A systematic review and meta‐analyses on animal models used in bone adhesive research

Abstract

Currently, steel implants are used for osteosynthesis of (comminuted) fractures and intra-articular bone defects. These osteosyntheses can sometimes be complicated procedures and can have several drawbacks including stress shielding of the bone. A bone glue might be a safe and effective alternative to current materials. Despite numerous animal studies on bone adhesives, no such material is clinically applied yet. We have conducted a systematic review to summarize the evidence in experimental animal models used in research on bone adhesive materials for trauma and orthopedic surgery. Additionally, we analysed the efficacy of the different bone adhesives for different experimental designs. A heterogeneity in experimental parameters including animal species, defect types, and control measurements resulted in a wide variety in experimental models. In addition, no standard outcome measurements could be identified. Meta-analysis on bone regeneration between adhesive treatment and nonadhesive treatment showed a high heterogeneity and no statistically significant overall effect (M: −0.71, 95% confidence interval [CI]: −1.63-0.21, p = 0.13). Besides, currently there is not enough evidence to draw conclusions based on the effectiveness of the individual types of adhesives or experimental models. A positive statistically significant effect was found for the adhesive treatment in comparison with conventional osteosynthesis materials (M: 2.49, 95% CI: 1.20-3.79, p = 0.0002). To enhance progression in bone adhesive research and provide valuable evidence for clinical application, more standard experimental parameters and a higher reporting quality in animal studies are needed.Statement of Clinical Significance: Current materials restoring anatomical alignments of bones have several drawbacks. A (biodegradable) adhesive for fixating bone defects can be a treatment breakthrough. Although numerous bone adhesives have been researched, most seemed to fail at the preclinical stage. An overview in this field is missing. This systematic review highlights the relevant parameters for design of experimental bone adhesive studies. It demonstrates evidence regardingThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Drosophila melanogaster: A Powerful Tiny Animal Model for the Study of Metabolic Hepatic Diseases

“…Translational science aims at using the scientific discoveries from preclinical models to set up the bases for clinical trials ( Gilliland et al, 2016 ; van Erk et al, 2021 ). Knowledge on liver pathologies has now increased, leading to the characterization of the biochemical mechanisms underlying disease progression and to the identification of specific biomarkers ( Friedman et al, 2018 ; Samuel and Shulman, 2018 ; Eslam and George, 2020 ).…”

In vitro and in vivo evaluation of a bio-inspired adhesive for bone fixation

“…Animal models, speci cally for assessing the adhesive e cacy of bone adhesive, are hardly found in the literature. A recent systemic review (41) focusing on in vivo evaluation of synthetic bone adhesive materials found that: (i) rabbits were the most frequently used species followed by rats, (ii) long bones were the most frequently studied regions, (iii) burr hole defect or cortical perforation models were the most frequently used for assessing bone glue.…”

“…So far, biomimetic CPC/OPS glues have been evaluated in vivo mostly regarding their biocompatibility, osseointegration or bioresorbability (15,18,20,23,24). However, animal models used for assessing their in vivo e cacy are scarcely reported (41). Few applications for bone xation were performed, but only in the regions without mechanical stress, such as the calvaria (20), or together with screws (18), which do not really necessitate the adhesive property of bone glue.…”

In Vitro and In Vivo Evaluation of a Bio-Inspired Adhesive for Bone Fixation

“…Animal models, specifically for assessing the adhesive efficacy of bone adhesives, are barely found in the literature. A recent systemic review [41] focusing on the in vivo evaluation of synthetic bone adhesive materials found that: (i) rabbits were the most frequently used species, followed by rats, (ii) long bones were the most frequently studied regions, and (iii) burr hole defect or cortical perforation models were the most frequently used for assessing bone glue.…”

“…So far, biomimetic CPC/OPS glues have been evaluated in vivo mostly regarding their biocompatibility, osseointegration, or bioresorbability [15,18,20,23,24]. However, animal models used for assessing their in vivo efficacy are scarcely reported [41]. Several applications for bone fixation were performed, but only in the regions without mechanical stress, such as the calvaria [20], or together with screws [18], which does not fully demonstrate the adhesive property of the bone glue.…”