Abstract
The ability of mesenchymal stem cells (MSCs) to transdifferentiate into a desired cell lineage has captured the imagination of scientists and clinicians alike. The limited ability for chondrocytes to regenerate in chondral injuries has raised the concept of using MSCs to help regenerate and repair damaged tissue. The expansion of cells in a laboratory setting to be delivered back to the patient is too costly for clinical use in the present tough economic climate. This process is slow with due to the complexity of trying to imitate the natural environment and biological stimulation of chondral cell replication and proliferation. Bone marrow aspirate concentrate (BMAC) has the potential to provide an easily accessible and readily available source of MSCs with key growth factors that can be used in treating chondral injuries. This review summarizes the underlying basic science of MSCs and the therapeutic potential of BMAC.
Highlights
The development of techniques to harvest and amplify specific cell lines using mesenchymal stem cells (MSCs) has generated huge interest in trauma and orthopedic surgery due to its potential for tissue repair and regeneration [1].Historically, chondral defects in the young patient have been treated with microfracture and mosaicplasty
Our aim is to review this literature regarding the basic science of bone marrow-derived stem cells and the therapeutic potential of bone marrow aspirate concentrate (BMAC) in the regeneration and repair of chondral injuries
The growth factor insulin-like growth factors (IGFs)-1 has proven useful to promote differentiation and chondrogenesis but has a short-lived effect due to rapid and effective clearance [2]. This has been overcome by Frisch et al using recombinant viral vectors to human bone marrow cell in vitro to provide sustained IGF-1 locally and facilitate differentiation and chondrogenesis [2]
Summary
The ability of mesenchymal stem cells (MSCs) to transdifferentiate into a desired cell lineage has captured the imagination of scientists and clinicians alike. The expansion of cells in a laboratory setting to be delivered back to the patient is too costly for clinical use in the present tough economic climate. This process is slow with due to the complexity of trying to imitate the natural environment and biological stimulation of chondral cell replication and proliferation. Bone marrow aspirate concentrate (BMAC) has the potential to provide an accessible and readily available source of MSCs with key growth factors that can be used in treating chondral injuries. This review summarizes the underlying basic science of MSCs and the therapeutic potential of BMAC. Specialty section: This article was submitted to Orthopedic Surgery, a section of the journal
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