Chapter 8-Clinical Issues in the Development of Cellular Systems for Use as Bone Graft Substitutes

    Published: Jan 2003

      Format Pages Price  
    PDF (2.5M) 22 $25   ADD TO CART
    Complete Source PDF (32M) 22 $154   ADD TO CART


    THE SUCCESSFUL REPAIR of skeletal defects is essential to the treatment of numerous orthopedic conditions such as fracture nonunion, spinal fusion, revision total joint arthroplasty, and segmental bone loss secondary to trauma or tumor resection. Various approaches to augment bone formation are presently available, but all of these treatment options are associated with significant limitations to their use. Autologous bone graft is still considered to be the gold standard and remains the most widely used therapy to stimulate bone repair. Unfortunately, only limited quantities of autograft may be harvested from the skeleton, and this invasive process often gives rise to considerable donor site morbidity, including persistent pain, paresthesia, infection, fracture or gait disturbance [1-4]. Cadaveric allograft bone has poor osteoinductive potential, and there continues to be concerns about graft resorption, inadequate revascularization, and possible transmission of pathogens [5-7]. Demineralized bone matrices are prepared by the acid extraction of allograft bone, resulting in the loss of the mineralized component while retaining collagen and noncollagenous proteins, including growth factors. However, demineralized bone matrices contain only minimal quantities of these growth factors. Because of differences in their processing, these substances possess variable osteoinductive activity and should generally be used as osteoconductive agents [8,9]. Clearly, alternative approaches for enhancing bone formation need to be developed.

    Author Information:

    Attawia, M

    Rosier, R

    Whang, PG
    Center for Health Sciences 76-134, Los Angeles, CA

    Lieberman, JR
    Center for Health Sciences 76-134, Los Angeles, CA

    Paper ID: MONO10065M

    Committee/Subcommittee: F04.48

    DOI: 10.1520/MONO10065M

    CrossRef ASTM International is a member of CrossRef.

    ISBN10: 0-8031-3356-1
    ISBN13: 978-0-8031-3356-3