ABSTRACT
Severe fractures damage blood vessels and disrupt circulation at the fracture site, which can lead to an increased risk of poor fracture healing. Angiogenesis, the formation of new blood vessels and vessel networks, plays a critical role in bone regeneration and fracture repair. Bone is a biologically advantaged tissue, in that it has the capacity to undergo regeneration as part of a repair process. Fracture healing is the most common and recognizable form of bone regeneration. The unique process of bone regeneration requires a coordinated coupling between osteogenesis and angiogenesis. Although the regeneration of the bone can be completed with minimal scarring, a signifi cant percentage of fractures fail to heal adequately. Non-union or delayed union of fractures and the repair of large segmental bone defects after tumour removal, infections or trauma remains a highly challenging and clinically important problem in orthopaedic surgery. Although new technologies and advances have substantially enhanced fracture healing and surgical outcomes, there remains a subset of fractures and related conditions that continue to be present with impaired healing. Consequently, new strategies to optimize bone regeneration are being developed. Current
approaches that aim to promote bone healing such as the use of bone morphogenetic proteins (BMPs) and mesenchymal stem cells (MSCs) are lacking angiogenic activity for bone regeneration.
