title: Bone tissue engineering and regenerative medicine: targeting pathological fractures.
abstract: Patients with bone diseases have the highest risk of sustaining fractures and of suffering from nonunion bone healing due to tissue degeneration. Current fracture management strategies are limited in design and functionality and do not effectively promote bone healing within a diseased bone environment. Fracture management approaches include pharmaceutical therapy, surgical intervention, and tissue regeneration for fracture prevention, fracture stabilization, and fracture site regeneration, respectively. However, these strategies fail to accommodate the pathological nature of fragility fractures, leading to unwanted side effects, implant failures, and nonunions. To target fragility fractures, fracture management strategies should include bioactive bone substitutes designed for the pathological environment. However, the clinical outcome of these materials must be predictable within various disease environments. Initial development of a targeted treatment strategy should focus on simulating the physiological in vitro bone environment to predict clinical effectiveness of the engineered bone. An in vitro test system can facilitate reduction of implant failures and non-unions in fragility fractures.
authors.affiliation: Department of Bioengineering and Institute for Biological Interfaces of Engineering, Clemson University, Clemson, South Carolina.
authors.forename: Duong T
authors.initials: DT
authors.lastname: Nguyen
authors.forename: Karen J L
authors.initials: KJ
authors.lastname: Burg
mesh_terms: D001842:Bone and Bones; D050723:Fractures, Bone / Q000473:pathology / Q000628:therapy*; D006801:Humans; D044968:Regenerative Medicine; D023822:Tissue Engineering
keywords: bone disease; bone substitutes; bone tissue engineering; fragility fracture