A Flowchart for the Translational Research of CellBased Therapy in the Treatment of Long Bone Defects

Autologous cell-based tissue engineering may offer new opportunities for the treatment of long bone defects. Experimental work in small animal models requires an important up scaling to meet the dimensions of geometrically large bone segments that need reconstruction, and this is of uttermost importance to make tissue-engineered cell-based therapies work in clinical conditions. Many fragmentary results in laboratory conditions using mice or rats are described, but a framework for a stepwise up scaling is lacking. Nevertheless, this is essential to guide the preclinical process to a reliable outcome and hence needs to be included in the translational research strategy to lead to predictive results in patients. A structured flowchart provides insight in the progress    of the development of a robust tissue-engineered product, the process to reach the clinic, and the critical funding to support this translational step.