骨缺损修复生物材料的研究进展与应用前景

Research Progress and Application Prospects of Biomaterials for Bone Defect Repair

摘要: 骨骼作为具有高刚度和活跃新陈代谢的活体结构，其小缺损可通过自身修复机制愈合，但创伤、手术切除及骨相关疾病引发的超临界骨缺损(通常指长度大于1~2 cm或骨周损失超50%)需借助生物材料辅助修复。生物材料凭借良好的生物相容性、机械性能及功能调控潜力，成为骨缺损修复领域的核心研究方向，其通过模拟细胞外基质、调节细胞行为及构建适宜微环境，为骨再生提供关键支撑。本文系统综述了骨缺损修复相关生物材料的研究现状，重点分类阐述了无机材料(金属材料、生物陶瓷等)和天然生物材料(生物聚合物、水凝胶、自体衍生材料等)的成分特性、改性技术、作用机制及临床应用研究成果，分析了材料表面结构、孔隙率、离子释放等关键因素对骨整合与再生的影响。同时，展望了纳米复合材料、聚乙烯醇(PVA)基材料及基因工程靶向生物材料等新型材料的发展趋势，提出未来研究应聚焦于模拟骨再生自然过程(如血管生成与骨生成耦合)，优化支架材料选择、几何结构设计及生物分子控释系统。本文为骨缺损修复生物材料的研发与临床转化提供参考，以期推动骨外科治疗中骨替代材料的创新与应用。

Abstract: Bone, as a living structure with high stiffness and active metabolism, can heal small defects through its intrinsic repair mechanism. However, critical-sized bone defects (typically defined as defects longer than 1~2 cm or with more than 50% periosteal loss) caused by trauma, surgical resection, and bone-related diseases require assistance from biomaterials for effective repair. Biomaterials have emerged as a core research direction in bone defect repair due to their excellent biocompatibility, mechanical properties, and functional regulatory potential. By simulating the extracellular matrix, regulating cellular behaviors, and constructing a favorable microenvironment, biomaterials provide crucial support for bone regeneration. This article systematically reviews the current research status of biomaterials related to bone defect repair, focusing on the classification, compositional characteristics, modification technologies, mechanisms of action, and clinical application research results of inorganic materials (metallic materials, bioceramics, etc.) and natural biomaterials (biopolymers, hydrogels, autologous-derived materials, etc.). It analyzes the effects of key factors such as material surface structure, porosity, and ion release on osseointegration and regeneration. Meanwhile, the development trends of novel materials, such as nanocomposites composed of biodegradable polymers, polyvinyl alcohol (PVA)-based materials, and gene-engineered targeted biomaterials for bone regeneration, are prospected. Future research should aim to better simulate the natural process of bone regeneration, such as the coupling between angiogenesis and osteogenesis. Although imitating nature is challenging, recent scientific and technological advancements indicate the possibility of fabricating bone scaffolds that support local and systemic biological functions. The rational selection of scaffold materials, their geometric structure design, pore size, and the ability to release biomolecules at an optimal rate will play a pivotal role in the development of bone scaffolds in the future. This article provides a reference for the research and development as well as clinical translation of biomaterials for bone defect repair, with the intention of promoting the innovation and application of bone substitute materials in orthopedic therapy.