Enhancing the biological integration of massive bone allograft by a tissue engineering approach : from perfusion-decellularization to recellularization

In reconstructive orthopedic surgery, massive bone allografts are essential tool in our therapeutic arsenal for compensating significant bone tissue loss. However, they are associated with a high rate of postoperative complications, which can compromise patient quality of life and, in some cases, prognosis. This doctoral thesis proposes a novel treatment method aimed at enhancing the osseous integration of these allografts. By considering bone as a complete organ, we leverage its intrinsic vascular network to maximize biological capabilities. Through extensive in vitro studies, preclinical tests on porcine models, and cell therapy-based recellularization trials, this work seeks to comprehensively characterize this new generation of bone allografts and their potential future benefits.