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Surgical approaches to the hip, postoperative course and complications The operation can be performed via a posterior approach, a trochanteric osteotomy , an anterolateral or Hardinge approach or an anterior approach ( Table 39.8 ). Each approach has its own a...

Adult tissue resident or somatic stem cells Stem cells resident in the di ff erent tissues and organs are responsible for providing replacements for specialised cells that have reached the end of their functional lifespan either through natural attrition or be...

CELLS Although both fully di ff erentiated cells (somatic cells) and stem cells are being used and developed for tissue engineering and regenerative therapy , most of the focus is on the use of stem cells, particularly somatic stem cells (SSCs) and induced pl...

Embryonic stem cells In the embryo, stem cells are able to give rise to all of the di ff er ent cell types of the body at the gamete stage (totipotent) and nearly all cell types (pluripotent) when at the blastocyst stage ( Figure 4.1 ). ESCs can be obtained f...

Exemplars: cells as a therapy as The delivery of cells into damaged tissues has long been used to facilitate enhanced regeneration. The first modern example of successful cell therapy was bone marrow transplantation for the treatment of leukaemia, which was ...

Exemplars: materials in development Synthetic and engineered polymers Synthetic polymers are those made from chemical processing of natural components or from complex synthesis from precursors such as fossil fuels. There are a great many synthetic polymers tha...

Exemplars: molecules in action Healing skin without scarring All tissues in the body , when damaged, are subject to a conserved process by which cells are recruited to the wound to remove damaged tissue fragments and then deposit and subsequently remodel the t...

FURTHER READING 16 : Fisher S. Handbook of regenerative medicine and tissue engineering . New Y ork: Hayle Medical, 2015. Wagner WR, Sakiyama-Elbert SE, Zhang G, Yaszemski MJ. Biomate - rials science: an introduction to materials in medicine , 4th edn. Oxford...

In vitro differentiation of stem cells to specialised tissue cells There is an enormous research e ff ort aimed at better under - standing the factors responsible for cell fate decisions and establishing e ff ective and reproducible protocols that can be used to...

In vitro differentiation of stem cells to specialised tissue cells There is an enormous research e ff ort aimed at better under - standing the factors responsible for cell fate decisions and establishing e ff ective and reproducible protocols that can be used to...

Induced pluripotent stem cells 10 The discovery in 2006 by Shinya Yamanaka, building on the 11 earlier work of John Gurdon, that certain types of specialised adult cells could be reprogrammed using genetic manipulation to become embryonic-like iPSCs was a ma...

INTRODUCTION Tissue engineering and regenerative medicine are relatively new but rapidly expanding multidisciplinary fields relevant to surgery that have the potential to transform the treatment of a wide range of human diseases. The ability of tissues to un...

KEY AREAS OF UNDERPINNING SCIENCE Advances in tissue engineering and more broadly regenera tive medicine are underpinned by developments in both the physical and biological sciences, building on the classical tissue engineering paradigm ( Figure 4.1 ). An impr...

Learning objectives To understand: The potential opportunities afforded by tissue engineering • and regenerative therapy The nature of stem cells, including somatic and adult stem • cells, embryonic stem cells and induced pluripotent stem cells Learning object...

MATERIALS A large number of materials have been used in tissue engineer ing and regenerative medicine, either as delivery vehicles or as sca ff olds; it is beyond the scope of this chapter to describe them extensively (see Further reading ). In simple terms, m...

MOLECULES Modification of the tissue environment during healing can be achieved by the delivery of molecules that are selected and able to specifically modify biological responses at the site of injury . In terms of tissue regeneration, these molecules can mo...

OPPORTUNITIES The potential impact of tissue engineering and regenerative therapies is so far-reaching that practising surgeons should be aware of the resulting opportunities to improve patient management. Several conditions that could benefit from this appro...

REFERENCES 1 Friedenstein AJ, Piatetzky-Shapiro II, Petrakova KV . Osteogenesis in transplants of bone marrow cells. J Embryol Exp Morphol 1966; 381–90. 2 Caplan AI. Mesenchymal stem cells. J Orthop Res 1991; 9 (5): 641–50. 3 Horwitz EM, Le Blanc K, Dominici ...