Trabecular bone scaffolding using a biomimetic approach.
The current treatment of large bone defects has several disadvantages. An alternative for using grafts or bone cement for the filling of bone cavities is the use of a bone scaffold that provides a temporary load-bearing function. This paper describes a biomechanical design procedure for a personalized implant with a geometry that has a good fit inside the defect and an internal architecture that provides a scaffold with optimized mechanical properties. These properties are optimized for a load-bearing application, for avoiding stress shielding in the bone surrounding the implant and for activation of osteoblasts seeded inside the scaffold. The design is based on medical images both of the defect and of healthy bone tissue that is representative for the tissue being replaced by the scaffold. Evaluation of the scaffold's mechanical properties is done with high-resolution finite element analyzes of the scaffold and healthy bone. This allows matching of the scaffold and bone mechanical properties, thus giving the scaffold its biomimetic properties.