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Mineralized collagen-modified PMMA cement enhances bone integration and reduces fibrous encapsulation in the treatment of lumbar degenerative disc disease.

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机构: [1]National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China. [2]Department of Orthopaedics, Orthopaedic Hospital of Xingtai, Xingtai 054000, China. [3]Department of Orthopedic Laboratory, Xingtai Institute of Orthopaedics, Xingtai 054000, China. [4]Beijing Allgens Medical Science and Technology Co., Ltd, Beijing 102609, China. [5]School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China. [6]Institute of Polymers, Composites and Biomaterials, National Research Council of Italy, Naples 80125, Italy.
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关键词: mineralized collagen lumbar degenerative disc disease percutaneous cement discoplasty fibrous encapsulation

摘要:
As a minimally invasive surgery, percutaneous cement discoplasty (PCD) is now contemplated to treat lumbar disc degeneration disease in elder population. Here, we investigated whether the osteogenic mineralized collagen (MC) modified polymethylmethacrylate (PMMA) cement could be a suitable material in PCD surgery. Injectability, hydrophilicity and mechanical properties of the MC-modified PMMA (PMMA-MC) was characterized. The introduction of MC did not change the application and setting time of PMMA and was easy to be handled in minimally invasive operation. Hydrophilicity of PMMA-MC was greatly improved and its elastic modulus was tailored to complement mechanical performance of bone under dynamic stress. Then, PCD surgery in a goat model with induced disc degeneration was performed with implantation of PMMA-MC or PMMA. Three months after implantation, micro-computed tomography analysis revealed a 36.4% higher circumferential contact index between PMMA-MC and bone, as compared to PMMA alone. Histological staining confirmed that the surface of PMMA-MC was in direct contact with new bone, while the PMMA was covered by fibrous tissue. The observed gathering of macrophages around the implant was suspected to be the cause of fibrous encapsulation. Therefore, the interactions of PMMA and PMMA-MC with macrophages were investigated in vitro. We discovered that the addition of MC could hinder the proliferation and fusion of the macrophages. Moreover, expressions of fibroblast-stimulating growth factors, insulin-like growth factor, basic fibroblast growth factor and tumor necrosis factor-β were significantly down-regulated in the macrophages cocultured with PMMA-MC. Together, the promoted osteointegration and reduced fibrous tissue formation observed with PMMA-MC material makes it a promising candidate for PCD surgery. © The Author(s) 2019. Published by Oxford University Press.

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出版当年[2020]版:
大类 | 2 区 工程技术
小类 | 2 区 材料科学:生物材料
最新[2023]版:
大类 | 1 区 医学
小类 | 2 区 材料科学:生物材料
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第一作者机构: [1]National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China.
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通讯机构: [1]National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China. [2]Department of Orthopaedics, Orthopaedic Hospital of Xingtai, Xingtai 054000, China. [3]Department of Orthopedic Laboratory, Xingtai Institute of Orthopaedics, Xingtai 054000, China. [*1]National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China. [*2]Department of Orthopaedic Surgery, The General Hospital of Xingtai Mining Industry Bloc., Orthopaedic Hospital of Xingtai, Xingtai 054000, China.
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