A Comparative Analysis of the Advantages and Disadvantages of Adult Mesenchymal Stem Cells and Induced Pluripotent Stem Cells in Bone Repair Applications

Bone defect repair remains a major clinical problem. Traditional bone grafting often faces practical limits such as donor site morbidity, limited availability, and immune rejection. Stem cell-mediated bone tissue engineering offers another route, and adult mesenchymal stem cells (MSCs) and induced pluripotent stem cells (iPSCs) have become the most widely discussed seed cells in this field. Work published over the past five years has compared these two cell types in terms of biological foundations, core application dimensions, and osteogenic repair efficacy, and has also tried to explain why each type runs into its own problems. MSCs have reliable safety profiles and are relatively easy to harvest, but their proliferation and differentiation capacities decline with donor age and passage number. This decline is often linked to senescence pathways such as p53/p21. iPSCs have near-unlimited proliferative capacity and tri-lineage differentiation potential, but they also face three core problems: tumorigenic risks from residual undifferentiated cells, epigenetic memory, and low differentiation efficiency. We compare these strengths and limits, propose a scenario-specific cell selection strategy for mild-to-moderate and severe bone defects, and discuss how genetic modification and culture optimization can enhance cell performance. This review offers a practical reference for choosing suitable seed cells and building tissue engineering frameworks in clinical bone repair.