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Woolf A.D.,Royal Cornwall Hospital | Erwin J.,Bone and Joint Research Group | March L.,University of Sydney
Best Practice and Research: Clinical Rheumatology | Year: 2012

Musculoskeletal conditions are common in men and women of all ages across all socio-demographic strata of society. They are the most common cause of severe long-term pain and physical disability and affect hundreds of millions of people around the world. They impact on all aspects of life through pain and by limiting activities of daily living typically by affecting dexterity and mobility. They affect one in four adults across Europe [1]. Musculoskeletal conditions have an enormous economic impact on society through both direct health expenditure related to treating the sequelae of the conditions and indirectly through loss of productivity. The prevalence of many of these conditions increases markedly with age, and many are affected by lifestyle factors, such as obesity and lack of physical activity. The burden of these conditions is therefore predicted to increase, in particular in developing countries. The impact on individuals and society of the major musculoskeletal conditions is reviewed and effective prevention, treatment and rehabilitation considered. The need to recognise musculoskeletal conditions as a global public health priority is discussed. © 2012 Published by Elsevier Ltd.

Kanczler J.M.,Bone and Joint Research Group | Ginty P.J.,University of Nottingham | White L.,University of Nottingham | Clarke N.M.P.,University of Southampton | And 3 more authors.
Biomaterials | Year: 2010

Regenerating bone tissue involves complex, temporal and coordinated signal cascades of which bone morphogenic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF165) play a prominent role. The aim of this study was to determine if the delivery of human bone marrow stromal cells (HBMSC) seeded onto VEGF165/BMP-2 releasing composite scaffolds could enhance the bone regenerative capability in a critical sized femur defect. Alginate-VEGF165/PDLLA-BMP-2 scaffolds were fabricated using a supercritical CO2 mixing technique and an alginate entrapment protocol. Increased release of VEGF165 (750.4 ± 596.8 ρg/ml) compared to BMP-2 (136.9 ± 123.4 ρg/ml) was observed after 7-days in culture. Thereafter, up till 28 days, an increased rate of release of BMP-2 compared to VEGF165 was observed. The alginate-VEGF165/PDLLA-BMP-2 + HBMSC group showed a significant increase in the quantity of regenerated bone compared to the alginate-VEGF165/PDLLA-BMP-2 and alginate/PDLLA groups respectively in a critical sized femur defect study as indices measured by μCT. Histological examination confirmed significant new endochondral bone matrix in the HBMSC seeded alginate-VEGF165/PDLLA-BMP-2 defect group in comparison to the other groups. These studies demonstrate the ability to deliver a combination of HBMSC with angiogenic and osteogenic factors released from biodegradable scaffold composites enhances the repair and regeneration of critical sized bone defects. © 2009 Elsevier Ltd. All rights reserved.

Evans N.R.,Bone and Joint Research Group | Davies E.M.,Southampton General Hospital | Dare C.J.,Southampton General Hospital | Oreffo R.O.C.,Bone and Joint Research Group | Oreffo R.O.C.,King Saud University
Regenerative Medicine | Year: 2013

Skeletal disorders requiring the regeneration or de novo production of bone present considerable reconstructive challenges and are one of the main driving forces for the development of skeletal tissue engineering strategies. The skeletal or mesenchymal stem cell is a fundamental requirement for osteogenesis and plays a pivotal role in the design and application of these strategies. Research activity has focused on incorporating the biological role of the mesenchymal stem cell with the developing fields of material science and gene therapy in order to create a construct that is not only capable of inducing host osteoblasts to produce bone, but is also osteogenic in its own right. This review explores the clinical need for reparative approaches in spinal arthrodesis, identifying recent tissue engineering strategies employed to promote spinal fusion, and considers the ongoing challenges to successful clinical translation. © 2013 Future Medicine Ltd.

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