Bone defects caused by trauma and disease have become urgent problems. Three-dimensional (3D) porous scaffolds for bone tissue engineering should ideally have an interconnected porous structure, good biocompatibility and mechanical properties similar to those of natural bones. In the present study, a chitosan/bioglass (CS/BG) 3D porous scaffold was constructed by initially preparing a CS fibre 3D porous scaffold by needle-punching, and then depositing BG on the scaffold by dip-coating. The CS/BG 3D porous scaffold had an interconnected porous structure, with a porosity of 77.52% and a pore size around 50 μm. Water absorption values of the CS fibre 3D porous scaffold and the corresponding CS/BG scaffold were 570% and 59%, respectively. The BG present in the latter significantly decreased the swelling of the CS fibres, thus improving the stability of the scaffolds. The CS/BG 3D porous scaffold possessed good mechanical properties, with a compression strength of 7.68 ± 0.38 MPa and an elastic modulus of 0.46 ± 0.02 GPa, which are well-matched to those of trabecular bone. In vitro cell assay results demonstrated that the CS/BG 3D porous scaffold had good biocompatibility, which facilitates the spreading and proliferation of human bone marrow stromal cells (hBMSCs). The CS/BG 3D porous scaffold is thus a suitable material for bone tissue engineering.

Introduction: Intra-articular injection of hyaluronic acid (HA) is often used as therapy for knee osteoarthritis because it is less expensive and less aggressive than total knee replacement. Therefore, it is important to document whether HA is safe and efficacious. We tested whether single and multiple injection viscosupplementation with HA is associated with clinically meaningful pain relief in a new randomized clinical trial (RCT). Our objective was to compare safety and efficacy of intra-articular HA in two formulations: one 3.0 ml injection of Durolane versus five 2.5 ml injections of Artz for the treatment of knee osteoarthritis pain. Methods: Patients (N = 349) from the People’s Republic of China were randomized to treatment (Durolane = 175, Artz = 174). The Durolane group received a 3.0 ml injection at week 0 (baseline), with sham skin punctures at weeks 1, 2, 3, and 4. The Artz group received one 2.5 ml injection at each of the same time points. The primary assessment tool was the Likert-type Western Ontario and McMaster University (WOMAC) pain scale at weeks 0, 6, 10, 14, 18, and 26. Secondary assessments were WOMAC physical function, knee stiffness, and global self-assessment, at identical time points. Statistically-controlled analyses were non-inferiority of Durolane over 18, then over 26 weeks, with a priori non-inferiority defined as 8% of the relevant scale. Acetaminophen was permitted as rescue analgesia and all adverse events (AEs) were recorded. Results: Overall study retention was excellent; 332 patients (95.1%) completed 18 weeks and 319 (91.4%) completed 26 weeks, with no significant retention difference between treatment arms. All variables met non-inferiority criteria over 18 and 26 weeks. Efficacy response in both arms was >90%. Treatment-related AEs were 9.8% (17/174) for Artz and 13.1% (23/175) for Durolane. Conclusions: A single injection of Durolane is non-inferior to 5 injections of Artz over 18 and 26 weeks for pain, physical function, global self-assessment, and knee stiffness. Both treatments were efficacious, safe, and well tolerated. Trial registration: ClinicalTrials.gov NCT01295580. Registered 11 February 2011.