China’s oyster-inspired ‘bone glue’ could revolutionise trauma care
Kathleen Tracey explores the development of “Bone-02”, the promising new bone glue currently undergoing clinical trials.
One orthopaedic surgeon joked in the coffee room: ‘That’s brilliant, we can get rid of all the trauma surgeons’.
In mid-September, claims of a medical breakthrough from China went viral on social media: a biodegradable glue that could mend bones in minutes. Some called it an ‘insane’ miracle, while others expressed scepticism. The source was Global Times China, reporting on the research team led by Lin Xianfeng in Zhejiang. They claim to have developed the adhesive capable of fixing fractures in a single injection. The glue hardens in 2-3 minutes, even in blood-rich environments, and is absorbed by the body as it heals.
Orthopaedic surgeons have been searching for a bone glue for over a century. In the 1880s, a German scientist named Themistocles Gluck developed a mixture of resin and paraffin wax to anchor knee replacements, laying the groundwork for modern bone cements. These bone cements are used today in joint replacements, but a true bone adhesive that meets all requirements of mechanical stability in physiological environments has proven elusive. The challenge is that bones live in messy, wet environments and need exactly 2% of movement in order to heal properly. So far, adhesives that work are all missing an important quality. Either they don’t biodegrade or they cannot withstand appropriate forces or they cannot form chemical bonds in bloody environments. If reports are true, ‘Bone-02’ (an affectionate nickname) does not suffer from any of these issues.
The need for a bone glue comes from the current, brutal methods of fracture fixation. In complex fractures requiring surgery, there are two options: external or internal fixation. Internal fixation is most common, and involves cutting open the limb and drilling screws and metal plates into the bone to hold it in place. External fixation follows the same principles, but screws are drilled directly into the bone from outside the body, and later removed.
Left: radiological film of internal fixation of tibial plateau fracture. Right: photo of external fixation of tibia
Unsurprisingly, these surgeries are not without risk. 1-2% of internal fixation surgeries lead to infection, and the risk in external fixation is even higher. Bone infection is notoriously difficult to eradicate, and often requires further surgery to remove affected bone. General anaesthetic and trauma to the body during surgery means recovery can take months, and any surgery carries the risk of damage to neurovascular structures. Popliteal artery dissection during knee surgery is a particularly infamous complication, which can result in amputation.
Metal hardware does not degrade and is generally left in the body to avoid more surgery, which can be inconvenient for patients, and poses a higher infection risk down the line. Patients with co-morbidities, particularly osteoporosis, have a high risk of ‘non-union’ even after fixation. A true bone adhesive could reduce mortality and morbidity for millions of patients around the world, improve quality of life and reduce workload for trauma surgeons.
Preclinical trials of ‘Bone-02’ have shown promising results. The glue was assessed in rabbit crush fractures, and they found rapid and flexible adhesion in a blood-rich environment, with 2-fold improvement in biomechanical performance and radiological appearance compared to traditional fixation and cement methods.
Representative photographs of rabbit fractures (K) repaired with internal fixation (L) compared with bone adhesive (M). J Cheng et al (2025)
Rather surprisingly, ‘Bone-02’ is based on the properties of oysters, which can cling to surfaces in wet environments. It is made of an organic-inorganic mixture of collagen, synthetic clay and polyethylene glycol, allowing it to form chemical bonds with organic material. Clinical trials are underway and, though no results have been officially published, preliminary findings show efficacy and safety in 150 treated patients. They have now received approval for multicentre, randomised clinical trials—the gold-standard data necessary for NICE approval.
This is undoubtedly good news, but some are already considering what this means for the future of trauma.
One orthopaedic surgeon joked in the coffee room: ‘That’s brilliant, we can get rid of all the trauma surgeons’.
It’s playful ribbing, but it’s true that if fractures can be fixed with one injection, trauma care may shift from operating theatres to emergency departments. Patients would face shorter hospital stays, with faster recovery and fewer complications. The NHS could free up beds, reduce waiting lists and lower costs—the all-important outcome in every medical development.
Our trauma colleagues don’t need to worry just yet; medicine moves at a snail’s pace, and even the most promising innovations can take over a decade to make their way to operating theatres. But for medical students who will be choosing specialties in the next few years, advancements like this are certainly something to consider; the field they enter may look different to the one they eventually practice in.
The development of a true bone adhesive marks a huge leap for trauma surgery and fracture fixation, and I hope researchers continue taking inspiration from the natural world. After 150 years, the answer to our fixation issue has come from the simple oyster; who knows what other discoveries are hiding in plain sight?
One orthopaedic surgeon joked in the coffee room: ‘That’s brilliant, we can get rid of all the trauma surgeons’.
In mid-September, claims of a medical breakthrough from China went viral on social media: a biodegradable glue that could mend bones in minutes. Some called it an ‘insane’ miracle, while others expressed scepticism. The source was Global Times China, reporting on the research team led by Lin Xianfeng in Zhejiang. They claim to have developed the adhesive capable of fixing fractures in a single injection. The glue hardens in 2-3 minutes, even in blood-rich environments, and is absorbed by the body as it heals.
Orthopaedic surgeons have been searching for a bone glue for over a century. In the 1880s, a German scientist named Themistocles Gluck developed a mixture of resin and paraffin wax to anchor knee replacements, laying the groundwork for modern bone cements. These bone cements are used today in joint replacements, but a true bone adhesive that meets all requirements of mechanical stability in physiological environments has proven elusive. The challenge is that bones live in messy, wet environments and need exactly 2% of movement in order to heal properly. So far, adhesives that work are all missing an important quality. Either they don’t biodegrade or they cannot withstand appropriate forces or they cannot form chemical bonds in bloody environments. If reports are true, ‘Bone-02’ (an affectionate nickname) does not suffer from any of these issues.
The need for a bone glue comes from the current, brutal methods of fracture fixation. In complex fractures requiring surgery, there are two options: external or internal fixation. Internal fixation is most common, and involves cutting open the limb and drilling screws and metal plates into the bone to hold it in place. External fixation follows the same principles, but screws are drilled directly into the bone from outside the body, and later removed.
Left: radiological film of internal fixation of tibial plateau fracture. Right: photo of external fixation of tibia
Unsurprisingly, these surgeries are not without risk. 1-2% of internal fixation surgeries lead to infection, and the risk in external fixation is even higher. Bone infection is notoriously difficult to eradicate, and often requires further surgery to remove affected bone. General anaesthetic and trauma to the body during surgery means recovery can take months, and any surgery carries the risk of damage to neurovascular structures. Popliteal artery dissection during knee surgery is a particularly infamous complication, which can result in amputation.
Metal hardware does not degrade and is generally left in the body to avoid more surgery, which can be inconvenient for patients, and poses a higher infection risk down the line. Patients with co-morbidities, particularly osteoporosis, have a high risk of ‘non-union’ even after fixation. A true bone adhesive could reduce mortality and morbidity for millions of patients around the world, improve quality of life and reduce workload for trauma surgeons.
Preclinical trials of ‘Bone-02’ have shown promising results. The glue was assessed in rabbit crush fractures, and they found rapid and flexible adhesion in a blood-rich environment, with 2-fold improvement in biomechanical performance and radiological appearance compared to traditional fixation and cement methods.
Representative photographs of rabbit fractures (K) repaired with internal fixation (L) compared with bone adhesive (M). J Cheng et al (2025)
Rather surprisingly, ‘Bone-02’ is based on the properties of oysters, which can cling to surfaces in wet environments. It is made of an organic-inorganic mixture of collagen, synthetic clay and polyethylene glycol, allowing it to form chemical bonds with organic material. Clinical trials are underway and, though no results have been officially published, preliminary findings show efficacy and safety in 150 treated patients. They have now received approval for multicentre, randomised clinical trials—the gold-standard data necessary for NICE approval.
This is undoubtedly good news, but some are already considering what this means for the future of trauma.
One orthopaedic surgeon joked in the coffee room: ‘That’s brilliant, we can get rid of all the trauma surgeons’.
It’s playful ribbing, but it’s true that if fractures can be fixed with one injection, trauma care may shift from operating theatres to emergency departments. Patients would face shorter hospital stays, with faster recovery and fewer complications. The NHS could free up beds, reduce waiting lists and lower costs—the all-important outcome in every medical development.
Our trauma colleagues don’t need to worry just yet; medicine moves at a snail’s pace, and even the most promising innovations can take over a decade to make their way to operating theatres. But for medical students who will be choosing specialties in the next few years, advancements like this are certainly something to consider; the field they enter may look different to the one they eventually practice in.
The development of a true bone adhesive marks a huge leap for trauma surgery and fracture fixation, and I hope researchers continue taking inspiration from the natural world. After 150 years, the answer to our fixation issue has come from the simple oyster; who knows what other discoveries are hiding in plain sight?
