Biomechanical evaluation of cell-loaded and cell-free hydroxyapatite implants for the reconstruction of segmental...

Porous hydroxyapatite (HA) scaffoldings are currently used in tissue engineering for bone reconstruction. When this osteoconductive biomaterial is combined with osteoprogenitor cells, it acquires osteoinductive features which accelerate and improve bone formation in vivo. The aim of our study was to assess the mechanical properties of HA-bone complexes undergoing indentation tests, and relate stiffness to composition and structure as examined by micro X-ray. To this purpose, 35-mm tibia diaphyseal resections were performed in sheep. Gaps were filled using porous HA cylinders. Implants were loaded with autologous bone marrow stromal cells (BMSC); cell-free cylinders were used as control. After 8 weeks, bone tissue was found within the internal macropores of cell-loaded HA carriers, and in control implants, bone formation was mostly limited to the outer surface. As assessed by indentation testing the stiffness values of bone-HA composites were halfway between those of HA scaffoldings and tibia bone. Cell-loaded implants were stiffer than cell-free ones. In a cell-loaded implant we also analyzed the variation of stiffness along the main axis of the tibia.