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Biological aspects of segmental bone defects management

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Abstract

Segmental bone defect management is among the most demanding issues in orthopaedics and there is a great medical need for establishing an appropriate treatment option. Tissue transfer, including bone autografts or free flaps, depending on the size of the bone deficiency, is currently the “gold standard” for treatment of such defects. Osteogenic cells in combination with adequate growth factors and a suitable scaffold, from the aspect of osteoinductivity, osteoconductivity and mechanical stability, are mandatory to successfully restore a bone defect as determined in the “diamond concept”. Our current knowledge on this topic is limited and mostly based on retrospective studies, case reports and a few small randomised clinical trials due to the lack of large and accurately designed randomised clinical trials using novel approaches to regenerative orthopaedics. However, preclinical research on different animal models for critical size defects is abundant, showing emerging candidate cells and cytokines for defect rebridgement. In this article we provide an overview on existing clinical studies and promising preclinical experiments that utilised osteogenic cells, growth factors and biomaterials, as well as their combination for repair of segmental bone defects.

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Acknowledgments

The research leading to these results has received funding from the European Community’s Seventh Framework Programme [FP7/2007-2013] under grant agreement no. HEALTH-F4-2011-279239. This work has also been supported in part by the Croatian Science Foundation project 08/5 BONE6-BIS.

Conflict of interest

M. Jankolija and I.P. are employees of Genera Research. S.V. is the founder of Genera Research. I.D.C., M.P., M. Jelic and L.G. declare that they have no conflict of interest and certify that they have no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing, arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

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Authors and Affiliations

  1. Laboratory for Mineralised Tissues, Centre for Translational and Clinical Research, School of Medicine, University of Zagreb, Šalata 11, Zagreb, 10000, HR, Croatia

    Ivo Dumic-Cule, Lovorka Grgurevic & Slobodan Vukicevic

  2. Department of Orthopaedic Surgery, School of Medicine, University of Zagreb, Zagreb, Croatia

    Marko Pecina & Mislav Jelic

  3. Genera Research, Rakov Potok, Croatia

    Morana Jankolija & Irena Popek

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  1. Ivo Dumic-Cule
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Correspondence to Slobodan Vukicevic.

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Dumic-Cule, I., Pecina, M., Jelic, M. et al. Biological aspects of segmental bone defects management. International Orthopaedics (SICOT) 39, 1005–1011 (2015). https://doi.org/10.1007/s00264-015-2728-4

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