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Review
. 2011 Jun;15(6):1266-86.
doi: 10.1111/j.1582-4934.2011.01265.x.

Bone regeneration: stem cell therapies and clinical studies in orthopaedics and traumatology

Enrique Gómez-Barrena  1 , Philippe Rosset, Ingo Müller, Rosaria Giordano, Carmen Bunu, Pierre Layrolle, Yrjö T Konttinen, Frank P Luyten
Affiliations
Review

Bone regeneration: stem cell therapies and clinical studies in orthopaedics and traumatology

Enrique Gómez-Barrena et al. J Cell Mol Med. 2011 Jun.

Abstract

Regenerative medicine seeks to repair or replace damaged tissues or organs, with the goal to fully restore structure and function without the formation of scar tissue. Cell based therapies are promising new therapeutic approaches in regenerative medicine. By using mesenchymal stem cells, good results have been reported for bone engineering in a number of clinical studies, most of them investigator initiated trials with limited scope with respect to controls and outcome. With the implementation of a new regulatory framework for advanced therapeutic medicinal products, the stage is set to improve both the characterization of the cells and combination products, and pave the way for improved controlled and well-designed clinical trials. The incorporation of more personalized medicine approaches, including the use of biomarkers to identify the proper patients and the responders to treatment, will be contributing to progress in the field. Both translational and clinical research will move the boundaries in the field of regenerative medicine, and a coordinated effort will provide the clinical breakthroughs, particularly in the many applications of bone engineering.

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Figures

Fig 1
Fig 1
Principle of bone tissue engineering.
Fig 2
Fig 2
Examples of biomaterials for scaffolding of human MSCs. (A) Porous BCP ceramics and (B) injectable paste made of CaP particles suspended in hydrogel for minimal invasive surgery.
Fig 3
Fig 3
Examples of biomaterials for MSC scaffolds. (A) Porous BCP granules, (B) with human MSCs (methylene blue staining), (C) BCP particles of 100–200 μm, (D) 3D constructs made of particles, cells and extracellular matrix, (E) BCP particles suspended in polysaccharide/collagen hydrogel and (F) MSCs cultured in 3D hydrogels (live/dead staining).
Fig 4
Fig 4
Relationship between bone diseases, cell therapy and biomaterials.
Fig 5
Fig 5
Computerized (CT) reconstruction of a non-union in a tibial diaphysis fracture.
Fig 6
Fig 6
(A) Early AVN of the hip, radiological images; (B) Magnetic resonance imaging of hips in the frontal plane, the same patient as in (A) showing characteristic images of AVN of both femoral heads, Ficat and Arlet stage II.
Fig 7
Fig 7
Different possibilities for cellular therapies for bone regeneration (A and B).
See this image and copyright information in PMC

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