title: Barriers to the clinical translation of orthopedic tissue engineering.
abstract: Tissue engineering and regenerative medicine have been the subject of increasingly intensive research for over 20 years, and there is concern in some quarters over the lack of clinically useful products despite the large sums of money invested. This review provides one perspective on orthopedic applications from a biologist working in academia. It is suggested that the delay in clinical application is not atypical of new, biologically based technologies. Some barriers to progress are acknowledged and discussed, but it is also noted that preclinical studies have identified several promising types of cells, scaffolds, and morphogenetic signals, which, although not optimal, are worth advancing toward human trials to establish a bridgehead in the clinic. Although this transitional technology will be replaced by more sophisticated, subsequent systems, it will perform valuable pioneering functions and facilitate the clinical development of the field. Some strategies for achieving this are suggested.
authors.affiliation: Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA. cevans@bidmc.harvard.edu
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Evans
mesh_terms: D001842:Bone and Bones / Q000502:physiology*; D003132:Commerce; D006801:Humans; D012926:Social Control, Formal; D023822:Tissue Engineering / Q000191:economics / Q000331:legislation & jurisprudence / Q000379:methods*; D057170:Translational Research, Biomedical / Q000191:economics / Q000331:legislation & jurisprudence / Q000379:methods*