Abstract

Injuries, including fractures make up half the work-load of an orthopaedic surgeon. Fractures produce a huge burden on the individual and on society. Currently many fractures are treated with metal implants to hold them. What orthopaedic surgeons would really like is a bone glue that can be injected and set the fracture without supplementary fixation. The use of relevant biomolecules that are involved in the healing process is a step towards that goal. However the biomolecules cannot be used clinically in isolation from scaffolds, and there may be a significant role for including cells in any material that can accelerate fracture healing. This presentation will outline how a fracture is treated, how it heals, and the potential technologies available to assist the healing process, an overview of the basic science and then review the current possible biomolecules. The current biomolecules available clinically are bone morphogenetic proteins -2 and -7, and parathyroid hormone. The presentation will cover the clinical trials that have and are being conducted with these molecules, especially BMP -2. Useful References Garrison KR, Donell S, Ryder J, Shemilt I, Mugford M, Harvey I, Song F. Clinical effectiveness and cost-effectiveness of bone morphogenetic proteins in the non-healing of fractures and spinal fusion: a systematic review. Health Technology Assessment 2007; 11(30):1-150. McAteer H, Griffin D, Donell S, Scammell B, Kon E, Stirling A, Lilford R. The Current Clinical Opportunities for Regenerative Medicine in Bone. Scoping Report University of Birmingham 2007 Hwww.pcpoh.bham.ac.uk/publichealth/methodology/docs/health_economics/Scoping_Report_Bone.pdf