Stem Cells for Bone Regeneration: Current State and Future Directions

Mesenchymal stem cells (MSCs) are capable of differentiating into osteoblasts, chondrocytes, and adipocytes, each of which is important for musculoskeletal tissue regeneration and repair. Reconstruction and healing of bony defects remains a major clinical challenge. Even as surgical practices advance, some severe cases of bone loss do not yield optimal recovery results. New techniques involving implantation of stem cells and tissue-engineered scaffolds are being developed to help improve bone and cartilage repair. The invasiveness and low yield of harvesting MSCs from the bone marrow (BMSCs) has led to the investigation of alternatives, including adipose-derived mesenchymal stem cells (ASCs). A review of the literature yielded several studies concerning the use of BMSCs and ASCs for the treatment of bone defects in both in vitro and in vivo models. Although both ASCs and BMSCs have demonstrated bone regenerative capabilities, BMSCs have outperformed ASCs in vitro. Despite these in vitro study findings, in vivo study results remain variable. Analysis of the literature seems to conclude there is no significant difference between bone regeneration using ASCs or BMSCs in vivo. Improved study design and standardization may enhance the application of these studies to patient care in the clinical setting. Address correspondence and reprint requests to Steven R. Buchman, MD, Associate Professor of Plastic and Reconstructive Surgery, Department of Surgery, Michigan Medicine 1540 E. Hospital Drive, SPC 4219, Ann Arbor, MI 48109; E-mail: sbuchman@med.umich.edu Received 10 September, 2018 Accepted 1 November, 2018 The authors report no conflicts of interest. This work was supported by National Institutes of Health grant NIH-R01 CA 125187-06. © 2019 by Mutaz B. Habal, MD.

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