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The incidence of bone and joint related disorders such as osteoporosis, arthritis, as well as other diseases such as obesity, diabetes, and cancer, which can cause injury to orthopedic tissues and affect the health and capability of the human skeleton is on the rise. In such situations, the body’s own regenerative capacities are often exceeded resulting in poor healing of bony defects. Such situations necessitate the use of grafting material to aid the body in its restorative attempts. It has been estimated that globally, one million bone-grafting procedures are performed annually on the pelvis, spine, and other body extremities. 11% of these procedures rely on the use of synthetic bone graft substitutes. According to market analysis this number is expected to rise even further in the coming years due to the aging population, lifestyle issues, risks associated with obtaining autograft bone, the need to achieve superior and optimum bone fusion, speedy patient recovery and the need to eliminate multiple surgeries (in case of bone harvesting from the patient). The challenge is to provide these synthetic substitutes with osteoconductive and osteoinductive properties comparable to autologous bone. While altering the physical and chemical properties of the synthetic graft materials has been partially successful in endowing them with the desirable osteoinductive and conductive properties, till date their performance within the human body is not comparable to that of autologous bone. Adding growth factors such as bone morphogenetic proteins (BMPs) and stem cells have been proposed as alternative strategies to boost the biological properties of these materials. In this thesis, we have mainly focused on optimizing the combination of ceramic materials with stem cells derived from the adult bone marrow (BM derived MSCs) to engineer a bone graft which has potential to be used clinically as a replacement for autografts

Pre-clinical validation of bone tissue engineering using mesenchymal stromal cells