PRINCIPLES OF TISSUE ENGINEERING APPLIED TO PROGRAMMABLE OSTEOGENESIS

This article presents a strategy for design, engineering, and fabricat ion of a bioresorbable, manufactured bone graft substitute (BGS) devic e. The approach is based on established precepts of osteogenesis, mole cular biology of hyaluronic acid and osteoinductive proteins, and theo retical preformance criteria for such a device collated from the liter ature of 1991 to 1996. Application of this design and engineering stra tegy results in a composite device consisting of a D,D-L,L-polyactic a cid macrostructure optimized to the architecture of cancellous bone, a microstructure composed of a filamentous velour of hyaluronan and a r ecombinant human bone morphogenetic protein 2 (rhBMP-2). The performan ce of this construct was tested in vivo in the dog, intertransverse pr ocess, spinal fusion model and in a critical sized defect of the rabbi t radius. Data from these studies are used to illustrate principle poi nts of the design and engineering concept. (C) 1998 John Wiley & Sons, Inc.