Delayed fracture healing and non-union fractures are major orthopaedic
issues that have become a significant healthcare burden. Among many approaches,
bone grafts facilitate the healing of non-union fractures. Native cancellous bones
represent a more viable and advantageous source of bone grafts due to structural and
biochemical similarity with natural bone. They also provide a large surface-to-volume
ratio to host cells and for the formation of the vasculature. Given these advantages, we
aimed to review some of the recent innovations in native cancellous bone graft
production, such as bone selection, decellularisation, demineralisation, and in vitro and
in vivo testing. Some endogenous and processing factors affecting performance are also
highlighted. In addition, innovations such as the coadministration of interleukin-4, and
impregnation of the scaffold with platelet-rich plasma are introduced to increase
scaffold performance. A brief overview of skeletal properties and metabolism, fracture
healing, and essential features of bone grafts is provided to appreciate these
innovations.
Keywords: Bone fracture, Bone graft, Fracture healing, Osteoblast, Osteoporosis, Scaffold.
