Over the last year, our understanding of the biological basis of orthopaedic pathology and its treatments has expanded. Particular attention continues to be directed toward the role of stem cells for tissue regeneration as well as the role of growth factors for healing augmentation. Substantial advances have also been made in our understanding of the response of stem cells to load, topography, and growth factors. While bench research is promising, recent clinical studies, specifically, those on the use of platelet-rich plasma (PRP), haven fallen short of expectations. The exact reasons for the disconnect between promising basic science research and discouraging clinical results is most likely multifactorial, and further research is needed to identify the various factors critical for success.
This article will review the most recent developments in the field of orthopaedic research. While this is a broad topic, attempts have been made to highlight studies that are approaching the translational stage, clinical studies evaluating the application of recent laboratory advances, and a few studies that represent interesting research pathways that are earlier in the discovery process. The goal of this review is to provide the practicing orthopaedic surgeon with a foundation to understand and apply the role of orthopaedic research in clinical practice.
Tendon and Ligament
Stem Cells, Growth Factors, and the Mechanical Environment
Much research has been focused on improving the reattachment of torn tendon to bone with stem cell therapy, specifically, discovering the signals required to stimulate stems cells to differentiate at the insertion site. Tendon-to-bone bioengineering is particularly challenged by the complex transition site that must allow for load transfer between two distinct tissues (tendon and bone).
Over the past year, several studies have examined how nanotopography and mechanical loading affect the differentiation of human tendon stem cells. Sharma and Snedeker combined both mechanical and molecular cues by culturing bone marrow stromal stem cells on a hydrogel …
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