Tarek Ismail1, Rik Osinga2, Atanas Todorov3, Alexander Haumer4, Laurent A Tchang5, Christian Epple6, Nima Allafi7, Nadia Menzi8, René D Largo9, Alexandre Kaempfen10, Ivan Martin11, Dirk J Schaefer12, Arnaud Scherberich13. 1. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland; Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Switzerland. Electronic address: tarek.ismail@usb.ch. 2. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland; Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Switzerland. Electronic address: rik.osinga@usb.ch. 3. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland. Electronic address: atanastodo@gmail.com. 4. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland. Electronic address: alexander.haumer@usb.ch. 5. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland; Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Switzerland. Electronic address: laurenttchang@hotmail.com. 6. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland. Electronic address: christian.epple.ce@gmail.com. 7. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland. Electronic address: n.allafi@icloud.com. 8. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland. Electronic address: nadia.menzi@hotmail.com. 9. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland; Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Switzerland. Electronic address: rene.largo@yahoo.com. 10. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland; Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Switzerland. Electronic address: alexandre.kaempfen@usb.ch. 11. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Switzerland. Electronic address: ivan.martin@usb.ch. 12. Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Switzerland. Electronic address: dirk.schaefer@usb.ch. 13. Department of Biomedicine, University Hospital Basel, University of Basel, Switzerland; Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Switzerland. Electronic address: arnaud.scherberich@usb.ch.
Abstract
BACKGROUND: Avascular necrosis of bone (AVN) leads to sclerosis and collapse of bone and joints. The standard of care, vascularized bone grafts, is limited by donor site morbidity and restricted availability. The aim of this study was to generate and test engineered, axially vascularized SVF cells-based bone substitutes in a rat model of AVN. METHODS: SVF cells were isolated from lipoaspirates and cultured onto porous hydroxyapatite scaffolds within a perfusion-based bioreactor system for 5days. The resulting constructs were inserted into devitalized bone cylinders mimicking AVN-affected bone. A ligated vascular bundle was inserted upon subcutaneous implantation of constructs in nude rats. After 1 and 8weeks in vivo, bone formation and vascularization were analyzed. RESULTS: Newly-formed bone was found in 80% of SVF-seeded scaffolds after 8weeks but not in unseeded controls. Human ALU+cells in the bone structures evidenced a direct contribution of SVF cells to bone formation. A higher density of regenerative, M2 macrophages was observed in SVF-seeded constructs. In both experimental groups, devitalized bone was revitalized by vascularized tissue after 8 weeks. CONCLUSION: SVF cells-based osteogenic constructs revitalized fully necrotic bone in a challenging AVN rat model of clinically-relevant size. SVF cells contributed to accelerated initial vascularization, to bone formation and to recruitment of pro-regenerative endogenous cells. STATEMENT OF SIGNIFICANCE: Avascular necrosis (AVN) of bone often requires surgical treatment with autologous bone grafts, which is surgically demanding and restricted by significant donor site morbidity and limited availability. This paper describes a de novo engineered axially-vascularized bone graft substitute and tests the potential to revitalize dead bone and provide efficient new bone formation in a rat model. The engineering of an osteogenic/vasculogenic construct of clinically-relevant size with stromal vascular fraction of human adipose, combined to an arteriovenous bundle is described. This construct revitalized and generated new bone tissue. This successful approach proposes a novel paradigm in the treatment of AVN, in which an engineered, vascularized osteogenic graft would be used as a germ to revitalize large volumes of necrotic bone.
BACKGROUND:Avascular necrosis of bone (AVN) leads to sclerosis and collapse of bone and joints. The standard of care, vascularized bone grafts, is limited by donor site morbidity and restricted availability. The aim of this study was to generate and test engineered, axially vascularized SVF cells-based bone substitutes in a rat model of AVN. METHODS: SVF cells were isolated from lipoaspirates and cultured onto porous hydroxyapatite scaffolds within a perfusion-based bioreactor system for 5days. The resulting constructs were inserted into devitalized bone cylinders mimicking AVN-affected bone. A ligated vascular bundle was inserted upon subcutaneous implantation of constructs in nude rats. After 1 and 8weeks in vivo, bone formation and vascularization were analyzed. RESULTS: Newly-formed bone was found in 80% of SVF-seeded scaffolds after 8weeks but not in unseeded controls. Human ALU+cells in the bone structures evidenced a direct contribution of SVF cells to bone formation. A higher density of regenerative, M2 macrophages was observed in SVF-seeded constructs. In both experimental groups, devitalized bone was revitalized by vascularized tissue after 8 weeks. CONCLUSION: SVF cells-based osteogenic constructs revitalized fully necrotic bone in a challenging AVN rat model of clinically-relevant size. SVF cells contributed to accelerated initial vascularization, to bone formation and to recruitment of pro-regenerative endogenous cells. STATEMENT OF SIGNIFICANCE: Avascular necrosis (AVN) of bone often requires surgical treatment with autologous bone grafts, which is surgically demanding and restricted by significant donor site morbidity and limited availability. This paper describes a de novo engineered axially-vascularized bone graft substitute and tests the potential to revitalize dead bone and provide efficient new bone formation in a rat model. The engineering of an osteogenic/vasculogenic construct of clinically-relevant size with stromal vascular fraction of human adipose, combined to an arteriovenous bundle is described. This construct revitalized and generated new bone tissue. This successful approach proposes a novel paradigm in the treatment of AVN, in which an engineered, vascularized osteogenic graft would be used as a germ to revitalize large volumes of necrotic bone.
Authors: Tarek Ismail; Alexander Haumer; Alexander Lunger; Rik Osinga; Alexandre Kaempfen; Franziska Saxer; Anke Wixmerten; Sylvie Miot; Florian Thieringer; Joerg Beinemann; Christoph Kunz; Claude Jaquiéry; Thomas Weikert; Felix Kaul; Arnaud Scherberich; Dirk J Schaefer; Ivan Martin Journal: Front Oncol Date: 2021-12-06 Impact factor: 6.244
Authors: Mar Gonzálvez-García; Carlos M Martinez; Victor Villanueva; Ana García-Hernández; Miguel Blanquer; Luis Meseguer-Olmo; Ricardo E Oñate Sánchez; José M Moraleda; Francisco Javier Rodríguez-Lozano Journal: Materials (Basel) Date: 2018-08-03 Impact factor: 3.623