Design, evaluation, and optimization of 3D printed truss scaffolds for bone tissue engineering

Mechanobiological optimization of scaffolds for bone tissue engineering

Synthetic bone graft scaffolds aim to generate new bone tissue and alleviate the limitations of autografts and allografts. To meet that aim, it is essential to have a design approach able to generate scaffold architectures that will promote bone formation. Here, we present a topology-varying design optimization method, the "mixed-topology" approach, that generates new designs from a set of starting structures. This approach was used with objective functions focusing on improving the scaffold's local mechanical microenvironments to mechanobiologically promote bone formation within the scaffold and constraints to ensure manufacturability and achieve desired macroscale properties. The results demonstrate that this approach can successfully generate scaffold designs with improved microenvironments, taking into account different combinations of relevant stimuli and constraints.

Optimal mechanical properties of Hydroxyapatite gradient Voronoi porous scaffolds for bone applications - A numerical study

Irregular Voronoi-based lattice (IVL) structures in tissue engineering (TE) have significant potential for bone regeneration. These scaffolds can mimic natural human bone interconnectivity by gradually altering strut thickness (ST) and seed point space (PS), which affects both mechanical and biological characteristics. This paper investigates the impact of design parameters, ST and PS, on Hydroxyapatite (HA) ILV structures' mechanical properties (elastic modulus (E) and maximum compressive strength (MCS)) and geometrical characteristics (pore number, size, and distribution, surface area (SA), and surface area-to-volume ratio (SA/VR)). Four types of IVL scaffolds were designed; PC-TC (Constant PS-Constant ST), PC-TG (Constant PS-Gradient ST), PG-TC (Gradient PS-Constant ST), and PG-TG (Gradient PS-Gradient ST). The study, conducted through linear static structural finite element analysis (FEA) with maximum stress criteria, underscores the profound impact of irregularity and morphology on mechanical performance and geometrical features. Regarding SA and SA/VR, a comparison between PC-TC with other proposed scaffolds showed a minor improvement for PC-TG, while higher significant improvements were found for both PG-TG and PG-TC. In terms of pores distribution and number, no noticeable improvement was observed for the PC-TG scaffold compared to PC-TC. In contrast, PG-TC and PG-TG lattices demonstrated a variety of pore distributions and approximately doubled pore numbers. Studying mechanical properties, considering E and MCS, showcases substantial gains for PG-TC. It, however, revealed that for the rest of the scaffolds, no enhancement was observed regarding E. Based on these results, gradient PS proved to be more effective than gradient ST in enhancing mechanical performance and geometrical properties. Due to these improvements, this study holds promise for expediting bone regeneration and reducing postoperative complications in bone replacement applications.

Analytical relationships for 2D Re-entrant auxetic metamaterials: An application to 3D printing flexible implants

Both 2D and 3D re-entrant designs are among the well-known prevalent auxetic structures exhibiting negative Poisson's ratio. The present study introduces novel analytical relationships for 2D re-entrant hexagonal honeycombs for both negative and positive ranges of the cell interior angle θ (θ<0 showing a negative Poisson's ratio). The derived analytical solutions are validated against finite element method (FEM) and experimental results. The results show that, compared to the analytical solutions available in the literature, the analytical relationships presented in this study provide the most accurate results for elastic modulus, Poisson's ratio, and yield stress. The analytical/computational tools are then implemented for designing Kinesio taping (KT) structures applicable to treatment of Achilles tendon injuries. One of the main features of the Achilles tendon is a natural auxetic behavior. Poisson's ratio distribution of an Achilles tendon is obtained using longitudinal and transverse strains and are then used to design and 3D print thermoplastic polyurethane (TPU) KT structures with non-uniform distribution of auxetic unit cells. The presented novel KT shows that it is capable of replicating the deformation and global and local Poisson's ratio distributions, similar to those of the Achilles tendon. Due to the absence of similar formulations and procedures in the literature, the results are expected to be instrumental for designing and 3D printing of flexible implants with unusual auxeticity.

Effect of Cell Geometry on the Mechanical Properties of 3D Voronoi Tessellation

Irregular 3D biological scaffolds have been widely observed in nature. Therefore, in the current work, new designs are proposed for lightweight 3D scaffolds based on Voronoi tessellation with high porosity. The proposed designs are inspired by nature, which has undoubtedly proven to be the best designer. Thus, the Rhinoceros 7/Grasshopper software was used to design three geometric models for both normal and elongated Voronoi structures: homogeneous, gradient I, and gradient II. Then, stereolithography (SLA) additive manufacturing was utilized to fabricate biopolymeric materials. Finally, a compression test was carried out to study and compare the mechanical properties of the designed samples. The gradient I cylinder show the highest Young's modulus. For the Homogeneous and gradient II cylinders, elongated Voronoi structures show superior mechanical properties and energy absorption compared to normal Voronoi designs. Hence, these designs are promising topologies for future applications.

3D printing of cellulose nanocrystals based composites to build robust biomimetic scaffolds for bone tissue engineering

Cellulose nanocrystals (CNC) are drawing increasing attention in the fields of biomedicine and healthcare owing to their durability, biocompatibility, biodegradability and excellent mechanical properties. Herein, we fabricated using fused deposition modelling technology 3D composite scaffolds from polylactic acid (PLA) and CNC extracted from Ficus thonningii. Scanning electron microscopy revealed that the printed scaffolds exhibit interconnected pores with an estimated average pore size of approximately 400 µm. Incorporating 3% (w/w) of CNC into the composite improved PLA mechanical properties (Young's modulus increased by ~ 30%) and wettability (water contact angle decreased by ~ 17%). The mineralization process of printed scaffolds using simulated body fluid was validated and nucleation of hydroxyapatite confirmed. Additionally, cytocompatibility tests revealed that PLA and CNC-based PLA scaffolds are non-toxic and compatible with bone cells. Our design, based on rapid 3D printing of PLA/CNC composites, combines the ability to control the architecture and provide improved mechanical and biological properties of the scaffolds, which opens perspectives for applications in bone tissue engineering and in regenerative medicine.

Clinical Applications of Poly-Methyl-Methacrylate in Neurosurgery: The In Vivo Cranial Bone Reconstruction

Background: Biomaterials and biotechnology are becoming increasingly important fields in modern medicine. For cranial bone defects of various aetiologies, artificial materials, such as poly-methyl-methacrylate, are often used. We report our clinical experience with poly-methyl-methacrylate for a novel in vivo bone defect closure and artificial bone flap development in various neurosurgical operations. Methods: The experimental study included 12 patients at a single centre in 2018. They presented with cranial bone defects after various neurosurgical procedures, including tumour, traumatic brain injury and vascular pathologies. The patients underwent an in vivo bone reconstruction from poly-methyl-methacrylate, which was performed immediately after the tumour removal in the tumour group, whereas the trauma and vascular patients required a second surgery for cranial bone reconstruction due to the bone decompression. The artificial bone flap was modelled in vivo just before the skin closure. Clinical and surgical data were reviewed. Results: All patients had significant bony destruction or unusable bone flap. The tumour group included five patients with meningiomas destruction and the trauma group comprised four patients, all with severe traumatic brain injury. In the vascular group, there were three patients. The average modelling time for the artificial flap modelling was approximately 10 min. The convenient location of the bone defect enabled a relatively straightforward and fast reconstruction procedure. No deformations of flaps or other complications were encountered, except in one patient, who suffered a postoperative infection. Conclusions: Poly-methyl-methacrylate can be used as a suitable material to deliver good cranioplasty cosmesis. It offers an optimal dural covering and brain protection and allows fast intraoperative reconstruction with excellent cosmetic effect during the one-stage procedure. The observations of our study support the use of poly-methyl-methacrylate for the ad hoc reconstruction of cranial bone defects.

Functionally graded additive manufacturing for orthopedic applications

Background

Additive Manufacturing due to its benefits in developing parts with complex geometries and shapes, has evolved as an alternate manufacturing process to develop implants with desired properties. The structure of human bones being anisotropic in nature is biologically functionally graded i,e. The structure possesses different properties in different directions. Therefore, various orthopedic implants such as knee, hip and other bone plates, if functionally graded can perform better. In this context, the development of functionally graded (FG) parts for orthopedic application with tailored anisotropic properties has become easier through the use of additive manufacturing (AM).

Objectives

and Rationale: The current paper aims to study the various aspects of additively manufactured FG parts for orthopedic applications. It presents the details of various orthopedic implants such as knee, hip and other bone plates in a structured manner. A systematic literature review is conducted to study the various material and functional aspects of functionally graded parts for orthopedic applications. A section is also dedicated to discuss the mechanical properties of functionally graded parts.

Conclusion

The literature revealed that additive manufacturing can provide lot of opportunities for development of functionally graded orthopedic implants with improved properties and durability. Further, the effect of various FG parameters on the mechanical behavior of these implants needs to be studied in detail. Also, with the advent of various AM technologies, the functional grading can be achieved by various means e.g. density, porosity, microstructure, composition, etc. By varying the AM parameters. However, the current limitations of cost and material biocompatibility prevent the widespread exploitation of AM technologies for various orthopedic applications.

In vitro static and dynamic cell culture study of novel bone scaffolds based on 3D-printed PLA and cell-laden alginate hydrogel

The aim of this paper was to design and fabricate a novel composite scaffold based on the combination of 3D-printed PLA-based triply minimal surface structures (TPMS) and cell-laden alginate hydrogel. This novel scaffold improves the low mechanical properties of alginate hydrogel and can also provide a scaffold with a suitable pore size, which can be used in bone regeneration applications. In this regard, an implicit function was used to generate some Gyroid TPMS scaffolds. Then the fused deposition modeling (FDM) process was employed to print the scaffolds. Moreover, the micro-CT technique was employed to assess the microstructure of 3D-printed TPMS scaffolds and obtain the real geometries of printed scaffolds. The mechanical properties of composite scaffolds were investigated under compression tests experimentally. It was shown that different mechanical behaviors could be obtained for different implicit function parameters. In this research, to assess the mechanical behavior of printed scaffolds in terms of the strain-stress curves on, two approaches were presented: equivalent volume and finite element-based volume. Results of strain-stress curves showed that the finite-element based approach predicts a higher level of stress. Moreover, the biological response of composite scaffolds in terms of cell viability, cell proliferation, and cell attachment was investigated. In this vein, a dynamic cell culture system was designed and fabricated, which improves mass transport through the composite scaffolds and applies mechanical loading to the cells, which helps cell proliferation. Moreover, the results of the novel composite scaffolds were compared to those without Alginate, and it was shown that the composite scaffold could create more viability and cell proliferation in both dynamic and static cultures. Also, it was shown that scaffolds in dynamic cell culture have a better biological response than in static culture. In addition, Scanning electron microscopy was employed to study the cell adhesion on the composite scaffolds, which showed excellent attachment between the scaffolds and cells.

Characterization of biocompatible scaffolds manufactured by fused filament fabrication of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate)

We characterize poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBH) scaffolds for tissue repair and regeneration, manufactured by three-dimensional fused filament fabrication (FFF). PHBH belongs to the class of polyhydroxyalkanoates with interesting biodegradable and biocompatible capabilities, especially attractive for tissue engineering. Equally, FFF stands as a promising manufacturing technology for the production of custom-designed scaffolds. We address thermal, rheological and cytotoxicity properties of PHBH, placing special emphasis on the mechanical response of the printed material in a wide deformation range. Indeed, effective mechanical properties are assessed in both the linear and nonlinear regime. To warrant uniqueness of the material parameters, these are measured directly through digital image correlation, both in tension and compression, while experimental data fitting of finite-element analyses is only adopted for the determination of the second invariant coefficient in the nonlinear regime. Mechanical data are clearly porosity dependent, and they are given for both the cubic and the honeycomb infill pattern. Local strain spikes due to the presence of defects are observed and measured: those falling in the range 70-100% lead to macro-crack development and, ultimately, to failure. Results suggest the significant potential attached to FFF printing of PHBH for customizable medical devices which are biocompatible and mechanically resilient.

Custom Shoe Sole Design and Modeling Toward 3D Printing

This study introduces a design procedure for improving an individual’s footwear comfort with body weight index and activity requirements by customized three-dimensional (3D)-printed shoe midsole lattice structure. This method guides the selection of customized 3D-printed fabrications incorporating both physical and geometrical properties that meet user demands. The analysis of the lattice effects on minimizing the stress on plantar pressure was performed by initially creating various shoe midsole lattice structures designed. An appropriate common 3D printable material was selected along with validating its viscoelastic properties using finite element analysis. The lattice structure designs were analyzed under various loading conditions to investigate the suitability of the method in fabricating a customized 3D-printed shoe midsole based on the individual’s specifications using a single material with minimum cost, time, and material use.

Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction

Rupture of the scapholunate interosseous ligament can cause the dissociation of scaphoid and lunate bones, resulting in impaired wrist function. Current treatments (e.g., tendon-based surgical reconstruction, screw-based fixation, fusion, or carpectomy) may restore wrist stability, but do not address regeneration of the ruptured ligament, and may result in wrist functional limitations and osteoarthritis. Recently a novel multiphasic bone-ligament-bone scaffold was proposed, which aims to reconstruct the ruptured ligament, and which can be 3D-printed using medical-grade polycaprolactone. This scaffold is composed of a central ligament-scaffold section and features a bone attachment terminal at either end. Since the ligament-scaffold is the primary load bearing structure during physiological wrist motion, its geometry, mechanical properties, and the surgical placement of the scaffold are critical for performance optimisation. This study presents a patient-specific computational biomechanical evaluation of the effect of scaffold length, and positioning of the bone attachment sites. Through segmentation and image processing of medical image data for natural wrist motion, detailed 3D geometries as well as patient-specific physiological wrist motion could be derived. This data formed the input for detailed finite element analysis, enabling computational of scaffold stress and strain distributions, which are key predictors of scaffold structural integrity. The computational analysis demonstrated that longer scaffolds present reduced peak scaffold stresses and a more homogeneous stress state compared to shorter scaffolds. Furthermore, it was found that scaffolds attached at proximal sites experience lower stresses than those attached at distal sites. However, scaffold length, rather than bone terminal location, most strongly influences peak stress. For each scaffold terminal placement configuration, a basic metric was computed indicative of bone fracture risk. This metric was the minimum distance from the bone surface to the internal scaffold bone terminal. Analysis of this minimum bone thickness data confirmed further optimisation of terminal locations is warranted.