Clinical Applications of Bone Tissue Engineering in Orthopedic Trauma
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Purpose of Review
Orthopedic trauma is a major cause of morbidity and mortality worldwide. Although many fractures tend to heal if treated appropriately either by non-operative or operative methods, delayed or failed healing, as well as infections, can lead to devastating complications. Tissue engineering is an exciting, emerging field with much scientific and clinical relevance in potentially overcoming the current limitations in the treatment of orthopedic injuries.
While direct translation of bone tissue engineering technologies to clinical use remains challenging, considerable research has been done in studying how cells, scaffolds, and signals may be used to enhance acute fracture healing and to address the problematic scenarios of nonunion and critical-sized bone defects. Taken together, the research findings suggest that tissue engineering may be considered to stimulate angiogenesis and osteogenesis, to modulate the immune response to fractures, to improve the biocompatibility of implants, to prevent or combat infection, and to fill large gaps created by traumatic bone loss. The abundance of preclinical data supports the high potential of bone tissue engineering for clinical application, although a number of barriers to translation must first be overcome.
This review focuses on the current and potential applications of bone tissue engineering approaches in orthopedic trauma with specific attention paid to acute fracture healing, nonunion, and critical-sized bone defects.
KeywordsOrthopedic trauma Bone fracture Bone tissue engineering Stem cells Biomaterials
This work was supported in part by the CASIS (Grant no. GA-2016-236), the U.S. Department of Defense (DOD W81XWH-14-2-0003, DOD W81XWH-14-1-0217, DOD W81XWH-15-2-0011), the National Institutes of Health (1UG3 TR002136), and the Ri.MED Foundation, Palermo, Italy.
Compliance with Ethical Standards
Conflict of Interest
The authors (Peter N. Mittwede, Riccardo Gottardi, Peter G. Alexander, Ivan S. Tarkin, and Rocky S. Tuan) declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This review article does not contain any human or animal studies performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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