1
|
Laubach M, Bessot A, Saifzadeh S, Savi FM, Hildebrand F, Bock N, Hutmacher DW, McGovern J. In vivo study to assess fat embolism resulting from the Reamer-Irrigator-Aspirator 2 system compared to a novel aspirator-based concept for intramedullary bone graft harvesting. Arch Orthop Trauma Surg 2024; 144:1535-1546. [PMID: 38367064 PMCID: PMC10965743 DOI: 10.1007/s00402-024-05220-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 02/08/2024] [Indexed: 02/19/2024]
Abstract
INTRODUCTION Fat embolism (FE) following intramedullary (IM) reaming can cause severe pulmonary complications and sudden death. Recently, a new harvesting concept was introduced in which a novel aspirator is used first for bone marrow (BM) aspiration and then for subsequent aspiration of morselized endosteal bone during sequential reaming (A + R + A). In contrast to the established Reamer-Irrigator-Aspirator (RIA) 2 system, the new A + R + A concept allows for the evacuation of fatty BM prior to reaming. In this study, we hypothesized that the risk of FE, associated coagulopathic reactions and pulmonary FE would be comparable between the RIA 2 system and the A + R + A concept. MATERIALS AND METHODS Intramedullary bone graft was harvested from intact femora of 16 Merino sheep (age: 1-2 years) with either the RIA 2 system (n = 8) or the A + R + A concept (n = 8). Fat intravasation was monitored with the Gurd test, coagulopathic response with D-dimer blood level concentration and pulmonary FE with histological evaluation of the lungs. RESULTS The total number and average size of intravasated fat particles was similar between groups (p = 0.13 and p = 0.98, respectively). D-dimer concentration did not significantly increase within 4 h after completion of surgery (RIA 2: p = 0.82; A + R + A: p = 0.23), with an interaction effect similar between groups (p = 0.65). The average lung area covered with fat globules was similar between groups (p = 0.17). CONCLUSIONS The use of the RIA 2 system and the novel A + R + A harvesting concept which consists of BM evacuation followed by sequential IM reaming and aspiration of endosteal bone, resulted in only minor fat intravasation, coagulopathic reactions and pulmonary FE, with no significant differences between the groups. Our results, therefore, suggest that both the RIA 2 system and the new A + R + A concept are comparable technologies in terms of FE-related complications.
Collapse
Affiliation(s)
- Markus Laubach
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia.
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, 4059, Australia.
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Agathe Bessot
- Max Planck Queensland Centre for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies, School of Biomedical Sciences, Faculty of Health, and Translational Research Institute (TRI), Queensland University of Technology (QUT), Brisbane, QLD, 4102, Australia
- Translational Research Institute (TRI), 37 Kent Street, Woolloongabba, QLD, 4102, Australia
| | - Siamak Saifzadeh
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Medical Engineering Research Facility, Queensland University of Technology, Chermside, QLD, 4032, Australia
| | - Flavia Medeiros Savi
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- Max Planck Queensland Centre for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Nathalie Bock
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Max Planck Queensland Centre for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies, School of Biomedical Sciences, Faculty of Health, and Translational Research Institute (TRI), Queensland University of Technology (QUT), Brisbane, QLD, 4102, Australia
- Translational Research Institute (TRI), 37 Kent Street, Woolloongabba, QLD, 4102, Australia
| | - Dietmar W Hutmacher
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- Max Planck Queensland Centre for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia
| | - Jacqui McGovern
- Max Planck Queensland Centre for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies, School of Biomedical Sciences, Faculty of Health, and Translational Research Institute (TRI), Queensland University of Technology (QUT), Brisbane, QLD, 4102, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia
- Translational Research Institute (TRI), 37 Kent Street, Woolloongabba, QLD, 4102, Australia
| |
Collapse
|
2
|
Russo Serafini M, Mowat A, Mustafa S, Saifzadeh S, Shabab T, Bas O, O’Rourke N, W. Hutmacher D, Medeiros Savi F. 3D-Printed Medical-Grade Polycaprolactone (mPCL) Scaffold for the Surgical Treatment of Vaginal Prolapse and Abdominal Hernias. Bioengineering (Basel) 2023; 10:1242. [PMID: 38002366 PMCID: PMC10669821 DOI: 10.3390/bioengineering10111242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/27/2023] [Accepted: 10/03/2023] [Indexed: 11/26/2023] Open
Abstract
The expected outcome after a scaffold augmented hernia repair is the regeneration of a tissue composition strong enough to sustain biomechanical function over long periods. It is hypothesised that melt electrowriting (MEW) medical-grade polycaprolactone (mPCL) scaffolds loaded with platelet-rich plasma (PRP) will enhance soft tissue regeneration in fascial defects in abdominal and vaginal sheep models. A pre-clinical evaluation of vaginal and abdominal hernia reconstruction using mPCL mesh scaffolds and polypropylene (PP) meshes was undertaken using an ovine model. Each sheep was implanted with both a PP mesh (control group), and a mPCL mesh loaded with PRP (experimental group) in both abdominal and vaginal sites. Mechanical properties of the tissue-mesh complexes were assessed with plunger tests. Tissue responses to the implanted meshes were evaluated via histology, immunohistochemistry and histomorphometry. At 6 months post-surgery, the mPCL mesh was less stiff than the PP mesh, but stiffer than the native tissue, while showing equitable collagen and vascular ingrowth when compared to PP mesh. The results of this pilot study were supportive of mPCL as a safe and effective biodegradable scaffold for hernia and vaginal prolapse repair, hence a full-scale long-term study (over 24-36 months) with an adequate sample size is recommended.
Collapse
Affiliation(s)
- Mairim Russo Serafini
- Department of Pharmacy, Universidade Federal de Sergipe, São Cristóvão 49100-000, Brazil;
- Centre in Regenerative Medicine, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.S.); (T.S.); (O.B.); (D.W.H.)
| | - Alexandra Mowat
- Faculty of Medicine, University of Queensland, Brisbane, QLD 4072, Australia
- Queen Elisabeth II Jubilee Hospital, Brisbane, QLD 4108, Australia;
| | - Susanah Mustafa
- Queen Elisabeth II Jubilee Hospital, Brisbane, QLD 4108, Australia;
| | - Siamak Saifzadeh
- Centre in Regenerative Medicine, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.S.); (T.S.); (O.B.); (D.W.H.)
- Medical Engineering Research Facility, Queensland University of Technology, Brisbane, QLD 4032, Australia
| | - Tara Shabab
- Centre in Regenerative Medicine, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.S.); (T.S.); (O.B.); (D.W.H.)
- Australian Research Council Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Onur Bas
- Centre in Regenerative Medicine, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.S.); (T.S.); (O.B.); (D.W.H.)
- Australian Research Council Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Nicholas O’Rourke
- Department of Hepato-Pancreato-Biliary Surgery, Royal Brisbane and Women’s Hospital, University of Queensland, Brisbane, QLD 4029, Australia;
| | - Dietmar W. Hutmacher
- Centre in Regenerative Medicine, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.S.); (T.S.); (O.B.); (D.W.H.)
- Australian Research Council Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, QLD 4059, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing, Brisbane, QLD 4059, Australia
| | - Flavia Medeiros Savi
- Centre in Regenerative Medicine, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.S.); (T.S.); (O.B.); (D.W.H.)
- Australian Research Council Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, QLD 4059, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing, Brisbane, QLD 4059, Australia
| |
Collapse
|
3
|
Laubach M, Herath B, Bock N, Suresh S, Saifzadeh S, Dargaville BL, McGovern J, Wille ML, Hutmacher DW, Medeiros Savi F. In vivo characterization of 3D-printed polycaprolactone-hydroxyapatite scaffolds with Voronoi design to advance the concept of scaffold-guided bone regeneration. Front Bioeng Biotechnol 2023; 11:1272348. [PMID: 37860627 PMCID: PMC10584154 DOI: 10.3389/fbioe.2023.1272348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023] Open
Abstract
Three-dimensional (3D)-printed medical-grade polycaprolactone (mPCL) composite scaffolds have been the first to enable the concept of scaffold-guided bone regeneration (SGBR) from bench to bedside. However, advances in 3D printing technologies now promise next-generation scaffolds such as those with Voronoi tessellation. We hypothesized that the combination of a Voronoi design, applied for the first time to 3D-printed mPCL and ceramic fillers (here hydroxyapatite, HA), would allow slow degradation and high osteogenicity needed to regenerate bone tissue and enhance regenerative properties when mixed with xenograft material. We tested this hypothesis in vitro and in vivo using 3D-printed composite mPCL-HA scaffolds (wt 96%:4%) with the Voronoi design using an ISO 13485 certified additive manufacturing platform. The resulting scaffold porosity was 73% and minimal in vitro degradation (mass loss <1%) was observed over the period of 6 months. After loading the scaffolds with different types of fresh sheep xenograft and ectopic implantation in rats for 8 weeks, highly vascularized tissue without extensive fibrous encapsulation was found in all mPCL-HA Voronoi scaffolds and endochondral bone formation was observed, with no adverse host-tissue reactions. This study supports the use of mPCL-HA Voronoi scaffolds for further testing in future large preclinical animal studies prior to clinical trials to ultimately successfully advance the SGBR concept.
Collapse
Affiliation(s)
- Markus Laubach
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Munich, Germany
| | - Buddhi Herath
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Metro North Hospital and Health Service, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
| | - Nathalie Bock
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sinduja Suresh
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Biomechanics and Spine Research Group at the Centre of Children’s Health Research, Queensland University of Technology, Brisbane, QLD, Australia
| | - Siamak Saifzadeh
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Medical Engineering Research Facility, Queensland University of Technology, Chermside, QLD, Australia
| | - Bronwin L. Dargaville
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jacqui McGovern
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology, Brisbane, QLD, Australia
| | - Marie-Luise Wille
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, Australia
| | - Dietmar W. Hutmacher
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology, Brisbane, QLD, Australia
| | - Flavia Medeiros Savi
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, Australia
| |
Collapse
|
4
|
Laubach M, Bessot A, McGovern J, Saifzadeh S, Gospos J, Segina DN, Kobbe P, Hildebrand F, Wille ML, Bock N, Hutmacher DW. An in vivo study to investigate an original intramedullary bone graft harvesting technology. Eur J Med Res 2023; 28:349. [PMID: 37715198 PMCID: PMC10503043 DOI: 10.1186/s40001-023-01328-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 08/28/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Harvesting bone graft (BG) from the intramedullary canal to treat bone defects is largely conducted using the Reamer-Irrigator-Aspirator (RIA) system. The RIA system uses irrigation fluid during harvesting, which may result in washout of osteoinductive factors. Here, we propose a new harvesting technology dedicated to improving BG collection without the potential washout effect of osteoinductive factors associated with irrigation fluid. This novel technology involves the conceptual approach of first aspirating the bone marrow (BM) with a novel aspirator prototype, followed by reaming with standard reamers and collecting the bone chips with the aspirator (reaming-aspiration method, R-A method). The aim of this study was to assess the harvesting efficacy and osteoinductive profile of the BG harvested with RIA 2 system (RIA 2 group) compared to the novel harvesting concept (aspirator + R-A method, ARA group). METHODS Pre-planning computed tomography (CT) imaging was conducted on 16 sheep to determine the femoral isthmus canal diameter. In this non-recovery study, sheep were divided into two groups: RIA 2 group (n = 8) and ARA group (n = 8). We measured BG weight collected from left femur and determined femoral cortical bone volume reduction in postoperative CT imaging. Growth factor and inflammatory cytokine amounts of the BGs were quantified using enzyme-linked immunosorbent assay (ELISA) methods. RESULTS The use of the stand-alone novel aspirator in BM collection, and in harvesting BG when the aspirator is used in conjunction with sequential reaming (R-A method) was proven feasible. ELISA results showed that the collected BG contained relevant amounts of growth factors and inflammatory cytokines in both the RIA 2 and the ARA group. CONCLUSIONS Here, we present the first results of an innovative concept for harvesting intramedullary BG. It is a prototype of a novel aspirator technology that enables the stepwise harvesting of first BM and subsequent bone chips from the intramedullary canal of long bones. Both the BG collected with the RIA 2 system and the aspirator prototype had the capacity to preserve the BG's osteoinductive microenvironment. Future in vivo studies are required to confirm the bone regenerative capacity of BG harvested with the innovative harvesting technology.
Collapse
Affiliation(s)
- Markus Laubach
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia.
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, 4059, Australia.
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Agathe Bessot
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies, School of Biomedical Sciences, Faculty of Health, and Translational Research Institute (TRI), Queensland University of Technology (QUT), Brisbane, QLD, 4102, Australia
| | - Jacqui McGovern
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies, School of Biomedical Sciences, Faculty of Health, and Translational Research Institute (TRI), Queensland University of Technology (QUT), Brisbane, QLD, 4102, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia
| | - Siamak Saifzadeh
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Medical Engineering Research Facility, Queensland University of Technology, Chermside, QLD, 4032, Australia
| | - Jonathan Gospos
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia
| | - Daniel N Segina
- Department of Orthopaedics, Holmes Regional Trauma Center, Melbourne, FL, USA
| | - Philipp Kobbe
- Department of Trauma and Reconstructive Surgery, BG Klinikum Bergmannstrost, Halle, Germany
- Department of Trauma and Reconstructive Surgery, University Hospital Halle, Halle, Germany
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Marie-Luise Wille
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia
| | - Nathalie Bock
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies, School of Biomedical Sciences, Faculty of Health, and Translational Research Institute (TRI), Queensland University of Technology (QUT), Brisbane, QLD, 4102, Australia
| | - Dietmar W Hutmacher
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia.
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, 4059, Australia.
- Max Planck Queensland Centre (MPQC) for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD, 4000, Australia.
- ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia.
| |
Collapse
|
5
|
Sparks DS, Savi FM, Dlaska CE, Saifzadeh S, Brierly G, Ren E, Cipitria A, Reichert JC, Wille ML, Schuetz MA, Ward N, Wagels M, Hutmacher DW. Convergence of scaffold-guided bone regeneration principles and microvascular tissue transfer surgery. Sci Adv 2023; 9:eadd6071. [PMID: 37146134 PMCID: PMC10162672 DOI: 10.1126/sciadv.add6071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A preclinical evaluation using a regenerative medicine methodology comprising an additively manufactured medical-grade ε-polycaprolactone β-tricalcium phosphate (mPCL-TCP) scaffold with a corticoperiosteal flap was undertaken in eight sheep with a tibial critical-size segmental bone defect (9.5 cm3, M size) using the regenerative matching axial vascularization (RMAV) approach. Biomechanical, radiological, histological, and immunohistochemical analysis confirmed functional bone regeneration comparable to a clinical gold standard control (autologous bone graft) and was superior to a scaffold control group (mPCL-TCP only). Affirmative bone regeneration results from a pilot study using an XL size defect volume (19 cm3) subsequently supported clinical translation. A 27-year-old adult male underwent reconstruction of a 36-cm near-total intercalary tibial defect secondary to osteomyelitis using the RMAV approach. Robust bone regeneration led to complete independent weight bearing within 24 months. This article demonstrates the widely advocated and seldomly accomplished concept of "bench-to-bedside" research and has weighty implications for reconstructive surgery and regenerative medicine more generally.
Collapse
Affiliation(s)
- David S Sparks
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Department of Plastic and Reconstructive Surgery, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, QLD, Australia
| | - Flavia M Savi
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Constantin E Dlaska
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Siamak Saifzadeh
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- Medical Engineering Research Facility, Queensland University of Technology, Chermside, QLD, Australia
| | - Gary Brierly
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Edward Ren
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Amaia Cipitria
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Potsdam, Germany
- Biodonostia Health Research Institute, San Sebastian, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Johannes C Reichert
- Department of Orthopaedics and Orthopaedic Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald, Germany
| | - Marie-Luise Wille
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Michael A Schuetz
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, QLD, Australia
| | - Nicola Ward
- Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Michael Wagels
- Department of Plastic and Reconstructive Surgery, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, QLD, Australia
- Australian Centre for Complex Integrated Surgical Solutions (ACCISS), Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Dietmar W Hutmacher
- Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Additive Biomanufacturing, Queensland University of Technology, Kelvin Grove, QLD, Australia
| |
Collapse
|
6
|
Steele JAM, Moore AC, St-Pierre JP, McCullen SD, Gormley AJ, Horgan CC, Black CR, Meinert C, Klein T, Saifzadeh S, Steck R, Ren J, Woodruff MA, Stevens MM. In vitro and in vivo investigation of a zonal microstructured scaffold for osteochondral defect repair. Biomaterials 2022; 286:121548. [PMID: 35588688 PMCID: PMC7615488 DOI: 10.1016/j.biomaterials.2022.121548] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/28/2022] [Accepted: 04/23/2022] [Indexed: 01/15/2023]
Abstract
Articular cartilage is comprised of zones that vary in architecture, extracellular matrix composition, and mechanical properties. Here, we designed and engineered a porous zonal microstructured scaffold from a single biocompatible polymer (poly [ϵ-caprolactone]) using multiple fabrication strategies: electrospinning, spherical porogen leaching, directional freezing, and melt electrowriting. With this approach we mimicked the zonal structure of articular cartilage and produced a stiffness gradient through the scaffold which aligns with the mechanics of the native tissue. Chondrocyte-seeded scaffolds accumulated extracellular matrix including glycosaminoglycans and collagen II over four weeks in vitro. This prompted us to further study the repair efficacy in a skeletally mature porcine model. Two osteochondral lesions were produced in the trochlear groove of 12 animals and repaired using four treatment conditions: (1) microstructured scaffold, (2) chondrocyte seeded microstructured scaffold, (3) MaioRegen™, and (4) empty defect. After 6 months the defect sites were harvested and analyzed using histology, micro computed tomography, and Raman microspectroscopy mapping. Overall, the scaffolds were retained in the defect space, repair quality was repeatable, and there was clear evidence of osteointegration. The repair quality of the microstructured scaffolds was not superior to the control based on histological scoring; however, the lower score was biased by the lack of histological staining due to the limited degradation of the implant at 6 months. Longer follow up studies (e.g., 1 yr) will be required to fully evaluate the efficacy of the microstructured scaffold. In conclusion, we found consistent scaffold retention, osteointegration, and prolonged degradation of the microstructured scaffold, which we propose may have beneficial effects for the long-term repair of osteochondral defects.
Collapse
Affiliation(s)
- Joseph A M Steele
- Department of Materials, Imperial College London, SW7 2AZ, UK; Department of Bioengineering, Imperial College London, SW7 2AZ, UK; Institute of Biomedical Engineering, Imperial College London, SW7 2AZ, UK; Division of Biomaterials and Regenerative Medicine, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, SE 171 77, Sweden
| | - Axel C Moore
- Department of Materials, Imperial College London, SW7 2AZ, UK; Department of Bioengineering, Imperial College London, SW7 2AZ, UK; Institute of Biomedical Engineering, Imperial College London, SW7 2AZ, UK
| | - Jean-Philippe St-Pierre
- Department of Materials, Imperial College London, SW7 2AZ, UK; Department of Bioengineering, Imperial College London, SW7 2AZ, UK; Institute of Biomedical Engineering, Imperial College London, SW7 2AZ, UK
| | - Seth D McCullen
- Department of Materials, Imperial College London, SW7 2AZ, UK; Department of Bioengineering, Imperial College London, SW7 2AZ, UK; Institute of Biomedical Engineering, Imperial College London, SW7 2AZ, UK
| | - Adam J Gormley
- Department of Materials, Imperial College London, SW7 2AZ, UK; Department of Bioengineering, Imperial College London, SW7 2AZ, UK; Institute of Biomedical Engineering, Imperial College London, SW7 2AZ, UK; Division of Biomaterials and Regenerative Medicine, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, SE 171 77, Sweden
| | - Conor C Horgan
- Department of Materials, Imperial College London, SW7 2AZ, UK; Department of Bioengineering, Imperial College London, SW7 2AZ, UK; Institute of Biomedical Engineering, Imperial College London, SW7 2AZ, UK
| | - Cameron Rm Black
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Developmental Origins of Health and Disease, Institute of Developmental Sciences, University of Southampton Medical School, Southampton, SO16 6YD, UK; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Australia
| | - Christoph Meinert
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Travis Klein
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; ARC Training Centre in Additive Biomanufacturing, Brisbane, Australia
| | - Siamak Saifzadeh
- Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Australia
| | - Roland Steck
- Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Australia
| | - Jiongyu Ren
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; ARC Training Centre in Additive Biomanufacturing, Brisbane, Australia
| | - Maria A Woodruff
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; ARC Training Centre in Additive Biomanufacturing, Brisbane, Australia.
| | - Molly M Stevens
- Department of Materials, Imperial College London, SW7 2AZ, UK; Department of Bioengineering, Imperial College London, SW7 2AZ, UK; Institute of Biomedical Engineering, Imperial College London, SW7 2AZ, UK; Division of Biomaterials and Regenerative Medicine, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, SE 171 77, Sweden.
| |
Collapse
|
7
|
Sparks DS, Medeiros Savi F, Saifzadeh S, Wille ML, Wagels M, Hutmacher DW. Bone Regeneration Exploiting Corticoperiosteal Tissue Transfer for Scaffold-Guided Bone Regeneration. Tissue Eng Part C Methods 2022; 28:202-213. [PMID: 35262425 DOI: 10.1089/ten.tec.2022.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Contemporary reconstructive approaches for critical size bone defects carry significant disadvantages. As a result, clinically driven research has focused on the development and translation of alternative therapeutic concepts. Scaffold-guided tissue regeneration (SGTR) is an emerging technique to heal critical size bone defects. However, issues synchronizing scaffold vascularization with bone-specific regenerative processes currently limit bone regeneration for extra large (XL, 19 cm3) critical bone defects. To address this issue, we developed a large animal model that incorporates a corticoperiosteal flap (CPF) for sustained scaffold neovascularization and bone regeneration. In 10 sheep, we demonstrated the efficacy of this approach for healing medium (M, 9 cm3) size critical bone defects as demonstrated on plain radiography, microcomputed tomography, and histology. Furthermore, in two sheep, we demonstrate how this approach can be safely extended to heal XL critical size defects. This article presents an original CPF technique in a well-described preclinical model, which can be used in conjunction with the SGTR concept, to address challenging critical size bone defects in vivo. Impact statement This article describes a novel scaffold-guided tissue engineering approach utilizing a corticoperiosteal flap for bone healing in critical size long bone defects. This approach will be of use for tissue engineers and surgeons exploring vascularized tissue transfer as an option to regenerate large volumes of bone for extensive critical size bone defects both in vivo and in the clinical arena.
Collapse
Affiliation(s)
- David S Sparks
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia.,Department of Plastic & Reconstructive Surgery, Princess Alexandra Hospital, Woolloongabba, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, Australia
| | - Flavia Medeiros Savi
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia.,ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia
| | - Siamak Saifzadeh
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia.,Medical Engineering Research Facility, Queensland University of Technology, Chermside, Australia
| | - Marie-Luise Wille
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia.,ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia
| | - Michael Wagels
- Department of Plastic & Reconstructive Surgery, Princess Alexandra Hospital, Woolloongabba, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, Australia.,Australian Centre for Complex Integrated Surgical Solutions (ACCISS), Princess Alexandra Hospital, Woolloongabba, Australia.,Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Australia
| | - Dietmar W Hutmacher
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia.,ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia.,Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Australia
| |
Collapse
|
8
|
Ren J, Paxton NC, Hammond J, Saifzadeh S, Steck R, Lawrence FA, Woodruff MA. Novel resin tissue array system reduces sample preparation time, labour and reagent costs in bone tissue histology. Bone 2021; 153:116155. [PMID: 34411775 DOI: 10.1016/j.bone.2021.116155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 11/30/2022]
Abstract
Resin histology plays an essential role in the analysis of hard tissues, such as bone and teeth, as well as in the context of metallic implant analysis. However, the techniques of resin embedding, followed by ground sectioning, are very costly due to significantly increased reagent cost and labour time when compared to the conventional paraffin histology approach. In the present study, a novel resin array system was developed to increase the affordability of a project analysing rat femur tissues containing metallic or polymeric implants. The resin array system enabled the simultaneous embedding of the femur samples in groups of eight samples compared to the conventional resin method where samples are processed individually. The ground sections produced with the resin array system allowed uniform ROI selection, ground section thickness, staining consistency, and histological analysis with Goldner's trichrome stain, offering a substantial opportunity for reproducible immunohistochemistry which is unable to be achieved when processing samples embedded individually. The application of this novel resin array system significantly reduced resource usage when compared to doing the same analysis on individual samples. A reduction of approximately 40% was achieved for both total labour time and total reagent cost through the use of the array system compared with individual embedding. This novel resin array system has widespread applicability to many bone, hard tissue, and metallic implant studies, offering substantial conservation of research funds and increased accessibility to advanced techniques for commercial partners due to more cost-effective sample preparation and more accurate, reproducible data.
Collapse
Affiliation(s)
- Jiongyu Ren
- Queensland University of Technology (QUT), 2 George St, Brisbane, QLD 4000, Australia
| | - Naomi C Paxton
- Queensland University of Technology (QUT), 2 George St, Brisbane, QLD 4000, Australia
| | - Joshua Hammond
- Queensland University of Technology (QUT), 2 George St, Brisbane, QLD 4000, Australia
| | - Siamak Saifzadeh
- Queensland University of Technology (QUT), 2 George St, Brisbane, QLD 4000, Australia
| | - Roland Steck
- Queensland University of Technology (QUT), 2 George St, Brisbane, QLD 4000, Australia
| | - Felicity A Lawrence
- Queensland University of Technology (QUT), 2 George St, Brisbane, QLD 4000, Australia
| | - Maria A Woodruff
- Queensland University of Technology (QUT), 2 George St, Brisbane, QLD 4000, Australia.
| |
Collapse
|
9
|
Henkel J, Medeiros Savi F, Berner A, Fountain S, Saifzadeh S, Steck R, Epari DR, Woodruff MA, Knackstedt M, Schuetz MA, Hutmacher DW. Scaffold-guided bone regeneration in large volume tibial segmental defects. Bone 2021; 153:116163. [PMID: 34461285 DOI: 10.1016/j.bone.2021.116163] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
Large volume losses in weight bearing long bones are a major challenge in clinical practice. Despite multiple innovations over the last decades, significant limitations subsist in current clinical treatment options which is driving a strong clinical demand for clinically translatable treatment alternatives, including bone tissue engineering applications. Despite these shortcomings, preclinical large animal models of large volume segmental bone defects to investigate the regenerative capacity of bone tissue engineering strategies under clinically relevant conditions are rarely described in literature. We herein present a newly established preclinical ovine animal model for the treatment of XL volume (19 cm3) segmental tibial defects. In eight aged male Merino sheep (age > 6 years) a mid-diaphyseal tibial segmental defect was created and stabilized with a 5.6 mm Dynamic Compression Plate (DCP). We present short-term (3 months) and long-term (12-15 months) results of a pilot study using medical grade Polycaprolactone-Tricalciumphosphate (mPCL-TCP) scaffolds combined with a dose of 2 mg rhBMP-7 delivered in Platelet-Rich- Plasma (PRP). Furthermore, detailed analyses of the mechanical properties of the scaffolds as well as interfragmentary movement (IFM) and DCP-surface strain in vitro and a comprehensive description of the surgical and post-surgery protocol and post-mortem analysis is given.
Collapse
Affiliation(s)
- Jan Henkel
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, Kelvin Grove, Australia; Department of Trauma Surgery, Lutheran Hospital Goettingen-Weende, Goettingen, Germany
| | - Flavia Medeiros Savi
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, Kelvin Grove, Australia; ARC Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing, Australia; Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia
| | - Arne Berner
- Department of Trauma Surgery, University Hospital of Regensburg, Regensburg, Germany; Australian Research Council Industrial Transformation Training Centre in Additive Biomanufacturing, Australia
| | - Stephanie Fountain
- Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia
| | - Siamak Saifzadeh
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, Kelvin Grove, Australia; Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia; Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Australia
| | - Roland Steck
- Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Australia
| | - Devakar R Epari
- Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia
| | - Maria A Woodruff
- Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia
| | - Mark Knackstedt
- Department of Applied Mathematics, Australian National University (ANU), Canberra, Australia
| | - Michael A Schuetz
- Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Australia
| | - Dietmar W Hutmacher
- Centre in Transformative Biomimetics in Bioengineering, Queensland University of Technology, Kelvin Grove, Australia; ARC Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing, Australia; Faculty of Engineering, School of Mechanical Medical & Process Engineering, Queensland University of Technology, Kelvin Grove, Australia; Australian Research Council Industrial Transformation Training Centre in Additive Biomanufacturing, Australia; Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Australia.
| |
Collapse
|
10
|
Ren J, Kohli N, Sharma V, Shakouri T, Keskin-Erdogan Z, Saifzadeh S, Brierly GI, Knowles JC, Woodruff MA, García-Gareta E. Poly-ε-Caprolactone/Fibrin-Alginate Scaffold: A New Pro-Angiogenic Composite Biomaterial for the Treatment of Bone Defects. Polymers (Basel) 2021; 13:3399. [PMID: 34641215 PMCID: PMC8512525 DOI: 10.3390/polym13193399] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/11/2022] Open
Abstract
We hypothesized that a composite of 3D porous melt-electrowritten poly-ɛ-caprolactone (PCL) coated throughout with a porous and slowly biodegradable fibrin/alginate (FA) matrix would accelerate bone repair due to its angiogenic potential. Scanning electron microscopy showed that the open pore structure of the FA matrix was maintained in the PCL/FA composites. Fourier transform infrared spectroscopy and differential scanning calorimetry showed complete coverage of the PCL fibres by FA, and the PCL/FA crystallinity was decreased compared with PCL. In vitro cell work with osteoprogenitor cells showed that they preferentially bound to the FA component and proliferated on all scaffolds over 28 days. A chorioallantoic membrane assay showed more blood vessel infiltration into FA and PCL/FA compared with PCL, and a significantly higher number of bifurcation points for PCL/FA compared with both FA and PCL. Implantation into a rat cranial defect model followed by microcomputed tomography, histology, and immunohistochemistry after 4- and 12-weeks post operation showed fast early bone formation at week 4, with significantly higher bone formation for FA and PCL/FA compared with PCL. However, this phenomenon was not extrapolated to week 12. Therefore, for long-term bone regeneration, tuning of FA degradation to ensure syncing with new bone formation is likely necessary.
Collapse
Affiliation(s)
- Jiongyu Ren
- Faculty of Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (J.R.); (G.I.B.); (M.A.W.)
| | - Nupur Kohli
- Regenerative Biomaterials Group, The RAFT Institute & The Griffin Institute, Northwick Park & Saint Mark’s Hospital, London HA1 3UJ, UK; (N.K.); (V.S.)
- Department of Mechanical Engineering, Imperial College London, London SW7 1AL, UK
| | - Vaibhav Sharma
- Regenerative Biomaterials Group, The RAFT Institute & The Griffin Institute, Northwick Park & Saint Mark’s Hospital, London HA1 3UJ, UK; (N.K.); (V.S.)
| | - Taleen Shakouri
- Division of Biomaterials & Tissue Engineering, Eastman Dental Institute, University College London, Rowland Hill Street, London NW3 2PF, UK; (T.S.); (Z.K.-E.); (J.C.K.)
| | - Zalike Keskin-Erdogan
- Division of Biomaterials & Tissue Engineering, Eastman Dental Institute, University College London, Rowland Hill Street, London NW3 2PF, UK; (T.S.); (Z.K.-E.); (J.C.K.)
| | - Siamak Saifzadeh
- Medical Engineering Research Facility, Queensland University of Technology, Brisbane, QLD 4059, Australia;
| | - Gary I. Brierly
- Faculty of Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (J.R.); (G.I.B.); (M.A.W.)
| | - Jonathan C. Knowles
- Division of Biomaterials & Tissue Engineering, Eastman Dental Institute, University College London, Rowland Hill Street, London NW3 2PF, UK; (T.S.); (Z.K.-E.); (J.C.K.)
- UCL Eastman-Korea Dental Medicine Innovation Centre, Dankook University, Cheonan 31116, Korea
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Centre for Regenerative Medicine, Dankook University, Cheonan 31116, Korea
| | - Maria A. Woodruff
- Faculty of Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (J.R.); (G.I.B.); (M.A.W.)
| | - Elena García-Gareta
- Regenerative Biomaterials Group, The RAFT Institute & The Griffin Institute, Northwick Park & Saint Mark’s Hospital, London HA1 3UJ, UK; (N.K.); (V.S.)
- Division of Biomaterials & Tissue Engineering, Eastman Dental Institute, University College London, Rowland Hill Street, London NW3 2PF, UK; (T.S.); (Z.K.-E.); (J.C.K.)
| |
Collapse
|
11
|
Cheng M, Janzekovic J, Mohseni M, Medeiros Savi F, McGovern J, Galloway G, Wong C, Saifzadeh S, Wagels M, Hutmacher DW. A Preclinical Animal Model for the Study of Scaffold-Guided Breast Tissue Engineering. Tissue Eng Part C Methods 2021; 27:366-377. [PMID: 33906394 DOI: 10.1089/ten.tec.2020.0387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Scaffold-guided breast tissue engineering (SGBTE) has the potential to transform reconstructive breast surgery. Currently, there is a deficiency in clinically relevant animal models suitable for studying novel breast tissue engineering concepts. To date, only a small number of large animal studies have been conducted and characterization of these large animal models is poorly described in the literature. Addressing this gap in the literature, this publication comprehensively describes our original porcine model based on the current published literature and the experience gained from previous animal studies conducted by our research group. In a long-term experiment using our model, we investigated our SGBTE approach by implanting 60 additively manufactured bioresorbable scaffolds under the panniculus carnosus muscle along the flanks of 12 pigs over 12 months. Our model has the flexibility to compare multiple treatment modalities where we successfully investigated scaffolds filled with various treatments of immediate and delayed fat graft and augmentation with platelet rich plasma. No wound complications were observed using our animal model. We were able to grow clinically relevant volumes of soft tissue, which validates our model. Our preclinical large animal model is ideally suited to assess different scaffold or hydrogel-driven soft tissue regeneration strategies. Impact statement The ability to regenerate soft tissue through scaffold-guided tissue engineering concepts can transform breast reconstructive surgery. We describe an original preclinical large animal model to study controlled and reproducible scaffold-guided breast tissue engineering (SGBTE) concepts. This model features the flexibility to investigate multiple treatment conditions per animal, making it an efficient model. We have validated our model with a long-term experiment over 12 months, which exceeds other shorter published studies. Our SGBTE concept provides a more clinically relevant approach in terms of breast reconstruction. Future studies using this model will support the translation of SGBTE into clinical practice.
Collapse
Affiliation(s)
- Matthew Cheng
- Center for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Plastic and Reconstructive Surgery, Princess Alexandra Hospital, Brisbane, Australia
| | - Jan Janzekovic
- Center for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Mina Mohseni
- Center for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Flavia Medeiros Savi
- Center for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Jacqui McGovern
- Center for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Australia.,School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Graham Galloway
- Imaging Technology, Translational Research Institute, Brisbane, Australia
| | - Clement Wong
- Breast and Endocrine Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Siamak Saifzadeh
- Center for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Michael Wagels
- Center for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Plastic and Reconstructive Surgery, Princess Alexandra Hospital, Brisbane, Australia.,Herston Biofabrication Institute, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Dietmar W Hutmacher
- Center for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Australia.,School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.,ARC ITTC in Additive Biomanufacturing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
12
|
Futrega K, Music E, Robey PG, Gronthos S, Crawford R, Saifzadeh S, Klein TJ, Doran MR. Characterisation of ovine bone marrow-derived stromal cells (oBMSC) and evaluation of chondrogenically induced micro-pellets for cartilage tissue repair in vivo. Stem Cell Res Ther 2021; 12:26. [PMID: 33413652 PMCID: PMC7791713 DOI: 10.1186/s13287-020-02045-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022] Open
Abstract
Abstract Bone marrow stromal cells (BMSC) show promise in cartilage repair, and sheep are the most common large animal pre-clinical model. Objective The objective of this study was to characterise ovine BMSC (oBMSC) in vitro, and to evaluate the capacity of chondrogenic micro-pellets manufactured from oBMSC or ovine articular chondrocytes (oACh) to repair osteochondral defects in sheep. Design oBMSC were characterised for surface marker expression using flow cytometry and evaluated for tri-lineage differentiation capacity. oBMSC micro-pellets were manufactured in a microwell platform, and chondrogenesis was compared at 2%, 5%, and 20% O2. The capacity of cartilage micro-pellets manufactured from oBMSC or oACh to repair osteochondral defects in adult sheep was evaluated in an 8-week pilot study. Results Expanded oBMSC were positive for CD44 and CD146 and negative for CD45. The common adipogenic induction ingredient, 3-Isobutyl-1-methylxanthine (IBMX), was toxic to oBMSC, but adipogenesis could be restored by excluding IBMX from the medium. BMSC chondrogenesis was optimal in a 2% O2 atmosphere. Micro-pellets formed from oBMSC or oACh appeared morphologically similar, but hypertrophic genes were elevated in oBMSC micro-pellets. While oACh micro-pellets formed cartilage-like repair tissue in sheep, oBMSC micro-pellets did not. Conclusion The sensitivity of oBMSC, compared to human BMSC, to IBMX in standard adipogenic assays highlights species-associated differences. Micro-pellets manufactured from oACh were more effective than micro-pellets manufactured from oBMSC in the repair of osteochondral defects in sheep. While oBMSC can be driven to form cartilage-like tissue in vitro, the effective use of these cells in cartilage repair will depend on the successful mitigation of hypertrophy and tissue integration. Supplementary information The online version contains supplementary material available at 10.1186/s13287-020-02045-3.
Collapse
Affiliation(s)
- K Futrega
- Centre for Biomedical Technologies (CBT), Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,National Institute of Dental and Craniofacial Research (NIDCR), National Institutes of Health (NIH), Bethesda, Maryland, USA.,Translational Research Institute (TRI), Brisbane, Queensland, Australia
| | - E Music
- Translational Research Institute (TRI), Brisbane, Queensland, Australia.,School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - P G Robey
- National Institute of Dental and Craniofacial Research (NIDCR), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - S Gronthos
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - R Crawford
- Centre for Biomedical Technologies (CBT), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - S Saifzadeh
- Centre for Biomedical Technologies (CBT), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - T J Klein
- Centre for Biomedical Technologies (CBT), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - M R Doran
- Centre for Biomedical Technologies (CBT), Queensland University of Technology (QUT), Brisbane, Queensland, Australia. .,National Institute of Dental and Craniofacial Research (NIDCR), National Institutes of Health (NIH), Bethesda, Maryland, USA. .,Translational Research Institute (TRI), Brisbane, Queensland, Australia. .,School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia. .,Mater Research Institute - University of Queensland (UQ), Translational Research Institute (TRI), Brisbane, Queensland, Australia.
| |
Collapse
|
13
|
Black C, Kanczler JM, de Andrés MC, White LJ, Savi FM, Bas O, Saifzadeh S, Henkel J, Zannettino A, Gronthos S, Woodruff MA, Hutmacher DW, Oreffo ROC. Characterisation and evaluation of the regenerative capacity of Stro-4+ enriched bone marrow mesenchymal stromal cells using bovine extracellular matrix hydrogel and a novel biocompatible melt electro-written medical-grade polycaprolactone scaffold. Biomaterials 2020; 247:119998. [PMID: 32251928 PMCID: PMC7184676 DOI: 10.1016/j.biomaterials.2020.119998] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 12/15/2022]
Abstract
Many skeletal tissue regenerative strategies centre around the multifunctional properties of bone marrow derived stromal cells (BMSC) or mesenchymal stem/stromal cells (MSC)/bone marrow derived skeletal stem cells (SSC). Specific identification of these particular stem cells has been inconclusive. However, enriching these heterogeneous bone marrow cell populations with characterised skeletal progenitor markers has been a contributing factor in successful skeletal bone regeneration and repair strategies. In the current studies we have isolated, characterised and enriched ovine bone marrow mesenchymal stromal cells (oBMSCs) using a specific antibody, Stro-4, examined their multipotential differentiation capacity and, in translational studies combined Stro-4+ oBMSCs with a bovine extracellular matrix (bECM) hydrogel and a biocompatible melt electro-written medical-grade polycaprolactone scaffold, and tested their bone regenerative capacity in a small in vivo, highly vascularised, chick chorioallantoic membrane (CAM) model and a preclinical, critical-sized ovine segmental tibial defect model. Proliferation rates and CFU-F formation were similar between unselected and Stro-4+ oBMSCs. Col1A1, Col2A1, mSOX-9, PPARG gene expression were upregulated in respective osteogenic, chondrogenic and adipogenic culture conditions compared to basal conditions with no significant difference between Stro-4+ and unselected oBMSCs. In contrast, proteoglycan expression, alkaline phosphatase activity and adipogenesis were significantly upregulated in the Stro-4+ cells. Furthermore, with extended cultures, the oBMSCs had a predisposition to maintain a strong chondrogenic phenotype. In the CAM model Stro-4+ oBMSCs/bECM hydrogel was able to induce bone formation at a femur fracture site compared to bECM hydrogel and control blank defect alone. Translational studies in a critical-sized ovine tibial defect showed autograft samples contained significantly more bone, (4250.63 mm3, SD = 1485.57) than blank (1045.29 mm3, SD = 219.68) ECM-hydrogel (1152.58 mm3, SD = 191.95) and Stro-4+/ECM-hydrogel (1127.95 mm3, SD = 166.44) groups. Stro-4+ oBMSCs demonstrated a potential to aid bone repair in vitro and in a small in vivo bone defect model using select scaffolds. However, critically, translation to a large related preclinical model demonstrated the complexities of bringing small scale reported stem-cell material therapies to a clinically relevant model and thus facilitate progression to the clinic.
Collapse
Affiliation(s)
- C Black
- Bone & Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Human Development & Health, Institute of Developmental Sciences, University of Southampton, SO16 6YD, UK
| | - J M Kanczler
- Bone & Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Human Development & Health, Institute of Developmental Sciences, University of Southampton, SO16 6YD, UK
| | - M C de Andrés
- Bone & Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Human Development & Health, Institute of Developmental Sciences, University of Southampton, SO16 6YD, UK; Cartilage Epigenetics Group, Rheumatology Division, Biomedical Research Institute of A Coruña (INIBIC), Hospital Universitario de A Coruña-CHUAC, 15006 A Coruña ,Spain
| | - L J White
- School of Pharmacy, Biodiscovery Institute, University Park, University of Nottingham, Nottingham, NG7 2RD, UK
| | - F M Savi
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia; Institute of Health Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - O Bas
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia; Institute of Health Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - S Saifzadeh
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia
| | - J Henkel
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia
| | - A Zannettino
- Myeloma Research Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia and Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia and Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - S Gronthos
- Mesenchymal Stem Cell Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia and Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - M A Woodruff
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia
| | - D W Hutmacher
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia; Institute of Health Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - R O C Oreffo
- Bone & Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Human Development & Health, Institute of Developmental Sciences, University of Southampton, SO16 6YD, UK; College of Biomedical Engineering, China Medical University, Taichung, 40402, Taiwan.
| |
Collapse
|
14
|
Griffin M, Castro N, Bas O, Saifzadeh S, Butler P, Hutmacher DW. The Current Versatility of Polyurethane Three-Dimensional Printing for Biomedical Applications. Tissue Engineering Part B: Reviews 2020; 26:272-283. [DOI: 10.1089/ten.teb.2019.0224] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Michelle Griffin
- Charles Wolfson Centre for Reconstructive Surgery, Royal Free Hospital, London, United Kingdom
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom
| | - Nathan Castro
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Onur Bas
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Siamak Saifzadeh
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Peter Butler
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Dietmar Werner Hutmacher
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
15
|
Sparks DS, Saifzadeh S, Savi FM, Dlaska CE, Berner A, Henkel J, Reichert JC, Wullschleger M, Ren J, Cipitria A, McGovern JA, Steck R, Wagels M, Woodruff MA, Schuetz MA, Hutmacher DW. A preclinical large-animal model for the assessment of critical-size load-bearing bone defect reconstruction. Nat Protoc 2020; 15:877-924. [PMID: 32060491 DOI: 10.1038/s41596-019-0271-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 11/11/2019] [Indexed: 12/31/2022]
Abstract
Critical-size bone defects, which require large-volume tissue reconstruction, remain a clinical challenge. Bone engineering has the potential to provide new treatment concepts, yet clinical translation requires anatomically and physiologically relevant preclinical models. The ovine critical-size long-bone defect model has been validated in numerous studies as a preclinical tool for evaluating both conventional and novel bone-engineering concepts. With sufficient training and experience in large-animal studies, it is a technically feasible procedure with a high level of reproducibility when appropriate preoperative and postoperative management protocols are followed. The model can be established by following a procedure that includes the following stages: (i) preoperative planning and preparation, (ii) the surgical approach, (iii) postoperative management, and (iv) postmortem analysis. Using this model, full results for peer-reviewed publication can be attained within 2 years. In this protocol, we comprehensively describe how to establish proficiency using the preclinical model for the evaluation of a range of bone defect reconstruction options.
Collapse
Affiliation(s)
- David S Sparks
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Department of Plastic & Reconswrapping a sterile Coban wrap around the limb distallytructive Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, Queensland, Australia
| | - Siamak Saifzadeh
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Medical Engineering Research Facility, Queensland UCoban wrap only comes non-sterile. Sterilize Coban wrap before use.niversity of Technology, Chermside, Queensland, Australia
| | - Flavia Medeiros Savi
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,ARC Centre for Additive Biomanufactthe mounting resin base cement. Use it only in a laboratory fume cabinet and withuring, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Constantin E Dlaska
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Queensland, Australia
| | - Arne Berner
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Department of Trauma Surgery, University Hospital of Regensburg, Regensburg, Germany
| | - Jan Henkel
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Johannes C Reichert
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, König-Ludwig-Haus, Julius-Maximilians-University, Würzburg, Germany.,Department of Orthopaedic and Trauma Surgery, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany
| | - Martin Wullschleger
- Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Queensland, Australia.,Griffith University, School of Medicine, Southport, Queensland, Australia
| | - Jiongyu Ren
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Amaia Cipitria
- Department of Biomaterials, Max Planck Institute of Colloids and Interfaces, Potsdam, Germany
| | - Jacqui A McGovern
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Roland Steck
- Medical Engineering Research Facility, Queensland UCoban wrap only comes non-sterile. Sterilize Coban wrap before use.niversity of Technology, Chermside, Queensland, Australia
| | - Michael Wagels
- Department of Plastic & Reconswrapping a sterile Coban wrap around the limb distallytructive Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, Queensland, Australia.,Australian Centre for Complex Integrated Surgical Solutions (ACCISS), Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Maria Ann Woodruff
- ARC Centre for Additive Biomanufactthe mounting resin base cement. Use it only in a laboratory fume cabinet and withuring, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Biofabrication and Tissue Morphology Group, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Michael A Schuetz
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, Queensland, Australia
| | - Dietmar W Hutmacher
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia. .,ARC Centre for Additive Biomanufactthe mounting resin base cement. Use it only in a laboratory fume cabinet and withuring, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
| |
Collapse
|
16
|
Sparks DS, Savi FM, Saifzadeh S, Schuetz MA, Wagels M, Hutmacher DW. Convergence of Scaffold-Guided Bone Reconstruction and Surgical Vascularization Strategies-A Quest for Regenerative Matching Axial Vascularization. Front Bioeng Biotechnol 2020; 7:448. [PMID: 31998712 PMCID: PMC6967032 DOI: 10.3389/fbioe.2019.00448] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/13/2019] [Indexed: 02/06/2023] Open
Abstract
The prevalent challenge facing tissue engineering today is the lack of adequate vascularization to support the growth, function, and viability of tissue engineered constructs (TECs) that require blood vessel supply. The research and clinical community rely on the increasing knowledge of angiogenic and vasculogenic processes to stimulate a clinically-relevant vascular network formation within TECs. The regenerative matching axial vascularization approach presented in this manuscript incorporates the advantages of flap-based techniques for neo-vascularization yet also harnesses the in vivo bioreactor principle in a more directed "like for like" approach to further assist regeneration of the specific tissue type that is lost, such as a corticoperiosteal flap in critical sized bone defect reconstruction.
Collapse
Affiliation(s)
- David S Sparks
- Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Department of Plastic & Reconstructive Surgery, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, QLD, Australia
| | - Flavia Medeiros Savi
- Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Siamak Saifzadeh
- Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Medical Engineering Research Facility, Queensland University of Technology, Chermside, QLD, Australia
| | - Michael A Schuetz
- Department of Orthopaedic Surgery, Royal Brisbane Hospital, Herston, QLD, Australia.,Jamieson Trauma Institute, Royal Brisbane Hospital, Herston, QLD, Australia
| | - Michael Wagels
- Department of Plastic & Reconstructive Surgery, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.,Southside Clinical Division, School of Medicine, University of Queensland, Woolloongabba, QLD, Australia.,Australian Centre for Complex Integrated Surgical Solutions, Woolloongabba, QLD, Australia
| | - Dietmar W Hutmacher
- Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia.,ARC Centre for Additive Bio-Manufacturing, Queensland University of Technology, Kelvin Grove, QLD, Australia
| |
Collapse
|
17
|
Brierly GI, Ren J, Baldwin J, Saifzadeh S, Theodoropoulos C, Tsurkan MV, Lynham A, Hsu E, Nikolarakos D, Werner C, Woodruff MA, Hutmacher DW, Bray LJ. Investigation of Sustained BMP Delivery in the Prevention of Medication-Related Osteonecrosis of the Jaw (MRONJ) in a Rat Model. Macromol Biosci 2019; 19:e1900226. [PMID: 31549786 DOI: 10.1002/mabi.201900226] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/21/2019] [Indexed: 01/06/2023]
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) poses an ongoing challenge for clinicians and researchers. Currently, there is a lack of preventative measures available for at-risk patients undergoing tooth extractions, especially those with prior bisphosphonate treatment due to osteoporosis or bone metastasis diagnoses. Here, these issues are addressed using a preventative tissue engineering strategy against MRONJ development. This study evaluates the efficacy of a poly(ethylene glycol)-heparin hydrogel as a tool for the delivery of arginylglycylaspartic acid (RGD) and recombinant human bone morphogenic protein-2 (rhBMP-2). Three groups of skeletally mature rats each receive two doses of intravenous zoledronic acid prior to surgery and undergo extraction of the right first mandibular molar with gingival closure. Experimental groups either have the sockets left empty, filled with hydrogel minus rhBMP-2, or filled with hydrogel plus rhBMP-2. Eight weeks postoperatively specimens are analyzed using radiological, histological, and scanning electron microscopy (SEM) techniques. µCT analysis shows increased bone formation with hydrogel/rhBMP-2 delivery compared to the empty socket. Hydrogel-treated groups display increased presence of osteocytes and increased osteoclastic action compared to the empty sockets. These results represent the first step toward improved delivery of rhBMP-2 and a potential MRONJ preventative for patients undergoing bisphosphonate treatment.
Collapse
Affiliation(s)
- Gary I Brierly
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland, 4006, Australia
| | - Jiongyu Ren
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4001, Australia
| | - Jeremy Baldwin
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4001, Australia
| | - Siamak Saifzadeh
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4001, Australia
| | - Christina Theodoropoulos
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4001, Australia
| | - Mikhail V Tsurkan
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,Leibniz Institute of Polymer Research Dresden e.V., Max Bergmann Center for Biomaterials, Hohe Straße 6, 01069, Dresden, Saxony, Germany
| | - Anthony Lynham
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4001, Australia
| | - Edward Hsu
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland, 4006, Australia
| | - Dimitrios Nikolarakos
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Carsten Werner
- Leibniz Institute of Polymer Research Dresden e.V., Max Bergmann Center for Biomaterials, Hohe Straße 6, 01069, Dresden, Saxony, Germany.,Center for Regenerative Therapies Dresden, Technische Universität Dresden, Fetscherstraße 105, 01307, Dresden, Saxony, Germany
| | - Maria A Woodruff
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4001, Australia
| | - Dietmar W Hutmacher
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4001, Australia
| | - Laura J Bray
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.,School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4001, Australia.,Leibniz Institute of Polymer Research Dresden e.V., Max Bergmann Center for Biomaterials, Hohe Straße 6, 01069, Dresden, Saxony, Germany
| |
Collapse
|
18
|
Li JJ, Dunstan CR, Entezari A, Li Q, Steck R, Saifzadeh S, Sadeghpour A, Field JR, Akey A, Vielreicher M, Friedrich O, Roohani-Esfahani SI, Zreiqat H. A Novel Bone Substitute with High Bioactivity, Strength, and Porosity for Repairing Large and Load-Bearing Bone Defects. Adv Healthc Mater 2019; 8:e1900641. [PMID: 31310457 DOI: 10.1002/adhm.201900641] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
19
|
Li JJ, Dunstan CR, Entezari A, Li Q, Steck R, Saifzadeh S, Sadeghpour A, Field JR, Akey A, Vielreicher M, Friedrich O, Roohani‐Esfahani S, Zreiqat H. Bone Regeneration: A Novel Bone Substitute with High Bioactivity, Strength, and Porosity for Repairing Large and Load‐Bearing Bone Defects (Adv. Healthcare Mater. 8/2019). Adv Healthc Mater 2019. [DOI: 10.1002/adhm.201970031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jiao Jiao Li
- Biomaterials and Tissue Engineering Research UnitSchool of Aerospace, Mechanical and Mechatronic EngineeringUniversity of Sydney Sydney NSW 2006 Australia
- Raymond Purves Bone and Joint Research LaboratoriesInstitute of Bone and Joint ResearchKolling InstituteNorthern Sydney Local Health DistrictFaculty of Medicine and HealthUniversity of Sydney St Leonards NSW 2065 Australia
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
| | - Colin R. Dunstan
- Biomaterials and Tissue Engineering Research UnitSchool of Aerospace, Mechanical and Mechatronic EngineeringUniversity of Sydney Sydney NSW 2006 Australia
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
| | - Ali Entezari
- School of Aerospace, Mechanical and Mechatronic EngineeringUniversity of Sydney Sydney NSW 2006 Australia
| | - Qing Li
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
- School of Aerospace, Mechanical and Mechatronic EngineeringUniversity of Sydney Sydney NSW 2006 Australia
| | - Roland Steck
- Medical Engineering Research Facility (MERF)Institute of Health and Biomedical Innovation (IHBI)Queensland University of Technology Prince Charles Hospital Campus Brisbane QLD 4000 Australia
| | - Siamak Saifzadeh
- Medical Engineering Research Facility (MERF)Institute of Health and Biomedical Innovation (IHBI)Queensland University of Technology Prince Charles Hospital Campus Brisbane QLD 4000 Australia
| | - Ameneh Sadeghpour
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
- Allegra Orthopaedics Limited Sydney NSW 2000 Australia
| | - John R. Field
- Centre for Orthopaedic Trauma and ResearchUniversity of Adelaide Adelaide SA 5000 Australia
| | - Austin Akey
- Center for Nanoscale SystemsHarvard University Cambridge MA 02138 USA
| | - Martin Vielreicher
- Institute of Medical BiotechnologyDepartment of Chemical and Biological EngineeringFriedrich Alexander University of Erlangen‐Nürnberg Erlangen 91052 Germany
| | - Oliver Friedrich
- Institute of Medical BiotechnologyDepartment of Chemical and Biological EngineeringFriedrich Alexander University of Erlangen‐Nürnberg Erlangen 91052 Germany
| | | | - Hala Zreiqat
- Biomaterials and Tissue Engineering Research UnitSchool of Aerospace, Mechanical and Mechatronic EngineeringUniversity of Sydney Sydney NSW 2006 Australia
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
- Radcliffe Institute for Advanced StudyHarvard University Cambridge MA 02138 USA
| |
Collapse
|
20
|
Abstract
This study reports on scaffold-based periodontal tissue engineering in a large preclinical animal model. A biphasic scaffold consisting of bone and periodontal ligament compartments manufactured by melt and solution electrospinning, respectively, was used for the delivery of in vitro matured cell sheets from 3 sources: gingival cells (GCs), bone marrow-derived mesenchymal stromal cells (Bm-MSCs), and periodontal ligament cells (PDLCs). The construct featured a 3-dimensional fibrous bone compartment with macroscopic pore size, while the periodontal compartment consisted of a flexible porous membrane for cell sheet delivery. The regenerative performance of the constructs was radiographically and histologically assessed in surgically created periodontal defects in sheep following 5 and 10 wk of healing. Histologic observation demonstrated that the constructs maintained their shape and volume throughout the entirety of the in vivo study and were well integrated with the surrounding tissue. There was also excellent tissue integration between the bone and periodontal ligament compartments as well as the tooth root interface, enabling the attachment of periodontal ligament fibers into newly formed cementum and bone. Bone coverage along the root surface increased between weeks 5 and 10 in the Bm-MSC and PDLC groups. At week 10, the micro-computed tomography results showed that the PDLC group had greater bone fill as compared with the empty scaffold, while the GC group had less bone than the 3 other groups (control, Bm-MSC, and PDLC). Periodontal regeneration, as measured by histologically verified new bone and cementum formation with obliquely inserted periodontal ligament fibers, increased between 5 and 10 wk for the empty, Bm-MSC, and PDLC groups, while the GC group was inferior to the Bm-MSC and PDLC groups at 10 wk. This study demonstrates that periodontal regeneration can be achieved via the utilization of a multiphasic construct, with Bm-MSCs and PDLCs obtaining superior results as compared with GC-derived cell sheets.
Collapse
Affiliation(s)
- C Vaquette
- 1 Queensland University of Technology, Brisbane, Australia.,2 Center in Regenerative Medicine, Institute of Health of Biomedical Innovation, Kelvin Grove, Australia.,3 School of Dentistry, The University of Queensland, Herston, Australia
| | - S Saifzadeh
- 1 Queensland University of Technology, Brisbane, Australia.,2 Center in Regenerative Medicine, Institute of Health of Biomedical Innovation, Kelvin Grove, Australia
| | - A Farag
- 3 School of Dentistry, The University of Queensland, Herston, Australia
| | - D W Hutmacher
- 1 Queensland University of Technology, Brisbane, Australia.,2 Center in Regenerative Medicine, Institute of Health of Biomedical Innovation, Kelvin Grove, Australia
| | - S Ivanovski
- 3 School of Dentistry, The University of Queensland, Herston, Australia
| |
Collapse
|
21
|
Li JJ, Dunstan CR, Entezari A, Li Q, Steck R, Saifzadeh S, Sadeghpour A, Field JR, Akey A, Vielreicher M, Friedrich O, Roohani‐Esfahani S, Zreiqat H. A Novel Bone Substitute with High Bioactivity, Strength, and Porosity for Repairing Large and Load-Bearing Bone Defects. Adv Healthc Mater 2019; 8:e1801298. [PMID: 30773833 DOI: 10.1002/adhm.201801298] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/18/2019] [Indexed: 12/18/2022]
Abstract
Achieving adequate healing in large or load-bearing bone defects is highly challenging even with surgical intervention. The clinical standard of repairing bone defects using autografts or allografts has many drawbacks. A bioactive ceramic scaffold, strontium-hardystonite-gahnite or "Sr-HT-Gahnite" (a multi-component, calcium silicate-based ceramic) is developed, which when 3D-printed combines high strength with outstanding bone regeneration ability. In this study, the performance of purely synthetic, 3D-printed Sr-HT-Gahnite scaffolds is assessed in repairing large and load-bearing bone defects. The scaffolds are implanted into critical-sized segmental defects in sheep tibia for 3 and 12 months, with bone autografts used for comparison. The scaffolds induce substantial bone formation and defect bridging after 12 months, as indicated by X-ray, micro-computed tomography, and histological and biomechanical analyses. Detailed analysis of the bone-scaffold interface using focused ion beam scanning electron microscopy and multiphoton microscopy shows scaffold degradation and maturation of the newly formed bone. In silico modeling of strain energy distribution in the scaffolds reveal the importance of surgical fixation and mechanical loading on long-term bone regeneration. The clinical application of 3D-printed Sr-HT-Gahnite scaffolds as a synthetic bone substitute can potentially improve the repair of challenging bone defects and overcome the limitations of bone graft transplantation.
Collapse
Affiliation(s)
- Jiao Jiao Li
- Biomaterials and Tissue Engineering Research Unit School of Aerospace, Mechanical and Mechatronic Engineering University of Sydney Sydney NSW 2006 Australia
- Raymond Purves Bone and Joint Research Laboratories Institute of Bone and Joint Research Kolling Institute Northern Sydney Local Health District Faculty of Medicine and Health University of Sydney St Leonards NSW 2065 Australia
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
| | - Colin R. Dunstan
- Biomaterials and Tissue Engineering Research Unit School of Aerospace, Mechanical and Mechatronic Engineering University of Sydney Sydney NSW 2006 Australia
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
| | - Ali Entezari
- School of Aerospace, Mechanical and Mechatronic Engineering University of Sydney Sydney NSW 2006 Australia
| | - Qing Li
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
- School of Aerospace, Mechanical and Mechatronic Engineering University of Sydney Sydney NSW 2006 Australia
| | - Roland Steck
- Medical Engineering Research Facility (MERF) Institute of Health and Biomedical Innovation (IHBI) Queensland University of Technology Prince Charles Hospital Campus Brisbane QLD 4000 Australia
| | - Siamak Saifzadeh
- Medical Engineering Research Facility (MERF) Institute of Health and Biomedical Innovation (IHBI) Queensland University of Technology Prince Charles Hospital Campus Brisbane QLD 4000 Australia
| | - Ameneh Sadeghpour
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
- Allegra Orthopaedics Limited Sydney NSW 2000 Australia
| | - John R. Field
- Centre for Orthopaedic Trauma and Research University of Adelaide Adelaide SA 5000 Australia
| | - Austin Akey
- Center for Nanoscale Systems Harvard University Cambridge MA 02138 USA
| | - Martin Vielreicher
- Institute of Medical Biotechnology Department of Chemical and Biological Engineering Friedrich Alexander University of Erlangen‐Nürnberg Erlangen 91052 Germany
| | - Oliver Friedrich
- Institute of Medical Biotechnology Department of Chemical and Biological Engineering Friedrich Alexander University of Erlangen‐Nürnberg Erlangen 91052 Germany
| | | | - Hala Zreiqat
- Biomaterials and Tissue Engineering Research Unit School of Aerospace, Mechanical and Mechatronic Engineering University of Sydney Sydney NSW 2006 Australia
- Australian Research Council Training Centre for Innovative BioEngineering Sydney NSW 2006 Australia
- Radcliffe Institute for Advanced Study Harvard University Cambridge MA 02138 USA
| |
Collapse
|
22
|
Sudheesh Kumar P, Hashimi S, Saifzadeh S, Ivanovski S, Vaquette C. Additively manufactured biphasic construct loaded with BMP-2 for vertical bone regeneration: A pilot study in rabbit. Materials Science and Engineering: C 2018; 92:554-564. [DOI: 10.1016/j.msec.2018.06.071] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 05/29/2018] [Accepted: 06/30/2018] [Indexed: 12/18/2022]
|
23
|
Tufekci P, Tavakoli A, Dlaska C, Neumann M, Shanker M, Saifzadeh S, Steck R, Schuetz M, Epari D. Early mechanical stimulation only permits timely bone healing in sheep. J Orthop Res 2018; 36:1790-1796. [PMID: 29159911 DOI: 10.1002/jor.23812] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/11/2017] [Indexed: 02/04/2023]
Abstract
Bone fracture healing is sensitive to the fixation stability. However, it is unclear which phases of healing are mechano-sensitive and if mechanical stimulation is required throughout repair. In this study, a novel bone defect model, which isolates an experimental fracture from functional loading, was applied in sheep to investigate if stimulation limited to the early proliferative phase is sufficient for bone healing. An active fixator controlled motion in the fracture. Animals of the control group were unstimulated. In the physiological-like group, 1 mm axial compressive movements were applied between day 5 and 21, thereafter the movements were decreased in weekly increments and stopped after 6 weeks. In the early stimulatory group, the movements were stopped after 3 weeks. The experimental fractures were evaluated with mechanical and micro-computed tomography methods after 9 weeks healing. The callus strength of the stimulated fractures (physiological-like and early stimulatory) was greater than the unstimulated control group. The control group was characterized by minimal external callus formation and a lack of bone bridging at 9 weeks. In contrast, the stimulated groups exhibited advanced healing with solid bone formation across the defect. This was confirmed quantitatively by a lower bone volume in the control group compared to the stimulated groups.The novel experimental model permits the application of a well-defined load history to an experimental bone fracture. The poor healing observed in the control group is consistent with under-stimulation. This study has shown early mechanical stimulation only is sufficient for a timely healing outcome. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1790-1796, 2018.
Collapse
Affiliation(s)
- Pelin Tufekci
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Aramesh Tavakoli
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Constantin Dlaska
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Mirjam Neumann
- Trauma Service, Princess Alexandra Hospital, Brisbane, Australia
| | - Mihir Shanker
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Siamak Saifzadeh
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Roland Steck
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| | - Michael Schuetz
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia.,Trauma Service, Princess Alexandra Hospital, Brisbane, Australia
| | - Devakar Epari
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, 4059, Queensland, Australia
| |
Collapse
|
24
|
Pelekanos M, Leinenga G, Odabaee M, Odabaee M, Saifzadeh S, Steck R, Götz J. Establishing sheep as an experimental species to validate ultrasound-mediated blood-brain barrier opening for potential therapeutic interventions. Am J Cancer Res 2018; 8:2583-2602. [PMID: 29721100 PMCID: PMC5928910 DOI: 10.7150/thno.22852] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 03/02/2018] [Indexed: 11/14/2022] Open
Abstract
Rationale: Treating diseases of the brain such as Alzheimer's disease (AD) is challenging as the blood-brain barrier (BBB) effectively restricts access of a large number of potentially useful drugs. A potential solution to this problem is presented by therapeutic ultrasound, a novel treatment modality that can achieve transient BBB opening in species including rodents, facilitated by biologically inert microbubbles that are routinely used in a clinical setting for contrast enhancement. However, in translating rodent studies to the human brain, the presence of a thick cancellous skull that both absorbs and distorts ultrasound presents a challenge. A larger animal model that is more similar to humans is therefore required in order to establish a suitable protocol and to test devices. Here we investigated whether sheep provide such a model. Methods: In a stepwise manner, we used a total of 12 sheep to establish a sonication protocol using a spherically focused transducer. This was assisted by ex vivo simulations based on CT scans to establish suitable sonication parameters. BBB opening was assessed by Evans blue staining and a range of histological tests. Results: Here we demonstrate noninvasive microbubble-mediated BBB opening through the intact sheep skull. Our non-recovery protocol allowed for BBB opening at the base of the brain, and in areas relevant for AD, including the cortex and hippocampus. Linear time-shift invariant analysis and finite element analysis simulations were used to optimize the position of the transducer and to predict the acoustic pressure and location of the focus. Conclusion: Our study establishes sheep as a novel animal model for ultrasound-mediated BBB opening and highlights opportunities and challenges in using this model. Moreover, as sheep develop an AD-like pathology with aging, they represent a large animal model that could potentially complement the use of non-human primates.
Collapse
|
25
|
Brierly G, Bray L, Theodoropoulos C, Saifzadeh S, Hsu E, Nikolarakos D, Woodruff M, Hutmacher D. A pilot study into prevention of antiresorptive drug-related osteonecrosis of the jaw in a porcine animal model. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
26
|
Hobbenaghi R, Mahboob P, Saifzadeh S, Javanbakht J, Manesh JYY, Mortezaee R, Touni SR, Hosseini E, Aghajanshakeri S, Moloudizargari M, Javaherypour S. Retraction note: Histopathological features of bone regeneration in a canine segmental ulnar defect model. Diagn Pathol 2016; 11:124. [PMID: 27802815 PMCID: PMC5090946 DOI: 10.1186/s13000-016-0573-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 10/19/2016] [Indexed: 11/21/2022] Open
Affiliation(s)
- Rahim Hobbenaghi
- Department of Pathology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Pariya Mahboob
- Graduate, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Siamak Saifzadeh
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Javad Javanbakht
- Department of Pathobiology, Faculty of Veterinary Medicine, Tehran University, Tehran, Iran.
| | - Javad Yaghoobi Yeganeh Manesh
- Graduate of Islamic Azad University of Shahrekord, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
| | - Rasool Mortezaee
- Student of Ferdowsi University of Mashhad, Faculty of Veterinary Medicine, Ferdowsi University, Mashahd, Iran
| | - Seyed Rashid Touni
- Ph.D Student of Anatomy and Embryology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Ehsan Hosseini
- Faculty of Para Veterinary Medicine, Ilam University, Ilam, Iran
| | - Shahin Aghajanshakeri
- Student of Veterinary Medicine, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Milad Moloudizargari
- Student of Veterinary Medicine, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Soheil Javaherypour
- Student of Veterinary Medicine, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| |
Collapse
|
27
|
Alayan J, Vaquette C, Saifzadeh S, Hutmacher D, Ivanovski S. Comparison of early osseointegration of SLA®
and SLActive®
implants in maxillary sinus augmentation: a pilot study. Clin Oral Implants Res 2016; 28:1325-1333. [DOI: 10.1111/clr.12988] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Jamil Alayan
- School of Dentistry and Oral Health; Centre for Medicine and Oral Health; Menzies Health Institute Queensland; Griffith University; Southport Australia
| | - Cedryck Vaquette
- Institute for Health and Biomedical Innovation; Queensland University of Technology; Kelvin Grove Australia
| | - Siamak Saifzadeh
- Institute for Health and Biomedical Innovation; Queensland University of Technology; Kelvin Grove Australia
| | - Dietmar Hutmacher
- Institute for Health and Biomedical Innovation; Queensland University of Technology; Kelvin Grove Australia
| | - Saso Ivanovski
- School of Dentistry and Oral Health; Centre for Medicine and Oral Health; Menzies Health Institute Queensland; Griffith University; Southport Australia
| |
Collapse
|
28
|
Hobbenaghi R, Mahboub P, Saifzadeh S, Javanbakht J, Manesh JYY, Mortezaee R, Touni SR, Hosseini E, Aghajanshakeri S, Moloudizargari M, Javaherypour S. Erratum to: Histopathological features of bone regeneration in a canine segmental ulnar defect model. Diagn Pathol 2016; 11:84. [PMID: 27613500 PMCID: PMC5018184 DOI: 10.1186/s13000-016-0534-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 08/15/2016] [Indexed: 11/10/2022] Open
Affiliation(s)
- Rahim Hobbenaghi
- Department of Pathology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Paria Mahboub
- Graduate, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Siamak Saifzadeh
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, Qld, 4059, Australia
| | - Javad Javanbakht
- Department of Pathobiology, Faculty of Veterinary Medicine, Tehran University, Tehran, Iran.
| | - Javad Yaghoobi Yeganeh Manesh
- Gradute of Islamic Azad University of bShahrekord, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
| | - Rasool Mortezaee
- Student of Ferdowsi University of Mashhad, Faculty of Veterinary Medicine, Ferdowsi University, Mashahd, Iran
| | - Seyed Rashid Touni
- Ph.D Student of Anatomy and Embryology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Ehsan Hosseini
- Faculty of Para Veterinary Medicine, Ilam University, Ilam, Iran
| | - Shahin Aghajanshakeri
- Student of Veterinary Medicine, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Milad Moloudizargari
- Student of Veterinary Medicine, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Soheil Javaherypour
- Student of Veterinary Medicine, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| |
Collapse
|
29
|
Kirby GTS, White LJ, Steck R, Berner A, Bogoevski K, Qutachi O, Jones B, Saifzadeh S, Hutmacher DW, Shakesheff KM, Woodruff MA. Microparticles for Sustained Growth Factor Delivery in the Regeneration of Critically-Sized Segmental Tibial Bone Defects. Materials (Basel) 2016; 9:ma9040259. [PMID: 28773384 PMCID: PMC5502923 DOI: 10.3390/ma9040259] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 03/18/2016] [Accepted: 03/18/2016] [Indexed: 11/16/2022]
Abstract
This study trialled the controlled delivery of growth factors within a biodegradable scaffold in a large segmental bone defect model. We hypothesised that co-delivery of vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF) followed by bone morphogenetic protein-2 (BMP-2) could be more effective in stimulating bone repair than the delivery of BMP-2 alone. Poly(lactic-co-glycolic acid) (PLGA ) based microparticles were used as a delivery system to achieve a controlled release of growth factors within a medical-grade Polycaprolactone (PCL) scaffold. The scaffolds were assessed in a well-established preclinical ovine tibial segmental defect measuring 3 cm. After six months, mechanical properties and bone tissue regeneration were assessed. Mineralised bone bridging of the defect was enhanced in growth factor treated groups. The inclusion of VEGF and PDGF (with BMP-2) had no significant effect on the amount of bone regeneration at the six-month time point in comparison to BMP-2 alone. However, regions treated with VEGF and PDGF showed increased vascularity. This study demonstrates an effective method for the controlled delivery of therapeutic growth factors in vivo, using microparticles.
Collapse
Affiliation(s)
- Giles T S Kirby
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
- School of Pharmacy, University Park, The University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Lisa J White
- School of Pharmacy, University Park, The University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Roland Steck
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| | - Arne Berner
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
- Department of Trauma Surgery, University of Regensburg, Regensburg 93164, Germany.
| | - Kristofor Bogoevski
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| | - Omar Qutachi
- School of Pharmacy, University Park, The University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Brendan Jones
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| | - Siamak Saifzadeh
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| | - Dietmar W Hutmacher
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| | - Kevin M Shakesheff
- School of Pharmacy, University Park, The University of Nottingham, University Park, Nottingham NG7 2RD, UK.
| | - Maria A Woodruff
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisban, QLD 4006, Australia.
| |
Collapse
|
30
|
Li JJ, Roohani-Esfahani SI, Dunstan CR, Quach T, Steck R, Saifzadeh S, Pivonka P, Zreiqat H. Efficacy of novel synthetic bone substitutes in the reconstruction of large segmental bone defects in sheep tibiae. ACTA ACUST UNITED AC 2016; 11:015016. [PMID: 26894676 DOI: 10.1088/1748-6041/11/1/015016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The treatment of large bone defects, particularly those with segmental bone loss, remains a significant clinical challenge as current approaches involving surgery or bone grafting often do not yield satisfactory long-term outcomes. This study reports the evaluation of novel ceramic scaffolds applied as bone graft substitutes in a clinically relevant in vivo model. Baghdadite scaffolds, unmodified or modified with a polycaprolactone coating containing bioactive glass nanoparticles, were implanted into critical-sized segmental bone defects in sheep tibiae for 26 weeks. Radiographic, biomechanical, μ-CT and histological analyses showed that both unmodified and modified baghdadite scaffolds were able to withstand physiological loads at the defect site, and induced substantial bone formation in the absence of supplementation with cells or growth factors. Notably, all samples showed significant bridging of the critical-sized defect (average 80%) with evidence of bone infiltration and remodelling within the scaffold implant. The unmodified and modified baghdadite scaffolds achieved similar outcomes of defect repair, although the latter may have an initial mechanical advantage due to the nanocomposite coating. The baghdadite scaffolds evaluated in this study hold potential for use as purely synthetic bone graft substitutes in the treatment of large bone defects while circumventing the drawbacks of autografts and allografts.
Collapse
Affiliation(s)
- Jiao Jiao Li
- Biomaterials and Tissue Engineering Research Unit, School of AMME, University of Sydney, Sydney, NSW 2006, Australia. These authors contributed equally
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Berner A, Henkel J, Woodruff MA, Saifzadeh S, Kirby G, Zaiss S, Gohlke J, Reichert JC, Nerlich M, Schuetz MA, Hutmacher DW. Scaffold-cell bone engineering in a validated preclinical animal model: precursors vs differentiated cell source. J Tissue Eng Regen Med 2015; 11:2081-2089. [PMID: 26648044 DOI: 10.1002/term.2104] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 09/08/2015] [Accepted: 10/05/2015] [Indexed: 01/09/2023]
Abstract
The properties of osteoblasts (OBs) isolated from the axial skeleton (tOBs) differ from OBs of the orofacial skeleton (mOBs) due to the different embryological origins of the bones. The aim of the study was to assess and compare the regenerative potential of allogenic bone marrow-derived mesenchymal progenitor cells with allogenic tOBs and allogenic mOBs in combination with a mPCL-TCP scaffold in critical-sized segmental bone defects in sheep tibiae. After 6 months, the tibiae were explanted and underwent biomechanical testing, micro-computed tomography (microCT) and histological and immunohistochemical analyses. Allogenic MPCs demonstrated a trend towards a better outcome in biomechanical testing and the mean values of newly formed bone. Biomechanical, microCT and histological analysis showed no significant differences in the bone regeneration potential of tOBs and mOBs in our in vitro study, as well as in the bone regeneration potential of different cell types in vivo. Copyright © 2015 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- A Berner
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Trauma Surgery, University of Regensburg, Germany
| | - J Henkel
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - M A Woodruff
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - S Saifzadeh
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - G Kirby
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - S Zaiss
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Trauma Surgery, University of Regensburg, Germany
| | - J Gohlke
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - J C Reichert
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Orthopaedics and Accident Surgery, Waldkrankenhaus Protestant Hospital, Berlin, Germany
| | - M Nerlich
- Department of Trauma Surgery, University of Regensburg, Germany
| | - M A Schuetz
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - D W Hutmacher
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
32
|
Alayan J, Vaquette C, Saifzadeh S, Hutmacher D, Ivanovski S. A histomorphometric assessment of collagen-stabilized anorganic bovine bone mineral in maxillary sinus augmentation - a randomized controlled trial in sheep. Clin Oral Implants Res 2015; 27:734-43. [PMID: 26147764 DOI: 10.1111/clr.12652] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To histomorphometrically compare the use of collagen-stabilized anorganic bovine bone (ABBM-C) (test) to anorganic bovine bone + autogenous bone (ABBM + AB) (control) in maxillary sinus augmentation. MATERIALS AND METHODS Nine sheep underwent bilateral sinus augmentation. Each sinus was randomized to receive either control or test bone graft. Three animals were sacrificed at 8 weeks, and six animals were sacrificed at 16 weeks post-grafting. The 18 sinuses were processed for histomorphometry, which assessed the area fraction of new bone (%NB), residual graft (%RG) and soft tissue components (% STM), as well as graft particle osseointegration (% OI), within three zones equally distributed from the augmented sinus floor. RESULTS At week 16, a significant increase in %NB was evident across all three zones in the control group when compared to week 8. A significantly greater %NB was evident in the control group when compared to the test group in zones 2 (P < 0.001) and 3 (P < 0.001). There was a significant increase in %OI in week 16 when compared to week 8 across all three zones in the control group (P < 0.001). %OI in the control group was significantly greater across all three zones when compared to the test group at week 16 (P < 0.001). Zone was found to be a significant main effect (P < 0.001) that was independent of time and treatment with decreasing %OI in distant zones. %RG did not significantly change with time for both groups. There was a significant reduction in %ST in week 16 when compared to week 8 across all three zones in the control group (P < 0.001). %ST in the test group was significantly greater across all zones when compared to the control group at week 16 (P < 0.001). CONCLUSION Both groups exhibited very similar histomorphometric measurements in the zones proximal to the resident sinus wall. The % NB and % OI were greatest in the zones proximal to resident bony walls and gradually decreased as the distance from the proximal walls increased. There was greater % NB and % OI in the control group when compared to the test group in the distant zone.
Collapse
Affiliation(s)
- Jamil Alayan
- School of Dentistry and Oral Health, Centre for Medicine and Oral Health, Griffith University, Southport, Qld, Australia
| | - Cedryck Vaquette
- Institute for Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld, Australia
| | - Siamak Saifzadeh
- Institute for Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld, Australia
| | - Dietmar Hutmacher
- Institute for Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld, Australia
| | - Saso Ivanovski
- School of Dentistry and Oral Health, Centre for Medicine and Oral Health, Griffith University, Southport, Qld, Australia
| |
Collapse
|
33
|
Yong MRNO, Saifzadeh S, Woodruff M, Askin GN, Labrom RD, Hutmacher DW, Adam CJ. Erratum to: Biological performance of a polycaprolactone-based scaffold plus recombinant human morphogenetic protein-2 (rhBMP-2) in an ovine thoracic interbody fusion model. Eur Spine J 2015; 24:871. [PMID: 25663643 DOI: 10.1007/s00586-015-3780-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Mostyn R N O Yong
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60, Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia,
| | | | | | | | | | | | | |
Collapse
|
34
|
Yong MRNO, Savi FM, Woodruff MA, Saifzadeh S, Askin GN, Labrom RD, Hutmacher DW, Adam CJ. Longitudinal performance of polycaprolactone-based scaffold plus recombinant human morphogenetic protein-2 (rhBMP-2) in large preclinical animal model: 6- versus 12 months. Scoliosis 2015. [PMCID: PMC4340250 DOI: 10.1186/1748-7161-10-s1-o58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
35
|
Berner A, Woodruff M, Lam C, Arafat M, Saifzadeh S, Steck R, Ren J, Nerlich M, Ekaputra A, Gibson I, Hutmacher D. Effects of scaffold architecture on cranial bone healing. Int J Oral Maxillofac Surg 2014; 43:506-13. [DOI: 10.1016/j.ijom.2013.05.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 04/11/2013] [Accepted: 05/14/2013] [Indexed: 11/26/2022]
|
36
|
Hobbenaghi R, Mahboob P, Saifzadeh S, Javanbakht J, Manesh JYY, Mortezaee R, Touni SR, Hosseini E, Aghajanshakeri S, Moloudizargari M, Javaherypour S. Histopathological features of bone regeneration in a canine segmental ulnar defect model. Diagn Pathol 2014; 9:59. [PMID: 24636669 PMCID: PMC3995496 DOI: 10.1186/1746-1596-9-59] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 03/07/2014] [Indexed: 11/27/2022] Open
Abstract
Background Today, finding an ideal biomaterial to treat the large bone defects, delayed unions and non-unions remains a challenge for orthopaedic surgeions and researchers. Several studies have been carried out on the subject of bone regeneration, each having its own advantages. The present study has been designed in vivo to evaluate the effects of cellular auto-transplantation of tail vertebrae on healing of experimental critical bone defect in a dog model. Methods Six indigenous breeds of dog with 32 ± 3.6 kg average weight from both sexes (5 males and 1 female) received bilateral critical-sized ulnar segmental defects. After determining the health condition, divided to 2 groups: The Group I were kept as control I (n = 1) while in Group II (experimental group; n = 5) bioactive bone implants were inserted. The defects were implanted with either autogeneic coccygeal bone grafts in dogs with 3-4 cm diaphyseal defects in the ulna. Defects were stabilized with internal plate fixation, and the control defects were not stabilized. Animals were euthanized at 16 weeks and analyzed by histopathology. Results Histological evaluation of this new bone at sixteen weeks postoperatively revealed primarily lamellar bone, with the formation of new cortices and normal-appearing marrow elements. And also reformation cortical compartment and reconstitution of marrow space were observed at the graft-host interface together with graft resorption and necrosis responses. Finally, our data were consistent with the osteoconducting function of the tail autograft. Conclusions Our results suggested that the tail vertebrae autograft seemed to be a new source of autogenous cortical bone in order to supporting segmental long bone defects in dogs. Furthermore, cellular autotransplantation was found to be a successful replacement for the tail vertebrae allograft bone at 3-4 cm segmental defects in the canine mid- ulna. Clinical application using graft expanders or bone autotransplantation should be used carefully and requires further investigation. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2028232688119271.
Collapse
Affiliation(s)
| | | | | | - Javad Javanbakht
- Department of Pathobiology, Faculty of Veterinary Medicine, Tehran University, Tehran, Iran.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Yong MRNO, Saifzadeh S, Askin GN, Labrom RD, Hutmacher DW, Adam CJ. Biological performance of a polycaprolactone-based scaffold plus recombinant human morphogenetic protein-2 (rhBMP-2) in an ovine thoracic interbody fusion model. Eur Spine J 2014; 23:650-7. [PMID: 24253932 PMCID: PMC3940801 DOI: 10.1007/s00586-013-3085-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 10/25/2013] [Accepted: 10/26/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE We develop a sheep thoracic spine interbody fusion model to study the suitability of polycaprolactone-based scaffold and recombinant human bone morphogenetic protein-2 (rhBMP-2) as a bone graft substitute within the thoracic spine. The surgical approach is a mini-open thoracotomy with relevance to minimally invasive deformity correction surgery for adolescent idiopathic scoliosis. To date there are no studies examining the use of this biodegradable implant in combination with biologics in a sheep thoracic spine model. METHODS In the present study, six sheep underwent a 3-level (T6/7, T8/9 and T10/11) discectomy with randomly allocated implantation of a different graft substitute at each of the three levels: (a) calcium phosphate (CaP) coated polycaprolactone-based scaffold plus 0.54 μg rhBMP-2 (b) CaP-coated PCL-based scaffold alone or (c) autograft (mulched rib head). Fusion was assessed at 6 months post-surgery. RESULTS Computed Tomographic scanning demonstrated higher fusion grades in the rhBMP-2 plus PCL-based scaffold group in comparison with either PCL-based scaffold alone or autograft. These results were supported by histological evaluations of the respective groups. Biomechanical testing revealed significantly higher stiffness for the rhBMP-2 plus PCL-based scaffold group in all loading directions in comparison with the other two groups. CONCLUSION The results of this study demonstrate that rhBMP-2 plus PCL-based scaffold is a viable bone graft substitute, providing an optimal environment for thoracic interbody spinal fusion in a large animal model.
Collapse
Affiliation(s)
- Mostyn R N O Yong
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60, Musk Avenue, Kelvin Grove, Brisbane, QLD 4059 Australia
| | - Siamak Saifzadeh
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60, Musk Avenue, Kelvin Grove, Brisbane, QLD 4059 Australia
| | - Geoffrey N Askin
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60, Musk Avenue, Kelvin Grove, Brisbane, QLD 4059 Australia
| | - Robert D Labrom
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60, Musk Avenue, Kelvin Grove, Brisbane, QLD 4059 Australia
| | - Dietmar W Hutmacher
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60, Musk Avenue, Kelvin Grove, Brisbane, QLD 4059 Australia
| | - Clayton J Adam
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60, Musk Avenue, Kelvin Grove, Brisbane, QLD 4059 Australia
| |
Collapse
|
38
|
Cipitria A, Reichert JC, Epari DR, Saifzadeh S, Berner A, Schell H, Mehta M, Schuetz MA, Duda GN, Hutmacher DW. Polycaprolactone scaffold and reduced rhBMP-7 dose for the regeneration of critical-sized defects in sheep tibiae. Biomaterials 2013; 34:9960-8. [DOI: 10.1016/j.biomaterials.2013.09.011] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
|
39
|
Yong MRNO, Saifzadeh S, Askin GN, Labrom RD, Hutmacher DW, Adam CJ. Establishment and characterization of an open mini-thoracotomy surgical approach to an ovine thoracic spine fusion model. Tissue Eng Part C Methods 2013; 20:19-27. [PMID: 23600860 DOI: 10.1089/ten.tec.2012.0746] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
A large animal model is required for the assessment of minimally invasive, tissue-engineering-based approaches to thoracic spine fusion, with relevance to deformity correction surgery for human adolescent idiopathic scoliosis. Here, we develop a novel open mini-thoracotomy approach in an ovine model of thoracic interbody fusion that allows the assessment of various fusion constructs, with a focus on novel, tissue-engineering-based interventions. The open mini-thoracotomy surgical approach was developed through a series of mock surgeries, and then applied in a live sheep study. Customized scaffolds were manufactured to conform with intervertebral disc space clearances that were required of the study. Six male Merino sheep aged 4-6 years and weighing 35-45 kg underwent the procedure mentioned earlier and were alloted a survival timeline of 6 months. Each sheep underwent a three-level discectomy (T6/7, T8/9, and T10/11) with a randomly allocated implantation of a different graft substitute at each of the following three levels: (1) polycaprolactone (PCL)-based scaffold plus 0.54 μg recombinant human bone morphogenetic protein-2 (rhBMP-2); (2) PCL-based scaffold alone; or (3) autograft. The sheep were closely monitored postoperatively for signs of pain (i.e., gait abnormalities/teeth gnawing/social isolation). Fusion assessments were conducted postsacrifice using computed tomography and hard-tissue histology. All scientific work was undertaken in accordance with the study protocol that was approved by the Institute's committee on animal research. All six sheep were successfully operated on and reached the allotted survival timeline, thereby demonstrating the feasibility of the surgical procedure and postoperative care. There were no significant complications and during the postoperative period, the animals did not exhibit marked signs of distress according to the previously described assessment criteria. Computed tomographic scanning demonstrated higher fusion grades in the rhBMP-2 plus PCL-based scaffold group in comparison to either PCL-based scaffold alone or autograft. These results were supported by a histological evaluation of the respective groups. This novel open mini-thoracotomy surgical approach to the ovine thoracic spine represents a safe surgical method that can reproducibly form the platform for research into various spine-tissue-engineered constructs and their fusion-promoting properties.
Collapse
|
40
|
Reichert JC, Berner A, Saifzadeh S, Hutmacher DW. Preclinical Animal Models for Segmental Bone Defect Research and Tissue Engineering. Regen Med 2013. [DOI: 10.1007/978-94-007-5690-8_40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
41
|
Reichert JC, Cipitria A, Epari DR, Saifzadeh S, Krishnakanth P, Berner A, Woodruff MA, Schell H, Mehta M, Schuetz MA, Duda GN, Hutmacher DW. A tissue engineering solution for segmental defect regeneration in load-bearing long bones. Sci Transl Med 2012; 4:141ra93. [PMID: 22764209 DOI: 10.1126/scitranslmed.3003720] [Citation(s) in RCA: 242] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The reconstruction of large defects (>10 mm) in humans usually relies on bone graft transplantation. Limiting factors include availability of graft material, comorbidity, and insufficient integration into the damaged bone. We compare the gold standard autograft with biodegradable composite scaffolds consisting of medical-grade polycaprolactone and tricalcium phosphate combined with autologous bone marrow-derived mesenchymal stem cells (MSCs) or recombinant human bone morphogenetic protein 7 (rhBMP-7). Critical-sized defects in sheep--a model closely resembling human bone formation and structure--were treated with autograft, rhBMP-7, or MSCs. Bridging was observed within 3 months for both the autograft and the rhBMP-7 treatment. After 12 months, biomechanical analysis and microcomputed tomography imaging showed significantly greater bone formation and superior strength for the biomaterial scaffolds loaded with rhBMP-7 compared to the autograft. Axial bone distribution was greater at the interfaces. With rhBMP-7, at 3 months, the radial bone distribution within the scaffolds was homogeneous. At 12 months, however, significantly more bone was found in the scaffold architecture, indicating bone remodeling. Scaffolds alone or with MSC inclusion did not induce levels of bone formation comparable to those of the autograft and rhBMP-7 groups. Applied clinically, this approach using rhBMP-7 could overcome autograft-associated limitations.
Collapse
Affiliation(s)
- Johannes C Reichert
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland 4059, Australia
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Reichert JC, Epari DR, Wullschleger ME, Berner A, Saifzadeh S, Nöth U, Dickinson IC, Schuetz MA, Hutmacher DW. [Bone tissue engineering. Reconstruction of critical sized segmental bone defects in the ovine tibia]. Orthopade 2012; 41:280-7. [PMID: 22476418 DOI: 10.1007/s00132-011-1855-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Well-established therapies for bone defects are restricted to bone grafts which face significant disadvantages (limited availability, donor site morbidity, insufficient integration). Therefore, the objective was to develop an alternative approach investigating the regenerative potential of medical grade polycaprolactone-tricalcium phosphate (mPCL-TCP) and silk-hydroxyapatite (silk-HA) scaffolds.Critical sized ovine tibial defects were created and stabilized. Defects were left untreated, reconstructed with autologous bone grafts (ABG) and mPCL-TCP or silk-HA scaffolds. Animals were observed for 12 weeks. X-ray analysis, torsion testing and quantitative computed tomography (CT) analyses were performed. Radiological analysis confirmed the critical nature of the defects. Full defect bridging occurred in the autograft and partial bridging in the mPCL-TCP group. Only little bone formation was observed with silk-HA scaffolds. Biomechanical testing revealed a higher torsional moment/stiffness (p < 0.05) and CT analysis a significantly higher amount of bone formation for the ABG group when compared to the silk-HA group. No significant difference was determined between the ABG and mPCL-TCP groups. The results of this study suggest that mPCL-TCP scaffolds combined can serve as an alternative to autologous bone grafting in long bone defect regeneration. The combination of mPCL-TCP with osteogenic cells or growth factors represents an attractive means to further enhance bone formation.
Collapse
Affiliation(s)
- J C Reichert
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australien.
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Fan W, Wu C, Miao X, Liu G, Saifzadeh S, Sugiyama S, Afara I, Crawford R, Xiao Y. Biomaterial scaffolds in cartilage–subchondral bone defects influencing the repair of autologous articular cartilage transplants. J Biomater Appl 2012; 27:979-89. [DOI: 10.1177/0885328211431310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The repair of articular cartilage typically involves the repair of cartilage–subchondral bone tissue defects. Although various bioactive materials have been used to repair bone defects, how these bioactive materials in subchondral bone defects influence the repair of autologous cartilage transplant remains unclear. The aim of this study was to investigate the effects of different subchondral biomaterial scaffolds on the repair of autologous cartilage transplant in a sheep model. Cylindrical cartilage–subchondral bone defects were created in the right femoral knee joint of each sheep. The subchondral bone defects were implanted with hydroxyapatite–β-tricalcium phosphate (HA–TCP), poly lactic-glycolic acid (PLGA)-HA–TCP dual-layered composite scaffolds (PLGA/HA–TCP scaffolds), or autologous bone chips. The autologous cartilage layer was placed on top of the subchondral materials. After 3 months, the effect of different subchondral scaffolds on the repair of autologous cartilage transplant was systematically studied by investigating the mechanical strength, structural integration, and histological responses. The results showed that the transplanted cartilage layer supported by HA–TCP scaffolds had better structural integration and higher mechanical strength than that supported by PLGA/HA–TCP scaffolds. Furthermore, HA–TCP-supported cartilage showed higher expression of acid mucosubstances and glycol-amino-glycan contents than that supported by PLGA/HA–TCP scaffolds. Our results suggested that the physicochemical properties, including the inherent mechanical strength and material chemistry of the scaffolds, play important roles in influencing the repair of autologous cartilage transplants. The study may provide useful information for the design and selection of proper subchondral biomaterials to support the repair of both subchondral bone and cartilage defects.
Collapse
Affiliation(s)
- Wei Fan
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
- Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, People’s Republic of China
| | - Chengtie Wu
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
| | - Xigeng Miao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
| | - Gang Liu
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
| | - Siamak Saifzadeh
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
| | - Sadahiro Sugiyama
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
| | - Isaac Afara
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
| | - Ross Crawford
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia
| |
Collapse
|
44
|
Berner A, Boerckel JD, Saifzadeh S, Steck R, Ren J, Vaquette C, Zhang JQ, Nerlich M, Guldberg RE, Hutmacher DW, Woodruff MA. Biomimetic tubular nanofiber mesh and platelet rich plasma-mediated delivery of BMP-7 for large bone defect regeneration. Cell Tissue Res 2012; 347:603-12. [DOI: 10.1007/s00441-011-1298-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 12/07/2011] [Indexed: 10/25/2022]
|
45
|
Reichert JC, Epari DR, Wullschleger ME, Saifzadeh S, Steck R, Lienau J, Sommerville S, Dickinson IC, Schütz MA, Duda GN, Hutmacher DW. Establishment of a preclinical ovine model for tibial segmental bone defect repair by applying bone tissue engineering strategies. Tissue Eng Part B Rev 2010; 16:93-104. [PMID: 19795978 DOI: 10.1089/ten.teb.2009.0455] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Currently, well-established clinical therapeutic approaches for bone reconstruction are restricted to the transplantation of autografts and allografts, and the implantation of metal devices or ceramic-based implants to assist bone regeneration. Bone grafts possess osteoconductive and osteoinductive properties; however, they are limited in access and availability and associated with donor-site morbidity, hemorrhage, risk of infection, insufficient transplant integration, graft devitalization, and subsequent resorption resulting in decreased mechanical stability. As a result, recent research focuses on the development of alternative therapeutic concepts. The field of tissue engineering has emerged as an important approach to bone regeneration. However, bench-to-bedside translations are still infrequent as the process toward approval by regulatory bodies is protracted and costly, requiring both comprehensive in vitro and in vivo studies. The subsequent gap between research and clinical translation, hence, commercialization, is referred to as the "Valley of Death" and describes a large number of projects and/or ventures that are ceased due to a lack of funding during the transition from product/technology development to regulatory approval and subsequently commercialization. One of the greatest difficulties in bridging the Valley of Death is to develop good manufacturing processes and scalable designs and to apply these in preclinical studies. In this article, we describe part of the rationale and road map of how our multidisciplinary research team has approached the first steps to translate orthopedic bone engineering from bench to bedside by establishing a preclinical ovine critical-sized tibial segmental bone defect model, and we discuss our preliminary data relating to this decisive step.
Collapse
Affiliation(s)
- Johannes C Reichert
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Saifzadeh S, Pourreza B, Hobbenaghi R, Naghadeh BD, Kazemi S. Autogenous greater omentum, as a free nonvascularized graft, enhances bone healing: an experimental nonunion model. J INVEST SURG 2009; 22:129-37. [PMID: 19283616 DOI: 10.1080/08941930802566730] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Reconstruction of vascularity is an early event in fracture healing and upregulation of angiogenesis may therefore promote the formation of bone. We have investigated the potentiality of autogenous free nonvascularized greater omentum to stimulate the formation of bone in an experimental hypertrophic nonunion model. Twelve dogs assigned into two identical groups underwent a standard nonunion operation. In the experimental group, this was followed by application of autogenous greater omentum as a free nonvascularized graft around the osteotomy gap. Radiographic assessments were conducted time-sequentially until euthanasia 16 weeks after surgery. Histological analysis was performed on the mid-radial diaphysis containing the 4-month-old osteotomy site. Radiological and histological properties of the group treated with free transplant of the greater omentum revealed complete union. In contrast, there was no evidence indicating union in the control group. Analyses of the radiological and histological scores confirmed that osteotomies treated with free transplant of the autogenous greater omentum had united, whereas the osteotomies of the control group failed to unite. Significant differences between the mean values for radiological and histological-grading score in the control and experimental groups were detected (p < 0.05). We showed that free graft of autogenous greater omentum could stimulate the formation of competent bone in an environment deprived of its normal vascularization. Hence, it could be recommended to enhance healing when the fractures are at risk of nonunion.
Collapse
Affiliation(s)
- Siamak Saifzadeh
- Department of Clinical Sciences College of Veterinary Medicine, Urmia University, Urmia, Iran.
| | | | | | | | | |
Collapse
|
47
|
Saifzadeh S, Hobbenaghi R, Asadolahi A. Linear esophagotomy reinforcement with nonvascularized omental autograft (NOA). J INVEST SURG 2009; 22:207-13. [PMID: 19466659 DOI: 10.1080/08941930902866253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Esophagotomy is commonly complicated by dehiscence and leakage. Recent studies provided evidence that omentopexy may reinforce the esophageal suture line and decrease the rate of postoperative complications. The use of nonvascularized omental autograft (NOA) to strengthen the linear esophagotomy wound is novel and this was derived from its successful use in other location by Saifzadeh et al. The goal of the current study was to examine the role of NOA on the healing quality of primary esophagotomy wound. Linear esophageal incisions of 8-10 mm were made at the cervical esophagus in 20 New Zealand white rabbits, which were assigned to two identical groups (10 rabbits in each group). The incisions were sutured in both groups but additionally covered by NOA in Group Pi. Twenty-eight days after the operations, the experimental animals were killed, and identical segments of the esophagus with the esophagotomy line at the center were removed. The intact specimens were evaluated for bursting pressure and histologic appearance. Bursting pressure was higher in Group Pi. Microscopic evaluation in Group Pi rabbits revealed the participation of NOA in esophagotomy healing, tough complete epithelial regeneration, marked neovascularization, and muscular regeneration and overgrowth. This study showed demonstrable benefit from the use of NOA in reinforcement of cervical esophagotomy. To the best of our knowledge, this is the first report of strengthening of the esophageal suture line with the transplantation of NOA.
Collapse
Affiliation(s)
- Siamak Saifzadeh
- Department of Clinical Sciences, College of Veterinary Medicine, Urmia University, Urmia, Iran.
| | | | | |
Collapse
|
48
|
Reichert JC, Saifzadeh S, Wullschleger ME, Epari DR, Schütz MA, Duda GN, Schell H, van Griensven M, Redl H, Hutmacher DW. The challenge of establishing preclinical models for segmental bone defect research. Biomaterials 2009; 30:2149-63. [PMID: 19211141 DOI: 10.1016/j.biomaterials.2008.12.050] [Citation(s) in RCA: 255] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Accepted: 12/19/2008] [Indexed: 01/17/2023]
Abstract
A considerable number of international research groups as well as commercial entities work on the development of new bone grafting materials, carriers, growth factors and specifically tissue-engineered constructs for bone regeneration. They are strongly interested in evaluating their concepts in highly reproducible large segmental defects in preclinical and large animal models. To allow comparison between different studies and their outcomes, it is essential that animal models, fixation devices, surgical procedures and methods of taking measurements are well standardized to produce reliable data pools and act as a base for further directions to orthopaedic and tissue engineering developments, specifically translation into the clinic. In this leading opinion paper, we aim to review and critically discuss the different large animal bone defect models reported in the literature. We conclude that most publications provide only rudimentary information on how to establish relevant preclinical segmental bone defects in large animals. Hence, we express our opinion on methodologies to establish preclinical critically sized, segmental bone defect models used in past research with reference to surgical techniques, fixation methods and postoperative management focusing on tibial fracture and segmental defect models.
Collapse
Affiliation(s)
- Johannes C Reichert
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, 60 Musk Avenue, Kelvin Grove, Qld 4059, Australia.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Saifzadeh S, Hobbenaghi R, Asri-Rezaei S, Shokouhi S J F, Dalir-Naghadeh B, Rohi S M. Evaluation of 'Section-Ligation-Release (SLR)' technique devised for castration in the stallion. Reprod Domest Anim 2008; 43:678-84. [PMID: 18507795 DOI: 10.1111/j.1439-0531.2007.00969.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A novel technique [Section-Ligation-Release (SLR)] was evaluated for castration in the horse. Clinical traits, serum testosterone concentrations after challenge with human chorionic gonadotrophin (hCG), and histopathological changes of the testicular tissue were assessed. Five stallions, aged 24-48 months, were castrated using SLR technique under general anaesthesia. Both spermatic cords in each stallion were exposed at the scrotal neck by two 5-cm long incisions, followed by sharp dissection through the parietal vaginal tunic. Both vascular and non-vascular structures in the cords were triple clamped, transected and ligated. Both testes were left in situ. Serum testosterone concentrations were measured pre-operatively and at 2 months after castration following IV administration of 1 x 10(4) IU of hCG. Both testes from each castrate were collected at 2 months for histopathologic examination. SLR castration was successfully achieved. Moderated scrotal and preputial swelling was the only experienced short-term complication. Serum testosterone concentrations were significantly lower than basal pre-operative levels at 2 months after castration, and did not respond to hCG. On histopathology, hyalinization of the seminiferous tubules and loss of testicular interstitial tissue were indicative of complete avascular necrosis. This novel primary closure castration technique of stallion is a simple practical method, with minimal post-operative complications; and could be safely advocated as an alternative to the traditional castration techniques allowing for second intention healing of scrotal wounds.
Collapse
Affiliation(s)
- S Saifzadeh
- Department of Clinical Sciences, Urmia University, Urmia, Iran.
| | | | | | | | | | | |
Collapse
|
50
|
Shokouhi S F, Saifzadeh S, Tajik H, Hobbi S. The Efficacy of Aqueous Extract of Iranian Garlic on the Healing of Burn Wound: A Clinical and Microbiological Study. ACTA ACUST UNITED AC 2008. [DOI: 10.3923/ajava.2008.162.168] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|