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Objective: The aim of this study was to investigate the prospective association between physical activity (PA), independently or in conjunction with other contributing factors, and osteoporosis (OP) outcomes., Methods: The Physical Activity in Osteoporosis Outcomes (PAOPO) study was a community-based cohort investigation. A structured questionnaire was used to gather the participants' sociodemographic characteristics. Bone mineral density (BMD) measurements were performed to assess OP outcomes, and the relationship between BMD and OP was evaluated within this cohort., Results: From 2013 to 2014, 8,471 participants aged 18 years and older were recruited from Tangshan, China's Jidong community. Based on their PA level, participants were categorized as inactive, moderately active, or very active. Men showed higher physical exercise levels than women across the activity groups. BMD was significantly higher in the very active group than in the moderately active and inactive groups. Individuals aged > 50 years are at a higher risk of developing OP and osteopenia., Conclusion: The PAOPO study offers promising insights into the relationship between PA and OP outcomes, encouraging the implementation of PA in preventing and managing OP., (Copyright © 2024 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.)

3D printed porous titanium alloy implants is an advanced orthopedic material for joint replacement. However, the high risk of aseptic loosening and periprosthetic infection is difficult to avoid, and the declined autophagy of osteoporosis-derived bone marrow mesenchymal stem cells (OP-BMSCs) further severely impairs the osseointegration under the osteoporotic circumstance. It is thus becoming urgently significant to develop orthopedic materials with autophagy regulation and antibacterial bioactivity. In this regard, a novel class of multifunctional hydrogel-integrated 3D printed bioactive prosthetic interfaces is engineered for in situ osseointegration in osteoporosis. The hydrogel is fabricated from the dynamic crosslinking of synthetic polymers, natural polymers, and silver nanowires to deliver autophagy-regulated rapamycin. Therefore, the resultant soft material exhibits antibacterial ability, biocompatibility, degradability, conductive, self-healing, and stimuli-responsive abilities. In vitro experiments demonstrate that the hydrogel-integrated 3D printed bioactive prosthetic interfaces can restore the declined cellular activities of OP-BMSCs by upregulating the autophagy level and show excellent antibacterial activity against S. aureus and MRSA. More remarkably, the multifunctional 3D printed bioactive prosthetic interfaces significantly improve osseointegration and inhibit infection in osteoporotic environment in vivo. This study provides an efficient strategy to develop novel prosthetic interfaces to reduce complications after arthroplasty for patients with osteoporosis., (© 2022 Wiley-VCH GmbH.)

Osteoporosis is one of the most prevalent age-related diseases worldwide and is characterized by a systemic deterioration of bone strength (bone mineral density and bone quality) with a resulting increase in fragility fractures. Due to the complex osteoporotic pathological environment, it is a huge challenge to induce bone regeneration under osteoporosis conditions. In this study, we successfully nanoengineer a bioinspired mineralized hydrogel from the supramolecular assembly of nano-hydroxyapatite, sodium carbonate, and polyacrylic acid, termed as CHAp-PAA. The resultant nanocomposite hydrogels can maintain their initial morphology and mechanical properties under physiological conditions, while exhibiting good primary stability, biocompatibility, bioactivity, and osteoconductivity. We demonstrate that this optimized hydrogel scaffold has shown superior performance for bone marrow stem cells (BMSCs) proliferation, differentiation, and extracellular matrix production in vitro. Remarkably, the mineralized CHAp-PAA hydrogels could be used as scaffolds for the critical-sized bone defect (6.0 mm diameter and 10.0 mm depth) in the osteoporotic rabbit model. Without the delivery of additional therapeutic agents or stem cells, these CHAp-PAA hydrogel scaffolds can improve bone ingrowth and accelerate new bone formation even in complex osteoporotic pathological environments. Therefore, this work presents a type of bioinspired multifunctional mineral hydrogel that offers an alternative strategy to manage osteoporosis. STATEMENT OF SIGNIFICANCE., Competing Interests: Declaration of Competing Interest All authors declare no conflict of interest., (Copyright © 2020. Published by Elsevier Ltd.)

Purpose : Osteoporosis is more likely to cause serious complications after joint replacement, mainly due to physiological defects of endogenous osteogenic cells and the pathological osteoclast activity. It is a feasible solution to design a prosthetic surface interface that specifically addresses this troublesome situation. Methods : A novel "three-dimensional (3D) inorganic-organic supramolecular bioactive interface" was constructed consisting of stiff 3D printing porous metal scaffold and soft multifunctional, self-healable, injectable, and biodegradable supramolecular polysaccharide hydrogel. Apart from mimicking the bone extracellular matrix, the bioactive interface could also encapsulate bioactive substances, namely bone marrow mesenchymal stem cells (BMSCs) and bone morphogenetic protein-2 (BMP-2). A series of in vitro characterizations, such as topography and mechanical characterization, in vitro release of BMP-2, biocompatibility analysis, and osteogenic induction of BMSCs were carried out. After that, the in vivo osseointegration effect of the bioactive interface was investigated in detail using an osteoporotic model. Results : The administration of injectable supramolecular hydrogel into the inner pores of 3D printing porous metal scaffold could obviously change the morphology of BMSCs and facilitate its cell proliferation. Meanwhile, BMP-2 was capable of being sustained released from supramolecular hydrogel, and subsequently induced osteogenic differentiation of BMSCs and promoted the integration of the metal microspores-bone interface in vitro and in vivo . Moreover, the osteoporosis condition of bone around the bioactive interface was significantly ameliorated. Conclusion : This study demonstrates that the 3D inorganic-organic supramolecular bioactive interface can serve as a novel artificial prosthesis interface for various osteogenesis-deficient patients, such as osteoporosis and rheumatoid arthritis., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

[Display omitted] • Bionic 3D printed porous titanium alloy has controllable pore size and porosity. • Ultrasound-mediated rapamycin delivery restores the declined cellular activities of OP-BMSCs by upregulating the autophagy. • This novel therapy effectively promote prosthetic interface osseointegration in osteoporosis. Osteoporosis-derived bone marrow mesenchymal stem cells (OP-BMSCs) have impaired cell function, low osteogenic activity, and potential osteoclast inducibility, resulting in insufficient osseointegration and increased risk of catastrophic postoperative complications after arthroplasty. The low autophagy activity of OP-BMSCs contributed to poor osseointegration, which could be regulated by the classical autophagic activator, rapamycin. Hence, it is of great significance to regulate autophagy by rapamycin to promote osseointegration at the three-dimensional (3D) printed prosthetic interfaces under osteoporotic environment. In this study, 3D printed porous titanium alloy prosthetic interfaces with bionic pore size and porosity were prepared and implanted into the distal femur of osteoporosis rabbits. Subsequently, a transdermal drug delivery device was used to deliver rapamycin to the interfaces implantation sites. Ultrasound-mediated rapamycin delivery could restore the declined cellular activities (including cell viability, proliferation, migration, and osteogenesis), as well as inhibit potential osteoclast-inducing capacity and adipogenic differentiation by upregulating the autophagy level of OP-BMSCs. Moreover, percutaneous ultrasound-mediated rapamycin delivery significantly improved bone ingrowth and osseointegration of prosthetic interfaces in osteoporotic environment. To conclude, this novel therapy combining 3D printed bionic prosthesis and percutaneous ultrasound-mediated rapamycin delivery can effectively promote prosthetic interfaces osseointegration by regulating autophagy after arthroplasty for patients with osteoporosis. [ABSTRACT FROM AUTHOR]

• An anti-osteoporosis and osteogenesis-inducing bioactive interface was constructed. • This interface induced osteogenesis and inhibited osteoclastogenesis in vitro. • Enhanced osseointegration was achieved under osteoporotic microenvironment. • Osteoporosis was ameliorated around the interface via regulation of the OPG/RANKL. Osteoporosis leads to various complications, such as prosthesis loosening and periprosthetic fracture, after joint replacement. This is mainly due to the impaired osteogenesis and excessive osteoclastic activity in osteoporotic microenvironment, which leads to insufficient osseointegration between prostheses and host bone. In this study, a functional drug-releasing inorganic–organic bioactive interface was constructed, comprising inorganic three-dimensional (3D) printed porous titanium alloy interface and organic poloxamer 407 temperature-sensitive hydrogel loaded with a novel anti-osteoporosis drug (technetium methylenediphosphonate, 99Tc-MDP). The inorganic–organic bioactive interface showed good biocompatibility and exhibited a sustained release profile. This performance enhanced osteogenic differentiation, inhibited the expression of osteoclast-related genes and inhibited the osteoclastogenesis, as compared with traditional bisphosphonates (alendronate) in vitro. When implanted into the distal femoral defect using an osteoporotic rabbit model, the 99Tc-MDP-loaded bioactive interface exhibited the most stable osseointegration with native bone. Furthermore, the drug delivery system inhibited osteoclastic activity via regulation of the osteoprotegerin/receptor activator of NF-κB ligand (OPG/RANKL) signaling pathway, which significantly ameliorated the osteoporosis status to effectively prevent continuous bone destruction around the interface. This study has clinical significance, as it demonstrates that the 99Tc-MDP modified inorganic–organic interface serve as a novel artificial prosthetic interface for patients with poor osteogenesis. [ABSTRACT FROM AUTHOR]

The serious complications after arthroplasty in patients with osteoporosis is a challenge for orthopedics. Three-dimensional (3D)-printed porous titanium (pTi) alloys have the character of low stiffness, similar to cortical bone, and are seemed as promising materials in orthopedic applications, but limited by the bio-inert of titanium alloy. Thus, improving the bioactivity of the prosthesis and bone regeneration around the implant are crucial for the osseointegration. Herein, we established rabbit model of osteoporosis by bilateral ovariectomy, and the bioactive interface was constructed by coating 3D-printed pTi scaffolds with autologous platelet-rich plasma (PRP) prepared by traditional and Freeze-Dried methods. The pTi have advantages of ideal pore size, porosity and mechanical properties matching with bone tissue. In vitro , PRP-coated pTi significantly promoted bone marrow mesenchymal stem cells (BMSCs) attachment, proliferation, migration, and osteogenic differentiation. In vivo studies of the implant coatings were performed using osteoporosis models. The results indicated that this PRP-coated bioactive interface enhanced bone regeneration and osseointegration. Besides, compared with Traditional PRP, the Freeze-Dried PRP-coated pTi exhibited the superiority of promoting cell activity and osteogenic differentiation of BMSCs, and better bone formation. The novel Freeze-Dried PRP-coated pTi shows potential for the development of artificial prosthesis with bioactive interface for patients with osteoporosis. Unlabelled Image • 3D-printed Ti6Al4V scaffolds coated with Freeze-Dried platelet-rich plasma is fabricated as a bioactive interface. • The composite scaffolds promoted OP-BMSCs attachment, proliferation, survival, migration, and osteogenic differentiation. • Achieving the effect of enhancing osseointegration in osteoporosis. [ABSTRACT FROM AUTHOR]