Engineering of bone grafts

• Published in: Nature biotechnology 2000-09, Vol.18 (9), p.929-930
• Main Author: Niklason, Laura E
• Format: Article
• Language: English
• Subjects: Agriculture; Animals; Bioinformatics; Biomedical and Life Sciences; Biomedical Engineering - methods; Biomedical Engineering/Biotechnology; Biomedicine; Biotechnology; Bone and Bones - physiology; Bone Development; Bone Morphogenetic Proteins - metabolism; Bone Morphogenetic Proteins - therapeutic use; Bone Transplantation; Cnidaria - chemistry; Humans; Life Sciences; news-and-views; Regeneration - physiology; Sheep; Transforming Growth Factor beta - metabolism; Transforming Growth Factor beta - therapeutic use; Transforming Growth Factor beta1
• ISSN: 1087-0156; 1546-1696
• DOI: 10.1038/79394

Our bony skeletons provide the structural girders and mechanical support that allow our limbs and bodies to move freely in a gravitational universe. The repair of bony defects resulting from surgery, trauma, or abnormal development falls generally into the purview of orthopedics. Orthopedic operations account for over 1 million surgical procedures annually in this country, and incur a health care cost of greater than $500 million per year. In orthopedic procedures, bones that are fractured or have other defects are most typically repaired using autogenous bone grafts. Bony segments are taken from one part of the patient's body that is not essential (like the brim of the pelvis), and transplanted to repair bones that are essential for weight-bearing or other functions, such as the bones of the leg. Although this strategy is often successful, it is rather like "robbing Peter to pay Paul," in that the patient must suffer the pain and potential complications of harvest from one bone in order to repair another. Revolutionary alternatives to autogenous bone grafting are now in the pipeline. The engineering of replacement bones in the laboratory from combinations of cells, bioactive factors, and supportive three-dimensional matrices has accelerated in recent years (Fig. 1), and real progress is being made toward one day producing personalized "spare parts" for patients with bony injuries. In this issue, two groups have reported progress in this exciting field.