Bone-adhesive materials: clinical requirements, mechanisms of action, and future perspective

Each year, millions of people suffer from complex bone fractures which require proper external or internal fixation. This fixation is usually achieved by means of devices such as plates, pins, and screws. These traditional fixation strategies are associated with severe drawbacks, which have prompted research and development of a variety of bone-adhesive biomaterials as alternative. However, a clinically applicable bone-adhesive biomaterial—in the form of a bone-glue or bone-adhesive membrane—that meets all requirements has not yet been identified. This perspective article discusses the current state of the art of bone-adhesive materials with a particular focus on their clinical requirements, mechanisms of action, and future perspective. To develop adhesive biomaterials with specific affinity to bone tissue, a more rational design should be implemented. This perspective article is intended as a starting point and inspiration for future research and development of suitable bone-adhesive materials.