New technologies for the enhancement of skeletal repair

T. William Axelrad, Sanjeev Kakar, Thomas A. Einhorn

Research output: Contribution to journalArticlepeer-review

87 Scopus citations


Although fracture healing is a well-optimized biological process that leads to healing, approximately 10-20% of fractures result in impaired or delayed healing and these fractures may benefit from the use of biotechnologies to enhance skeletal repair. Peptide signaling molecules such as the bone morphogenetic proteins have been shown to stimulate the healing of fresh fractures, nonunions, and spinal fusions and side effects from their use appear to be minimal. Other growth factors currently being studied for local application include growth and differentiation factor-5 (GDF-5), vascular endothelial growth factor (VEGF), transforming growth factor β (TGFβ), and platelet-derived growth factor (PDGF). Molecules such as prostaglandin E receptor agonists and the thrombin-related peptide, TP508, have shown promise in animal models of fracture repair. Gene therapy using various growth factors or combinations of factors might also aid in fracture repair, particularly as new methods for delivery that do not require viral vectors are developed. Systemic therapy with agents such as parathyroid hormone (PTH), growth hormone (GH), and the HMG-CoA reductase inhibitors are also under investigation. As these and other technologies are shown to be safe and effective, their use will become a part of the standard of care in managing skeletal injuries.

Original languageEnglish (US)
Pages (from-to)S49-S62
Issue numberSUPPL. 1
StatePublished - Mar 2007


  • Bone morphogenetic protein
  • EP2 receptor agonist
  • EP4 receptor agonist
  • Fracture repair
  • Gene therapy
  • HMG-CoA reductase inhibitors
  • Nonunion
  • Parathyroid hormone
  • Platelet-derived growth factor
  • TP508
  • Transforming growth factor β
  • Vascular endothelial growth factor

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine


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