SUMIT PANNU

R.N. 15001511009

M.TECH (BME)

DCRUS&T, MURTHAL

(SONEPAT)

“Tissue Engineering is an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function or a whole organ”

Langer, R & Vacanti JP, Tissue engineering. Science 260, 920-6; 1993.

CARTILAGE BONE

3.Tools of bone and 3.Tools of bone and cartilage T.E.cartilage T.E.

• Cells– Living part of tissue– Produces protein and provides function of cells– Gives tissue reparative properties

• Scaffold– Provides structural support and shape to construct– Provides place for cell attachment and growth– Usually biodegradable and biocompatible

• Bioreactor– Cell Signaling-Signals that tell the cell what to do– Proteins or Mechanical Stimulation

•There are roughly 1 million cases of skeletal defects a year that require bone-graft procedures to achieve union. Socioeconomic consequences in treating these patients with bone fractures is a major concern for india, that will increase in the next few years due the ageing of their population.

•Current treatments are based on autologous and autogenous bone grafts or as an alternative to these, metal and ceramics.

4.NEED OF BONE AND CARTILAGE T.E.

• Autologous bone graft, that is, bone taken from another part of the patient’s own body, has been the gold standard of bone replacement for many years

• Poly(®-hydroxy acids), including PGA, PLA, and their copolymer PLGA, are the most popular and widely used synthetic polymeric materials in bone and cartilage tissue engineering. • Synthetic degradable hydrogels are emerged as a way to deliver cells and serve as injectable scaffolds for tissue engineering. PEG-based hydrogel scaffolds have been developed for bone regeneration.

• These polymers, having a long history of use as degradable surgical sutures, have gained FDA approval for certain human use and are reasonably biocompatible.

6. Material used in scaffolds for Bone & Cartilage T.E.

7.Bioreactors for Bone and Cartilage T.E.

• COCULTURE BIOREACTORS

• MAGNETIC FORCE BIOREACTOR

• COMPRESSION SYSTEMS

• PERFUSION SYSTEM

• ROTATING VESSEL

• SPINNER FLASK

• PARALLEL-PLATE BIOREACTOR

8. HOW IT IS DONE

•Osteoarthritis (OA) affects 40,000,000 Indians, is the second most common cause for long term disability, and is expected to affect 18.2% of the population by 2020.

•Eighty percent of patients diagnosed with OA report limited ability and 20% cannot perform major daily activities.

• Numerous surgical and medical treatments are used to treat OA; including autologous chondrocyte implantation, debridement arthroplasty, and conservative management (including weight loss, moderate exercise, and non-steroidal anti-inflammatory medication).

9.LITERATURE REVIEW

Currently Available Treatments:

•Treatments have been developed to prevent or delay total joint arthroplasty.

•Initial treatment options for OA include transplantation of whole joints, partial joints, osteochondral segments, and autologous chondrocyte implantation.

•The success of each of these techniques is limited. Although whole or partial joint transplantation may be used for any size defect, it requires a healthy cadaver donor that is size matched.

• Additionally, there is risk of disease transmission and rejection of the transplanted tissue.

• Decreased cell viability at the time of transplantation is also an issue creating morbidity

•Total joint arthroplasty is performed nearly 500,000 times per year in the hip alone, and its frequency increased 50% over 13 years as the mean age and activity of the general population increases in India.

• Arthroplasty generally restores function; however, the rate of total hip arthroplasty revision surgeries is up to 30% with only 72% of implants surviving 10 years.

10.Regulatory issues

• US FDA regulates the tissue engineering on case by

case basis.

• Japan, changed the regulations in 2003, which restricted

the approval for the harvesting and supply of stem cells

and their by approved research units.

• Licensed tissue banks are the importers and suppliers of

human tissue in France and Spain.

• Consistency in bio-processing and in therapeutic results (GMP as basis for stable product)

• Measures of cost effectiveness

• ‘Regulatory intelligence’: e.g. assignment to specific classification categories will funnel products into varying regimes of risk and functionality .

•Although several major progresses have been introduced in the field of bone regenerative medicine during the years, current therapies, such as bone grafts, still have many limitations.

• Moreover, and in spite of the fact that material science technology has resulted in clear improvements in the field of bone substitution medicine, no adequate bone substitute has been developed and hence large bone defects/injuries still represent a major challenge for orthopaedic and reconstructive surgeons.

•

11.FUTURE SCOPE OF BONE AND CARTILAGE T.E

• Bone and Cartilage Tissue Engineering (TE) has been emerging as a valid approach to the current therapies for bone regeneration/substitution. In contrast to classic biomaterial approach, it is based on the understanding of tissue formation and regeneration, and aims to induce new functional tissues, rather than just to implant new spare parts.

References:

[1]- Sommerfeldt, D. W., Rubin, C.T., ―Biology of bone and how it orchestrates the form and function of the skeleton‖, Eur. Spine J., 10:2, S86-95, 2001.

[2]- Rodan , G. A., ―Introduction to bone biology‖, Bone, 13:1, S3-6, 1992.

[3]- Sikavitsas, V. I., Temenoff, J. S., Mikos A. G., ―Biomaterials and bone mechanotransduction‖, Biomaterials, , 22:19, 2581-2593, 2001. [4]- Hill, P.A., Orth, M., Brt. J. Orthod. 1998, 25, 101.

[5] Patrick Jr CW, Mikos AG, McIntire. Prospectus of tissue engineering. In: Patrick Jr CW, Mikos AG, McIntire LV, editors. Frontiers in tissue engineering. New York, USA: Elsevier Science, 1998.

[6] Naughton GK, et al. Emerging developments in tissue engineering and cell technology. Tissue Eng 1995;1(2):211}9.

[7] Langer R, Vacanti JP. Tissue engineering. Science 1993;260: 920}6.

[8] Agrawal C, Niederauer G, Micallef D, Athanasiou K. The use of PLA}PGA polymers in orthopaedics. In: Encyclopedic handbook of biomaterials and bioengineering. New York: Marcel Dekker, 1995. p. 2081}115.

[9] Bajpai PK. Biodegradable sca!olds in orthopedic, oral and maxillofacial surgery. In: Rubin LR, editor. Biomaterials in reconstructive surgery. Mosby: St. Louis, 1983. p. 156.

[10] .Reinholz GG, LuL, Saris DBF, Yaszemski MJ,O’Driscoll SW. Animal models for cartilage reconstruction. Biomaterials 2004;25:1511-1521.

[10] .Reinholz GG, LuL, Saris DBF, Yaszemski MJ, O’Driscoll SW. Animal models for cartilage reconstruction. Biomaterials 2004;25:1511-1521.

[11]. Akens MK, Hurtig MB. Influence of species and anatomical location on chondrocyte expansion. BMC Musculoskeletal Disorders 2005;6:23-31.

[12]. Stevens MM, George JH. Exploring and engineering the cell surface interface. Science 2005;310:1135-8.

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