Abstract
The problem of bone regeneration has engaged both physicians and scientists since the beginning of medicine. Not only can bone heal itself following most injuries, but when it does, the regenerated tissue is often indistinguishable from healthy bone. Problems arise, however, when bone does not heal properly, or when new tissue is needed, such as when two vertebrae are required to fuse to stabilize adjacent spine segments. Despite centuries of research, such procedures still require improved therapeutic methods to be devised. Autologous bone harvesting and grafting is currently still the accepted benchmark, despite drawbacks for clinicians and patients that include limited amounts, donor site morbidity, and variable quality. The necessity for an alternative to this “gold standard” has given rise to a bone-graft and substitute industry, with its central conundrum: what is the best way to regenerate bone? In this review, we dissect bone anatomy to summarize our current understanding of its constituents. We then look at how various components have been employed to improve bone regeneration. Evolving strategies for bone regeneration are then considered.
Highlights
The human skeletal system consists of 206 bones and provides a rigid support for every other organ in the body
Bone formation was observed in the group with vascularized periosteum, but incomplete osteogenesis was found if the periosteum was non-vascularized, and no bone was found if beta-tricalcium phosphate (b-TCP) alone was implanted
Baldwin et al recently created an orthotopic xenograft model to evaluate their tissue-engineered periosteum, a construct that included osteoprogenitor and vascular compartments [27]. Their multiphasic construct combined a star-polyethylene glycol (PEG) heparin hydrogel system loaded with human umbilical vein endothelial cells (HUVECs) with a poly (ε-caprolactone) tubular scaffold seeded with human bone marrow-derived mesenchymal stem stem cells cells (MSCs)
Summary
The human skeletal system consists of 206 bones and provides a rigid support for every other organ in the body. Of cases where healing is compromised, the economic and health burden is conditions,The such as Burden arthritisofand back pain, affect more than 1.7 billion people significant. These conditions are the leading cause of years lived with disability in countries, and thecause second and back pain, affect more than 1.7 billion people worldwide. The concept of a tissue engineering “triangle” consisting growth factors, cells, and scaffolds of growth factors, cells, and scaffoldshas hascontinued continuedtotoprovide provideaagrowing growinglist listofofbone bonegraft graftsubstitutes For those trying to develop bone graft substitutes through biomimicry, it is important to. What does does and does not work whenwhen used used for treating bone bone injuries?
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