Abstract
Due to the vasculature defects and/or the avascular nature of cartilage, as well as the complex gradients for bone-cartilage interface regeneration and the layered zonal architecture, self-repair of cartilage and subchondral bone is challenging. Currently, the primary osteochondral defect treatment strategies, including artificial joint replacement and autologous and allogeneic bone graft, are limited by their ability to simply repair, rather than induce regeneration of tissues. Meanwhile, over the past two decades, three-dimension (3D) printing technology has achieved admirable advancements in bone and cartilage reconstruction, providing a new strategy for restoring joint function. The advantages of 3D printing hybrid materials include rapid and accurate molding, as well as personalized therapy. However, certain challenges also exist. For instance, 3D printing technology for osteochondral reconstruction must simulate the histological structure of cartilage and subchondral bone, thus, it is necessary to determine the optimal bioink concentrations to maintain mechanical strength and cell viability, while also identifying biomaterials with dual bioactivities capable of simultaneously regenerating cartilage. The study showed that the regeneration of bone-cartilage interface is crucial for the repair of osteochondral defect. In this review, we focus on the significant progress and application of 3D printing technology for bone-cartilage interface regeneration, while also expounding the potential prospects for 3D printing technology and highlighting some of the most significant challenges currently facing this field.
Highlights
During activities such as walking, kneeling, rotating and jumping, the knee joint is subjected to compression, shear and tension forces from the whole body, where the bone-chondral interface serves as a transitional interface between viscoelastic cartilage and solid bone, maintaining structural stability (Hoemann et al, 2012)
Alternative grading systems that can accurately assess the degree of cartilage damage, include the International Cartilage Repair Society (ICRS), Oswestry Arthroscopy Score (OAS), Histology/Histochemistry Grading System (HHGS), and Osteoarthritis Research Society International (OARSI) Cartilage Histopathology Assessment System (OOCHAS) (Custers et al, 2007)
The approach based on monophasic scaffolds has become obsolete, many research groups have developed bilayer and triple-layer scaffolds that mimic the osteochondral cartilage and bone layering structure
Summary
During activities such as walking, kneeling, rotating and jumping, the knee joint is subjected to compression, shear and tension forces from the whole body, where the bone-chondral interface serves as a transitional interface between viscoelastic cartilage and solid bone, maintaining structural stability (Hoemann et al, 2012). Common surgical treatments for OCD occurring in large areas currently used in clinical practice include autologous chondrocyte implantation (ACI) (Kubosch et al, 2018; Schuette et al, 2021), osteochondral allograft transplantation (OCA) (Gilat et al, 2021) and matrix-induced autologous chondrocyte implantation (MACI) (Gao et al, 2019). Considering that the bone-cartilage interface structure is surrounded by cartilage and subchondral bone, all of which have their own structural layers, current research is concentrated on the development of multi-factor combinations and advanced delivery methods for reliable osteochondral tissue regeneration (Han et al, 2015). We present the current challenges and future directions in this field to support the development of effective 3D printing methods for osteochondral interface regeneration (Figure 1)
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