Innovation in orthopaedic basic science continues to abound. In this review, we highlight several notable studies published in the last twelve months with a focus on subject areas that were the topic of workshops at the 2009 annual meeting of the Orthopaedic Research Society (ORS) and that relate to the research of some of this year's Kappa Delta Award recipients. These papers and workshops reveal an exciting multidisciplinary approach to understanding mechanisms of tissue degeneration and injury—in particular, through the study of mechanobiology (physical effects on cells) and of aging. They also demonstrate important advances in the search for novel therapies to improve musculoskeletal tissue repair and regeneration through the use of stem cells, growth factors such as bone morphogenetic proteins (BMPs), or factors found in platelet-rich plasma as well as novel factors, particularly neurochemicals, molecules whose functions are primarily associated with the nervous system. A brisk pace in the clinical development of tissue-engineering scaffolds and refinement of total joint replacement materials is also evident.