Part II: Biologic Augmentation Strategies as Useful Adjuncts in Musculoskeletal Surgery.

Osseous healing after injury, whether by arthritis, osteonecrosis, or fracture, follows a fairly predictable and stepwise order of events. New bone formation requires osteoinductive, osteoconductive, and osteogenetic signals and environments for rapid and complete healing. Biologic augmentation strategies, such as bone marrow aspirate concentrates and other forms of mesenchymal stem cells, have been studied with renewed interest as a way to enhance healing in patients who have osteoarthritis, osteonecrosis, delayed unions, and nonunions. Many studies have demonstrated positive results in favor of biologic augmentation strategies to treat or temporize arthritis, osteonecrosis, and nonunion. Future research is required to definitively determine the utility of these biologic augmentation strategies, and larger randomized controlled trials with longer-term follow ups are needed.