承重骨大段骨缺损的治疗：传统与新型骨移植材料

余丹; 沈文怡; 戴家慧; 朱慧勇

doi:10.1631/jzus.B2300669

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Review | Updated：2025-05-28

承重骨大段骨缺损的治疗：传统与新型骨移植材料
Treatment of large bone defects in load-bearing bone: traditional and novel bone grafts
浙江大学学报（英文版）（B辑：生物医学和生物技术） 2025年26卷第5期页码：421-447
Affiliations：

1.Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
2.Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
Funds：

the National Natural Science Foundation of China(82202450)
DOI：10.1631/jzus.B2300669
中图分类号：
CSTR：
收稿日期：2023-09-19，

修回日期：2024-01-10，

网络出版日期：2025-04-30，

纸质出版日期：2025-05-28
Accepted：

余丹,沈文怡,戴家慧等.承重骨大段骨缺损的治疗：传统与新型骨移植材料[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2025,26(05):421-447.

Dan YU, Wenyi SHEN, Jiahui DAI, et al. Treatment of large bone defects in load-bearing bone: traditional and novel bone grafts[J]. Journal of zhejiang university-science b (biomedicine & biotechnology), 2025, 26(5): 421-447.
余丹,沈文怡,戴家慧等.承重骨大段骨缺损的治疗：传统与新型骨移植材料[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2025,26(05):421-447. DOI： 10.1631/jzus.B2300669.

Dan YU, Wenyi SHEN, Jiahui DAI, et al. Treatment of large bone defects in load-bearing bone: traditional and novel bone grafts[J]. Journal of zhejiang university-science b (biomedicine & biotechnology), 2025, 26(5): 421-447. DOI： 10.1631/jzus.B2300669.

摘要

因严重创伤、肿瘤、囊肿以及广泛感染等原因造成的承重骨缺损是临床上常见的疾病。尽管骨具有自我修复和再生的潜能，但超过临界尺寸的大段骨缺损的修复仍是极大的临床挑战。传统的修复方法是使用自体骨或同种异体骨移植替代缺损部位缺失的骨组织，其中自体骨移植至今仍然是临床治疗的“金标准”。然而，传统骨移植材料的应用受到可获取骨量、供区并发症和免疫排斥等缺点的限制。近年来，临床对骨移植替代物的需求推动了新型骨移植材料的发展。除关注骨传导性和骨诱导性外，力学性能的优化是近年来增强新型骨移植材料治疗承重骨缺损可行性的重点。但大多数生物材料支架尚不能提供足够的力学强度。目前研究面临的核心挑战在于如何在机械需求和组织再生需求间找到适当的平衡。本文就传统和新型骨移植材料在承重骨缺损中的应用及其优缺点进行综述，并重点介绍了基于材料、结构和功能仿生的新型骨移植物发展策略，以期为未来的研究提供新的思路和方向。

Abstract

Large bone defects in load-bearing bone can result from tumor resection

osteomyelitis

trauma

and other factors. Although bone has the intrinsic potential to self-repair and regenerate

the repair of large bone defects which exceed a certain critical size remains a substantial clinical challenge. Traditionally

repair methods involve using autologous or allogeneic bone tissue to replace the lost bone tissue at defect sites

and autogenous bone grafting remains the “gold standard” treatment. However

the application of traditional bone grafts is limited by drawbacks such as the quantity of extractable bone

donor-site morbidities

and the risk of rejection. In recent years

the clinical demand for alternatives to traditional bone grafts has promoted the development of novel bone-grafting substitutes. In addition to osteoconductivity and osteoinductivity

optimal mechanical properties have recently been the focus of efforts to improve the treatment success of novel bone-grafting alternatives in load-bearing bone defects

but most biomaterial synthetic scaffolds cannot provide sufficient mechanical strength. A fundamental challenge is to find an appropriate balance between mechanical and tissue-regeneration requirements. In this review

the use of traditional bone grafts in load-bearing bone defects

as well as their advantages and disadvantages

is summarized and reviewed. Furthermore

we highlight recent development strategies for novel bone grafts appropriate for load-bearing bone defects based on substance

structural

and functional bionics to provide ideas and directions for future research.

关键词

Keywords

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