Mouser Vivian H M, Levato Riccardo, Bonassar Lawrence J, D'Lima Darryl D, Grande Daniel A, Klein Travis J, Saris Daniel B F, Zenobi-Wong Marcy, Gawlitta Debby, Malda Jos
1 Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
2 Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA.
Cartilage. 2017 Oct;8(4):327-340. doi: 10.1177/1947603516665445. Epub 2016 Sep 1.
Three-dimensional (3D) bioprinting techniques can be used for the fabrication of personalized, regenerative constructs for tissue repair. The current article provides insight into the potential and opportunities of 3D bioprinting for the fabrication of cartilage regenerative constructs. Although 3D printing is already used in the orthopedic clinic, the shift toward 3D bioprinting has not yet occurred. We believe that this shift will provide an important step forward in the field of cartilage regeneration. Three-dimensional bioprinting techniques allow incorporation of cells and biological cues during the manufacturing process, to generate biologically active implants. The outer shape of the construct can be personalized based on clinical images of the patient's defect. Additionally, by printing with multiple bio-inks, osteochondral or zonally organized constructs can be generated. Relevant mechanical properties can be obtained by hybrid printing with thermoplastic polymers and hydrogels, as well as by the incorporation of electrospun meshes in hydrogels. Finally, bioprinting techniques contribute to the automation of the implant production process, reducing the infection risk. To prompt the shift from nonliving implants toward living 3D bioprinted cartilage constructs in the clinic, some challenges need to be addressed. The bio-inks and required cartilage construct architecture need to be further optimized. The bio-ink and printing process need to meet the sterility requirements for implantation. Finally, standards are essential to ensure a reproducible quality of the 3D printed constructs. Once these challenges are addressed, 3D bioprinted living articular cartilage implants may find their way into daily clinical practice.
三维（3D）生物打印技术可用于制造个性化的、用于组织修复的再生构建体。本文深入探讨了3D生物打印在制造软骨再生构建体方面的潜力和机遇。尽管3D打印已在骨科临床中使用，但向3D生物打印的转变尚未发生。我们相信，这一转变将是软骨再生领域向前迈出的重要一步。三维生物打印技术允许在制造过程中加入细胞和生物信号，以生成具有生物活性的植入物。构建体的外部形状可以根据患者缺损的临床图像进行个性化定制。此外，通过使用多种生物墨水进行打印，可以生成骨软骨或分层组织的构建体。通过与热塑性聚合物和水凝胶进行混合打印，以及在水凝胶中加入电纺网，可以获得相关的机械性能。最后，生物打印技术有助于实现植入物生产过程的自动化，降低感染风险。为了推动临床上从非生物植入物向活体3D生物打印软骨构建体的转变，需要解决一些挑战。生物墨水和所需的软骨构建体结构需要进一步优化。生物墨水和打印过程需要满足植入的无菌要求。最后，标准对于确保3D打印构建体的可重复质量至关重要。一旦这些挑战得到解决，3D生物打印的活体关节软骨植入物可能会进入日常临床实践。
