Preface

Fracture care is an ever-evolving discipline of medicine with rapidly developing new diagnosis methods, treatment recommendations, and innovations in fixation and bone repair. Disability-related fractures throughout all areas of the body affect millions of people worldwide, and the orthopaedic surgeon is tasked with using the latest in evidence-based medicine to improve patient outcomes.

*Current Fracture Care* is a text that was conceived to gather information on the latest evidence-based practices in fracture care. Chapters have been written by experts from all over the world and have been peer-reviewed prior to publication. I would like to extend a thank you to all the authors who have contributed to this text, as well as the staff at IntechOpen for their support in creating this book.

> **John T. Riehl** Department of Orthopaedic Surgery, Medical City UNT/TCU Orthopaedic Surgery Residency Program, Texas Bone and Joint, Denton, Texas, USA

> > **Jan P. Szatkowski** Department of Orthopaedic Surgery, Indiana University Health, USA

**1**

**Chapter 1**

**Abstract**

Recent Advances, Challenges and

Future Opportunities for the Use

of 3D Bioprinting in Large Bone

The healing of bone fractures is a well-known physiological process involving various cell types and signaling molecules interacting at the defect site to repair lost bone tissue. However, large bone defects meaning large tissue loss are a complicated problem in orthopedic surgery. In this chapter, we first present the bone treatment procedure and current commonly employed physical and surgical strategies for the treatment of this kind of fracture such as autografts, allografts, xenografts, and synthetic bone grafts as well as tissue engineering techniques. Further to this, we discuss the common limitations that motivate researchers to develop new strategies to overcome these problems. Finally, we will highlight future prospects and novel technologies such as 3D bioprinting which could overcome some of the mentioned challenges in the field of large bone defect reconstruction, with the benefit of fabri-

**Keywords:** large bone defect (LBd), bone regeneration, tissue engineering,

There are 206 bones in human bodies and they consisted of 15% of body weight

[1]. Bone defects usually occur by trauma, arthritis, fracture, diseases, etc. and large bone defects need extra intervention to regenerate bone structure and functionality [2]. Bone fractures are very common in societies and around 15.3 million bone fractures with 14 million healthcare visits annually in the United States and it expands with the incensement of the elderly population [3]. The bone defects treatment process can be unsuccessful and lead to delays in treatment, non-unions, and malunions. According to the definition of the Food and Drug Administration (FDA), if the treatment lasts more than 9 months, we are faced with non-unions, but in clinical investigations, this can vary from 2 to 12 months [4]. Considering the high prevalence and the importance of the successfulness of the treatment process, scientists are looking for the best treatment method to treat bone injuries, especially

Defect Treatment

*Mostafa Shahrezaee and Ali Zamanian*

cating personalized and vascularized medicine.

3D bioprinting, regenerative surgery

**1. Introduction**
