The future of bone repairs might be a 'glue gun'

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CC:0 Photo by Harlie Raethel on Unsplash
CC:0 Photo by Harlie Raethel on Unsplash

Korean and US researchers have modified a glue gun to print out bone grafts, which they say could be 3D printed directly onto fractures and defects during surgery. The tool has so far been tested in rabbits, where the team was able to quickly create complex bone implants without the need for prefabricated parts being made in advance. Additionally, the team made these grafts with high structural flexibility, as well as the ability to release anti-inflammatory antibiotics and aid natural bone regrowth at the grafting site. Importantly, our current methods of fixing bones use either metal, donor bone or 3D printed materials to repair the break - all of which take time to build or prepare in the case of irregular bone breaks. In this new study, the team were able to print in situ, taking a feature of natural bone that is known to promote healing and a biocompatible plastic and mixing them into a 'glue' that will bind and conform to the jagged grooves of a fractured bone.

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From: Cell Press

3D printing “glue gun” can generate bone grafts directly onto fractures in animals

Scientists have developed a tool made from a modified glue gun that can 3D print bone grafts directly onto fractures and defects during surgery. The tool, described September 5th in the Cell Press journal Device, has been tested in rabbits to quickly create complex bone implants without the need for prefabricating in advance. What’s more, the team optimized the 3D-printed grafts for high structural flexibility, release of anti-inflammatory antibiotics, and promotion of natural bone regrowth at the grafting site.

Historically, bone implants have been made of metal, donor bone, or even more recently 3D-printed material. However, in cases involving irregular bone breaks, these implants must be designed and produced prior to surgery to allow for appropriate fitting.

“Our proposed technology offers a distinct approach by developing an in situ printing system that enables a real-time fabrication and application of a scaffold directly at the surgical site,” says Jung Seung Lee, co-author and associate professor of biomedical engineering at Sungkyunkwan University. “This allows for highly accurate anatomical matching even in irregular or complex defects without the need for preoperative preparation such as imaging, modeling, and trimming processes.”

The material fed into the glue gun is a filament comprised of two major components: a feature of natural bone known to promote healing called hydroxyapatite (HA) and a biocompatible thermoplastic called polycaprolactone (PCL). PCL can liquify in temperatures as low as 60°C, which when applied with a heat-modified glue gun, is cool enough to prevent tissue damage during surgical application while being able to conform to the jagged grooves of fractured bone. By adjusting the proportion of HA to PCL within the filament, the team can customize the hardness and strength of the grafts to fit different anatomical needs.

“Because the device is compact and manually operated, the surgeon can adjust the printing direction, angle, and depth during the procedure in real time,” says Lee. “Also, we demonstrated that this process could be completed in a matter of minutes. This highlights a significant advantage in terms of reducing operative time and improving procedural efficiency under real surgical conditions.”

Since infection is a common concern with surgical implants, the researchers incorporated vancomycin and gentamicin, two anti-bacterial compounds, into the filament. In both petri dish culture and liquid medium, the filament scaffold successfully inhibited the growth of E. coli and S. aureas, two common bacteria prone to cause infection post-surgery. Due to physical properties of HA and PCL within the filament, the drugs are released slowly and are able to diffuse directly onto the surgical site over several weeks.

“This localized delivery approach offers meaningful clinical advantages over systemic antibiotic administration by potentially reducing side effects and limiting the development of antibiotic resistance, while still effectively protecting against postoperative infection,” says Lee.

As a proof of concept, the device was tested on the severe femoral bone fractures in rabbits. Within 12 weeks after surgery, the team found no signs of infection or necrosis and greater bone regeneration outcomes when compared to rabbits grafted with bone cement—a sealing compound commonly used for treating bone defects.

“The scaffold was designed not only to integrate biologically with surrounding bone tissue but also to gradually degrade over time and be replaced by newly formed bone,” says Lee. “The results showed that the printing group exhibited superior outcomes in key structural parameters such as bone surface area, cortical thickness, and polar moment of inertia, suggesting more effective bone healing and integration.”

Next the team is setting their sights on optimizing the anti-bacterial potential of the scaffold even further and preparing the procedure for human trials.

“Clinical adoption will require standardized manufacturing processes, validated sterilization protocols, and preclinical studies in large animal models to meet regulatory approval standards,” says Lee. “If these steps are successfully achieved, we vision this approach becoming a practical and immediate solution for bone repair directly in the operating room.”

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Journal/
conference:
Device
Research:Paper
Organisation/s: Korea University College of Medicine, Korea
Funder: This work was supported by the National Research Foundation of Korea (grant 2022R1C1C1011682) funded by the Korea government, the Ministry of Science and ICT (MSIT). This work was also supported by a Korean Fund for Regenerative Medicine grant funded by the Korea government (MSIT, the Ministry of Health & Welfare) (23B0103L1). Additionally, this work was supported by a grant of the Korea-US Collaborative Research Fund (KUCRF), funded by the Ministry of Science and ICT and Ministry of Health & Welfare, Republic of Korea (RS-2024-00467213). This work was supported by the Karl van Tassel (1925) Career Development Professorship and the Department of Mechanical Engineering, Massachusetts Institute of Technology (MIT).
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