Current Osteoporosis Reports

, Volume 16, Issue 4, pp 490–503 | Cite as

Origin of Reparative Stem Cells in Fracture Healing

  • Beth C. BragdonEmail author
  • Chelsea S. Bahney
Orthopedic Management of Fractures (S Bukata and L Gerstenfeld, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Orthopedic Management of Fractures


Purpose of Review

The identity and functional roles of stem cell population(s) that contribute to fracture repair remains unclear. This review provides a brief history of mesenchymal stem cell (MSCs) and provides an updated view of the many stem/progenitor cell populations contributing to fracture repair.

Recent Findings

Functional studies show MSCs are not the multipotential stem cell population that form cartilage and bone during fracture repair. Rather, multiple studies have confirmed the periosteum is the primary source of stem/progenitor cells for fracture repair. Newer work is also identifying other stem/progenitor cells that may also contribute to healing.


Although the heterogenous periosteal cells migrate to the fracture site and contribute directly to callus formation, other cell populations are involved. Pericytes and bone marrow stromal cells are now thought of as key secretory centers that mostly coordinate the repair process. Other populations of stem/progenitor cells from the muscle and transdifferentiated chondroctyes may also contribute to repair, and their functional role is an area of active research.


Skeletal stem cell Fracture Mesenchymal stem cell Periosteum Pericyte 



This publication was supported financially by the National Institutes of Health (NIH) through the National Center for Advancing Translational Sciences Grant Numbers UCSF-UL1TR000004 and BU-1UL1TR001430, the National Institute of Arthritis and Musculoskeletal and Skin (NIAMS) R01-AR056637 and K99AR068582, the AO Foundation Start-Up Grant (CSB, #S-14-114B), the UCSF Core Center for Musculoskeletal Biology and Medicine Grant Number P30AR066262, and the Research Evaluation & Allocation Committee (REAC) UCSF School of Medicine. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. We would like to thank Emily Moore at Columbia University and Dr. Johnny Huard at the Stedmann Phillipon Research Institute and UT Health for providing helpful information and discussion that contributed to this review. The authors acknowledge institutional support from the UCSF/ZSFG Orthopaedic Trauma Institute and Boston University School of Medicine Department of Orthopaedic Surgery.

Compliance with Ethical Standards

Conflict of Interest

Bragdon reports grants from the NIH and NIAMS, during the conduct of the study and fees as a grant reviewer from Musculoskeletal Transplant Foundation.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryBoston University School of MedicineBostonUSA
  2. 2.Orthopaedic Trauma Institute, Department of Orthopaedic SurgeryUniversity of California, San Francisco (UCSF)San FranciscoUSA

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