Tissue Engineering in Orthopaedics and Musculoskeletal Sciences

Orthopaedic surgery as a speciality lends itself well to tissue engineering. Many musculoskeletal tissues are frequently damaged or lost in injury and disease, and show a limited capacity for repair. Although orthopaedic surgery has been successful in replacing cartilage, the coming years will establish whether a shift from replacement towards regeneration of tissue is feasible. There has been an increasing interest in tissue engineering approaches to deal with damaged or lost tissue [1-3]. Tissue engineering is an exciting strategy that employs stem cells, scaffolds and growth factors or mediators either in isolation or in combination. It is the expanding science of generating tissue using molecular and cellular techniques, combined with material engineering principles, to replace tissue surgically. This could be in the form of cells with or without matrices. Many tissue engineering advances are being made in orthopaedics and this is partly due to the familiarity with bone marrow derived mesenchymal stem cells. In this review we will cover mesenchymal stem cells, scaffolds, bioreactors and growth factors applicable to orthopaedics and musculoskeletal sciences. This is followed by specific discussions on Dupuytren’s disease where there is early evidence of stem cell etiology, and bone and cartilage tissue engineering.