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Thursday, 20 April, 2000, 00:54 GMT 01:54 UK
Bone building 'breakthrough'

The technique can replace lost bone
Revolutionary techniques that avoid the need for painful bone grafting methods could be in common use within five years, say experts.

The process of growing new bones using the patient's own bone marrow - reported in this week's New Scientist - may be some way off.

But UK scientists believe they have almost perfected a technique which uses natural growth-promoting chemicals, along with a special porous "scaffold".

This allows the bone to grow back naturally to fill the gap.

At the moment there are a number of techniques used by doctors to replace bone lost because of an accident, arthritis or even the removal of a tumour.

'Bone banks'

Sometimes, a section of bone is taken from another part of the skeleton, such as the top of the pelvic bone, which is broken up before being put into place.

Unfortunately, the area from which the bone is taken can remain painful for some time after the operation.

If the patient has had a hip replacement, the head of the leg bone, the femur, is occasionally frozen in case more bone is needed later.

Grafts donated by other people to "bone banks" are sometimes used, but these not only must be screened for diseases such as hepatitis and HIV, but there is also the risk that the bone will be rejected by the recipient's immune system.

Marrow used as seed

Sometimes doctors will use metal replacements, but these do not perform as well as bone.

The latest advance takes a sample of bone marrow from the patient, then uses it to "seed" chunks of a substance called hydroxyapatite, which is the mineral component of bone.

Growth factors are also added, and after between four to six weeks, the cells have secreted a layer of bone, bonding the layers of hydroxyapatite together.

The bone piece can then be grafted back into the patient.

Porous scaffold

The team, from Dutch company IsoTis, have already managed to replace 2-cm lengths of rabbit bone using this technique.

However, British researchers have achieved good results in animals simply by using a porous scaffold made out of a polymer called Polyactive.

The polymer is slowly absorbed as the new bone grows to replace it.

Professor Peter Revell, a professor of histopathology at the Royal Free & University College Medical School, said that his team was working on moulding three-dimensional scaffolds to replace lost bone.

He said: "We would expect that these techniques would be in use in the UK in between three to five years."

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