Alteration of clot architecture using bone substitute biomaterials (beta-tricalcium phosphate) significantly delays the early bone healing process

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Wang, Xin
Luo, Yan
Yang, Yan
Zheng, Baoyu
Yan, Fuhua
Wei, Fei
Friis, Thor E
Crawford, Ross W
Xiao, Yin
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2018
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Abstract

When a bone substitute biomaterial is implanted into the body, the material's surface comes into contact with circulating blood, which results in the formation of a peri-implant hematoma or blood clot. Although hematoma formation is vital for the early bone healing process, knowledge concerning the biomaterial-induced structural properties of blood clots is limited. Here, we report that implantation of beta-tricalcium phosphate (β-TCP) in a bone defect healing model in rats resulted in significantly delayed early bone healing compared to empty controls (natural healing). In vitro studies showed that β-TCP had a profound effect on the overall structure of hematomas, as was observed by fibrin turbidity, scanning electron microscopy (SEM), compaction assays, and fibrinolysis. Under the influence of β-TCP, clot formation had a significantly shortened lag time and there was enhanced lateral fibrin aggregation during the clot polymerization, which resulted in clots composed of thinner fibers. Furthermore, fibrin clots that formed around β-TCP exhibited reduced compaction and increased resistance to fibrinolysis. Together, these results provide a plausible mechanism for how implanted bone-substitute materials may impact the structural properties of the hematoma, thereby altering the early bone healing processes, such as cell infiltration, growth factor release and angiogenesis.

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Journal of Materials Chemistry B

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6

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48

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© 2018 Royal Society of Chemistry. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal website for access to the definitive, published version.

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Macromolecular and materials chemistry

Biomedical engineering

Chemical engineering

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Materials Science, Biomaterials

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Wang, X; Luo, Y; Yang, Y; Zheng, B; Yan, F; Wei, F; Friis, TE; Crawford, RW; Xiao, Y, Alteration of clot architecture using bone substitute biomaterials (beta-tricalcium phosphate) significantly delays the early bone healing process, Journal of Materials Chemistry B, 2018, 6 (48), pp. 8204-8213

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