Making new bone in the lab

Researchers at the University of Southampton are creating bone in the lab to help patients who suffer damage to their joints through injury or disease.


By combining bone stem cells with a 3D printed scaffold, Professor Richard Oreffo and team have been able to recreate hip implants custom designed for the patient.


There’s a place for synthetic implants, but by repairing your own body with your own tissue there is less chance of rejection.


The team use and apply scaffolds in a range of materials, including titanium which are then seeded with the patient’s own bone stem cells and a bone graft. This 3D printed, custom designed implant can then be inserted into the patient.


There are tens of thousands of bone injuries in the UK each year. With an increasingly ageing population, this method for creating bone is an exciting concept. Professor Richard Oreffo hopes that given their data from 3 patients over the last 12 months, within 5-7 years the procedure could become mainstream, routine practice.

So you make bones and cartilage in the lab. What personally inspired you to create this technology?


"I have been fascinated by bone, bone formation and bone repair for 25 years and started working in the bone tissue regeneration field about 12-13 years ago, and my work has been driven by two main personal drivers.



"The first driver comes from a simple question my daughter asked me when she was five: 'Dad, if I broke my bone, would you be able to mend it?' I still remember that moment very clearly. When your daughter asks you such a question, it really does open your eyes to the wide potential of the research we do and the personal application. We all know someone who could benefit from new approaches to generate bone and we are all ageing! This has really focused my whole approach. Twelve years on, I am now driven by how to generate large amounts of bone, and every now and again my daughter does ask me – have we solved it yet?"


"The other main driver behind my work was when I met an orthopaedic surgeon at the University of Oxford a number of years ago and he showed me an example of a patient with Chondrosarcoma, a cancer where the patient had lost almost all of her hip. At that stage, there was very little that the orthopaedic surgeons could do in terms of replacing the huge amount of lost bone. Since then, I have wanted to work out new strategies that can combine a patients' own bone stem cells with an appropriate scaffold to make large amounts of bone that will translate from the lab to the clinic.


"These two moments really set me looking at how we can make large amounts of clinically relevant and functional bone."


Tell us a little about the science behind your exhibit


"We want to combine stem cells with a scaffold, in essence what we're trying to do is create a living bone composite that the body will take on and accept.


Copyright: University of Southampton
Copyright: University of Southampton
"It should be simple – we know the cell that makes bone (called an osteoblast), but bone is a complex tissue requiring a blood supply and has unique mechanical properties. In addition, the bone stem cell is also extremely rare and difficult to isolate. So today, there is still a huge unmet need for ways to make bone – with some 60,000 hip, 50,000 forearm and 40,000 vertebral fractures every year in the UK. There's place for synthetic implants, but ideally you want to repair your body with your own tissue, as there is less chance of rejection. I believe the key is to create a living bone composite and then integrate that into the patient's body."


How do you go from stem cell to scaffold?


"Stem cells are essentially amazing. Think of them as basic tissue building blocks as they have this unique ability to become different cell types and are the source of all tissue in the body. We can harness bone stem cells or skeletal stem cells from your bone marrow, and then change them (we say they are differentiated) to become bone, cartilage or connective tissue which is then combined with a synthetic scaffold to which the cells 'coat'. We are looking to generate what we hope is a functional, structural and mechanically equivalent tissue, comparable to bone."


Is this happening now?


"Yes. One of the recent exciting successes has been the use of 3D printed hip implants. The beauty of this approach is that it can be custom designed for the patient. We can print in a variety of materials, even titanium. We can then seed this with the patient's own bone stem cells from their bone marrow together with a bone graft, and then put this back into the patient. At present, there are only a few patients in receipt, but it is very exciting to see how you can translate something that appears to be science fiction into science fact."