Biologische Rekonstruktion von großen Knochendefekten

Liodakis, E; Pacha, Tarek Omar; Aktas, G; Sehmisch, Stephan; Mommsen, Philipp

doi:10.1007/s00113-022-01267-9

Cited by 3 publications

(4 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nonetheless, as described earlier by Hollister and Murphy [238], to routinely establish standardized large-scale multicentre (pre)clinical research efforts, we must first define the goal of BTE and the role that biomaterial implants play in achieving this aim-that is, we must find viable and both clinical and economical approaches to bone regeneration in orthopaedic surgery for long bone defects. In particular, there is limited guidance on the specific surgical indications, the current medico-legal status and reimbursement, and the (large-scale) clinical trials that should be performed [246,247].…”

Section: Three-dimensional-printed Bone Regeneration Scaffolds-quo Va...mentioning

confidence: 99%

The Concept of Scaffold-Guided Bone Regeneration for the Treatment of Long Bone Defects: Current Clinical Application and Future Perspective

Laubach

Hildebrand

Suresh

et al. 2023

JFB

View full text Add to dashboard Cite

The treatment of bone defects remains a challenging clinical problem with high reintervention rates, morbidity, and resulting significant healthcare costs. Surgical techniques are constantly evolving, but outcomes can be influenced by several parameters, including the patient’s age, comorbidities, systemic disorders, the anatomical location of the defect, and the surgeon’s preference and experience. The most used therapeutic modalities for the regeneration of long bone defects include distraction osteogenesis (bone transport), free vascularized fibular grafts, the Masquelet technique, allograft, and (arthroplasty with) mega-prostheses. Over the past 25 years, three-dimensional (3D) printing, a breakthrough layer-by-layer manufacturing technology that produces final parts directly from 3D model data, has taken off and transformed the treatment of bone defects by enabling personalized therapies with highly porous 3D-printed implants tailored to the patient. Therefore, to reduce the morbidities and complications associated with current treatment regimens, efforts have been made in translational research toward 3D-printed scaffolds to facilitate bone regeneration. Three-dimensional printed scaffolds should not only provide osteoconductive surfaces for cell attachment and subsequent bone formation but also provide physical support and containment of bone graft material during the regeneration process, enhancing bone ingrowth, while simultaneously, orthopaedic implants supply mechanical strength with rigid, stable external and/or internal fixation. In this perspective review, we focus on elaborating on the history of bone defect treatment methods and assessing current treatment approaches as well as recent developments, including existing evidence on the advantages and disadvantages of 3D-printed scaffolds for bone defect regeneration. Furthermore, it is evident that the regulatory framework and organization and financing of evidence-based clinical trials remains very complex, and new challenges for non-biodegradable and biodegradable 3D-printed scaffolds for bone regeneration are emerging that have not yet been sufficiently addressed, such as guideline development for specific surgical indications, clinically feasible design concepts for needed multicentre international preclinical and clinical trials, the current medico-legal status, and reimbursement. These challenges underscore the need for intensive exchange and open and honest debate among leaders in the field. This goal can be addressed in a well-planned and focused stakeholder workshop on the topic of patient-specific 3D-printed scaffolds for long bone defect regeneration, as proposed in this perspective review.

show abstract

Section: Three-dimensional-printed Bone Regeneration Scaffolds-quo Va...mentioning

confidence: 99%

The Concept of Scaffold-Guided Bone Regeneration for the Treatment of Long Bone Defects: Current Clinical Application and Future Perspective

Laubach

Hildebrand

Suresh

et al. 2023

JFB

View full text Add to dashboard Cite

show abstract

“…Scaffolds fabricated from mPCL alone are known to promote an innate immune response ( Baker et al, 2011 ); however, the subcutaneous implantation of the mPCL-HA composite scaffold resulted—as expected from clinical studies ( Laubach et al, 2023b ; Liodakis et al, 2023 )—in a minimal non-inflammatory response as depicted by the IHC results for all experimental groups. In particular, we observed weak staining of foreign body giant cells with iNOS (M1 macrophage phenotype marker), indicating a balanced host defense to the scaffold-bone graft constructs.…”

Section: Discussionmentioning

confidence: 78%

“…For SGBR, suitable degradation properties of the scaffold and enhancement of bioactivity are best achieved by incorporating ceramic fillers such as hydroxyapatite (HA) ( Bartnikowski et al, 2019 ), which also increase bone-forming potential in vivo ( Chuenjitkuntaworn et al, 2010 ; Ma et al, 2019 ). Biodegradable composite implants made of PCL-HA are approved by the United States Food and Drug Administration (FDA) for bone defect treatment (DePuy Synthes’ TRUMATCH Graft Cage) ( Liodakis et al, 2023 ); however, these implants do not present with a fully interconnected three-dimensional (3D) pore architecture, which is essential for SGBR ( Laubach et al, 2023b ).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, in the past, 3D-printed Voronoi scaffolds have been associated with successful bone regeneration attempts using titanium-based biomaterials ( Chen et al, 2020 ; Liang et al, 2022 ; Lu et al, 2023 ). However, despite the known relevance of biodegradable PCL-HA as a composite material for bone regeneration ( Liodakis et al, 2023 ), it has not been assessed within the context of 3D-printed SGBR scaffolds with the Voronoi design, which is the objective of this work.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation