MIT 20 441J - REGENERATION OF JOINT TISSUES (56 pages)

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REGENERATION OF JOINT TISSUES



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REGENERATION OF JOINT TISSUES

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Lecture Notes


Pages:
56
School:
Massachusetts Institute of Technology
Course:
20 441j - Biomaterials-Tissue Interactions

Unformatted text preview:

Massachusetts Institute of Technology Harvard Medical School Brigham and Women s Hospital VA Boston Healthcare System 2 79J 3 96J 20 441 HST522J REGENERATION OF JOINT TISSUES Bone M Spector Ph D CONFLICT OF INTEREST STATEMENT Prof Spector derives royalty income from certain products referred to as Bio Oss from Geistlich Pharma Wolhusen Switzerland TISSUES COMPRISING JOINTS Permanent Regeneration Prosthesis Scaffold Bone Yes Yes Articular cartilage No Yes Meniscus No Yes Ligaments No Yes Synovium No No In the process of being developed TYPES OF TISSUES Which Tissues Can Regenerate Spontaneously Yes No Connective Tissues Bone Articular Cartilage Ligament Intervertebral Disc Others Epithelia e g epidermis Muscle Cardiac Skeletal Smooth Nerve FACTORS THAT CAN PREVENT REGENERATION Size of defect e g bone does not regenerate in large defects Solution fill defect with osteoconductive particles that adapt to the cavity or a form filling absorbable cement Collapse of surrounding tissue into the defect e g periodontal defects Solution membranes for guided tissue regeneration GTR Excessive strains in the reparative tissue e g unstable fractures Solution fracture fixation apparatus Disease ELEMENTS OF TISSUE ENGINEERING REGENERATIVE MEDICINE SCAFFOLD Porous absorbable synthetic e g polyglycolic acid and natural e g collagen biomaterials CELLS Autologous or Allogeneic Differentiated cells of same type as tissue Stem cells e g bone marrow derived Other cell types e g dermal cells REGULATORS Growth factors or their genes Mechanical loading Static versus dynamic culture bioreactor Used individually or in combination but often with a scaffold CASE STUDY Problem 56 year old man received ablative tumor surgery 8 years previously in the form of a subtotal mandibulectomy 7 cm had been bridged with a titanium reconstruction plate since initial surgery Head and neck region had been further compromised by radiation treatment Because he had been given Warfarin for an aortic valve



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