Bone Healing Materials in the Treatment of Recalcitrant Nonunions and Bone Defects.
Bone Healing Materials in the Treatment of Recalcitrant Nonunions and Bone Defects.
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DOI：
10.3390/ijms23063352
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发表时间：
2022-03-20
影响因子：
5.6
通讯作者：
Rodríguez-Merchán EC
中科院分区：
文献类型：
--
作者：
Rodríguez-Merchán EC
骨缺损和顽固性骨不连的常用治疗方法是自体骨移植。然而，由于获得自体骨移植物的局限性和其获取相关的发病率，近年来开发了各种骨愈合材料。骨缺损和顽固性骨不连的三种主要治疗策略是合成骨移植物替代品（BGS）， BGS结合生物活性分子，以及BGS和干细胞（基于细胞的构建物）。关于BGS，已经开发了许多生物材料来制备骨组织工程支架，包括生物金属（钛，铁，镁，锌），生物陶瓷（羟基磷灰石（HA）），磷酸三钙（TCP），生物聚合物（胶原，聚乳酸（PLA），聚己内酯（PCL））和生物复合材料（HA/MONs@miR-34a复合涂层，生物玻璃（BG）基ABVF-BG（抗生素释放骨空隙填充）腻子）。骨组织工程支架是促进组织向内生长和新骨再生的临时植入物。它们的发展是为了通过在几何、机械和生物性能方面的适当设计来改善骨愈合。在BGS与生物活性分子结合方面，骨形态发生蛋白（BMPs）是最有效的骨诱导生长因子之一。近年来，一些天然聚合物（胶原蛋白、纤维蛋白、壳聚糖、透明质酸、明胶和海藻酸盐）和合成聚合物（聚乳酸、聚乙醇酸、聚乳酸-乙醇内酯、聚e-己内酯（PCL）、聚对二氧环酮以及由乙醇酸/碳酸三亚甲基组成的共聚物）已被研究作为骨组织工程的潜在支撑材料。关于BGS和干细胞（基于细胞的构建），主要的策略是骨髓基质细胞、脂肪来源的间充质细胞、骨膜来源的干细胞，以及水凝胶和细胞或生物活性分子的3D生物打印。目前，对顽固性骨不连和骨缺损的生物治疗进行了大量的研究，尽管其应用仍远未推广。生物学治疗顽固性骨不连和骨缺损的疗效有待进一步研究。
The usual treatment for bone defects and recalcitrant nonunions is an autogenous bone graft. However, due to the limitations in obtaining autogenous bone grafts and the morbidity associated with their procurement, various bone healing materials have been developed in recent years. The three main treatment strategies for bone defects and recalcitrant nonunions are synthetic bone graft substitutes (BGS), BGS combined with bioactive molecules, and BGS and stem cells (cell-based constructs). Regarding BGS, numerous biomaterials have been developed to prepare bone tissue engineering scaffolds, including biometals (titanium, iron, magnesium, zinc), bioceramics (hydroxyapatite (HA)), tricalcium phosphate (TCP), biopolymers (collagen, polylactic acid (PLA), polycaprolactone (PCL)), and biocomposites (HA/MONs@miR-34a composite coating, Bioglass (BG)-based ABVF-BG (antibiotic-releasing bone void filling) putty). Bone tissue engineering scaffolds are temporary implants that promote tissue ingrowth and new bone regeneration. They have been developed to improve bone healing through appropriate designs in terms of geometric, mechanical, and biological performance. Concerning BGS combined with bioactive molecules, one of the most potent osteoinductive growth factors is bone morphogenetic proteins (BMPs). In recent years, several natural (collagen, fibrin, chitosan, hyaluronic acid, gelatin, and alginate) and synthetic polymers (polylactic acid, polyglycolic acid, polylactic-coglycolide, poly(e-caprolactone) (PCL), poly-p-dioxanone, and copolymers consisting of glycolide/trimethylene carbonate) have been investigated as potential support materials for bone tissue engineering. Regarding BGS and stem cells (cell-based constructs), the main strategies are bone marrow stromal cells, adipose-derived mesenchymal cells, periosteum-derived stem cells, and 3D bioprinting of hydrogels and cells or bioactive molecules. Currently, significant research is being performed on the biological treatment of recalcitrant nonunions and bone defects, although its use is still far from being generalized. Further research is needed to investigate the efficacy of biological treatments to solve recalcitrant nonunions and bone defects.
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