Abstract
Hyaline articular cartilage lacks blood vessels, lymphatics, and nerves and is characterised by limited self-repair ability following injury. Traditional techniques of articular cartilage repair and regeneration all have certain limitations. The development of tissue engineering technology has brought hope to the regeneration of articular cartilage. The strategies of tissue-engineered articular cartilage can be divided into three types: “cell-scaffold construct,” cell-free, and scaffold-free. In “cell-scaffold construct” strategies, seed cells can be autologous chondrocytes or stem. Among them, some commercial products with autologous chondrocytes as seed cells, such as BioSeed®-C and CaReS®, have been put on the market and some products are undergoing clinical trials, such as NOVOCART® 3D. The stem cells are mainly pluripotent stem cells and mesenchymal stem cells from different sources. Cell-free strategies that indirectly utilize the repair and regeneration potential of stem cells have also been used in clinical settings, such as TruFit and MaioRegen. Finally, the scaffold-free strategy is also a new development direction, and the short-term repair results of related products, such as NOVOCART® 3D, are encouraging. In this paper, the commonly used techniques of articular cartilage regeneration in surgery are reviewed. By studying different strategies and different seed cells, the clinical application status of tissue-engineered articular cartilage is described in detail.
Highlights
Hyaline articular cartilage is a highly specialised connective tissue that lacks blood vessels, lymphatics, and nerves
Compared with osteochondral autologous transplantation (OAT), osteochondral allograft transplantation (OCA) has the advantages of causing less trauma, being simpler to perform, and having a wider graft source, avoiding the occurrence of donor site morbidity; OCA can repair a large area of cartilage defects at one time and reconstruct the complete articular surface composed of mature hyaline cartilage
Mologne et al [26] have proven that allogenic lateral femoral condyle transplantation can be used to repair medial femoral condyle cartilage defects, and there is no significant difference in the effect of repairing the medial femoral condyle with the medial femoral condyle graft, which expands the source of transplantation for medial femoral condyle OCA
Summary
Hyaline articular cartilage is a highly specialised connective tissue that lacks blood vessels, lymphatics, and nerves. Articular cartilage injury is common, and the incidence of cartilage defects in patients undergoing arthroscopy is as high as 61-63% [1]. The large number of patients becomes a heavy burden for the medical system. Commonly used techniques of articular cartilage regeneration include microfracture (MF), osteochondral autologous transplantation (OAT), osteochondral allograft transplantation (OCA), particulated articular cartilage implantation (PACI), and autologous chondrocyte implantation (ACI). These methods all have their own limitations, Stem Cells International. Tissue engineering technology has been considered the most promising method for regenerating articular cartilage. This article will introduce these traditional methods and the concept of tissue-engineered articular cartilage according to different strategies and seed cells
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