Review of bone graft and bone substitutes with an emphasis on fracture surgeries

Abstract

BackgroundAutogenous bone graft is the gold standard bone graft material. However, due to limitations of supply and morbidity associated with autograft harvest, various bone substitutes have been considered. This article aims to review the properties of the bone graft and various bone substitutes currently available in orthopedic surgery.Main bodySynthetic bone substitutes consist of hydroxyapatite, tricalcium phosphate, calcium sulfate, or a combination of these minerals. Synthetic porous substitutes share several advantages over allografts, including unlimited supply, easy sterilization, and storage. However, they also have some disadvantages, such as brittle properties, variable rates of resorption, and poor performance in some clinical conditions. Recently, attention has been drawn to osteoinductive materials, such as demineralized bone matrix and bone morphogenetic proteins.ConclusionDespite tremendous efforts toward developing autograft alternatives, a single ideal bone graft substitute has not been developed. The surgeon should understand the properties of each bone graft substitute to facilitate appropriate selection in each specific clinical situation.

Photobiomodulation Therapy Associated with Heterologous Fibrin Biopolymer and Bovine Bone Matrix Helps to Reconstruct Long Bones

“…The distribution of animals in their respective groups in the present study, as well as the number of specimens (n), was based on the principle of the 3 R's, in which there is a commitment by the world scientific community to follow the Russell-Burch Principles (1959) "reduction, replacement and refinement" in the use of animals that, increasingly, remain active in scientific and academic circles. Therefore, it was decided to not perform groups with defects filled only by clot, autogenous bone [3,17] or Bio-Oss ® [5,7,28,45], widely previously published in the literature, including the same methodology used in the present experiment and also from the same research group [39,[46][47][48], focusing on only in the originality and aims of the research.…”

“…However, the limitations of supply, involvement of two surgical areas and morbidity mainly related to the collection of the autograft can be considered disadvantages of this technique. In this way, several bone substitutes are tested and used in surgeries, both dental (on facial bones) and orthopedic (on long bones) [3].…”

Developments in Antibiotic-Eluting Scaffolds for the Treatment of Osteomyelitis

“…These can be designed to incorporate the best features of all available biomaterials and can be 3D-printed, therefore allowing scalability and/or patient-specificity [93]. Composites have come at a time when the field of bone tissue engineering is moving away from the concept of an 'ideal' bone substitute, towards applications that depend on the clinical context [94][95][96]. There is still a need for large-scale randomised control trials in this area before definitive conclusions can be reached.…”

<p>Effects of miR-26a on Osteogenic Differentiation of Bone Marrow Mesenchymal Stem Cells by a Mesoporous Silica Nanoparticle - PEI - Peptide System</p>

“…SD rBMSCs were seeded in a 96-well plate with a concentration of 5 × 10 3 cells/well and incubated overnight prior to starting the treatments. The cells were washed with PBS and transferred to a low serum medium (5% FBS) without penicillin or streptomycin, prior to treating them with varying concentrations (5,10,20,25,50, and 100 μg/mL) of MSN@PEI-KALA, MSN_miR-26a@PEI-KALA and MSN_miR-NC@PEI-KALA. The CCK-8 assay was used to assess the cell viability at 12 h and 24 h post transfection.…”

“…3 Nonetheless, the volume of bone that is possible to be harvested from the iliac crest is restricted, and complications such as morbidity at the harvest site, local hematoma, and remodeling issues of the implanted bone are few of the significant concerns in clinical practices. 4,5 Because of the abovementioned limitations of autogenous graft, there is an urgent need to devise novel clinical therapeutic approaches or methods and/or efficacious and efficient components with improved bone regeneration. 6 Bone tissue engineering (BTE) has emerged as a promising bone regeneration methodology as it is capable of providing sufficient mechanical strength and promoting vascularization for their biocompatibility, biodegradability, and porosity.…”