In situ биопечать в реконструкции костных дефектов: современное состояние и перспективы применения в травматологии и ортопедии

Биопечать является одной из наиболее динамично развивающихся технологий в регенеративной медицине, объединяющей клеточную биологию, инженерию, химию и материаловедение для создания жизнеспособных тканевых конструктов, в том числе непосредственно в зоне повреждения, т.е. интраоперационно или in situ. Значительный интерес представляет биопечать для регенерации костных дефектов, учитывая высокую распространенность травматических повреждений и ограниченную эффективность стандартных методов ауто- и аллотрансплантации. Целью настоящего обзора является анализ современного состояния in situ биопечати в реконструкции костных дефектов, характеризация существующих технических решений и биочернил, а также выявление ключевых препятствий для клинической трансляции с оценкой возможных путей их преодоления. В обзоре рассмотрены фундаментальные принципы интраоперационного нанесения биочернил в раневое ложе, приведены новые данные о способах и устройствах биопечати при замещении костных дефектов, представлены примеры успешного применения технологии в эксперименте. Выделены тренды совершенствования и точки взаимодействия биопечати с ортопедическими методами лечения, определены перспективы применения in situ биопечати в травматологии и ортопедии, основанные на разработке роботизированных систем для работы в операционном поле, совершенствовании органных строительных блоков, их трансплантации с учетом стадий и особенностей травмы. Показано, что in situ биопечать не является альтернативой классическим ортопедическим методикам, а органично интегрируется в них в качестве усиливающего регенеративного компонента, что позволяет повысить эффективность замещения обширных дефектов за счет стимуляции собственного остеогенного потенциала пациента.

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