Engineering Personalized Devices for Critical Long Bone Defects
Abstract
Extremity defects resulting from injuries on the battlefield need both timely and effective treatment to replace the damaged or lost bone. Given that there are no "ideal" treatments, the Veteran/patient will at a minimum need a lengthy hospital stay and experience delay in return to duty/work, with a possible permanent loss of function, or loss of a limb. Conventional methods for long bone regeneration (autologous grafts obtained from the same individual) show high rates of success in healing by replacing bone. Nonetheless, some other treatment approaches (i.e., limb prostheses) fail to achieve the natural state -- recipients often complain that "it does not feel natural." There currently is no effective treatment of extensive extremity bone injuries, especially in cases where donor sites for grafting no longer exist due to multiple extremity injury. In these cases, multiple surgical procedures are needed and in most occasions are not able to return limb form and function. Thus, there is a desperate need for the development of a customizable device, which efficiently regenerates large bone defects that avoids multiple surgeries, is predictable, and more economic than currently employed rehabilitation routines. This project will use a three-dimensional (3D) printing technology to "print" resorbable structures made from bioactive ceramic material composed of calcium and phosphate, which make up nearly 67% of natural bones found in our body. These scaffolds can be customized to the defect site and avoid the need for bone graft harvesting while using the individual s own body to regrow the lost bone structure. Given that this bioceramic scaffold is resorbable and degrades over time, no secondary procedure is necessary to remove the scaffold. These 3D printed scaffolds can be fabricated in intricate designs for an over-the-counter product, which can be fitted with a simple surgical device in the operating room to be customized to a specific site. Alternatively, they can be individually designed, fabricated, and tailored to fit the defect using the patients/Veterans computed tomography (CT) scan data. To accelerate bone formation and allow faster patient recovery, we will use the 3D fabricated bioceramic scaffolds in conjunction (via coating) with the bone-forming agent, dipyridamole -- an agent that has been employed and administered in clinical medicine for decades with an excellent safety profile and that increases the body s capability to regenerate bone. This project, over 3 years, will determine how the 3D printed constructs with dipyridamole promote bone growth in bone healing environments and will translate these findings to clinical practice. The proposed experiments will enable rapid maximization of this approach to promote long bone segmental regeneration and will allow the generation of key information for Food and Drug Administration (FDA) approval and deployment of our technology to clinical trials. In 3 years from this project s starting date, the technology will be initially applied towards improving the quality of life for not only wounded Soldiers returning from active duty, but also for victims of trauma in civilian life who have experienced loss of bone. A saved limb can make a tremendous difference in the life of any Soldier or civilian. The potential success of these personalized engineered 3D printed devices to reconstruct large bony defects when the autologous (from the patient s own body) option is not feasible will be an exceptional advancement in the field of bone repair. The technology development and establishment will ensure successful treatment outcomes with less surgery and less time spent in hospitals for individuals that would not fully recover from injury though current technology and treatment strategies available.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610772
Entities
People
- Eduardo RodrÃguez
Organizations
- Grossman School of Medicine
- United States Army