Abstract

Bone is a dynamic organ with high regenerative potential and provides essential biological functions in the body, such as providing body mobility and protection of internal organs, regulating hematopoietic cell homeostasis, and serving as important mineral reservoir. Bone defects, which can be caused by trauma, cancer and bone disorders, pose formidable public health burdens. Even though autologous bone grafts, allografts, or xenografts have been used clinically, repairing large bone defects remains as a significant clinical challenge. Bone tissue engineering (BTE) emerged as a promising solution to overcome the limitations of autografts and allografts. Ideal bone tissue engineering is to induce bone regeneration through the synergistic integration of biomaterial scaffolds, bone progenitor cells, and bone-forming factors. Successful stem cell-based BTE requires a combination of abundant mesenchymal progenitors with osteogenic potential, suitable biofactors to drive osteogenic differentiation, and cell-friendly scaffold biomaterials. Thus, the crux of BTE lies within the use of cell-friendly biomaterials as scaffolds to overcome extensive bone defects. In this review, we focus on the biocompatibility and cell-friendly features of commonly used scaffold materials, including inorganic compound-based ceramics, natural polymers, synthetic polymers, decellularized extracellular matrix, and in many cases, composite scaffolds using the above existing biomaterials. It is conceivable that combinations of bioactive materials, progenitor cells, growth factors, functionalization techniques, and biomimetic scaffold designs, along with 3D bioprinting technology, will unleash a new era of complex BTE scaffolds tailored to patient-specific applications.

Highlights

  • Considered as one of a few organs with high regenerative potential, bone is a dynamic form of connective tissue with complex cellular composition and highly specialized organicinorganic architecture (Perez et al, 2018)

  • We recently demonstrated that a pH-triggered, selfassembled, and bioprintable hybrid hydrogel scaffold composited with carboxymethyl chitosan and amorphous calcium phosphate exhibited excellent biocompatibility and promoted bone formation in vivo (Zhao et al, 2019)

  • We showed that when graphene oxide was incorporated into poly(polyethylene glycol citrate-coNisopropylacrylamide) (PPCN) to fabricate the resultant hybrid materials referred to as GO-P, the composite scaffold maintained the thermoresponsive behavior of PPCN, effectively supporting BMSC survival and proliferation (Zhao et al, 2018)

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Summary

Introduction

Considered as one of a few organs with high regenerative potential, bone is a dynamic form of connective tissue with complex cellular composition and highly specialized organicinorganic architecture (Perez et al, 2018). Repairing large bone defects represents a challenge for musculoskeletal surgeons. Millions suffer from a decreased quality of life as a result of segmental bone defects caused by trauma, tumors, and other musculoskeletal pathologies (Dimitriou et al, 2011). Despite its remarkable remodeling potential of small defects, human bone tissue is unable to bridge and heal large segmental defects. Autologous bone graft has been the gold standard for reconstruction of large bony deficiencies (Herford et al, 2011). Allografts and xenografts may be the first alternatives to autografts, but they have the risk of transmission of infectious agents. Allografts may be slow to incorporate or can even be rejected (Campana et al, 2014)

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