Bone Regeneration and Repair

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Bone Regeneration and Repair

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Bone Regeneration and Repair

Biology and Clinical Applications

Edited by

Jay R. Lieberman, ^MD

Department of Orthopaedic Surgery David Geffen School of Medicine University of California, Los Angeles, CA

and

Gary E. Friedlaender, ^MD

Department of Orthopaedics and Rehabilitation

Yale University School of Medicine, New Haven, CT

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999 Riverview Drive, Suite 208 Totowa, New Jersey 07512

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Cover illustrations: Figure 5, Chapter 14, “Bone Grafting for Total Joint Arthroplasty: Biology and Clinical Applica- tions,” by M. Hamadouche et al. Figure 2B, Chapter 8, "Grafts and Bone Substitutes," by D. Sutherland and M. Bostrom.

Cover design by Patricia F. Cleary.

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Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging in Publication Data

Bone regeneration and repair : biology and clinical applications / edited by Jay R. Lieberman and Gary E. Friedlander.

p. ; cm.

Includes bibliographical references and index.

ISBN 0-89603-847-5 (alk. paper) e-ISBN 1-59259-863-3

1. Bone regeneration. 2. Regeneration (Biology) 3. Transplantation of organs, tissues, etc.

[DNLM: 1. Bone Regeneration—physiology. 2. Bone Regeneration—genetics. 3. Bone and Bones—physiology.

WE 200 B71285 2005] I. Lieberman, Jay R. II. Friedlander, Gary E.

RC930.B665 2005 617.4’710592—dc22

2004010551

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Preface

Bone is unique in its inherent capability to completely regenerate without scar tissue formation. This characteristic is central to skeletal homeostasis, fracture repair, as well as bone graft incorporation. However, in some circumstances the regenerative capacity of bone is altered or damaged in a manner that precludes such a special pattern of repair.

Fracture nonunions, lost bone stock supporting total joint arthroplasties, and periodontal defects are frustrating examples of these difficult clinical challenges. Allogeneic bone and even autogenous bone grafts have not provided solutions for all these problems, at times related to limitations of their regenerative capacities and also when not used in a manner that respects their biological or biomechanical needs.

Over the past few decades, scientists and clinicians have been exploring the use of growth factors and bone graft substitutes to stimulate and augment the body’s innate regenerative capabilities. The development of recombinant proteins and the applica- tion of gene therapy techniques could dramatically improve treatment for disorders of bone, cartilage and other skeletal tissues.