Regeneration von Knochendefekten mit computergesteuerter Herstellung von Gerüstträgern

Zusammenfassung

Die Behandlung ausgedehnter Knochen-defekte nach Traumata oder durch Tumoren stellt nach wie vor eine signifikante Heraus-forderung im klinischen Alltag dar. Aufgrund der bestehenden Limitationen aktueller Therapiestandards haben Knochen-Tissue-Engineering (TE)-Verfahren zunehmend an Bedeutung gewonnen. Die Entwicklung von Additive-Manufacturing (AM)-Verfahren hat dabei eine grundlegende Innovation ausgelöst: Durch AM lassen sich dreidimensionale Gerüstträger in einem computergestützten Schichtfür-Schicht-Verfahren aus digitalen 3D-Vorlagen erstellen. Wurden mittels AM zunächst nur Modelle zur haptischen Darstellung knöcherner Pathologika und zur Planung von Operationen hergestellt, so ist es mit der Entwicklung nun möglich, detaillierte Scaffoldstrukturen zur Tissue-Engineering-Anwendung im Knochen zu fabrizieren. Die umfassende Kontrolle der internen Scaffoldstruktur und der äußeren Scaffoldmaße erlaubt eine Custom-made-Anwendung mit auf den individuellen Knochendefekt und die entsprechenden (mechanischen etc.) Anforderungen abgestimmten Konstrukten. Ein zukünftiges Feld ist das automatisierte ultrastrukturelle Design von TE-Konstrukten aus Scaffold-Biomaterialien in Kombination mit lebenden Zellen und biologisch aktiven Wachstumsfaktoren zur Nachbildung natürlicher (knöcherner) Organstrukturen.

Summary

Large bone defects resulting from trauma or tumour surgery are still considered a major challenge in clinical practice. Despite high clinical demand, current treatment options have a number of shortcomings. Bone tissue engineering (BTE)-strategies have therefore been extensively investigated in recent years. The invention of additive manufacturing (AM)-techniques two decades ago has had a huge impact on the BTE field ever since then: Via AM a solid three dimensional structure can be formed from a digital 3D model using a layer-by-layer fabrication process. In the beginning, AM was mainly used to build 3D models of bone pathologies (e. g. fractures, bone tumours) to enable haptic assessment before and during surgery for planning and executing the surgical procedure. However, as new techniques and materials have been developed, AM can nowadays be used to manufacture ultrastructured three dimensional scaffolds for BTE applications as well. Providing control over the internal scaffold architecture on micrometer scale as well as over the external macroscopic scaffold shape, AM enables the fabrication of patientspecific and/or custom-made scaffolds individually tailored to exactly match the size and requirements (e. g. mechanical properties) of a bone defect. In the future, new technologies that enable the direct fabrication of scaffolds with a parallel spatially controlled deposition of cells and growth factors will further underpin the clinical application of bone tissue engineering.

Schlüsselwörter

Additive Manufacturing - Rapid Prototyping - Knochen-Tissue-Engineering - Scaffold - computergestütztes Design

Keywords

Additive manufacturing - rapid prototyping - bone tissue engineering - bone regeneration - scaffold - computer aided design

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