Bone Graft Prefabrication Following the In Vivo Bioreactor Principle.
Large bone defect treatment represents a great challenge due to the difficulty of functional and esthetic reconstruction. Tissue-engineered bone grafts created by in vitro manipulation of bioscaffolds, seed cells, and growth factors have been considered potential treatments for bone defect reconstruction. However, a significant gap remains between experimental successes and clinical translation. An emerging strategy for bridging this gap is using the in vivo bioreactor principle and flap prefabrication techniques. This principle focuses on using the body as a bioreactor to cultivate the traditional triad (bioscaffolds, seed cells, and growth factors) and leveraging the body's self-regenerative capacity to regenerate new tissue. Additionally, flap prefabrication techniques allow the regenerated bone grafts to be transferred as prefabricated bone flaps for bone defect reconstruction. Such a strategy has been used successfully for reconstructing critical-sized bone defects in animal models and humans. Here, we highlight this concept and provide some perspective on how to translate current knowledge into clinical practice.
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.
Ru-Lin
RL
Huang
Department of Organ Fabrication, Keio University School of Medicine, Tokyo, Japan.
Eiji
E
Kobayashi
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.
Kai
K
Liu
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China. Electronic address: dr.liqingfeng@shsmu.edu.cn.
Qingfeng
Q
Li
D000818:Animals; D001861:Bone Regeneration; D016025:Bone Transplantation / Q000379:methods*; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D023822:Tissue Engineering / Q000379:methods
Bone graft; Bone regeneration; Flap prefabrication; In vivo bioreactor; In vivo tissue engineering
Plast Reconstr Surg. 1981 Sep;68(3):404-10
7267814
Cell Transplant. 2015;24(10):1957-68
25398079
Ann Surg Innov Res. 2011 Mar 20;5:2
21418603
Stem Cells Dev. 2012 Mar 20;21(5):655-67
22085228
J Craniofac Surg. 2012 May;23 (3):732-7
22565889
Mater Sci Eng C Mater Biol Appl. 2012 Aug 1;32(6):1536-41
24364957
J Craniofac Surg. 2013 Nov;24(6):1914-21
24220373
J Reconstr Microsurg. 2014 Nov;30(9):627-34
25025508
J Cell Mol Med. 2006 Jul-Sep;10(3):716-26
16989731
Exp Ther Med. 2014 Apr;7(4):958-962
24669258
Tissue Eng Part A. 2015 Jan;21(1-2):96-105
25135080
Int J Oral Maxillofac Surg. 2004 Mar;33(2):164-72
15050073
Microsurgery. 1994;15(9):618-23
7845188
J Orthop Res. 2005 Jul;23(4):916-23
16023008
Tissue Eng Part C Methods. 2015 May;21(5):489-98
25345571
J Biomed Mater Res A. 2014 Aug;102(8):2491-501
23946164
J Mater Sci Mater Med. 2011 May;22(5):1279-91
21448669
Sci Rep. 2016 Mar 22;6:23367
27000963
Artif Organs. 2013 Oct;37(10):884-93
23646847
Ann Plast Surg. 2010 Jan;64(1):98-104
20010414
Tissue Eng Part A. 2015 May;21(9-10):1520-8
25603924
Nagoya J Med Sci. 2010 Aug;72(3-4):111-7
20942265
Tissue Eng Part A. 2011 Jun;17(11-12):1643-50
21306292
Int J Oral Maxillofac Surg. 2010 Apr;39(4):379-87
20167453
Plast Reconstr Surg. 2010 May;125(5):1372-82
20440157
Am J Surg. 2004 Jul;188(1A Suppl):36-41
15223501
Tissue Eng. 2007 Jul;13(7):1549-60
17518756
Int J Oral Maxillofac Surg. 2006 Mar;35(3):265-9
16257511
J Surg Res. 1996 Feb 15;61(1):221-6
8769970
Eur Surg Res. 2011;46(3):148-55
21372579
Bone. 2013 Dec;57(2):484-92
23954755
Proc Natl Acad Sci U S A. 2005 Aug 9;102(32):11450-5
16055556
J Reconstr Microsurg. 2014 Mar;30(3):145-52
24399691
Tissue Eng Part A. 2015 Oct;21(19-20):2480-94
26262757
Artif Organs. 2014 Feb;38(2):167-74
23845001
PLoS One. 2015 Sep 04;10 (9):e0137167
26340447
Tissue Eng Part A. 2014 Dec;20(23-24):3189-97
24919114
Tissue Eng Part A. 2009 Dec;15(12):3923-30
19563263
Tissue Eng Part A. 2015 May;21(9-10):1680-94
25760576
Indian J Plast Surg. 2012 Sep;45(3):444-52
23450373
Tissue Eng Part A. 2015 Oct;21(19-20):2495-503
26262560
Stem Cells Transl Med. 2012 Jun;1(6):480-91
23197852
Bone Joint Res. 2012 Aug 01;1(8):192-7
23610689
Nat Med. 2008 Feb;14(2):213-21
18193059
J Cell Mol Med. 2014 Jul;18(7):1478-85
24801710
Arch Orthop Trauma Surg. 2011 Oct;131(10):1459-66
21594572
Int J Oral Maxillofac Surg. 2001 Dec;30(6):469-78
11829227
J Reconstr Microsurg. 2015 May;31(4):291-9
25785651
Acta Orthop Traumatol Turc. 2010;44(5):403-9
21343692
Int J Oral Maxillofac Surg. 2001 Oct;30(5):373-9
11720037
Regen Med. 2016 Jul;11(5):475-81
27357365
ANZ J Surg. 2013 Apr;83(4):255-61
23088676
J Plast Reconstr Aesthet Surg. 2010 Dec;63(12):2160-7
20194051
Biomaterials. 2015 Aug;61:246-56
26004237
BMC Med. 2012 Jul 26;10:81
22834465
Biomaterials. 2014 Jan;35(4):1163-75
24239301
Int J Oral Maxillofac Surg. 2009 Mar;38(3):201-9
19168327
Lancet. 2012 Mar 10;379(9819):943-52
22405797
J Trauma. 2009 Jul;67(1):165-7
19590329
Biomaterials. 2006 Jun;27(17):3163-7
16504287
J Pediatr Surg. 1998 Jul;33(7):991-6; discussion 996-7
9694083
Lancet. 2004 Aug 28-Sep 3;364(9436):766-70
15337402
Int J Oral Maxillofac Surg. 2015 Jun;44(6):791-7
25617952
Biomed Res Int. 2013;2013:935046
24106724
Plast Reconstr Surg. 1999 Sep;104(3):793-7
10456533
Plast Reconstr Surg. 2012 Jan;129(1):55e-65e
22186585
Science. 2010 Jul 30;329(5991):538-41
20576850
J Tissue Eng Regen Med. 2010 Mar;4(3):216-23
19960489
Plast Reconstr Surg. 2006 Jul;118(1):1e-4e
16816662
Plast Reconstr Surg. 2010 May;125(5):1393-402
20440159
J Tissue Eng Regen Med. 2013 Aug;7(8):654-64
22438065
J Reconstr Microsurg. 2013 Oct;29(8):559-60
23709122
Int J Oral Maxillofac Surg. 1999 Dec;28(6):461-3
10609751
Plast Reconstr Surg. 1982 Mar;69(3):568
7038734
J Reconstr Microsurg. 2013 May;29(4):241-8
23479343
Biomaterials. 2015 Oct;67:308-22
26232880
Biomed Mater. 2013 Feb;8(1):014106
23353764
BMC Musculoskelet Disord. 2011 Jan 31;12:31
21281488
Osteoarthritis Cartilage. 2014 Aug;22(8):1186-96
24981632
Arch Orthop Trauma Surg. 2012 Sep;132(9):1353-62
22643804
Chin Med J (Engl). 2013 Dec;126(23):4540-4
24286422
J Reconstr Microsurg. 2010 Feb;26(2):95-102
20013595
BMC Musculoskelet Disord. 2013 Nov 08;14:318
24209783
J Oral Maxillofac Surg. 2012 Sep;70(9):2191-7
22365977
Int J Oral Maxillofac Surg. 2014 Feb;43(2):163-72
24238866
Tissue Eng Part C Methods. 2010 Dec;16(6):1503-14
20575690
Am J Transplant. 2015 Jan;15(1):64-75
25403742
Eur Urol. 2007 Sep;52(3):884-90
17229515
Eur Urol. 2007 Nov;52(5):1492-8
17561337
JAMA. 1991 Oct 9;266(14):1953-5
1895472
Biomed Res Int. 2013;2013:762132
24000327
Biores Open Access. 2013 Aug;2(4):266-72
23914333
J Tissue Eng Regen Med. 2017 Feb;11(2):542-552
26251084
Nat Med. 2010 Jul;16(7):814-20
20543851
FASEB J. 2007 Feb;21(2):511-22
17172640
Circulation. 2007 Jan 23;115(3):353-60
17200440
Proc Natl Acad Sci U S A. 2013 Mar 5;110(10):3997-4002
23401508
Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Nov;114(5 Suppl):S153-9
23063392
Biomaterials. 2010 Dec;31(36):9452-61
20869769
Proc Natl Acad Sci U S A. 2010 Feb 23;107(8):3299-304
19820164
Plast Reconstr Surg. 1980 Jul;66(1):109-15
6156468
J Biomech. 2014 Jun 27;47(9):1931-2
24746021
Front Biosci (Schol Ed). 2011 Jan 01;3:61-8
21196357
PLoS One. 2013 Aug 09;8(8):e71667
23951215
Tissue Eng Part C Methods. 2015 Sep;21(9):889-97
25809081
Biomaterials. 2006 Mar;27(7):1081-7
16120459
Biomaterials. 2010 Jun;31(18):4935-43
20346504
Clin Oral Investig. 2014 Jul;18(6):1671-8
24248640
Lancet. 2010 Aug 7;376(9739):440-8
20692530
Tissue Eng Part C Methods. 2010 Aug;16(4):653-9
19778169
J Craniofac Surg. 2007 Jan;18(1):43-8
17251834