Advances in Regenerative Orthopedics Christopher H. Evans, PhD, DSc  Mayo Clinic Proceedings  Volume 88, Issue 11, Pages 1323-1339 (November 2013) DOI: 10.1016/j.mayocp.2013.04.027 Copyright © 2013 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 Strategies for regeneration. A, In traditional tissue engineering approaches, a first procedure removes tissue biopsy samples. Autologous cells are isolated, seeded on a matrix, and incubated in a bioreactor under conditions in which new tissue is formed. The graft is implanted into the patient in a second procedure. B, Expedited approaches require a single percutaneous, minimally invasive, or intraoperative procedure. Adapted from Tissue Eng.9 Mayo Clinic Proceedings 2013 88, 1323-1339DOI: (10.1016/j.mayocp.2013.04.027) Copyright © 2013 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 Regeneration of the human phalanx. A, Thumb at presentation. B, Thumb at 1 week covered by a pedical of abdominal skin. C, At 6 weeks, the thumb was well healed. D, Radiograph of the thumb before implantation of scaffold seeded with autologous periosteal cells. E, Six weeks after implantation, the thumb was normal length. F, Radiograph of the implant 6 weeks after implantation. G, At 28 months, the patient had good pinch strength (2.3 kg). H, Radiograph at 28 months showing evidence of remodeling. From N Engl J Med,55 with permission. Mayo Clinic Proceedings 2013 88, 1323-1339DOI: (10.1016/j.mayocp.2013.04.027) Copyright © 2013 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 3 Clinical procedure for adhesive implantation into a cartilage defect. A, A mini-incision exposed the cartilage defect. B, The adhesive was applied to the base and walls of the defect, followed by surgical microfracture. C, The hydrogel solution was injected into the defect and photopolymerized in situ with light. D, Bleeding from the microfracture holes was trapped in and around the hydrogel. From Sci Transl Med,101 with permission. Mayo Clinic Proceedings 2013 88, 1323-1339DOI: (10.1016/j.mayocp.2013.04.027) Copyright © 2013 Mayo Foundation for Medical Education and Research Terms and Conditions