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RESEARCH ARTICLE

Investigating the Influence of Architecture and Material

Composition of 3D Printed Anatomical Design

Scaffolds for Large Bone Defects

Evangelos Daskalakis *, Fengyuan Liu , Boyang Huang , Anil A. Acar ,
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2
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Glen Cooper , Andrew Weightman , Gordon Blunn , Bahattin Koç , Paulo Bartolo *
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1 School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, United Kingdom
2 Faculty of Engineering and Natural Sciences, Sabanci University, Orhanli-Tuzla, Istanbul, 34956, Turkey
3 School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, PO1 2DT, United Kingdom
Abstract: There is a significant unmet clinical need to prevent amputations due to large bone loss injuries. We are addressing
this problem by developing a novel, cost-effective osseointegrated prosthetic solution based on the use of modular pieces,
bone bricks, made with biocompatible and biodegradable materials that fit together in a Lego-like way to form the prosthesis.
This paper investigates the anatomical designed bone bricks with different architectures, pore size gradients, and material
compositions. Polymer and polymer-composite 3D printed bone bricks are extensively morphological, mechanical, and
biological characterized. Composite bone bricks were produced by mixing polycaprolactone (PCL) with different levels
of hydroxyapatite (HA) and β-tri-calcium phosphate (TCP). Results allowed to establish a correlation between bone bricks
architecture and material composition and bone bricks performance. Reinforced bone bricks showed improved mechanical
and biological results. Best mechanical properties were obtained with PCL/TCP bone bricks with 38 double zig-zag filaments
and 14 spiral-like pattern filaments, while the best biological results were obtained with PCL/HA bone bricks based on 25
double zig-zag filaments and 14 spiral-like pattern filaments.

Keywords: Biomanufacturing, Bone grafts, Hydroxyapatite, Polycaprolactone, β-Tri-calcium phosphate, Tissue engineering
*Correspondence to: Paulo Bartolo, School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL,
United Kingdom; paulojorge.bartolo@manchester.ac.uk
Received: March 16, 2020; Accepted: June 4, 2020; Published Online: February 24, 2021

Citation: Daskalakis E, Liu F, Huang B, et al., 2021, Investigating the Influence of Architecture and Material Composition of
3D Printed Anatomical Design Scaffolds for Large Bone Defects. Int J Bioprint, 7(2):268. http://doi.org/10.18063/ijb.v7i2.268

1. Introduction Several surgical techniques have been developed to
treat large bone problems, usually requiring multiple
Bone defects associated with non-unions and large bone and complex procedures with significant morbidity.
loss problems often resulted in large healing periods, Amputation is, in most cases, the clinical approach as it
significant clinical complications, and long-term provides short recovery time but with significant loss of
morbidity. Moreover, the inoculation of pathogens at the limb function . Other techniques include internal fixators,
[4]
time of the initial trauma, surgery, or during the healing bone shortening, distraction osteogenesis, and induced
process may lead to a delay of fracture union, loosening membrane .
[5]
of fixation, and chronic osteomyelitis [1],[2] . The treatment Internal fixation methods such as intramedullary nails
of these defects is complex and expensive, placing a or plates used to stabilize bone gaps after septic conditions
burden on the public health system . Moreover, the costs increase the risk for complications due to infections after
[3]
resulting from the patient’s inability to work and high risk internal fixation, which may lead to even larger defects . It is
[6]
of depression are also significant . also possible to replace entire limbs using megaprostheses,
[4]
© 2021 Daskalakis, et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International
License (http://creativecommons.org/licenses/by-nc/4.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the
original work is properly cited.
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