Tissue engineering of bone

Whereas most bone defects will heal spontaneously, 5 to 10 % will require further treatment for compromised healing. In addition, there are specific clinical settings in which large pieces of bone must be resected. In these challenging situations, autologous bone graft is the preferred treatment to obtain bone union. However, autologous bone cannot always be harvested in sufficient amount and has several limitations. Alternatively, surgeons can use osteoconductive bone substitutes but their success is limited as they only provide Q scaffold, which needs to be invaded by bone forming cells to achieve bone repair. Recent advances in cell and molecular biology have opened new avenues for improving the osteogenic potential of these materials including their supplementation with either mesenchymal stem cells or growth factors. Whereas preliminary clinical studies have shown that these strategies could be interesting alternatives, further prospective randomized trials are needed to objectively compare them to established treatment.