We have explored the applicability of printed scaffold by comparing osteogenic ability and biodegradation property of three resorbable biomaterials. A polylactic acid/hydroxyapatite (PLA/HA) composite with a pore size of 500 μm and 60% porosity was fabricated by three-dimensional printing. Three-dimensional printed PLA/HA, β-tricalcium phosphate (β-TCP) and partially demineralized bone matrix (DBM) seeded with bone marrow stromal cells (BMSCs) were evaluated by cell adhesion, proliferation, alkaline phosphatase activity and osteogenic gene expression of osteopontin (OPN) and collagen type I (COL-1). Moreover, the biocompatibility, bone repairing capacity and degradation in three different bone substitute materials were estimated using a critical-size rat calvarial defect model in vivo. The defects were evaluated by micro-computed tomography and histological analysis at four and eight weeks after surgery, respectively. The results showed that each of the studied scaffolds had its own specific merits and drawbacks. Three-dimensional printed PLA/HA scaffolds possessed good biocompatibility and stimulated BMSC cell proliferation and differentiation to osteogenic cells. The outcomes in vivo revealed that 3D printed PLA/HA scaffolds had good osteogenic capability and biodegradation activity with no difference in inflammation reaction. Therefore, 3D printed PLA/HA scaffolds have potential applications in bone tissue engineering and may be used as graft substitutes in reconstructive surgery.

Cartilage injury is extremely common and leads to joint dysfunction. Existing joint prostheses do not remodel with host joint tissue. However, developing large-scale biomimetic anisotropic constructs mimicking native cartilage with structural integrity is challenging. In the present study, we describe anisotropic cartilage regeneration by three-dimensional (3D) bioprinting dual-factor releasing and gradient-structured constructs. Dual-factor releasing mesenchymal stem cell (MSC)–laden hydrogels were used for anisotropic chondrogenic differentiation. Together with physically gradient synthetic biodegradable polymers that impart mechanical strength, the 3D bioprinted anisotropic cartilage constructs demonstrated whole-layer integrity, lubrication of superficial layers, and nutrient supply in deep layers. Evaluation of the cartilage tissue in vitro and in vivo showed tissue maturation and organization that may be sufficient for translation to patients. In conclusion, one-step 3D bioprinted dual-factor releasing and gradient-structured constructs were generated for anisotropic cartilage regeneration, integrating the feasibility of MSC- and 3D bioprinting–based therapy for injured or degenerative joints.

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The study suggests the potential of the novel 3D PCL scaffold augmented with MSCs as an alternative meniscal substitution, although this approach requires further improvement before being used in clinical practice.

The repair of large bone defects with complex geometries remains a major clinical challenge. Here, we explored the feasibility of fabricating polylactic acid-hydroxyapatite (PLA-HA) composite scaffolds. These scaffolds were constructed from vascularized tissue engineered bone using an in vivo bioreactor (IVB) strategy with three-dimensional printing technology. Specifically, a rabbit model was established to prefabricate vascularized tissue engineered bone in two groups. An experimental group (EG) was designed using a tibial periosteum capsule filled with 3D printed (3DP) PLA-HA composite scaffolds seeded with bone marrow stromal cells (BMSCs) and crossed with a vascular bundle. 3DP PLA-HA scaffolds were also combined with autologous BMSCs and transplanted to tibial periosteum without blood vessel as a control group (CG). After four and eight weeks, neovascularisation and bone tissues were analysed by studying related genes, micro-computed tomography (Micro-CT) and histological examinations between groups. The results showed that our method capably generated vascularized tissue engineered bone in vivo. Furthermore, we observed significant differences in neovascular and new viable bone formation in the two groups. In this study, we demonstrated the feasibility of generating large vascularized bone tissues in vivo with 3DP PLA-HA composite scaffolds.

Level IV, therapeutic study.

Porous tantalum (Ta) scaffold is a novel implant material widely used in orthopedics including joint surgery, spinal surgery, bone tumor surgery, and trauma surgery. However, porous Ta scaffolds manufactured using the traditional method have many disadvantages. We used selective laser melting (SLM) technology to manufacture porous Ta scaffolds, and the pore size was controlled to 400 μm. The compressive strength and elastic modulus of the porous scaffolds were evaluated in vitro. To evaluate the osteogenesis and osseointegration of Ta scaffolds manufactured by SLM technology, cytocompatibility in vitro and osseointegration ability in vivo were evaluated. This porous Ta scaffold group showed superior cell adhesion and proliferation results of human bone mesenchymal stem cells (hBMSCs) compared with the control porous Ti6Al4V group. Moreover, the alkaline phosphatase (ALP) activity at day 7 and the semiquantitative analysis of Alizarin red staining at day 21 demonstrated that osteogenic differentiation of hBMSCs was enhanced in the Ta group. The porous Ta scaffold was implanted into a cylindrical bone defect with a height and diameter of 1 and 0.5 cm, respectively, in the lateral femoral condyle of New Zealand rabbits. Radiographic analysis showed that the new bone formation in Ta scaffolds was higher than that in Ti6Al4V scaffolds. Histological images indicated that compared with porous Ti6Al4V scaffolds, Ta scaffolds increased bone ingrowth and osseointegration. The porous Ta scaffold manufactured by SLM not only has a regular pore shape and connectivity but also has controllable elastic modulus and compressive strength. Moreover, the osteogenesis and osseointegration results in vitro and in vivo were improved compared with those of the porous Ti6Al4V scaffold manufactured using the same technology. These findings demonstrate that the porous Ta scaffold manufactured by SLM is potentially useful for orthopedic clinical application.