Journal: Journal of Functional Biomaterials
Article Title: The Concept of Scaffold-Guided Bone Regeneration for the Treatment of Long Bone Defects: Current Clinical Application and Future Perspective
doi: 10.3390/jfb14070341
Figure Lengend Snippet: Exemplary challenges and failures in the use of cylindrical titanium mesh cage implants for bone defects. X-ray of a 29-year-old male with a segmental tibial defect and treatment for definitive fixation with an intramedullary nail and cylindrical titanium mesh cage (DePuy Synthes) ( A ). The asterisks in A1 highlight the graft material four months after grafting, which is packed into and on the outer surface of the cylindrical mesh implant. After 90 months, there is stagnation in the bony consolidation on the surface of the implant (asterisks) compared to plain radiography findings after four months and, in particular, no evidence of a bony structure within the cylindrical titanium mesh cage (triangles) (( B1) : anterior–posterior; ( B2 ): lateral). Patient-specific titanium mesh implant (DePuy Synthes) packed with RIA system graft material implanted to treat a femoral defect ( C ). Twenty-eight months after implantation, a subtle but distinctive callus formed bridging the defect on the implant surface (( D ), asterisks indicating bone bridge). However, no bony consolidation was observed in the inner part of the titanium mesh. The triangles in D indicate that the mesh structure is radiolucent, which would not be possible if ABG remodelling and thus successful regeneration of the graft material of the RIA system had occurred. ( A , B ): reproduced from Supplement of Ref. , with permission from the British Editorial Society of Bone & Joint Surgery; ( C ): reproduced from Supplement of Ref. , reprinted with permission from American Association for the Advancement of Science (AAAS).
Article Snippet: The first clinical application of cylindrical (spinal) titanium mesh cages (DePuy Motech, Warsaw, IN, USA) was described in 1999 for combination with cancellous bone allograft and demineralized bone matrix for the reconstruction of posttraumatic diaphyseal tibial defects in two patients [ ].
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