医用生物陶瓷的功能性生物适配机制及应用

doi:10.15541/jim20230244

无机材料学报 ›› 2024, Vol. 39 ›› Issue (1): 1-16.DOI: 10.15541/jim20230244

• 专题评述 • 下一篇

医用生物陶瓷的功能性生物适配机制及应用

郑嘉乾¹^,²(), 卢霄³^,⁴, 鲁亚杰³^,⁵, 王迎军¹^,², 王臻¹^,³^,⁵(), 卢建熙³^,⁴()

1.华南理工大学国家人体组织功能重建工程技术研究中心, 广州 510006
2.华南理工大学材料科学与工程学院, 广州 510641
3.上海骨科生物材料技术创新中心, 上海 201114
4.上海贝奥路生物材料有限公司, 上海 201114
5.中国人民解放军空军军医大学西京医院, 骨科, 西安 710032

收稿日期:2023-05-20 修回日期:2023-06-27 出版日期:2024-01-20 网络出版日期:2023-07-28
通讯作者: 王臻, 教授. E-mail: wangzhen@fmmu.edu.cn;
卢建熙, 教授. E-mail: lujianxi888@hotmail.com
作者简介:郑嘉乾(1994-), 男, 博士研究生. E-mail: mszjq2021@mail.scut.edu.cn

Functional Bioadaptability in Medical Bioceramics: Biological Mechanism and Application

ZHENG Jiaqian¹^,²(), LU Xiao³^,⁴, LU Yajie³^,⁵, WANG Yingjun¹^,², WANG Zhen¹^,³^,⁵(), LU Jianxi³^,⁴()

1. National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, China
2. School of Materials Science and Engineering, South China University of Technology, Guangzhou 510641, China
3. Shanghai Orthopaedic Biotechnology Innovation Center, Shanghai 201114, China
4. Shanghai Bio-lu Biomaterials Co., Ltd., Shanghai 201114, China
5. Department of Orthopedics, Xijing Hospital, The Air Force Medical University, Xi'an 710032, China

Received:2023-05-20 Revised:2023-06-27 Published:2024-01-20 Online:2023-07-28
Contact: WANG Zhen, professor. E-mail: wangzhen@fmmu.edu.cn;
LU Jianxi, professor. E-mail: lujianxi888@hotmail.com
About author:ZHENG Jiaqian (1994-), male, PhD candidate. E-mail: mszjq2021@mail.scut.edu.cn
Supported by:
National Key Research and Development Program of China(2021YFB3800800);National Natural Science Foundation of China(32000960);Shanghai Science and Technology Innovation Action Plan(22S31906500)

摘要/Abstract

摘要：

为了获得满意的临床疗效, 优质医用生物陶瓷应该具备怎样的性能一直困扰着广大研究者。自20世纪90年代以来, 作者团队致力于研发医用生物陶瓷, 从基础科学研究到成果转化, 再到临床应用, 积累了丰富的研究和应用经验, 相继提出了“生物适配”和“精准生物适配”理论。本文围绕“医用生物陶瓷(磷酸钙类材料)的功能性生物适配”这一主题分享本团队的学术研究成果和临床应用经验，从结构适配、降解适配、力学适配、应用适配等四个角度, 结合骨科临床应用背景, 探讨如何实现其生物适配和设计制造的有效衔接，旨在为医用生物陶瓷的设计、制造、监管和应用提供依据和建议。

关键词: 生物陶瓷, 生物适配, 材料微结构, 生物降解, 骨再生, 血管化, 专题评述

Abstract:

The question of what qualities excellent medical bioceramics must possess to ensure satisfactory prognosis for bone healing and reconstruction remains a topic of great interest in both clinical and biomaterial sciences. Our team has been dedicated to researching medical bioceramics since the 1990s, involving basic scientific research, applied translational research, and clinical trials. Consequently, we have amassed a wealth of research and implementation experience. In this article, we aim to explore the subject of “Functional Bioadaptability in Medical Bioceramics”, specifically focusing on calcium phosphate-based materials. We summarized how to effectively combine bioadaptability with design and manufacturing of medical bioceramics in the background of orthopedic clinical application, with the following aspects of structural adaptability, degradative adaptability, mechanical adaptability, and application adaptability. Hopefully, some suggestions put forward can ultimately provide valuable insights and recommendations for the design, production, supervision, and application of the upcoming medical bioceramics.

Key words: bioceramics, bioadaptability, material microstructure, biodegradation, osteo-regeneration, vascularization, perspective

中图分类号:

TQ174

郑嘉乾, 卢霄, 鲁亚杰, 王迎军, 王臻, 卢建熙. 医用生物陶瓷的功能性生物适配机制及应用[J]. 无机材料学报, 2024, 39(1): 1-16.

ZHENG Jiaqian, LU Xiao, LU Yajie, WANG Yingjun, WANG Zhen, LU Jianxi. Functional Bioadaptability in Medical Bioceramics: Biological Mechanism and Application[J]. Journal of Inorganic Materials, 2024, 39(1): 1-16.

图/表 13

Fig. 1 Theory of “Cell-Material-Blood supply” interacting with trinity tissue regeneration[17]

Fig. 2 Effects of microstructure on cell recombination and proliferation[21,27] (a) Cell motility in bioceramic microstructure with three-dimensional flow dynamic culture system, perfusion bioreactor; (b) SEM images of the cross section of a scaffold seeded with sheep MSCs; (c) Histological section of the cell-TCP composite stained with May-Grünwald Giemsa (A-F)

Fig. 3 Different kinds of interconnective pore size β-TCP porous ceramics with the same macroporous size (300-400 μm) evaluated in vivo[31] (a-e) Interconnective pore size is 70, 100, 120, 150, and 200 μm, respectively; (f) The lumen of new blood vessels passing through the interconnection became narrower and larger after entering the hole, resembling a string-of-beads shape. Scale bars in all images are 100 μm

Fig. 4 Blood vessels growth curve guided by porous ceramic rod at different time[17]

Fig. 5 Effect of packing method on degradation[63] (a, d) Radiographs of cases with loose packing; (b, c) Radiographs of cases implanted with β-TCP granules by dense packing

Fig. 6 Mechanically enhanced bioceramics[72] (a) Structure of mechanically enhanced bioceramics; (b) Wedge- shaped implant for high tibial osteotomy (HTO); (c, d) Microstructures of the bioinspired β-TCP bioceramics showing the dense/porous interface (c), and macroporous structure (d)

Fig. 7 Clinical case of the bird’s nest-like frame structure implant

Fig. 8 Clinical case of long, hollow tubular frame structure implant

Fig. 9 Failure clinical case showing the implant broken due to stress concentration and insufficient support

Fig. 10 Bioceramics used in combination with chondrocytes to achieve better cartilage tissue repair[85] (a) Repaired with bioceramic-chondrocyte constructs implant, 2 w postsurgery; (b) Repaired with bioceramic-chondrocyte constructs implant, 24 w postsurgery; (c) Repaired with bioceramic without cells implant, 24 w postsurgery; (d) Defect without any implant (control), 24 w postsurgery

Fig. 11 Standard surgical procedure for ONFH treatment, performed with surgical ancillary instruments[44] (a) Insertion of the Kirschner wire under fluoroscopy; (b) Core decompression by drilling; (c) Necrosis debridement by minimal reamers; (d) Bioceramic granules packing; (e) Insertion of the porous bioceramic rods

Fig. 12 Van Gieson staining of “In Vivo Bioreactor” in rabbits showed the “Rebar Coagulated Bone” structure[102] Yellow arrow: Newly formed bone; White arrow: Connective. Scale bar: 50 μm (blue), 20 μm (green); Colorful figures are available on website

Fig. 13 Application of“In vivo Bioreactor” in operation[77] (a) Multi-material, structural, and technical bone defect repair solution; (b) Bioceramics granules being used; (c) Bioceramics microstructure; (d) Composite in operation

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医用生物陶瓷的功能性生物适配机制及应用

Functional Bioadaptability in Medical Bioceramics: Biological Mechanism and Application

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