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It is known that the restoration of fractures or bone defects after trauma is one of the urgent problems of modern orthopedics and traumatology. Bone morphogenetic proteins (BMPs) are a group of growth and differentiation factors that are a large subfamily of the transforming growth factor- (TGF-) superfamily. To date, more than 20 types of different BMPs have been identified based on structural similarities, and it has been found that some of them, like BMP-2, -4, -6, -7, and -9, have the most pronounced osteogenic properties. BMPs induce migration, proliferation, and differentiation of undifferentiated mesenchymal stem cells to form osteoblasts and chondroblasts. BMPs have significant inductive effects on various stages of the bone healing process, such as inflammation, angiogenesis, callus formation, and bone remodeling. It is known that recombinant (rh) rhBMP-2 and rhBMP-7 (approved for clinical use in humans by the USA Food and Drug Administration (FDA)), together with the use of bone grafts, they are used to activate reparative osteogenesis in injuries and to replace bone defects in spinal surgery. Therefore, due to its unique properties, the use of BMPs in bone tissue regeneration is one of the most promising and rapidly developing directions in practical medicine. This review discusses the most important concepts regarding the use of BMPs in stimulating bone regeneration, including their mechanisms of action, modes of use, efficacy, and their advantages and disadvantages.
It is known that the restoration of fractures or bone defects after trauma is one of the urgent problems of modern orthopedics and traumatology. Bone morphogenetic proteins (BMPs) are a group of growth and differentiation factors that are a large subfamily of the transforming growth factor- (TGF-) superfamily. To date, more than 20 types of different BMPs have been identified based on structural similarities, and it has been found that some of them, like BMP-2, -4, -6, -7, and -9, have the most pronounced osteogenic properties. BMPs induce migration, proliferation, and differentiation of undifferentiated mesenchymal stem cells to form osteoblasts and chondroblasts. BMPs have significant inductive effects on various stages of the bone healing process, such as inflammation, angiogenesis, callus formation, and bone remodeling. It is known that recombinant (rh) rhBMP-2 and rhBMP-7 (approved for clinical use in humans by the USA Food and Drug Administration (FDA)), together with the use of bone grafts, they are used to activate reparative osteogenesis in injuries and to replace bone defects in spinal surgery. Therefore, due to its unique properties, the use of BMPs in bone tissue regeneration is one of the most promising and rapidly developing directions in practical medicine. This review discusses the most important concepts regarding the use of BMPs in stimulating bone regeneration, including their mechanisms of action, modes of use, efficacy, and their advantages and disadvantages.
BACKGROUND: Reconstruction of extensive defects to bone tissue is one of the important problems of orthopedics and traumatology. Especially in acuteis, the problem is associated with the restoration of bone tissue in conditions of its deficiency in pediatric patients. AIM: The aim of the study is to analyze modern methods of surgical treatment in children with extensive bone tissue injuries based on the published literature. MATERIALS AND METHODS: Our report presents a review of the literature of methods of surgical treatment of extensive bone defects. The literature search was carried out in several databases such as PubMed, ScienceDirect, E-library, GoogleScholar for the period from 2005 to 2020, using the keywords given below. As a result of the search, 105 foreign and 37 domestic sources were found. After exclusion, 56 articles were analyzed, all presented works were published in the last 15 years. RESULTS: The gold standard for replacing bone defects is still the use of autografts, including the use of technologies on a vascular pedicle. Various types of xenografts and allografts of bone tissue are increasingly being replaced by various kinds of synthetic implants. CONCLUSIONS: To date, there is no single generally accepted standard for the surgical treatment of extensive bone defects. The option of surgical treatment of extensive bone tissue defects using tissue-engineered bone implants with axial blood supply seems to be extremely interesting and promising.
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