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Review
. 2016 Oct:12:43-54.
doi: 10.1016/j.ebiom.2016.09.016. Epub 2016 Sep 20.

Bone Graft Prefabrication Following the In Vivo Bioreactor Principle

Ru-Lin Huang  1 , Eiji Kobayashi  2 , Kai Liu  1 , Qingfeng Li  3
Affiliations
Review

Bone Graft Prefabrication Following the In Vivo Bioreactor Principle

Ru-Lin Huang et al. EBioMedicine. 2016 Oct.

Abstract

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.

Keywords: Bone graft; Bone regeneration; Flap prefabrication; In vivo bioreactor; In vivo tissue engineering.

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Figures

Fig. 1
Fig. 1
Schematic illustration of the BTE paradigm. (A) Classic in vitro BTE paradigm. (B) In vivo BTE paradigm.
Fig. 2
Fig. 2
Illustration of the role of an IVB.
Fig. 3
Fig. 3
Schematic concept of flap prefabrication, flap prelamination, and tissue prefabrication. (A) Technological paradigm of traditional flap prefabrication. (B) Technological paradigm of flap prelamination. (C) Technological paradigm of tissue prefabrication following the IVB principle.
Fig. 4
Fig. 4
(A) Published articles on bone graft prefabrication following the IVB principle from Jan. 1, 1991, to Jan. 1, 2016, on PubMed. (B) Break-down of the published articles according to IVB strategies.
Fig. 5
Fig. 5
Further trends of bone defect reconstruction using prefabricated bone grafts.
See this image and copyright information in PMC

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