Nonallograft osteoconductive bone graft substitutes

Area of Science:

• Orthopaedic surgery
• Biomaterials science
• Regenerative medicine

Background:

• Bone grafting is common, with synthetic substitutes gaining market share.
• Current synthetic bone graft substitutes have limited clinical trial data despite years of use.
• These materials include hydroxyapatite, tricalcium phosphate, and calcium sulfate, with varying properties.

Purpose of the Study:

• To review the composition, histology, indications, and clinical experience of synthetic bone graft substitutes.
• To highlight the advantages and disadvantages of synthetic bone graft substitutes.
• To discuss the evolving role of synthetic bone graft substitutes in orthopaedic applications.

Main Methods:

• Review of existing literature on synthetic bone graft substitutes.
• Analysis of composition, fabrication, and properties of various synthetic materials.
• Examination of clinical data and indications for approved orthopaedic bone graft substitutes.

Main Results:

• Synthetic bone graft substitutes offer benefits like availability and sterilization but differ in osteoconductivity.
• Ceramic implants have drawbacks including brittleness and variable resorption, impacting bone remodeling.
• Their primary use has shifted towards bone graft extenders and pharmaceutical carriers.

Conclusions:

• Synthetic bone graft substitutes present a growing alternative to traditional grafts but require further well-designed clinical trials.
• Understanding material properties is crucial for optimizing their use in orthopaedic procedures.
• Their role is evolving, with a focus on enhancing autografts and delivering therapeutics.