Challenges of bone tissue engineering in orthopaedic patients

Abstract

Bone defects may impede normal biomechanics and the structural stability of bone as an organ. In many cases, the correction of bone defects requires extensive surgical intervention involving the use of bone-grafting techniques and other procedures in which healing is slow, there is a high risk of infection and considerable pain is provoked - with no guarantee of complete correction of the defect. Therefore, the search for surgical alternatives continues to present a major challenge in orthopaedic traumatology. The reamer-irrigator-aspirator (RIA) system, which was devised to avoid the problems that can arise with autograft harvesting from the iliac crest, consists of collecting the product of the femoral canal after reaming. The RIA technique improves osteogenic differentiation of mesenchymal stem cells, compared to bone marrow aspiration or cancellous bone harvesting from the iliac crest using a spoon. Another approach, the Masquelet technique, consists of reconstructing a long bone defect by means of an induced membrane grown onto an acrylic cement rod inserted to fill the defect; in a second surgical step, once the membrane is constituted, the cement rod is removed and cancellous autograft is used to fill the defect. Both in RIA and in the Masquelet technique, osteosynthesis is usually needed. Bone transportation by compression-distraction lengthening principles is commonly implemented for the treatment of large bone loss. However, complications are frequently encountered with these techniques. Among new techniques that have been proposed to address the problem of large bone loss, the application of stem cells in conjunction with tissue engineering techniques is very promising, as is the creation of personalised medicine (or precision medicine), in which molecular profiling technologies are used to tailor the therapeutic strategy, to ensure the right method is applied for the right person at the right time, after determining the predisposition to disease among the general population. All of the above techniques for addressing bone defects are discussed in this paper.

The Effects of a Pulsed Electromagnetic Field on the Proliferation and Osteogenic Differentiation of Human Adipose-Derived Stem Cells

“…Previous research has already shown that hASCs have various differentiation potentials and can differentiate into other cells [ 17 , 32 , 33 ]. Several lines of research have illustrated that stimulating factors are able to promote proliferation and osteogenic differentiation of ASCs [ 34 ]. Thus, we hypothesized that PEMF is likely to enhance hASC proliferation and differentiation into osteoblasts or their progenitor cells.…”

Shape Memory Polyurethane and its Composites for Various Applications

“…More than 4.5 million reconstructive surgical procedures are reported to be executed yearly worldwide in response to the bone injuries [36]. A constant increase in diseases such as osteoporosis, tumors, and osteonecrosis has also been witnessed due to disordered lifestyle responsible for annihilation of bone tissues.…”

Mineralized nanofibrous scaffold promotes phenamil‐induced osteoblastic differentiation while mitigating adipogenic differentiation

“…Autograft, the gold standard of bone grafts, is commonly used as a surgical solution to solve large bone defects (Calori, Mazza, Colombo, & Ripamonti, ). Yet, bone grafts contain limitations such as donor‐site morbidity and postoperative pain and infection (Guerado & Caso, ). Bone tissue engineering aims to provide alternative treatments for critical‐sized defects through the combination usage of cells, scaffolds, and signaling molecules (Laurencin, Ashe, Henry, Kan, & Lo, ).…”