Bone Adhesives in Trauma and Orthopedic Surgery

University of Gießen—Marburg Department of Trauma Surgery Rudolf-Buchheim-Strasse 7 35385 Gießen Germany Rudolf-Buchheim-Strasse 7 35385 Gießen Germany
European Journal of Trauma 03/2006; 32(2):141-148. DOI: 10.1007/s00068-006-6040-2

ABSTRACT Adhesives, especially bone adhesives, are resorbed and degraded to non-toxic products after fulfilling their function in contact
with the living organism. The use of such bone adhesives has found growing interest in all fields of medicine in the last
50 years. The dream of trauma and orthopedic surgeons for alternatives to osteosynthesis and pins is reflected in the development
of a variety of surrogates of biological or synthetic origin. Despite a longstanding history of research in this field up
to now a clinically applicable alternative could not have been found on the field of bone gluing. The application consistently
collapsed, because these adhesives were not tailored to the conditions met within the living organism. The following article
is meant to provide an overview of the development, the state of the art and today’s knowledge of bone adhesives. In addition,
the article wants to pinpoint the tremendous progress made on this subject, made possible by the joint effort of basic researchers
and surgeons. The results show that in the future a successful reconstructive surgery will emerge from the application of
synthetic biomaterials.

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    ABSTRACT: The purpose of this study was to investigate the bond strength of a new bone adhesive based on ethylene glycol-oligolactide-bismethacrylate on 36 sheep. A 2-cm metaphysial segment was produced on the ulna of each sheep by an oscillating saw and it was not stabilized by any type of additional osteosynthesis. Adhesive was applied to the osteotomy gaps in 18 sheep, the remaining 18 animals served as controls. A total of 6 animals with glue and 6 controls were euthanized after 21, 42 and 84 days. The bond strength after repair of the gaps through bone adhesive compared to a control group was studied by using a four-point bending test. There was a continual increase of bending stiffness from 21 to 84 days in all sheep, with the highest bending stiffness of 102.83 N/mm2 by the glue group after 84 days as opposed to the control group with 58.48 N/mm2 (p = 0.25). Morphological investigations showed more callus formation by the control group than the adhesive group after 84 days (p = 0.04). In addition, an in vitro gluing of the ulna segment was performed with a four-point bending test after 10, 60 and 360 min polymerization time. The in vitro gluing of the ulna segment showed a continual increase of bending stiffness to 17.32 N/mm2 after 360 min (p = 0.59).
    Biomedizinische Technik 01/2008; 53(2):77-85. · 1.16 Impact Factor
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    ABSTRACT: The use of adhesives in surgery is an old but mostly unfulfilled dream (Donkerwolcke et al., 1998). Compared to conventional bonding techniques employed in surgery today like stitching, fixing with screws, pins, and plates, gluing has several advantages because it represents a fast and uncomplicated technique that causes no or only slight injuries of surrounding tissue and enables a homogenous load distribution between bonded materials (Rimpler, 1996). If such an adhesive would be gradually self-degrading in the body, newly formed tissue could replace the adhesive during the healing process and a complete regeneration of the damaged tissue would be possible. A gradual degradation of the adhesive would also maintain the necessary bonding strength within the tissue repair period and finally no foreign material would remain in the body.
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    ABSTRACT: Nature has been developing adhesives for millions of years, mankind for just a few thousands of years. For this reason it is worth having a closer look at what nature does and how we can develop bio-inspired adhesives for technical and medical applications. Some examples of natural materials which have already been used for technical adhesives are casein, latex rubber, tree gum, and adhesives derived from natural sources used for the waterproofing of natural textiles, the production of paper, and the sealing of jars (Papov et al., 1995; Creton and Papon, 2003). Bio-inspired adhesives can be found in all areas of the natural world. Because of their origin, those adhesives are also called biological adhesives or bioadhesives and they fulfill several different functions (Smith and Callow, 2006; Carrington, 2008; Antonietti and Fratzl, 2010). Plants use adhesives, for example, for self-healing and for protecting themselves against wood defects, while animals use sticky materials for protecting themselves against predators and for hunting prey (Keckes et al., 2003; Schreiber et al., 2005; Flammang, 2006; Voigt and Gorb, 2008; Plaza et al., 2009). Microorganisms use adhesive material for settlement, surface attachment, and colonization (Melzer et al., 2008; Flammang et al., 2009; Santos et al., 2009; Scholz et al., 2009). Higher organisms, such as humans, rely on an inducible adhesive system: the wound healing promoter fibrinogen ((Berlind et al., 2010), which is discussed in detail in Chapter 15, p. 225 of this book).