Abstract
Cartilage is a tension- and load-bearing tissue and has a limited capacity for intrinsic self-healing. While microfracture and arthroplasty are the conventional methods for cartilage repair, these methods are unable to completely heal the damaged tissue. The need to overcome the restrictions of these therapies for cartilage regeneration has expanded the field of cartilage tissue engineering (CTE), in which novel engineering and biological approaches are introduced to accelerate the development of new biomimetic cartilage to replace the injured tissue. Until now, a wide range of hydrogels and cell sources have been employed for CTE to either recapitulate microenvironmental cues during a new tissue growth or to compel the recovery of cartilaginous structures via manipulating biochemical and biomechanical properties of the original tissue. Towards modifying current cartilage treatments, advanced hydrogels have been designed and synthesized in recent years to improve network crosslinking and self-recovery of implanted scaffolds after damage in vivo. This review focused on the recent advances in CTE, especially self-healing hydrogels. The article firstly presents the cartilage tissue, its defects, and treatments. Subsequently, introduces CTE and summarizes the polymeric hydrogels and their advances. Furthermore, characterizations, the advantages, and disadvantages of advanced hydrogels such as multi-materials, IPNs, nanomaterials, and supramolecular are discussed. Afterward, the self-healing hydrogels in CTE, mechanisms, and the physical and chemical methods for the synthesis of such hydrogels for improving the reformation of CTE are introduced. The article then briefly describes the fabrication methods in CTE. Finally, this review presents a conclusion of prevalent challenges and future outlooks for self-healing hydrogels in CTE applications.
Highlights
Hydrogels are attractive for clinical applications because of their high-water content and physicochemical properties, like what are found in native human tissues
Various reversible bonding strategies are currently available for the development of new self-healing hydrogels, they do not meet all the specifications required for cartilage tissue engineering (CTE)
Clinical applications of new biomaterials can be limited by the cost and difficulty of passing safety and regulatory processes
Summary
With the growth of the elderly population in recent years, it is predicted that more than 15% of people aged 60 years and older (nearly 310 million people) will develop cartilage-related problems [2]. Surgical methods, such as cartilage chondroplasty and microfractures, have been developed to treat cartilage defects, they have been unable to entirely repair the damaged cartilage. The important constraint limiting CTE outcomes is the poor cell migration and growth inside implanted scaffolds, which yields new cartilage with undesirable physiological properties [2,3]
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