Large bone defects

Revascularizing and replacing damaged bone tissue

 

Prof Mauro Alini

Vice Director AO Research Institute Davos

Focus Area Leader a.i.: Large bone defects

Large bone defects (eg, tumor excision, critical size defect fractures, non-union) remain a clinical problem in bone reconstructive surgery. Current treatments involving autologous or allogenic grafts present the problem of implant availability and quality, in the first case, or associated infection and immune response risks, in the second. In addition, as bone formation is highly dependent on the presence of osteogenic cells at the implant site, vascularization is also a major concern, as inadequate bone vascularization is usually associated with decreased bone formation, tissue necrosis, and implant integration failure, leading to impaired bone repair.

Our aim is to develop hybrid bone substitutes, based on the association of autologous cells and biodegradable scaffolds under autologous biological stimulation, in order to repair and regenerate the functional state of the damaged bone tissue. The induction of vessels within an artificial bone substitute, by co-seeding endothelial progenitor and mesenchymal stem cells, might improve the vascularization of the graft.

Microfluidic systems are able to enhance the development of a vascular environment, while investigating the role of angiogenic factors on vascular sprouting and development.

The role of the immune system in guiding and directing the healing response is gaining in importance.  This area of osteoimmunology is an exciting new field. We are investigating the role of the immune system in the healing process, and the potential of immune cell characterization to be used as a predictive marker of individual patient healing potential in a personalized medicine approach.

Other focus areas

Meet the team

See more about the team on the Musculoskeletal Regeneration group page

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