Abstract
Tendon and ligament damage demand a high level of medical attention as they are amongst the most frequently occurring orthopaedic injuries. This is because of their avascular anatomy which results in poor quality recovered tissue that is frequently more susceptible to re-injury as its load to failure force cannot withstand peak in vivo forces. The acquisition of mesenchymal stem cells offers a novel approach to the current trend of using tendon and ligament grafts. These cells are available in diverse sources throughout the body so are able to circumnavigate the ethical pitfalls surrounding the use of embryonic stem cells. These cells can be manipulated to differentiate into connective tissue cells and their self-renewal properties allow them to be delivered to the site of lesion and greatly improve the rate and quality of healing. The delivery of stem cells is divided into injections and scaffolds. Direct injections of the cells are the simplest form of delivery but are only used in the early form of injury when the lesion is confined to the cartilage layer. For more extensive regeneration, scaffolds are used to place the cells on in order to direct the regeneration to cover the required areas more completely. Despite their successful use in animal models and some human patients, more in-depth biological knowledge of the forces underpinning stem cell biology needs to be uncovered before their wholesale use in a clinical setting.
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Abbreviations
- ACL:
-
Anterior cruciate ligament
- BMP:
-
Bone morphogenetic protein
- CT:
-
Computerised (or computed) tomography
- ECM:
-
Extracellular matrix
- ESCs:
-
Embryonic stem cells
- ICM:
-
Inner cell mass
- MSCs:
-
Mesenchymal stem cells
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Khan, T., Khan, T., Khan, W.S., Malik, A.A. (2016). Clinical Application of Stem Cells to Include Muscle, Bone and Tendon Pathology. In: Pham, P. (eds) Bone and Cartilage Regeneration. Stem Cells in Clinical Applications. Springer, Cham. https://doi.org/10.1007/978-3-319-40144-7_4
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DOI: https://doi.org/10.1007/978-3-319-40144-7_4
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