Abstract
The need for a suitable tissue-engineered scaffold that can be used to heal load-bearing segmental bone defects (SBDs) is both immediate and increasing. During the past 30 years, various ceramic and polymer scaffolds have been investigated for this application. More recently, while composite scaffolds built using a combination of ceramics and polymeric materials are being investigated in a greater number, very few products have progressed from laboratory benchtop studies to preclinical testing in animals. This review is based on an exhaustive literature search of various composite scaffolds designed to serve as bone regenerative therapies. We analyzed the benefits and drawbacks of different composite scaffold manufacturing techniques, the properties of commonly used ceramics and polymers, and the properties of currently investigated synthetic composite grafts. To follow, a comprehensive review of in vivo models used to test composite scaffolds in SBDs is detailed to serve as a guide to design appropriate translational studies and to identify the challenges that need to be overcome in scaffold design for successful translation. This includes selecting the animal type, determining the anatomical location within the animals, choosing the correct study duration, and finally, an overview of scaffold performance assessment.
Highlights
Orthopedic injuries have been a major area of concern in medicine
Summary and Perspectives The clinical issues surrounding the treatment of load bearing segmental bone defects (SBD) need a multi-pronged approach for treatment
Current strategies focus on a combination of osteoconductive substrates delivering osteoinductive growth factors and osteogenic cell sources
Summary
Orthopedic injuries have been a major area of concern in medicine. In the late 1990’s, it was estimated that 7 million fractures occurred each year in the US alone [1, 2], and the total medical costs associated with all musculoskeletal conditions added up to nearly $215 billion/year [1,2,3]. Hybrid Bone Scaffolds Even though there are many advantages to CaPs, the drawbacks are significant and include mechanical instability, difficulty at shaping and forming it into a specific architecture, its long degradation rate and possible bioactivity issues. The challenge in developing a tissue engineered scaffold with ideal properties is to find a way to combine these completely different materials together, while maintaining a porous architecture and adequate mechanical properties that favor bone formation.
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