Three types of alternatives to collagen bone grafting

The use of collagen bone graft substitute block eliminates the supply and infection problems associated with autografts and allografts. However, most of the currently available bone substitutes are fragile and cannot withstand large loads. Extensive research is underway and the following two types of alternatives will improve this situation.

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• Bone conduction substitutes

• Alternative methods of tissue-engineered bone grafting

• Bone induced substitutes

Bone conduction substitutes

These are naturally occurring or synthetic substances that have biomechanical properties and structures similar to bone. It is a good collagen bone graft substitute strip. They include calcium triphosphate, hydroxyapatite, calcium carbonate, and glass-based cement. They are not biologically active, but simply provide a scaffold with a porous structure that resembles bone and in which cells can crawl and multiply. They are sometimes used alone in smaller defects but are often used in combination with autografts or allografts in larger defects.

Alternative methods of tissue-engineered bone grafting

In the field of collagen bone graft substitute, scaffolding with porous biomaterials combined with osteoblasts is the most promising alternative method for autologous bone grafting. However, some fundamental problems associated with scaffold-based bone tissue engineering techniques have not yet been fully resolved, thus hindering the widespread use of this technology in clinical practice. These problems include:

(1) Uneven distribution and inefficient inoculation of routinely inoculated seed cells in scaffold materials.

(2) Limited sources of seed cells.

(3) Immunosignal reaction of seed cells, etc.

Bone induced substitutes

These are substances that contain BMP. Small amounts of bone matrix proteins are naturally present in bone. Clinically useful and reproducible amounts of isolated human bone matrix proteins are manufactured by a process called recombinant genetic engineering. They are either used with carriers (e.g., collagen sponges) or added to osteoconductive materials. Recombinant human bone-forming protein-2 is one of the most studied bone morphogenetic proteins.

As a kind of collagen bone graft substitutes, its use in combination with autologous bone is equally successful in spinal fusion and osteointegration as it has been in combination with collagen sponge in open tibial fractures. Demineralized bone matrix (DBM) is a demineralized homogeneous bone that retains the protein and therefore has some osteoinductive properties. It can be applied in the form of elastic bands, gels, moldable putty, moldable bone chips, or injectable bone paste and is easy to handle. It is preferably used to augment rather than replace autograft material. Neither synthetic BMPs nor DBMS has any structural integrity unless mixed with bone graft or osteoconductive substitutes, and both have the disadvantage of being expensive.

Regardless of the type of bone graft used, proper surgical technique and tissue handling are critical to the success of the bone graft. Bone graft blocks should be well-pressed to the site where they are needed to promote healing. Loose blocks are often resorbed and are not useful. The stability of the graft and a healthy tissue bed with a good blood supply are critical. Uncontrollable infection is a contraindication to bone grafting, as the graft can quickly become infected and require subsequent resection if it cannot be resorbed. Therefore, it is usually best to delay bone grafting in open fractures until the wound has healed and the major risk of infection has been eliminated.

Guangdong Victory Biotech Co. Ltd. , with 2,000 ㎡ of floor space, a subsidiary of SHENGUAN HOLDINGS (GROUP) LIMITED, is located in Foshan, Guangdong Province, China, and has more than 15 years of experience in the field of collagen research and development. We have been specializing in the manufacturing of medical grade collagen, supplying atelocollagen of low pyrogen to the market.