Abstract
Stem cell therapy is an exciting and upcoming branch of tissue engineering with application in the field of orthopaedics. The most commonly used type of stem cells, mesenchymal stem cells (MSCs), can be easily isolated from bone marrow or synovium and cultured in vitro. Newer techniques using tissue engineering to regenerate musculoskeletal tissue by using biomimetic materials are now being studied. These osteoconductive three dimensional constructs seeded with MSCs are highly porous, biodegradable and biomechanically stable scaffolds which do not evoke an immunogenic host cell response. Research has shown the importance of growth factors in guiding and modulating the differentiation of MSCs in order to obtain the required cell type. Gene-based delivery systems have aided the delivery of sustained quantities of these growth factors. The evidence from growth factor enhanced tissue engineering studies for tissue healing looks very positive. This is a multi-disciplinary approach that integrates molecular, biochemical and clinical techniques with developmental and engineering processes. Initial studies indicate an immense potential for cell based strategies to enhance current orthopaedic approaches in skeletal tissue reconstruction. Ultimately, there is a need for randomised controlled trials on human populations to apply these findings to a clinical setting. Nevertheless, stem cell based tissue engineering in orthopaedics shows a promising future.
Highlights
Much of the interventions in orthopaedics today aim towards the restoration of normal function by replacing damaged tissues or organs in such a way so as to achieve effective, long-lasting and stable repair [1]
The autograft contains not just the stem cells and the 3D scaffold, and osteoinductive growth factors, of which human Bone Morphogenetic Protein (BMP) is frequently used since it was first described by Urist about 40 years ago [26]
We have previously shown that synovial fat pad derived mesenchymal stem cells (MSCs) expanded in fibroblast growth factor-2 (FGF-2) showed cell surface epitope expression similar to adult stem cells [54]
Summary
Much of the interventions in orthopaedics today aim towards the restoration of normal function by replacing damaged tissues or organs in such a way so as to achieve effective, long-lasting and stable repair [1]. MSCs are a useful cell source in tissue engineering due to their innate capacity for regeneration and their ability to be isolated and expanded using culture techniques. Calcitriol-loaded PLGA scaffolds seeded with/without MSCs were implanted in an animal model of a bone defect.
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