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Bone defects, including normal fracture healing as well as healing problems represent a global health problem. The need for better treatment of bone defects is one of the central issues of tissue engineering and regenerative medicine. Regenerative orthopedics has several approaches – activation of endogenous stem cells, stem cell therapy and tissue engineering. Development of new treatments is mainly focused on the tissue engineering strategies that include stem cells, bioactive signals and appropriate scaffold support. The aim of this review is to describe a variety of stem cells that have an ability to become bone cells and therefore are of central importance for bone tissue engineering. Several cell types have been proposed as starting material - embryonic stem cells, induced pluripotent stem cells and adult stem cells. Due to ethical and safety issues, embryonic and induced pluripotent stem cells may be more suitable for studying human development and tissue formation under diverse experimental conditions, and represent an excellent base for understanding human diseases and development of innovative therapeutic solutions. Among adult stem cells, mesenchymal stem cells are the most suitable for bone tissue engineering. They can be isolated from variety of mesenchymal tissues and can differentiate into osteoblasts when given appropriate mechanical support and osteoinductive signal. The near future of bone healing and regeneration is closely related to advances in tissue engineering. The optimization of protocols of bone graft production using autologous mesenchymal stem cells loaded on appropriate scaffolds, exposed to osteogenic inducers and mechanical force in bioreactor, should be able to solve the current limitations in managing bone injuries.

Bone defects, including normal fracture healing as well as healing problems represent a global health problem. The need for better treatment of bone defects is one of the central issues of tissue engineering and regenerative medicine. Regenerative orthopedics has several approaches – activation of endogenous stem cells, stem cell therapy and tissue engineering. Development of new treatments is mainly focused on the tissue engineering strategies that include stem cells, bioactive signals and appropriate scaffold support. The aim of this review is to describe a variety of stem cells that have an ability to become bone cells and therefore are of central importance for bone tissue engineering. Several cell types have been proposed as starting material - embryonic stem cells, induced pluripotent stem cells and adult stem cells. Due to ethical and safety issues, embryonic and induced pluripotent stem cells may be more suitable for studying human development and tissue formation under diverse experimental conditions, and represent an excellent base for understanding human diseases and development of innovative therapeutic solutions. Among adult stem cells, mesenchymal stem cells are the most suitable for bone tissue engineering. They can be isolated from variety of mesenchymal tissues and can differentiate into osteoblasts when given appropriate mechanical support and osteoinductive signal. The near future of bone healing and regeneration is closely related to advances in tissue engineering. The optimization of protocols of bone graft production using autologous mesenchymal stem cells loaded on appropriate scaffolds, exposed to osteogenic inducers and mechanical force in bioreactor, should be able to solve the current limitations in managing bone injuries.

Patients over the age of 65 are the fastest growing segment of the population, and it is estimated that it comprises 12.5% of the entire population in the developed countries. Advances in medicine, science and healthy lifestyles have promoted substantially increased lifespans, aswell as better quality of life with more physical activity. On the other hand, aging is associated with a variety of physiologic changes that affect orthopedic care. Due to natural involution processes older adults may not have the physiologic reserves necessary to promote healing or to prevent or recover fromcomplications. Degenerative diseases and injuries sustained from trauma in combination with physiologic changes and comorbidity in the aged pose a significant health problem in older adults and a major treatment challenge for an orthopaedic surgeon. This review summarizes some of these unique challenges in care for older orthopaedic patient.

Patients over the age of 65 are the fastest growing segment of the population, and it is estimated that it comprises 12.5% of the entire population in the developed countries. Advances in medicine, science and healthy lifestyles have promoted substantially increased lifespans, aswell as better quality of life with more physical activity. On the other hand, aging is associated with a variety of physiologic changes that affect orthopedic care. Due to natural involution processes older adults may not have the physiologic reserves necessary to promote healing or to prevent or recover fromcomplications. Degenerative diseases and injuries sustained from trauma in combination with physiologic changes and comorbidity in the aged pose a significant health problem in older adults and a major treatment challenge for an orthopaedic surgeon. This review summarizes some of these unique challenges in care for older orthopaedic patient.