The musculoskeletal system and tissue engineering in orthopaedics and otorhinolaryngology
01 / 1988 - unknown
METIS Erasmus Universiteit Rotterdam
The main purpose of this program is to study the basic principles of growth, healing and ageing of bone and cartilage relative to orthopaedics and otorhinolaryngology. Bone and cartilage tissue grows from the undifferentiated mesenchymal pre-stage to a mechanically load bearing matrix. Critical stages in this pathway are dictated by molecular and mechanical stimuli. In adult stages and particularly during healing the same stimuli are still active, albeit their influence is usually less strong than during development. Surgery on bone and cartilage for reconstructions in the head and neck region, in joints due to arthrosis or osteoporosis and after fractures or injuries is partly based on the self-healing capacity of the tissue. The surgeon tries to create optimal conditions and have the natural stimuli do the recovery processes. The research in this programme involves at the laboratory side a fundamental approach, using cell and molecular biology techniques, computer models and imaging techniques, to find the essential physical and molecular stimuli to (re)generate cartilage and bone. Cell differentiation stages and appropriate matrix development is examined and influenced. In particular the effects of mechanical forces is studied in primary cell cultures (cartilage) and cell lines (bone). The general aim in the cartilage research is to develop an optimal cartilage reconstruction construct, either from a biomaterial, a cultured autograft or a combination. Bioengineering methods are used to stimulate bone and cartilage cells and effects are studied by molecular techniques. Bone tissue from various clinical and animal experimental sources is evaluated using micro-CT scanning and computer models to simulate the bone turnover process. Clinical studies focus on improved evaluation of reconstruction techniques (e.g. X-ray stereophotogrammetry) and the incorporation of more subtle intervention protocols (e.g. growth hormone trials, electromagnetic stimulation, computer aided surgery). Further work concerns clinical outcome studies with respect to implant surgery, sport injuries and pediatric orthopaedics.