Review - bioactive glass implants for potential application in structural bone repair

Abstract Bioactive glass particles andweak scaffolds have been used to heal small contained bone defects but an unmet challenge is the development of bioactive glass implants with the requisite mechanical reliability and in vivo performance to heal structural bone defects. Inadequate mechanical strength and a brittle mechanical response have been key concerns in the use of bioactive glass scaffolds in structural bone repair. Recent research has shown the capacity to create strong porous bioactive glass scaffolds and the ability of these scaffolds to heal segmental bone defects in small and large rodents at a rate comparable to autogenous bone grafts. Loading these strong porous scaffolds with bone morphogenetic protein-2 can significantly enhance their ability to regenerate bone. Recentwork has also shown that coating the external surface of strong porous scaffolds with an adherent biodegradable polymer can dramatically improve their load-bearing capacity in flexural loading and their work of fracture (a measure of toughness). These tough and strong bioactive glass-polymer composites with an internal architecture conducive to bone infiltration could provide optimal synthetic implants for structural bone repair.