골대체물의 기초 및 최근 연구 동향 = Bone Substitutes: From Basic to Current Update

다국어 초록 (Multilingual Abstract)

Bone substitutes are being used increasingly in bony surgery as more than two million bone grafts are performed worldwide per year. Autobone grafts represent the gold standard for bone grafting, but morbidity and limited availability are the main problems. Allobone grafts are osteoconductive, but there are still concerns regarding the infection risks, costs, and donor availability issues. As an alternative, widely used ceramic-based synthetic bone substitutes are based alternatively on calcium (hydroxyapatite, tricalcium phosphate, calcium sulfate, calcium phosphate). Ceramic-based bone substitutes are osteoconductive, but they are weaker than cortical bone and are not osteoinductive. Bone morphogenic protein, demineralized bone matrix, and platelet-rich plasma are used to obtain an osteoinductive function. Recently, cell-based and gen-based bone substitutes were developed and studied. This paper reviews the basic information and the latest concepts on bone grafts and bone substitutes.

국문 초록 (Abstract)

골대체제는 전 세계적으로 한 해에 200만 건 이상 사용되고 있다. 자가골 이식이 골이식 중 가장 좋은 방법이나, 공여부의 문제, 채취량의 제한 등의 문제로 사용에 제한이 있다.
이를 대체하기 위하여 동종골 이식이 사용되나 동종골은 골전도능은 있으나, 자가골 이식에 비하여 골유도능이 부족하며, 감염의 위험, 면역반응 등의 문제가 있고 가격이 높고, 수급의 문제가 있을 수 있다. 그 대안으로 합성 골대체제가 만들어졌고 주로 세라믹 기반의 골대체제(황산칼슘, 인산칼슘, 삼인산칼슘, 수산화인회석 등)가 널리 사용되고 있다. 세라믹기반의 골대체제는 골전도능은 있으나 기계적 강도가 부족하고 생분해성의 문제가 있으며, 골유도능이 없다는 단점이 있다. 이에 골유도 기능을 얻기 위해 골형성단백질, 탈무기질화골기질, 혈소판 풍부 혈장 등이 사용되고 있다. 최근에는 세포 기반 및 유전자 기반 이식물들이 개발, 연구되고 있다. 이에 골이식, 골대체물에 대한 기본적인 사항과 최신 지견을 살펴보고자 한다.

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