Managing infected bone defects (IBDs) has long been a significant challenge in orthopedic medicine. However, recent advancements in biomaterials have led to the development of innovative bone regeneration scaffolds that not only stimulate bone growth but also combat infections. A new study, published in BME Frontiers, introduces an innovative dual-functional bone regeneration scaffold, named Qx-D, which holds great potential for treating IBDs.

The study, conducted by researchers at Beijing University of Chemical Technology (BUCT, Beijing, China), aimed to enhance early management and surgical outcomes for bone infections. The team focused on modifying demineralized bone matrix (DBM), a naturally derived material known for its ability to promote bone regeneration. While DBM is effective in stimulating bone growth, it lacks antimicrobial properties, making it vulnerable to infections. To address this issue, the researchers incorporated a macromolecular quaternary ammonium salt (QPEI) into the DBM structure. Using a simple Schiff base reaction, the team synthesized Qx-D scaffolds with adjustable feeding ratios. These scaffolds demonstrated strong antibacterial properties against various bacteria, including both Gram-positive and Gram-negative strains, such as Staphylococcus aureus (S. aureus), methicillin-resistant S. aureus (MRSA), and Escherichia coli (E. coli). The Qx-D scaffolds achieved a remarkable antibacterial efficiency of 99.9%, indicating broad-spectrum activity.

Apart from its antibacterial properties, Qx-D also exhibited good biocompatibility. In vitro studies showed that the scaffold supported the adhesion and differentiation of bone marrow stromal cells (BMSCs), which are essential for bone regeneration. Additionally, alkaline phosphatase (ALP) staining results suggested that Qx-D promoted the osteogenic differentiation of BMSCs without negatively affecting cell activity. The in vivo performance of Qx-D was tested in a rat model with infected bone defects. The results showed that Qx-D implantation significantly reduced inflammation and enhanced bone regeneration. Micro-computed tomography (CT) imaging revealed that the defect was nearly fully closed in the Qx-D group, with a significantly higher bone volume/total volume (BV/TV) ratio compared to the control group.

This study provides valuable insights into the creation of dual-functional bone scaffolds for treating infected bone defects. The Qx-D scaffold, which combines antibacterial and osteogenic properties, presents a promising alternative to current treatments that often rely on antibiotics, which can lead to drug resistance and other complications. The research team believes that Qx-D has the potential to transform the treatment of infected bone defects, improving patient outcomes and alleviating the burden of bone infections in orthopedic care. With continued development and clinical trials, Qx-D could become a standard treatment option for patients with infected bone defects, offering new hope to those affected by this challenging condition.

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