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Cited by 435Bone Tissue Engineering MaterialsBone fractures and treatmentsBone Tumor Diagnosis and Treatments

The use of bone-graft substitutes in large bone defects: Any specific needs?

Calori, G.M., Mazza, E., Colombo, M., Ripamonti, C.·2011·Injury
DOI 10.1016/j.injury.2011.06.011
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Abstract

Introduction The gold standard for restoring bone defects is still considered to be autologous bone grafting. However, clinical benefits are not guaranteed and donor-site complications and morbidity is not infrequent. Research is on-going for the development of alternative bone substitutes of both biological and synthetic origin. The purpose of this study was to evaluate the type of materials used and their efficacy for the treatment of large bone defects in traumatology and orthopaedic surgery.Materials and method A literature review was carried out of Embase and PubMed databases. Inclusion criteria were articles in English language focusing on the use of bone substitutes in trauma and orthopaedic surgery for the treatment of bone defects and included details on the structural, biological or biomechanical properties of the pure product. Furthermore, based on two clinical challenges, fracture non-union and impaction grafting we elaborated on the use of polytherapy for large bone defects as guided by the diamond concept.Results All the products indicated in this manuscript possess osteoconductive activities but have different resorption times and biomechanical properties. Bone graft substitute materials are used for a wide range of clinical applications even when the level of clinical evidence is low. The size and location of the defect and the local biological and mechanical environment as well as the biomechanical characteristics of the material determine the type of device that can be implanted in a bone defect.Conclusion Proper assessment of the biological and mechanical environment and accurate patient selection are necessary to judge the extent of therapy the injury warrants. A sound understanding of various aspects of biomaterial properties and their relation and influence towards bone healing is of utmost importance. We suggest the application of polytherapy for the treatment of large bone defects and advocate the use of the diamond concept as a guideline.

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Authors
Calori, G. M., Mazza, E., Colombo, M., & Ripamonti, C.
Affiliations
University of Milan (IT)
ORCID
Venue
Injury
Publisher
Elsevier BV
Published
2011-09
Volume
42
Pages
S56-S63
ISSN
0020-1383 (ISSN-L)
DOI
10.1016/j.injury.2011.06.011
OpenAlex
W2128128715
Cited by
435
References
84
Citations by year
2026: 22 · 2025: 23 · 2024: 20 · 2023: 25 · 2022: 35 · 2021: 32 · 2020: 36 · 2019: 27 · 2018: 31 · 2017: 45 · 2016: 32 · 2015: 25 · 2014: 29 · 2013: 37 · 2012: 15
FWCI
15.51
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Injury (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Physical Sciences › Engineering › Biomedical Engineering › Bone Tissue Engineering Materials
  • Health Sciences › Medicine › Epidemiology › Bone fractures and treatments
  • Health Sciences › Medicine › Rheumatology › Bone Tumor Diagnosis and Treatments
Keywords
bone graft substitutes, large bone defects, nonunion, impaction grafting, autologous bone graft, osteoconduction, tissue mechanics, polypharmacy, bone regeneration, trauma surgery, orthopedic surgery
MeSH terms
Absorption, Adult, Bone Cements, Bone Matrix, Bone Regeneration, Calcium Phosphates, Calcium Sulfate, Ceramics, Humans, Male, Transplantation, Autologous, Transplantation, Homologous, Bone Transplantation, Porosity, Treatment Outcome, Fracture Healing, Bone Substitutes, Compressive Strength, Bone Morphogenetic Proteins, Fractures, Bone, Tissue Scaffolds

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