Chapter 38 – Orthopedic Applications of Stem Cells

More than 33 million musculoskeletal injuries occur in the United States each year. Bone is capable of regeneration, and defects often heal spontaneously. However, cartilage, tendon, and ligament injuries usually heal by scar formation, which is inferior to the native tissue. Tissue engineering approaches to recapitulate the embryonic events that result in the development of native tissue have the potential to heal these tissues. The goal of tissue engineering is to generate biologic substitutes for repair, restoration and/or replacement of injured tissue. Typically, these approaches employ a combination of one or more of three components: cells (tissue function), growth factors and differentiation stimuli (lineage direction), and/or a scaffolding matrix (cell attachment and/or structural architecture). The generated construct should be site specific and integrate well at the host-graft interface.