Segmental bone defects resulting from trauma or pathological conditions represent formidable clinical challenges in orthopaedic surgery. Though current therapies include autografts and allografts or distraction osteogenesis, they are known for their inherent disadvantages like limited supply, increased morbidity, disease transmission potential and long term hospitalization respectively. In this context, tissue engineering becomes relevant for the treatment of large bone defects, where cells or growth factors are incorporated into a three-dimensional scaffold to mimic native tissue architecture and function in terms of osteoconduction, osteoinduction and osteointegration. Among the scaffolds, bioactive ceramics play an importance because of its similarity in chemical composition to bone. This review seeks to describe different tissue engineering approaches using bioactive ceramics towards bone regeneration in segmental bone defects. These include tissue-ingrowth (bioactive ceramics alone); cell transplantation (bioactive ceramics with mesenchymal stem cells) and signaling molecule (bioactive ceramics with growth factors).
Dr. Manitha B. Nair, Sullivan, P. J., and Mortensen, E. K., “Bone Tissue Engineering Approaches and Challenges using Bioactive Ceramic Scaffolds”, Nova publishers, 2011, pp. 45-74.