engleski

Biological aspects of segmental bone defects management

Segmental bone defect management is among the most demanding issues in orthopaedics and there is a great medical need for establishing an appropriate treatment option. Tissue transfer, including bone autografts or free flaps, depending on the size of the bone deficiency is currently the gold standard for treatment of such defects. Osteogenic cells in combination with adequate growth factors and suitable scaffold from aspect of osteoinductivity, osteoconductivity, and mechanical stability are mandatory to successfully fulfill bone defect as determined in diamond concept. Our current knowledge on this topic is limited and mostly based on retrospective studies, case reports and few small randomized clinical trials due to the lack of large and accurately designed randomized clinical trials using novel approaches of regenerative orthopaedics. However, preclinical research on different animal models of critical size defects is abundant, therefore emerging candidate cells and cytokines for defect rebridgement. In this article we provide an overview on existing clinical studies and promising preclinical experiments that utilized osteogenic cells, growth factors and biomaterials, as well as their combination for repair of segmental bone defect.

segmental bone defect; bone grafting; bone morphogenetic proteins; osteogenic cells; growth factors; cytokines

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