| Objective:Hemorrhage is a dangerous complication during orthopedics operation.Bleeding from bone marrow cavity can seldom be stopped by compression,ligation etc.Bone wax has been widely applied for orthopaedic hemostasis.It has recently been reported that bone wax can lead to complications,such as granulomas,in bone due to its indegradability,which delays fracture healing.In the current study,a novel integrated material for hemostasis and osteogenesis was prepared and its application in vivo and in vitro was verified,aim at providing a new solution for hemostasis in orthopedics operation.Methods:First of all,starch hydrogel precursor crosslinked by magnesium ions was prepared by a novel green gel frabrication plan preparation.It was then mixed with the ?-TCP Calcium Phosphate Ceramic(CPC),corn starch,calcium phosphate powder and 20%glycerol solution in certain proportion.Novel Integrated Material for both Hemostasis and Osteogenesis(IMHO)was prepared.Material and biological characteristics of IMHO were tested.Finally,we established a rat femoral defect model to further clearify the hemostatic and osteogenic properties of IMHO in vivo,and compared it with commercially available bone wax.Results:IMHO has great material characteristics.It has excellent plasticity and anti-collapsibility.IMHO has a porous structure,and the hydroxyapatite crystal phase appears on the surface.The crystal phase of IMHO changes from calcium phosphate to hydroxyapatite over time.The setting time of IMHO increases with the increase of liquid-solid ratio,which is sufficient to meet the needs of orthopedic surgery.In vitro degradation experiments show that IMHO can degrade more than 17%in 8 weeks.The maximum compression strength of IMHO samples can reach 12.11±0.91 MPa,and the maximum Young's Modulus can reach 109.63±24.63Mpa,which is consistent with the mechanical properties of cancellous bone.IMHO has good biocompatibility.Furthermore,IMHO has no obvious hemolysis effect on blood cells.IMHO can enhance osteogenesis ability of cells.ALP activity test suggests that IMHO extract had a significant positive effect on the ALP activity of MC3T3 cells,while alizarin red staining shows that IMHO extract formed more calcium nodules.qPCR results suggest that IMHO can significantly improve the expression of osteogenic genes ALP,OCN and OPN.The rat femoral defect filling experiment further confirms the in vitro results.IMHO is easy to operate and effectively seals the bleeding in the defect.Compared with the control group,IMHO has a blood loss rate of 0.43±0.23‰,which significantly reduces the blood loss of the rats.The 3-point bending stress of IMHO is 204.54±67.00N,which is significantly higher than that of the commercially available bone wax group.Histological staining further indicates that the IMHO material is degraded on the surface and the bone tissue is actively growing in compared with commercial bone wax group.Conclusion:IMHO is a good integrated material for hemostatic osteogenesis.It has excellent sealing,anti-disintegration and degradation properties,and can form hydroxyapatite crystal phase,which is conducive to bone formation.In vitro cell experiments showed that IMHO had good biocompatibility and osteogenic differentiation.In vivo bone defect model further shows that IMHO has good clinical value,it can effectively block bleeding and facilitate the formation of new bone. |
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