Orthopedics Research Today is a free monthly online journal that collates and summarizes the latest research about Orthopedics, including details on chronic injuries, muscoskeletal disorders, surgery, reconstruction.

Technology Insight: adult mesenchymal stem cells for osteoarthritis therapy.

Nöth U, Steinert AF, Tuan RS

U Nöth is an Assistant Professor of Orthopedic Surgery and Head of the Division of Tissue Engineering at the Orthopedic Center for Musculoskeletal Research, König-Ludwig-Haus, Julius-Maximilians-University, Würzburg, Germany, where AF Steinert is a Senior Resident and Head of the Division of Gene Therapy. RS Tuan is Chief of the Cartilage Biology and Orthopedics Branch at the National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.

Despite the high prevalence and morbidity of osteoarthritis (OA), an effective treatment for this disease is currently lacking. Restoration of the diseased articular cartilage in patients with OA is, therefore, a challenge of considerable appeal to researchers and clinicians. Techniques that cause multipotent adult mesenchymal stem cells (MSCs) to differentiate into cells of the chondrogenic lineage have led to a variety of experimental strategies to investigate whether MSCs instead of chondrocytes can be used for the regeneration and maintenance of articular cartilage. MSC-based strategies should provide practical advantages for the patient with OA. These strategies include use of MSCs as progenitor cells to engineer cartilage implants that can be used to repair chondral and osteochondral lesions, or as trophic producers of bioactive factors to initiate endogenous regenerative activities in the OA joint. Targeted gene therapy might further enhance these activities of MSCs. Delivery of MSCs might be attained by direct intra-articular injection or by graft of engineered constructs derived from cell-seeded scaffolds; this latter approach could provide a three-dimensional construct with mechanical properties that are congruous with the weight-bearing function of the joint. Promising experimental and clinical data are beginning to emerge in support of the use of MSCs for regenerative applications.

Published 14 May 2008 in Nat Clin Pract Rheumatol.
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