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Bone Grafting — Is There Another Way?

By Reina V. Slutske When a bone graft is performed, surgeons use allografts from dead bodies, autografts from the patient himself, and occasionally from the bone of an animal, or xenografts. Each of these pose a certain amount of risk, which is why many companies are looking for ways around it, producing new materials in a laboratory setting that could potentially replace the procedure.  

By Reina V. Slutske

When a bone graft is performed, surgeons use allografts from dead bodies, autografts from the patient himself, and occasionally from the bone of an animal, or xenografts. Each of these pose a certain amount of risk, which is why many companies are looking for ways around it, producing new materials in a laboratory setting that could potentially replace the procedure.

Ceramics, demineralized bone matrix, bone morphogentic protein and graft composites have all been used for grafting. However, there are several companies that are thinking beyond the traditional grafting system.

Sachin Mamidwar, general manager for Orthogen, has developed a calcium sulfate bone graft system that can be used as either the graft system alone or with another grafting system. NanoGen is different in that it stimulates bone growth, but is scheduled to dissolve away in 12 weeks. This process means that there is no other surgical procedure other than implantation, and the material is completely broken down in the system. “We are not looking to replace the bone,” he said. “What we are looking at is to regenerate the bone.”

Mamidwar said that calcium sulfate has been used as a bone grafting material for 100 years, calling it, “the oldest biomaterial.” However, the company’s nanotechnology makes it longer lasting in the body to stimulate the bone growth required in order to make a procedure successful.

For now, it’s approved only for dentistry, although Mamidwar sees NanoGen being used in different areas, including in orthopedics. It is something he plans to address at OrthoTec 2013 in Warsaw, IN. “The market is huge, and the potential is great,” he said. He said bone defects form for a variety of reasons, and that the mechanics that the body uses to generate bone can be translated from common dentistry to other bones and joints.

In addition to Orthogen, an Israeli company has been thinking about going from bone grafting and just building bones. Bonus BioGroup has been experimenting with creating bones from fat cells that are taken by liposuction. The system, invented by Dr. Shai Meretzki, will create a 3-D image of the area that needs the bone, then use culture bioreactors to grow the bone. Once it is, it can be implanted in the body. Unlike with allografts and xenografts, there is no chance of rejections, and there is no real surgery like with autografts.

Mamidwar says that there is great potential for Meretzki’s development, but with a task like bone growth from fat cells, there are a lot of questions that he isn’t sure there are answers for.

“What I don’t know is how long does it take to grow this bone,” he said. “Does this bone have all the properties that the normal bone in the body? What are they going to do with the patient while the bone is growing?”

There are many questions for the future of bone grafting, but for patients, that future may be less invasive and more technologically advanced.

Reina V. Slutske is the assistant editor for MD+DI. 

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