Applications of calcium phosphate-based cancellous bone void fillers in trauma surgery

For more than a century, fracture repair has been augmented with autogenous cancellous bone grafting, which supplies 3 requisite properties: growth factors for osteoinduction, progenitor stem cells for osteogenesis, and scaffolding for osteoconduction. However, disadvantages to using autogenous bone include procurement morbidity, longer operative time, and limited availability. Allograft is more readily available but does not supply osteoinductive or osteogenic properties. Better alternatives for bone grafting currently include autologous bone marrow, ceramics, allograft demineralized bone matrix, and regulatory growth factors; however, none of these fulfills all 3 requisite properties. Replacement or augmentation of autograft with a calcium phosphate-based composite graft, which combines the best elements of each component into a single engineered graft, is discussed.