Stem Cells in Orthopaedics
Stem Cells are primitive cells that have the ability to develop and mature into a variety of specialised tissue. The stem cells used in orthopaedic surgery are usually Mesenchymal Stem Cells (MSCs), are usually harvested from the bone marrow, fat or periosteum of patients themselves, then cultured in the laboratory. Mesenchymal stem cells are more differentiated cells than embryonic stem cells but they still have the potential to develop into muscle, bone, cartilage and other tissues. Furthermore, they are the patient's own cells, without the concern for problems of rejection. Potential applications include the use of stem cells in:-
- Growth plate arrest in children
- Cartilage problems like chondritis dessicans
- Anterior cruciate ligament (ACL) reconstruction
- Meniscus repair
- Development of artificial tissues like ligament, cartilage and bone
 Often, in other medical centers, the stem cells are harvested and then they need to be couriered to companies in Australia or Europe for cell culture. The National University Hospital at the National University of Singapore is the only center in Singapore with its own cell culture laboratory. This laboratory is a joint multi-million dollar project funded by the hospital, the university, as well as the National Bio-Medical Research Council of Singapore.
Currently, the Department of Orthopaedic Surgery at NUH and NUS is recognised as one of the international leaders in mesenchymal stem cells for use in orthopaedic surgery. This has resulted in numerous internationally recognized publications by our surgeons. Professor EH Lee, who directs all the the laboratory and clinical research on stem cells at NUH and NUS, recently co-edited a book on Stem Cells which has been adopted as a standard textbook by many centres internationally. Locally, the prestigious Annual Singapore Orthopaedic Association Young Orthopaedic Investigator Award has been won for the last 4 consecutive years by surgeons doing research on stem cells at the National University Hospital, Singapore and these include some of our current consultants such as Dr Andrew Dutton and Dr Kevin Lee.
Two of our surgeons, A/Prof James Hui and Dr Kevin Lee have also recently completed the world's first human trial using a minimally-invasive approach to treat cartilage defects in the knee using microfracture and injectable mesenchymal stem cell therapy. They will be presenting the results shortly and there are plans to next embark on a much larger randomized trial to evaluate the efficacy of this treatment.
Listed are some of the recent publications by our surgeons on the potential of stem cells in orthopaedics.
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