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20th October 2016

Rebuilding broken bones

Sports injuries, car accidents and disease – there are lots of reasons why bones can break. Now researchers are dreaming up new ways to heal and protect people of all ages

When a 13-year-old child limped into the offices of Professor Denis Dufrane in Belgium, the teenager’s sporting future looked bleak. After two years living with a bone defect, the young patient could not put their weight on their leg – dramatically limiting their ability to run and do all of the other things that adolescents do.

Fortunately, Prof Dufrane is a renowned expert in regenerative medicine, a cutting-edge new science that’s helping doctors to repair badly damaged bones. As the co-founder of a start-up with a new bone repair technology, he knew what to do.

By taking a sample of fatty tissue (under local anaesthesia to ensure the procedure was painless), Prof Dufrane’s team were able to extract stem cells from the patient’s fat. Stem cells have the capacity to be ‘reprogrammed’ to become various bodily tissues.

The scientists managed to create a kind of soft plasticine made of stem cells which a surgeon could model into the right shape and insert into the defective bone. Because the implant was made of the patient’s own cells, there is very little risk of rejection.

Slowly but surely, the plasticine hardened into normal bone and grew to fill the gap that had caused so many problems. “Fourteen months later, he resumed his sporting activities – he plays football, attends school and no longer needs to visit us,” Prof Dufrane says. “He has returned to normal life.”

These kinds of bone-mending technologies – drawing on innovation from medtech and biotech – are promising to revolutionise how doctors deal with fractures and bone disease.

One of the most interesting things about this trend is that it is increasingly personalised. Rather than implanting donor tissue or an artificial replacement part, tissue engineering will allow doctors to implant patients’ own cells.

Researchers in the US are growing customised pieces of replacement bone outside the body. To do this, they create an environment very similar to that of the human body and coax cells into growing into the desired size and shape – ready for implantation.

This work requires not just cell biologists but also 3D modelling experts and engineers to design and build a tailor-made scaffold on which bone cells can be grown.

While these technologies could improve the lives of people with serious bone disorders or who have suffered traumatic injuries, 3D printing is even changing how people recover from common breaks and fractures.

The traditional way to deal with a broken limb is to put it in a plaster cast for about six weeks. As anyone who has worn a cast will testify, they can be heavy and uncomfortable.

But new 3D-printed ‘open-lattice’ casts are set to change that. Waterproof, lightweight and comfortable, these plastic casts may even help bones to heal faster.

And, of course, they are personalised. Like many other 3D technologies, a unique cast can be produced by scanning the patient to get the exact dimensions of their arm and ensuring the broken area gets the support required to heal swiftly.

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Bone fractures are a bid deal in Europe with millions of people affected every year. As the population ages, the risk of fragility fractures goes up so innovations in bone health and repair will play an increasingly important role in the decades to come.

Love your bones: Today is World Osteoporosis Day. Find out more about bone health and how you can reduce your risk of fractures.

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