The vision of gluing two bone fragments with biodegradable and biocompatible adhesives remains highly fascinating and attractive to orthopedic surgeons. Possibly shorter operation times, better stabilization, lower infection rates, and unnecessary removal make this approach very appealing. After 30 years of research in this field, the first adhesive systems are now appearing in scientific reports that may fulfill the comprehensive requirements of bioadhesives for bone. For a successful introduction into clinical application, special requirements of the musculoskeletal system, challenges in the production of a bone adhesive, as well as regulatory hurdles still need to be overcome. In this article, we will give an overview of existing synthetic polymers, biomimetic, and bio-based adhesive approaches, review the regulatory hurdles they face, and discuss perspectives of how bone adhesives could be efficiently introduced into clinical application, including legal regulations.

Bioadhesion is a versatile tool used by many organisms for a variety of purposes. It has roles to play in construction, predation, defense, and attachment and covers different concepts based on biochemical and mechanical principles. The specific request on the bond combined with millions of years of evolution results in diverse inspirations for medical and technical applications. This requires knowledge of the adhesives themselves in terms of composition, structural design, and interaction with surfaces. This chapter gives an overview about natural adhesives and biological adhesives leading to bioinspired applications. The terminology used in this chapter is based on the adhesive’s origin and usage and the underlying concept: while natural adhesives are composed of bio-based raw materials for artificial applications, biological adhesives are expressed by natural organisms for versatile purposes. The latter in particular can lead to bioinspired applications that are not restricted to adhesion, including concepts to avoid adhesion as in terms of antifouling. Both kinds of adhesive, i.e., natural and biological, are relevant for biocompatible adhesives. This characteristic is mandatory for applications as in cosmetics, food, or medicine. In view of their interaction with vital tissues and their medical eligibility, a brief digression into biomimetic adhesives is given.