Abstract
Cartilage, especially articular cartilage, is a unique connective tissue consisting of chondrocytes and cartilage matrix that covers the surface of joints. It plays a critical role in maintaining joint durability and mobility by providing nearly frictionless articulation for mechanical load transmission between joints. Damage to the articular cartilage frequently results from sport-related injuries, systemic diseases, degeneration, trauma, or tumors. Failure to treat impaired cartilage may lead to osteoarthritis, affecting more than 25% of the adult population globally. Articular cartilage has a very low intrinsic self-repair capacity due to the limited proliferative ability of adult chondrocytes, lack of vascularization and innervation, slow matrix turnover, and low supply of progenitor cells. Furthermore, articular chondrocytes are encapsulated in low-nutrient, low-oxygen environment. While cartilage restoration techniques such as osteochondral transplantation, autologous chondrocyte implantation (ACI), and microfracture have been used to repair certain cartilage defects, the clinical outcomes are often mixed and undesirable. Cartilage tissue engineering (CTE) may hold promise to facilitate cartilage repair. Ideally, the prerequisites for successful CTE should include the use of effective chondrogenic factors, an ample supply of chondrogenic progenitors, and the employment of cell-friendly, biocompatible scaffold materials. Significant progress has been made on the above three fronts in past decade, which has been further facilitated by the advent of 3D bio-printing. In this review, we briefly discuss potential sources of chondrogenic progenitors. We then primarily focus on currently available chondrocyte-friendly scaffold materials, along with 3D bioprinting techniques, for their potential roles in effective CTE. It is hoped that this review will serve as a primer to bring cartilage biologists, synthetic chemists, biomechanical engineers, and 3D-bioprinting technologists together to expedite CTE process for eventual clinical applications.
Highlights
Articular cartilage, known as hyaline cartilage, is a unique and durable connective tissue that plays a critical role in physiological mobility by providing nearly frictionless articulation for mechanical load transmission between joints (Figure 1) (Ge et al, 2012)
Effective repairing of damaged cartilage tissues caused by high impact sports or diseases remain a major clinical challenge
Significant progresses have been made in Cartilage tissue engineering (CTE), including the identification and the use of chondrogenic biofactors, the isolation and characterization of chondrogenic progenitors from various sources, and the development of cell-friendly, biocompatible scaffold materials
Summary
Known as hyaline cartilage, is a unique and durable connective tissue that plays a critical role in physiological mobility by providing nearly frictionless articulation for mechanical load transmission between joints (Figure 1) (Ge et al, 2012). Human IPFP-MSCs seeded on 3D-printed CS scaffolds in chondrogenic media containing TGF-β3 and BMP-6 attached, proliferated, and differentiated into chondrocyte-like cells in the formation of cartilaginous tissue in vitro (Patra et al, 2012). This type of scaffolds exhibited a satisfactory swelling profile and moderate biodegradation, as well as being hemocompatible with sufficient mechanical strength for applications in cartilage tissue regeneration.
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