Skip to Main content Skip to Navigation
Journal articles

Reconstruction of Large Skeletal Defects: Current Clinical Therapeutic Strategies and Future Directions Using 3D Printing

Abstract : The healing of bone fractures is a well-orchestrated physiological process involving multiple cell types and signaling molecules interacting at the fracture site to replace and repair bone tissue without scar formation. However, when the lesion is too large, normal healing is compromised. These so-called non-union bone fractures, mostly arising due to trauma, tumor resection or disease, represent a major therapeutic challenge for orthopedic and reconstructive surgeons. In this review, we firstly present the current commonly employed surgical strategies comprising auto-, allo-, and xenograft transplantations, as well as synthetic biomaterials. Further to this, we discuss the multiple factors influencing the effectiveness of the reconstructive therapy. One essential parameter is adequate vascularization that ensures the vitality of the bone grafts thereby supporting the regeneration process, however deficient vascularization presents a frequently encountered problem in current management strategies. To address this challenge, vascularized bone grafts, including free or pedicled fibula flaps, or in situ approaches using the Masquelet induced membrane, or the patient's body as a bioreactor, comprise feasible alternatives. Finally, we highlight future directions and novel strategies such as 3D printing and bioprinting which could overcome some of the current challenges in the field of bone defect reconstruction, with the benefit of fabricating personalized and vascularized scaffolds.
Document type :
Journal articles
Complete list of metadatas

Cited literature [143 references]  Display  Hide  Download

https://www.hal.inserm.fr/inserm-02880917
Contributor : Meadhbh Brennan <>
Submitted on : Thursday, June 25, 2020 - 12:31:52 PM
Last modification on : Monday, October 19, 2020 - 10:52:30 AM
Long-term archiving on: : Wednesday, September 23, 2020 - 4:24:04 PM

File

Vidal et al.pdf
Publisher files allowed on an open archive

Identifiers

Collections

Citation

Luciano Vidal, Carina Kampleitner, Meadhbh Brennan, Alain Hoornaert, Pierre Layrolle. Reconstruction of Large Skeletal Defects: Current Clinical Therapeutic Strategies and Future Directions Using 3D Printing. Frontiers in Bioengineering and Biotechnology, Frontiers, 2020, 8, pp.61. ⟨10.3389/fbioe.2020.00061⟩. ⟨inserm-02880917⟩

Share

Metrics

Record views

43

Files downloads

113