Intraoperative Creation of Tissue-Engineered Grafts with Minimally Manipulated Cells: New Concept of Bone Tissue Engineering In Situ

Abstract

Transfer of regenerative approaches into clinical practice is limited by strict legal regulation of in vitro expanded cells and risks associated with substantial manipulations. Isolation of cells for the enrichment of bone grafts directly in the Operating Room appears to be a promising solution for the translation of biomedical technologies into clinical practice. These intraoperative approaches could be generally characterized as a joint concept of tissue engineering in situ. Our review covers techniques of intraoperative cell isolation and seeding for the creation of tissue-engineered grafts in situ, that is, directly in the Operating Room. Up-to-date, the clinical use of tissue-engineered grafts created in vitro remains a highly inaccessible option. Fortunately, intraoperative tissue engineering in situ is already available for patients who need advanced treatment modalities.

Keywords: bone repair; cell therapy; in situ; minimally manipulated cells; stem cells; surgery; tissue engineering.

Figure 1

New concept of tissue engineering in situ: intraoperative isolation of cells with minimal manipulation, cell seeding on scaffold and implantation during the same surgical procedure. Created with BioRender.com.

Figure 2

(a) Scaffold types for bone tissue engineering in situ. (b) Methods for physical modification of scaffolds immediately in the Operating Room. Created with BioRender.com.