Demineralized bone matrix and native bone morphogenetic protein in orthopaedic surgery

Area of Science:

• Orthopaedic Surgery
• Biomaterials Science
• Regenerative Medicine

Background:

• Demineralized bone matrix (DBM) has been recognized for its osteoinductive properties, stimulating bone formation when implanted.
• Early research involved crude bone morphogenetic protein and noncollagenous proteins, leading to clinical use of various DBM preparations.
• Global availability of DBM varies due to cultural norms and regulatory landscapes.

Purpose of the Study:

• To review the historical development of demineralized bone matrix (DBM) preparations.
• To examine the clinical application of different DBM materials in reconstructive orthopaedic surgery.
• To discuss the ongoing interest in the biological structure and osteoinductive potential of DBM.

Main Methods:

• Literature review of preclinical and clinical studies on demineralized bone matrix.
• Analysis of the evolution of DBM processing and preparation techniques.
• Examination of factors influencing DBM availability and application worldwide.

Main Results:

• DBM has progressed from crude proteins to refined preparations like chemosterilized autolyzed antigen-extracted allogenic bone.
• Different DBM preparations utilize various carriers and exhibit distinct handling properties.
• The osteoinductive potential of DBM materials can vary, influencing their efficacy.

Conclusions:

• DBM remains a significant biomaterial in reconstructive orthopaedic surgery due to its osteoinductive capabilities.
• Continued research into the biological structure of DBM is crucial for optimizing its use.
• Understanding the science of osteoinduction and osteoconduction is key to advancing DBM applications.