Article Authors: Gordon Slater| Tandose Sambo
Utilization of Substitute Bone Grafts
Within the orthopaedic and faciomaxillary surgical realms, the use of substitute bone grafts is becoming more mainstream. While traditional bone grafts have been utilized, the transition to engineered materials such as Coralline Hydroxyapatite (CHA) is proving to be quite effective. While dental applications including the treatment of mandibular defects have proven successful, the results have contributed to the application of CHA to other bone conditions in the body[3].
Bone grafts are predominantly scaffolds that enable new bone formation to take place over their foundation. With a variety of root causes such as surgery, trauma, infection, or congenital factors [3], treatment with bone grafts helps to restore the healthy function of the damaged bone. Via bone graft installation the regeneration of bone, as well as the proliferation of stem cells to encourage bone health, is facilitated.
As science and technology advances, internal healing mechanisms are better understood, and bio-engineering methods applied to patients in order to facilitate their health’s restoration. One of the aspects of orthopaedic healing that are factored into the patient care process involves understanding and healing of fractures.
Healing mechanisms are better understood, thanks to modern scientific research. In orthopaedics, there are a series of mechanisms such as distraction arthroplasty for instance, which facilitate the healing of fractured bone, with the utilization of external scaffolding to keep the joint immobile, and to facilitate the restoration of the joint. There are occurrences however, where treatment methods as an individual option are not feasible. Auxiliary mechanisms coupled with these methods will facilitate the final outcome that is desired by the patient.
At the time of writing of this article, bone grafts, bone substitutes and orthobiologics are the processes that are incorporated into the healing processes to enhance the patient experience and to restore fractures, or even cartilage loss. As medicine advances, material science is facilitating the advancement of the applications of these fields. Industry wide, there is a growing demand for these products and services, and it is always helpful for you as a patient to be aware of these changes for discussion with your orthopaedic surgeon.The human bone is one of the slowest healing areas of our bodies. With processes in place to advance the restoration of bone conditions, you can rest assured that if a fracture were to ever occur, healing mechanisms are in place to restore the integrity of your bones.
The History of Bone Grafts
As a self-healing mechanism, the human skeleton is designed to regenerate itself. Designed to thrive for many decades, the body has evolved to heal all manner of ailments that may befall it. Bones, as biological ceramic mechanisms, do have the ability to heal to their original conditions. The challenge is the time frame that the healing takes place. With an understanding of the body, the intention is to optimize the natural healing mechanisms of the body. Despite this fact, the following are some factors that can limit current orthopaedic care in bone healing:
- Site infections
- Restricted blood flows to the healing site
- Patient malnutrition
- Depending on the injury – extent of bone or tissue loss
Scientific discoveries such as modern bone grafts, bone substitutes and additional biologic enhancements, help to enhance healing processes. Bone grafts as a therapy, facilitate natural healing via the facilitation of what science dubs as “osteoinductive, osteoconductive and osteogenic mechanisms”. Coupled with orthobiologics, the methods are destined to pave the way to generating a whole new you when the need arises.
Properties of Bone Graft Enhancers
Modern bone grafts consist of naturally derived material substances that mimic the bone’s ceramic design. CHA is a material that fits this criteria. It consists of a porous scaffold. When introduced to the body, it facilitates cell migration and development towards its sites. Studies have indicated that approximately five weeks after introduction to the site, visible cell and bone development is identified. With time, the structure strength is enhanced and the site restored to the desired bone equivalence.
During the healing process, a series of healing mechanisms and even chemical exchanges take place in the healing of the site. The location structures actually grow and expand as they fuse into the surrounding environments. Cell accumulation is desired for bone growth. Utilizing the shell of the hydroxyapatite as a site for growth factor housing is a process that facilitates this accomplishment.
As CHA polymers have proven their effectiveness with time, the applications of the material for a variety of healing properties from fields ranging from dental to orthopaedic care are under investigation. From a materials science standpoint, scientists are still experimenting with the materials and have even tested the strength of new structures developed after the fusion of CHA with compounds such as graphene.
In those instances, as mentioned above, where wound infection is a possibility, science is also able to fuse the CHA scaffold with some silver and antibiotic fusion, to keep the site healthy and stable. A site restored by the infusion of hydroxyapatite is shown below. Additionally, in terms of the modern source for this material, coral reefs are leading the resource pool.
Image Credits: Swansea University
Orthopaedic Applications
Talk to your orthopaedic surgeon , for further details on your treatment options with a procedure such as the use of orthopaedic bone grafts in your healing. If you have bone loss of any kind, you are a prime candidate. Patients with conditions, who need hip replacement for instance, have found that if their prosthetic is infused with a CHA coating, their recovery is faster and pain is reduced due to faster healing mechanisms. Osteoarthritis candidates are also ideal candidates for treatments with CHA. Science continues to advance, and with such modern material advances, you can rest assured that your bones are safe with us!
Your health is your wealth!
Reference Articles:
- Bone Grafting with Coralline Hydroxyapatite: https://www.ecronicon.com/ecde/pdf/ECDE-18-01189.pdf
- Bone Grafts, Bone Substitutes and Orthobiologics: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3562252/
- Coralline Hydroxyapatite Bone Graft in Non-Contained Defects: Case Report: https://athenaeumpub.com/coralline-hydroxyapatite-bone-graft-in-non-contained-defects-case-report/
