{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:07:15Z","timestamp":1788865635732,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Lincotek Medical"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Funct. Biomater.","JFB"],"abstract":"<jats:p>Background: Injectable bone graft substitutes offer a practical alternative to preformed ceramic scaffolds by adapting to irregular bone defects while preserving osteoconductive properties. This study investigated the in vivo performance of hydroxyapatite\/tetracalcium phosphate (HA\/TTCP) granules, uncoated or alginate-coated, with or without autologous ovine bone marrow concentrate (oBMC), in a standardized sheep bone defect model. Methods: oBMC was characterized for cellular composition, viability, and recovery. Implanted HA\/TTCP formulations were evaluated after 6 and 12 weeks by micro-computed tomography and histomorphometry. Results: Uncoated HA\/TTCP granules promoted bone formation, integrating with host bone. Alginate coating improved injectability and handling but influenced granule organization and degradation. Uncoated HA\/TTCP + oBMC showed a more favorable response than the coated formulation, with higher bone-to-implant contact (p = 0.004) and bone volume (p = 0.031) at 12 weeks. A modest increase in peri-implant bone volume was observed from 6 to 12 weeks in the HA\/TTCP + oBMC group, though this did not retain statistical significance once clustering was accounted for. No significant direct effect of oBMC was observed compared with the cell-free formulation. Conclusions: Injectable HA\/TTCP granules + oBMC represent a promising single-step strategy for irregular bone defects, although further coating optimization is needed to preserve biological performance while maximizing handling advantages.<\/jats:p>","DOI":"10.3390\/jfb17090456","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:00:04Z","timestamp":1788861604000},"page":"456","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Injectable Hydroxyapatite and Tetracalcium Phosphate Granules Combined with Autologous Bone Marrow Concentrate: Toward Shape-Adaptive, Single-Step Bone Regeneration"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3778-4406","authenticated-orcid":false,"given":"Melania","family":"Maglio","sequence":"first","affiliation":[{"name":"Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6681-6374","authenticated-orcid":false,"given":"Enrico","family":"Lucarelli","sequence":"additional","affiliation":[{"name":"Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1\/10, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Michela","family":"Pierini","sequence":"additional","affiliation":[{"name":"Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1\/10, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9900-7357","authenticated-orcid":false,"given":"Chiara","family":"Bellotti","sequence":"additional","affiliation":[{"name":"Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1\/10, 40136 Bologna, 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Milena","family":"Fini","sequence":"additional","affiliation":[{"name":"Scientific Direction, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1\/10, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7843-5969","authenticated-orcid":false,"given":"Gianluca","family":"Giavaresi","sequence":"additional","affiliation":[{"name":"Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1\/10, 40136 Bologna, 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