Abstract
ABSTRACTPurposeTo use a 3D printed poly (L-lactide) acid (PLLA) and hydroxyapatite (HA) composite as a bone substitute for reconstruction of a critical bone defect in the radius of rabbits.MethodsA 1.5 cm ostectomy was performed in the radial diaphysis of 60 New Zealand white rabbits. The rabbits were divided into three groups according to surgical treatment of the bone defect (group I – control, group II – bone graft, group III – 3D PLLA). Each group was divided into four subgroups with different radiographic and histopathologic evaluation times (T1 – 15 days, T2 – 30 days, T3 – 60 days, T4 – 90 days).ResultsThe implant group had greater clinically lameness (p = 0.02), edema (p = 0.007), pain (p = 0.04) and more complications at the surgical site (p = 0.03). Histologically, this group showed greater congestion (p = 0.04), hemorrhage (p = 0.04) and inflammation. Osteogenesis was microscopically similar between days (p = 0.54) and treatments (p = 0.17), even though radiographically, more effective bone healing occurred in the graft group (II), with more callus and bone bridge formation.ConclusionsThe customization of a 3D PLLA/HA scaffold was successful. However, in animals receiving the polymer-ceramic composite less bone callus and bone bridge was formed compared to the graft group.
Highlights
A bone defect, which is not expected to consolidate without surgical or complementary intervention, is defined as a critically sized defect[1]
Bone tissue engineering has recently offered a real alternative to autologous bone graft
The animals were divided into three groups according to the surgical treatment of the bone defect: control was composed of 20 animals without any grafting; in animals in the graft group, the bone defect was filled with an iliac crest autologous graft; animals in poly (L-lactide) acid (PLLA) received a 3D printed bone implant for reconstruction of the bone defect
Summary
A bone defect, which is not expected to consolidate without surgical or complementary intervention, is defined as a critically sized defect[1]. Such defects are typically associated with high energy trauma, open fractures, infections and resection of bone tumors. Especially when associated with osteomyelitis, vascular injuries and inadequate stabilization can create challenging repair scenarios[2,3]. Despite developments in bone tissue engineering, the treatment of critical sized defects has remained challenging, and complications have a significant economic impact[4]. Autologous bone graft has been the gold standard for treatment of bone defects. Bone tissue engineering has recently offered a real alternative to autologous bone graft. Biomaterials and manufacturing methods, including three-dimensional (3D) printing, have emerged to fabricate scaffolds to assist bone repair[5,6,7]
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