NHS Golden Jubilee research paper exploring 3D bio-printing for bone regeneration gains international recognition

A Scottish medical paper exploring the prospect of 3D printing hip and knee joint replacements mixed with a patient’s own biological cells into the body has gained international recognition.

The research paper, co-authored by orthopaedic specialists at NHS Golden Jubilee in collaboration with the University of Strathclyde, investigated the use of 3-dimensional biological printing (3D bio-printing) technology with patient stem cells and other substances found in bones like calcium in order to create “scaffolds” that could help regenerate bone defects in the body.

The paper, entitled ‘3D bioactive composite scaffolds for bone tissue engineering’, was published in the influential medical journal Bioactive Materials in 2017 and has been awarded Best Paper by KeAi as part of the publisher’s 10-year anniversary celebrations, selected from over 200 papers published during the last decade.

To date, it has received more than 1,100 citations by other orthopaedic specialists and researchers, making it a landmark paper in its field.

Bone is the second most commonly transplanted tissue worldwide, with over 4 million operations using bone grafts or bone substitute materials annually to treat bone defects. Developing bioactive 3D scaffolds to support bone regeneration has now become a key area of focus within the rapidly expanding field of bone tissue engineering.

The primary author, Gareth Turnbull, was a Clinical Research Fellow at NHS Golden Jubilee when the paper was written and it also contributed to his Biomedical Engineering PhD at the University of Strathclyde, which awarded University status to NHS Golden Jubilee last year.

The collaborative partnership is aiming to assist in the recovery and remobilisation of NHSScotland through innovation in health care practice, as well as build the Clinical Research Fellowship programme to produce more cutting edge research in future.

Mr Turnbull said: “The reason we looked into this area is because a lot of patients can develop significant bone loss or destruction due to a number of conditions such as arthritis, cancer, infection or trauma.

“When patients lose bone it can be a difficult and time-consuming process to regenerate or heal these defects.

“The idea is that by using 3D printing technology combined with biological components such as patient stem cells, we’ll be able to produce live biological implants that could be placed into patients and heal into place within them, instead of the current alternatives like metal implants, which can fail over time in the body as they wear out or come loose.

“The main benefit for patients would be that instead of having your tumour or bone defect treated with an artificial implant, or having your arthritis treated with joint replacement, you would be able to receive a biological implant that would potentially contain your own cells that would then grow into your own body and become part of you.”

The Orthopaedic team at NHS Golden Jubilee, which currently performs around 30% of all hip and knee replacements in Scotland, is known for leading the way in a number of innovative techniques, including the use of robotics in joint replacements and enhanced recovery after surgery (ERAS) pathways.

Professor Jon Clarke, co-author and current Orthopaedic Research Lead at NHS Golden Jubilee, said: “Innovation that benefits patients is always high on our agenda and this award highlights this work.

“Joint replacements, like any mechanical devices, will eventually wear out, often within the life time of the patient. Biological constructs offer the potential for longer term survival, which could avoid the need for further operations.

“We believe technology like this could be become available for patient use within the next 10 years as other surgical specialties have managed to use similar technology elsewhere in the body, including other bones.

“The award and recognition is testament to the strength of the long collaboration that our Orthopaedic team has had with the University of Strathclyde.

“It also highlights the huge potential of our Orthopaedic Research Fellow Programme where aspiring academic trainees, like Gareth, can be nurtured to their full potential in order to produce high impact studies.”

“We’re very proud that our paper has been cited by other researchers so many times and we are very much looking forward to seeing where this research leads us in the near future.”

Co-author Will Shu, Professor of Biomedical Engineering at the University of Strathclyde, said: "Our collaboration with NHS Golden Jubilee represents a significant leap forward in surgical technology.

“By combining our expertise in 3D bio-printing with their pioneering techniques in orthopaedic surgery, we're not just enhancing current treatments but revolutionising them.

“This award is a testament to the global recognition of our partnership within the international research community.”

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