Delivery of Growth Factors to Enhance Bone Repair

Abstract

The management of critical-sized bone defects caused by nonunion, trauma, infection, malignancy, pseudoarthrosis, and osteolysis poses complex reconstruction challenges for orthopedic surgeons. Current treatment modalities, including autograft, allograft, and distraction osteogenesis, are insufficient for the diverse range of pathology encountered in clinical practice, with significant complications associated with each. Therefore, there is significant interest in the development of delivery vehicles for growth factors to aid in bone repair in these settings. This article reviews innovative strategies for the management of critical-sized bone loss, including novel scaffolds designed for controlled release of rhBMP, bioengineered extracellular vesicles for delivery of intracellular signaling molecules, and advances in regional gene therapy for sustained signaling strategies. Improvement in the delivery of growth factors to areas of significant bone loss has the potential to revolutionize current treatment for this complex clinical challenge.

Towards Stem Cell Therapy for Critical-Sized Segmental Bone Defects: Current Trends and Challenges on the Path to Clinical Translation

“…Therefore, employing a novel growth factor for a different indication necessitates additional FDA approval. Additionally, the high cost of growth factor therapies has hindered their use in a clinical setting, with studies indicating that the average cost of treatment with BMP-7 was 6.78% higher than that of an autologous bone graft, and BMP-7 itself accounted for 41.1% of the total cost [ 201 , 325 ].…”