Alina Kirillova1 Cambre Kelly1 Natalia von Windheim1 Ken Gall1

1, Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, United States

Bioresorbable bone adhesives have potential to revolutionize the clinical treatment of the human skeletal system, ranging from the fixation and osseointegration of permanent implants to the direct healing and fusion of bones without permanent fixation hardware.[1] With sufficient strength bioresorbable bone adhesives could ultimately become an ideal means for fixing bone fractures instead of conventional plates, nails, pins and screws used today.[2] Despite the evident clinical need, there are currently no bioresorbable bone adhesives in clinical use that can form a bond to bone in a wet environment strong enough to bear clinical loads and sustainable enough to allow fracture healing.[1]
Inspired by the sandcastle worm that creates a protective tubular shell around its body by gluing together sand grains and shell fragments underwater using a proteinaceous adhesive, we introduce a novel mineral-organic bone adhesive (aka Tetranite®) that cures in minutes in an aqueous environment and provides high bone-to-bone adhesive strength. The new bioresorbable material is measured to be more adhesive than both bioresorbable calcium phosphate and poly(methyl methacrylate) bone cements, which are standards of care in the clinic today. Osteointegration and bioresorbability of the bone adhesive are demonstrated over a 52-week period in a critically-sized distal femur defect in rabbits. Based on its unique capabilities, Tetranite is the first in a new class of biomaterials, which may spark innovative clinical treatments and revolutionize procedures in which bone regeneration or fixation is critical for treatment.

[1] Farrar, D. F. Bone adhesives for trauma surgery: A review of challenges and developments. International Journal of Adhesion and Adhesives 2012, 33, 89-97.
[2] Heiss, C.; Kraus, R.; Schluckebier, D.; Stiller, A.-C.; Wenisch, S.; Schnettler, R. Bone Adhesives in Trauma and Orthopedic Surgery. European Journal of Trauma 2006, 32, 141-148.
[3] Kirillova, A.; Kelly, C.; Von Windheim, N.; Gall, K. Bioinspired Mineral-Organic Bioresorbable Bone Adhesive. Advanced Healthcare Materials 2018, DOI: 10.1002/adhm.201800467.