Bone Morphogenetic Proteins in Craniofacial Surgery: Current Techniques, Clinical Experiences, and the Future of Personalized Stem Cell Therapy

Critical-size osseous defects cannot heal without surgical intervention and can pose a significant challenge to craniofacial reconstruction. Autologous bone grafting is the gold standard for repair but is limited by a donor site morbidity and a potentially inadequate supply of autologous bone. Alternatives to autologous bone grafting include the use of alloplastic and allogenic materials, mesenchymal stem cells, and bone morphogenetic proteins. Bone morphogenetic proteins (BMPs) are essential mediators of bone formation involved in the regulation of differentiation of osteoprogenitor cells into osteoblasts. Here we focus on the use of BMPs in experimental models of craniofacial surgery and clinical applications of BMPs in the reconstruction of the cranial vault, palate, and mandible and suggest a model for the use of BMPs in personalized stem cell therapies.

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Bone Substitutes in Orthopaedic Surgery: Current Status and Future Perspectives

Zeitschrift für Orthopädie und Unfallchirurgie ◽

10.1055/a-1073-8473 ◽

2020 ◽

Cited By ~ 1

Author(s):

André Busch ◽

Alexander Wegner ◽

Marcel Haversath ◽

Marcus Jäger

Keyword(s):

Donor Site ◽

Bone Substitutes ◽

Bone Defects ◽

Donor Site Morbidity ◽

Current Status ◽

Future Perspectives ◽

Autologous Bone Grafting ◽

Long Time ◽

Autologous Bone ◽

Autologous Bone Grafts

AbstractBone replacement materials have been successfully supplied for a long time. But there are cases, especially in critical sized bone defects, in which the therapy is not sufficient. Nowadays, there are multiple bone substitutes available. Autologous bone grafts remain the “gold standard” in bone regeneration. Yet, donor-site morbidity and the available amount of sufficient material are limitations for autologous bone grafting. This study aimed to provide information about the current status in research regarding bone substitutes. We report on the advantages and drawbacks of several bone substitutes. At the end, we discuss the current developments of combining ceramic substitutes with osteoinductive substances.

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Autologous Bone Grafting in Trauma and Orthopaedic Surgery: An Evidence-Based Narrative Review

Journal of Clinical Medicine ◽

10.3390/jcm10194347 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4347

Author(s):

Filippo Migliorini ◽

Francesco Cuozzo ◽

Ernesto Torsiello ◽

Filippo Spiezia ◽

Francesco Oliva ◽

...

Keyword(s):

Blood Loss ◽

Bone Graft ◽

Bone Grafting ◽

Orthopaedic Surgery ◽

Donor Site ◽

Autologous Bone Graft ◽

Iliac Crest Bone Graft ◽

Alternative Source ◽

Autologous Bone Grafting ◽

Autologous Bone

Autologous bone grafting is common in trauma and orthopaedic surgery. Both the Reamer Irrigator Aspirator (RIA) and Iliac Crest Bone Graft (ICBG) aim to obtain autologous bone graft. Although the process of harvesting a bone graft is considered simple, complications may occur. This study examined morbidity and pain at the donor site, blood loss, and iatrogenic fractures, comparing RIA and ICBG. The source of the autologous bone graft, the alternative graft sites, and the storage modalities of the harvested bone marrow were also evaluated. In May 2021, PubMed, Embase, Scopus, and Google Scholar were accessed, with no time constraints. RIA may produce greater blood loss, but with less morbidity and complications, making it a potential alternative source of bone grafting.

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Re-operation rate after surgical treatment of osteochondral lesions of the talus in paediatric and adolescent patients

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02282-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Daniel Körner ◽

Christoph E. Gonser ◽

Stefan Döbele ◽

Christian Konrads ◽

Fabian Springer ◽

...

Keyword(s):

Surgical Treatment ◽

Bone Grafting ◽

Cartilage Damage ◽

Osteochondral Lesions ◽

Retrograde Drilling ◽

Autologous Bone Grafting ◽

Operation Rate ◽

Group A ◽

Autologous Bone ◽

Group B

Abstract Background The aim of this study is to analyse the re-operation rate after surgical treatment of osteochondral lesions of the talus (OCLTs) in children and adolescents. Methods Between 2009 and 2019, 27 consecutive patients with a solitary OCLT (10 male, 17 female; mean age 16.9 ± 2.2 years; 8 idiopathic vs. 19 traumatic) received primary operative treatment (arthroscopy + bone marrow stimulation [BMS], n = 8; arthroscopy + retrograde drilling, n = 8; autologous chondrocyte implantation [ACI]/autologous bone grafting, n = 9; arthroscopy + BMS + retrograde drilling; n = 1; flake fixation, n = 1). Seventeen OCLTs were located at the medial and ten at the lateral talus. ‘Re-operation’ as the outcome measure was evaluated after a median follow-up of 42 months (range 6–117 months). Patients were further subdivided into groups A (re-operation, n = 7) and B (no re-operation, n = 20). Groups A and B were compared with respect to epidemiological, lesion- and therapy-related variables. Results Seven of 27 patients needed a re-operation (re-operation rate 25.9% after a median interval of 31 months [range 13–61 months]). The following operative techniques were initially used in these seven patients: arthroscopy + BMS n = 2, arthroscopy + retrograde drilling n = 4, ACI + autologous bone grafting n = 1. A comparison of group A with group B revealed different OCLT characteristics between both groups. The intraoperative findings according to the International Cartilage Repair Society (ICRS) classification revealed significantly more advanced cartilage damage in group B than in group A (p = 0.001). Conclusions We detected a re-operation rate of 25.9% after primary surgical OCLT treatment. Patients with re-operation had significantly lower ICRS classification stages compared to patients without re-operation.

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The Influence of an Occult Infection on the Outcome of Autologous Bone Grafting During Surgical Bone Reconstruction: A Large Single-Center Case-Control Study

Journal of Inflammation Research ◽

10.2147/jir.s297329 ◽

2021 ◽

Vol Volume 14 ◽

pp. 995-1005

Author(s):

Michael C Tanner ◽

Raban Arved Heller ◽

Andreas Grimm ◽

Stefan Zimmermann ◽

Maximilian Pilz ◽

...

Keyword(s):

Bone Grafting ◽

Case Control Study ◽

Case Control ◽

Bone Reconstruction ◽

Single Center ◽

Occult Infection ◽

Autologous Bone Grafting ◽

Autologous Bone ◽

Control Study

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Osteochondral defects of the talus treated with autologous bone grafting

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.86b4.14033 ◽

2004 ◽

Vol 86-B (4) ◽

pp. 521-526 ◽

Cited By ~ 54

Author(s):

D. Kolker ◽

M. Murray ◽

M. Wilson

Keyword(s):

Bone Grafting ◽

Osteochondral Defects ◽

Autologous Bone Grafting ◽

Autologous Bone

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Olecranon Apophyseal Nonunion in Adolescent Judo Players: A Report of Two Cases

Case Reports in Orthopedics ◽

10.1155/2018/8256074 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Kohei Yamaura ◽

Yutaka Mifune ◽

Atsuyuki Inui ◽

Hanako Nishimoto ◽

Yasuhiro Ueda ◽

...

Keyword(s):

Internal Fixation ◽

Bone Grafting ◽

Case Series ◽

Radiographic Evidence ◽

Level Of Evidence ◽

Old Patients ◽

Elbow Injury ◽

Autologous Bone Grafting ◽

Judo Athletes ◽

Autologous Bone

Olecranon apophyseal nonunion is an elbow injury from overuse that affects adolescent athletes such as baseball pitchers who participate in overhead throwing sports. However, such injury is rare in collision sports. Here, we report two patients with this condition who are Judo athletes. The purpose of this report was to describe three elbows with olecranon apophyseal nonunion in two adolescent patients participating in Judo. This is a case series; the level of evidence is 4. Two 15-year-old patients were evaluated. One suffered from unilateral and the other from bilateral chronic posterior elbow pain. They were diagnosed with olecranon apophyseal nonunion, which was treated using internal fixation and bone grafting. Radiographic evidence of the apophyseal union was observed four months postsurgery. Two elbows were treated with tension band wiring, then they underwent hardware removal six months postsurgery. Both patients returned to their previous levels of activities six months postsurgery. Internal fixation using autologous bone grafting was a useful treatment for these Judo athletes with olecranon apophyseal nonunion.

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