TABLE 3.

Pros, Cons, and Specific Areas Needed for Future Study in the Use of Stem Cells for Regeneration of Articular Cartilage^a

Pros Numerous in vivo; can be derived from muscle, adipose, and bone marrow Osteogenic and chondrogenic differentiation capacity Can regulate local immune environment Secretion of trophic factors to create a regenerative microenvironment Cons Risk for malignancy Repair tissue quality not equivalent to natural hyaline cartilage Cannot be modified prior to reintroduction (eg, BMAC) Insufficient clinical evidence to overcome federal restrictions Needs for future study Optimal delivery strategy (ie, injection, scaffold, implantation, etc) Standard technique and dosing regimen Large-scale, prospective, multicenter trials needed for outcome evidence Improved national and international collaboration in research Collaboration with governing bodies to promote scientific advancement

^aBMAC, bone marrow aspirate concentrate.