genortГений ортопедииGenij Ortopedii1028-44272542-131XЦЕНТР ИЛИЗАРОВА10.18019/1028-4427-2023-29-6-662-668JIAINDgenort-2895Research ArticleОбзор литературыLiterature reviewБиосовместимые имплантаты в ортопедии: инженерия костной тканиBiocompatible implants in orthopedics: bone tissue engineeringhttps://orcid.org/0000-0001-5791-1989ПопковА. В.PopkovA. V.

Арнольд Васильевич Попков – доктор медицинских наук, профессор, главный научный сотрудник

Arnold V. Popkov – Doctor of Medical Sciences, Professor, Chief Researcher

apopkov.46@mail.ruhttps://orcid.org/0000-0002-8996-867XПопковД. А.PopkovD. A.

Дмитрий Арнольдович Попков – доктор медицинских наук, профессор РАН, член-корреспондент Французской академии медицинских наук, врач травматолог-ортопед, руководитель Клиники

Dmitry A. Popkov – Doctor of Medical Sciences, Professor of the Russian Academy of Sciences, Corresponding Member of the French Academy of Medical Sciences, Head of the Clinic

dpopkov@mail.ruНациональный медицинский исследовательский центр травматологии и ортопедии имени академика Г.А. ИлизароваРоссияIlizarov National Medical Research Centre for Traumatology and OrthopedicsRussian FederationНациональный медицинский исследовательский центр травматологии и ортопедии имени академика Г.А. Илизарова; Крагуевацкий университет, медицинский факультетРоссияIlizarov National Medical Research Centre for Traumatology and Orthopedics; University of Kragujevac, Faculty of MedicineRussian Federation202328122023296662668Copyright © Попков А.В., Попков Д.А., 20232023Попков А.В., Попков Д.А.Popkov A.V., Popkov D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ilizarov-journal.com/jour/article/view/2895Введение

Введение. Технологический прогресс в течение последних 30 лет способствовал исследованиям и прогрессу в области имплантов для реконструктивной ортопедии. Это направление позволило практически полностью отказаться от применения аутоимплантов из-за недостатков их использования.

Цель

Цель. Продемонстрировать достижения последних 30 лет в разработке биоимплантатов, являющихся альтернативой костной пластике в реконструктивной ортопедии.

Материалы и методы

Материалы и методы. При подготовке обзора для поиска информации использовались научные платформы PubMed, Scopus, ResearchGate, RSCI. Поисковыми словами и словосочетаниями были: биоактивные остеоиндуктивные импланты, костные трансплантаты, костная реконструкция, гидроксиапатит, костные скаффолды, bioactive osteoinductive implants, bone grafting, bone reconstruction, hydroxyapatite, bone scaffolds.

Результаты

Результаты. Основные направления тканевой инженерии в области ортопедии представлены 3D-имплантами, обеспечивающими детерминированную клеточную миграцию, пролиферацию и дифференцировку и сохраняющие на протяжении требуемого времени достаточную механическую прочность своей структуры. Сочетание биодеградируемых имплантов с импрегнацией их костным морфогенетическим белком стимулирует регенерацию реконструируемой кости. Программируемая и контролируемая резорбция имплантов в сочетании с замещением их новой костной тканью является основным вектором развития инженеринга костной ткани.

Обсуждение

Обсуждение. Данный обзор включил в себя представление и критическое обсуждение экспериментального и клинического применения биотолерантных, биоинертных и биоактивных материалов, разрабатываемых и применяемых в настоящее время для реконструктивной ортопедии. Существует консенсусное мнение, что биоматериалы будущего, применяемые в ортопедии, должны обладать остеоиндуктивными и остеокондуктивными свойствами.

Заключение

Заключение. Свойства поликапролактона, импрегнированного гидроксиапатитом (от 10 дo 50 wt %) в сочетании с контролируемой и прогнозируемой абсорбцией, делают этот гибридный материал наиболее перспективным для изготовления имплантов в сравнении с иными композитными материалами.

Introduction Technological advances in bone tissue engineering have improved orthopaedic implants and surgical techniques for bone reconstruction. This approach allows overcoming inconvenience of the paucity of autologous materials available and donor site morbidity.

Aim To demonstrate advances of the past 30 years in the development of bioimplants providing alternatives to bone grafting in reconstructive orthopaedics.

Methods Preparing the review, the scientific platforms such as PubMed, Scopus, ResearchGate, RSCI were used for information searching. Search words or word combinations were bioactive osteoinductive implants, bone grafting, bone reconstruction, hydroxyapatite, bone scaffolds.

Results The main trends in tissue engineering in the field of orthopaedics are represented by construction of three-dimensional structure implants guiding cell migration, proliferation and differentiation as well as mechanical support. Association with bone morphogenetic proteins, growth factors enables proliferation and differentiation of cell types of the targeted bone tissue. A promising advancement should be biodegradability with a controllable degradation rate to compliment cell/tissue in-growth and maturation in limb reconstruction.

Discussion This review presents and discusses the experimental and clinical application of biotolerant, bioinert and bioactive materials for reconstructive bone surgery. Future generations of biomaterials are designed to be osteoconductive and osteoinductive.

Conclusion Properties of polycaprolactone (PCL) filled with hydroxyapatite (from 10 to 50 wt %) make this hybrid material with controllable absorption a promising strategy for reconstructive surgery in comparison to other materials.

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The authors declare that there are no conflicts of interest present.