Abstract
Fractures are one of the most frequently occurring traumatic events worldwide. Approximately 10% of fractures lead to bone healing disorders, resulting in strain for affected patients and enormous costs for society. In order to shed light into underlying mechanisms of bone regeneration (habitual or disturbed), and to develop new therapeutic strategies, various in vivo, ex vivo and in vitro models can be applied. Undeniably, in vivo models include the systemic and biological situation. However, transferability towards the human patient along with ethical concerns regarding in vivo models have to be considered. Fostered by enormous technical improvements, such as bioreactors, on-a-chip-technologies and bone tissue engineering, sophisticated in vitro models are of rising interest. These models offer the possibility to use human cells from individual donors, complex cell systems and 3D models, therefore bridging the transferability gap, providing a platform for the introduction of personalized precision medicine and finally sparing animals. Facing diverse processes during fracture healing and thus various scientific opportunities, the reliability of results oftentimes depends on the choice of an appropriate model. Hence, we here focus on categorizing available models with respect to the requirements of the scientific approach.
Highlights
Bone fractures are among the most common types of traumatic events worldwide.the treatment itself leads to a high economic burden for the society
High-risk groups such as patients with osteoporosis, the elderly or malnourished, post-menopausal women or patients with impaired blood supply are vulnerable to the development of fracture healing disorders
In addition to animal models, in vitro models are promising tools to mimic and explore in detail various sub-aspects or key aspects of bone healing research. These in vitro models are often based on bone tissue engineering (BTE) strategies (Table 2)
Summary
Bone fractures are among the most common types of traumatic events worldwide. The treatment itself leads to a high economic burden for the society. Despite sophisticated therapeutic strategies, aggravating circumstances such as delayed fracture healing or non-union, which occur in about 10% of fractures, lead to a prolonged regeneration process and to a burden for the affected patients. High-risk groups such as patients with osteoporosis, the elderly or malnourished, post-menopausal women or patients with impaired blood supply are vulnerable to the development of fracture healing disorders. To investigate processes of adequate or impaired fracture healing in more detail, various in vivo, ex vivo or in vitro models exist to provide the opportunity for targeted and focused scientific basic and translational research
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