A Review on Stem Cell Application in Orthopedics
Nyoman Gede Grenata Nanda Ustriyana
*
Orthopedic and Traumatology Department, Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia.
I Gusti Lanang Ngurah Agung Artha Wiguna
Orthopedic and Traumatology Department, Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia.
Jordaniel Setiabudi
Orthopedic and Traumatology Department, Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia.
*Author to whom correspondence should be addressed.
Abstract
Background: Stem cell therapy is an emerging field in regenerative orthopaedics that offers new possibilities for managing bone, cartilage, ligament, and spinal disorders. Multiple sources of stem cells including bone marrow, adipose tissue, amnion, placenta, and umbilical cord provide populations with the ability for self renewal, differentiation, and strong paracrine activity.
Objectives: This literature review summarizes current evidence on stem cell types, harvesting methods, biological mechanisms, and their therapeutic applications across major orthopaedic conditions such as bone defects, osteoarthritis, ligament injuries, spinal disorders, and congenital abnormalities.
Methods: A narrative synthesis was performed using experimental, translational, and clinical studies involving mesenchymal stem cells, adipose derived stem cells, amnion derived stem cells, and umbilical cord derived stem cells.
Results: Stem cells support tissue regeneration through osteogenic, chondrogenic, angiogenic, and immunomodulatory pathways. In bone healing, mesenchymal stem cells enhance osteoinduction and osteogenesis, particularly when combined with biomaterials or growth factors. In cartilage restoration and osteoarthritis, stem cells promote matrix formation, reduce inflammation, and improve clinical outcomes after intra-articular injection. In ligament and tendon injury, stem cells increase vascularity, fibroblast activity, and biomechanical recovery. Applications in spinal surgery include improvement of fusion rates, intervertebral disc regeneration, and neuroprotective effects after spinal cord injury. Stem cells also show promise in congenital spine and bone disorders by supporting osteogenesis and chondrogenesis. Potential complications include immune modulation imbalance, formation of ectopic bone, and uncertain long-term cell survival.
Conclusion: Stem cell therapy provides a promising regenerative option in orthopaedic practice with increasing evidence of benefit. However, optimal protocols, cell sources, dosage, delivery techniques, and long-term safety require further validation through high-quality clinical studies. However, potential complications include immunosuppressive effects, ectopic bone growth, and inflammatory reactions. Continued research is essential to validate the benefits and efficacy of stem cells, especially in orthopaedics.
Keywords: Stem cells, mesenchymal stem cells, orthopaedics, bone regeneration, cartilage regeneration, osteoarthritis, spinal disorders, tissue repair