Jan 22, 2018 | By Tess
A collaborative research team from Harvard’s Wyss Institute, the Julius Wolff Institute, the Berlin-Brandenburg Center for Regenerative Therapies, and Charité’s Center for Musculoskeletal Surgery has come together to study the benefits of 3D printed titanium-mesh scaffolds in implants. The preclinical study, which was recently published in the journal Science Translational Medicine, reports that 3D printed scaffolds do indeed help to optimize bone regeneration in patients.
Within the medical field, the treatment of large bone defects or injuries has remained a tricky area. People who have suffered serious defects in either their upper or lower extremities due to an infection, cancer, or trauma must often undergo amputation, as it has been historically difficult to regrow or fix bone tissue that has been damaged beyond a certain point.
One existing treatment has consisted of creating customized bone grafts from the patient’s own bone tissue, though success rates of this method have been not been great.
According to the recent report, however, customized 3D printed titanium-mesh scaffolds could be a potential solution to the medical challenge, as the implants promote and enable natural bone regeneration.
A team from the Charité's Center for Musculoskeletal Surgery have demonstrated the ability to design and manufacture customized 3D printed scaffolds to treat large bone defects. Using a CT scan of the patient in question’s bones, the medical team can generate a 3D model of the defective bone.
Based on this digital model, a custom-fit scaffold can be 3D modeled and subsequently sent to be made out of medical-grade titanium using a laser sintering 3D printer. The resulting product is a 3D printed titanium implant notable for its porous, scaffold structure.
It is this 3D printed structure that is crucial to promoting bone regeneration, as it allows the doctors to fill the implant with the patient’s bone tissue, growth factors, and bone replacement material. Notably, the 3D printed mesh structures have been mechanically optimized to “further enhance the healing process.”
As Dr. Anne-Marie Pobloth, a veterinarian from the Julius Wolff Institute at Charité, explained: “[My team] started by using computer modeling to mechanobiologically optimize a standard-size scaffold. Using a large animal model, we were then able to study its actual effects on bone regeneration. As the process of bone regeneration is very similar to that found in humans, we were able to make inferences regarding bone healing in humans.”
So far, the Charité Center for Musculoskeletal Surgery has implanted customized 3D printed bone implants into a total of 19 patients, all of whom have shows promising results.
The 3D printed implants themselves are characterized by a honeycomb-like structure which is constructed in such a way than small channels are formed which promote and guide bone regeneration. Importantly, the researchers found they could alter the stiffness of the implant by changing the strut diameter of the honeycomb structure, which allowed them to test the effectiveness of varying stiffnesses.
“We assumed that bone regrowth would vary according to the stiffness of the implanted scaffold,” said Dr. Georg N. Nuda, director of the Julius Wolff Center for Biomechanics and Musculoskeletal Regeneration. “Therefore, in order to study the effects of mechanical stimulation during the bone regeneration process, we used four test groups receiving implants of varying stiffness.”
The results of these tests showed that softer implants were more conducive to bone regeneration. Trauma surgeon PF Dr. Philipp Schwabe explained: “Even after only three months, radiographic evidence showed that soft implants, produced faster bone growth in response to increased mechanical stimulation than stiffer implants.”
In fact, the researchers found that the biomechanical properties of the 3D printed implants had a direct effect on how much bone formed and the quality of the regenerated bone.
Moving forward from this realization, the collaborative team is working on designing and producing softer, mechanobiologically optimized titanium-mesh scaffolds using 3D printing technologies. The team says that its technique could even be used to treat spinal, oral, and maxillofacial defects down the line.
Posted in 3D Printing Application
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