Page 79 - IJB-9-2

International Journal of Bioprinting Clinical applications of bioprinted active bone

facing traditional treatment method. Nevertheless, the and fibula showed that there was a mass occupying the
3D-printed personalized bioactive bone can outperform proximal end of the left tibia (Figure 1A and B). MRI
the traditional repair method by addressing the prevalent showed multiple mass-occupying masses in the proximal
challenges of the latter method . left tibia, which may be benign (Figure 1C). Pre-operative
[5]
3D bioprinting is used to assemble biological materials biopsy showed striated muscle and fibrous tissue, and there
through a layer-by-layer deposition method with computer were proliferative capillaries and venules in the fibrous
assistance and at the same time accurately colonize active tissue. Thus, the preliminary diagnosis of the case was
cells or cytokines on the biological scaffold, adjust the shape osteofibrous dysplasia. To promote the healing of bone
and size of the scaffold and porosity, and then regulate the defects after tibial tumor resection, we planned to use
interactions between cells, cytokines, and materials . 3D-bioprinted active bone scaffolds for filling and repair.
[6]
After obtaining informed consent from the patient, the
In this case, we used bioink prepared from the patient’s physicians discussed the plan to perform left tibial tumor
autologous platelet-rich plasma (PRP) to combine with resection and implantation of bioprinted active bone for
polycaprolactone/β-tricalcium phosphate (PCL/β-TCP) repair before surgery. The application of bioprinted active
composite scaffold material to print personalized PCL/β- bone to repair bone defects was approved by the Ethics
TCP/PRP active scaffolds layer by layer with the help of Committee of the Ninth People’s Hospital affiliated with
digital medicine, autologous blood enrichment, and 3D Shanghai Jiao Tong University School of Medicine.
bioprinting technology.
The bioprinted active bone was designed and printed
Compared with traditional bone implant materials, with the CT scan data obtained before the surgery
3D-bioprinted personalized active bone not only (Figure 2), and the whole process of printing was carried
completely matches the shape of the bone defect of the out in a 10,000 level GMP laboratory. Approximately
affected limb but also has a highly bionic microstructure. In 35 mL of peripheral venous blood was drawn from the
addition, the activation of PRP in the active bone material patient before surgery, and approximately 4 mL of PRP
can release a variety of bioactive factors. These advantages was prepared by two rounds of centrifugation. PCL/β-
could facilitate the ingrowth of cells and blood vessels and TCP composite material and autologous PRP gel were
accelerate the repair process . then printed layer by layer through dual channels to obtain
[7]
2. Case presentation bioprinted active bone with a porosity of approximately
55% (Figure 3A), which was then placed in normal saline
A 16-year-old female patient was presented with for later use. During the operation, a longitudinal incision
intermittent pain in the left calf, which had lasted for was made on the anterolateral side of the left proximal tibia,
6 months. The patient developed proximal left calf pain separated layer by layer. After exposing the tumor area of
after exercising, which was relieved by rest, followed by the proximal tibia, a hole was drilled and opened, and
intermittent flare. A tumor was palpable in the proximal the lesions in the tibia were removed with a curette. The
left calf, approximately 1 × 1 cm in size, with an unclear tumor lesions were approximately 3 cm × 2.5 cm × 2 cm
boundary, poor mobility, and mild tenderness. The X-ray in size as well as gray-white and medium in texture. The
and computed tomography (CT) scan of the left tibia marginal tissue of the inner wall of the tibia was removed

A B C

D

Figure 1. (A–D) Lower left extremity imaging examination.

Volume 9 Issue 2 (2023) 71 https://doi.org/10.18063/ijb.v9i2.654