A major unsolved problem in orthopedic surgery is how to manage massive bone defects after tumors, osteomyelitis or non-unions. These are all bone defects that often do not heal and often lead to amputations. The current options are all severely inadequate and the demand for an innovative solution urgent. The Smart Bone Project, focuses on in situ tissue engineering of bone -not in the lab, but in the patient. 

Bone morphogenic proteins (BMPs) are cytokines, that induce formation of bone. BMPs have been successful in experimentally but not in the clinical practice. Why? We believe that better carriers for the protein are needed and that combinations with other bone active drugs can improve the results.

In the Smart Bone Project, we will evaluate two biomimetic scaffolds 1) a (HA/CaS) ceramic, and 2) a macroporous cryogel (gelatin-HA-CS). We will incorporate BMP and anti bone-resorbing bisphosphonate. The scaffolds provide structural support for cells and vessels, and serve as a bioactive reservoir allowing controlled release of the drugs during tissue ingrowth. Our overall purpose is to prove that this can be used in the worst case scenario in bone healing, in a massive bone defect. The project takes the idea from bench-to-bedside. First, we will identify the optimal material and drug doses, test in animal models and evaluate using new state-of-the-art imaging method (PET-CT). Based on these results, we will initiate proof-of-concept randomized clinical studies.