The treatment of femoral neck fracture using VEGF-loaded nanographene coated internal fixation screws

Abstract

PurposePrevious studies have proved that vascular endothelial growth factor (VEGF) has a dual role in the promotion of new bone formation and blood vessel repair during fracture healing. However, how to introduce VEGF to a fracture site safely and effectively is still a challenge. This study aimed to prepare a VEGF-loaded nanographene coated internal fixation screw and to evaluate its effects in the treatment of femoral neck fracture.MethodsNanographene coated screws were prepared by direct liquid-phase exfoliation of the graphite method, and the surface characteristics were observed through scanning electron microscopy (SEM). VEGF was loaded on nanographene coatings through physical adsorption, and the VEGF controlled release was examined by ELISA. Then a canine femoral neck fracture model was built to examine both the angiogenic and osteogenic properties of the VEGF-loaded coated screws. X-ray, micro-CT-based microangiography, and histopathologic evaluation were used to assess the fracture healing progress.ResultsThe results demonstrated that nanographene could load VEGF effectively, and the accumulative release of VEGF clearly increased during the entire testing period (9 days) without burst release. In canine fracture models, the results of X-ray, microangiography, and histopathologic examination proved that the speed of fracture healing, new bone formation area, and revascularization of the fractured femoral heads in the VEGF-loaded coated screws groups were significantly higher than in the control groups.ConclusionOur study proved that VEGF-loaded nanographene coated screws were effective in the treatment of femoral neck fracture and prevention of avascular necrosis of femoral head.

Research hotspots and trends in internal fixation of femoral neck fractures from 2010 to 2022: A 12-year bibliometric analysis

“…[31] As material science advances, the composition of bone screws is undergoing continual evolution. Recent studies have demonstrated that the use of a new porous Ta-coated SiC (pTa-SiC) scaffold [32] and a vascular endothelial growth factor loaded nanographene-coated internal fixation screw [33] can enhance bone healing. Despite these promising results, questions remain.…”

“…[38] However, more recent studies have focused on the material and surgical approach of INFNF. For instance, the utilization of a new pTa-SiC scaffold [32] and a vascular endothelial growth factor loaded nanographene-coated internal fixation screw [33] has been demonstrated to enhance bone healing. While the availability of relevant clinical studies remains limited, the development of materials science is expected to lead to more studies in this area.…”

Evaluation of tissue in repair with natural latex and / or hyaluronic acid in surgical bone defects

“…VEGF is relevant for bone formation, influencing vascularization and differentiation of bone and endothelial cells, and the absence of typically active forms of VEGF in bone formation may result in reduced initial calcification (39). In addition, VEGF increases bone fracture healing speed and bone neoformation area (40).…”

Method for reconstructing femoral head blood supply by anastomosing the intraosseous artery

“…While conventional surgical interventions can realign the fracture fragments, they fall short in re-establishing the native vascular integrity. Techniques such as bone flap transplantation, bone marrow aspirations, and VEGF (Vascular Endothelial Growth Factor) implantation serve as indirect modalities to revascularize the femoral head, showing potential in attenuating the postoperative incidence of avascular necrosis [ [5] , [6] , [7] ]. Nonetheless, the prolonged treatment duration, substantial costs, and variable efficacy curtail their universal adoption.…”