Engineering bone: challenges and obstacles

Abstract

Repair of large bone defects is still a challenge for the orthopaedic, reconstructive and maxillo-facial surgeon. Availability of pluripotent stem cells from either autologous or allogenic sources and the potential of inducing the osteogenic phenotype is motivating exploration and development of custom-tailored materials known as "bioengineered bone constructs". In such cases, the clinical scenario involves either expansion of stem cells in monolayer and loading them into a porous scaffold prior to surgery or direct cell expansion within the scaffold, and implanting this novel construct back into the donor patient. In this review, we delineate, from an engineering perspective, the progress that has been made to date and the challenges remaining in successfully translating this promising (but not yet definitively established) approach from bench to the bedsite.

Bone tissue engineering: A review in bone biomimetics and drug delivery strategies

“…[27][28][29][30][31] In practice, most bone tissue engineering approaches implement a combination of these strategies. However, two primary tissue engineering strategies have emerged as the most promising approaches.…”

Osteogenesis and angiogenesis: The potential for engineering bone

“…Researchers are now trying to address this problem of whether it is a prevascularised scaffold developed in vitro or the release of angiogenic factors from scaffolds that promote angiogenesis in situ that will optimally enhance bone morphogenesis in situ. Development of these bone scaffolds requires an internal interconnecting microarchitecture sufficiently porous to promote cellingrowth and significantly strong enough to withstand the exerted forces on bone (Logeart-Avramoglou et al, 2005). Enhanced migration of endothelial cells into the matrix to develop vascular beds will be critical to the survival of these implanted bone constructs.…”

How to use BMP-2 for clinical applications? A review on pros and cons of existing delivery strategies

“…Of these, autografts were considered as golden standard as these are osteogenic, osteoconductive, and osteoinductive [7][8][9]. However, the use of autografts is limited due to the given volume quantities and due to donor site morbidities which are frequently observed and typically accompanied by chronic pain [10].…”