Transplantation of nano-bioglass/gelatin scaffold in a non-autogenous setting for bone regeneration in a rabbit ulna

Bioactive glass has been investigated for variety of tissue engineering applications. In this study, fabrication, in vitro and in vivo evaluation of bioactive glass nanocomposite scaffold were investigated. The nanocomposite scaffolds with compositions based on gelatin and bioactive glass nanoparticles were prepared. The apatite formation at the surface of the nanocomposite samples confirmed by Fourier transform infrared spectroscopy, scanning electron microscopy and X-ray powder diffraction analyses. The in vitro characteristics of bioactive glass scaffold as well as the in vivo bone formation capacity of the bioactive glass scaffold in rabbit ulnar model were investigated. The bioactive glass scaffold showed no cytotoxicity effects in vitro. The nanocomposite scaffold made from gelatin and bioactive glass nanoparticles could be deliberated as an extremely bioactive and prospective bone tissue engineering implant. Bioactive glass scaffolds were capable of guiding bone formation in a rabbit ulnar critical-sized-defect model. Radiographic evaluation indicated that successful bridging of the critical-sized defect on the sides both next to and away from the radius took place using bioactive glass scaffolds. X-ray analysis also proposed that bioactive glass scaffolds supported normal bone formation via intramembranous formation     

纳米复合支架结构与生物学性能

通过复合成型致孔一体技术制备纳米羟基磷灰石/聚酰胺66 (n-HA/PA66) 硬组织修复支架,采用SEM、XRD、IR和燃烧实验等测试手段对复合支架进行表征。结果表明:n-HA粒子以纳米尺度均匀分布于复合支架材料中;复合材料的两相界面为氢键键合和配位键合;支架的孔隙相互贯通,不仅有平均孔径约450 μ m的大孔,大孔壁上还富含0.5~50 μ m的微孔。动物实验证实,该纳米复合支架具有高的生物活性和好的组织相容性,能与硬组织形成骨性结合,其孔隙范围有利于骨组织、血管、骨细胞的长入,可作为硬组织修复的良好载体。      

Fabrication and in vitro evaluation of a sponge-like bioactive-glass/gelatin composite scaffold for bone tissue engineering

In this work a bioactive composite scaffold, comprised of bioactive-glass and gelatin, is introduced. Through direct foaming a sponge-like composite of a sol–gel derived bioactive-glass (70S30C; 70% SiO₂, 30% CaO) and porcine gelatin was developed for use as a biodegradable scaffold for bone tissue engineering. The composite was developed to provide a suitable alternative to synthetic polymer based scaffolds, allowing directed regeneration of bone tissue. The fabricated scaffold was characterised through X-ray microtomography, scanning electron and light microscopy demonstrating a three dimensionally porous and interconnected structure, with an average pore size (170 μm) suitable for successful cell proliferation and tissue ingrowth. Acellular bioactivity was assessed through apatite formation during submersion in simulated body fluid (SBF) whereby the rate and onset of apatite nucleation was found to be comparable to that of bioactive-glass. Modification of dehydrothermal treatment parameters induced varying degrees of crosslinking, allowing the degradation of the composite to be tailored to suit specific applications and establishing its potential for a wide range of applications. Use of genipin to supplement crosslinking by dehydrothermal treatment provided further means of modifying degradability. Biocompatibility of the composite was qualified through successful cultures of human dental pulp stem cells (HDPSCs) on samples of the composite scaffold. Osteogenic differentiation of HDPSCs and extracellular matrix deposition were confirmed through positive alkaline phosphatase staining and immunohistochemistry.     

磷酸钙骨水泥/明胶复合组织工程支架材料的制备及其结构与性能

磷酸钙骨水泥组织工程支架材料具有良好的生物相容性和骨传导性,是一种良好的骨组织工程支架材料,但是这种材料存在力学性能差的缺点,限制了它的应用.本文采用生物相容性良好的可降解明胶材料与磷酸钙骨水泥支架进行复合,制备出的明胶/磷酸钙骨水泥复合支架材料,其压缩强度可达3.7MPa,比复合前磷酸钙支架材料的强度提高了37倍,而且材料具有良好的柔韧性,适合用作为非承重部位骨组织缺损修复用组织工程支架材料.     

In vivo performance of bilayer hydroxyapatite scaffolds for bone tissue regeneration in the rabbit radius

The objective of this study was to investigate the in vivo biomechanical performance of bone defects implanted with novel bilayer hydroxyapatite (HAp) scaffolds that mimic the cortical and cancellous organization of bone. The scaffolds maintained architectural continuity in a rabbit radius segmental defect model and were compared to an untreated defect group (negative control) and autologous bone grafts (positive control). Micro-CT evaluations indicated total bone and scaffold volume in the experimental group was significantly greater than the defect group but lesser than the autologous bone graft treatment. The flexural toughness of the scaffold and the autograft groups was significantly greater than the flexural toughness of the defect group. Interestingly, the absolute density of the bone mineral as well as calcium to phosphorus (Ca/P) ratio in that mineral for the scaffold and autograft contralateral bones was significantly higher than those for the defect contralaterals suggesting that the scaffolds contributed to calcium homeostasis. It was concluded from this study that new bone regenerated in the bilayer HAp scaffolds was comparable to the empty defects and while the HAp scaffolds provided significant increase in modulus when compared to empty defect and their flexural toughness was comparable to autografts after 8 weeks of implantation.     

In vitro and in vivo biological characterizations of a new poly(amino acids)/calcium sulfate composite material for bone regeneration

A new poly(amino acids)/calcium sulfate (PAA/CS) composite was synthesized by melt polycondensation from a biodegradable PAA copolymer based on 6-aminocaproic acid and the bioactive CS. Its degradability, biocompatibility, bioactivity, and osteoconductivity were evaluated in vitro and in vivo, using phosphate buffer solution soaking test, MG63 adhesion test, and bone defect model repair test, respectively. The PAA/CS composite exhibited a much lower degradation rate than the CS, as 21.6 % of weight loss after immersing in phosphate buffer solution for 5 weeks. Moreover, the pH value of local environment restored to neutrality condition after a sharp drop in the first week. The MG63 cells adhered well on the surfaces of PAA and PAA/CS plates with their filopodium and lamellipodium, and displayed great osteogenic differentiation competence. The bone defect model repair test revealed that the composite could be intimately incorporated with the surrounding bone without causing any deleterious reaction. Radiological and histological evaluation indicated the PAA/CS granules were capable of guiding new bone formation and had a much slower degradation rate than the CS. In conclusion, the PAA/CS composite is expected to be a new bone graft material for its favorable bioactivity and biocompatibility and reasonable degradability.     

Fabrication and development of artificial osteochondral constructs based on cancellous bone/hydrogel hybrid scaffold

Using tissue engineering techniques, an artificial osteochondral construct was successfully fabricated to treat large osteochondral defects. In this study, porcine cancellous bones and chitosan/gelatin hydrogel scaffolds were used as substitutes to mimic bone and cartilage, respectively. The porosity and distribution of pore size in porcine bone was measured and the degradation ratio and swelling ratio for chitosan/gelatin hydrogel scaffolds was also determined in vitro. Surface morphology was analyzed with the scanning electron microscope (SEM). The physicochemical properties and the composition were tested by using an infrared instrument. A double layer composite scaffold was constructed via seeding adipose-derived stem cells (ADSCs) induced to chondrocytes and osteoblasts, followed by inoculation in cancellous bones and hydrogel scaffolds. Cell proliferation was assessed through Dead/Live staining and cellular activity was analyzed with IpWin5 software. Cell growth, adhesion and formation of extracellular matrix in composite scaffolds blank cancellous bones or hydrogel scaffolds were also analyzed. SEM analysis revealed a super porous internal structure of cancellous bone scaffolds and pore size was measured at an average of 410 ± 59 μm while porosity was recorded at 70.6 ± 1.7 %. In the hydrogel scaffold, the average pore size was measured at 117 ± 21 μm and the porosity and swelling rate were recorded at 83.4 ± 0.8 % and 362.0 ± 2.4 %, respectively. Furthermore, the remaining hydrogel weighed 80.76 ± 1.6 % of the original dry weight after hydration in PBS for 6 weeks. In summary, the cancellous bone and hydrogel composite scaffold is a promising biomaterial which shows an essential physical performance and strength with excellent osteochondral tissue interaction in situ. ADSCs are a suitable cell source for osteochondral composite reconstruction. Moreover, the bi-layered scaffold significantly enhanced cell proliferation compared to the cells seeded on either single scaffold. Therefore, a bi-layered composite scaffold is an appropriate candidate for fabrication of osteochondral tissue.     

用于骨缺损修复的新型可注射自固化复合材料

硫酸钙骨水泥具有良好的骨传导性,但降解速率快、生物活性差的缺点限制了其临床应用.本文将β-磷酸三钙纳米颗粒(粒径43.8±9.0 nm)和半水硫酸钙颗粒(粒径5–21μm)混合作为固相,与液相聚乙烯醇溶液(5 wt.%)按优化重量比混匀,制备了可注射自固化复合材料.该材料具有合理的自固化时间(11.7–19.2 min)及适宜的压缩强度(2.28–6.33 MPa).同时,利用镁颗粒作为成孔剂,制备出大孔径(大于100μm)的多孔支架.体外细胞实验显示,MC3T3-E1细胞伸展良好,表现出大量的板状伪足和伸展的丝状伪足,表明该复合材料无细胞毒性.将可注射复合材料植入比格犬股骨髁缺损区,10个月后骨缺损愈合良好,表明该材料具有良好的骨缺损修复潜力.     

介孔生物活性玻璃/脱钙骨复合支架的制备及性能研究

将介孔生物活性玻璃(MBG)与脱钙骨(DB)复合, 利用浸渍法制备出MBG/DB复合支架材料. 采用红外光谱(FTIR), 扫描电镜(SEM), X射线衍射(XRD), 电子万能材料试验机等方法对牛松质骨(CB)、DB、MBG/DB复合支架进行表征. 结果表明, CB经浸酸处理后制备的DB, 孔径大小在200~600μm范围内, 孔隙率约为71%, 抗压性能比CB明显降低(1.10±0.31)MPa, 而采用浸渍法制备的复合支架, 孔隙率降为40%左右, 而压缩强度明显提高(8.49± 2.14)MPa. 体外生物活性测试表明: 复合支架具有良好的生物活性.     

Application potential of bone marrow mesenchymal stem cell (BMSCs) based tissue-engineering for spinal cord defect repair in rat fetuses with spina bifida aperta

Spina bifida aperta are complex congenital malformations resulting from failure of fusion in the spinal neural tube during embryogenesis. Despite surgical repair of the defect, most patients who survive with spina bifida aperta have a multiple system handicap due to neuron deficiency of the defective spinal cord. Tissue engineering has emerged as a novel treatment for replacement of lost tissue. This study evaluated the prenatal surgical approach of transplanting a chitosan–gelatin scaffold seeded with bone marrow mesenchymal stem cells (BMSCs) in the healing the defective spinal cord of rat fetuses with retinoic acid induced spina bifida aperta. Scaffold characterisation revealed the porous structure, organic and amorphous content. This biomaterial promoted the adhesion, spreading and in vitro viability of the BMSCs. After transplantation of the scaffold combined with BMSCs, the defective region of spinal cord in rat fetuses with spina bifida aperta at E20 decreased obviously under stereomicroscopy, and the skin defect almost closed in many fetuses. The transplanted BMSCs in chitosan–gelatin scaffold survived, grew and expressed markers of neural stem cells and neurons in the defective spinal cord. In addition, the biomaterial presented high biocompatibility and slow biodegradation in vivo. In conclusion, prenatal transplantation of the scaffold combined with BMSCs could treat spinal cord defect in fetuses with spina bifida aperta by the regeneration of neurons and repairmen of defective region.     

Porous nano-hydroxyapatite/collagen scaffold containing drug-loaded ADM–PLGA microspheres for bone cancer treatment

To develop adriamycin (ADM)-encapsulated poly(lactic-co-glycolic acid) (PLGA) nanoparticles in a porous nano-hydroxyapatite/collagen scaffold (ADM–PLGA–NHAC). To provide novel strategies for future treatment of osteosarcoma, the properties of the scaffold, including its in vitro extended-release properties, the inhibition effects of ADM–PLGA–NHAC on the osteosarcoma MG63 cells, and its bone repair capacity, were investigated in vivo and in vitro. The PLGA copolymer was utilized as a drug carrier to deliver ADM–PLGA nanoparticles (ADM–PLGA–NP). Porous nano-hydroxyapatite and collagen were used to materials to produce the porous nano-hydroxyapatite/collagen scaffold (NHAC), into which the ADM–PLGA–NP was loaded. The performance of the drug-carrying scaffold was assessed using multiple techniques, including scanning electron microscopy and in vitro extended release. The antineoplastic activities of scaffold extracts on the human osteosarcoma MG63 cell line were evaluated in vitro using the cell counting kit-8 (CCK8) method and live-dead cell staining. The bone repair ability of the scaffold was assessed based on the establishment of a femoral condyle defect model in rabbits. ADM–PLGA–NHAC and NHAC were implanted into the rat muscle bag for immune response experiments. A tumor-bearing nude mice model was created, and the TUNEL and HE staining results were observed under optical microscopy to evaluate the antineoplastic activity and toxic side effects of the scaffold. The composite scaffold demonstrated extraordinary extended-release properties, and its extracts also exhibited significant inhibition of the growth of osteosarcoma MG63 cells. In the bone repair experiment, no significant difference was observed between ADM–PLGA–NHAC and NHAC by itself. In the immune response experiments, ADM–PLGA–NHAC exhibited remarkable biocompatibility. The in vivo antitumor experiment revealed that the implantation of ADM–PLGA–NHAC in the tumor resulted in a improved antineoplastic effect and fewer adverse side effects than direct intraperitoneal injection of ADM. The ADM–PLGA–NHAC developed in this study exhibited excellent extended-release drug properties, bone repairing and antineoplastic efficacy, which make it a promising osteoconductivity material with the capability to inhibit osteosarcoma.     

Comparative study on the role of gelatin,chitosan and their combination as tissue engineered scaffolds on healing and regeneration of critical sized bone defects: an in vivo study

Gelatin and chitosan are natural polymers that have extensively been used in tissue engineering applications. The present study aimed to evaluate the effectiveness of chitosan and gelatin or combination of the two biopolymers (chitosan–gelatin) as bone scaffold on bone regeneration process in an experimentally induced critical sized radial bone defect model in rats. Fifty radial bone defects were bilaterally created in 25 Wistar rats. The defects were randomly filled with chitosan, gelatin and chitosan–gelatin and autograft or left empty without any treatment (n?=?10 in each group). The animals were examined by radiology and clinical evaluation before euthanasia. After 8?weeks, the rats were euthanized and their harvested healing bone samples were evaluated by radiology, CT-scan, biomechanical testing, gross pathology, histopathology, histomorphometry and scanning electron microscopy. Gelatin was biocompatible and biodegradable in vivo and showed superior biodegradation and biocompatibility when compared with chitosan and chitosan–gelatin scaffolds. Implantation of both the gelatin and chitosan–gelatin scaffolds in bone defects significantly increased new bone formation and mechanical properties compared with the untreated defects (P?<?0.05). Combination of the gelatin and chitosan considerably increased structural and functional properties of the healing bones when compared to chitosan scaffold (P?<?0.05). However, no significant differences were observed between the gelatin and gelatin–chitosan groups in these regards (P?>?0.05). In conclusion, application of the gelatin alone or its combination with chitosan had beneficial effects on bone regeneration and could be considered as good options for bone tissue engineering strategies. However, chitosan alone was not able to promote considerable new bone formation in the experimentally induced critical-size radial bone defects.     

FePSe3-Nanosheets-Integrated Cryogenic-3D-Printed Multifunctional Calcium Phosphate Scaffolds for Synergistic Therapy of Osteosarcoma

Clinical treatment of osteosarcoma encounters great challenges of postsurgical tumor recurrence and extensive bone defect. To develop an advanced artificial bone substitute that can achieve synergistic bone regeneration and tumor therapy for osteosarcoma treatment, a multifunctional calcium phosphate composite enabled by incorporation of bioactive FePSe₃-nanosheets within the cryogenic-3D-printed α-tricalcium phosphate scaffold (TCP-FePSe₃) is explored. The TCP-FePSe₃ scaffold exhibits remarkable tumor ablation ability due to the excellent NIR-II (1064 nm) photothermal property of FePSe₃-nanosheets. Moreover, the biodegradable TCP-FePSe₃ scaffold can release selenium element to suppress tumor recurrence by activating of the caspase-dependent apoptosis pathway. In a subcutaneous tumor model, it is demonstrated that tumors can be efficiently eradicated via the combination treatment with local photothermal ablation and the antitumor effect of selenium element. Meanwhile, in a rat calvarial bone defect model, the superior angiogenesis and osteogenesis induced by TCP-FePSe₃ scaffold have been observed in vivo. The TCP-FePSe₃ scaffold possesses improved capability to promote the repair of bone defects via vascularized bone regeneration, which is induced by the bioactive ions of Fe, Ca, and P released during the biodegradation of the implanted scaffolds. The TCP-FePSe₃ composite scaffolds fabricated by cryogenic-3D-printing illustrate a distinctive strategy to construct multifunctional platform for osteosarcoma treatment.     

Fabrication of nanocrystalline hydroxyapatite doped degradable composite hollow fiber for guided and biomimetic bone tissue engineering

Natural bone tissue possesses a nanocomposite structure interwoven in a three-dimensional (3-D) matrix, which plays critical roles in conferring appropriate physical and biological properties to the bone tissue. Single type of material may not be sufficient to mimic the composition, structure and properties of native bone, therefore, composite materials consisting of both polymers, bioceramics, and other inorganic materials have to be designed. Among a variety of candidate materials, polymer-nanoparticle composites appear most promising for bone tissue engineering applications because of superior mechanical properties, improved durability, and surface bioactivity when compared with conventional polymers or composites. The long term objective of this project is to use highly aligned, bioactive, biodegradable scaffold mimicking natural histological structure of human long bone, and to engineer and regenerate human long bone both in vitro and in vivo. In this study, bioactive, degradable, and highly permeable composite hollow fiber membranes (HFMs) were fabricated using a wet phase phase-inversion approach. The structure of the hollow fiber membranes was examined using scanning electron microscopy (SEM); degradation behavior was examined using weigh loss assay, gel permeation chromatography (GPC), and differential scanning calorimetry (DSC); and bioactivity was evaluated with the amount of calcium deposition from the culture media onto HFM surface. Doping PLGA HFMs with nanoHA results in a more bioactive and slower degrading HFM than pure PLGA HFMs.     

Application of strontium-doped calcium polyphosphate scaffold on angiogenesis for bone tissue engineering

The key factor for regenerating large segmental bone defects through bone tissue engineering is angiogenesis in scaffolds. Attempts to overcome this problem, it is a good strategy to develop a new scaffold with bioactivity to induce angiogenesis in bone tissue engineering. In our previous research, the ability of strontium-doped calcium polyphosphate (SCPP) to stimulate the release of angiogenic growth factors from cultured osteoblasts was studied. This study was performed to determine the ability of SCPP to induce angiogenesis within in vitro co-culture model of human umbilical vein endothelial cells (HUVEC) and osteoblasts co-cultured. The bioactivity of developed scaffolds to induce angiogenesis in vivo was also researched in this paper. Co-cultured model has been developed in vitro and then cultured with SCPP scaffold as well as calcium polyphosphate (CPP) scaffold and hydroxylapatite (HA) scaffold. The results showed that the optimal ratio of HUVEC and osteoblasts co-cultured model for in vitro angiogenesis was 5:1. The model could maintain for more than 35 days when cultured with the scaffold and show the best activity at 21st day. Compared with those in CPP and HA scaffold, the formation of tube-like structure and the expression of platelet endothelial cell adhesion molecule in co-cultured model is better in SCPP scaffold. The in vivo immunohistochemistry staining for VEGF also showed that SCPP had a potential to promote the formation of angiogenesis and the regeneration of bone. SCPP scaffold could be served as a potential biomaterial with stimulating angiogenesis in bone tissue engineering and bone repair.     

Covalently Grafted Biomimetic Matrix Reconstructs the Regenerative Microenvironment of the Porous Gradient Polycaprolactone Scaffold to Accelerate Bone Remodeling

Integrating a biomimetic extracellular matrix to improve the microenvironment of 3D printing scaffolds is an emerging strategy for bone substitute design. Here, a “soft–hard” bone implant (BM-g-DPCL) consisting of a bioactive matrix chemically integrated on a polydopamine (PDA)-coated porous gradient scaffold by polyphenol groups is constructed. The PDA-coated “hard” scaffolds promoted Ca²⁺ chelation and mineral deposition; the “soft” bioactive matrix is beneficial to the migration, proliferation, and osteogenic differentiation of stem cells in vitro, accelerated endogenous stem cell recruitment, and initiated rapid angiogenesis in vivo. The results of the rabbit cranial defect model (Φ = 10 mm) confirmed that BM-g-DPCL promoted the integration between bone tissue and implant and induced the deposition of bone matrix. Proteomics confirmed that cytokine adhesion, biomineralization, rapid vascularization, and extracellular matrix formation are major factors that accelerate bone defect healing. This strategy of highly chemically bonded soft–hard components guided the construction of the bioactive regenerative scaffold.     

骨修复用生物玻璃复合材料研究进展

生物玻璃是一类性能优良的生物材料,具有良好的生物活性和生物相容性,作为骨修复植入体可以在材料界面与人体骨组织之间形成化学键合,诱导骨的修复与再生.将生物玻璃与其它材料进行复合,可以制备出生物活性和机械性能优良的骨修复复合材料.综述了生物玻璃复合材料的研究现状,并探讨了该类材料目前存在的不足,展望了其发展趋势.     

Structurally and Functionally Optimized Silk‐Fibroin–Gelatin Scaffold Using 3D Printing to Repair Cartilage Injury In Vitro and In Vivo

Articular cartilage repair remains a great challenge for clinicians and researchers. Recently, there emerges a promising way to achieve one‐step cartilage repair in situ by combining endogenic bone marrow stem cells (BMSCs) with suitable biomaterials using a tissue engineering technique. To meet the increasing demand for cartilage tissue engineering, a structurally and functionally optimized scaffold is designed, by integrating silk fibroin with gelatin in combination with BMSC‐specific‐affinity peptide using 3D printing (3DP) technology. The combination ratio of silk fibroin and gelatin greatly balances the mechanical properties and degradation rate to match the newly formed cartilage. This dually optimized scaffold has shown superior performance for cartilage repair in a knee joint because it not only retains adequate BMSCs, due to efficient recruiting ability, and acts as a physical barrier for blood clots, but also provides a mechanical protection before neocartilage formation and a suitable 3D microenvironment for BMSC proliferation, differentiation, and extracellular matrix production. It appears to be a promising biomaterial for knee cartilage repair and is worthy of further investigation in large animal studies and preclinical applications. Beyond knee cartilage, this dually optimized scaffold may also serve as an ideal biomaterial for the regeneration of other joint cartilages.     

不同孔隙率锶磷灰石陶瓷体内异位成骨能力的比较

采用健康兔的骨髓组织,体外培养,诱导分化为成骨细胞,分别与孔径约为450～700μm、孔隙率分别为50%、60%、70%的Sr-HA以及孔隙率为70%的纯羟磷灰石陶瓷体复合,自体回植到兔背脊肌内.同时以未复合细胞的相同孔隙率的陶瓷材料作为对照,植入后4周、12周和24周取材,行四环素荧光染色观察,定量计算各组陶瓷材料新骨的形成量和速度,比较不同孔隙率锶磷灰石陶瓷材料的异位成骨能力.结果表明,复合成骨细胞的各组陶瓷在植入兔背脊肌内4周后均有新骨形成,随着植入时间的延长,骨组织的数量不断增加;孔隙率为70%的Sr-HA陶瓷和HA陶瓷的新骨形成数量和速度明显优于低孔隙率的Sr-HA陶瓷.四环素荧光标记还显示未复合成骨细胞的Sr-HA陶瓷和HA陶瓷孔隙内也有荧光沉积.Sr-HA多孔陶瓷是较理想的骨组织工程支架材料,成骨细胞复合Sr-HA陶瓷用于骨缺损的修复,具有广阔的临床应用前景.     

Processing and properties of porous titanium with high porosity coated by bioactive titania nanotubes

A porous titanium scaffold with a porosity of 70% and a pore size of about 200–300 μm was fabricated using the space-holder sintering process. Furthermore, the bioactive TiO₂ nanotubes with a tube size of approximately 100 nm were prepared successfully on the surface of the porous titanium by anodization and heat-treatment. The bioactivity of the scaffold was evaluated by immersing the samples into the simulated body fluid for 7 days. Results show that the porous titanium scaffold coated with anatase nanotubes has the superior ability of hydroxyapatite formation. Meanwhile, the scaffold has a high compressive strength of 36.8 MPa, which can be used as a cancellous bone substitute.