{"id":8622,"date":"2022-11-08T12:42:53","date_gmt":"2022-11-08T10:42:53","guid":{"rendered":"https:\/\/www.bonalive.com\/en\/?p=8622"},"modified":"2023-05-04T08:32:45","modified_gmt":"2023-05-04T05:32:45","slug":"pros-and-cons-of-5-bone-graft-substitutes","status":"publish","type":"post","link":"https:\/\/www.bonalive.com\/en\/news\/pros-and-cons-of-5-bone-graft-substitutes\/","title":{"rendered":"Pros and cons of 5 bone graft substitutes"},"content":{"rendered":"

Need of a bone graft substitute<\/h3>\n

The skeletal system is developed and maintained by two continuous processes: bone modeling and remodeling. New bone growth occurs, and damaged bone is repaired or removed. Sometimes, however, additional assistance might be needed for the bone to heal and repair itself.<\/p>\n

Orthopedic and trauma surgeons are regularly confronted with situations where an empty cavity remains in the patient’s bone. This can happen, for example, after removal of tumors or infected bone tissue. Depending on many factors, such as the patient\u2019s age and background, defect type, site and size, additional material might be needed to fill the cavity and help the bone heal itself.<\/p>\n

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\"Natural<\/h3>\n

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Finding the ideal bone graft substitute<\/h3>\n

\"Ideal<\/p>\n

An ideal bone graft should first and foremost be biocompatible. This means that the body will accept the foreign material i.e. it does not evoke an immune response. The material should be durable; the shape, volume and structure should be maintained over time.<\/p>\n

The bone graft substitute should also allow for and ideally promote the forming of new blood vessels (vascularity and angiogenesis). A porous structure is thus required \u2013 so that oxygen and nutrients might be transported to the cells and tissues. To make space for bone ingrowth, the material needs to be bio-absorbable. Finally, the bone graft substitute should be cost-effective and readily available for purchase.2<\/sup><\/a><\/p>\n

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The material should be durable; the shape, volume and structure should be maintained over time.<\/p><\/blockquote>\n

Besides the material itself having different properties and features, the biological environment and mechanical stability are important to consider. How well vascularized is the cavity site? Is there an ongoing or high risk of infection? Does the patient have osteoporosis or diabetes?<\/p>\n

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The diamond concept<\/h3>\n

The \u2018diamond concept\u2019 is a framework describing 4 integral factors of bone healing: osteoconductive scaffolds, growth factors, mechanical environment, and osteogenic cells. All of them need consideration when planning the treatment. Prof. T. Blokhuis shortly describes the diamond concept in a Bonalive webinar excerpt from 2021 below.<\/p>\n

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