Regenerative medicine in lower limb reconstruction

Abstract

Bone is a highly specialized connective tissue and has a rare quality as one of the few tissues that can repair without a scar to regain pre-injury structure and function. Despite the excellent healing capacity of bone, tumor, infection, trauma and surgery can lead to significant bone loss requiring skeletal augmentation. Bone loss in the lower limb poses a complex clinical problem, requiring reconstructive techniques to restore form and function. In the past, amputation may have been the only option; however, there is now an array of reconstructive possibilities and cellular therapies available to salvage a limb. In this review, we will evaluate current applications of bone tissue engineering techniques in limb reconstruction and identify potential strategies for future work.

Natural and Synthetic Polymers for Bone Scaffolds Optimization

“…Gradually, the spongy immature bone is reabsorbed through an internal remodeling process and it is replaced with lamellar mature bone [5]. Despite its self-healing ability, in the presence of large (>5 cm) defects (i.e., non-union fractures, tumor ablations, maxillofacial trauma or degeneration), bones cannot self-repair and reconstructive techniques and cellular therapies are required [11,12].…”

“…In addition to the trauma, other diseases affect the bone tissue such as tumors, infections, osteopetrosis, pseudoarthrosis, osteoporosis and others [4,11,[13][14][15]. Conventional therapies for osteoporosis and osteopetritis include both non-pharmacological and pharmacological approaches.…”

Dual-functional composite scaffolds for inhibiting infection and promoting bone regeneration

“…Although autogenous bone forms an effective bone graft, it faces problems such as insufficient donor bone mass and complications in the donor area [ 10 , 11 ]. The alternative treatment of allogeneic graft is also limited by its potential risk of immune rejection and infection [ 12 , 13 ]. Bone transportation technology based on distraction osteogenesis is an effective method to bone reconstruction, but its main disadvantage is that the treatment time is too long, which can reach 10 months or more [ [14] , [15] , [16] ].…”