Clinical translation of a patient-specific scaffold-guided bone regeneration concept in four cases with large long bone defects

Laubach, Markus; Suresh, Sinduja; Herath, Buddhi; Wille, Marie‐Luise; Delbrück, Heide; Alabdulrahman, Hatem; Hutmacher, Dietmar W.; Hildebrand, Frank

doi:10.1016/j.jot.2022.04.004

Cited by 46 publications

(58 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The repair and treatment of infected bone defects is a common challenge in multidisciplinary fields such as orthopedic clinics, biomaterials science, and tissue engineering. 78 , 79 Presently, autologous, or allogeneic bone grafting is widely regarded as the optimal approach for addressing bone defects. Nonetheless, its clinical implementation is often hindered by constraints such as scarcity of donors, donor site discomfort, infection, and hemorrhaging.…”

Section: Tissue Engineering Treatment Of Bone Infectionsmentioning

confidence: 99%

Prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections

Qin,

Yang,

Zhao

et al. 2024

Bone Res

View full text Add to dashboard Cite

Osteomyelitis is a devastating disease caused by microbial infection in deep bone tissue. Its high recurrence rate and impaired restoration of bone deficiencies are major challenges in treatment. Microbes have evolved numerous mechanisms to effectively evade host intrinsic and adaptive immune attacks to persistently localize in the host, such as drug-resistant bacteria, biofilms, persister cells, intracellular bacteria, and small colony variants (SCVs). Moreover, microbial-mediated dysregulation of the bone immune microenvironment impedes the bone regeneration process, leading to impaired bone defect repair. Despite advances in surgical strategies and drug applications for the treatment of bone infections within the last decade, challenges remain in clinical management. The development and application of tissue engineering materials have provided new strategies for the treatment of bone infections, but a comprehensive review of their research progress is lacking. This review discusses the critical pathogenic mechanisms of microbes in the skeletal system and their immunomodulatory effects on bone regeneration, and highlights the prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections. It will inform the development and translation of antimicrobial and bone repair tissue engineering materials for the management of bone infections.

show abstract

Section: Tissue Engineering Treatment Of Bone Infectionsmentioning

confidence: 99%

Prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections

Qin,

Yang,

Zhao

et al. 2024

Bone Res

View full text Add to dashboard Cite

show abstract

“…[8][9][10] This concept was demonstrated in a recent study which aimed to guide bone healing in several complex long bone defects in humans. [11] Here, CT scans were conducted to produce 3D models of the defects, and the inner structure was based on a repeating triangular pore architecture. Scaffolds were then printed with a PCL-tricalcium phosphate blend, filled with autologous bone graft material and then implanted, with promising outcomes observed in terms of bone ingrowth and patient weight bearing.…”

Section: Introductionmentioning

confidence: 99%

“…[31][32][33][34][35] For example, BMP2 has been combined with autologous bone graft material inside a 3D printed scaffold implanted in a long bone defect in a human. [11] However, use of BMP2 is associated with various adverse effects such as inflammation and ectopic bone formation. [33] Excessive BMP2 concentrations and leakage outside of the implant site may be the leading causes of such adverse events, [33] motivating the development of delivery systems for controlled growth factor release.…”

Section: Introductionmentioning

confidence: 99%

Integrating Melt Electrowriting and Fused Deposition Modeling to Fabricate Hybrid Scaffolds Supportive of Accelerated Bone Regeneration

Eichholz,

Pitacco,

Burdis

et al. 2023

Adv Healthcare Materials

View full text Add to dashboard Cite

Emerging additive manufacturing (AM) strategies can enable the engineering of hierarchal scaffold structures for guiding tissue regeneration. Here, the advantages of two AM approaches, melt electrowriting (MEW) and fused deposition modelling (FDM), are leveraged and integrated to fabricate hybrid scaffolds for large bone defect healing. MEW is used to fabricate a microfibrous core to guide bone healing, while FDM is used to fabricate a stiff outer shell for mechanical support, with constructs being coated with pro‐osteogenic calcium phosphate (CaP) nano‐needles. Compared to MEW scaffolds alone, hybrid scaffolds prevent soft tissue collapse into the defect region and support increased vascularization and higher levels of new bone formation 12 weeks post‐implantation. In an additional group, hybrid scaffolds are also functionalized with BMP2 via binding to the CaP coating, which further accelerates healing and facilitates the complete bridging of defects after 12 weeks. Histological analyses demonstrate that such scaffolds support the formation of well‐defined annular bone, with an open medullary cavity, smooth periosteal surface, and no evidence of abnormal ectopic bone formation. These results demonstrate the potential of integrating different AM approaches for the development of regenerative biomaterials, and in particular, demonstrate the enhanced bone healing outcomes possible with hybrid MEW‐FDM constructs.

show abstract

“…Bone defects of the lower extremity that are > 5 cm in diameter are considered critical [ 2 , 3 ]. When this threshold is reached, complex surgical procedures like vascularized bone transplantation, segmental bone transport, or Masquelet technique are required [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

Predictive factors for docking site procedure in bone transport for large lower extremity segmental defects

Pacha

Aktaş

Graulich

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Segmental bone transport is a common technique for treating large segmental bone defects. However, a docking site procedure is often necessary in segmental bone transport. To date, no prognostic factors for the need of docking site procedure have been reported. Thus, the decision is often made at random, based on the surgeon’s subjective judgment and experience. The aim of this study was to identify prognostic factors for the need of docking site operation. Methods Patients with segmental bone transport in lower extremity bone defects were included regardless of age, aetiology, and defect size. We excluded patients undergoing treatments that were not yet completed, and those who discontinued therapy by any reason. The need for docking site operation was modelled with logistical and linear regression as well as univariate analysis of variances (ANOVA). Receiver operating characteristics (ROC) curve analysis was also performed. Results Twenty-seven patients from age 12 to 74 years (mean age: 39.07 ± 18.20 years) were included. The mean defect size was 76.39 ± 41.10 mm. The duration of transport (days) showed a significant influence (p = 0.049, 95%CI: 1.00–1.02) on the need for docking site operation. No other significant influences were detected. Conclusion A link between the duration of transport and the need for docking site operation was detected. Our data showed that if a threshold of about 188 days is exceeded, docking surgery should be considered.

show abstract

Clinical translation of a patient-specific scaffold-guided bone regeneration concept in four cases with large long bone defects

Cited by 46 publications

References 71 publications

Prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections

Prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections

Integrating Melt Electrowriting and Fused Deposition Modeling to Fabricate Hybrid Scaffolds Supportive of Accelerated Bone Regeneration

Predictive factors for docking site procedure in bone transport for large lower extremity segmental defects

Contact Info

Product

Resources

About