Polylactic acid (PLA) is one of the most commonly used materials in the biomedical sector because of its processability, mechanical properties and biocompatibility. Among the different techniques that are feasible to process this biomaterial, additive manufacturing (AM) has gained attention recently, as it provides the possibility of tuning the design of the structures. This flexibility in the design stage allows the customization of the parts in order to optimize their use in the tissue engineering field. In the recent years, the application of PLA for the manufacture of bone scaffolds has been especially relevant, since numerous studies have proven the potential of this biomaterial for bone regeneration. This review contains a description of the specific requirements in the regeneration of bone and how the state of the art have tried to address them with different strategies to develop PLA-based scaffolds by AM techniques and with improved biofunctionality.

The repair of osteochondral defects is one of the major clinical challenges in orthopaedics. Well-established osteochondral tissue engineering methods have shown promising results for the early treatment of small defects. However, less success has been achieved for the regeneration of large defects, which is mainly due to the mechanical environment of the joint and the heterogeneous nature of the tissue. In this study, we developed a multi-layered osteochondral scaffold to match the heterogeneous nature of osteochondral tissue by harnessing additive manufacturing technologies and combining the established art laser sintering and material extrusion techniques. The developed scaffold is based on a titanium and polylactic acid matrix-reinforced collagen “sandwich” composite system. The microstructure and mechanical properties of the scaffold were examined, and its safety and efficacy in the repair of large osteochondral defects were tested in an ovine condyle model. The 12-week in vivo evaluation period revealed extensive and significantly higher bone in-growth in the multi-layered scaffold compared with the collagen–HAp scaffold, and the achieved stable mechanical fixation provided strong support to the healing of the overlying cartilage, as demonstrated by hyaline-like cartilage formation. The histological examination showed that the regenerated cartilage in the multi-layer scaffold group was superior to that formed in the control group. Chondrogenic genes such as aggrecan and collagen-II were upregulated in the scaffold and were higher than those in the control group. The findings showed the safety and efficacy of the cell-free “translation-ready” osteochondral scaffold, which has the potential to be used in a one-step surgical procedure for the treatment of large osteochondral defects. Graphic abstract

Disadvantages in the use of polylactic acid (PLA) as a base material for Tissue Engineering applications include the low osteoconductivity of this biomaterial, its acidic degradation and the deficient cellular adhesion on its surface. In order to counteract these drawbacks, calcium carbonate (CaCO₃) and β-tricalcium phosphate (Ca₃(PO4)₂, β-TCP) were proposed in this work as additives of PLA-based support structures. Composite scaffolds (PLA:CaCO₃: β-TCP 95:2.5:2.5) manufactured by fused deposition modeling (FDM) were tested under enzymatic degradation using proteinase K enzymes to assess the modification of their properties in comparison with neat PLA scaffolds. The samples were characterized before and after the degradation test by optical microscopy, scanning electron microscopy, compression testing and thermogravimetric and calorimetric analysis. According to the results, the combination of the PLA matrix with the proposed additives increases the degradation rate of the 3D printed scaffolds, which is an advantage for the application of the composite scaffold in the field of Tissue Engineering. The higher degradation rate of the composite scaffolds could be explained by the release of the additive particles and the statistically higher microporosity of these samples compared to the neat PLA ones.

Surface modification of 3D-printed PLA structures is a major issue in terms of increasing the biofunctionality and expanding the tissue engineering applications of these parts. In this paper, different exposure times were used for low-pressure oxygen plasma applied to PLA 3D-printed scaffolds. Alkali surface treatments were also evaluated, aiming to compare the modifications introduced on the surface properties by each strategy. Surface-treated samples were characterized through the quantification of carboxyl groups, energy-dispersive X-ray spectroscopy, water contact angle measurements, and differential scanning calorimetry analysis. The change in the surface properties was studied over a two-week period. In addition, an enzymatic degradation analysis was carried out to evaluate the effect of the surface treatments on the degradation profile of the 3D structures. The physicochemical characterization results suggest different mechanism pathways for each type of treatment. Alkali-treated scaffolds showed a higher concentration of carboxyl groups on their surface, which enhanced the enzymatic degradation rate, but were also proven to be more aggressive towards 3D-printed structures. In contrast, the application of the plasma treatments led to an increased hydrophilicity of the PLA surface without affecting the bulk properties. However, the changes on the properties were less steady over time.