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Clinical Applications of Bone Tissue Engineering in Orthopedic Trauma

  • Organ Development and Regeneration (D Shin and U Apte, Section Editors)
  • Published:
Current Pathobiology Reports

Abstract

Purpose of Review

Orthopedic trauma is a major cause of morbidity and mortality worldwide. Although many fractures tend to heal if treated appropriately either by non-operative or operative methods, delayed or failed healing, as well as infections, can lead to devastating complications. Tissue engineering is an exciting, emerging field with much scientific and clinical relevance in potentially overcoming the current limitations in the treatment of orthopedic injuries.

Recent Findings

While direct translation of bone tissue engineering technologies to clinical use remains challenging, considerable research has been done in studying how cells, scaffolds, and signals may be used to enhance acute fracture healing and to address the problematic scenarios of nonunion and critical-sized bone defects. Taken together, the research findings suggest that tissue engineering may be considered to stimulate angiogenesis and osteogenesis, to modulate the immune response to fractures, to improve the biocompatibility of implants, to prevent or combat infection, and to fill large gaps created by traumatic bone loss. The abundance of preclinical data supports the high potential of bone tissue engineering for clinical application, although a number of barriers to translation must first be overcome.

Summary

This review focuses on the current and potential applications of bone tissue engineering approaches in orthopedic trauma with specific attention paid to acute fracture healing, nonunion, and critical-sized bone defects.

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Funding

This work was supported in part by the CASIS (Grant no. GA-2016-236), the U.S. Department of Defense (DOD W81XWH-14-2-0003, DOD W81XWH-14-1-0217, DOD W81XWH-15-2-0011), the National Institutes of Health (1UG3 TR002136), and the Ri.MED Foundation, Palermo, Italy.

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Authors and Affiliations

  1. Center for Cellular and Molecular Engineering, School of Medicine, University of Pittsburgh, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA

    Peter N. Mittwede, Riccardo Gottardi, Peter G. Alexander & Rocky S. Tuan

  2. Department of Orthopaedic Surgery, School of Medicine, University of Pittsburgh, 3471 Fifth Avenue, Suite 1010 Pittsburgh, PA, 15312, USA

    Peter N. Mittwede, Ivan S. Tarkin & Rocky S. Tuan

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  1. Peter N. Mittwede
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Correspondence to Rocky S. Tuan.

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The authors (Peter N. Mittwede, Riccardo Gottardi, Peter G. Alexander, Ivan S. Tarkin, and Rocky S. Tuan) declare that they have no conflicts of interest.

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Mittwede, P.N., Gottardi, R., Alexander, P.G. et al. Clinical Applications of Bone Tissue Engineering in Orthopedic Trauma. Curr Pathobiol Rep 6, 99–108 (2018). https://doi.org/10.1007/s40139-018-0166-x

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