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Misra RDK, Misra KP. Process-structure-biofunctional paradigm in cellular structured implants: an overview and perspective on the synergy between additive manufacturing, bio-mechanical behaviour and biological functions. ARTIFICIAL CELLS, NANOMEDICINE, AND BIOTECHNOLOGY 2023; 51:630-640. [PMID: 37933821 DOI: 10.1080/21691401.2023.2278156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/29/2023] [Indexed: 11/08/2023]
Abstract
The overview describes the synergy between biological sciences and cellular structures processed by additive manufacturing to elucidate the significance of cellular structured implants in eliminating stress shielding and in meeting the bio-mechanical property requirements of elastic modulus, impact resistance, and fatigue strength in conjunction with the biological functionality. The convergence of additive manufacturing, computer-aided design, and structure-property relationships is envisaged to provide the solution to the current day challenges in the biomedical arena. The traditional methods of fabrication of biomedical devices including casting and mechanical forming have limitations because of the mismatch in micro/microstructure, mechanical, and physical properties with the host site. Additive manufacturing of cellular structured alloys via electron beam melting and laser powder bed fusion has benefits of fabricating patient-specific design that is obtained from the computed tomography scan of the defect site. The discussion in the overview consists of two aspects - the first one describes the underlying reason that motivated 3D printing of implants from the perspective of minimising stress shielding together with the mechanical property requirements, where the mechanical properties of cellular structured implants depend on the cellular architecture and percentage cellular porosity. The second aspect focuses on the biological response of cellular structured devices.
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Affiliation(s)
- R D K Misra
- Department of Metallurgical, Materials and Biomedical Engineering and Biomedical and Biomaterials Research Laboratory, Center for Structural and Functional Materials, University of Texas at El Paso, El Paso, Texas, USA
| | - K P Misra
- Department of Physics, Manipal University Jaipur, Jaipur, Rajasthan, India
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Yang W, Wang C, Luo W, Apicella A, Ji P, Wang G, Liu B, Fan Y. Effectiveness of biomechanically stable pergola-like additively manufactured scaffold for extraskeletal vertical bone augmentation. Front Bioeng Biotechnol 2023; 11:1112335. [PMID: 37057137 PMCID: PMC10089125 DOI: 10.3389/fbioe.2023.1112335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Objective: Extraskeletal vertical bone augmentation in oral implant surgery requires extraosseous regeneration beyond the anatomical contour of the alveolar bone. It is necessary to find a better technical/clinical solution to solve the dilemma of vertical bone augmentation. 3D-printed scaffolds are all oriented to general bone defect repair, but special bone augmentation design still needs improvement.Methods: This study aimed to develop a structural pergola-like scaffold to be loaded with stem cells from the apical papilla (SCAPs), bone morphogenetic protein 9 (BMP9) and vascular endothelial growth factor (VEGF) to verify its bone augmentation ability even under insufficient blood flow supply. Scaffold biomechanical and fluid flow optimization design by finite element analysis (FEA) and computational fluid dynamics (CFD) was performed on pergola-like additive-manufactured scaffolds with various porosity and pore size distributions. The scaffold geometrical configuration showing better biomechanical and fluid dynamics properties was chosen to co-culture for 2 months in subcutaneously into nude mice, with different SCAPs, BMP9, and (or) VEGF combinations. Finally, the samples were removed for Micro-CT and histological analysis.Results: Micro-CT and histological analysis of the explanted scaffolds showed new bone formation in the “Scaffold + SCAPs + BMP9” and the “Scaffold + SCAPs + BMP9 + VEGF” groups where the VEGF addition did not significantly improve osteogenesis. No new bone formation was observed either for the “Blank Scaffold” and the “Scaffold + SCAPs + GFP” group. The results of this study indicate that BMP9 can effectively promote the osteogenic differentiation of SCAPs.Conclusion: The pergola-like scaffold can be used as an effective carrier and support device for new bone regeneration and mineralization in bone tissue engineering, and can play a crucial role in obtaining considerable vertical bone augmentation even under poor blood supply.
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Affiliation(s)
- Wei Yang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Chao Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, China
- *Correspondence: Chao Wang,
| | - Wenping Luo
- Laboratory Animal Center, Southwest University, Chongqing, China
| | - Antonio Apicella
- Advanced Materials Lab, Department of Architecture and Industrial Design, University of Campania, Aversa, Italy
| | - Ping Ji
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Gong Wang
- Technology and Engineering Center for Space Utilization, Chinese Academy of Sciences, Beijing, China
| | - Bingshan Liu
- Technology and Engineering Center for Space Utilization, Chinese Academy of Sciences, Beijing, China
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, China
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Fauzi A, Alvarino A, Yanwirasti Y, Sahputra RE, Suharmanto S. Effects of Amnion Lyophilization Sterile Radiation against the Number of Osteoblasts and Osteocytes in Nonunion Fractures: An Experimental Research Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: This study used an experimental posttest-only control group design that involved white rats of the Sprague Dawley strain.
Methods: The samples used were 8-week-old rats, weighing 250–350 grams of the male sex. The study was conducted on five groups of rats with a total of seven rats per group.
Results: The mean value of osteocytes in the control group was 00.00 ± 00.00 and in the ALSR group it was 87.14 ± 44.85. The mean value of osteoblasts in the control group was 50.06 ± 5.76 and in the ALSR group it was 283.63 ± 22.86. This study showed that there were differences in the number of osteocytes and osteoblasts in the two groups.
Conclusion: The study reported that the ALSR group had significantly different numbers of osteoblasts and osteocytes than the control group.
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Pfeiffenberger M, Bartsch J, Hoff P, Ponomarev I, Barnewitz D, Thöne-Reineke C, Buttgereit F, Gaber T, Lang A. Hypoxia and mesenchymal stromal cells as key drivers of initial fracture healing in an equine in vitro fracture hematoma model. PLoS One 2019; 14:e0214276. [PMID: 30947253 PMCID: PMC6449067 DOI: 10.1371/journal.pone.0214276] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 03/11/2019] [Indexed: 12/20/2022] Open
Abstract
Fractures in horses–whether simple fractures with just one clean break, or incomplete greenstick with stress fractures, or complications such as shattered bones can all be either minimal or even catastrophic. Thus, improvement in fracture healing is a hallmark in equine orthopedics. The fracture healing process implements a complex sequence of events including the initial inflammatory phase removing damaged tissue, re-establishment of vessels and mesenchymal stromal cells, a soft and hard callus phase closing the fracture gap as well as the remodeling phase shaping the bone to a scar-free tissue. Detailed knowledge on processes in equine fracture healing in general and on the initial phase in particular is apparently very limited. Therefore, we generated equine in vitro fracture hematoma models (FH models) to study time-dependent changes in cell composition and RNA-expression for the most prominent cells in the FH model (immune cells, mesenchymal stromal cells) under conditions most closely adapted to the in vivo situation (hypoxia) by using flow cytometry and qPCR. In order to analyze the impact of mesenchymal stromal cells in greater detail, we also incubated blood clots without the addition of mesenchymal stromal cells under the same conditions as a control. We observed a superior survival capacity of mesenchymal stromal cells over immune cells within our FH model maintained under hypoxia. Furthermore, we demonstrate an upregulation of relevant angiogenic, osteogenic and hypoxia-induced markers within 48 h, a time well-known to be crucial for proper fracture healing.
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Affiliation(s)
- Moritz Pfeiffenberger
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
| | - Janika Bartsch
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Paula Hoff
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
| | - Igor Ponomarev
- Research Center of Medical Technology and Biotechnology, Bad Langensalza, Germany
| | - Dirk Barnewitz
- Research Center of Medical Technology and Biotechnology, Bad Langensalza, Germany
| | - Christa Thöne-Reineke
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Frank Buttgereit
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
| | - Timo Gaber
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
| | - Annemarie Lang
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, Berlin, Germany
- * E-mail:
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Bone Regeneration Is Promoted by Orally Administered Bovine Lactoferrin in a Rabbit Tibial Distraction Osteogenesis Model. Clin Orthop Relat Res 2015; 473:2383-93. [PMID: 25822454 PMCID: PMC4457759 DOI: 10.1007/s11999-015-4270-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 03/17/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Lactoferrin, an iron-binding glycoprotein which belongs to the transferrin family, has been shown to promote bone growth. However, reports regarding effects of lactoferrin on bone regeneration during distraction osteogenesis are limited. Our study was designed to investigate the effect of bovine lactoferrin treatment on bone formation of the distracted callus. QUESTIONS/PURPOSES We asked whether bovine lactoferrin enhances bone formation of the distraction callus as determined by (1) radiographic and histologic appearances; (2) dual-energy x-ray absorptiometry (DXA) analysis of bone mineral composition and bone mineral density; (3) micro-CT measures of trabecular architecture; and (4) biomechanical strength of the healing bone. Additionally, serology, reverse transcription (RT)-PCR, and immunohistochemistry were used to explore the possible mechanisms of bovine lactoferrin use on bone formation during distraction osteogenesis. METHODS Unilateral tibial osteodistraction was performed on 80 New Zealand White rabbits with a distraction rate of 1 mm per day for 10 days. Animals then were divided randomly into two groups: (1) vehicle and (2) bovine lactoferrin. At 4 and 8 weeks after completion of distraction, the animals were sacrificed. Lengthened tibias and serum samples were obtained and subjected to radiologic, DXA, micro-CT, histologic, and biomechanical examinations, and serum, RT-PCR and immunohistochemical analyses. RESULTS Radiologic, DXA, micro-CT, histologic, and biomechanical examinations indicated that bovine lactoferrin treatment not only accelerated bone formation at early stages of distraction osteogenesis but also promoted bone consolidation at late stages. The ultimate force of the distracted calluses was increased by 37% (118.8 ± 6.65 N in the lactoferrin group and 86.5 ± 5.47 N in the vehicle group; p < 0.001) and 84% (384.8 ± 18.4 N in the lactoferrin group and 209.0 ± 15.2 N in the vehicle group; p < 0.001) at 4 and 8 weeks, respectively. Moreover, serum analysis showed that bovine lactoferrin treatment significantly increased serum levels of bone alkaline phosphatase and decreased serum levels of tartrate resistant acid phosphatase 5b. In addition, RT-PCR and immunohistochemical analyses suggested that bovine lactoferrin treatment induced a lower receptor activator of nuclear factor-kappaB (RANK) ligand/osteoprotegerin (RANKL/OPG) ratio in the distracted callus. CONCLUSIONS The results of our study suggest that bovine lactoferrin treatment could promote bone regeneration during distraction osteogenesis in the rabbit. The results indicate that the OPG/RANKL/RANK system might be a major mechanism for increased bone formation and decreased bone resorption in distraction osteogenesis with bovine lactoferrin treatment. CLINICAL RELEVANCE Oral administration of bovine lactoferrin may provide a feasible approach for promoting osteogenesis during distraction osteogenesis.
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Ruiz-Ibán MA, Gonzalez-Lizán F, Diaz-Heredia J, Elías-Martin ME, Correa Gorospe C. Effect of VEGF-A165 addition on the integration of a cortical allograft in a tibial segmental defect in rabbits. Knee Surg Sports Traumatol Arthrosc 2015; 23:1393-1400. [PMID: 24296989 DOI: 10.1007/s00167-013-2785-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 11/17/2013] [Indexed: 11/24/2022]
Abstract
PURPOSE Long-bone segmental defects caused by infection, fracture, or tumour are a challenge for orthopaedic surgeons. Structural allografts are sometimes used in their treatment but their poor biological characteristics are a liability. The objective of this study was to determine whether the addition of recombinant vascular endothelial growth factor-A (VEGF) to a structural allograft improved its integration into a rabbit tibial segmental defect in a non-union model. METHODS Tibial segmental defects were filled with heat sterilized allogenic tubular tibiae sections and then stabilized with a screw plate. In the VEGF treatment group (n = 6 tibiae), 2 μg of VEGF added to a 50 μl matrigel solution was inserted into the allograft cavity. In the control group (n = 6 tibiae), only matrigel was added. After 12 weeks, macroscopic and microscopic analysis, radiographs, and computerized micro-tomography (micro-CT) were performed. If allograft consolidation was present, a torsional resistance analysis was performed. RESULTS Addition of VEGF to the allograft decreased the rate of osteosynthesis failure compared with the control group (1/6 vs. 5/6, p = 0.08), increased trabecular continuity evaluated by micro-CT in the bone-allograft interphases (8/12 vs. 2/12, p = 0.036) and histological trabecular continuity (7/12 vs. 0/12, p = 0.0046). Full consolidation was observed in three tibiae of the VEGF group and one in the control group (differences not significant); however, torsional resistance showed no significant differences (n.s.). CONCLUSION Addition of VEGF to a structural allograph inserted into a rabbit tibial segmental defect increased allograft integration rate. Further research in this direction might help clinicians in dealing with large bone defects.
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Affiliation(s)
- Miguel Angel Ruiz-Ibán
- Department of Orthopaedic Surgery and Trauma, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9.100, 28034, Madrid, Spain.
| | - Fausto Gonzalez-Lizán
- Department of Orthopaedic Surgery and Trauma, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9.100, 28034, Madrid, Spain
| | - Jorge Diaz-Heredia
- Department of Orthopaedic Surgery and Trauma, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9.100, 28034, Madrid, Spain
| | - Maria Elena Elías-Martin
- Department of Anesthesiology and Reanimation, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9.100, 28034, Madrid, Spain
| | - Carlos Correa Gorospe
- Experimental Surgery Unit, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9.100, 28034, Madrid, Spain
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Jiang X, Chen Y, Fan X, Zhang H, Kun L. Osteogenesis and mineralization in a rabbit mandibular distraction osteogenesis model is promoted by the human LMP-1 gene. J Orthop Res 2015; 33:521-6. [PMID: 25641592 DOI: 10.1002/jor.22811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 12/10/2014] [Indexed: 02/04/2023]
Abstract
To observe the effects of LIM mineralization protein-1 (LMP-1) on bone regeneration in the distraction zone based on gene transduction, 36 New Zealand white rabbits underwent mandibular lengthening with a distraction rate of 2 mm/day. The animals were then randomly divided into group A and group B (n = 18, each). At the end of the distraction, Ad5-EGFP viruses and Ad5-LMP-1/EGFP viruses were injected into the distraction gaps in groups A and B, respectively. Seven days later, five randomly selected animals from each group were sacrificed to evaluate the survival of the virus. Four and 8 weeks after distraction osteogenesis (DO), six samples randomly selected from each group underwent CT scanning and dual energy X-ray absorptiometry detection. Eight weeks after DO, the rabbits were sacrificed, and the distracted mandibles were harvested. Six animals from each group processed for radiography, micro-CT, histology, and the rest samples were taken three-point bend testing. Using this model, better bone formation and mineralization in the distracted callus were observed in group B when compared with those in group A. The results suggest local transduction with LMP-1 gene promotes osteogenesis and mineralization in DO.
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Affiliation(s)
- Xiaowen Jiang
- Department of Stomatology, The First People's Hospital of Chenzhou, University of China South, No. 102 Luojiajing Road, Chenzhou, Hunan Province, 423000, China
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Makhdom AM, Hamdy RC. The Role of Growth Factors on Acceleration of Bone Regeneration During Distraction Osteogenesis. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:442-53. [DOI: 10.1089/ten.teb.2012.0717] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Asim M. Makhdom
- Division of Orthopaedic Surgery, Shriners Hospital for Children, Montreal Children Hospital, McGill University, Montreal, QC, Canada
- Department of Orthopaedic Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Reggie C. Hamdy
- Division of Orthopaedic Surgery, Shriners Hospital for Children, Montreal Children Hospital, McGill University, Montreal, QC, Canada
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Frey SP, Jansen H, Raschke MJ, Meffert RH, Ochman S. VEGF improves skeletal muscle regeneration after acute trauma and reconstruction of the limb in a rabbit model. Clin Orthop Relat Res 2012; 470:3607-14. [PMID: 22806260 PMCID: PMC3492641 DOI: 10.1007/s11999-012-2456-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 06/18/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND Complicated tibial fractures with severe soft tissue trauma are challenging to treat. Frequently associated acute compartment syndrome can result in scarring of muscles with impaired function. Several studies have shown a relationship between angiogenesis and more effective muscle regeneration. Vascular endothelial growth factor (VEGF) is associated with angiogenesis but it is not clear whether it would restore muscle force, reduce scarring, and aid in muscle regeneration after acute musculoskeletal trauma. QUESTIONS/PURPOSES Therefore, we asked whether local application of VEGF (1) restores muscle force, (2) reduces scar tissue formation, and (3) regenerates muscle tissue. METHODS We generated acute soft tissue trauma with increased compartment pressure in 22 rabbits and shortened the limbs to simulate fracture débridement. In the test group (n = 11), a VEGF-coated collagen matrix was applied locally around the osteotomy site. After 10 days of limb shortening, gradual distraction of 0.5 mm per 12 hours was performed to restore the original length. Muscle force was measured before trauma and on every fifth day after trauma. Forty days after shortening we euthanized the animals and histologically determined the percentage of connective and muscle tissue. RESULTS Recovery of preinjury muscle strength was greater in the VEGF group (2.4 N; 73%) when compared with the control (1.8 N; 53%) with less connective and more muscle tissue in the VEGF group. The recovery of force was related to the percentage of connective tissue versus muscle fibers. CONCLUSIONS Local application of VEGF may improve restoration of muscle force by reducing connective tissue and increasing the relative amount of muscle fibers. CLINICAL RELEVANCE VEGF may be useful to improve skeletal muscle repair by modulating muscle tissue regeneration and fibrosis reduction after acute trauma.
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Affiliation(s)
- Soenke Percy Frey
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University of Wuerzburg, Oberduerrbacher Str 6, 97080 Wuerzburg, Germany.
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Das A, Botchwey E. Evaluation of angiogenesis and osteogenesis. TISSUE ENGINEERING PART B-REVIEWS 2011; 17:403-14. [PMID: 21902609 DOI: 10.1089/ten.teb.2011.0190] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Bone regeneration has long been a major focus for tissue engineers and the importance of vascularization to the bone regeneration process has been well documented. Over the past decade, technological advances in the areas of stem cell biology, scaffold fabrication, and protein engineering have significantly enhanced our understanding of the interplay between vascularization and bone growth. This review, therefore, describes the commonly used models for investigating the complex interactions between osteoblastic cells and endothelial cells, evaluates the different tools utilized to investigate the relationship between vascularization and bone growth in vivo, and finally, summarizes possible areas of research related to therapeutic development.
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Affiliation(s)
- Anusuya Das
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22908, USA
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