Growth factors: possible new clinical tools. A review.

Bone tissue contains numerous cell-to-cell signaling peptides called growth factors with potent effects on bone cell metabolism. In vivo studies over the last 5 years have demonstrated that growth factors can stimulate bone formation and bone healing and these results have made them candidates for use in orthopedic surgery. In numerous clinical conditions enhanced bone formation and bone healing could improve the results of surgery; clinical trials using growth factors to stimulate bone formation in spinal surgery, and to stimulate healing of bone defects, have been initiated. Growth factors for clinical use will become commercially available in the near future. This review describes the main growth factors and their actions in vitro and in vivo in relation to bone tissue and bone healing. Possible areas for clinical use are also discussed.