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Effect of the ACA on Future Research into Regenerative Strategies for Bone Deficit
Larsen M, Mishra R, Dean D, Miller M
Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center
2014-03-15
Presenter: Michael Larsen
Affidavit:
Michael Larsen was involved in the development of this project. While the manuscript or presentation isn't completed yet, he will be a contributing author to said work.
Director Name: Gregory Pearson
Author Category: Resident Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
To date one of the leading areas of research investment in regenerative medicine has been in the surgical repair of bone deficit. Candidate therapies using cutting edge resorbable scaffolding materials, bone progenitor and vascularizing cells, growth factors, and bioreactors are likely, at least initially, to be expensive. Translation of these technologies may be more challenging than ever in the current environment of reduced federal funding. Moreover, the Affordable Care Act (ACA) may act as a disincentive due to the limitation of reimbursement for any particular therapy. Will there be any incentive to develop new therapies if available off-the-shelf bone substitute materials or implants are relatively less expensive, especially for short term outcomes? The use of 3D printers may provide an opportunity to leverage recent breakthroughs in regenerative medicine. The preparation of well-fitting, patient-specific, inert implants (e.g., cranial, hip, knee, and spine) saves operating room time and decreases the cost and risk for a patient. Will funding be sufficient to develop and translate 3D printed artificial bone grafts? Promising studies of 3D printed bone scaffolds now include hydrogel and porous solid polymer implants where seeded bone and vascular progenitor cells have been cultured in bioreactors. The resulting neo-tissue may allow better integration of the resulting implant. Our conclusion is that although research and translation funding is scarce, investment in this research is justified if 3D printed bone implants continue to provide better fit, better host integration, shorter implantation surgeries, and less revision surgery, and longer term stability than off-the-shelf implants.
