30845 Suppl Giot.pdf - Giornale Italiano di Ortopedia e Traumatologia

gruppo A ha ricevuto un impianto di gel piastrinico e frustoli di osso
liofilizzato, il gruppo B ha ricevuto gel piastrinico+osso liofilizzato+
MSC, e nel gruppo C sono stati impiantati solo frustoli di osso liofilizzato.
Le MSC sono state prelevate da cresta iliaca durante l’intervento,
e dopo concentrazione, sono state combinate con frustoli e gel
piastrinico autologo. L’esame clinico-radiografico è stato eseguito a
sei settimane, dodici settimane e sei mesi ha mostrato una crescente
osteointegrazione dell’impianto, che a due settimane è risultato pari
al 45% nel gruppo A, 60% nel gruppo B e 20% nel gruppo C. Sia
radiograficamente che con misure istomorfometriche l’omoinnesto è
risultato meglio integrato nei gruppi A e B rispetto al gruppo C con
soli frammenti di liofilizzato.
L’obiettivo della medicina rigenerativa è la rigenerazione piuttosto
che la semplice riparazione dei tessuti, intendendo con quest’ultima
la sostituzione rapida ma incompleta del tessuto danneggiato con
tessuto cicatriziale, mentre la prima si propone la piena funzionalità
attraverso meccanismi alla base dello sviluppo tissutale. Grazie alle
sue innate proprietà dinamiche l’osso ha la capacità di rispondere
pienamente a strategie di rigenerazione tissutale.
La lentezza con cui i prodotti dell’ingegneria tissutale arrivano
all’applicazione clinica è legata alla complessità della funzione
richiesta: più complicata la domanda clinica, più difficile, lungo
e costoso il processo di sviluppo e validazione 38 . I continui
progressi derivanti dalla combinazione dell’ingegneria tissutale,
della biologia cellulare e molecolare, e della scienza dei materiali
offrono soluzioni tecnologicamente avanzate e clinicamente affidabili,
il cui successo crescente conferma il valore delle strategie
terapeutiche della medicina rigenerativa 39 .
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