Editorial [Stem Cell Applications and Tissue Engineering Approaches in Orthopaedic Surgery and Musculoskeletal Medicine (Guest Editor: Wasim S. Khan)] (original) (raw)

2012, Current Stem Cell Research & Therapy

Musculoskeletal tissue is frequently damaged or lost in injury and disease. Orthopaedic surgery has been highly successful in repairing, realigning and replacing damaged musculoskeletal structures. The coming years will establish whether a paradigm shift from fixation towards regeneration of tissue is possible, clinically feasible and financially viable. There has been an increasing interest in stem cell applications and tissue engineering approaches in surgical practice to deal with damaged or lost tissue [1-3]. Tissue engineering is an exciting strategy being explored to deal with damaged or lost tissue. It is the science of generating tissue using molecular and cellular techniques, combined with material engineering principles, to replace tissue. This could be in the form of cells with or without matrices. Although there have been developments in almost all surgical disciplines [1], the greatest advances are being made in orthopaedics, especially in bone repair [3]. This is due to many factors including the familiarity with bone marrow derived mesenchymal stem cells and bone grafting. STEM CELLS Stem cells are a self-renewing, slow-cycling cell population that exhibits a high proliferation potential and the ability to undergo multilineage differentiation. They can be isolated from tissues of individuals of various ages and maintain capacity for multilineage differentiation. Protocols for the culture [4] and, chondrogenic, osteogenic and adipogenic differentiation of bone marrow derived mesenchymal stem cells have been described [5, 6]. The rationale behind these protocols is discussed in this issue as well as highlighting the different regulators which determine the lineage a particular mesenchymal stem cell will differentiate into. By the end of last century, there was considerable interest in the use of mesenchymal stem cells for clinical tissue engineering applications. Unlike embryonic stem cells, the use of autologous postnatal mesenchymal stem cells is generally well accepted by society. Mesenchymal stem cells are less tumourogenic than their embryonic counterparts [7] and provide an autologous source of cells eliminating concerns regarding rejection and disease transmission. Cells with mesenchymal stem cell characteristics have been isolated from many different adult tissues including bone marrow, liver, dental pulp, periosteum, skin, retina, adipose tissue, skeletal muscle, synovial tissue, the infrapatellar fat pad, and more recently, cartilage [8-14].