Local factors of stimulation of reparative osteogenesis (literature review)

In addition to improving the methods of reduction and fixation of fractures, an urgent direction of modern research is the possibility of using local factors for stimulating reparative osteogenesis. These factors are classified according to the mechanism of biological action on osteogenic, osteoconductive, osteoinductive. In this article, we analyzed the scientific literature on the use of bone grafting (autologous and allogeneic bone grafts), bone substitutes (demineralized bone matrix (DBM), ceramics and cement based on calcium phosphate, bioactive glass), synthetic growth factors (bone morphogenetic proteins (BMP), fibroblast growth factors (FGF), vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF) and insulin-like growth factor (IGF)), cell therapy (autologous bone marrow aspirate concentrate (BMAC), PRP therapy). The significant progress achieved with the use of osteogenic, osteoconductive osteoinductive factors with delayed fracture co-solidification still does not bring the finish line in solving such a complex problem. Currently, there is great interest in the possibility of topical administration of bisphosphonates, both alone and in combination with other components. The article demonstrates studies of the local use of bisphosphonates (etidronate) in combination with lanthanide ions and calcium in fractures in animals, and their positive effect on the reparative process.