From oysters to orthopedics: Bone-02 as a novel injectable fixation material

Abstract

Fractures remain a major global health burden, with 178 million new cases reported in 2019 and annual costs exceeding $100 billion worldwide. Conventional fixation methods, though effective, are limited by stress shielding, delayed remodeling, and the need for secondary hardware removal. Bio-inspired adhesives have long been sought as alternatives, and recent reports describe Bone-02, a novel oyster-inspired injectable adhesive developed at Wenzhou Medical University and Sir Run Run Shaw Hospital in Hangzhou. Bone-02 is designed to cure in wet physiological environments, achieve stable fixation within minutes, and biodegrade over approximately six months. Early clinical experience in more than 150 patients suggests rapid application, reduced operative time, and favorable recovery outcomes, with one case of wrist fracture reportedly managed in under three minutes and healing completed within six months. The material mimics oyster cement, combining organic and inorganic bone-derived components to provide mechanical strength, biodegradability, and safety, though mechanistic details and degradation by-products remain undisclosed. While these preliminary institutional reports are compelling, independent validation, peer-reviewed clinical data, and multicenter trials are lacking. Key questions regarding long-term safety, union rates, inflammatory response, and performance under load-bearing conditions must be resolved before global adoption. Bone-02 represents a promising advance in fracture fixation, with the potential to minimize invasiveness, eliminate hardware-related morbidity, and redefine fracture care worldwide. However, it should currently be regarded as an experimental innovation requiring rigorous scientific validation before routine clinical use.