First long term succesful in situ tissue engineering

What is it about?

We were able to help Regenerate significant bone defects in two patients using a clinically approved β-tricalciumphosphate/hydroxyapatite (HA), fibrin glue and directly auto-transplanted bone marrow aspirate from the iliac crest with the creation of an arterio-venous loop to supply oxygenation from the very first moment on. The following post-operative courses were uneventful. The final examinations took place after 36 and 72 months after the initial operations. Computer tomography (CT), magnetic resonance imaging (MRI) and doppler ultrasound revealed patent arterio-venous (AV) loops in the bone grafts as well as completely healed bone defects.

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Why is it important?

Although the fascinating prospects of Tissue Engineering (TE) and Regenerative Medicine (RM) gained much popularity from the early 1990ies on, direct clinical translation has been hampered by numerous obstacles. When it comes to clinical application the transition from laboratory constructs into a human recipient the lack of initial vascularization has been the key problem. To overcome the common problem of donor-site morbidity of standard autologous bone grafts, we successfully combined tissue engineering techniques for the first time with the arteriovenous loop model to generate vascularized large bone grafts. We present two cases of large bone defects after debridement of an osteomyelitis.

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