Bone marrow derived stem cells in joint and bone diseases: a concise review

Abstract

Stem cells have huge applications in the field of tissue engineering and regenerative medicine. Their use is currently not restricted to the life-threatening diseases but also extended to disorders involving the structural tissues, which may not jeopardize the patients' life, but certainly influence their quality of life. In fact, a particularly popular line of research is represented by the regeneration of bone and cartilage tissues to treat various orthopaedic disorders. Most of these pioneering research lines that aim to create new treatments for diseases that currently have limited therapies are still in the bench of the researchers. However, in recent years, several clinical trials have been started with satisfactory and encouraging results. This article aims to review the concept of stem cells and their characterization in terms of site of residence, differentiation potential and therapeutic prospective. In fact, while only the bone marrow was initially considered as a "reservoir" of this cell population, later, adipose tissue and muscle tissue have provided a considerable amount of cells available for multiple differentiation. In reality, recently, the so-called "stem cell niche" was identified as the perivascular space, recognizing these cells as almost ubiquitous. In the field of bone and joint diseases, their potential to differentiate into multiple cell lines makes their application ideally immediate through three main modalities: (1) cells selected by withdrawal from bone marrow, subsequent culture in the laboratory, and ultimately transplant at the site of injury; (2) bone marrow aspirate, concentrated and directly implanted into the injury site; (3) systemic mobilization of stem cells and other bone marrow precursors by the use of growth factors. The use of this cell population in joint and bone disease will be addressed and discussed, analysing both the clinical outcomes but also the basic research background, which has justified their use for the treatment of bone, cartilage and meniscus tissues.

The effect of intra‐articular injection of autologous bone marrow stem cells on pain and knee function in patients with osteoarthritis

“…9,16 Systemic mobilization of SC and other BM precursors (CD34 + ) using growth factors represents minimum manipulation and consequently a reduction in the risk of introducing viruses and prions. 17,18 Therefore, we used SC from BM stimulated in vivo. It is important to consider that BM hematopoietic stem cells, mesenchymal progenitors and immune cells increase significantly after G-CSF stimulation in vivo.…”

Regenerative treatment in osteochondral lesions of the talus: autologous chondrocyte implantation versus one-step bone marrow derived cells transplantation

“…These cells are capable of differentiation in many lineages, like bone and cartilage, under the stimulation of paracrine factors from the micro-environment [13,15,16]. After the aspiration of the stem cells and their Bniche^from the iliac crest, the whole bone marrow aspirate is concentrated directly in operating room and then loaded on a scaffold and implanted [5,8,13].…”

Clinical and radiographic outcomes of concentrated bone marrow aspirate with allograft and demineralized bone matrix for posterolateral and interbody lumbar fusion in elderly patients

“…However, it is linked with certain potential donor site morbidities (such as donor site pain, hematoma, paresthesia and infection) that limit its use in spine surgery [2]. Cell-based therapies such as bone marrow aspirate (BMA) have been developed as an alternative to ICBG [3,4]. BMA can be obtained via a relatively noninvasive method from the iliac crest during spine surgery and is often used in combination with biological scaffolds such as allograft and demineralized bone matrix (DBM).…”