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Treatment of critical-sized bone defects: clinical and tissue engineering perspectives

  • General Review • BONE - TRAUMA
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Critical-sized bone defects are defined as those that will not heal spontaneously within a patient’s lifetime. Current treatment options include vascularized bone grafts, distraction osteogenesis, and the induced membrane technique. The induced membrane technique is an increasingly utilized method with favorable results including high rates of union. Tissue engineering holds promise in the treatment of large bone defects due to advancement of stem cell biology, novel biomaterials, and 3D bioprinting. In this review, we provide an overview of the current operative treatment strategies of critical-sized bone defects as well as the current state of tissue engineering for such defects.

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Acknowledgements

Generous support from Kent Thiry and Denise O’Leary, Boswell Foundation, NIH R01AR057837 (NIAMS), and NIH 1U01AR069395 (NIAMS).

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Authors and Affiliations

  1. School of Medicine, University of California, San Francisco (UCSF), 513 Parnassus Ave, San Francisco, CA, 94143, USA

    Erika Roddy

  2. Department of Orthopaedic Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Malcolm R. DeBaun & Michael J. Gardner

  3. School of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Adam Daoud-Gray

  4. Department of Orthopedic Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Yunzhi P. Yang

  5. Department of Bioengineering, Stanford University, 318 Campus Drive, Stanford, CA, 94305, USA

    Yunzhi P. Yang

  6. Department of Materials Science and Engineering, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Yunzhi P. Yang

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  1. Erika Roddy
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  2. Malcolm R. DeBaun
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  5. Michael J. Gardner
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Correspondence to Michael J. Gardner.

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Drs. Roddy, DeBaun, Daoud, and Yang have no conflicts of interest to declare. Dr. Gardner reports personal fees from DePuy-Synthes, personal fees from KCI, personal fees from Miami Medical, personal fees from Biocomposites, personal fees from Pacira, outside the submitted work.

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Roddy, E., DeBaun, M.R., Daoud-Gray, A. et al. Treatment of critical-sized bone defects: clinical and tissue engineering perspectives. Eur J Orthop Surg Traumatol 28, 351–362 (2018). https://doi.org/10.1007/s00590-017-2063-0

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