Vertebral compression fractures are typical of osteoporosis and their treatment can require the injection of a cement through a minimally invasive procedure to restore vertebral body height. This study reports the development of an injectable calcium sulphate-based composite cement able to stimulate bone regeneration while inhibiting osteoclast bone resorption. To this aim, different types of strontium-containing mesoporous glass particles (Sr-MBG) were added to calcium sulphate powder to impart a pro-osteogenic effect, and the influence of their size and textural features on the cement properties was investigated. Anti-osteoclastogenic properties were conferred by incorporating into poly(lactic-co-glycolic)acid (PLGA) nanoparticles, a recombinant protein able to inhibit osteoclast activity (i.e., ICOS-Fc). Radiopaque zirconia nanoparticles (ZrO2) were also added to the formulation to visualize the cement injection under fluoroscopy. The measured cement setting times were suitable for the clinical practice, and static mechanical testing determined a compressive strength of ca. 8 MPa, comparable to that of human vertebral bodies. In vitro release experiments indicated a sustained release of ICOS-Fc and Sr2+ ions up to 28 days. Overall, the developed cement is promising for the treatment of vertebral compression fractures and has the potential to stimulate bone regeneration while releasing a biomolecule able to limit bone resorption.
Biodegradable composite materials represent one of the major areas of investigation for bone tissue engineering due to their tuneable compositional and mechanical properties, which can potentially mimic those of bone and potentially avoid the removal of implants, mitigating the risks for the patient and reducing the overall clinical costs. In addition, the introduction of additive manufacturing technologies enables a strict control over the final morphological features of the scaffolds. In this scenario, the optimisation of 3D printable resorbable composites, made of biocompatible polymers and osteoinductive inorganic phases, offers the potential to produce a chemically and structurally biomimetic implant, which will resorb over time. The present work focuses on the development and process optimisation of two hybrid composite filaments, to be used as feedstock for the fused filament fabrication 3D printing process. A Poly L-lactic acid matrix was blended with either rod-like nano-hydroxyapatite (nano-HA) or nanoparticles of mesoporous bioactive glasses, both partially substituted with strontium (Sr2+), due to the well-known pro-osteogenic effect of this ion. Both inorganic phases were incorporated into Poly L-lactic acid using an innovative combination of processes, obtaining a homogeneous distribution throughout the polymer whilst preserving their ability to release Sr2+. The filament mechanical properties were not hindered after the incorporation of the inorganic phases, resulting in tensile strengths and moduli within the range of cancellous bone, 50 ± 10 MPa and 3 ± 1 GPa. Finally, the rheological characterization of the hybrid composites indicated a shear thinning behaviour, ideal for the processing with fused filament fabrication, proving the potential of these materials to be processed into 3D structures aiming bone regeneration.
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