Scaffolds For Bone Engineering Research Articles

The synergistic effect of micro-topography and biochemical culture environment to promote angiogenesis and osteogenic differentiation of human mesenchymal stem cells

Critical failures associated with current engineered bone grafts involve insufficient induction of osteogenesis of the implanted cells and lack of vascular integration between graft scaffold and host tissue. This study investigated the combined effects of surface microtextures and biochemical supplements to achieve osteogenic differentiation of human mesenchymal stem cells (hMSCs) and revascularization of the implants in vivo. Cells were cultured on 10μm micropost-textured polydimethylsiloxane (PDMS) substrates in either proliferative basal medium (BM) or osteogenic medium (OM). In vitro data revealed that cells on microtextured substrates in OM had dense coverage of extracellular matrix, whereas cells in BM displayed more cell spreading and branching. Cells on microtextured substrates in OM demonstrated a higher gene expression of osteoblast-specific markers, namely collagen I, alkaline phosphatase, bone sialoprotein, and osteocalcin, accompanied by substantial amount of bone matrix formation and mineralization. To further investigate the osteogenic capacity, hMSCs on microtextured substrates under different biochemical stimuli were implanted into subcutaneous pockets on the dorsal aspect of immunocompromised mice to study capacity for ectopic bone formation. In vivo data revealed greater expression of osteoblast-specific markers coupled with increased vascular invasion on microtextured substrates with hMSCs cultured in OM. Together, these data represent a novel regenerative strategy that incorporates defined surface microtextures and biochemical stimuli to direct combined osteogenesis and re-vascularization of engineered bone scaffolds for musculoskeletal repair and relevant bone tissue engineering applications.

Enhancing osteoblast-affinity of titanium scaffolds for bone engineering by use of ultraviolet light treatment.

Ultraviolet (UV) treatment immediately prior to use is attracting attention as an effective surface conditioning method for titanium to improve osteoblast-affinity. The affinity of titanium to osteoblasts in two-dimensional plate culture has been well studied, but that in three-dimensional cultures remains unclear. Here, we examined the effect of UV treatment on titanium scaffolds, comprising micro-thin titanium fibers, used in bone engineering. Titanium scaffolds, with and without UV treatment, were seeded with rat bone marrow derived osteoblasts, and the number of cells attached to scaffolds and osteoblastic phenotype in the cultures were examined. UV treatment improved the wettability of scaffolds and significantly reduced the percentage of surface carbon. Along with these physicochemical changes in the scaffolds, cell attachment increased by a factor of 1.3 as compared to that of the untreated control. In addition, alkaline phosphatase activity and calcium deposition significantly increased by a factor of 2.3 and 2.0, respectively. Robust formation of mineralized structures consisting of clear peaks of calcium and phosphorus was observed in the UV-treated scaffolds. The observed increase in osteoblast affinity and capability of mineralized matrix formation indicates the potential use of UV-treated titanium scaffolds for bone engineering.

Repairing critical-size segmental defects: morphology of tissue engineering bone scaffolds and its effects on cell loading

Repairing critical-size segmental defects: morphology of tissue engineering bone scaffolds and its effects on cell loading

Delivering MC3T3-E1 cells into injectable calcium phosphate cement through alginate-chitosan microcapsules for bone tissue engineering

To deliver cells deep into injectable calcium phosphate cement (CPC) through alginate-chitosan (AC) microcapsules and investigate the biological behavior of the cells released from microcapsules into the CPC. Mouse osteoblastic MC3T3-E1 cells were embedded in alginate and AC microcapsules using an electrostatic droplet generator. The two types of cell-encapsulating microcapsules were then mixed with a CPC paste. MC3T3-E1 cell viability was investigated using a Wst-8 kit, and osteogenic differentiation was demonstrated by an alkaline phosphatase (ALP) activity assay. Cell attachment in CPC was observed by an environment scanning electron microscopy. Both alginate and AC microcapsules were able to release the encapsulated MC3T3-E1 cells when mixed with CPC paste. The released cells attached to the setting CPC scaffolds, survived, differentiated, and formed mineralized nodules. Cells grew in the pores concomitantly created by the AC microcapsules in situ within the CPC. At Day 21, cellular ALP activity in the AC group was approximately four times that at Day 7 and exceeded that of the alginate microcapsule group (P<0.05). Pores formed by the AC microcapsules had a diameter of several hundred microns and were spherical compared with those formed by alginate microcapsules. AC microcapsule is a promising carrier to release seeding cells deep into an injectable CPC scaffold for bone engineering.

Printability of calcium phosphate: Calcium sulfate powders for the application of tissue engineered bone scaffolds using the 3D printing technique

In this study, calcium phosphate (CaP) powders were blended with a three-dimensional printing (3DP) calcium sulfate (CaSO4)-based powder and the resulting composite powders were printed with a water-based binder using the 3DP technology. Application of a water-based binder ensured the manufacture of CaP:CaSO4 constructs on a reliable and repeatable basis, without long term damage of the printhead.Printability of CaP:CaSO4 powders was quantitatively assessed by investigating the key 3DP process parameters, i.e. in-process powder bed packing, drop penetration behavior and the quality of printed solid constructs. Effects of particle size, CaP:CaSO4 ratio and CaP powder type on the 3DP process were considered. The drop penetration technique was used to reliably identify powder formulations that could be potentially used for the application of tissue engineered bone scaffolds using the 3DP technique.Significant improvements (p<0.05) in the 3DP process parameters were found for CaP (30-110μm):CaSO4 powders compared to CaP (<20μm):CaSO4 powders. Higher compressive strength was obtained for the powders with the higher CaP:CaSO4 ratio. Hydroxyapatite (HA):CaSO4 powders showed better results than beta-tricalcium phosphate (β-TCP):CaSO4 powders. Solid and porous constructs were manufactured using the 3DP technique from the optimized CaP:CaSO4 powder formulations. High-quality printed constructs were manufactured, which exhibited appropriate green compressive strength and a high level of printing accuracy.

Poly(Glycerol Sebacate) Elastomer: A Novel Material for Mechanically Loaded Bone Regeneration

The selection criteria for potential bone engineering scaffolds are based chiefly on their relative mechanical comparability to mature bone. In this study, we challenge this notion by obtaining full regeneration of a rabbit ulna critical size defect by employing the elastomeric polymer, poly(glycerol sebacate) (PGS). We tested the regeneration facilitated by PGS alone, PGS in combination with hydroxyapatite particles, or PGS seeded with bone marrow stromal cells. We investigated the quantity and quality of the regenerated bone histologically, by microcomputed tomography and by four-point bending flexural mechanical testing at 8 weeks postimplantation. We conclude that the relatively lower stiffness of this biocompatible elastomer allows a load-transducing milieu in which osteogenesis, matrix deposition, and eventual bone maturation can take place. This study's results suggest that PGS elastomer is an auspicious osteoconductive material for the regeneration of bony defects. These results call for an innovative reassessment of the current art of selection for novel bone scaffold materials.

Reprogramming of mesenchymal stem cells derived from iPSCs seeded on biofunctionalized calcium phosphate scaffold for bone engineering

Human induced pluripotent stem cell-derived mesenchymal stem cells (iPSC-MSCs) are a promising choice of patient-specific stem cells with superior capability of cell expansion. There has been no report on bone morphogenic protein 2 (BMP2) gene modification of iPSC-MSCs for bone tissue engineering. The objectives of this study were to: (1) genetically modify iPSC-MSCs for BMP2 delivery; and (2) to seed BMP2 gene-modified iPSC-MSCs on calcium phosphate cement (CPC) immobilized with RGD for bone tissue engineering. iPSC-MSCs were infected with green fluorescence protein (GFP-iPSC-MSCs), or BMP2 lentivirus (BMP2-iPSC-MSCs). High levels of GFP expression were detected and more than 68% of GFP-iPSC-MSCs were GFP positive. BMP2-iPSC-MSCs expressed higher BMP2 levels than iPSC-MSCs in quantitative RT-PCR and ELISA assays (p < 0.05). BMP2-iPSC-MSCs did not compromise growth kinetics and cell cycle stages compared to iPSC-MSCs. After 14 d in osteogenic medium, ALP activity of BMP2-iPSC-MSCs was 1.8 times that of iPSC-MSCs (p < 0.05), indicating that BMP2 gene transduction of iPSC-MSCs enhanced osteogenic differentiation. BMP2-iPSC-MSCs were seeded on CPC scaffold biofunctionalized with RGD (RGD-CPC). BMP2-iPSC-MSCs attached well on RGD-CPC. At 14 d, COL1A1 expression of BMP2-iPSC-MSCs was 1.9 times that of iPSC-MSCs. OC expression of BMP2-iPSC-MSCs was 2.3 times that of iPSC-MSCs. Bone matrix mineralization by BMP2-iPSC-MSCs was 1.8 times that of iPSC-MSCs at 21 d. In conclusion, iPSC-MSCs seeded on CPC were suitable for bone tissue engineering. BMP2 gene-modified iPSC-MSCs on RGD-CPC underwent osteogenic differentiation, and the overexpression of BMP2 in iPSC-MSCs enhanced differentiation and bone mineral production on RGD-CPC. BMP2-iPSC-MSC seeding on RGD-CPC scaffold is promising to enhance bone regeneration efficacy.

Bionanomaterials for bone tumor engineering and tumor destruction

Recent advances have led to the development of multifunctional bionanomaterials that can target a bone tumor and deliver therapeutic drugs or genes. Bionanomaterial-based bone cancer treatment offers hope for treating bone cancer and provides many exciting possibilities to enable important new therapeutic outcomes. Physicists, chemists, engineers, biologists, and clinicians will continue to address research questions at the level of fundamental biology and science to develop novel biomaterials and systems, particularly enabling cost-effective and large-scale production of multifunctional nanomaterial systems. This review provides a comprehensive reflection of the recent advancements in bionanomaterials for use in bone cancer treatment. The review examines in detail different bionanomaterials (hydroxyapatite nanocrystals and nanometals, nanoscale conjugated copolymer, selenium and liposome) that have been researched and developed over the last six years for bone tissue engineering. It also discusses an important area of research - the use of engineered bone scaffolds in cancer treatment. Recently, bone scaffolds have been identified as potential targets for metastatic spread as well as a means by which escape from tumor dormancy can be studied. This review also includes discussions of a highly potent new class of anticancer compounds, e.g., geminal bisphosphonates, that has been shown to have strong affinity towards various hydroxyapatite-based bone scaffolds with controlled adsorption and release for anticancer activity. Finally, perspectives on future directions in nanotechnology-enabled bone tumor treatment are presented.

Continuous digital light processing (cDLP): Highly accurate additive manufacturing of tissue engineered bone scaffolds

Highly accurate rendering of the external and internal geometry of bone tissue engineering scaffolds affects fit at the defect site, loading of internal pore spaces with cells, bioreactor-delivered nutrient and growth factor circulation, and scaffold resorption. It may be necessary to render resorbable polymer scaffolds with 50 µm or better accuracy to achieve these goals. This level of accuracy is available using Continuous Digital Light Processing (cDLP) which utilizes a DLP® (Texas Instruments, Dallas, TX) chip. One such additive manufacturing device is the envisionTEC (Ferndale, MI) Perfactory®. To use cDLP we integrate a photo-crosslinkable polymer, a photo-initiator, and a biocompatible dye. The dye attenuates light, thereby limiting the depth of polymerization. In this study we fabricated scaffolds using the well-studied resorbable polymer, poly(propylene fumarate) (PPF), titanium dioxide (TiO2) as a dye, Irgacure® 819 (BASF [Ciba], Florham Park, NJ) as an initiator, and diethyl fumarate as a solvent to control viscosity.

Robocasting chitosan/nanobioactive glass dual-pore structured scaffolds for bone engineering

Here we produced a novel nano-composite scaffold made of chitosan (Chit) and nanobioactive glass (nBG) retaining dual-pore structure through the robocasting technique. Robotic-dispensed composite solution (Chit with 10wt% nBG) was rapidly solidified under a dry-ice cooled bath, which was subsequently freeze-dried. The scaffold featured the pre-designed macrochanneled (hundreds of micrometers) pore configuration and contained well-developed micropores (a few to 10μm in size) throughout the framework. The addition of nBG facilitated rapid induction of bone mineral-like apatite in a simulated body fluid, demonstrating in vitro bone-bioactivity. On the dual-pore structured scaffolds, bone cells presented good adherence and active growth with culture time. The developed Chit/nBG scaffolds may find potential usefulness as bone tissue engineering matrices.

Dynamic culture improves MSC adhesion on freeze-dried bone as a scaffold for bone engineering

To investigate the interaction between mesenchymal stem cells (MSCs) and bone grafts using two different cultivation methods: static and dynamic. MSCs were isolated from rat bone marrow. MSC culture was analyzed according to the morphology, cell differentiation potential, and surface molecular markers. Before cell culture, freeze-dried bone (FDB) was maintained in culture for 3 d in order to verify culture medium pH. MSCs were co-cultured with FDB using two different cultivation methods: static co-culture (two-dimensional) and dynamic co-culture (three-dimensional). After 24 h of cultivation by dynamic or static methods, histological analysis of Cell adhesion on FDB was performed. Cell viability was assessed by the Trypan Blue exclusion method on days 0, 3 and 6 after dynamic or static culture. Adherent cells were detached from FDB surface, stained with Trypan Blue, and quantified to determine whether the cells remained on the graft surface in prolonged non-dynamic culture. Statistical analyses were performed with SPSS and a P < 0.05 was considered significant. The results showed a clear potential for adipogenic and osteogenic differentiation of MSC cultures. Rat MSCs were positive for CD44, CD90 and CD29 and negative for CD34, CD45 and CD11bc. FDBs were maintained in culture for 3 d and the results showed there was no significant variation in the culture medium pH with FDB compared to pure medium pH (P > 0.05). In histological analysis, there was a significant difference in the amount of adhered cells on FDB between the two cultivation methods (P < 0.05). The MSCs in the dynamic co-culture method demonstrated greater adhesion on the bone surface than in static co-culture method. On day 0, the cell viability in the dynamic system was significantly higher than in the static system (P < 0.05). There was a statistical difference in cell viability between days 0, 3 and 6 after dynamic culture (P < 0.05). In static culture, cell viability on day 6 was significantly lower than on day 3 and 0 (P < 0.05). An alternative cultivation method was developed to improve the MSCs adhesion on FDB, demonstrating that dynamic co-culture provides a superior environment over static conditions.

Development of 3D wet-spun polymeric scaffolds loaded with antimicrobial agents for bone engineering

Three-dimensional wet-spun microfibrous meshes of a star poly(∈-caprolactone) were developed as potential scaffolds endowed with antimicrobial activity. The in vitro release kinetics of the meshes, under physiological conditions, was initially fast and then a sustained release for more than one month was observed. Cell cultures of a murine pre-osteoblast cell line showed good cell viability and adhesion on the wet-spun star poly(∈-caprolactone) fiber scaffolds. These promising results indicate a potential application of the developed meshes as engineered bone scaffolds with antimicrobial activity.

Perfusion electrodeposition of calcium phosphate on additive manufactured titanium scaffolds for bone engineering

A perfusion electrodeposition (P-ELD) system was reported to functionalize additive manufactured Ti6Al4 V scaffolds with a calcium phosphate (CaP) coating in a controlled and reproducible manner. The effects and interactions of four main process parameters – current density ( I), deposition time ( t), flow rate ( f) and process temperature ( T) – on the properties of the CaP coating were investigated. The results showed a direct relation between the parameters and the deposited CaP mass, with a significant effect for t ( P = 0.001) and t– f interaction ( P = 0.019). Computational fluid dynamic analysis showed a relatively low electrolyte velocity within the struts and a high velocity in the open areas within the P-ELD chamber, which were not influenced by a change in f. This is beneficial for promoting a controlled CaP deposition and hydrogen gas removal. Optimization studies showed that a minimum t of 6 h was needed to obtain complete coating of the scaffold regardless of I, and the thickness was increased by increasing I and t. Energy-dispersive X-ray and X-ray diffraction analysis confirmed the deposition of highly crystalline synthetic carbonated hydroxyapatite under all conditions (Ca/P ratio = 1.41). High cell viability and cell–material interactions were demonstrated by in vitro culture of human periosteum derived cells on coated scaffolds. This study showed that P-ELD provides a technological tool to functionalize complex scaffold structures with a biocompatible CaP layer that has controlled and reproducible physicochemical properties suitable for bone engineering.

T-19 Bone Engineering Scaffolds

T-19 Bone Engineering Scaffolds

Human umbilical cord stem cell encapsulation in calcium phosphate scaffolds for bone engineering

Human bone marrow mesenchymal stem cells (hBMSCs) require an invasive procedure to harvest, and have lower self-renewal potential with aging. Umbilical cord mesenchymal stem cells (hUCMSCs) are a relatively new stem cell source; this study reveals a self-setting and load-bearing calcium phosphate construct that encapsulates these stem cells. The flexural strength (mean ± sd; n = 5) of the hUCMSC-encapsulating calcium phosphate cement (CPC) increased from (3.5 ± 1.1) MPa without polyglactin fibers, to (11.7 ± 2.1) MPa with 20% of polyglactin fibers ( p < 0.05). hUCMSCs attached to the bone mineral-mimicking scaffold in the osteogenic media and differentiated down the osteogenic lineage, yielding elevated alkaline phosphatase (ALP) and osteocalcin (OC) gene expressions. ALP and OC on the CPC-fiber scaffold was 2-fold those on CPC control without fibers. hUCMSCs encapsulated inside the scaffolds retained excellent viability and cell density. The encapsulated hUCMSCs inside four different constructs successfully differentiated down the osteogenic lineage and synthesized bone minerals, as confirmed by mineral staining, SEM, and XRD. The percentage of mineral area synthesized by the encapsulated hUCMSCs increased from about 3% at day-7, to 12% at day-21 ( p < 0.05). In conclusion, this study demonstrated that hUCMSCs encapsulated in the bioengineered scaffolds osteo-differentiated and synthesized bone minerals. The self-setting CPC–chitosan–fiber scaffold supported the viability and osteogenic differentiation of the encapsulated hUCMSCs, and had mechanical strength matching that of cancellous bone.

Hydroxyapatite bone substitutes developed via replication of natural marine sponges

The application of synthetic cancellous bone has been shown to be highly successful when its architecture mimics that of the naturally interconnected trabeculae bone it aims to replace. The following investigation demonstrates the potential use of marine sponges as precursors in the production of ceramic based tissue engineered bone scaffolds. Three species of natural sponge, Dalmata Fina (Spongia officinalis Linnaeus, Adriatic Sea), Fina Silk (Spongia zimocca, Mediterranean) and Elephant Ear (Spongia agaricina, Caribbean) were selected for replication. A high solid content (80 %wt), low viscosity (126 mPas) hydroxyapatite slurry was developed, infiltrated into each sponge species and subsequently sintered, producing a scaffold structure that replicated pore architecture and interconnectivity of the precursor sponge. The most promising of the ceramic tissue engineered bone scaffolds developed, Spongia agaricina replicas, demonstrated an overall porosity of 56-61% with 83% of the pores ranging between 100 and 500 microm (average pore size 349 microm) and an interconnectivity of 99.92%.

Inducing angiogenesis at tissue engineered bone scaffold by an arteriovenous loop in rabbits

Objective To compare the effects of 2 vascular carriers, arteriovenous loop and arteri-ovenous bundle, on inducing angiogenesis in coral scaffold of vascularized tissue-engineered bone in animal models.Methods Thirty-six adult male New Zealand rabbits were randomized into 2 even groups.In group A, an arteriovenous loop (AVL) was formed by microsurgical anastomosis at the proximal ends between the femoral poptiteal artery and vein, and placed in the circular side groove of the coral block (6 mm × 8 mm × 10 mm) .In group B, flow-through vessels bundles of both femoral artery and vein were placed in the side grooves of the coral block.All the implants in 2 groups were wrapped by a micro-porous expand-ed-polytetrafluoroethylene (ePTFE) membrane, and fixed subcutaneously by suturing.Evaluation methods included gross morphological observations, histological examinations, India ink perfusion and vascular casting after 2, 4, 6 weeks.The density of blood vessels was analyzed by the statistical software SPSS 10.0.Results All the corals were encased by newly formed fibrovascular tissues in 2 groups.Ink-stained vessels distributed the surfaces and side grooves, and invaded the interspaces of corals.The degree of vascularization increased over the course of experiment.Blood vessel density demonstrated a significant continuous increase between 2 and 6 weeks after implantation in group A.The mean value of blood vessel density in group A (2 weeks 276.60±4.67, 4 weeks 517.20±10.66, 6 weeks 707.00 ±11.87) was significantly higher than in group B (2 weeks 153.60 ±7.16, 4 weeks 269.40±6.80, 6 weeks 279.20±6.53) (P <0.01).Vascular casting showed that in group A, significant blood vessels sprouted from all areas of the loop, espe-cially at the entrance of the arteriovenous pediele where the small tubes were densely interconnected.In group B, however, no blood vessels sprouted from the arteriovenous bundles and only some small vessels grew from the entrance and exit.Conclusions A vascularized coral model can be constructed by inserting an ar-teriovenous loop or an arteriovenous bundle, useful in vascular bone tissue engineering.The former, however, have stronger abilities to induce angiogenesis than the latter. Key words: Tissue engineering; Bone; Angiogenesis; Coral; Arteriovenous loop

Surface Characteristics of Nanocrystalline Apatites: Effect of Mg Surface Enrichment on Morphology, Surface Hydration Species, and Cationic Environments

The incorporation of foreign ions, such as Mg2+, exhibiting a biological activity for bone regeneration is presently considered as a promising route for increasing the bioactivity of bone-engineering scaffolds. In this work, the morphology, structure, and surface hydration of biomimetic nanocrystalline apatites were investigated before and after surface exchange with such Mg2+ ions, by combining chemical alterations (ion exchange, H2O-D2O exchanges) and physical examinations (Fourier transform infrared spectroscopy (FTIR) and high-resolution transmission electron microscopy (HRTEM)). HRTEM data suggested that the Mg2+/Ca2+ exchange process did not affect the morphology and surface topology of the apatite nanocrystals significantly, while a new phase, likely a hydrated calcium and/or magnesium phosphate, was formed in small amount for high Mg concentrations. Near-infrared (NIR) and medium-infrared (MIR) spectroscopies indicated that the samples enriched with Mg2+ were found to retain more water at their surface than the Mg-free sample, both at the level of H2O coordinated to cations and adsorbed in the form of multilayers. Additionally, the H-bonding network in defective subsurface layers was also noticeably modified, indicating that the Mg2+/Ca2+ exchange involved was not limited to the surface. This work is intended to widen the present knowledge on Mg-enriched calcium phosphate-based bioactive materials intended for bone repair applications.

Mechanical and in vitro evaluations of composite PLDLLA/TCP scaffolds for bone engineering

Bone tissue engineering scaffolds have two challenging functional tasks to play; to be bioactive by encouraging cell proliferation and differentiation, and to provide suitable mechanical stability upon implantation. Composites of biopolymers and bioceramics unite the advantages of both materials, resulting in better processability, enhanced mechanical properties through matrix reinforcement and osteoinductivity. Novel composite blends of poly(L-lactide-co-D,L-lactide)/tricalcium phosphate (PLDLLA/TCP) were fabricated into scaffolds by an extrusion deposition technique customised from standard rapid prototyping technology. PLDLLA/TCP composite material blends of various compositions were prepared and analysed for their mechanical properties. PLDLLA/TCP (10%) was optimised and fabricated into scaffolds. Compressive mechanical properties for the composite scaffolds were measured. In vitro studies were conducted using porcine bone-marrow stromal cells (BMSCs). Cell-scaffold constructs were induced using osteogenic induction factors for up to 8 weeks. Cell proliferation, viability and differentiation capabilities were assayed using phase-contrast light microscopy, scanning electron microscopy, DNA quantification (Pico Green), Alamar Blue metabolic assay; FDA/PI fluorescent assay and western blot analysis for osteopontin. Microscopy observations showed BMSCs possessed high proliferative capabilities and demonstrated bridging across the pores of the scaffolds. FDA/PI staining as well as Alamar Blue assay showed high viability of BMSCs cultured on the composite scaffolds. Cell numbers, based on DNA quantitation, were observed to increase continuously up to the eighth week of study. Western blot analysis showed increased osteopontin synthesis on the scaffolds compared to tissue culture plastic. Based on our results the PLDLLA/TCP scaffolds exhibited good potential and biocompatibility for bone tissue engineering applications.

Regenerative medicine in bone tumor surgery

In bone tumor surgery, target of bone tissue engineering technique will be the reconstruction of large bone void after tumor excision. It may be also useful to accelerate the regeneration of processed autologous bone grafts such as irradiated bone. Interconnected porous ceramics bone substitutes have been considered to be useful as a scaffold for bone engineering. We started a clinical trial on bone regeneration to evaluate its safety and efficiency using mesenchymal stem cells derived from autologous bone marrow aspirates and porous hydroxyapatite ceramics as a scaffold. In this study, after osteoblastic differentiation culture for several weeks, cells integrated to porous ceramics are transplanted into the defect after removal of large benign bone tumor.