Convergence of scaffold-guided bone regeneration principles and microvascular tissue transfer surgery.
David S SparksFlavia M SaviConstantin Edmond DlaskaSiamak SaifzadehGary I BrierlyEdward RenAmaia CipitriaJohannes Christian ReichertMarie-Luise WilleMichael A SchuetzNicola WardMichael WagelsDietmar Werner HutmacherPublished in: Science advances (2023)
A preclinical evaluation using a regenerative medicine methodology comprising an additively manufactured medical-grade ε-polycaprolactone β-tricalcium phosphate (mPCL-TCP) scaffold with a corticoperiosteal flap was undertaken in eight sheep with a tibial critical-size segmental bone defect (9.5 cm 3 , M size) using the regenerative matching axial vascularization (RMAV) approach. Biomechanical, radiological, histological, and immunohistochemical analysis confirmed functional bone regeneration comparable to a clinical gold standard control (autologous bone graft) and was superior to a scaffold control group (mPCL-TCP only). Affirmative bone regeneration results from a pilot study using an XL size defect volume (19 cm 3 ) subsequently supported clinical translation. A 27-year-old adult male underwent reconstruction of a 36-cm near-total intercalary tibial defect secondary to osteomyelitis using the RMAV approach. Robust bone regeneration led to complete independent weight bearing within 24 months. This article demonstrates the widely advocated and seldomly accomplished concept of "bench-to-bedside" research and has weighty implications for reconstructive surgery and regenerative medicine more generally.
Keyphrases
- bone regeneration
- tissue engineering
- minimally invasive
- cell therapy
- coronary artery bypass
- total knee arthroplasty
- healthcare
- stem cells
- mesenchymal stem cells
- physical activity
- bone marrow
- body mass index
- surgical site infection
- weight loss
- acute coronary syndrome
- study protocol
- young adults
- silver nanoparticles
- soft tissue