THE ROLE OF GENETIC POLYMORPHISMS IN BONE TISSUE REGENERATION FOLLOWING INJURY

Abstract

Individual variations in fracture healing have sparked interest in genetic polymorphisms; however, the inconsistency of the reported associations has limited their utility for the early prediction of delayed union or nonunion. The objective of this study was to critically synthesize existing data on the role of genetic polymorphisms in post-traumatic bone regeneration and to define the conditions under which they might be used for prognostic purposes. The study drew upon Russian and international publications from 2022–2026, sourced from PubMed, Europe PMC, and various scientific journals, as well as official data from the Ministry of Health of the Russian Federation. A qualitative comparative analysis was conducted, encompassing clinical studies of polymorphisms, research on gene expression, and experimental models of bone regeneration. Key parameters—such as sample characteristics, the timing of healing assessments, outcome definitions, the inclusion of clinical covariates, and the presence of independent validation—were compared; no quantitative meta-analysis was performed. The author examined polymorphisms in genes related to the inflammatory response, osteogenic differentiation, and bone metabolism. In a study of 108 patients, an association with impaired bone union was identified for the GG genotype of the −174C>G variant in the *IL6* gene, whereas no significant differences in the frequencies of the *IL1B* genotypes were observed. A prognostic model incorporating variants of *TNFRSF11B*, *TGFB1*, and *IL6* demonstrated a sensitivity of 83% and a specificity of 84%; however, variations in clinical outcomes and a lack of independent validation have limited the generalizability of these findings. This comparison allowed for a distinction to be made between the functional roles of specific genes and the evidence supporting the prognostic value of their variants. To assess the added value of genotyping, it was proposed to compare a clinical model with a model augmented by genetic markers, using an independent prospective cohort.