ROLE OF VARIOUS MODALITIES IN STIMULATING OSTEOGENESIS

ROLE OF VARIOUS MODALITIES IN STIMULATING OSTEOGENESIS

1. Growth factors and related molecules
   • BMP 2and 7
   • Transforming growth factor TGF beta
   • Fibroblast growth factor FGF 1and2
   • PDGF
   • PGE2
2. Systemic enhancement
   • Parathyroid hormone
     • role of teriparatide in osteoporotic #

• growth hormone, insulin like growth factors

3. Physical enhancement
   • mechanical stimulation – role of micromotion
     • intermittent compressive / shear forces – enchondral ossification
     • tensile stress – intramembranous ossification
     • constant compressive stresses (hydrostatic stress ) - inhibit enchondral ossification - cartilage
     • high shear stress – fibrous tissue formation
   • distraction osteogenesis – in non union
   • electrical stimulation
   • ultrasound stimulation
4. Bone grafts

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