The use of stem cells in orthopedic practice has been increasing exponentially. Thus, stem cells have been identified to have wide ranging functions. Where some have identified them as a natural source of immune modulators, others have utilized them for regenerative medicine purposes. Some investigative teams are working on evaluating the potential of stem cells for translation into clinical practice, while physicians have been using minimally manipulated autologous stem cells in their practice to treat their patients. In this issue, we wanted to discuss some critical aspects of stem cells biology, function and therapeutic potential, with a specific focus on orthopedics.
We acknowledge the advancement of stem cell therapy for knee osteoarthritis with a comparison between autologous and allogeneic mesenchymal stem cell injections into the knee joint and their potential benefit to slow down osteoarthritis disease progression. Related to this interesting topic and to address some of the controversial issues around stem cell therapy for knee OA in particular and in orthopedics in general, this symposium also provides an insight into the health policy, regulatory, and clinical development, as well as market access of the clinical use of stem cells in the United States compared with other countries.
As our field spans all ages, the use of stem cells for pediatric orthopedic applications is covered with an emphasis on osteogenesis imperfecta, hypophosphatasia, and bone regeneration. Moreover, the use of mesenchymal stem cells alternatives is also discussed. With the ever-increasing number of patients with degenerative disk disease and discogenic back and neck pain, the scientific and clinical community in the spine field has been actively focusing on the potential benefits on adult stem cells for the treatment of intervertebral disk degeneration. The challenges that stem cell therapies may face for clinical applications in the spine field are also articulated.
In contrast, the scientific community also identified stem cells that can be associated with tumors leaving us not only wondering if all stem cells are created equal but also whether there are good and bad stem cells. Thus, one of the reviews introduces the concept of cancer stem cells from sarcomas and speculates about their potential to mediate drug resistance.
Overall, this special issue intends to initiate fundamental as well as practical conversations about a new era in the use of stem cells as biologics for orthopedic applications.