Tissue Engineering and Regenerative Medicine Cranioplasty Using Polycaprolactone-Tricalcium Phosphate: Management and Treatment Outcomes

Abstract

Cranioplasty is a procedure commonly performed as the next step in management for patients with decompressive craniectomy. It is commonly associated with complications that might result in implant failure and reoperation. Tissue engineering and regenerative medicine (TERM) involve the development of biological substitutes that restore tissue function and regrow and replace damaged tissues. TERM is a potential solution that might allow for improved long-term outcomes in cranioplasty. To present a case series that describes the management and treatment outcomes of using TERM in cranioplasty, using polycaprolactone-tricalcium phosphate (PCL-TCP) implants in 2 patients. In 2 young adults, large bone defects of the skull following decompressive craniectomy were reconstructed using patient-specific implants manufactured from PCL-TCP. Bone marrow aspirate was used as autologous biologic that incorporates stem cell and growth factors into the implant. Both patients recovered without any complications following surgery. Physical examination shows favorable healing outcomes with the defect area having a hard texture upon palpation. Postoperative imaging performed at 8 and 20 months for each patient, respectively, demonstrated ossification over the defect area. Satisfactory bone growth is seen with TERM cranioplasty. The PCL-TCP implant is a novel and recommendable alternative to currently available patient-specific implants used in cranioplasty. TERM cranioplasty is the potential solution to the quest of finding the ideal cranioplasty implant.