From Bone To Blood Flow: Tissue Engineering In Orthopedics - A Narrative Review.

Abstract

Musculoskeletal injuries and degenerative conditions necessitate advanced regenerative solutions. Tissue engineering has emerged as a pivotal field in orthopedic care, particularly in vascularized bone and cartilage regeneration. This narrative review examines the latest advancements in vascular tissue engineering, including scaffold design, cell-based techniques, and growth factor delivery. A comprehensive literature search was conducted using PubMed, ScienceDirect, and Google Scholar, focusing on innovations and challenges in the field. Vascularized bone grafts (VBGs) outperform non-vascularized counterparts in promoting healing and integration. Advances in scaffold materials, such as smart scaffolds and hybrid biomaterials, enhance osteogenesis and angiogenesis. Cellular therapies, utilizing mesenchymal stem cells and induced pluripotent stem cells, synergistically improve vascularization and bone regeneration. Growth factors like VEGF and bone morphogenic protein (BMP-2), integrated with innovative delivery systems, enable sustained angiogenic stimulation and scaffold integration. While significant strides have been made, challenges persist in achieving full vascular integration and replicating native tissue architecture. Innovations in scaffold technology and vascular surgery techniques hold promise for transforming orthopedic tissue engineering and improving patient outcomes.