2011 AOA Symposium: Tissue Engineering and Tissue Regeneration

Abstract

Improvements in our understanding of biological and biomechanical aspects of connective-tissue degeneration, healing, and repair have revealed the potential to develop novel approaches to tissue repair and regeneration. New knowledge about the basic cellular and molecular processes that govern tissue repair has emerged from the fields of cell biology, molecular biology, and molecular genetics. Ongoing developments in related fields, such as biomaterials and stem cells, have also suggested new ways to attack old problems in orthopaedics. This symposium brought together experts to address several important areas: (1) the use of local osteoinductive factors for spine fusion, (2) systemic agents and mesenchymal stromal cells to manipulate bone formation and remodeling, and (3) the use of scaffolds and platelet-derived factors for ligament-healing. We discuss biologic approaches to tissue-healing and regeneration, ranging from experimental techniques that are currently in preclinical testing to techniques that are currently in use. The basic principles related to tissue-healing and regeneration presented here will provide the basis for future studies in tissue engineering and related fields. Spine arthrodesis is one of the most challenging applications for bone graft materials and bone-healing. The nonunion rate associated with arthrodesis for management of degenerative lumbar spine disease ranges from 10% to 45%1,2. The combination of biologic and environmental factors makes the achievement of spine fusion sensitive to systemic issues that inhibit bone-healing, such as nonsteroidal anti-inflammatory drugs, corticosteroids, and nicotine. Bone graft substitutes are associated with one or more of four potential healing mechanisms3. An osteogenic material, by definition, has live osteoblasts that are capable of making bone matrix, which mineralizes normally. Osteoconductivity is the ability of a material to serve as a scaffold to support new bone ingrowth and/or ongrowth and can be influenced by the three-dimensional macrostructure as well as features such as …