Clinical Applications of Bone Tissue Engineering in Orthopedic Trauma.
Clinical Applications of Bone Tissue Engineering in Orthopedic Trauma.
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DOI：
10.1007/s40139-018-0166-x
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发表时间：
2018-06
影响因子：
--
通讯作者：
Tuan, Rocky S
中科院分区：
文献类型：
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作者：
Mittwede, Peter N;Gottardi, Riccardo;Alexander, Peter G;Tarkin, Ivan S;Tuan, Rocky S
骨科创伤是世界范围内发病率和死亡率的主要原因。虽然许多骨折如果通过非手术或手术方法适当治疗往往会愈合，但延迟愈合或愈合失败以及感染可能导致毁灭性的并发症。组织工程是一个令人兴奋的，新兴的领域，具有很大的科学和临床意义，在潜在的克服目前的限制，在治疗骨科损伤。虽然骨组织工程技术直接转化为临床应用仍然具有挑战性，但在研究细胞、支架和信号如何用于促进急性骨折愈合和解决骨不连和临界尺寸骨缺损的问题方面已经进行了大量研究。总的来说，研究结果表明，组织工程可以被认为是刺激血管生成和成骨，调节对骨折的免疫反应，提高植入物的生物相容性，预防或对抗感染，并填补创伤性骨丢失造成的巨大缺口。大量的临床前数据支持骨组织工程在临床应用中的巨大潜力，尽管首先必须克服一些翻译障碍。本文综述了骨组织工程方法在创伤骨科中的应用现状和潜力，特别关注急性骨折愈合、骨不连和临界骨缺损。
Orthopaedic trauma is a major cause of morbidity and mortality worldwide. Although many fractures tend to heal if treated appropriately either by nonoperative 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 orthopaedic 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 orthopaedic trauma with specific attention paid to acute fracture healing, nonunion, and critical-sized bone defects.