Enhancing Poly-ε-Caprolactone Implant Performance: Synergistic Surface Modifications With Osteon-Like Microstructure, Cold Atmospheric Plasma, and Extracellular Matrix Coating.

Surface modifications of polycaprolactone (PCL) implants influence osseointegration by altering cell adhesion, proliferation, and differentiation. Osteon-like microtopography has been shown to enhance these parameters compared to untreated PCL. Additional treatments, such as cold atmospheric plasma (CAP) and extracellular matrix (ECM) coatings, may further improve bioactivity. This study evaluates and compares the osteogenic potential of osteon-like microtopography, CAP treatment on non-microstructured PCL, ECM coating on non-microstructured PCL, and their combination. Modified PCL samples were analyzed for cell adhesion, proliferation, and differentiation using primary human mesenchymal stem cells. Compared to osteon-like microtopography, CAP-treated and ECM-coated surfaces the combination of all three increased cell adhesion by nearly two-fold. Cell proliferation followed a similar trend, with the combination treatment showing the greatest enhancement by day 10. Alkaline phosphatase activity peaked with osteon-like microtopography, while mineralization was maximized with the combination treatment. In summary, the integration of osteon-like microtopography with CAP treatment and ECM coating synergistically improves cell adhesion, proliferation, and differentiation, offering a promising strategy for optimizing PCL implants to improve osseointegration.