The regeneration of bone in segmental defects has historically been a challenge in the orthopedic field. In particular, a lack of vascular supply often leads to nonunion and avascular necrosis. While the gold standard of clinical care remains the autograft, this approach is limited for large bone defects. Therefore, allograft bone is often required for defects of critical size though a high complication rate is directly attributable to their limited ability to revitalize, revascularize, and remodel resulting in necrosis and re-fracture. However, emerging insights into the mechanisms of bone healing continue to expand treatment options for bony defects to include synthetic materials, growth factors, and cells. The success of such strategies hinges on fabricating an environment that can mimic the body’s natural healing process, allowing for vascularization, bridging, and remodeling of bone. Biological, chemical, and engineering techniques have been explored to determine the appropriate materials and factors for potential use. This review will serve to highlight some of the historical and present uses of allografts and autografts and current strategies in bone tissue engineering for the treatment for bony defects, with particular emphasis on vascularization.
- Bone tissue engineering
- Endothelial cells
- Growth factors
- Mesenchymal stem cells
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Orthopedics and Sports Medicine