中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (2): 507-515.doi: 10.12307/2025.897

• 生物材料综述 biomaterial review • 上一篇    下一篇

3D打印聚乳酸骨支架修复骨缺损

杨凤丽 1，2，周  朝2，熊  伟3，周宇翔2，李登顺2，王  鑫4，李展振 1，2   

  1. 1江西中医药大学，江西省南昌市   330004；2舟山定海广华医院，浙江省舟山市   316000；3浙江中医药大学，浙江省杭州市  310000；4解放军总医院，北京市   100028
  • 收稿日期:2024-09-30 接受日期:2024-11-25 出版日期:2026-01-18 发布日期:2025-07-03
  • 通讯作者: 李展振，博士生导师，江西中医药大学，江西省南昌市 330004；舟山定海广华医院，浙江省舟山市 316000 王鑫，骨科博士，研究生导师，解放军总医院，北京市 100028
  • 作者简介:杨凤丽，女，1998年生，河南省驻马店市人，汉族，江西中医药大学创新基地学院在读硕士，主要从事骨伤科研究。
  • 基金资助:
    舟山市市级公益类计划(2022C31034)，项目负责人：周朝；江西中医药大学研究生创新专项资金(JZYC23S24)，项目参与人：熊伟

3D printed poly-L-lactic acid bone scaffolds in repair of bone defects

Yang Fengli1, 2, Zhou Chao2, Xiong Wei3, Zhou Yuxiang2, Li Dengshun2, Wang Xin4, Li Zhanzhen1, 2   

  1. 1Jiangxi University of Chinese Medicine, Nanchang 330004, Jiangxi Province, China; 2Zhoushan Dinghai Guanghua Hospital, Zhoushan 316000, Zhejiang Province, China; 3Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China; 4Chinese PLA General Hospital, Beijing 100028, China 
  • Received:2024-09-30 Accepted:2024-11-25 Online:2026-01-18 Published:2025-07-03
  • Contact: Li Zhanzhen, Doctoral supervisor, Jiangxi University of Chinese Medicine, Nanchang 330004, Jiangxi Province, China; Zhoushan Dinghai Guanghua Hospital, Zhoushan 316000, Zhejiang Province, China Wang Xin, MD, Master’s supervisor, Chinese PLA General Hospital, Beijing 100028, China
  • About author:Yang Fengli, Master candidate, Jiangxi University of Chinese Medicine, Nanchang 330004, Jiangxi Province, China; Zhoushan Dinghai Guanghua Hospital, Zhoushan 316000, Zhejiang Province, China
  • Supported by:
    Zhoushan City Public Welfare Project, No. 2022C31034 (to ZC); Graduate Innovation Special Fund of Jiangxi University of Chinese Medicine, No. JZYC23S24 (to XW)

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摘要：

文题释义：
3D打印：以根据预先设置的3D模型数据为参考，通过计算机控制打印设备对打印材料进行逐层加工，最终制造出满足需求的三维实体模型的加工技术。
聚乳酸：一种生物可降解高分子材料，其特点是无毒、力学强度高、可塑性好、生物体内可降解，已被美国食品药物监管局批准应用于人体，被广泛应用于骨组织工程支架的制备。

背景：3D打印的骨组织工程支架在骨缺损修复的研究和临床治疗中具有明显优势。聚乳酸作为3D打印骨支架的重要原料之一，在进行骨缺损修复时应用潜力巨大，但临床患者的骨缺损诱因不同，对聚乳酸骨支架的综合性能提出了不同要求。
目的：对3D打印技术和聚乳酸支架的发展及支架在骨髓炎、骨肿瘤、骨坏死和骨质疏松等骨病环境下进行骨修复时所选用的设计策略进行归纳与综述。
方法：从中国知网、万方、PubMed、Science Direct与Web of Science数据库中检索和筛选发表时间为1994-2024年的相关文献。英文检索词：“3D printing，Polylactic acid，Bone tissue engineering scaffold，Osteomyelitis，Bone tumor，Osteonecrosis，Osteoporosis，Bone defect”，中文检索词：“3D打印，聚乳酸，骨组织工程支架，骨髓炎，骨肿瘤，骨坏死，骨质疏松，骨缺损”，对筛选出的62篇文献进行系统归纳与分析。
结果与结论：①聚乳酸因具有无毒性、可加工性强、生物相容性好以及能在人体环境中自我降解的特性，被认为是理想的人工骨支架设计原料。3D打印技术的应用使得聚乳酸骨支架能够满足仿生人工骨修复材料的多层多孔结构设计要求，并优化了力学性能，以更好地进行骨修复。②根据不同的骨病微环境，适时调整聚乳酸支架的功能设计对支架综合成骨效能的发挥十分重要。文章讨论了聚乳酸支架在骨髓炎、骨肿瘤、骨坏死和骨质疏松等骨病环境下的应用，强调了针对不同骨病所导致的骨缺损，合理把握骨病治疗与骨组织再生的时间节点的重要性。③尽管聚乳酸支架在骨修复中显示出潜力，但仍存在一些问题，如需要进一步优化支架的结构设计以适配新骨再生，增强支架的生物活性，并兼顾其他功能(如抗菌、抗肿瘤及抗骨质疏松等)以适应不同病理环境下骨组织修复的需求。
https://orcid.org/0009-0009-5672-0860(杨凤丽)；https://orcid.org/0009-0005-9971-3813(李展振)；https://orcid.org/0000-0002-7930-073X(王鑫)

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料；口腔生物材料；纳米材料；缓释材料；材料相容性；组织工程

关键词: 3D打印, 聚乳酸, 骨组织工程支架, 骨髓炎, 骨肿瘤, 骨坏死, 骨质疏松, 骨缺损

Abstract: BACKGROUND: 3D-printed bone tissue engineering scaffolds have obvious advantages in the research and clinical treatment of bone defect repair. As one of the important raw materials for 3D printed bone scaffolds, poly-L-lactic acid has a great potential for application in performing bone defect repair, but clinical patients with different bone defect causative factors have different requirements for the comprehensive performance of poly-L-lactic acid bone scaffolds.
OBJECTIVE: To summarize and review the development of 3D printing technology and poly-L-lactic acid scaffolds and the design strategies chosen for scaffolds for bone repair in the setting of bone diseases such as osteomyelitis, bone tumor, osteonecrosis, and osteoporosis.
METHODS: Literature from CNKI, WanFang, PubMed, Science Direct, and Web of Science databases were searched and screened from 1994 to 2024. Search terms were “3D printing, polylactic acid, bone tissue engineering scaffold, osteomyelitis, bone tumor, osteonecrosis, osteoporosis, bone defect” in Chinese and English. The screened 62 articles were systematically summarized and analyzed.
RESULTS AND CONCLUSION: (1) Poly-L-lactic acid is considered to be an ideal raw material for artificial bone scaffold design due to its non-toxicity, processability, biocompatibility, and ability to self-degrade in the human environment. The application of 3D printing technology has enabled poly-L-lactic acid bone scaffolds to meet the multilayered and porous structural design requirements of biomimetic artificial bone repair materials, and to optimize the mechanical properties for better bone repair. (2) According to different bone disease microenvironments, timely adjustment of the functional design of poly-L-lactic acid scaffolds is important for the comprehensive osteogenic efficacy of the scaffolds. The article discusses the application of poly-L-lactic acid scaffolds in bone disease environments such as osteomyelitis, bone tumor, osteonecrosis, and osteoporosis, and highlights the importance of rationally grasping the timing of bone disease treatment and bone tissue regeneration for bone defects caused by different bone diseases. (3) Although poly-L-lactic acid scaffolds show potential in bone repair, there are still some problems, such as the need to further optimize the structural design of the scaffolds to fit new bone regeneration, enhance the bioactivity of the scaffolds, and take into account other functions (e.g., antimicrobial, anti-tumor, and anti-osteoporosis) in order to adapt to the needs of bone tissue repair in different pathological environments.


Key words: 3D printing, poly-L-lactic acid, bone tissue engineering scaffolds, osteomyelitis, bone tumor, osteonecrosis, osteoporosis, bone defects

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