Le tissu osseux est caractérisé par sa matrice minéralisée qui est soumise à des activités de formation et de résorption assurant son renouvellement et son remaniement tout au long de la vie. En cas de lésions, l’os est capable de se réparer naturellement de façon à rétablir son intégrité et ses propriétés physiques. Cependant, certaines pathologies ou interventions chirurgicales peuvent aboutir à des pertes massives de substance osseuse et le processus naturel d’autoréparation est alors insuffisant. En première intention, la greffe osseuse est envisagée (autogreffe et allogreffe), néanmoins, du fait d’une disponibilité réduite et des risques de rejet et de transmission d’agents infectieux, cette technique n’est pas réalisable dans toutes les situations cliniques. Le chirurgien peut alors avoir recours à des biomatériaux ostéoconducteurs mais ceux-ci ne sont utilisables que dans le cas de comblement de défauts de petite taille car ils sont simplement un support passif à la néoformation osseuse. Ces limites pourraient être dépassées grâce au concept d’ingénierie tissulaire, en concevant des biomatériaux innovants ayant un fort pouvoir ostéogène conféré notamment par des facteurs de croissance ou des cellules ostéoprogénitrices. Dans notre travail, nous avons cherché à mettre au point un nouveau produit d’ingénierie tissulaire permettant la réparation de défauts osseux. La stratégie envisagée repose sur l’association d’un support tridimensionnel et de cellules souches adultes dérivées du tissu adipeux humain (ASC). L’originalité du système provient de la matrice tridimensionnelle, qui est un hydrogel thermosensible composé de monomère synthétique Glycosyl-Nucléoside-Fluoré (GNF) de faible poids moléculaire. Dans le domaine de la régénération osseuse, les hydrogels cellularisés sont généralement utilisés comme matrice associée à des molécules ostéogéniques (BMP2, Béta-Glycérophosphate) ou à des ions (Calcium : Ca2+, Phosphate : PO42-) pour permettre la differenciation ostéoblastique des cellules encapsulées dans le gel. Cependant, dans notre travail, nous n’avons pas fait appel à ces facteurs ostéogéniques. Notre étude a révélé que l’hydrogel de GNF possède les critères essentiels pour être utilisé en clinique : la non-toxicité, la biocompatibilité, la biodégradabilité, l’injectabilité et la biointégration. Des injections de complexe gel/ASC réalisées en site ectopique chez l’animal ont démontré que le gel se forme in situ en moins de 20 minutes et que les cellules encapsulées ont survécu pendant plusieurs mois. In situ, les ASC se sont différerenciées en ostéoblastes matures, exprimant la phosphatase alcaline et l’ostéocalcine et synthétisant une matrice extracellulaire riche en phosphate de calcium. Ces travaux ont donc permis de développer un produit d’ingénierie tissulaire innovant, associant un support tridimensionnel, l’hydrogel de GNF, à une composante cellulaire, les ASC. Cette matrice cellularisée apparaît prometteuse comme système injectable pour des applications cliniques de régénération osseuse. / Bone tissue is characterized by its mineralized matrix which is subject to formation and resorption activities ensuring its renewal and remodeling throughout the life. In case of damage, the bone can repair itself naturally to restore its integrity and its physical properties. Nevertheless, some pathologies or surgical procedures can lead to massive loss of bone and the natural process of self-repair is insufficient. First line, the bone graft is considered (autograft and allograft), however, due to reduced availability and risks of rejection and transmission of infectious agents, this technique is not feasible in all clinical situations. The surgeon can then make use of osteoconductive biomaterials but these are only usable in the case of filling of small defects because they are simply passive scaffold for bone formation. These limits may be exceeded through the concept of tissue enginee- ring, designing innovative biomaterials with high osteogenic power conferred by particular growth factors or osteoprogenitor cells. In our work we seek to develop a new product of tissue engineering to repair bone defects. The proposed strategy is based on the combination of a three-dimensional scaffold and adult stem cells derived from human adipose tissue (ASC). The originality of this system comes from the three-dimensional matrix, which is a thermosensitive hydrogel composed of synthetic monomeric Glycosyl-Nucleoside-Fluorinated (GNF) low molecular weight. In the field of bone regeneration, hydrogels are generally used as cellularized matrix molecules associated with osteogenic (BMP2, Beta-Glycerophosphate) or ions (Calcium : Ca2+, Phosphate : PO42-) to allow osteoblast differentiation of cells encapsulated in the gel. However, in our work, we have not used these osteogenic factors. Our study revealed that the hydrogel of GNF has the essential criteria to be used in clinical practice : non-toxicity, biocompatibility, biodegradability, injectability and biointegration. Injections of gel/ASC complex performed in animal ectopic site have showed that the gel is formed in situ within 20 minutes and encapsulated cells survived and proliferated for several months. In situ, ASC were differentiated into mature osteoblasts expressing alkaline phosphatase and osteocalcin and synthesizing an extracellular matrix rich in calcium phosphate. So, this work has allowed the development of an innovative product for tissue engineering, combining a three-dimensional scaffold, the GNF based hydrogel, a cellular component, the ASC. This cellularized matrix appears promising as injection system for clinical applications of bone regeneration.

Afin de résoudre la problématique des substituts osseux faiblement vascularisés, un des challenges majeurs en ingénierie tissulaire osseuse est de favoriser le développement précoce d’une microvascularisation. La reproduction du microenvironnement local et l’organisation cellulaire in situ sont des approches innovantes pour optimiser la formation osseuse. En Biofabrication, la Bioimpression Assistée par Laser (LAB) est une technologie émergente permettant l’impression de cellules et de biomatériaux avec une résolution micrométrique. L’objectif de ce travail était d’étudier l’effet de l’organisation de la pré-vascularisation par LAB sur la régénération osseuse. La station de bioimpression Novalase a été utilisée pour imprimer des motifs de cellules endothéliales sur un « biopaper » constitué de collagène et de cellules souches issues de la papille apicale. Les paramètres d’impression, densités cellulaires et conditions de recouvrement ont été optimisés afin de favoriser la formation d’un réseau microvasculaire avec une architecture définie in vitro. Ce modèle a ensuite été transposé in vivo, grâce à la bioimpression in situ de cellules endothéliales au niveau de défauts osseux critiques chez la souris, afin d’évaluer si la prévascularisation organisée par LAB permettait de promouvoir et contrôler spatialement le processus de régénération osseuse. Les résultats ont montré que la bioimpression permettait d’augmenter la densité de vaisseaux dans les défauts osseux et de favoriser la régénération osseuse. / In order to solve the issue of poorly vascularized bone substitutes, development of a microvasculature into tissue-engineered bone substitutes represents a current challenge. The reproduction of local microenvironment and in situ organization of cells are innovating approaches to optimize bone formation. In Biofabrication, Laser-Assisted Bioprinting (LAB) has emerged as a relevant method to print living cells and biomaterials with micrometric resolution. The aim of this work was to study the effect of prevascularization organized by LAB on bone regeneration. The laser workstation Novalase was used to print patterns of endothelial cells onto a « biopaper » of collagen hydrogel seeded with stem cells from the apical papilla. Printing parameters, cell densities and overlay conditions were optimized to enhance the formation of microvascular networks with a defined architecture in vitro. This model was then transposed in vivo, through in situ bioprinting of endothelial cells into mouse calvarial bone defects of critical size, to investigate if prevascularization organized by LAB can promote and spatially control bone regeneration. The results showed that bioprinting allowed to increase blood vessel density in bone defects and promote bone regeneration.

La technique des membranes induites par un conformateur en polymethylmethacrylate (PMMA) et greffe d’os spongieux autologue a été décrite par Masquelet pour la régénération des pertes de substance osseuse segmentaire des os longs. Cette technique en deux temps pourrait avantageusement être utilisée pour la reconstruction des pertes de substances osseuses segmentaires mandibulaires en cancérologie en cas d’échec ou de contre-indication des greffes osseuse revascularisées. Le premier objectif de ce travail était d’évaluer les propriétés histologiques et biologiques des membranes induites par un conformateur en PMMA avec radiothérapie, et de les comparer avec celles induites par un conformateur en silicone. Ce matériau plus souple que le PMMA a été choisi comme alternative au PMMA dans le but de faciliter l’ablation du conformateur. Les membranes induites par le PMMA ou le silicone en sous-cutané chez des rats Wistar avaient une structure histologique et des propriétés biologiques comparables mais les résultats étaient plus stables pour les membranes induites par le silicone. Le second objectif de ce travail était de proposer un procédé d’ingénierie tissulaire en alternative à la greffe d’os spongieux autologue. La néoformation osseuse au sein d’une membrane induite par un conformateur en silicone avec greffe de différentes combinaisons de céramique phosphocalcique biphasique macroporeuse (MBCP+™), de moelle osseuse totale, de simvastatine et de rhBMP-2 a été évaluée chez des rats Wistar en sous-cutané puis en site osseux fémoral. Les résultats n’ont pas permis de montrer de néoformation osseuse significative dans les groupes avec simvastatine. Par contre, une néoformation osseuse significative a été montrée dans les groupes avec rhBMP-2, avec ou sans radiothérapie. Un effet substantiel de l’adjonction de moelle osseuse totale a également été retrouvé. / Induced membrane technique with a polymethylmethacrylate (PMMA) spacer and autologous cancellous bone graft has been proposed by doctor Masquelet for segmental long bone reconstruction. This two stage technique could be proposed for segmental mandibular bone reconstruction in oncological situations in case of failure or contraindication of revascularized autologous bone graft. The first objective of this study was to evaluate the histological and biological properties of membranes induced by PMMA with radiotherapy, and to compare them to membranes induced by silicone. This material smoother than PMMA has been chosen to facilitate spacer removal. Membranes induced by both materials in subcutaneous models in rats had similar histological and biological properties, but membranes induced by silicone were less affected by radiotherapy. The second objective of this study was to propose a tissue engineering procedure as an alternative to autologous bone graft. The new bone formation inside silicone induced membranes has been analyzed after implantation of different combinations of macroporous biphasic phosphocalcic ceramic (MBCP+™), total bone marrow, simvastatine and rhBMP-2 in subcutaneous and femoral osseous models in rats. No significant new bone formation has been demonstrated in simvastatin groups. However, a significant new bone formation has been demonstrated in rhBMP-2 groups, with or without radiotherapy. An increased new bone formation has also been demonstrated with total bone marrow.

In this thesis, several types of scaffolds composed of different materials and designed structures and functions were fabricated by 3D plotting under mild conditions (room temperature and without using any organic solvent). Broad biomaterials including inorganic (such as calcium phosphate cement and mesoporous bioglass), organic (such as alginate and gelatin) and composite materials were prepared into printable pastes to plot as 3D scaffolds for bone tissue engineering. Organic/inorganic biphasic and bipartite structure, core/shell alginate/nano-hydroxyapatite and hollow fiber structure were designed and realized. Scaffolds with multi functions including suitable mechanical properties, sustained drug/protein delivery and in vitro vascularization were achievable. 3D plotting provided great achievements in the field of tissue engineering by preparing advanced scaffolds, as well as by plotting cell/matrix constructs, and even complex tissues and organs.

Bone is a remarkable multifunctional tissue with the ability to regenerate and remodel without generating any scar tissue. However, bone loss due to injury or diseases can be a great challenge and affect the patient significantly. Transplanting bone graft from one site in the patient to the site of fracture or bone void, i.e. autologous bone grafting is commonly used throughout the world. The transplanted bone not only fills voids, but is also bone inductive, housing the particular cells that are needed for bone regeneration. Nevertheless, a regenerative complement to autograft is of great interest and importance because the benefits from an off-the-shelf product with as good of healing capacity as autograft will circumvent most of the drawbacks with autograft. With a regenerative-medicine approach, the use of biomaterials loaded with bioactive molecules can avoid donor site morbidity and the problem of limited volume of material. Two such regenerative products that utilize bone morphogenetic protein 7 and 2 have been used for more than a decade in the clinic. However, some severe side effects have been reported, such as severe swelling due to inflammation and ectopic bone formation. Additionally, the products require open surgery, use of supra physiological doses of the BMPs due to poor localization and retention of the growth factors. The purpose of this thesis was to harness the strong inductive capability of the BMP-2 by optimizing the carrier of this bioactive protein, thereby minimizing the side effects that are associated with the clinical products and facilitating safe and localized bone regeneration at the desired site. We focused on an injectable hyaluronan-based carrier. The strategy was to use the body’s own regenerative pathway to stimulate and enhance bone healing in a manner similar to the natural bone-healing process. The hyaluronan-based carrier has a similar composition to the natural extracellular matrix and is degraded by resident hyaluronidase enzymes. Earlier studies have shown a more controlled release and improved mechanical properties when adding a weight of 25 percent of hydroxyapatite, a calcium phosphate that constitutes the inorganic part of the bone matrix. In Paper I, the aim was to improve the carrier by adding other forms of calcium phosphate. The results indicated that the bone formation was enhanced when using nano-sized hydroxyapatite. We wished to further develop the carrier system but were lacking an animal model with high output and easy access. We also wanted to provide paired data and were committed to the 3 Rs of refinement, reduction and replacement. To meet these challenges, we developed and refined an animal model, and this is described in Paper II. In Paper III, we characterized and optimized the handling properties of the carrier. In Paper IV, we discovered the importance of crushing the material, thus enhancing permeability and enlarging the surface area. In Paper V, we sought to further optimize biomaterial properties of the hydrogel through covalently bonding of bisphosphonates to the hyaluronan hydrogel. The results demonstrated exceptional retention of the growth factor BMP-2. In Paper VI, the in vivo response related to the release of the growth factor was examined by combining a SPECT/PET/µCT imaging method to visualize both the retention of the drug, and the in-vivo response in terms of mineralization.

Cette thèse porte sur l'étude du réseau lacuno-canaliculaire (Lacuno-canalicular Network : LCN) osseux grâce à différentes techniques de microscopie optique. Le LCN correspond à l'empreinte dans la matrice osseuse du réseau ostéocytaire formé de cellules dendritiques (les ostéocytes) interconnectées. Bien qu'il joue un rôle majeur dans la formation, le remodelage et le maintien des propriétés biomécaniques de l'os, les informations sur ce réseau cellulaire dans sa globalité restent limitées. Cela provient notamment de la difficulté à caractériser ce réseau dense et complexeavec une résolution sub-micrométrique sur des échelles allant jusqu'à l'organe entier. Dans cetravail de thèse nous avons cherché à améliorer la caractérisation du LCN en utilisant deux approches : la mise en place d'une méthode d'analyse du LCN à grande échelle à partir dela microscopie confocale d'une part et l'évaluation du potentiel de la microscopienon linéaire pour l'étude du LCN d'autre part.Dans un premier temps nous avons mis au point un protocole allant de la préparation des échantillons jusqu'au traitement des images et à l'analyse des données afin d'optimiser l'imagerie confocale des tissus osseux dans le but d'obtenir une analyse quantitative du réseau à grande échelle. Les résultats préliminaires mettent en évidence une grande variabilité des paramètres du réseau à toutes les échelles révélant la complexité de celui-ci. Cette analyse a été mise en pratique afin d'étudier les variations du LCN à l'échelle d'un fémur entier de souris.Dans un second temps, nous avons évaluer le potentiel de la microscopie optique non linéaire et notamment de la génération de troisième harmonique (THG) pour l'imagerie et l'étude du LCN. Nous avons tout d'abord montré la possibilité de visualiser le LCN, sans marquage fluorescent, grâce à la microscopie THG. A partir de cette preuve de principe nous avons expliqué l'origine des contrastes observés dans l'os par microscopie THG : un signal provenant des porosités et permettant de visualiser le réseau et un signal de fond structuré provenant des interfaces entre les fibrilles de collagène. Nous avons également évaluer les possibilités de la combinaisons de signaux non linéaires, principalement ceux de la THG et de la SHG (génération de seconde harmonique) qui permettent de visualiser simultanément le réseau et la matrice de collagène respectivement. Une corrélation entre la structure du réseau et l'organisation du collagène a pu être établie grâce à la visualisation de ces deux signaux sur de grandes échelles. Enfin des résultats quantitatifs sur le LCN ont pu être obtenus à partir des images THG permettant une étude des effets de la micro-gravité sur la structure de ce réseau. / This thesis focuses on the study of bone lacuno-canalicular network (LCN) using different optical microscopy techniques. The LCN is the porosity network in the bone matrix where the cellular network lie. It is formed of dendritic cells: the osteocytes which are connected to each other. Although it plays a major role in the formation, remodeling and maintenance of biomechanical properties of bone, only little is known about this network as a whole. This can be explain by the difficult characterization of such a dense and complex network with sub-micron resolution and scales up to the entire organ. In this work we have sought to improve the characterization of the LCN using two approaches: the development of a method to analyse the network on large scale using confocal microscopy on one hand, and the assessment of the potential of non linear microscopy technique to study the LCN on the other hand.First, we have developed a protocol from sample preparation to image processing and data analysis to optimize confocal imaging of bone tissue in order to obtain a quantitative large scale analysis of the network. Preliminary results show a wide variation of network parameters at all scales revealing its complexity. This analysis was then used in order to assess changes in the LCN across an entire mice femur.Secondly, we study the potential of the non-linear optical microscopies especially the third harmonic generation (THG) microscopy for imaging and the study of the LCN. Initially, we demonstrated the ability to visualise the LCN without fluorescent labelling using THG microscopy. From this proof of concept we explained the origin of the different ThG microscopy contrasts observed in bone tissue: a signal from the porosities allowing to visualize the network and a structured background signal generated at the interfaces between collagen fibrils. We also assess the possibilities of combinations between different non-linear signals, mainly THG and SHG (second harmonic generation) that can simultaneously image the network and the collagen matrix respectively. A correlation between the network structure and collagen organization has been established using the visualization of these two signals over large scales. Finally quantitative parameters of the LCN were obtained from THG images and applied to study the effects of microgravity on the cellular network structure.

Regeneration, a spontaneous response of bones in response to injuries, infections and fractures, is severely compromised in certain clinical circumstances. Unfortunately, several shortcomings are associated with the current treatment of bone grafting method such as donor shortage and immune response for allografts and donor morbidity for autografts. Thus, the development of clinical alternates is essential. One promising adjunct method is bone tissue engineering that includes the implantation of a scaffold containing the cells with the supplementation of suitable growth factors. Among the various classes of materials, biodegradable polymers are commonly preferred because their use does not necessitate a secondary surgery for their removal after the intended use. Commercially available polymers such as poly (lactic- co- glycolic acid) and polycaprolactone are expensive and degrade slowly. This motivates the development of novel synthetic biodegradable polymers that are affordable and can be tuned to tailor for specific biomedical applications. The primary aim of this thesis is to synthesize effective biodegradable polymers for drug delivery and bone tissue engineering. The properties of these polymers such as modulus, hydrophobicity and crosslinking etc. were tailored based on the variations in chemical bonds, chain lengths and the molar stoichiometric ratios of the monomers for specific clinical applications. Based on the above variations, degradation and release kinetics were tuned. The cytocompatibilty properties for these polymers were studied and suitable mineralization studies were conducted to determine their potential for bone regeneration.

Made available in DSpace on 2016-06-02T19:22:09Z (GMT). No. of bitstreams: 1 5384.pdf: 3646799 bytes, checksum: cae5edc100d549896cd5997951a21e99 (MD5) Previous issue date: 2013-06-21 / Universidade Federal de Sao Carlos / Lead (Pb) is an ubiquitous pollutant in the environmental ecosystem. Its distribution is mainly anthropogenic, coming from the burning of fossil fuels, mining and production of various industrial products. There is little knowledge of the effect of the Pb and its compounds on bone metabolism as well as potential therapies for frames contamination related to the lead. The aim of this study was to determine possible changes in the bones of adult rats contaminated with lead acetate correlated them to the effects of hydroxyapatite and the resveratrol in adult rats contaminated with lead acetate. The biomechanical, biometric, biophysical, microtomographic bone parameters, the radiographic density, the concentration of Pb and metalloproteinase activity in bone tissue were analyzed. The animals were distributed into 6 groups of 8 rats each: control, treated with saline 0.9% (0.1 ml/100g BM), hydroxyapatite, treat with hydroxyapatite (100 mg/kg BM), contaminated, treated with lead acetate (250 mg/kg BM), contaminated + hydroxyapatite, treated with lead acetate (250mg/kg BM) and hydroxyapatite (100mg/kg BM); the treatments were carry out once per week for 8 weeks by gastric gavage. The groups contaminated + resveratrol, treated with lead acetate (250 mg/kg BM) and resveratrol (0.7 mg/kg BM ) and DMSO, treated with dimethylsulfoxide (0.1 ml/100g BM), 5 times a week for 8 weeks by intraperitoneal injections. The contamination with lead acetate promoted incorporation of it in bone tissue leading to a reduction in bone strength of femurs and vertebrae, reduction of vertebral trabecular contingent, and increased activity of metalloproteins type 2. The treatment with hydroxyapatite (100 mg/kg MC) as well with resveratrol (0.7 mg/kg MC) prevented the deleterious effects of lead contamination at the proposed dose, including reducing the activity values of metalloproteins type 2 to levels similar to that of control group. Therefore, the results point to hydroxyapatite and resveratrol as potential treatment agents in lead contamination, preventing damage to the quality of bone tissue caused by this element. / Chumbo (Pb) é um poluente ubíquo no ecossistema cuja distribuição ambiental é principalmente antropogênica, oriunda da queima de combustíveis fósseis, mineração e fabricações industriais diversas. Há pouco conhecimento do envolvimento do Pb e seus compostos sobre o metabolismo ósseo bem como das potenciais terapias para quadros de contaminação relacionadas ao chumbo. O objetivo deste estudo foi avaliar as alterações ósseas causadas pelo acetato de chumbo correlacionado-as aos efeitos da hidroxiapatita e do resveratrol em ratos adultos contaminados com acetato de chumbo. Foram analisados os parâmetros biomecânicos, biométricos, biofísicos, microtomográficos ósseos, a densidade radiográfica, a concentração de Pb e a atividade de metaloproteinases no tecido ósseo. Os animais foram distribuidos em 6 grupos com 8 ratos cada: controle, tratados com salina 0,9% (0,1 ml/100g MC), hidroxiapatita, tratados com hidroxiapatita (100 mg/kg MC), contaminado, tratados com acetato de chumbo (250 mg/kg MC) e contaminado + hidroxiapatita, tratados com acetato da chumbo (250 mg/kg MC) e hidroxiapatita (100 mg/kg MC), 1 vez por semana, por 8 semanas pelo método de gavagem gástrica. Grupo contaminado + resveratrol, tratados com acetato da chumbo (250 mg/kg MC) e resveratrol (0,7 mg/kg MC) e DMSO, tratado com dimetilsulfóxido (0,1 ml/100g MC), 5 vezes por semana, por 8 semanas por meio de injeções intraperitoneais. A contaminação com acetato de chumbo promoveu incorporação de chumbo no tecido ósseo provocando redução da resistência óssea de fêmures e vértebras e do contingente trabecular das vértebras analisadas, promovendo aumento da atividade de metaloproteinases tipo 2. Tanto o tratamento com 100 mg/kg MC de hidroxiapatita quanto o de 0,7 mg/kg MC de resveratrol preveniram os efeitos deletérios da contaminação com chumbo na dose proposta, inclusive reduzindo os valores de atividade de metaloproteinases tipo 2 para níveis semelhantes ao do grupo controle. Portanto, os resultados apontam a hidroxiapatita e o resveratrol como potenciais agentes de tratamento preventivo na contaminação com chumbo, evitando os prejuízos à qualidade do tecido ósseo provocadas por este elemento.

The growing incidences of orthopedic problems globally have created a huge demand for strong bioactive materials for bone tissue engineering. Over the years, studies have shown chemical, physical, and mechanical properties of biomaterials influence the cellular interactions at the material-tissue interface, which subsequently controls biological response to materials. Strong biomaterials with surface properties that actively direct cellular response hold the key for engineering the next generation orthopedic implants. With its unique properties graphene can be used to reinforce poly (ε-caprolactone) (PCL) to prepare strong and bioactive polymer nanocomposites for bone tissue regeneration. The thesis entitled ―Engineering bioactive and multifunctional graphene polymer composites for bone tissue regeneration” systematically studies the effect of different chemically functionalized and metal-graphene hybrid nanoparticles in PCL composites for bone tissue engineering. The thesis comprises of seven chapters. Chapter 1 is an outline review on the impact of graphene and graphene derived particles to prepare supporting substrates for tissue regeneration and the associated cell response to multifunctional graphene substrate. This chapter discusses how cells interact with different graphene based particles and the interplay between cells performance and multifunctional properties of graphene based substrates. Chapter 2 describes the role, if any, of the functionalization of graphene on mechanical properties, stem cell response and bacterial biofilm formation. PCL composites of graphene oxide (GO), reduced GO (RGO) and amine-functionalized GO (AGO) were prepared at different filler contents (1%, 3% and 5%). Although the addition of the nanoparticles to PCL markedly increased the storage modulus, this increase was higher for GO and AGO than with RGO. In vitro cell studies revealed that the AGO and GO particles significantly increased human mesenchymal stem cell (hMSC) proliferation. AGO was most effective in augmenting stem cell osteogenesis leading to mineralization. Bacterial studies revealed that interaction with functionalized GO induced bacterial cell death due to membrane damage which was further accentuated by amine groups in AGO. The synergistic effect of oxygen containing functional groups and amine groups on AGO-reinforced composites renders the optimal combination of improved modulus, favorable stem cell response and biofilm inhibition desired for orthopaedic applications. In Chapter 3, toward preparing strong multi-biofunctional materials, poly(ethylenimine) (PEI) conjugated graphene oxide (GO_PEI) was synthesized using poly(acrylic acid) (PAA) as spacer and incorporated in PCL at different fractions. GO_PEI significantly promoted proliferation and formation of focal adhesions in hMSCs on PCL. GO_PEI was highly potent in inducing stem cell osteogenesis leading to 90% increase in alkaline phosphatase activity and mineralization over neat PCL with 5% filler content and was 50% better than GO. Remarkably, 5% GO_PEI was as potent as soluble osteo-inductive factors. Increased adsorption of osteogenic factors due to the amine and oxygen containing functional groups on GO_PEI augment stem cell differentiation. GO_PEI was also highly efficient in imparting bactericidal activity with 85% reduction in counts of E. coli colonies compared to neat PCL at 5% filler content and was more than twice as efficient as GO. This may be attributed to the synergistic effect of the sharp edges of the particles along with the presence of the different chemical moieties. Thus, in contrast to using labile biomolecules, GO_PEI based polymer composites can be utilized to prepare bioactive resorbable biomaterials for fabricating orthopedic devices for fracture fixation and tissue engineering. Chapter 4 describes the preparation of hybrid nanoparticles of graphene sheets decorated with strontium metallic nanoparticles and its advantages in bone tissue engineering. Strontium-decorated reduced graphene oxide (RGO_Sr) nanoparticles were synthesized by facile reduction of graphene oxide and strontium nitrate. X-ray diffraction, transmission electron microscopy, and atomic force microscopy revealed that the hybrid particles were composed of RGO sheets decorated with 200 – 300 nm metallic strontium particles. Thermal gravimetric analysis further confirmed the composition of the hybrid particles as 22 wt% of strontium. Macroporous tissue scaffolds were prepared incorporating RGO_Sr particles in PCL. The PCL/RGO_Sr scaffolds were found to elute strontium ions in aqueous medium. Osteoblast proliferation and differentiation was significantly higher in the PCL scaffolds containing the RGO_Sr particles in contrast to neat PCL and PCL/RGO scaffolds. The increased biological activity can be attributed to the release of strontium ions from the hybrid nanoparticles. This study demonstrates that composites prepared using hybrid nanoparticles that elute strontium ions can be used to prepare scaffolds with osteoinductive property. These findings have important implications for designing the next generation of biomaterials for use in tissue regeneration. Chapter 5 discusses the use of hybrid graphene-silver particles (RGO_Ag) to reinforce PCL and compared with PCL/RGO and PCL/Ag composites containing RGO and silver nanoparticles (AgNPs), respectively. RGO_Ag hybrid particles were well dispersed in the PCL matrix unlike the RGO and AgNPs due to enhanced exfoliation. RGO_Ag led to 77 % increase in the modulus of PCL and provided a conductive network for electron transfer. Electrical conductivity increased four orders of magnitude from 10-11 S/cm to 10-7 S/cm at 5 wt % filler that greatly exceeded the improvements with the use of RGO and AgNP in PCL. RGO_Ag particles reinforced in PCL showed sustained release of silver ions from the PCL matrix unlike the burst release from PCL/Ag. PCL/RGO_Ag and PCL/RGO composites were non-toxic to hMSCs and supported osteogenic differentiation unlike the PCL/Ag composites which were highly toxic at ≥3% filler content. The PCL/RGO_Ag composites exhibited good antibacterial effect due to a combination of silver ion release from the AgNPs and the mechanical rupture induced by the RGO in the hybrid nanoparticles. Thus, the synergistic effect of Ag and RGO in the PCL matrix uniquely yielded a multifunctional material for use in implantable biomedical devices and tissue engineering. Chapter 6 presents investigation of potential differences in the biological response to graphene in polymer composites in the form of 2D substrates and 3D scaffolds. Results showed that osteoblast response to graphene in polymer nanocomposites is markedly altered between 2D substrates and 3D scaffold due to the roughness induced by the sharp edges of graphene at the surface in 3D but not in 2D. Osteoblast organized into aggregates in 3D scaffolds in contrast to more well spread and randomly distributed cells on 2D discs due to the macro-porous architecture of the scaffolds. Increased cell-cell contact and altered cellular morphology led to significantly higher mineralization in 3D scaffolds compared to 2D. This study demonstrates that the cellular response to nanoparticles in composites can change markedly by varying the processing route. Chapter 7 summarizes the important results and future directions of the work. This chapter provides general conclusions arising from this study, and makes suggestions for future work designed to provide a greater understanding of the in vivo response in terms of bio-distribution of the released functionalized graphene from the scaffold or substrate must be assessed with special attention on their accumulation or excretion.

This diploma thesis deals with the comparative analysis of the physiological, degenerative and postoperative state of the lumbar spine. The problem was solved by computational modeling using the finite element method. For this solution, it was necessary to create appropriate computational models. The spine physiological state was compared with cases of the lumbar spine with different levels of spondylolisthesis, cases of the lumbar spine with different sacral angles, and cases of lumbar spine with applied fixators. Based on the performed analyses, it was found that spine degenerative state has a great influence on the distribution of stress in the vertebral discs and the vertebra itself. Compared to the physiological state, with increasing level of the spondylolisthesis the stress in the vertebral discs increases, while the stress in the vertebral section decreases. Furthermore, the spondylolisthesis affects the force flow. The higher the level of the spondylolisthesis, the more the force flow is shifted onto the posterior articular ligaments. The best results in terms of the spine physiological state were achieved with the applied fixator model.