纳米羟基磷灰石/羧甲基壳聚糖-海藻酸钠复合骨水泥的性能

背景：目前普遍使用的黏合剂对粉碎骨折块进行黏合复位或多或少都存在一些缺陷。 目的：研制具有黏接骨骼作用的生物活性骨水泥。 方法：应用共沉淀法制备纳米羟基磷灰石/羧甲基壳聚糖-海藻酸钠复合材料作为骨水泥的固相粉体,将柠檬酸衍生物配制成溶液作为液相。通过优化实验,从骨水泥的固化时间、抗压强度、抗拉强度、抗稀散性等方面确定最佳配比。 结果与结论：纳米羟基磷灰石/羧甲基壳聚糖-海藻酸钠质量比为65/35,其中羧甲基壳聚糖和海藻酸钠质量比为4∶1时复合成粉体,并按固液比为1.0∶0.5(g∶mL)调拌后形成的骨水泥呈膏状,塑形性和抗稀散性能良好,固化时间12~18 min,抗压强度为(4.5±2.1) MPa。体外黏接猪股骨头抗拉强度在不同室温下无显著性差异无显著性意义(P > 0.05),固化后2 h的抗拉强度达到24 h的94%。骨水泥为多孔状结构,孔径为100~300 μm,纳米羟基磷灰石分布较均匀。提示制备的纳米羟基磷灰石/羧甲基壳聚糖-海藻酸钠复合骨水泥具有良好的生物活性、适当的力学强度以及较好的黏合强度。     

可注射性纳米羟基磷灰石、壳聚糖复合材料修复骨缺损的实验研究

目的：观察可注射性羟基磷灰石/壳聚糖复合材料对兔桡骨骨缺损修复效果。方法：18只新西兰白兔双侧桡骨中段建立长度为10mm节段性缺损,将可注射性纳米羟基磷灰石/壳聚糖复合材料植入一侧骨缺损作为实验组,另一侧植入单纯羟基磷灰石材料作为对照组,于第4、8、12周末,分别行大体、X线检查、组织学、电镜检测,观察该材料对骨缺损的修复效果。结果：①大体观察、X线检查提示：实验组骨痂生长良好,骨缺损完全修复,对照组骨缺损部分修复,部分骨皮质不连续。②组织形态学: 术后12周,实验组新生骨皮质连接完整,髓腔完全再通;对照组少量新生骨形成,部分纤维组织填充③电镜检查:12周实验组材料基本降解,被新生骨组织替代。结论：可注射性纳米羟基磷灰石/壳聚糖复合材料骨缺损修复能力较单纯羟基磷灰石好,具有确实的骨缺损修复能力。     

纳米羟基磷灰石/壳聚糖/半水硫酸钙为可注射骨组织工程支架材料的可行性

背景：前期实验采用仿生学原理制备了可注射性纳米羟基磷灰石/壳聚糖/半水硫酸钙复合材料,但其与骨髓间充质干细胞的生物相容性还不十分清楚。目的：探讨纳米羟基磷灰石/壳聚糖/半水硫酸钙作为注射型骨组织工程支架材料的可行性。方法：将第3代兔骨髓间充质干细胞与可注射纳米羟基磷灰石/壳聚糖/半水硫酸钙支架复合培养,作为实验组;以单纯接种培养的骨髓间充质干细胞为对照组,倒置显微镜下观察细胞生长情况,MTT法检测细胞增殖,扫描电镜观察细胞在材料表面生长与增殖。将纳米羟基磷灰石/壳聚糖/半水硫酸钙支架埋植在家兔背部肌袋内,埋植后2,4,6,8周进行病理学观察。结果与结论：实验组细胞生长、增殖良好,与对照组无明显差异。支架埋植后2周,材料周围有中等量中性粒细胞、淋巴细胞和巨细胞浸润,可见小血管与纤维母细胞增生,材料已被炎性细胞分割、围绕散碎;埋植后4周,可见少量淋巴细胞、纤维母细胞聚集,炎症反应进一步消退,肌纤维排列、形态正常;埋植后6周,材料周围炎症反应轻微,组织水肿不明显;埋植后8周,炎症反应基本消退,材料基本降解完成,肌纤维形态基本正常。表明纳米羟基磷灰石/壳聚糖/半水硫酸钙复合物具有良好的细胞相容性和生物降解性,可作为注射型支架材料。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

壳聚糖/纳米羟基磷灰石分层复合支架的生物相容性研究

制备壳聚糖/纳米羟基磷灰石(CS/nHA)分层复合支架,对其进行细胞毒性评价.分离培养大鼠软骨细胞接种于支架,相差显微镜和扫描电镜观察细胞的黏附及生长情况.动物皮下埋植试验观察其组织相容性.实验结果证实壳聚糖/纳米羟基磷灰石分层复合支架具有良好的生物相容性,有望成为较好的骨软骨组织工程支架.     

壳聚糖微球复合丝素基硫酸钙骨水泥的理化特性

背景：脊柱成形和脊柱后凸成形治疗中采用的硫酸钙骨水泥理化性质好,对人体无毒性作用,同时具有降解性能,但单独使用降解较快。 目的：研制具有载药缓释功能的壳聚糖微球丝素基硫酸钙骨水泥。 方法：采用三聚磷酸钠乳化交联法制备壳聚糖微球。采用浓度分别为3%,6%,9%的丝素溶液与CaSO₄•0.5H₂O混合,通过万能力学试验机确定骨水泥力学性能最佳时的丝素浓度,在此浓度下,按壳聚糖微球占CaSO₄•0.5H₂O的质量比分别为0.5%,1%,5%的比例制备壳聚糖微球丝素基硫酸钙骨水泥,测定其抗压强度,并通过X射线多晶衍射仪及傅里叶红外光谱明确达到最佳抗压强度组的骨水泥成分,电镜观察复合骨水泥中壳聚糖微球的形态。 结果与结论：当丝素溶液浓度为6%,壳聚糖微球含量为0.5%时,复合骨水泥的抗压强度最大,为  (39.17±1.96) MPa,此时复合骨水泥的初凝时间为(12.99±1.63) min,终凝时间为(21.55±0.54) min;骨水泥中主要晶相组成为硫酸钙,傅里叶红外光谱结果证实复合骨水泥中含有丝素及壳聚糖;复合骨水泥中的微球表面稍有皱缩,但球形仍然完整,未见明显破坏,可见在制备复合骨水泥的过程中微球能保持稳定而不被破坏。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

Preparation and characterization of nano-hydroxyapatite/chitosan composite scaffolds

A novel nano-hydroxyapatite (HA)/chitosan composite scaffold with high porosity was developed. The nano-HA particles were made in situ through a chemical method and dispersed well on the porous scaffold. They bound to the chitosan scaffolds very well. This method prevents the migration of nano-HA particles into surrounding tissues to a certain extent. The morphologies, components, and biocompatibility of the composite scaffolds were investigated. Scanning electron microscopy, porosity measurement, thermogravimetric analysis, X-ray diffraction, X-ray photoelectron spectroscopy, and Fourier transformed infrared spectroscopy were used to analyze the physical and chemical properties of the composite scaffolds. The biocompatibility was assessed by examining the proliferation and morphology of MC 3T3-E1 cells seeded on the scaffolds. The composite scaffolds showed better biocompatibility than pure chitosan scaffolds. The results suggest that the newly developed nano-HA/chitosan composite scaffolds may serve as a good three-dimensional substrate for cell attachment and migration in bone tissue engineering.     

Effects of chitosan addition to self-setting bone cement

The Cementek is a self-setting bone cement composed of a solid phase and a liquid phase. After mixing these two phases, it sets in situ to form an hydroxyapatite (HAp) as the only end product. It is difficult to introduce a new component into this cement without modifying the final product and its mechanical properties. In order to improve the mechanical properties of the Cementek, a natural polymer (chitosan) was added in the initial formulation. Two types of chitosan were added into the Cementek, at various concentration, in either the liquid or the solid phase. The effects of chitosan addition on the properties of the self-setting bone cement are examined. The different composites were characterized by the determination of the setting time, the chemical transformation by X-ray diffraction and mechanical tests. The chemical transformations were not affected by the addition of chitosan neither in the liquid nor in the solid phase. The maturation towards HAp appeared to be complete for all the composites. The setting time was decreased by the addition of chitosan in the solid phase. However the setting time value of each composite remained compatible with a practical use in situ. This study shows that the maturation mode of the samples directly affects the mechanical properties of the obtained composites. The sterilization of the cement with chitosan has been studied.     

纳米羟基磷灰石/胶原药物载体的制备

以湿法制备出平均粒径为50nm的羟基磷灰石粉体，并采用超声分散，将纳米羟基磷灰石分散在酸溶的胶原稀溶液中。测试结果显示，羟基磷灰石在胶原溶液中形成了稳定的分散体系，该分散体系的稳定性与体系的pH值以及羟基磷灰石和胶原的相对浓度有关。     

可注射壳聚糖/纳米羟基磷灰石/胶原复合材料的生物相容性实验研究

目的　评价可注射壳聚糖/纳米羟基磷灰石/胶原复合材料的组织相容性,以及探讨材料负载骨髓基质干细胞进行骨修复的可行性。 方法　壳聚糖/纳米羟基磷灰石/胶原材料与BrdU标记的rBMSc混合,注射入大鼠皮下,于皮下植入后24 h,14 d和28 d分别断颈处死大鼠,进行大体观察、HE、MASSON染色、免疫组化染色。 结果　壳聚糖/纳米羟基磷灰石/胶原材料在室温呈液态,经1 ml注射器26号针头注射入大鼠皮下后,材料在体内可以迅速原位成形成凝胶状态,并在原位保持形状,BrdU标记的rBMSc弥散于材料中,28 d的免疫组化结果显示细胞存活良好。 结论　壳聚糖/纳米羟基磷灰石/胶原复合材料具有良好的组织相容性,是一种良好的负载干细胞的骨组织工程支架。     

Preparation and characterization of nano-hydroxyapatite/chitosan/konjac glucomannan composite

Nano-hydroxyapatite (n-HA)/chitosan (CS)/konjac glucomannan (KGM) composite was prepared by coprecipitation method and investigated by thermal gravitivity/differentiate thermal analysis, Fourier transform infrared spectroscopy, X-ray diffraction, inductively coupled plasma emission spectroscopy, scanning electron microscopy, and energy dispersive X-ray analyzer. The analyses showed that the three phases of n-HA, CS, and KGM combined closely to each other. Further, in vitro tests were conducted to investigate the degradation and bioactivity of the composite. During immersion in simulated body fluid (SBF), pores appeared and a new substance containing Ca and P formed on the surface of the composite. Also, the concentration of Ca and P in SBF changed and weight loss of the composite was observed during time. The composite revealed a high degradation in SBF. Evidently, the new composite has a potential to be used as a carrier of implantable drug delivery system. The biodegradation rate and route could be different from CS and KGM, which will provide an opportunity to control the degradation rate or drug releasing rate by simply adjusting the ratio of CS and KGM.     

抗生素骨水泥与人工关节置换后的翻修

背景：抗生素骨水泥是预防和治疗人工关节置换以及翻修后感染的重要方法。 目的：综述抗生素骨水泥的研究进展以及人工关节置换后翻修。 方法：通过计算机检索Pubmed数据库、中国知网数据库、中国生物医学文献数据库、维普期刊全文数据库、万方数据库,时间范围在1978年至2012年,中文检索词“骨水泥”、“抗生素骨水泥”、“感染”、“关节置换”;英文检索词“bone cement”、“antibiotic bone cement”、“infection”、“joint replacement”。 结果与结论：共检索到相关文献335篇。通过阅读标题、摘要以及全文进行初步筛选,最后保留29篇文献进行深入的分析。抗生素骨水泥目前已广泛应用于人工关节置换以及翻修后感染的治疗,可以降低初次关节置换和翻修后感染的风险。适量的抗生素与骨水泥混合后其材料特性和力学性能不会发生改变。不同抗生素在骨水泥中的释放率也存在不同,与骨水泥的孔隙率有着密切的关系,在骨水泥中加入能够增加孔隙率的添加剂,可以达到最终增加抗生素释放的目的。     

碱性成纤维细胞生长因子复合纳米羟基磷灰石/壳聚糖复合物修复兔桡骨缺损

背景：纳米羟基磷灰石/壳聚糖复合物具有良好的力学性能和生物相容性,可用于骨损伤的修复,是一种有应用前景的骨替代品。碱性成纤维细胞生长因子可促进组织修复, 目的：观察碱性成纤维细胞生长因子复合纳米羟基磷灰石/壳聚糖复合物修复兔骨缺损的效果。 方法：构建桡骨缺损兔模型,按植入材料的不同共分为3组,实验组植入纳米羟基磷灰石/壳聚糖复合物+碱性成纤维细胞生长因子,对照植入组纳米羟基磷灰石/壳聚糖复合物,空白组无任何材料植入。 结果与结论：干预12周时,X射线片检查显示,实验组骨植入区新骨发生骨性融合,髓腔再通骨缺损已基本消失;苏木精-伊红染色结果显示,实验组出现成熟的板层骨、成熟的哈弗氏系统以及破骨细胞增生引起的骨质吸收区;以上结果均为实验组的修复效果优于对照组。证实,碱性成纤维细胞生长因子复合纳米羟基磷灰石/壳聚糖复合物可促进骨缺损修复,效果优于单独应用纳米羟基磷灰石/壳聚糖复合物。     

羧乙基壳聚糖-纳米羟基磷灰石复合材料细胞相容性和生物力学性能的实验研究

制备羧乙基壳聚糖-纳米羟基磷灰石(NCECS/nHA)复合材料,研究其生物力学性能以及与气管软骨细胞的生物相容性。方法 气管软骨片段取自8周龄大耳白兔,Ⅱ型胶原酶消化,将所获得软骨细胞传代培养。将体外制备的NCECS/nHA复合材料分别进行干态标本和湿态标本的生物力学检测。将第3代软骨细胞种植到NCECS/nHA复合材料,分别计算材料表面软骨细胞在2h、6h、12h细胞贴壁率,并用噻唑蓝(MTT)法测定细胞增殖活性。结果 NCECS/nHA复合材料具有良好的生物力学性能。兔气管软骨细胞在NCECS/nHA复合材料表面上12h的贴壁率达(88.4±2.1)％,与其他组差异无统计学意义(P＞0.05)。同时MTT显示气管软骨细胞在NCECS/nHA复合材料表面生长状态良好。扫描电镜结果显示软骨细胞在NCECS/nHA薄膜上增殖和分化良好。结论 NCECS/nHA复合材料具备良好的细胞相容性和适宜的生物力学强度,作为一种具有开发潜力的生物材料,可用于组织工程气管的体外构建。     

Development of calcium phosphate cement using chitosan and citric acid for bone substitute materials.

We developed a calcium phosphate cement that could be molded into any desired shape due to its chewing-gum-like consistency after mixing. The powder component of the cement consists of alpha-tricalcium phosphate and tetracalcium phosphate, which were made by decomposition of hydroxyapatite ceramic blocks. The liquid component consists of citric acid, chitosan and glucose solution. In this study, we used 20% citric acid (group 20) and 45% citric acid (group 45). The mechanical properties and biocompatibility of this new cement were investigated. The setting times of cements were 5.5 min, in group 20 and 6.4 min, in group 45. When incubated in physiological saline, the cements were transformed to hydroxyapatite at 3, and 6 weeks, the compressive strengths were 15.6 and 20.7 MPa, in group 45 and group 20, respectively. The inflammatory response around the cement implanted on the bone and in the subcutaneous tissue in rats was more prominent in group 45 than in group 20 at 1 week after surgery. After 4 weeks, the inflammation disappeared and the cement had bound to bone in both groups. These results indicate that this new calcium phosphate cement is a suitable bone substitute material and that the concentration of citric acid in the liquid component affects its mechanical properties and biocompatibility.     

聚乳酸/壳聚糖纳米纤维/纳米羟基磷灰石支架与兔软骨细胞的相容性

背景：传统的支架材料存在疏水性强,材料表面缺乏细胞表面受体特异结合的生物活性分子,材料的酸性降解产物易引发无菌性炎性反应等不足。根据仿生原理及软骨真实结构和构成来选择和制备组织工程软骨支架能够获得理想效果。 目的：制备聚乳酸/壳聚糖纳米纤维/纳米羟基磷灰石支架,评价其与兔膝关节软骨细胞的生物相容性,探讨其应用于关节软骨组织工程的可行性。 方法：采用二次相分离技术制备聚乳酸/壳聚糖纳米纤维/纳米羟基磷灰石复合支架,将第3代新西兰兔软骨细胞接种至复合支架材料上复合培养,倒置相差显微镜下观察细胞生长情况。细胞-支架复合物在24孔板中培养5 d以后,将其植入裸鼠皮下8周。 结果与结论：聚乳酸/壳聚糖纳米纤维/纳米羟基磷灰石支架材料经化学合成后,具有合适的三维多孔结构,孔隙率为90%,孔径300~450 μm;植入裸鼠皮下8周后Ⅱ型胶原免疫组织化学染色和甲苯胺蓝染色显示细胞-支架复合物中的软骨细胞可以像天然软骨一样分泌黏多糖和Ⅱ型胶原。提示生物材料聚乳酸/壳聚糖纳米纤维/纳米羟基磷灰石对于兔软骨细胞有良好的生物相容性,可作为生物组织工程支架。     

Antibacterial and mechanical properties of bone cement impregnated with chitosan nanoparticles

Although total joint replacement has become commonplace in recent years, bacterial infection remains a significant complication following this procedure. One approach to reduce the incidence of joint replacement infection is to add antimicrobial agents to the bone cement used to fix the implant. In this in vitro study, we investigated the use of chitosan nanoparticles (CS NP) and quaternary ammonium chitosan derivative nanoparticles (QCS NP) as bactericidal agents in poly(methyl methacrylate) (PMMA) bone cement with and without gentamicin. The antibacterial activity was tested against Staphylococcus aureus (S. aureus) and Staphylococcus epidermidis (S. epidermidis). A 10(3)-fold reduction in the number of viable bacterial cells upon contact with the surface was achievable using QCS NP at a nanoparticle/bone cement weight ratio of 15%. The inhibition of S. aureus and S. epidermidis growth on the surface of the CS NP and QCS NP-loaded bone cements was clearly shown using the LIVE/DEAD Baclight bacterial viability kits and fluorescence microscopy. The CS NP and QCS NP also provided a significant additional bactericidal effect to gentamicin-loaded bone cement. The antibacterial effectiveness remained high even after the modified bone cements had been immersed for 3 weeks in an aqueous medium. No cytotoxic effect of the CS NP- and QCS NP-loaded cements was shown in a mouse fibroblast MTT cytotoxicity assay. Mechanical tests indicated that the addition of the CS and QCS in nanoparticulate form allowed the retention of a significant degree of the bone cement's strength. These results indicate a new promising strategy for combating joint implant infection.     

3D打印成型纳米羟基磷灰石/壳聚糖/聚己内酯三元复合支架材料的构建及表征

文题释义： 组织工程骨：将体外培养的功能相关的种子细胞种植于天然的或人工合成的支架材料内,加入生长因子体外培养一段时间,将他们移植到体内,促进组织修复和骨再生的人工骨。组织工程骨形成的3要素为：支架材料、成骨细胞、生长因子。 生物陶瓷：生物表面活性陶瓷通常含有羟基,还可做成多孔性,生物组织可长入并同其表面发生牢固的键合;生物吸收性陶瓷的特点是能部分吸收或者全部吸收,在生物体内能诱发新生骨的生长。生物活性陶瓷具有骨传导性,它作为一个支架,成骨在其表面进行;还可作为多种物质的外壳或填充骨缺损。生物陶瓷有羟基磷灰石陶瓷、磷酸三钙陶瓷等。  背景：目前常用的骨缺损修复支架材料种类较多,但单一类型材料难以满足骨组织工程支架材料的要求,通过合适的方法将几种单一材料组合形成复合型材料,综合考虑各种材料优缺点,是近年来学者们的研究重点。 目的：构建纳米羟基磷灰石/壳聚糖/聚己内酯三元复合支架材料,并作表征分析研究。 方法：采用3D打印成型技术制备纳米羟基磷灰石/壳聚糖/聚己内酯多孔三元复合支架材料,从X射线衍射分析、吸水率、抗压强度、体外降解性能、孔径分析、扫描电镜分析等多个维度对支架材料进行表征研究。 结果与结论：①X射线衍射分析显示,纳米羟基磷灰石/壳聚糖/聚己内酯多孔三元复合支架的晶型峰图与羟基磷灰石粉末衍射标准卡片类似,表明该三元复合支架是通过物理作用相互结合的,不影响羟基磷灰石的生物学功能;②三元复合支架的吸水率为18.28%,亲水性好,支架可承受的最大压力为1 415 N,其体外降解速率与成骨速率相当;③显微镜下可见三元复合支架的内孔为方形,孔径250 µm,孔径大小均匀、分布有致;④扫描电镜下三元复合支架可见,壳聚糖和聚己内酯组成的纤维排列整齐有序,成网格状, 羟基磷灰石呈颗粒状在纤维表面均匀分布,三元复合材料呈现均匀、疏松的微孔结构;⑤结果表明,通过3D打印成型技术可成功制备纳米羟基磷灰石/壳聚糖/聚己内酯三元复合支架材料,其具有适度的抗压强度、一定的孔隙率、适宜的降解速度和吸水率,能为修复骨缺损的奠定基础。 ORCID: 0000-0002-6321-9160(余和东) 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程       

多孔纳米羟基磷灰石/聚酰胺复合骨修复材料的制备

BACKGROUND: Compared with dense bone repair materials, porous materials has lower intensity, but its three-dimensional porous network structure can ensure a larger surface area that is more conducive to cell adhesion, growth and division as well as nutrient transmission. OBJECTIVE: To investigate the preparation and performance of porous nano-hydroxyapatite/polyamide composites. METHODS: Porous nano-hydroxyapatite/polyamide composites were prepared using chemical foaming method, and different composite bone repair materials were made by regulating foaming agent amount and nano-hydroxyapatite content. Mechanical properties, porosity and composition of the composite bone repair materials were detected. RESULTS AND CONCLUSION: Porous nano-hydroxyapatite/polyamide composites were substantially tubular  channels, and had relatively good connectivity and uniform distribution, with a pore size of 260-400 μm, porosity of 35%-57%. Foaming agent amount, nano-hydroxyapatite content and density of composite materials all are influential factors of the total porosity. Porous nano-hydroxyapatite/polyamide composites have better mechanical properties and compressive strength than the cancellous bone, and the foaming agent has no influence on its shape, composition and diffraction peaks.      

Repair of segmental bone defects using bioactive bone cement: comparison with PMMA bone cement.

We developed a bioactive bone cement (BABC) that consists of apatite and wollastonite containing glass ceramic (AW-GC) powder and bisphenol-A-glycidyl dimethacrylate (Bis-GMA) based resin. In the present study, the effectiveness of the BABC for repair of segmental bone defects under load-bearing conditions was examined using a rabbit tibia model. Polymethylmethacrylate (PMMA) bone cement was used as a control. A 15-mm length of bone was resected from the middle of the shaft of the tibia, and the tibia was fixed by two Kirschner wires. The defects were replaced by cement. Each cement was used in 12 rabbits; six rabbits were sacrificed at 12 and 25 weeks after surgery, and the tibia containing the bone cement was excised and tension tested. At both the intervals studied, the failure loads of the BABC were significantly higher than those of the PMMA cement. The BABC was in direct contact with bone, whereas soft tissue was observed between the cement and bone in all PMMA cement specimens. Results indicated that the BABC was useful as a bone substitute under load-bearing conditions.     

Biological fixation of fibrous materials to bone using chitin/chitosan as a bone formation accelerator

Biological fixation or anchorage of fibrous materials to bone by bone ingrowth into the spaces between fibers is a major concern in developing novel medical implants, including artificial ligaments. Toward this end, we evaluated the efficacy of chitin/chitosan as a bone formation accelerator. Specimens of polyester nonwoven fabric coated with chitin/chitosan were implanted into holes drilled into the distal ends of rat femora. Uncoated fabric specimens were used as controls. At 1 or 2 weeks after implantation, the specimens were retrieved, and the fixation strength was measured by mechanical testing. Histological sections of 2-week implantation specimens were prepared, and the area of new bone tissue formed in the spaces between the fibers of the fabric was measured. The chitin/chitosan coating significantly increased the fixation strength and the area of bone tissue formed in the spaces between the fibers. The mean fixation strength of chitin/chitosan-coated fabric specimens was more than twice that of the controls at 2 weeks after implantation. These results demonstrated that the chitin/chitosan coating effectively induced bone formation in the spaces between the fibers and enhanced biological fixation of the fibrous materials to the bone.