Severe bone defects caused by accident, disease or tumour removal are extremely debilitating. Bone injury or deterioration can affect anyone, but older people face a significantly higher risk of degenerative bone disease and non-healing fractures which often lead to permanent disability.
- More than 20,000 hip and knee revision surgeries are performed in the UK each year (10% of all replacement surgeries)
- One in two women and one in five men over 50 suffer a non-healing fracture due to conditions such as osteoporosis
- Risk increases dramatically with age: 2% of women at 50 have osteoporosis, rising to over 25% at 80
- Globally, more than 2.5 million bone grafts are carried out each year at a cost of approximately $3.4 billion
Current treatment options
Non–healing fractures, bone defects caused by disease and tumour removal, hip and knee replacement revisions and spinal fusion surgery are currently treated with bone grafts. But this procedure can be fraught with problems, including:
- A lack of available tissue
- Pain and non-healing from where bone has been taken
- Disease transmission if bone is from a donor
- Rejection of the bone graft when the bone graft is from a donor
- Inconsistent bone quality
Grow your own bone
Building on our wound healing research, RAFT is developing and testing ‘scaffolds’ that will encourage bone to regenerate – quite literally allowing new bone to grow wherever it’s needed within the body.
RAFT’s bone regeneration research scientists are working to create off-the-shelf artificial bone graft alternatives that will overcome the problems associated with harvesting bone grafts and provide an alternative to this painful and invasive procedure, bringing effective treatment to millions.
We are currently exploring two research streams for bone regeneration:
1. SmartCaP®- a novel bone void filler
RAFT has developed SmartCaP®, a novel composite biomaterial which will be used for the treatment of bone defects. This material contains two key components which, in combination, will mimic the molecular structure of natural bone:
- A porous biomaterial, developed by RAFT, which has been proven to generate new blood vessels; something that is essential for the growth of new bone
- Calcium Phosphate; a mineral found naturally in bone which plays an important role in giving the material its osteogenic (bone-forming) properties
The new material will be suitable for filling bone defects anywhere in the body, including hip and knee revision surgeries and spinal fusion treatment. It could also be potentially used in dental applications.
RAFT’s research partners for this bone regeneration research are:
- Prof Gordon W Blunn, Professor of Bioengineering, University of Portsmouth and Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, UCL, London
- Dr Martyn Snow, Consultant Orthopaedic Surgeon, Royal Orthopaedic Hospital, Birmingham
- Dr Alodia Orera, Materials Scientist, Aragon Institute of Materials Science and University of Zaragoza, Spain
- Prof Jonathan Knowles, Professor of Biomaterials Science, Eastman Dental Institute, UCL, London
- Prof Francesco D’Aiuto and Dr. Federico Moreno Sancho, Consultant Dental Surgeons, Eastman Dental Institute, UCL, London.
2. Creating a robust 3D biomaterial for large bone defects
The porous biomaterial of RAFT’s Smart Matrix® product has great bone-healing potential, but is not strong enough to be manipulated into the robust three-dimensional (3D) shapes needed to support bone growth in large defects and serious fractures. RAFT has therefore developed a way to combine the biomaterial with a structurally robust material, so that it can be moulded into the 3D shapes required for the treatment of large bone defects.
The two materials have been combined to produce a scaffold, which will guide new bone to grow to the required shape and size while ensuring that the tissue also has sufficient oxygen to develop, through the growth of new blood vessels.
This robust 3D material could be used for the treatment of non-union fractures – a serious complication when a fracture doesn’t heal due to movement, poor blood supply or infection.
RAFT’s research partner for this bone regeneration research is Dr Mia Woodruff, Associate Professor at Queensland University of Technology, Australia. Dr Woodruff’s group specialises in the production of 3D robust scaffolds for hard tissue regeneration using state-of-the-art manufacturing facilities. The group also has the expertise required to develop these scaffolds both in the lab (in vitro) and in the body (in vivo).
A strong outcome
Allowing bone to regenerate within the body will eliminate the need for bone grafts, providing significant benefits for both patients and the healthcare system, including:
- Reducing the level of disability caused by bone injury and degenerative bone disease
- Helping older patients to regain their independence and mobility
- Reducing the number of invasive operations currently required for patients suffering from bone injuries or disease
- Reducing the time spent in hospital due to fewer operations and the need for recurring treatment
- Enabling people to recover faster from treatment for degenerative bone disease
- A much less painful procedure than bone grafting, because the patient’s own bone regrows
- Less anxiety and stress for the patient
RAFT bone regeneration research scientists:
- Dr Nupur Kohli
- Dr Vaibhav Sharma
- Dr Elena Garcia