title: Biological aspects of segmental bone defects management.
abstract: Segmental bone defect management is among the most demanding issues in orthopaedics and there is a great medical need for establishing an appropriate treatment option. Tissue transfer, including bone autografts or free flaps, depending on the size of the bone deficiency, is currently the "gold standard" for treatment of such defects. Osteogenic cells in combination with adequate growth factors and a suitable scaffold, from the aspect of osteoinductivity, osteoconductivity and mechanical stability, are mandatory to successfully restore a bone defect as determined in the "diamond concept". Our current knowledge on this topic is limited and mostly based on retrospective studies, case reports and a few small randomised clinical trials due to the lack of large and accurately designed randomised clinical trials using novel approaches to regenerative orthopaedics. However, preclinical research on different animal models for critical size defects is abundant, showing emerging candidate cells and cytokines for defect rebridgement. In this article we provide an overview on existing clinical studies and promising preclinical experiments that utilised osteogenic cells, growth factors and biomaterials, as well as their combination for repair of segmental bone defects.
authors.affiliation: Laboratory for Mineralised Tissues, Centre for Translational and Clinical Research, School of Medicine, University of Zagreb, Šalata 11, Zagreb, 10000, HR, Croatia.
authors.forename: Ivo
authors.initials: I
authors.lastname: Dumic-Cule
authors.forename: Marko
authors.initials: M
authors.lastname: Pecina
authors.forename: Mislav
authors.initials: M
authors.lastname: Jelic
authors.forename: Morana
authors.initials: M
authors.lastname: Jankolija
authors.forename: Irena
authors.initials: I
authors.lastname: Popek
authors.forename: Lovorka
authors.initials: L
authors.lastname: Grgurevic
authors.forename: Slobodan
authors.initials: S
authors.lastname: Vukicevic
mesh_terms: D000818:Animals; D064592:Autografts; D001847:Bone Diseases / Q000601:surgery; D018786:Bone Substitutes; D016025:Bone Transplantation / Q000379:methods; D001842:Bone and Bones; D016207:Cytokines / Q000502:physiology; D058752:Free Tissue Flaps; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000502:physiology; D033581:Stem Cell Transplantation; D023822:Tissue Engineering; D014945:Wound Healing / Q000502:physiology
chemical_list: D018786:Bone Substitutes; D016207:Cytokines; D036341:Intercellular Signaling Peptides and Proteins