"This research raises the possibility that we can create new skeletal stem cells from patients' own tissues and use them to grow new cartilage."

The scientists are hopeful that the breakthrough would allow missing bone parts and cartilage to be grown in a lab and then transplanted, lowering the chance of rejection.

"Right now, if you have lost a significant portion of your leg or jaw bones, you have to borrow from Peter to pay Paul in that you have to cut another bone like the fibula into the shape you need, move it and attach it to the blood supply," said Dr Longaker.

"But if your existing bone is not available or not sufficient, using this research you might be able to put some of your own fat into a biomimetic scaffold, let it grow into the bone you want in a muscle or fat pocket, and then move that new bone to where it's needed."

Scientists are even hopeful that they could coax fat cells into becoming skeleton stem cells which could then be injected into a damaged area during a simple operation. It could be particularly useful in knee and hip operations for the elderly and prevent arthritis.

"The number of skeletal stem cells decreases dramatically with age, so bone fractures or dental implants don't heal very well in the elderly because new bone doesn't grow easily, said lead author Dr Charles Chan.

"But perhaps you will be able to take fat from the patient's body during surgery, combine it with these reprogramming factors right there in the operating room and immediately transplant new skeletal stem cells back into the patient."

Although researchers have so far only mapped the skeletal stem cell system in mice, they are confident that they will be able to do the same in humans.

"In this research we now have a Rosetta Stone that should help find the human skeletal stem cells and decode the chemical language they use to steer their development," added Dr Chan.

"The pathways in humans should be very similar and share many of the major genes used in the mouse skeletal system."

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Broken bones and torn cartilage could be regrown in simple operation

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