Degradable orthopedic hardware

 描述：可降解的骨科修复装置将提供显著的临床益处，以克服目前在骨重建、降解动力学和骨整合方面的限制。目前的选择主要局限于不可降解的金属，由于其强大的机械性能和易于植入，已成为骨科修复的黄金标准，而应力屏蔽、感染、骨重塑和二次手术移除的限制已将人们的兴趣转向可降解设备。由聚乳酸和聚乙醇酸组成的骨科螺钉和钢板已成为可降解五金件的主要候选材料，减少了取出的需要，并改善了骨重建。然而，聚乳酸和聚乙醇酸螺钉和钢板会因降解产物、骨溶解和不完全骨重建而引起炎症反应。因此，具有适当的机械性能、可调节的和完全可降解的、有利于成骨的骨科硬件将对骨科修复在促进加速愈合、减少二次手术和改善患者的长期结果方面产生重大影响。我们的长期目标是开发完全可降解的螺丝、板材和棒材，使用生物活性分子功能化的丝蛋白来促进健康的骨重建和整合。本研究的目的是确定所提出的丝素材料是否能够满足可降解骨科系统的结构需求，并成功地引导成骨重建。我们假设功能化的Silk矫形五金件可以在6-12个月的时间内完全降解，同时促进骨整合，以优化矫形修复的效用和满足机械要求。我们广泛的体外和体内初步数据支持这一假说。这项研究的基本原理是从根本上深入了解功能化和可降解的骨科螺钉和钢板在加速愈合和指导成功的骨重建中的作用。预计预期结果将通过提出能够满足骨折固定的机械需求并解决目前的限制和并发症的硬件设计，对矫形外科修复产生实质性的积极影响。一个有合作历史的跨学科研究团队将进行研究[大卫·卡普兰-丝绸生物材料、生物工程、阿拉·纳扎里安-生物力学/生物医学和动物研究、山姆·林和布莱恩·斯奈德-整形外科医生]。

 DESCRIPTION: Degradable orthopedic repair devices would provide significant clinical benefits to overcome current limitations in bone remodeling, degradation kinetics and bone integration. Current options are limited primarily to nondegradable metals which have become the gold standard for orthopedic repairs due to robust mechanical properties and ease of implantation, while limitations of stress shielding, infections, bone remodeling and second surgical removals have shifted significant interest toward degradable devices. Orthopedic screws and plates composed of polylactic and polyglycolic acids have become lead candidates for degradable hardware with a reduced need for removal and improved bone remodeling. However, polylactic and polyglycolic acid screws and plates are associated with inflammatory reactions due to degradation products, osteolysis and incomplete bone remodeling. Thus, orthopedic hardware that has appropriate mechanical properties, tunable and full degradation and is pro-osteogenic would have a major impact on orthopedic repairs in promoting accelerated healing, reducing second surgeries and improving long-term patient outcomes. Our long term goal is to develop fully degradable screws, plates and rods using silk protein functionalized by bioactive molecules to promote healthy bone remodeling and integration. The objective of the proposed research is to determine the ability of the proposed silk format to meet the structural needs of degradable orthopedic systems and successfully direct pro-osteogenic remodeling. We hypothesize that functionalized silk orthopedic hardware can be tuned to fully degrade over a 6-12 month time while promoting osteointegration to optimize utility in orthopedic repairs and meeting mechanical requirements. Our extensive preliminary in vitro and in vivo data support this hypothesis. The rationale for this research is to gain fundamental insight into the role of functionalized and degradable orthopedic screws and plates in accelerating healing and directing successful bone remodeling. The anticipated outcomes are expected to have a substantial positive impact on orthopedic repairs by presenting hardware designs capable of meeting mechanical needs of fracture fixation and addressing current limitations and complications. An interdisciplinary team of investigators who have a history of collaborative efforts will conduct the studies [David Kaplan - silk biomaterials, bioengineering, Ara Nazarian - biomechanics/biomiaging and animal studies, Sam Lin and Brian Snyder - orthopedic surgeons].