AccScience Publishing / IJB / Online First / DOI: 10.36922/IJB025390400
RESEARCH ARTICLE

Three-dimensional-printed hydroxyapatite/ zirconium dioxide composite scaffold incorporating bone morphogenetic protein-2 for lumbar vertebral bone defect repair in rhesus macaques

Rui Qiu1 Hua-Teng Zhou2 Ren-Fu Quan2* Can-Da Xu2 Tuo Wang2 Wei-Bin Du2 Huan-Huan Gao2 Xiao-Long Huang2 Cai-Yin Xu3 Long-Bao Lv3 Xi-Cheng Wei4 Jin-Fu Wang5
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1 Department of Orthopedic Surgery, Huang Jia Si Hospital of Yushan County (Yushan People’s Hospital), Shangrao, Jiangxi, China
2 Department of Orthopedics, Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
3 Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, China
4 Department of Polymer Materials, School of Materials Science and Engineering, Shanghai University, Shanghai, China
5 Institute of Cell and Development, College of Life Sciences, Zhejiang University, Hangzhou, Zhejiang, China
Received: 26 September 2025 | Accepted: 9 December 2025 | Published online: 18 December 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Bone defects caused by various factors have become a persistent challenge in orthopedic clinics, and traditional treatment methods mainly involve the use of artificial bone or autologous bone transplantation. However, these methods have considerable limitations, such as donor site bone loss, immune rejection, and the risk of secondary infection at the donor site. Therefore, considering these limitations and the rapid development of the field of bone tissue engineering, this study adopted light-curing stereolithography three-dimensional (3D) printing technology to design bone scaffold materials. The technology was used to prepare hydroxyapatite (HA)/zirconium dioxide (ZrO2) porous composites with satisfactory mechanical properties as tissue-engineering bone scaffolds. A bone morphogenetic protein- 2-loaded gelatin/chitosan hydrogel sustained-release system was prepared via an emulsification and cross-linking process. Subsequently, rhesus macaque bone marrow mesenchymal stem cells, acting as osteogenic progenitors, were seeded into the system. Novel HA/ZrO2 scaffolds were fabricated using stereolithography 3D printing technology to serve as bone graft substitutes. The resulting scaffold exhibited a 3D interconnected porous structure and showed good biocompatibility and osteoinductive ability in a rhesus macaque lumbar vertebral bone defect model. The results confirmed that the scaffold achieved osteogenic efficiency comparable to that of autologous bone grafting in rhesus macaques. Therefore, the developed scaffold material has promising potential in bone defect repair.  

Graphical abstract
Keywords
Hydroxyapatite
Nanomaterials
Three-dimensional printing
Tissue-engineered bone
Vertebral defect; Zirconium dioxide
Funding
This work was supported by the Medical and Health Science and Technology Project in Zhejiang Province [2024KY261] and Zhejiang Natural Science Foundation Project (LQN25H270017).
Conflict of interest
The authors declare no conflict of interest.
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing