Santoro Angelo, Voto Andrea, Fortino Luigi, Guida Raffaella, Laudisio Carolina, Cillo Mariarosaria, D'Ursi Anna Maria
Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy.
Scuola di Specializzazione in Farmacia Ospedaliera, Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy.
Int J Mol Sci. 2025 Mar 27;26(7):3085. doi: 10.3390/ijms26073085.
In recent years, the management of bone defects in regenerative medicine and orthopedic surgery has been the subject of extensive research efforts. The complexity of fractures and bone loss arising from trauma, degenerative conditions, or congenital disorders necessitates innovative therapeutic strategies to promote effective healing. Although bone tissue exhibits an intrinsic regenerative capacity, extensive fractures and critical-sized defects can severely compromise this process, often requiring bone grafts or substitutes. Tissue engineering approaches within regenerative medicine have introduced novel possibilities for addressing nonunions and challenging bone defects refractory to conventional treatment methods. Key components in this field include stem cells, bioactive growth factors, and biocompatible scaffolds, with a strong focus on advancements in bone substitute materials. Both natural and synthetic substitutes present distinct characteristics and applications. Natural grafts-comprising autologous, allogeneic, and xenogeneic materials-offer biological advantages, while synthetic alternatives, including biodegradable and non-biodegradable biomaterials, provide structural versatility and reduced immunogenicity. This review provides a comprehensive analysis of the diverse bone grafting alternatives utilized in orthopedic surgery, emphasizing recent advancements and persistent challenges. By exploring both natural and synthetic bone substitutes, this work offers an in-depth examination of cutting-edge solutions, fostering further research and innovation in the treatment of complex bone defects.
近年来，再生医学和骨外科中骨缺损的管理一直是广泛研究的主题。创伤、退行性疾病或先天性疾病引起的骨折和骨质流失的复杂性，需要创新的治疗策略来促进有效愈合。尽管骨组织具有内在的再生能力，但广泛的骨折和临界尺寸的骨缺损会严重影响这一过程，通常需要骨移植或替代物。再生医学中的组织工程方法为解决骨不连和传统治疗方法难以处理的挑战性骨缺损带来了新的可能性。该领域的关键组成部分包括干细胞、生物活性生长因子和生物相容性支架，特别关注骨替代材料的进展。天然和合成替代物都具有不同的特性和应用。天然移植物包括自体、同种异体和异种材料，具有生物学优势，而合成替代物，包括可生物降解和不可生物降解的生物材料，则提供结构多样性并降低免疫原性。本综述全面分析了骨外科中使用的各种骨移植替代物，强调了近期的进展和持续存在的挑战。通过探索天然和合成骨替代物，本文深入研究了前沿解决方案，促进了在复杂骨缺损治疗方面的进一步研究和创新。
