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. 2020 Nov 25:30:75-84.
doi: 10.1016/j.jare.2020.11.011. eCollection 2021 May.

Robotic in situ 3D bio-printing technology for repairing large segmental bone defects

Lan Li  1   2   3 , Jianping Shi  1   4 , Kaiwei Ma  2 , Jing Jin  1 , Peng Wang  1   3 , Huixin Liang  1   3 , Yi Cao  5 , Xingsong Wang  2 , Qing Jiang  1   3
Affiliations

Robotic in situ 3D bio-printing technology for repairing large segmental bone defects

Lan Li et al. J Adv Res. .

Abstract

Introduction: The traditional clinical treatment of long segmental bone defects usually requires multiple operations and depends on donor availability. The 3D bio-printing technology constitutes a great potential therapeutic tool for such an injury. However, in situ 3D bio-printing remains a major challenge.

Objectives: In this study, we report the repair of long segmental bone defects by in situ 3D bio-printing using a robotic manipulator 3D printer in a swine model.

Methods: We systematically optimized bio-ink gelation under physiological conditions to achieve desirable mechanical properties suitable for bone regeneration, and a D-H kinematic model was used to improve printing accuracy to 0.5 mm.

Results: These technical improvements allowed the repair of long segmental defects generated on the right tibia of pigs using 3D bio-printing within 12 min. The 3D bio-printing group showed improved treatment effects after 3 months.

Conclusion: These findings indicated that robotic in situ 3D bio-printing is promising for direct clinical application.

Keywords: 3D bio-printing; In situ; Regenerative medicine; Robotic; Tissue engineering.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Crosslinking time and compressibility of the bio-ink. (A) Crosslinking times of filaments with different diameters under different UV light intensities. (B) Compressibility of the bio-ink. (C) Stress–strain curves of the bio-ink. The compression strains in various cycles were 15%, 20%, 25%, and 30%, respectively. (D) Dissipated energy levels in various cycles. (E) Compression-relaxation cycles to the same specimen for 20 cycles with no interruption between consecutive cycles. The compression strain was set at 30%. (F) Dissipated energy (black) and recovery percentage (red) of the bio-ink.
Fig. 2
Fig. 2
Biocompatibility assessment of the bio-ink. (A) Gene expression levels at days 7 and 14. (B,C) ALP activity at day 7 and 21. *p < 0.05.
Fig. 3
Fig. 3
In vitro printing test results. (A) 3D comparison between the 3D printed sample (before accuracy improvement) and the intact bone. (B) 3D comparison between the 3D printed sample (after accuracy improvement) and the intact bone.
Fig. 4
Fig. 4
Whole process of in situ 3D bio-printing. (A) Flow chart of the in vivo study. (B) General view of the robotic manipulator-based 3D printer. (C) The process of in situ printing. (D) Printed scaffold, with a porous structure.
Fig. 5
Fig. 5
In vivo study results. (A) Micro CT scans of the blank control and 3DP groups 12 weeks post-surgery. (B) 3D reconstruction of the blank control and 3DP groups at 12 postoperative weeks. (C) BV/TV ratios. (D) Trabecular morphology. *p < 0.05.
Fig. 6
Fig. 6
Goldner trichrome results. (A) General view of the injured region in the blank control group. Goldner trichrome stained sections analyzed at 40x (B) and 100x (C) in the control group. (D) General view of the injured region in the 3DP group. Goldner trichrome stained samples assessed at 40x (E) and 100x (F) in the 3DP group.
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