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

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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.