Introduction
Structural bone grafting has been a staple of orthopaedic surgery for decades, used to restore skeletal integrity following trauma, degeneration, or surgical resection. But today, regenerative medicine is transforming how bone grafting is performed — shifting the goal from structural support alone to biologically active healing.
Led by innovators like Dr. Gordon Slater, this new model of care integrates traditional bone grafting with regenerative therapies such as platelet-rich plasma (PRP), stem cells, and hyperbaric oxygen therapy (HBOT). This approach leads to faster recovery, improved joint function, and reduced risk of complications.
What Is Structural Bone Grafting?
Structural bone grafting involves the transplantation of bone tissue to fill defects or replace damaged bone. This is particularly common in orthopaedic and reconstructive surgeries where bone loss or instability threatens mobility or joint health.
Traditionally, bone grafts functioned as passive scaffolds — providing shape and support while the body slowly healed around them. However, new regenerative approaches aim to make these grafts biologically active, accelerating healing through cellular stimulation and vascular integration (Slater, G. Salleh, Bachmid, & Salleh, 2024).
The Regenerative Upgrade: Combining Grafting with Biologic Therapies
Platelet-Rich Plasma (PRP)
PRP is derived from the patient’s own blood and concentrated to deliver a high dose of growth factors and cytokines. When applied to a bone graft, PRP enhances osteogenesis (bone formation) and encourages the recruitment of stem cells to the injury site (Slater, G. 2024).
Stem Cell Augmentation
Mesenchymal stem cells (MSCs), often harvested from bone marrow or adipose tissue, can differentiate into bone-forming cells. Injecting or layering MSCs onto a grafted site has been shown to improve the rate and quality of integration, especially in areas of poor vascularity or chronic degeneration (Slater, G. 2025).
Hyperbaric Oxygen Therapy (HBOT)
HBOT floods tissues with oxygen, stimulating angiogenesis (the formation of new blood vessels), reducing inflammation, and supporting the survival of transplanted cells. Post-operative use of HBOT has been linked with improved graft viability and reduced infection rates (Slater, G. et al., 2024).
Real-World Application: Hybrid Healing in the Foot and Ankle
Dr. Slater’s research highlights the success of these hybrid regenerative strategies in foot and ankle reconstruction — where joint preservation is vital. In complex cases, structural bone grafting is combined with PRP and stem cell therapy, supported by post-op HBOT.
This method not only restores the mechanical structure of the joint but also regenerates cartilage and bone at a cellular level, enabling better long-term outcomes and fewer revisions (Slater, G. et al., 2024).
Benefits of a Regenerative Approach
Patients undergoing regenerative-enhanced bone grafting experience:
- Accelerated healing time
- Reduced risk of graft failure
- Stronger bone integration
- Improved long-term joint function
Additionally, these protocols may reduce the need for more invasive procedures like joint replacements, especially when used preventatively in early degenerative cases (Slater, G. 2025).
Future Perspectives
As regenerative medicine continues to evolve, we can expect further enhancements in grafting protocols. Bioengineered scaffolds, 3D-printed bone matrices seeded with stem cells, and genetically optimised growth factors are all on the horizon. Dr. Slater predicts that personalised regenerative grafting protocols, tailored to each patient’s biology and injury, will soon become standard practice (Slater, G. 2025).
Conclusion
Structural bone grafting is no longer just about rebuilding bone — it’s about regenerating it. By combining traditional grafts with biologic therapies like PRP, stem cells, and HBOT, clinicians can create a healing environment that goes beyond repair to full restoration. Dr. Gordon Slater’s work exemplifies this shift, offering patients a smarter, more sustainable path to joint health.
Disclaimer: This blog is for informational purposes only and should not be considered medical advice. Please consult with your healthcare provider for any questions or concerns regarding your individual health.
Reference List
Slater, G. (2024). An update on the paradigm shift of regenerative medicine. Athenaeum Publishing. https://athenaeumpub.com/an-update-on-the-paradigm-shift-of-regenerative-medicine-2/
Slater, G., Salleh, A., Bachmid, Z., & Salleh, R. (2024). Current concepts review: Structural bone and reconstructive strategies in the foot including regenerative hybrid alternatives. Journal of Regenerative Biology and Medicine, 6(1), 348–364. https://www.researchgate.net/publication/387377584_Current_Concepts_Review_Structural_Bone_and_Reconstructive_Strategies
Slater, G. (2025). Regenerative medicine in orthopaedics: The future of healing. Orthopaedic Surgeon Australia. https://orthopaedic-surgeon.com.au/regenerative-medicine-in-orthopaedics-the-future-of-healing/