ABSTRACT
Orthopedics has long been associated with the development of tissue engineering techniques and biomaterials through the use of bone grafting techniques, including autograft, allograft, and xenograft, as well as through bone lengthening techniques with distraction osteogenesis; fixation devices made of metal, ceramic, or biodegradable materials; and organic or nonorganic bone substitutes. However, in the current clinical scene, when bone grafts are required autogenous bone grafting has been the gold standard because of its obvious advantages in osteogenic capacity, osteoconduction, mechanical properties, and the lack of adverse immunological response. In fact, autograft accounts for nearly 70% of surgical procedures involving bone grafts or bone substitutes in Japan according to a survey by the Japanese Orthopedic Association. [1] On the other hand, autogenous bone grafting techniques have some limitations, [2] such as the requirement of additional surgery for harvesting and the availability of grafts of the correct size and shape. Furthermore, autograft techniques all carry the risk of donor site morbidity, [3-5] which can include long-lasting pain, fracture, nerve damage, and infection, none of which are experienced when other techniques are employed.
