7% in L1 and L2 respectively. Trabecular thickness significantly increased after alendronate treatment, whereas trabecular separation remained constant. The degree of anisotropy for the alendronate - treated group was decreased compared with that of the control group. Bone surface to volume ratio declined significantly in the alendronate-reated group, whereas alendronate induced a higher bone surface density.Conclusion. Alendronate increased the structural properties of canine trabecular bone after short-term treatment at a dose of 0. 5 mg · kg-1·day-1.

Computational Simulations of Bone Remodeling under Natural Mechanical Loading or Muscle Malfunction Using Evolutionary Structural Optimization Method

Live bone inherently responds to applied mechanical stimulus by altering its internal tissue composition and ultimately biomechanical properties, structure and function. The final formation may structurally appear inferior by design but complete by function. To understand the loading response, this paper numerically investigated structural remodeling of mature sheep femur using evolutionary structural optimization method (ESO). Femur images from Computed Tomography scanner were used to determine the elastic modulus variation and subsequently construct finite element model of the femur with stiffest elasticity measured. Major muscle forces on dominant phases of healthy sheep gait were imposed on the femur under static mode. ESO was applied to progressively alter the remodeling of numerically simulated femur from its initial to final design by iteratively removing elements with low strain energy density (SED). The computations were repeated with two different mesh sizes to test the convergence. The elements within the medullary canal had low SEDs and therefore were removed during the optimization. The SEDs in the remaining elements varied with angle around the circumference of the shaft. Those elements with low SED were inefficient in supporting the load and thus fundamentally explained how bone remodels itself with less stiff inferior tissue to meet load demand. This was in line with the Wolff’s law of transformation of bone. Tissue growth and remodeling process was found to shape the sheep femur to a mechanically optimized structure and this was initiated by SED in macro-scale according to traditional principle of Wolff’s law.

The Effect of Bone Loss Pattern on the Structural Capacity of the Proximal Femur

The effect of age-related bone loss on the structural capacity of the proximal femur were investigated by Finite Element Analysis (FEA). Four bone loss patterns were considered. These were "uniform cortical bone loss", "neck cortical bone loss", "intertrochanteric cortical bone loss" and "uniform trabecular bone loss". The results show that the two "non-uniform cortical bone loss" patterns are more dangerous than the "uniform cortical bone loss" pattern, and that the cortical bone loss in intertrochanteric region is associated with a greater reduction in cortical failure load than the cortical bone loss in the femoral neck. The trabecular bone loss causes a limited decrease in both cortical failure and trabecular failure loads. This research should be helpful to the clinical assessment of femur fracture risk due to age-related bone loss.

A new design of 3D-printed orthopedic bone plates with auxeticstructures to mitigate stress shielding and improve intra-operative bending

Orthopedic bone plates are most commonly used for bone fracture fixation for more than 100 years.The bone plate design had evolved over time overcoming many challenges such as insufficient strength and excessive plate–bone contact affecting the blood circulation.However,it is only made of two materials,either stainless steel(AISI 316L)or titanium(Ti–6Al–4V).There are two main limitations of metallic bone implants,namely stress shielding and the problem of malocclusion caused by the displacement of the fracture site during healing.To overcome the two problems,a new bone plate design with the incorporation of auxetic structures is proposed in this work.This study aims to use auxetic structure section in the bone plate that would decrease the stiffness of the region,thereby mitigating the stress-shielding effect and at the same time act as a deformable section to enable intra-operative bending for effective alignment while having enough bending strength and stiffness.Two different auxetic structures namely re-entrant honeycomb and missing rib structures were considered.The auxetic structure incorporated bone plates were designed,finite element analysis was done,fabricated using direct metal laser sintering technique,and tested.The results indicate that the re-entrant honeycomb structure incorporated bone plates serve as an effective bone design compared to the conventional bone plate design,in terms of stress shielding and intra-operative bending while offering similar mechanical and bending strength.

Bone morphogenetic proteins:Relationship between molecular structure and their osteogenic activity

Bone morphogenetic proteins(BMPs)are a family of potent,multifunctional growth factors belonging to transforming growth factor-(TGF-).They are highly conservative in structures.Over 20 members of BMPs with varying functions such as embryogenesis,skeletal formation,hematopoiesis and neurogenesis have been identified in human body.BMPs are unique growth factors that can induce the formation of bone tissue individually.BMPs can induce the differentiation of bone marrow mesenchymal stem cells into osteoblastic lineage and promote the proliferation of osteoblasts and chondrocytes.BMPs stimulate the target cells by specific membrane-bound receptors and signal transduced through mothers against decapentaplegic(Smads)and mitogen activated protein kinase(MAPK)pathways.It has been demonstrated that BMP-2,BMP-4,BMP-6,BMP-7,and BMP-9 play an important role in bone formation.This article focuses on the molecular characterization of BMPs family members,mechanism of osteogenesis promotion,related signal pathways of osteogenic function,relationships between structure and osteogenetic activity,and the interactions among family members at bone formation.

Design and Preparation of Bone Tissue Engineering Scaffolds with Porous Controllable Structure

A novel method of designing and preparing bone tissue engineering scaffolds with controllable porous structure of both macro channels and micro pores was proposed. The CAD software UG NX3.0 was used to design the macro channels＇ shape, size and distribution. By integrating rapid prototyping and traditional porogen technique, the macro channels and micro pores were formed respectively. The size, shape and quantity of micro pores were controlled by porogen particulates. The sintered β-TCP porous scaffolds possessed connective macro channels of approximately 500 μm and micro pores of 200-400 μm. The porosity and connectivity of micro pores became higher with the increase of porogen ratio, while the mechanical properties weakened. The average porosity and compressive strength offl-TCP scaffolds prepared with porogen ratio of 60wt% were 78.12% and 0.2983 MPa, respectively. The cells＇ adhesion ratio of scaffolds was 67.43%. The ALP activity, OCN content and cells micro morphology indicated that cells grew and proliferated well on the scaffolds.

Development and Application of an Instrument for Analysis of Bone Structure on Radiographs

An instrument used for quantitative assessment of trabecular structure of radius on radiograph including trabecular number and trabecular width was developed using a microdensitometer and a single-chip microcomputer. The device is characterized by its high sensitivity, good reproducibility, convenience and economy. The results obtained with the instrument were significantly correlated to actual bone mineral content, This device can be used for the diagnosis of osteoporosis, fluorosis, rickets and bone damages caused by cadmium.

Effects of fabrication of conjugates between different polyphenols and bovine bone proteins on their structural and functional properties

Covalent complexes of bovine bone proteins(BBP)with four polyphenols(chlorogenic acid(CA),quercetin(Q),rutin(R),epigallocatechin gallate(EGCG))with were prepared to increase the high-value utilization degree of bovine bone.The differences in coupling effect and structural and functional properties between the conjugates were also investigated.The results showed that EGCG-BBP had the highest polyphenolic equivalent at 88.05 mg/g protein and the lowest sulfhydryl group content.EGCG-BBP also had the best covalent effect.The SDS-PAGE and fluorescence spectra results revealed that the molecular weight of the conjugates increased significantly as different polyphenols conjugated with the aromatic amino acids in BBP,resulting in significant changes in the structure of EGCG-BBP.Fourier Transform infrared spectroscopy(FTIR)analysis demonstrated that the amide I band of conjugates was slightly shifted,indicating that the polyphenols were covalently bonded with BBP.Based on the results of this study and well-established mechanisms,it could be speculated that the best covalent effect of EGCG may be not only due to the eight phenolic hydroxyl groups but also to its two benzene rings,which are greatly increased in its reaction site.In terms of functional characteristics,EGCG-BBP had the highest 1-diphenyl-2-picryl-hydrazyl radical(DPPH·)scavenging capacity,while Q-BBP had the best solubility.Thus,this study provides a theoretical basis for different polyphenols’structural and functional effects on covalently modified proteins.

骨组织工程中传统与仿生支架结构设计的差异

背景:多孔支架作为新骨生长的临时基质在骨修复过程中起着关键作用,其中多孔支架的结构设计是骨修复过程中的研究重点。目的:综述传统支架(规则、均匀的支架)和仿生支架(不规则、不均匀的支架)在骨组织工程研究领域的应用。方法:检索中国知网(CNKI)、维普、万方、Web of Science、Science Direct、PubMed、EI等数据库,选取2008年1月至2024年3月发表的文献,中文检索词为“骨组织工程,仿生支架,骨小梁,传统支架,骨修复,三周期极小曲面”,英文检索词为“bone tissue engineering,bionic scaffolds,bone trabeculae,traditional scaffolds,bone repair,TPMS”。最终纳入81篇文献进行综述。结果与结论:骨支架的结构设计是实现骨修复和骨再生的关键,骨组织工程中的支架技术已取得显著进展。传统的规则多孔支架因简单的制造流程和良好的机械性能被广泛应用,然而这类支架往往缺乏生物活性,难以模拟自然骨组织的复杂微环境,限制了其在促进细胞增殖和骨再生方面的能力。相反,仿生支架通过模拟自然骨组织的结构特征,提供了更适宜的生理微环境,促进了成骨细胞的增殖、分化及新骨的形成,为骨缺损有效治疗提供了新的思路。尽管仿生支架在理论上具有巨大的潜力,但在实际应用中仍面临诸多挑战,支架的生物相容性、生物活性及长期稳定性等因素仍需通过临床试验进行进一步验证。

Gyroid结构钛仿生骨支架修复下颌骨节段性缺损的生物力学性能

背景:三周期最小表面的多孔结构是最有前景的骨科生物结构之一,其中的Gyroid结构具有高比表面积、高渗透率、均曲率为零等特点。目的:通过有限元分析结合力学压缩实验测试,筛选出与下颌骨松质骨弹性模量范围相匹配的4 mm单胞Gyroid结构TC4仿生骨支架壁厚区间。方法:建立不同壁厚(0.1,0.2,0.3,0.4,0.5,0.6,0.7,0.8 mm)4 mm单胞Gyroid结构有限元模型,分析Gyroid结构的等效弹性模量,筛选出与下颌骨松质骨弹性模量范围相匹配的Gyroid结构壁厚区间,壁厚分别为0.2,0.3,0.4,0.5,0.6,0.7 mm。根据有限元分析筛选结果,以Ti6Al4V为原料,采用选择性激光熔融技术制备不同壁厚的3D打印Gyroid结构试件,进行大颗粒喷砂酸蚀处理,通过力学压缩实验测试试件的弹性模量与抗压强度。结果与结论:(1)有限元分析结果显示,随着壁厚的增加,Gyroid结构的等效弹性模量升高,其中壁厚为0.2-0.7 mm Gyroid结构的等效弹性模量在下颌骨松质骨弹性模量范围内(1.5-4.0 GPa),用于3D打印Gyroid结构试件;(2)力学压缩实验结果显示,随着壁厚的增加,Gyroid结构试件的弹性模量与抗压强度均升高,其中0.3-0.5 mm壁厚Gyroid结构试件的弹性模量在下颌骨松质骨弹性模量范围内,0.3-0.7 mm壁厚Gyroid结构试件的抗压强度符合下颌骨的力学性能;(3)结果显示0.3-0.5 mm壁厚Gyroid结构与下颌骨的弹性模量范围相适应。

抗纤维化与促“H”型血管核壳结构生物支架修复临界骨缺损

背景:在骨组织愈合过程中,促进新生骨的血管化是加速骨组织修复的常用策略,然而骨缺损修复过程中过快的纤维化进程常常被忽略。目的:设计并制备一种具有调节新生骨痂内纤维化及血管化进程的核壳结构仿生支架,表征其物理学特征,验证其体内外抗纤维化与促成骨性能。方法:制备具有调节新生骨痂内纤维化及血管化进程的核壳结构仿生支架,外层壳结构由聚己内酯静电纺丝纳米纤维负载成纤维细胞活化蛋白抑制剂组成,内层核结构由甲基丙烯酸酐明胶水凝胶负载去铁胺组成,表征静电纺丝和水凝胶的物理学特征,利用活死染色与CCK-8实验验证材料的生物相容性。通过成纤维细胞体外实验分析支架壳结构的抗纤维化作用,通过MC3T3-E1细胞体外实验分析支架壳结构中成纤维细胞活化蛋白抑制剂的促成骨作用,通过人脐静脉内皮细胞分析支架核结构中去铁胺的促血管形成作用。通过大鼠临界骨缺损实验评估核壳结构仿生支架的骨修复作用。结果与结论:①核壳结构仿生支架具有良好的生物相容性,静电纺丝技术制备的聚己内酯电纺纤维具有疏水性,在物理层面上有效阻隔外源性纤维组织长入,电纺纤维膜在2周内可有效释放抗纤维化药物成纤维细胞活化蛋白抑制剂,释放的抗纤维化药物可以抑制骨缺损周围成纤维细胞的生长、黏附,有效降低成纤维相关蛋白的表达,同时可促进MC3T3-E1细胞成骨蛋白的表达,加快其矿化速度;支架核结构中的去铁胺可促进人脐静脉内皮细胞的迁移、成管能力,并促进其强烈表达“H”血管特征性蛋白。②在SD大鼠的股骨制造临界骨缺损模型中,相较于聚己内酯膜,核壳结构仿生支架实现了骨缺损的有效修复。③结果表明,核壳结构仿生支架在预防骨痂过度纤维化的同时促进新生骨痂内“H”血管形成,能有效避免骨不连的发生,加速临界骨缺损修复进程。

Mechanically strong porous bioceramic tubes facilitate large segmental bone defect repair by providing long-term structurally stability and promoting osteogenesis

Mechanically strong magnesium-doped Ca-silicate bioceramic scaffolds have many advantages in repairing large segmental bone defects.Herein we combine β-TCP with 6 mol%magnesium-doped calcium silicate(Mg6)at three different ratios(TCP,TCP+15%Mg6,TCP+85%Mg6)to find an appropriate ratio which can exert considerable influence on bone regeneration.In this study,the bioceramic scaffolds were assessed for mechanical strength,bioactive ion release,biocompatibility,and osteogenic capacity through in vitro testing.Additionally,the potential for promoting bone regeneration was investigated through in vivo implantation of porous tube-like scaffolds.The results showed that the compressive strength increased with the augmentation of Mg6 component.Especially the compressive strength of the TCP+85%Mg6 group reached 38.1±3.8 MPa,three times that of the other two groups.Furthermore,extensive in vivo investigations revealed that the TCP+85%Mg6 bioceramic scaffolds were particularly beneficial for the osteogenic capacity of critical-sized femoral defects(20 mm in length).Altogether,magnesium doping in bioceramic implants is a promising strategy to provide stronger mechanical support and enhance osteogenesis to accelerate the repair of large defects.

新型混编支架的制备与径向支撑力学行为

背景:编织支架因良好的柔顺性被广泛应用于狭窄动脉的治疗,但在提供足够的径向支撑性能方面存在明显局限。目的:针对单一材料制成的编织支架存在径向支撑力不足的问题,采用不同力学参数的生物可降解材料混合编织支架,探究影响混编支架径向力学性能的影响因素。方法:在镁合金支架中引入铁合金纱线,采用有限元分析法对不同编织参数的混编支架进行参数化分析,通过与0.18 mm直径镁合金纱线制备的普通支架进行对比,评估其径向支撑力、径向回弹率和扩张不均匀性。结果与结论:①当铁合金纱线直径为0.18 mm和0.14 mm时,随着铁合金纱线数量的增多,混编支架的径向支撑力增加;此时,尽管直径0.14 mm铁合金纱线提供的径向支撑力小于同数量的0.18 mm铁合金纱线,但增加细铁合金纱线的数量可以达到与较粗铁合金纱线混编支架相媲美的径向支撑力。当铁合金纱丝直径为0.10 mm时,随着铁合金纱线数量的增加,混编支架的径向支撑力降低。②增大编织角度,混编支架的径向支撑力降低,但其径向回弹率和狗骨率得到了改善。通过降低编织角可以改善小直径铁合金纱线造成的支架径向支撑力不足。③结果显示,在镁合金支架中引入铁合金纱线,可以实现在不增加纱线直径的情况下精确地调整支架的径向力学性能,这不仅克服了单一材料支架的局限性,也为多材料支架的设计提供了新思路。

Osteoporosis Prediction for Trabecular Bone using Machine Learning: A Review

Trabecular bone holds the utmost importance due to its significance regarding early bone loss.Diseases like osteoporosis greatly affect the structure of the Trabecular bone which results in different outcomes like high risk of fracture.The objective of this paper is to inspect the characteristics of the Trabecular Bone by using the Magnetic Resonance Imaging(MRI)technique.These characteristics prove to be quite helpful in studying different studies related to Trabecular bone such as osteoporosis.The things that were considered before the selection of the articles for the systematic review were language,research field,and electronic sources.Only those articles written in the English language were selected as it is the most prominent language used in scientific,engineering,computer science,and biomedical researches.This literature review was conducted on the articles published between 2006 and 2020.A total of 62 research papers out of 1050 papers were extracted which were according to our topic of review after screening abstract and article content for the title and abstract screening.The findings from those researches were compiled at the end of the result section.This systematic literature review presents a comprehensive report on scientific researches and studies that have been done in the medical area concerning trabecular bone.

Understanding the effects of structured self-assessment in directed,self-regulated simulation-based training of mastoidectomy:A mixed methods study

Objective:Self-directed training represents a challenge in simulation-based training as low cognitive effort can occur when learners overrate their own level of performance.This study aims to explore the mechanisms underlying the positive effects of a structured self-assessment intervention during simulation-based training of mastoidectomy.Methods:A prospective,educational cohort study of a novice training program consisting of directed,self-regulated learning with distributed practice(5x3 procedures)in a virtual reality temporal bone simulator.The intervention consisted of structured self-assessment after each procedure using a rating form supported by small videos.Semi-structured telephone interviews upon completion of training were conducted with 13 out of 15 participants.Interviews were analysed using directed content analysis and triangulated with quantitative data on secondary task reaction time for cognitive load estimation and participants’self-assessment scores.Results:Six major themes were identified in the interviews:goal-directed behaviour,use of learning supports for scaffolding of the training,cognitive engagement,motivation from self-assessment,selfassessment bias,and feedback on self-assessment(validation).Participants seemed to self-regulate their learning by forming individual sub-goals and strategies within the overall goal of the procedure.They scaffolded their learning through the available learning supports.Finally,structured self-assessment was reported to increase the participants’cognitive engagement,which was further supported by a quantitative increase in cognitive load.Conclusions:Structured self-assessment in simulation-based surgical training of mastoidectomy seems to promote cognitive engagement and motivation in the learning task and to facilitate self-regulated learning.

Fractures and Biomechanical Characteristics of the Bone

The biological tissue is affected by external and internal deformation forces: tractive/tensile forces, shearing and compressive forces. The bone is deformed under the effect of a force. If the load exceeds the bone solidity limitation, fracture occurs. A mature bone consists of compact and spongy bone tissue. The basic structural unit of the cortical bone tissue is osteons and spongiosa consists of a network of bone trabeculae. The organic and mineral parts of the bone are responsible for the special bone characteristics. The effect of a physical activity on the mechanical characteristics of the bone is associated with the intensity of the load. Fractures are more common in elderly people as the bone structure is altered on account of osteoporosis and contains less bone tissue. Biomechanical characteristics with anatomic and histological bone structure as well as osteoporotic hip fractures are described in the paper.

Effects of Teriparatide and Aerobic Exercise on Lumbar Spine Microstructure in Ovariectomized and Tail-Suspended Rats

Osteoporosis is an increasingly prevalent malady of the elderly that is associated with bone fragility and increased risk of fractures. Osteoporosis treatments focus on restoring bone strength and quality. Teriparatide (TPTD) is a therapeutic agent that has been shown to increase bone strength by improving the volume and connectivity of trabecular bone. Exercise is also known to have pro-osteogenic effects. Here we used a rat model of severe osteoporosis (ovariectomized and tail-suspension) to evaluate the effects of TPTD, exercise and a combination of TPTD and exercise on the microstructure of trabecular bone. TPTD mono-therapy and TPTD combined with exercise treatment significantly increased bone mineral density (BMD) in the whole body. Micro-computed tomography analysis revealed that a combination of exercise and TPTD treatment significantly decreased bone surface to volume and trabecular separation compared with those of the control and exercise groups. Node-strut analysis indicated that exercise or TPTD alone did not affect trabecular bone connectivity. However, the combination of exercise and TPTD treatment significantly decreased measures of trabecular bone connectivity (node number) that are consistent with a transition from rod-like to plate-like of trabecular bone microstructures. The combination treatment with exercise and TPTD improved microstructure of trabecular bone in the OVX and tail-suspended rats. These results indicate that combining exercise with TPTD represents a viable means to improve cancellous bone strength in osteoporosis populations.

Hartree-Fock Calculations of ¹⁶O and ⁴⁰Ca Nuclei Using Fish-Bone Potential

Hartree-Fock calculations are carried out to describe some properties of 16O and 40Ca nuclei using the two forms of fish-bone potential (I and II). A computer simulation search program has been introduced to solve this problem. The Hilbert space was restricted to three dimensional variational space spanned by single spherical harmonic oscillator orbits. Binding energies, root mean square radii and form factors are found to have a good fit with experimental data.

硼硅酸盐生物活性玻璃的矿化及机理初探

目的探讨硼硅酸盐生物活性玻璃体外矿化成类骨层状结构的机理。方法模拟体内环境,将硅酸盐玻璃(0B)、硼硅酸盐玻璃(2B)和硼酸盐玻璃(3B)浸泡于SBF溶液和含有明胶的SBF溶液中1周;随后采用质量损失分析、SEM、EDS、XRD及FTIR等测试方法对多种生物活性玻璃的矿化产物进行系统分析与比较;采用固体核磁NMR对生物玻璃进行玻璃结构分析。结果浸泡1周后,SEM观察到硼硅酸盐玻璃(2B)和不含硅的硼酸盐玻璃(3B)表面产生层状矿化产物,而硅酸盐玻璃(0B)表面只有一层矿化产物层;XRD和FTIR结果显示3种玻璃的表面产物均为含有部分羟基磷灰石的钙磷化合物;固体核磁波谱(11B)测试结果表明硼硅酸盐玻璃(2B)和不含硅的硼酸盐玻璃(3B)都存在大量[BO_(3)]平面三角体。最后,当硼硅酸盐玻璃(2B)浸泡在含有明胶的SBF溶液后,其矿化产物仍能维持层状结构;通过EDS分析可知形成明胶有机层和含羟基磷灰石的无机层相互堆积的特殊层状结构。结论2B和3B玻璃内部存在大量[BO_(3)]平面三角体所构造的二维平面结构。矿化过程中,不溶性反应物沉积在二维平面结构上,从而使矿化产物呈现层状结构。在浸泡液中添加一定量的明胶后,其可以有效地与硼硅酸盐玻璃的层状矿化结构相互匹配结合,最终堆叠形成有机相层与无机层相互交错的特殊结构。