Bone grafts and biomaterials substitutes for bone defect repair: A review.
Bone grafts and biomaterials substitutes for bone defect repair: A review.
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DOI：
10.1016/j.bioactmat.2017.05.007
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发表时间：
2017-12
影响因子：
18.9
通讯作者：
Yeung KWK
中科院分区：
文献类型：
--
作者：
Wang W;Yeung KWK
在骨科临床上，骨移植物一直被用于治疗骨缺损、骨延迟愈合或骨不连以及脊柱融合，尽管合成骨移植替代物的出现。然而，在长期随访研究中发现同种异体移植物和合成替代物与宿主骨的整合受到危害。因此，增强这些移植物和替代物与宿主骨的骨整合是相当重要的。为了解决这个问题，人们考虑在结构性同种异体移植物和合成替代品中添加各种生长因子，例如骨形态发生蛋白（BMP）、甲状旁腺激素（PTH）和富血小板血浆（PRP）。尽管这些因子的临床应用表现出良好的骨形成，但由于成本高和潜在的不良副作用，它们的进一步应用受到限制。或者，生物无机离子如镁、锶和锌被认为是成骨生物因子的替代物。本文就骨移植和骨替代材料以及生物和生物无机因素在骨缺损治疗中的应用作一综述。当前研究揭示了相关生物无机离子在其治疗剂作用中的最常见特异性靶点[273]。自体骨移植在骨传导和骨诱导方面是临床骨再生的金标准。然而，有限的可用性和供体部位的发病率是令人担忧的。同种异体骨因其形式多样、数量大而成为骨科手术的第二大选择。不幸的是，与使用自体移植物相比，降低的骨诱导性可能导致较差的愈合。因此，合成骨替代物和生物因子，例如磷酸钙（CaP）骨水泥和陶瓷、羟基磷灰石（HAp）和重组人骨形态蛋白（rhBMP-2和rhBMP-7），被认为单独或组合用于骨组织再生。
Bone grafts have been predominated used to treat bone defects, delayed union or non-union, and spinal fusion in orthopaedic clinically for a period of time, despite the emergency of synthetic bone graft substitutes. Nevertheless, the integration of allogeneic grafts and synthetic substitutes with host bone was found jeopardized in long-term follow-up studies. Hence, the enhancement of osteointegration of these grafts and substitutes with host bone is considerably important. To address this problem, addition of various growth factors, such as bone morphogenetic proteins (BMPs), parathyroid hormone (PTH) and platelet rich plasma (PRP), into structural allografts and synthetic substitutes have been considered. Although clinical applications of these factors have exhibited good bone formation, their further application was limited due to high cost and potential adverse side effects. Alternatively, bioinorganic ions such as magnesium, strontium and zinc are considered as alternative of osteogenic biological factors. Hence, this paper aims to review the currently available bone grafts and bone substitutes as well as the biological and bio-inorganic factors for the treatments of bone defect. Most common specific targets of relevant bioinorganic ions in their role of therapeutic agents revealed by current researches [273]. Autologous bone graft is the gold standard clinical material for bone regeneration in term of osteoconduction and osteoinduction. However, limited availability and donor site morbidity are concerned. Bone allograft becomes to the second higher option for orthopaedic procedures due to the availability in various forms and large quantities. Unfortunately, reduced osteoinductivity may lead to inferior healing as compared with the use of autologous grafts. Hence, synthetic bone substitutes and biological factors e.g. calcium phosphate (CaP) cements and ceramics, hydroxyapatite (HAp) and recombinant human bone morphological proteins (rhBMP-2 and rhBMP-7) are considered, either alone or combined, for bone tissue regeneration.
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影响因子：
3.7
作者：
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通讯作者：
Aspenberg P
影响因子：
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通讯作者：
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作者：
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通讯作者：
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