Il principio della camera biologica nel trattamento delle pseudoartrosi complesse e delle perdite di sostanza ossee: quali materiali e perché?

Abstract

Bone regeneration presents a unique challenge to both clinicians and scientists. Recently, a vast amount of knowledge has been attained with regard to the molecular mediators, cell populations and the overall cascade of events participating in the bone repair processes. For the treatment of bone non-unions or bone defects, the ‘Diamond Concept’ for biological enhancement supports the associated implantation of mesenchymal stem cells, a scaffold and growth factors. Prior to the implantation of any or all of these materials however, the surgeon must develop the ideal biological environment where molecular and physiological processes will evolve facilitating an early and successful osteogenesis leading to bone continuity. This privileged environment is the “Biological Chamber” that can create the best conditions promoting the regeneratiion and thus optimizing the results. A “bioreactor” is crated in order to reproduce ideal laboratory conditions. The “Biological Chamber” must be asteptic, vascularized and protected, that means not completely isolated but surrounded selectively in order to mantain the proper contacts with the surrounding tissues.The notion of creating the optimum ‘biological chamber’ represents the centre of the highest biological activity and in a sense the heart of the “Diamond Concept”.