Biomedical Engineering Reference
In-Depth Information
1.3.2 Economic impact of osteoporosis and
related fractures
Current direct medical costs of osteoporosis in the USA have been estimated
at US$13.7-20.3 billion. This burden is projected to grow by approximately
50% by 2025. A similar situation is expected to take place in other developed
countries (Day, 1996; Ray
et al
., 1997; Hoerger
et al
., 1999; Chrischilles
et al
., 1994).
In the USA, it has been estimated that total cost of incident fractures will
rise from US$209 billion during 2006-2015 to US$228 billion for 2016-2025.
Some interesting predictions about fracture sites and race/ethnicity of the
affected population in USA have been reported. Across fracture types, the
largest changes are predicted for pelvic fractures, where incidence increases
by 56% and costs are predicted to rise by 60% between 2005 and 2025. By
race/ethnicity, the proportion of fractures and costs among the non-white
population will increase from 14% and 12% in 2005, respectively, to 21% and
19% in 2025. The most rapid increase is projected to occur in the Hispanic
and other subpopulations. The annual costs for Hispanics are estimated to
grow from US$754 million in 2005 to over US$2 billion per year by 2025
for an increase of 175%. Similarly, the other population shows cost increases
of 175%, starting from a smaller 2005 total of US$502 million and rising
to more than US$1.38 billion per year in 2025 (Burge
et al
., 2007).
1.3.3 Costs of cancellous bone grafting versus
alternative methods in trauma surgery
At present, one of the most popular and used techniques for substituting
bone in those conditions where bone replacement is required is the use of
autologous bone. Autologous bone grafts are prescribed in numerous cases such
as defect pilon tibial, osteomyelitis, arthodesis, juvenile bone cysts, fracture,
ventral spondylodesis, tibial plateau fractures and non-unions (lohmann
et
al
., 2007). The main advantages of autologous bone are its biological nature
which avoids possible disease transmission or host rejection and also its
osteoconductive, osteoinductive and osteogenetic properties.
Cancellous bone grafting is currently the most frequent method for
replacement of bone tissue. Worldwide, in 10% of all orthopaedic operations,
a bone substitute is necessary. In Germany, 125 000 bone grafts are harvested
per year (Bischo, 1995). owing to the easy access and high transplant quantity,
autogenous bone is predominantly taken from the iliac crest. However, the
use of autologous bone as a bone graft or replacement also presents several
disadvantages, such as deep infection, prolonged wound drainage, nerve
injuries and chronic pain.
Allogenic bone material has been predominantly taken from the femoral
