A Novel Fiber Embedded Hydrogel Temporomandibular Joint Disc Replacement

新型纤维嵌入水凝胶颞下颌关节盘置换术

基本信息

批准号：
10893071
负责人：
Kevin Labus
金额：
$ 51.38万
依托单位：
COLORADO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10893071
关键词：
Anatomy Animal Model Animals Articulation Automobile Driving Biological Biomechanics Biomimetics Body Weight Cadaver Cartilage Complex Computer Models Control Groups Custom Degenerative polyarthritis Development Disease Elements Environment Evaluation Excision Exhibits Failure Fatigue Fiber Foundations Friction Geometry Goals Health Homeostasis Human Hydrogels Implant In Situ In Vitro Inflammatory Response Joints Kinetics Location Mastication Measures Mechanical Stress Mechanics Methods Modeling Operative Surgical Procedures Pain Pathologic Patients Performance Periodicity Physiological Play Polymers Population Property Replacement Arthroplasty Research Role Safety Scanning Severities Sheep Solid Stress Structure Structure of articular disc of temporomandibular joint Surface Surgical complication Surgical sutures Techniques Temporomandibular Joint Temporomandibular Joint Disorders Testing Tissues Work X-Ray Computed Tomography arthropathies biomaterial compatibility biomechanical model biomechanical test bone design experimental study fabrication implant design implant material implementation strategy in vivo joint destruction mechanical behavior mechanical load mechanical properties melting morphometry novel polyvinyl alcohol hydrogel pressure prevent radiological imaging reconstruction resilience response rumination sample fixation scaffold sheep model translational model

项目摘要

Project Summary Temporomandibular joint (TMJ) disorders inflict approximately 5% to 12% of the population. For advanced disorders of the articular TMJ disc, which typically do not respond to conservative treatments, disc resection is the most common surgical intervention. However, the TMJ disc plays a critical role in distributing mechanical stresses and preventing wear to the articular surfaces of the joint. Thus, removing the disc can further disrupt joint homeostasis, driving degeneration and the development of osteoarthritis, which can lead to highly invasive and challenging surgical interventions such as reconstructions and total joint replacement. Prior attempts at replacing the disc with alloplastic implants have led to deleterious pathological changes related to wear debris, implant fragmentation, and adverse inflammatory responses. Therefore, it is crucial to consider wear, mechanical strength, and biocompatibility of disc replacement materials in the context of long-term cyclic loading in the TMJ. Overall, there is a critical need for disc replacements that can restore the homeostasis of the joint when disc resection is required prior to the development of severe joint degeneration. Accordingly, the objective of this proposal is to create an artificial TMJ disc that replaces the mechanical function of the native disc and prevents subsequent degeneration of the joint. Towards this goal, the proposed research will characterize the mechanical loading environment of the TMJ in order to determine the mechanical criteria of a TMJ disc replacement needed to minimize internal stresses in the joint (Specific Aim 1). Further, non- resorbable fiber-embedded hydrogel materials will be fabricated, optimized to exhibit biomimetic properties, and developed into a patient-specific synthetic TMJ disc implant. Rigorous mechanical evaluations will determine material durability and suitability as a TMJ disc replacement (Specific Aim 2). Finally, a large animal study will be utilized to evaluate the safety and efficacy of the developed TMJ disc replacement (Specific Aim 3). Successful completion of the proposed work would represent a paradigm shift in the treatment of TMJ disc disorders that can mitigate further joint degeneration and prevent more invasive and complicated surgeries.

项目概要大约 5% 至 12% 的人口患有颞下颌关节 (TMJ) 疾病。对于高级颞下颌关节盘疾病，通常对保守治疗没有反应，椎间盘切除术是最常见的手术干预。然而，TMJ 盘在分配机械力方面起着至关重要的作用。应力并防止关节关节表面磨损。因此，取出光盘可能会进一步破坏关节稳态，导致退化和骨关节炎的发展，这可能导致高度侵袭性以及具有挑战性的外科手术，例如重建和全关节置换。之前的尝试用异体植入物替换椎间盘导致了与磨损相关的有害病理变化碎片、植入物碎片和不良炎症反应。因此，考虑磨损至关重要，长期循环背景下椎间盘置换材料的机械强度和生物相容性加载到颞下颌关节中。总的来说，迫切需要椎间盘置换术来恢复椎间盘的稳态在发生严重关节退变之前需要进行椎间盘切除时的关节。据此，该提案的目标是创建一个人造颞下颌关节盘，以取代天然颞下颌关节盘的机械功能椎间盘并防止关节随后退化。为了实现这一目标，拟议的研究将表征 TMJ 的机械负载环境，以确定 TMJ 的机械标准需要进行 TMJ 椎间盘置换，以最大程度地减少关节内的内应力（具体目标 1）。此外，非将制造可吸收的纤维嵌入水凝胶材料，并对其进行优化以表现出仿生特性，并开发成针对患者的合成 TMJ 椎间盘植入物。严格的机械评估将确定材料的耐用性和作为 TMJ 椎间盘替代品的适用性（具体目标 2）。最后来个大动物研究将用于评估开发的 TMJ 椎间盘置换术的安全性和有效性（具体目标 3）。拟议工作的成功完成将代表 TMJ 椎间盘治疗的范式转变可以减轻进一步的关节退化并防止更具侵入性和复杂的手术的疾病。