Understanding tissue-engineered endochondral ossification; towards improved bone formation
1 Department of Oral and Maxillofacial Surgery, Orthodontics and Special Dental Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
2 Department of Immunology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
3 Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
Abstract
Endochondral ossification (EO) is the process by which the long bones of the body form and has proven to be a promising method in tissue engineering for achieving cell-mediated bone formation. The present review centred on state-of-the-art research pertaining to mesenchymal stem cells (MSCs)-mediated endochondral bone formation, focusing on the role of donor cells, extracellular matrix and host immune cells during tissue-engineered bone formation. Possible research avenues to improve graft outcome and bone output were highlighted, as well as emerging research that, when applied to tissue-engineered bone grafts, offers new promise for improving the likelihood of such grafts transition from bench to bedside.
Graphical Abstract

Keywords
- Endochondral ossification
- bone tissue engineering
- regenerative medicine
- mesenchymal stem cell differentiation
- extracellular matrix
- vascularisation
- collagen type X
- immune system
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