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J Am Acad Orthop Surg, Vol 14, No 10, September 2006, S163-S167.
© 2006 the American Academy of Orthopaedic Surgeons
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Management of Segmental Bony Defects: The Role of Osteoconductive Orthobiologics

Michael D. McKee, MD, FRCSC

Dr. McKee is Associate Professor, Division of Orthopaedics, Department of Surgery, St. Michael’s Hospital and the University of Toronto, Toronto, Ontario, Canada.

Dr. McKee or the department with which he is affiliated has received research or institutional support from Stryker Biotech and Zimmer.

Our knowledge about, and the availability of, orthobiologic materials has increased exponentially in the last decade. Although previously confined to the experimental or animal-model realm, several orthobiologics have been shown to be useful in a variety of clinical situations. As surgical techniques in vascular anastomosis, soft-tissue coverage, limb salvage, and fracture stabilization have improved, the size and frequency of bony defects (commensurate with the severity of the initial injury) have increased, as well. Because all methods of managing segmental bony defects have drawbacks, a need remains for a readily available, void-filling, inexpensive bone substitute. Such a bone substitute fulfills a permissive role in allowing new bone to grow into a given defect. Such potential osteoconductive materials include ceramics, calcium sulfate or calcium phosphate compounds, hydroxyapatite, deproteinized bone, corals, and recently developed polymers. Some materials that have osteoinductive properties, such as demineralized bone matrix, also display prominent osteoconductive properties.






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