First metatarsophalangeal joint (MPJ) arthroplasty procedures are a common podiatric procedure. However, almost one-third of cases require revision surgeries because of nonunions. Revision or salvage surgery requires more extensive hardware and bone grafts to recreate the first metatarsal. Unfortunately, salvage surgeries have a similar rate of failure attributed to delayed healing, bone graft dissolution, and the lack of bone ingrowth. Furthermore, patients who suffer from neuropathic comorbidities such as diabetes suffer from a diminished healing capacity. An increase in proinflammatory factors and the high presence of reactive oxygen species (ROS) present in diabetics are linked to lower fusion rates. To this end, there is a need for a clinically relevant bone graft to promote bone fusions in patients with neuropathic comorbidities. Incorporating thiol-ene networks for bone scaffolds has demonstrated increased osteogenic biomarkers over traditional polymeric materials. Furthermore, thiol-ene networks can act as antioxidants. Sulfide linkages within the network have an inherent ability to consume radical oxygen to create sulfoxide and sulfone groups. These unique properties of thiol-ene networks make them a promising candidate as bone grafts for diabetic patients. In this work, we propose a thiol-ene biomaterial to address the current limitations of MPJ fusion in diabetics by characterizing mechanical properties, degradation rates under accelerated conditions, and oxidative responsiveness under pathophysiologic conditions. We also demonstrated that thiol-ene-based materials could reduce the number of hydroxyl radicals associated with neuropathic comorbidities.
Keywords: biomaterials; degradation; diabetes; oxidation; thiol−ene; tissue engineering.