Critical analysis of the evidence for current technologies in bone-healing and repair

Wendy M. Novicoff, Abhijit Manaswi, Ma Calus V. Hogan, Shawn M. Brubaker, William Mihalko, Khaled J. Saleh

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Substances that enhance fracture-healing and bone regeneration have valuable clinical application and merit future research. Advances in these technologies will enhance our ability to heal fractures in a more effective and expedient manner. This review provides a brief description of the different techniques and technologies and their respective clinical utility. This paper also reviews the available literature on gene therapy, tissue engineering, growth factors, osteoconductive agents, and physical forces and assesses the evidence regarding the current status of these techniques of healing and regenerating bone. Only twenty-seven articles met our guidelines for studies containing Level-I evidence. We were able to determine that atrophic nonunions and pseudarthrosis led to poorer outcomes, and the results were uniformly poor irrespective of the technique used. Although the literature contains a large number of studies on the effects of different agents and modalities on bone repair and healing, it still is not clear how these agents work or in what circumstances they should be used. Many of the treatment modalities of interest are still at an experimental stage, so good evidence to support clinical practice is lacking. Additional multicenter, prospective randomized studies are needed to define the indications, specifications, dosage, limitations, and contraindications in the treatment of nonunions. Studies are also needed to address the full clinical feasibility of the role of each modality in fracture-healing and repair.

Original languageEnglish (US)
Pages (from-to)85-91
Number of pages7
JournalJournal of Bone and Joint Surgery - Series A
Volume90
Issue numberSUPPL. 1
DOIs
StatePublished - Feb 1 2008
Externally publishedYes

Fingerprint

Fracture Healing
Technology
Bone and Bones
Pseudarthrosis
Bone Regeneration
Tissue Engineering
Genetic Therapy
Intercellular Signaling Peptides and Proteins
Prospective Studies
Guidelines
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Critical analysis of the evidence for current technologies in bone-healing and repair. / Novicoff, Wendy M.; Manaswi, Abhijit; Hogan, Ma Calus V.; Brubaker, Shawn M.; Mihalko, William; Saleh, Khaled J.

In: Journal of Bone and Joint Surgery - Series A, Vol. 90, No. SUPPL. 1, 01.02.2008, p. 85-91.

Research output: Contribution to journalArticle

Novicoff, Wendy M. ; Manaswi, Abhijit ; Hogan, Ma Calus V. ; Brubaker, Shawn M. ; Mihalko, William ; Saleh, Khaled J. / Critical analysis of the evidence for current technologies in bone-healing and repair. In: Journal of Bone and Joint Surgery - Series A. 2008 ; Vol. 90, No. SUPPL. 1. pp. 85-91.
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