News “Super gel” provides insight into novel cartilage repair strategies
A team of material engineers at Harvard, led by Professor Zhigang Suo, has developed an extremely stretchy, robust, biocompatible and self-healing hydrogel, which researchers be- lieve has the potential to become a next-gen- eration cartilage repair treatment option for human joint defects. Treatments for OA aim to reduce pain and consequent immobility, and therapeutic strat- egies vary depending on the degree of sever- ity. The management of patients with OA in the early stages mainly consists of lifestyle changes and pharmacological analgesics, but for OA in the advanced stages, surgical inter- ventions (e.g. autologous chondrocyte implan- tation) and device-based treatment modalities (e.g. joint replacement implantation) are often regarded as the primary therapeutic options. However, in most cases these invasive thera- pies do not typically replicate the structural characteristics of healthy cartilage with its as- sociated biomechanical properties, resulting in
failed cartilage regeneration and the need for complex revision surgeries. Considering the drawbacks of current surgical approaches, as well as a crowded global joint replacement implant market, there is massive commercial interest in the emerging area of tissue engi- neering.
Hydrogels are widely used as scaffolds for cartilage tissue engineering research because of their great biocompatibility and elastic- ity, yet the scope of their applications is often limited due to low stretchability and poor me- chanical stability. “For a gel to work in those settings, it has to be able to stretch and expand under compression and tension without break- ing,” said one of the contributors, Jeong-Yun Sun. Unlike conventional hydrogels, this new- ly synthesised gel is capable of maintaining its enhanced toughness and elasticity over multi- ple stretches, and is able to stretch to 21 times its original length. This newly synthesised hy- drogel is a strong hybrid polymer created by
using a mixture of polyacrylamide and alginate to create a complex network far stronger than gels formed from polyacrylamide or alginate alone. The chemical structure of this network allows the whole structure to pull apart very slightly over a large area instead of permitting the gel to crack. Even with a huge crack, the gel was found to still stretch to 17 times its ini- tial length. A hydrogel of this superior stretch- ability, toughness and recoverability is likely to become the perfect scaffold, providing great promise for developing a novel cartilage repair strategy using a tissue engineering approach. This exciting development will take re- searchers a step closer to designing novel func- tional cartilage tissue substitutes to challenge the current treatment paradigm for cartilage repair. In addition, GlobalData expects fur- ther research in regards to the potential clini- cal benefits introduced by this next-generation cartilage scaffold, which could have enormous market implications.
Explosions are the main cause of spine injuries to wounded military personnel
Spinal injuries are among the most disabling conditions affecting wounded members of the U.S. military. Yet until recently, the nature of those injuries had not been adequately ex- plored. In a new study recently published in the
Journal of Bone and Joint Surgery (JBJS), a team of orthopaedic surgeons reviewed more than eight years of data on back, spinal col- umn, and spinal cord injuries sustained by American military personnel while serving in Iraq or Afghanistan. The injuries were then categorised according to anatomic location, neurological involvement, the cause of the in- jury, and accompanying wounds. The resulting analysis is an important first
step in helping orthopaedic surgeons develop treatment plans for these service members, as well as for severely injured civilians who sus- tain similar disabling injuries. • Of 10,979 evacuated combat casualties, 598 (5.45 percent) sustained a total of 2,101 spi- nal injuries.
• Explosions accounted for 56 percent of spine injuries, motor vehicle collisions for 29 percent, and gunshots for 15 percent.
• 92 percent of all injuries were fractures. • The average age at the time of injury was 26.5 years of age.
• 90 percent of the injured were enlisted per- sonnel.
• 84 percent of patients sustained their wounds as a result of combat.
• In 17 percent of injuries to the spine, the spinal cord also was injured.
• 53 percent of all gunshot wounds to the spine resulted in a spinal cord injury.
• Spinal injuries were frequently accom- panied by injuries to the abdomen, chest, head, and face. “In these current military conflicts, the
latest technologies in body armor, helmets, and other protective devices have helped save many soldiers’ lives,” says James A. Blair, MD, an orthopaedic surgery chief resident in the Department of Orthopaedics and Reha- bilitation, Brooke Army Medical Center, Fort Sam Houston, TX. “We also have access to ad- vanced life-saving techniques in the field and medical evacuation strategies that are keeping many more service members alive. “But when a person survives an explosion
or vehicle collision, there has still been a great deal of force on the body,” Blair adds. “Many of those survivors are coming to us with severe injuries to their spine and back. We needed to describe and characterise these injuries so rec- ommendations can be made on how to provide the most effective treatment and rehabilitation for our wounded warriors.” Although the survival rate is high for such
injuries, the disability rate also is quite high. This affects not only the service members, but also their families and the U.S. healthcare system. Therefore, the study’s authors note, further research is required to improve future outcomes for those with spinal injuries.
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