Abstract
Osteoarthritis is a major debilitating disease that is affecting thousands of Americans worldwide. A lack of blood supply makes regenerating and repairing cartilage naturally very difficult. Current treatment methods such as marrow stimulation, autograft, and allografts can be very costly, pose several challenges, and differ in their degrees of success. Because cartilage contains a unique structure, it is difficult to mimic by synthetic devices. Recent studies utilizing various biodegradable scaffolds seeded with stem cells, growth factors, and serums have shown promising results. This chapter will address the type of stem cells that have proven useful in cartilage differentiation as well as several polymers and composites used to make both synthetic and natural scaffolds. Although chondrocytes have the ability to regrow articular cartilage, dedifferentiation of these cells has made using bone marrow stems cells and adipose-derived stem cells more useful when induced by various growth factors. Growth factors such as transforming growth factor β, insulin growth factor-I, and bone morphogenic proteins have been seen to increase collagen and extracellular matrix (ECM) production and expression thus promoting chondrogenesis. Scaffolds derived from natural polymers such as alginate, fibrin, chitosan, and silk have shown to have increased biocompatibility and cell adherence, but have a decrease in mechanical properties. Scaffolds fabricated from synthetic polymers on the other hand have increased mechanical properties but may have trouble with cell attachment and even biocompatibility within in the human body. Nanostructured scaffolds have shown promise in improving the cell attachment and chondrogenic differentiation of stem cells due to their structural similarity to the ECM. Oftentimes efforts are also focused on the use of electrical and mechanical stimulations in conjunction with scaffolds and stem cells to promote cartilage regeneration. In spite of significant amount of research and novel methodologies developed in the laboratory setting this has not yet been translated into clinics.
Published Version
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