Polyethylene terephthalate filament woven tubular mesh bag functionalized via icariin/naringenin-loaded hydroxyapatite microspheres

Abstract Vesselplasty is an effective minimally invasive surgical technique for the treatment of osteoporotic vertebral compression fractures (OVCF) using bone-filling mesh containers (BFMCs). As a key component of BFMCs for embedding bone cement, bone-filling mesh bag can effectively reduce the leakage rate and improve the recovery of vertebral height. However, traditional bone-filling mesh bags show inadequate mechanical properties, porous structure and non-bioactive functionality, hindering further applications in clinical. Hence, we designed a novel bone-filling mesh bag functionalized with hydroxyapatite (HAP)-based drug-loaded microspheres. The woven tubular polyethylene terephthalate (PET) filament mesh bag can achieve uniform porosity (70.14%), robust mechanical properties (132.51 MPa/41.59 MPa of longitudinal/radial tensile strength). The hydroxyapatite microspheres adsorbed with icariin (ICA) and naringenin (NAR) were adhered to mesh bags using polydopamine to functionalize their surfaces. In vitro and in vivo implantation demonstrated fair biocompatibility, promoted significant new bone formation (the area ratio was 32.16% at 4-week), produced a denser trabecular network, enhanced structural stability, tissue maturity and interface bonding, revealing significant potential for defect repair of OVCF treatment.