Nanomedicine applications in orthopedic medicine: state of the art

Abstract

The technological and clinical need for orthopedic replacement materials has led to significant advances in the field of nanomedicine, which embraces the breadth of nanotechnology from pharmacological agents and surface modification through to regulation and toxicology. A variety of nanostructures with unique chemical, physical, and biological properties have been engineered to improve the functionality and reliability of implantable medical devices. However, mimicking living bone tissue is still a challenge. The scope of this review is to highlight the most recent accomplishments and trends in designing nanomaterials and their applications in orthopedics with an outline on future directions and challenges.

Keywords: implantable materials; nanomedicine; nanotoxicology; orthopedics; tissue engineering.

Figure 1

Scheme shows potential applications of nanomedicine in orthopedic medicine. Abbreviations: BG, bioactive glass; TCP, tricalcium phosphate.

Figure 2

Effects of surface nanostructuring on the cell viability, differentiation, and bactericidal capacity of CP Ti. Notes: (A, B) SEM images of TiO₂ nanotube layer and microporous titanium, respectively. (C, D) The nanostructuring effect on the MG-63 cell proliferation and ALP activity. Reproduced with permission of Dove Medical Press, from Xia L, Feng B, Wang P, et al. In vitro and in vivo studies of surface-structured implants for bone formation. Int J Nanomedicine. 2012;7:4873; permission conveyed through Copyright Clearance Center, Inc. Antibacterial activity of TiO₂ nanotubes. Figure 2C *P<0.05, n=9; Figure 2D. *P<0.05, n=7. (E) under UV radiation and (F) in the presence of silver NPs of different sizes. Copyright © 2014. John Wiley & Sons, Inc. Reproduced from Esfandiari N, Simchi A, Bagheri R. Size tuning of Ag-decorated TiO₂ nanotube arrays for improved bactericidal capacity of orthopedic implants. J Biomed Mater Res A. 2014;102(8):2625–2635. Abbreviations: CP, commercially pure; SEM, scanning electron microscope; ALP, alkaline phosphatase; UV, ultraviolet; NPs, nanoparticles; h, hours; TDN, titanium dioxide nanotubes.

Figure 3

Effect of carbon nanostructures on the performance of electrodeposited polysaccharide coatings on Ti foils. Notes: (A) SEM image of CS/GO (30 wt%) coating. (B) MTT viability and (C) SEM morphology of MG-63 cells cultured on the surface of the CS/GO coating. (D) A SEM image of alginate/BG/ND film. Copyright © 2013. Elsevier B.V. Reproduced from Mansoorianfar M, Shokrgozag MA, Mehrjoo M, Tamjid E, Simchi A. Nanodiamonds for surface engineering of orthopedic implants: enhanced biocompatibility in human osteosarcoma cell culture. Diam Relat Mater. 2013;40(0):107–114. (E) Formation of apatite phases on the surface of the alginate coating after 28 days of incubation in the SBF and (F) its MG-63 cell viability response. (G) The antibacterial performance of the CS/GO coating containing vancomycin against Staphylococcus aureus. Insets: plate counting images showing S. aureus bacteria colonies after 120 min incubation for the CS-30GO film containing (a) 0, (b) 0.5 and (c) 1 g/l antibiotics. (H) Cumulative drug release of the CS/GO (30 wt%) coating. Copyright © 2015. Elsevier B.V. Reproduced from Ordikhani F, Ramezani Farani M, et al. Physicochemical and biological properties of electrodeposited graphene oxide/chitosan films with drug-eluting capacity. Carbon. 2015;84(0):91–102. *Denotes significant difference between TPS and EPD coatings (P<0.05). ^#Denotes significant difference between CS and composite coatings (P<0.05). Abbreviations: SEM, scanning electron microscope; CS, chitosan; GO, graphene oxide; BG, bioactive glass; ND, nanodiamond; SBF, simulated body fluid; TPS, tissue culture polystyrene; EPD, electrophoretic deposition; MTT, 3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide.

Figure 3

Effect of carbon nanostructures on the performance of electrodeposited polysaccharide coatings on Ti foils. Notes: (A) SEM image of CS/GO (30 wt%) coating. (B) MTT viability and (C) SEM morphology of MG-63 cells cultured on the surface of the CS/GO coating. (D) A SEM image of alginate/BG/ND film. Copyright © 2013. Elsevier B.V. Reproduced from Mansoorianfar M, Shokrgozag MA, Mehrjoo M, Tamjid E, Simchi A. Nanodiamonds for surface engineering of orthopedic implants: enhanced biocompatibility in human osteosarcoma cell culture. Diam Relat Mater. 2013;40(0):107–114. (E) Formation of apatite phases on the surface of the alginate coating after 28 days of incubation in the SBF and (F) its MG-63 cell viability response. (G) The antibacterial performance of the CS/GO coating containing vancomycin against Staphylococcus aureus. Insets: plate counting images showing S. aureus bacteria colonies after 120 min incubation for the CS-30GO film containing (a) 0, (b) 0.5 and (c) 1 g/l antibiotics. (H) Cumulative drug release of the CS/GO (30 wt%) coating. Copyright © 2015. Elsevier B.V. Reproduced from Ordikhani F, Ramezani Farani M, et al. Physicochemical and biological properties of electrodeposited graphene oxide/chitosan films with drug-eluting capacity. Carbon. 2015;84(0):91–102. *Denotes significant difference between TPS and EPD coatings (P<0.05). ^#Denotes significant difference between CS and composite coatings (P<0.05). Abbreviations: SEM, scanning electron microscope; CS, chitosan; GO, graphene oxide; BG, bioactive glass; ND, nanodiamond; SBF, simulated body fluid; TPS, tissue culture polystyrene; EPD, electrophoretic deposition; MTT, 3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide.