By Mili Jayadeep | Science Editor
Bone fractures occur due to direct trauma to the bone resulting from sporting injuries, infections, falls or pre-existing conditions that result in brittle bones. Although bones have high reparative abilities, it can take an extended period of time for bone healing to occur. This also depends on the extent of the injury; bones that have undergone major trauma take a longer time to repair, meaning the healing process may be absent or slow in situations where the bone is severely damaged.
Usually in such situations, bone auto-transplantation is performed. This involves harvesting bone from the patient’s pelvis and using it as a transplant material at the site of injury. This is an invasive procedure and can lead to donor-site morbidity, problems at the site where bone has been removed for the transplant.
A new study details an alternative method of treating bone injury that focusses on inducing bone regeneration. The orthopaedics research lead, Deepak Raina explains:
“In cases involving severe open fractures in the lower leg, over 5 per cent of all fractures fail to heal. With our method, we will be able to avoid taking bone from the pelvis, which is a major gain for the patient.”
Researchers at Lund University in Sweden have collaborated with German scientists to develop a new method of inducing repair within bone to promote healing of fractures of the thigh or shin bone. The new study was published in the journal Science Advances. The scientists have used animal models to test the effects of certain drug compounds to cause bone regeneration. The promising nature of the results indicate that the procedure has the potential to be used on actual patients in the clinical setting.
The drug compounds used in this research initiative already have approval hence saving valuable time before being available in clinical practice:
“The drugs and materials we used in the study for the regeneration of bone are already approved. We simply packaged them in a new combination. Therefore, there are no real obstacles to already using the method in clinical studies for certain major bone defects that are difficult to resolve in patients. But we want to introduce the technique in a controlled form via clinical studies and have recently been granted ethical approval,”
This new research is invaluable as it offers a new way of managing severe injuries and bypasses the need for a hip auto-transplantation surgery. The mixture of compounds used by the scientists includes a bioactive protein (rhBMP-2), bisphosphonate and an artificial material engineered in Lund. All of these compounds are involved in the process of bone resorption, a necessary part of healing after bone trauma.
Deepak Raina says,
“The bone protein we use has had negative effects in previous studies due to a secondary premature bone resorption, among other things. We have successfully mitigated this effect with the bisphosphonate and, by packaging the drug in a slowly resorbing bone substitute, we can control the speed of release. In the current study with the combination, we achieved a six-fold reduction in the amount of protein compared to previous efforts, while still inducing bone formation. The result was that even fractures with an extensive bone defect could heal without complications. We believe this finding will be of great clinical use in the future,”
This research is very encouraging for orthopaedics and trauma speciality and could transform the management of severe bone fractures and offer a better prognosis to patients who have had such severe traumatic injuries to bones. The researchers are optimistic that their findings will help inform future clinical practice.