Abstract
Articular cartilage and the underlying subchondral bone are crucial in human movement and when damaged through disease or trauma impacts severely on quality of life. Cartilage has a limited regenerative capacity due to its avascular composition and current therapeutic interventions have limited efficacy. With a rapidly ageing population globally, the numbers of patients requiring therapy for osteochondral disorders is rising, leading to increasing pressures on healthcare systems. Research into novel therapies using tissue engineering has become a priority. However, rational design of biomimetic and clinically effective tissue constructs requires basic understanding of osteochondral biological composition, structure, and mechanical properties. Furthermore, consideration of material design, scaffold architecture, and biofabrication strategies, is needed to assist in the development of tissue engineering therapies enabling successful translation into the clinical arena. This review provides a starting point for any researcher investigating tissue engineering for osteochondral applications. An overview of biological properties of osteochondral tissue, current clinical practices, the role of tissue engineering and biofabrication, and key challenges associated with new treatments is provided. Developing precisely engineered tissue constructs with mechanical and phenotypic stability is the goal. Future work should focus on multi-stimulatory environments, long-term studies to determine phenotypic alterations and tissue formation, and the development of novel bioreactor systems that can more accurately resemble the in vivo environment.
Highlights
Osteochondral tissue is composed of articular cartilage, a specialised tissue that covers the distal ends of the bones in articulating joints, and the subchondral bone which anchors the cartilage to the underlying bone [1,2,3,4,5]
Dual compressive and shear mechanical stimulation of human articular chondrocytes encapsulated in gelatin methacrylate and hyaluronic acid methacrylate hydrogels have been demonstrated by Meinert et al [184]
Key areas of research include the maintenance of phenotype in the engineered tissue construct and the prevention of hypertrophic or fibrocartilage phenotypes being expressed
Summary
Osteochondral tissue is composed of articular cartilage, a specialised tissue that covers the distal ends of the bones in articulating joints, and the subchondral bone which anchors the cartilage to the underlying bone [1,2,3,4,5]. Osteochondral tissue is composed of distinct regions with articular cartilage, comprising the majority of the structure, and an underlying subchondral bone phase. Articular cartilage is avascular and aneural with low metabolic activity and when trauma or disease (e.g. osteoarthritis and rheumatoid arthritis) affects the tissue significant issues arise, which are difficult to treat due to the inherent inability of articular cartilage to self-regenerate in comparison to the greater healing capacity of bone (Fig. 1). Cartilage lacks ready access to a supply of circulating stem cells and nutrients relies on the synovial fluid for nourishment. This combined with its largely acellular composition and low metabolic activity results in a nearly complete lack of innate regenerative capacity.
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