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 $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
Building on our wound healing research RAFT is working to create a ‘scaffold’ 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 the procedure currently faces and provide an alternative to painful and invasive bone grafts, bringing effective treatment to millions.
We are currently exploring two research streams for bone regeneration:
1. Adapting the composition of Smart Matrix®
This project will combine RAFT’s Smart Matrix wound healing treatment with an osteogenic (bone-forming) material, to create a composite that will mimic the molecular structure of natural bone. Smart Matrix® has already been proven to be able to generate new blood vessels, something that is essential to allow new bone to grow.
The new material will be suitable for hip and knee revision surgeries and spinal fusion treatment and it could also potentially be used in dental applications.
2. Creating a robust 3D Form
Smart Matrix® has great healing potential but is not currently strong enough to be manipulated into robust three-dimensional (3D) shapes needed to support bone growth in large defects and serious fractures. We are therefore developing ways to combine Smart Matrix® with a structurally robust material that will allow it to be moulded in the 3D shape for the treatment of certain bone defects.
Our research will create a scaffold for bone to grow in the required shape and size while ensuring that the tissue also has the oxygen required 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
Bone regeneration programme cost:
Our two current projects in this area call for funding of £450,000 over the period from 2016 to 2018, to fund:
- Research scientists
- Running costs: project management and administration
- Laboratory costs: testing & analysis, materials
- Presentation at relevant conferences
- Production of publications
Bone regeneration project timeline:
Our research on both bone regeneration projects is scheduled for completion in autumn 2018, by which point we aim to be in a position to apply for approval to conduct clinical trials in order to bring new treatment to patients.
RAFT bone regeneration research scientists:
- Dr Elena Garcia
- Dr Nupur Kohli
- Vaibhav Sharma