According to Age International, there are approximately 960 million people aged 60 and above in the world today. In many developing countries they make up around 62% of the population. However, by 2050 this figure is expected to increase to 2 billion as people are living longer. What’s more, almost 400 million will be over the age of 80.
While the prevalence of disability in those aged just 18 or under is around 5.8%, this is expected to increase to 84.2% in those aged 85 and over. One of these problems is joint and soft tissue damage. As we age, joints become thinner and the proteoglycans substances (components that help to provide cartilage resistance) alter. In doing so it makes the joints far less resilient and therefore more susceptible to damage.
To put this into perspective, currently, there are already millions of people worldwide who suffer from tissue damage caused by disease or trauma and every day, thousands of orthopaedic surgical procedures are performed to repair or replace these tissues. In the US alone, more than 500,000 people received bone defect repairs at a cost of $2.5 billion annually. And let’s not forget, this figure is likely to quadruple by 2050.
Clinical treatments for bone repair – What can be done?
While extensive studies have highlighted the considerable shortcomings, complications and limitations of current clinical treatments for bone repair including autograft and allograft transplants, there is an ever-increasing need for better bone tissue engineering techniques. One solution may be the advancement of biomaterial carriers or scaffolds.
These scaffolds act as a carrier or template for compatibly manufactured tissue cells, which in turn are able to form and grow. While manufactured scaffolds sound like the ideal solution to the growing bone disease problem, they are not without their issues. The main one being that the material used needs to possess many attributes. It has to…
- Host and support cells for a number of weeks
- Be of a highly porous nature to allow natural cell penetration and tissue fusion
- Form a strong bond with the natural bone and…
- Have sufficient mechanical properties
As you can see, that’s quite a tall order and researchers have found in the past that when one material hits a specific requisite, another has been negatively affected.
For example, porous metal scaffolds are considered the most suitable in terms of load-bearing capabilities. However, they are non-biodegradable and are susceptible to corrosion and wear.
In another example, polymers, such as polylactic acid, polyglycolic acid and polyurethane have also been tested, as have a number of copolymers. While many have excellent biocompatibility and biodegradability properties, they can lack the sufficient mechanical properties needed to support early-stage bone growth.
But what about ceramics?
As a bio-mimetic material with a mechanical strength equally suited for bone tissue repair, ceramic scaffolds may offer the perfect solution. Not only do they have sound biocompatible and osteoconductive properties, but also, they can be made to closely resemble the framework of bone.
While it appears that researchers may have hit upon an ideal solution this still doesn’t tackle the old age problem of supply and demand. Up until recently, producing ceramic scaffolds has been a time-consuming process, and when orthopaedic surgery figures are increased ten-fold, there needs to be a way of manufacturing biomaterial scaffolds, better, faster and with more accuracy.
3DP – Could the answer lie here?
Three-dimensional printing (3DP) is now used regularly in many industries as a way of rapidly prototyping an object. The process has demonstrated outstanding potential over the past decade, and ultimately, the promise of tailoring ‘ideal’ scaffolds using 3DP technology lies in its user-friendly capabilities.
These are the same capabilities that allow for an easy conversion of CAD data into a rapid and consistent construction; while at the same time, achieving the finished article utilising a wide variety of materials including bio-ceramics.
Clinical trials so far…
Already, the first case studies and clinical trials look very promising. Spanning several years, trials have demonstrated largely successful outcomes in the field of orthopaedic bioengineering. These include tests with new and advanced materials such as:
- Calcium phosphate ceramics including hydroxyapatite (HA) and beta-tricalcium phosphate (β -TCP), found for instance in the composition of MimetikOss (the first biomimetic bone regeneration material).
- Calcium phosphate cement (CPC’s) and
- Bioactive glass (BG)
Early results have indicated that it is indeed possible to reproduce and replicate exact match bio-ceramic scaffolds using 3DP technology. What’s more, the emergence of 3D printing technology allows clinicians to carry out these processes both quickly and accurately in order to help those with orthopaedic problems. In addition, several studies also found that by loading up the constructions with growth factors, the process was aided further, making for a more probable outcome once the scaffold was in place.
So where are we now and what about the future?
At present, the technique of manufacturing bio-ceramic scaffolds using 3DP technology is still in its infancy. As such, the process is continuing to play catch up with regards to meeting the demand for cost-effective, timely, and predictable tissue engineering solutions for patients. However, as more diverse materials are used and the methods of delivery (3D printing) evolve, the whole engineering process will become more streamlined, better, and indeed more predictable.
This will serve to better position us to help our aging population as we move deeper into the 21st century.3D-Printed Bio-Ceramic Scaffolds, A Real Game Changer for Orthopaedic Surgery!