Effects of bioactive strontium-substituted hydroxyapatite on osseointegration of polyethylene terephthalate artificial ligaments

The insufficient bioactivity of polyethylene terephthalate (PET) artificial ligaments severely weakens the ligament-bone healing in anterior cruciate ligament (ACL) reconstruction, while osteogenic modification is a prevailing method to enhance osseointegration of PET artificial ligaments. In the present study, strontium-substituted hydroxyapatite (SrHA) nanoparticles with different strontium (Sr) contents were synthesized via microwave-hydrothermal method and subsequently were coated on the surface of PET artificial ligaments. The results of XRD, FT-IR, TEM and ICP-OES revealed that the doping of Sr ions had no great influences on the phase composition, morphology and particle size of HA, but affected its chemical compositions and crystallinity. The SEM images showed that nanoparticles were successfully deposited on the surface of PET grafts, the surface hydrophilicity of which was significantly improved by the prepared coatings. The in vitro study revealed that the osteogenic activity of rat bone marrow mesenchymal stem cells (rBMSCs) was affected by varying concentrations of Sr ions in coatings and the optimal osteogenic differentiation was observed in the 2SrHA-PET group, which significantly up-regulated the expression of BMP-2, OCN, Col-I and VEGF. The enhanced osteogenic ability of the 2SrHA-PET group was further demonstrated through an in vivo study, which obviously promoted ligament-bone integration compared with that of PET and HA-PET groups, thus improving the biomechanical strength of the graft-bone complex. This study confirms that SrHA coatings can facilitate osseointegration in the repair of ligament injury in rabbits and thus offers a prospective method for ACL reconstruction by using Sr-containing biomaterial-modified PET artificial ligaments.