Bioreactor as a New Resource of Autologous Bone Graft to Overcome Bone Defect In Vivo

2017 ◽  
Vol 15 (4) ◽  
pp. 139-150
Author(s):  
Ahmad Jabir Rahyussalim ◽  
Aldo Fransiskus Marsetio ◽  
Tri Kurniawati
Author(s):  
Tie Liu ◽  
Wen Fang ◽  
Gang Wu ◽  
Yining Li ◽  
Janak L. Pathak ◽  
...  

Background: Bone grafts are in high demand due to the increase in the cases of bone defects mainly caused by trauma, old age, and disease-related bone damages. Tissue-engineered calcium phosphate (CaP) biomaterials match the major inorganic contents of bone, thereby could be the potential bone graft substitute. However, CaP-bone grafts lack the osteoinductivity that is vital for effective bone regeneration. In this study, we aimed to test the bone defect healing potential of biomimetically fabricated low dose BMP2-doped CaP (BMP2.BioCaP) grafts in a large animal model.Methods: Low dose BMP2 was doped internally (BMP2-int.BioCaP) or on the surface of CaP (BMP2-sur.BioCaP) grafts during the fabrication process. Our previous study showed the robust bone regenerative potential of BMP2-int.BioCaP and BMP2-sur.BioCaP grafts in the rat ectopic model. In this study, we investigated the bone defect healing potential of BMP2.BioCaP grafts in sheep humerus/femoral defects, as well as compared with that of autologous bone graft and clinically used deproteinized bovine bone (DBB) xenograft.Results: Different ways of BMP2 doping did not affect the surface morphology and degradation properties of the graft materials. Micro-CT and histology results showed robustly higher bone defect-healing potential of the BMP2.BioCaP grafts compared to clinically used DBB grafts. The bone defect healing potential of BMP2.BioCaP grafts was as effective as that of the autologous bone graft. Although, BMP2-int.BioCaP doped half the amount of BMP2 compared to BMP2-sur.BioCaP, its' bone defect healing potential was even robust. The BMP2.BioCaP grafts showed less immunogenicity compared to BioCaP or DBB grafts. The volume density of blood vessel-like and bone marrow-like structures in both BMP2.BioCaP graft groups were in a similar extent to the autologous group. Meticulous observation of higher magnification histological images showed active bone regeneration and remodeling during bone defect healing in BMP2.BioCaP graft groups.Conclusion: The robust bone regenerative potential of BMP2.BioCaP grafts in the ectopic model and in-situ bone defects in small and large animals warrant the pre-clinical studies on large animal critical-sized segmental bone defects.


2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Mohd Shahidan Noor Rahin ◽  
Khairul Nizam Siron ◽  
Ed Simor Khan Mor Japar Khan ◽  
Ahmad Hafiz Zulkifly ◽  
Nik Fatmy Nik Najmy

40 years old malay gentleman with underlying gout presenting with severe pain in both knees for 10 years, analgesic dependant and wheelchair ambulation. Examination of right knee shows fixed flexion at 10 degrees, range of movement 10-100 degree flexion, lateral collateral laxity and varus deformity. Left knee had fixed flexion at 10 degrees, range of movement 5-100 degree and varus deformity. Blood investigation showed uric acid. X-ray of bilateral knee showed severe tricompartmental arthritis with large medial tibial defect. The patient has undergone bilateral knee replacement in 5 months interval started with left knee. Surgical technique is the same for both knees, intraoperative shows a large posteromedial bone defect. We used 5mm metal augmentation on the right knee, but due to limited financial resources, we have to use the bone graft from the osteotomized bone for the augmentation on the left side. The bone augmentation was fixed with cancellous screw. The patient was referred to physiotherapy for range of motion exercises. 1 year post operatively patient able to ambulate without aid. Pain score improved. The patient does not require analgesia. Functional and knee score is excellent. Range of movement, bilateral knee are 0-100 degree. Radiological finding shows no evidence of construct failure in both metal block and bone graft construct. Severe arthritis with bone defect is common due to late presentation. Using autologous bone graft can provide good result as using expensive meta block for reconstruction.


Nanomaterials ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. 999 ◽  
Author(s):  
Mengying Liu ◽  
Yonggang Lv

Bone defects caused by fracture, disease or congenital defect remains a medically important problem to be solved. Bone tissue engineering (BTE) is a promising approach by providing scaffolds to guide and support the treatment of bone defects. However, the autologous bone graft has many defects such as limited sources and long surgical procedures. Therefore, xenograft bone graft is considered as one of the best substitutions and has been effectively used in clinical practice. Due to better preserved natural bone structure, suitable mechanical properties, low immunogenicity, good osteoinductivity and osteoconductivity in natural bone graft, decellularized and demineralized bone matrix (DBM) scaffolds were selected and discussed in the present review. In vivo animal models provide a complex physiological environment for understanding and evaluating material properties and provide important reference data for clinical trials. The purpose of this review is to outline the in vivo bone regeneration and remodeling capabilities of decellularized and DBM scaffolds in bone defect models to better evaluate the potential of these two types of scaffolds in BTE. Taking into account the limitations of the state-of-the-art technology, the results of the animal bone defect model also provide important information for future design of natural bone composite scaffolds.


2012 ◽  
Vol 2 (4) ◽  
pp. 307-313
Author(s):  
Li Gang ◽  
Zhi-Yuan Li ◽  
Hao Jing ◽  
Yue Zhou ◽  
Ning-Min Hu ◽  
...  

2017 ◽  
Vol 38 (5) ◽  
pp. 485-495 ◽  
Author(s):  
Riccardo D’Ambrosi ◽  
Camilla Maccario ◽  
Chiara Ursino ◽  
Nicola Serra ◽  
Federico Giuseppe Usuelli

Background: The purpose of this study was to evaluate the clinical and radiologic outcomes of patients younger than 20 years, treated with the arthroscopic-talus autologous matrix-induced chondrogenesis (AT-AMIC) technique and autologous bone graft for osteochondral lesion of the talus (OLT). Methods: Eleven patients under 20 years (range 13.3-20.0) underwent the AT-AMIC procedure and autologous bone graft for OLTs. Patients were evaluated preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively, using the American Orthopaedic Foot & Ankle Society Ankle and Hindfoot (AOFAS) score, the visual analog scale and the SF-12 respectively in its Mental and Physical Component Scores. Radiologic assessment included computed tomographic (CT) scan, magnetic resonance imaging (MRI) and intraoperative measurement of the lesion. A multivariate statistical analysis was performed. Results: Mean lesion size measured during surgery was 1.1 cm3 ± 0.5 cm3. We found a significant difference in clinical and radiologic parameters with analysis of variance for repeated measures ( P < .001). All clinical scores significantly improved ( P < .05) from T0 to T3. Lesion area significantly reduced from 119.1 ± 29.1 mm2 preoperatively to 77.9 ± 15.8 mm2 ( P < .05) at final follow-up as assessed by CT, and from 132.2 ± 31.3 mm2 to 85.3 ± 14.5 mm2 ( P < .05) as assessed by MRI. Moreover, we noted an important correlation between intraoperative size of the lesion and body mass index (BMI) ( P = .011). Conclusions: The technique can be considered safe and effective with early good results in young patients. Moreover, we demonstrated a significant correlation between BMI and lesion size and a significant impact of OLTs on quality of life. Level of Evidence: Level IV, retrospective case series.


Orthopedics ◽  
2012 ◽  
Author(s):  
Hui-Kuang Huang ◽  
Chao-Ching Chiang ◽  
Yu-Ping Su ◽  
Chi-Kuang Feng ◽  
Fang-Yao Chiu ◽  
...  

2018 ◽  
Vol 100-B (12) ◽  
pp. 1609-1617 ◽  
Author(s):  
A. M. Malhas ◽  
J. Granville-Chapman ◽  
P. M. Robinson ◽  
S. Brookes-Fazakerley ◽  
M. Walton ◽  
...  

Aims We present our experience of using a metal-backed prosthesis and autologous bone graft to treat gross glenoid bone deficiency. Patients and Methods A prospective cohort study of the first 45 shoulder arthroplasties using the SMR Axioma Trabecular Titanium (TT) metal-backed glenoid with autologous bone graft. Between May 2013 and December 2014, 45 shoulder arthroplasties were carried out in 44 patients with a mean age of 64 years (35 to 89). The indications were 23 complex primary arthroplasties, 12 to revise a hemiarthroplasty or resurfacing, five for aseptic loosening of the glenoid, and five for infection. Results Of the 45 patients, 16 had anatomical shoulder arthroplasties (ASA) and 29 had reverse shoulder arthroplasties (RSA). Postoperatively, 43/45 patients had a CT scan. In 41 of 43 patients (95%), the glenoid peg achieved > 50% integration. In 40 of 43 cases (93%), the graft was fully or partially integrated. There were seven revisions (16%) but only four (9%) required a change of baseplate. Four (25%) of the 16 ASAs were revised for instability or cuff failure. At two-year radiological follow-up, five of the 41 cases (11%) showed some evidence of lucent lines. Conclusion The use of a metal baseplate with a trabecular titanium surface in conjunction with autologous bone graft is a reliable method of addressing glenoid bone defects in primary and revision RSA setting in the short term. ASAs have a higher rate of complications with this technique.


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