Promoting bone generation through the accordion technique in critical-sized bone defects: a review

Area of Science:

• Orthopedic surgery
• Regenerative medicine
• Biomedical engineering

Background:

• Critical-sized bone defects present significant orthopedic reconstruction challenges.
• Distraction osteogenesis (DO) is a key technique for bone and soft tissue regeneration.
• Delayed consolidation in DO can lead to complications due to prolonged external fixation.

Purpose of the Study:

• To systematically review the accordion technique (AT) in distraction osteogenesis (DO).
• To analyze the biomechanical principles, operational strategies, and biological effects of AT.
• To identify challenges and future directions for AT clinical implementation.

Main Methods:

• Systematic review of experimental and clinical evidence on the accordion technique.
• Focus on biomechanical principles and mechanical stimulation strategies.
• Analysis of AT's role in modulating micromotion at the osteotomy site.

Main Results:

• The accordion technique (cyclic distraction-compression) shows promise for enhancing bone regeneration in DO.
• AT modulates axial micromotion, potentially accelerating bone healing.
• Optimal AT parameters (timing, amplitude, frequency) and underlying mechanisms require further investigation.

Conclusions:

• The accordion technique offers a promising strategy to improve bone regeneration outcomes in distraction osteogenesis.
• Standardization of AT clinical protocols is needed for widespread adoption.
• Further research into AT parameters and mechanisms will enhance its therapeutic potential for complex bone defects.