Mechanical regulation of bone regeneration during distraction osteogenesis

This is the authors' abstract. We don't add key points for this paper.

Distraction osteogenesis (DO) is a mechanobiological process of regenerating bone tissue by tension stress. DO is used clinically to lengthen bones or to treat critical size bone defects. Although DO provides satisfactory results in many cases, the prolonged period of treatment remains a major challenge that needs to be overcome. Various attempts have been devoted to accelerating bone regeneration during DO. One common approach is manipulation of the applied mechanical loading by altering distraction strategies. In this article, we reviewed relevant in vivo animal studies exploring the effects of changing mechanical environments, by varying distraction parameters (e.g., rate and frequency) or adding compression loading, on bone regeneration in DO. We further presented how the mechanically-regulated bone regeneration process during DO could be simulated by in silico models incorporating mechano-regulatory tissue differentiation rules. A comprehensive review of those in vivo and in silico studies may not solely provide important references for development of improved DO protocols in clinic, but also promote a deeper understanding of the mechanobiological mechanism of bone regeneration.