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Preconditioning of MSCs, using inflammatory mediators, is widely used in immunology and various cell therapies. We developed a three\u2010dimensional printed functionally graded scaffold (FGS), made of \u03b2\u2010TCP and PCL, for cell delivery at a specific location. The present study examined the efficacy of CD treatments with genetically modified (GM) MSCs over\u2010expressing PDGF\u2010BB (PDGF\u2010MSCs) or GM MSCs co\u2010over\u2010expressing IL\u20104 and PDGF\u2010BB and preconditioned for three days of exposure to lipopolysaccharide and tumor necrosis factor\u2010alpha (IL\u20104\u2010PDGF\u2010pMSCs) using the FGS for treating steroid\u2010induced ONFH in rabbits. We compared CD without cell\u2010therapy, with IL\u20104\u2010PDGF\u2010pMSCs alone, and with FGS loaded with PDGF\u2010MSCs or IL\u20104\u2010PDGF\u2010pMSCs. For the area inside the CD, the bone volume in the CD alone was higher than in both FGS groups. The IL\u20104\u2010PDGF\u2010pMSCs alone and FGS\u2009+\u2009PDGF\u2010MSCs reduced the occurrence of empty lacunae and improved osteoclastogenesis. There was no significant difference in angiogenesis among the four groups. The combined effect of GM MSCs or pMSCs and the FGS was not superior to the effect of each alone. To establish an important adjunctive therapy for CD for early ONFH in the future, it is necessary and essential to develop an FGS that delivers biologics appropriately and provides structural and mechanical support.<\/jats:p>","DOI":"10.1002\/jbm.a.37495","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T08:45:30Z","timestamp":1672994730000},"page":"1120-1134","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The efficiency of genetically modified mesenchymal stromal cells combined with a functionally graded scaffold for bone regeneration in corticosteroid\u2010induced osteonecrosis of the femoral head in rabbits"],"prefix":"10.1002","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6702-1242","authenticated-orcid":false,"given":"Masanori","family":"Tsubosaka","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University School of 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