Effect of Scaffolds Containing Chitosan and Hydroxyapatite in Bone Tissue Engineering Using Freeze-Drying Method: A Systematic Review
Introduction: This systematic review aimed to investigate the effects of chitosan and hydroxyapatite-containing scaffolds in bone tissue engineering by freeze-drying. Material and methods: Relevant articles were searched from several international databases including PubMed, Web of Science (Clarivate Analytics), Scopus, and the Cochrane Library and Embase. All studies were retrieved and reviewed up to June 15, 2025. The keywords (hydroxyapatite), (chitosan), (bone tissue engineering), and (freeze-drying method) were used to retrieve and review relevant articles. To find more relevant articles, Google Scholar was also manually searched, as well as the reference lists of the articles included in the systematic review, and were approved by the review board. The initial search of the reviewed databases resulted in 278 articles that were potentially relevant to the presented review. The total number of eligible articles retrieved in this study was 81. 72 titles, abstracts, and full texts remained for further screening after removing duplicate records. Of these, 63 did not meet the inclusion criteria and were therefore excluded. Finally, 9 articles were selected for qualitative synthesis. Results: Freeze-dried scaffolds containing chitosan and hydroxyapatite have been shown to be effective for bone tissue engineering, offering significant benefits based on a review of studies. This review highlights the diverse approaches and materials used in the development of chitosan and apatite-based scaffolds for bone regeneration. Conclusion: The reviewed studies demonstrate a wide range of cost-effectiveness. Therefore, further research is needed to explore the potential of chitosan and hydroxyapatite-containing scaffolds.