Doctors hoping to use stem cell therapy to help patients suffering from musculoskeletal conditions currently rely on autologous stem cell injections to encourage the body to self-heal. The procedures work for some patients but not for others. The stem cell community is looking for a better way, which may be on the horizon thanks to a new procedure for engineering bone segments.
A group of researchers from the New York Stem Cell Foundation Research Institute says they have developed a means of bone engineering capable of producing customized bone segments in a lab using stem cells. Their report, recently published by Scientific Reports, offers hope for people suffering from a full range of conditions, including osteoarthritis and bone fractures.
If what they have discovered can be modified to work on a large scale, it may someday be possible to engineer bone grafts, ligaments, and tendons from stem cells taken directly from a patient being treated for a musculoskeletal injury. It could mean a treatment that is more effective and safer than current treatment options.
Complex Tissue Engineering
The procedure in question, known as Segmental Additive Tissue Engineering, is a complicated procedure that requires engineering stem cells to create tissue using biomedical scaffolds. The scaffolds dictate the eventual size and shape of the resulting graft. It’s not easy to do and, as such, there still is no proof that the procedure could be used on a large scale.
To demonstrate their procedure, the researchers chose a defective bone from a rabbit. They created a scaffold that was then seeded with induced pluripotent stem cells and treated with a perfusion bioreactor that encouraged the stem cells to reproduce along the entire area of the scaffold. The resulting bone graft turned out to be a perfect match.
In principle, the procedure should be reproducible for creating bone grafts of nearly any size. But further research is required to see if the original results can be reproduced consistently. According to the scientists, an inhibiting factor is scale. Unfortunately, tissue engineering gets more difficult as the size of the required graft grows. Larger grafts require more engineered tissue. More engineered tissue leaves more room for errors and complications.
How Current Stem Cell Procedures Work
Current stem cell procedures applied to musculoskeletal injuries are a lot less complex. According to Apex Biologix, a Utah company that deals in prp kits and other regenerative medicine equipment and supplies, treating a patient for a condition like osteoarthritis is a matter of extracting autologous stem cells, processing them in a centrifuge, and then injecting them into the affected joint.
There is no scaffolding or perfusion bioreactor involved. Instead, the stem cells are believed to help by signaling the body’s repair mechanism to do what it should be doing naturally. The injected stem cells might also offer ‘starter material’ to get the healing process going.
Here’s the big difference: current stem cell procedures are not capable of producing large bone grafts or complete sections of tendon or ligament. As beneficial as the treatments are for some patients, they are very limited in their usefulness. What the New York researchers are proposing goes way beyond encouraging self-healing to actually engineer new tissue outside of the body.
Time will tell if their procedure can actually work on a large scale. In the meantime, patients all over the country will continue looking to autologous stem cell procedures to relieve the pain of osteoarthritis and other musculoskeletal injuries. Stem cell therapy gives them an option over invasive surgery and potentially addictive long-term pain medication use.