Insufficient vascularization of grafts often leads to delayed tissue ingrowth and impaired tissue function in tissue engineering. The surface topography of grafts plays critical roles in angiogenesis. In the present study, we prepared silk fibroin (SF)-based microtopography films with the number of convex dots ranging from 37 to 4835/mm². The convex dot-featured topography surfaces were characterized by scanning electron microscopy, a Profilm3D optical profilometer, atomic force microscopy, and a contact angle goniometer. The effect of microtopographic films on the proliferation, adhesion, and expression of angiogenic factors of human umbilical vein endothelial cells (HUVECs) was investigated. Our results demonstrated that the SF film surface with 2899 convex dots/mm² significantly enhanced adhesion, viability, and levels of vascular endothelial growth factors and basic fibroblast growth factors of HUVECs and significantly downregulated the level of α-SMA in human aortic smooth muscle cells, indicating that the microtopographic films could promote angiogenesis. Furthermore, in vitro results showed that HUVEC proliferation was positively correlated with yes-associated protein (YAP) activation, suggesting that the enhanced angiogenesis was mediated via the YAP pathway. Finally, mice subcutaneous embedding model results indicated that the SF film surface with 2899 convex dots/mm² could significantly enhance angiogenesis in vivo. Altogether, our results showed that the SF film surface with 2899 convex dots/mm² promoted the angiogenesis of HUVECs and offered a novel angiogenesis-promoting strategy of implant surface design for tissue engineering.

Introduction: In cases of hip joint damage, such as osteoarthritis (OA), rheumatoid arthritis (RA), avascular necrosis, or hip fractures, total hip arthroplasty (THA) is a critical surgical intervention. For individuals whose hip abnormalities stem from congenital issues, injuries, or previous operations, this procedure can encounter considerable obstacles, including complex bone defects, soft tissue deficiencies, and an increased risk of infections, which may result in poor alignment, joint instability, and higher need for revisions. This study explored the application of personalized, three-dimensional (3D)-printed porous tantalum buttresses designed specifically for acetabular reconstruction. Renowned for its compatibility with human biology, tantalum facilitates superior integration with natural bone.Methods: The development process started with the generation of meticulous computer-aided design (CAD) models, derived from preoperative imaging techniques such as computed tomography (CT) scans and (magnetic resonance imaging) MRIs, which allowed for the creation of components precisely matching each patient’s unique anatomical structure. The 3D-printed porous tantalum buttresses were made by cutting-edge additive manufacturing methods. The porosity of the tantalum structure promoted the growth of new bone tissue into the implant, improving its stability and durability. During surgeries, the buttress was positioned to reconstruct the acetabulum, laying a solid foundation for the artificial hip joint.Results: The results of our study showed that all surgeries were successfully completed with no significant vascular or nerve damage. Postoperative evaluations showed that the buttress had excellent biomechanical function and firm fixation, with a large amount of bone ingrowth, improving the fitness and performance of the implant while reducing the possibility of subsequent problems such as loosening or dislocation.Discussion: This innovative technique has great potential in clinical practice for better outcomes and quality of life for patients with complex hip deformities.

This study aims to investigate the suitable surgical strategies for applying TaBw01 porous tantalum rod across different stages of osteonecrosis of the femoral head (ONFH). TaBw01 tantalum rods were fabricated using type FTaY-1 tantalum powder via the foam impregnation-sintering method. Mechanical testing with the Instron 8801 universal testing machine and finite element analysis (FEA) assessed single tantalum rod implantation and impaction bone grafting combined with rod implantation. A total of 86 osteonecrosis of the femoral head (ONFH) patients (94 hips) were treated: the experimental group (45 patients, 50 hips) underwent surgical hip dislocation (SHD) with impaction bone grafting and tantalum rod implantation, while the control group (41 patients, 44 hips) received single rod implantation. Primary failure criteria included femoral head collapse (≥ 2 mm) or total hip arthroplasty. Patient-reported outcomes (PROs), including Harris Hip Score (HHS), Visual Analog Score (VAS), Hip Outcome Score Activities of Daily Living Subscale (HOS-ADL), and Hip Outcome Score Sport-Specific Subscale (HOS-SSS), were analyzed based on Minimum Clinically Important Difference (MCID). FEA confirmed stresses below the material’s yield and compressive strength. At 3 years, survival rates for ARCO (Association Research Circulation Osseous) stage IIb and IIc were higher in the experimental group (100%, 80.38%) than the control group, while stage IIa survival was 100% in the control group. The experimental group also had higher MCID attainment for HHS, HOS-ADL, and HOS-SSS. Compared with single TaBw01 implantation, impaction bone grafting combined with TaBw01 implantation via SHD demonstrated superior outcomes for ARCO stage IIb and IIc, with a minimum 2-year follow-up. while single TaBw01 implantation may be more suitable for stage IIa. This study emphasizes the importance of combining biological and biomechanical reconstruction in ONFH treatment.

Shelf acetabuloplasty is a viable treatment for developmental dysplasia of the hip (DDH), yet autologous bone grafts have faced challenges such as morphological mismatch, imprecise placement, and long-term graft resorption. The rapid advancement of 3D printing technology in orthopedics has enabled the acquisition of digital image correlation method (DICM) data from patient pelvic to bilateral femoral proximal regions through computed tomography (CT) scans. These data are then utilized by software to create 3D models and design individualized metal implants. Using tantalum-based type I (TA1) spherical powder as the raw material, a porous tantalum buttress with a pore size of 600 microns and a porosity of 75% was fabricated employing the selective electron beam melting (SEBM) technology. Our Center has applied this 3D-printed individualized porous tantalum buttress in shelf acetabuloplasty for 21 DDH patients (25 hips), including 6 males and 15 females, with a mean age of 21.38 ± 7.39 years. The follow-up period ranged from 12 to 47 months, averaging 22.64 ± 10.86 months. At the final follow-up, patient-reported outcomes (PROs) were used to assess the patient’s subjective feelings. Significant improvements were observed in the Non-Arthritic Hip Score (NAHS), modified Harris Hip Score (mHHS), Hip Outcome Score-Sports Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), and Visual Analog Scale (VAS) compared with preoperative levels (p < 0.01). Radiographic assessments indicated that the postoperative lateral centeredge (LCE) angle, Tonnis angle, acetabular angle (Sharp’s angle), and femoral head coverage all trended towards normal, with statistically significant differences (p < 0.01). There was no implant displacement or bone resorption in any case, and no progression in Tonnis grading for hip osteoarthritis (OA) was noted postoperatively, with an 84% patient satisfaction rate. The early follow-up results of 3D-printed individualized porous tantalum buttress in shelf acetabuloplasty are satisfactory, indicating a reliable application prospect for the treatment of DDH patients.