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World J Orthop. Nov 18, 2026; 17(11): 118182
Published online Nov 18, 2026. doi: 10.5312/wjo.118182
Osteoreparative potential of nanofibrillated cellulose, xenograft, and butvar-phenolic adhesive-based composite
Berik E Tuleubayev, Bakhtiyar K Makhatov, Vladimir A Vinokurov, Yevgeniy K Kamyshanskiy, Yekaterina Y Kossilova, Saule B Akhmetova, Amina A Koshanova, Marat Z Davletbaev, Marietta G Arutyunyan
Berik E Tuleubayev, Amina A Koshanova, Department of Surgical Diseases, Karaganda Medical University, Karaganda 100000, Kazakhstan
Bakhtiyar K Makhatov, Yekaterina Y Kossilova, Marat Z Davletbaev, Marietta G Arutyunyan, Department of Surgery Diseases, NPJSC “Karaganda Medical University”, Karaganda 100000, Kazakhstan
Vladimir A Vinokurov, Department of Physical and Colloidal Chemistry, Federal State Autonomous Educational Institution of Higher Education Gubkin Russian State University of Oil and Gas, Moscow 119991, Moskva, Russia
Yevgeniy K Kamyshanskiy, Pathology Unit of the University Clinic, Karaganda Medical University, Karaganda 100000, Kazakhstan
Saule B Akhmetova, Department of Biomedicine, NPJSC “Karaganda Medical University”, Karaganda 100000, Kazakhstan
Co-first authors: Berik E Tuleubayev and Bakhtiyar K Makhatov.
Author contributions: Tuleubayev BE, Akhmetova SB, Davletbaev MZ, Arutyunyan MG and Vinokurov VA designed the research study; Makhatov BK, Kamyshanskiy YK, Koshanova AA, Kossilova YY performed the research; Tuleubayev BE and Makhatov BK made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper.
Supported by The Science Committee of the Ministry of Education and Science of the Republic of Kazakhstan, No. АР19678427.
Institutional animal care and use committee statement: The study was conducted according to the European Convention for the Protection of Vertebrate Animals used for Experimental and other Scientific Purposes (2010) and approved by the Local Ethics Committee of Karaganda Medical University (No. 18).
Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this paper.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Data sharing statement: All data analyzed during this study are included in this article.
Corresponding author: Bakhtiyar K Makhatov, Doctorate Student, Department of Surgery Diseases, NPJSC “Karaganda Medical University”, Gogol Street 40, Karaganda 100000, Kazakhstan.
mahatov@qmu.kz
Received: December 26, 2025
Revised: February 6, 2026
Accepted: October 8, 2026
Published online: November 18, 2026
Processing time: 319 Days and 11.3 Hours
BACKGROUND
The development of bone substitutes that combine mechanical stability with high osteoregenerative potential remains a challenge in orthopedics. Previous studies demonstrated the efficacy of a composite based on nanofibrillated cellulose (NFC) and bone xenograft in rabbit models. We reasoned that given their individual properties, combining these components could yield superior outcomes and identified a suitable binding agent to achieve this. We hypothesize that a uniformly mixed composite provides superior integration and stability compared with standard bone grafting methods.
AIM
To evaluate the osteoregenerative potential, remodeling patterns, and migration resistance of NFC/xenograft/Butvar-phenolic (BP)-adhesive composite in a rat femoral defect model.
METHODS
Ninety-nine rats were randomly divided into three equal groups, and a defect (2 mm diameter, 1 mm deep) was created in the mid-diaphysis of the femur. In the first group (control), intervention was performed without defect filling. In the second group (xenograft), the defect was filled with a xenograft prepared according to the Marburgbone bank system. In the third group (composite), a homogeneous mixture was prepared by pre-mixing the components, and this material was implanted into the defect cavity. Eleven animals from each group were withdrawn from the experiment on days 30, 60, and 90, and histological, histochemical, and histomorphometric examinations of the femur at the surgical site were performed to assess bone defect regeneration, remodeling, and composite migration. An infected wound model was also established. The defect cavity of 11 animals in each of the xenograft and composite groups was inoculated with Staphylococcus aureus prior to graft filling. The animals were withdrawn from the experiment on day 30, and histological examination was performed to assess inflammation.
RESULTS
The use of a composite of NFC, xenograft, and BP adhesive improved cortical bone regeneration on days 30 and 60 relative to the control group and xenograft group (P = 0.001). On day 30, the composite underwent active remodeling in both the central and peripheral zones compared with the xenograft and exhibited better fixation within the defect site compared with both control group and xenograft group, including less intramedullary and extraosseous migration. This trend persisted on days 60 and 90. In the infected wound model, composite implantation was associated with reduced severity of inflammatory injury compared with the xenograft, including osteonecrosis (P = 0.001) and polymorphonuclear granulocyte infiltration (P = 0.001).
CONCLUSION
The composite based on NFC, xenograft, and BP adhesive exhibits osteoconductive and osteoinductive potential for bone defect repair in a rat femur injury model. The results demonstrate high biocompatibility and a low incidence of complications, including composite migration. In a wound infected with Staphylococcus aureus, the composite provides favorable early resistance to infection-related injury.
Core Tip: This preclinical study investigates a tricomponent bone substitute comprised of nanofibrillated cellulose, thermally disinfected bone xenograft (Marburg Bone Bank System), and polyvinyl butyral-phenolic (Butvar-phenolic) adhesive implanted as a uniformly premixed composite in a rat femoral diaphyseal defect model. The mixed composite demonstrated superior cortical plate regeneration on days 30 and 60, significantly reduced intramedullary migration, and more pronounced scaffold remodeling compared with xenograft alone. In a Staphylococcus aureus-inoculated wound model, the composite markedly attenuated osteonecrosis and polymorphonuclear granulocyte infiltration. These results support its dual role as an osteoconductive/osteoinductive scaffold with inherent barrier resistance to infection-related bone injury.
