Regenerative repair of bone defeots with osteoinduotive hydroxyapatite fabr icated to match the defect and implanted with combined use of computer-aided design, computer-aided manufaoturing, and computer-assisted surgery systems : a feasibility study in a

目前，大骨缺损的再生修复是一个具有挑战性的课题。本研究的目的是实现大面积骨缺损修复到原始三维（3D）解剖状态。在3D图像上，将一个假想的球形恶性骨肿瘤放置在一只犬的左髂骨中。术前使用计算机辅助设计软件计划全肿瘤切除。在计算机图像上构建用于填充所产生的骨缺损的植入物的图像。用计算机辅助制造系统制造与成像的骨缺损相同的多孔羟基磷灰石植入物。为了按照术前计划在3^CT图像上切除髂骨，进行了计算机辅助手术。CT扫描显示种植体周围有新骨形成，连续CT扫描显示种植体周围有新骨形成，重建后的髂骨恢复了原有的解剖结构。这种新的方法可以实现有效和精确的再生修复大骨缺损，而无需植骨。

Currently, regenerative repair of large bone detect is a challenging issue. The aim of this study was to achieve repair of large bone defects to the original three-dimensional(3D) anatomical state. An imaginary spherical malignant bone tumor of was placed in the left ilium of a canine on the 3D imaue. Resection of the whole tumor was planned preoperatively by using computer-aided design software. An image of the implant to fill the resulting bone defect was constructed on the computer image. A porous hydroxyapatite implant identical to the imaged bone defect was made with a computer-aided manufacturing system. To resect the iliac bone as planned preoperatively on the 3^CT image, computer-aided surgery was performed. The defect was filled with the fabricated implant and coated with a putty carrier with BMP-2.New bone formation was noted around each implant on CT images and remodeled to restore the original anatomy of the ilium on serial CT images. This new method may enable efficacious and precise regenerative repair of large bone defect without bone grafting.