Cornell Charles N
Clinical Orthopedic Surgery at Weill College of Medicine of Cornell University, Hospital for Special Surgery, New York, New York 10021, USA.
Bull Hosp Jt Dis. 2004;62(1-2):13-7.
"Osteobiologics" is the term that has been introduced to refer to the class of engineered materials that have been created and which promote healing of fractures and bone defects. The list of osteobiologics is rapidly expanding as new products incorporating osteoconductive materials are mixed with a variety of osteoinductive proteins, demineralized bone, and preparations of osteogenic cells. The growth in osteobiologics has been stimulated by the early success of osteoconductive materials as graft substitutes in the repair of fractures and by the increasing demand for grafts in all areas of orthopaedics. Although allografts have historically been employed with success, the number of donors has grown much slower than demand leading to the development of artificial materials. Manufactured bone graft substitutes, or osteobiologics, attempt to mimic the components of an autogeneous bone graft by reproducing the bone matrix, which is osteoconductive and osteoinductive. Other products aim to introduce osteogenic cells by concentrating bone marrow while others introduce differing growth factors from platelets in peripheral blood. Very few of these products have been supported by appropriate clinical studies and as such their value is unknown. Orthopaedic surgeons employing these products must understand the basic science principles behind their development in order to understand the indications and limitations of their application. Properly designed clinical studies should be performed to determine the usefulness and cost-effectiveness of both current and future products.
“骨生物材料”是一个引入的术语，用于指代已制造出来的、能促进骨折和骨缺损愈合的一类工程材料。随着包含骨传导材料的新产品与多种骨诱导蛋白、脱矿骨和成骨细胞制剂混合，骨生物材料的种类正在迅速增加。骨传导材料作为骨折修复中的移植替代物早期取得的成功以及骨科各领域对移植材料需求的不断增加，刺激了骨生物材料的发展。尽管同种异体移植物在历史上一直成功应用，但供体数量的增长比需求慢得多，这导致了人工材料的开发。人造骨移植替代物，即骨生物材料，试图通过复制具有骨传导性和骨诱导性的骨基质来模拟自体骨移植的成分。其他产品旨在通过浓缩骨髓来引入成骨细胞，还有一些产品则引入外周血中血小板的不同生长因子。这些产品中很少有得到适当临床研究的支持，因此它们的价值尚不清楚。使用这些产品的骨科医生必须了解其研发背后的基础科学原理，以便理解其应用的适应症和局限性。应该进行设计合理的临床研究，以确定现有和未来产品的有效性和成本效益。
