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Systemically administered zoledronic acid activates locally implanted synthetic hydroxyapatite particles enhancing peri-implant bone formation : A regenerative medicine approach to improve fracture fixation

Markeviciute, Vetra (författare)
Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lithuanian University of Health Sciences
Puthia, Manoj (författare)
Lund University,Lunds universitet,Schmidtchen lab,Forskargrupper vid Lunds universitet,Schmidtchen Lab,Lund University Research Groups
Arvidsson, Linnea (författare)
Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Klinisk och experimentell benläkning,Forskargrupper vid Lunds universitet,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical and experimental bone healing,Lund University Research Groups
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Liu, Yang (författare)
Lund University,Lunds universitet,Klinisk och experimentell benläkning,Forskargrupper vid Lunds universitet,Clinical and experimental bone healing,Lund University Research Groups,Second Affiliated Hospital Zhejiang University
Törnquist, Elin (författare)
Lund University,Lunds universitet,Avdelningen för Biomedicinsk teknik,Institutionen för biomedicinsk teknik,Institutioner vid LTH,Lunds Tekniska Högskola,Department of Biomedical Engineering,Departments at LTH,Faculty of Engineering, LTH
Tengattini, Alessandro (författare)
Institut Laue Langevin
Huang, Jintian (författare)
Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Klinisk och experimentell benläkning,Forskargrupper vid Lunds universitet,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical and experimental bone healing,Lund University Research Groups
Bai, Yiguang (författare)
North Sichuan Medical College,Skåne University Hospital
Vater, Corina (författare)
University Clinic Carl Gustav Carus at the TU Dresden
Petrolis, Robertas (författare)
Lithuanian University of Health Sciences
Zwingenberger, Stefan (författare)
University Clinic Carl Gustav Carus at the TU Dresden
Krisciukaitis, Algimantas (författare)
Lithuanian University of Health Sciences
Smailys, Alfredas (författare)
Lithuanian University of Health Sciences
Lukosevicius, Saulius (författare)
Lithuanian University of Health Sciences
Stravinskas, Mindaugas (författare)
Lithuanian University of Health Sciences
Isaksson, Hanna (författare)
Lund University,Lunds universitet,NanoLund: Centre for Nanoscience,Annan verksamhet, LTH,Lunds Tekniska Högskola,Avdelningen för Biomedicinsk teknik,Institutionen för biomedicinsk teknik,Institutioner vid LTH,Building Bone Killing Bugs,Forskargrupper vid Lunds universitet,LTH profilområde: Nanovetenskap och halvledarteknologi,LTH profilområden,LTH profilområde: Teknik för hälsa,LU profilområde: Ljus och material,Lunds universitets profilområden,LU profilområde: Proaktivt åldrande,Other operations, LTH,Faculty of Engineering, LTH,Department of Biomedical Engineering,Departments at LTH,Faculty of Engineering, LTH,Lund University Research Groups,LTH Profile Area: Nanoscience and Semiconductor Technology,LTH Profile areas,Faculty of Engineering, LTH,LTH Profile Area: Engineering Health,Faculty of Engineering, LTH,LU Profile Area: Light and Materials,Lund University Profile areas,LU Profile Area: Proactive Ageing
Tarasevicius, Sarunas (författare)
Lithuanian University of Health Sciences
Lidgren, Lars (författare)
Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Building Bone Killing Bugs,Forskargrupper vid Lunds universitet,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups
Tägil, Magnus (författare)
Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Building Bone Killing Bugs,Forskargrupper vid Lunds universitet,Klinisk och experimentell benläkning,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Clinical and experimental bone healing
Raina, Deepak Bushan (författare)
Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Building Bone Killing Bugs,Forskargrupper vid Lunds universitet,Klinisk och experimentell benläkning,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Clinical and experimental bone healing
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 (creator_code:org_t)
Engelska.
Ingår i: Acta Biomaterialia. - 1742-7061.
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Fracture fixation in an ageing population is challenging and fixation failure increases mortality and societal costs. We report a novel fracture fixation treatment by applying a hydroxyapatite (HA) based biomaterial at the bone-implant interface and biologically activating the biomaterial by systemic administration of a bisphosphonate (zoledronic acid, ZA). We first used an animal model of implant integration and applied a calcium sulphate (CaS)/HA biomaterial around a metallic screw in the tibia of osteoporotic rats. Using systemic ZA administration at 2-weeks post-surgery, we demonstrated that the implant surrounded by HA particles showed significantly higher peri‑implant bone formation compared to the unaugmented implants at 6-weeks. We then evaluated the optimal timing (day 1, 3, 7 and 14) of ZA administration to achieve a robust effect on peri‑implant bone formation. Using fluorescent ZA, we demonstrated that the uptake of ZA in the CaS/HA material was the highest at 3- and 7-days post-implantation and the uptake kinetics had a profound effect on the eventual peri‑implant bone formation. We furthered our concept in a feasibility study on trochanteric fracture patients randomized to either CaS/HA augmentation or no augmentation followed by systemic ZA treatment. Radiographically, the CaS/HA group showed signs of increased peri‑implant bone formation compared with the controls. Finally, apart from HA, we demonstrated that the concept of biologically activating a ceramic material by ZA could also be applied to β-tricalcium phosphate. This novel approach for fracture treatment that enhances immediate and long-term fracture fixation in osteoporotic bone could potentially reduce reoperations, morbidity and mortality. Statement of significance: • Fracture fixation in an ageing population is challenging. Biomaterial-based augmentation of fracture fixation devices has been attempted but lack of satisfactory biological response limits their widespread use. • We report the biological activation of locally implanted microparticulate hydroxyapatite (HA) particles placed around an implant by systemic administration of the bisphosphonate zoledronic acid (ZA). The biological activation of HA by ZA enhances peri‑implant bone formation. •Timing of ZA administration after HA implantation is critical for optimal ZA uptake and consequently determines the extent of peri‑implant bone formation. • We translate the developed concept from small animal models of implant integration to a proof-of-concept clinical study on osteoporotic trochanteric fracture patients. • ZA based biological activation can also be applied to other calcium phosphate biomaterials.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

Nyckelord

Bisphosphonate
Fracture fixation
Hydroxyapatite
Implant loosening

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art (ämneskategori)
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