Enlightenment of Growth Plate Regeneration Based on Cartilage Repair Theory: A Review.

Xianggang Wang,He Liu,Yuzhe Liu,Zhonghan Wang,Yirui Bao,Chenyu Wang,Jincheng Wang,Haotian Bai,Zuhao Li,Ming Ren

doi:10.3389/fbioe.2021.654087

Abstract

The growth plate (GP) is a cartilaginous region situated between the epiphysis and metaphysis at the end of the immature long bone, which is susceptible to mechanical damage because of its vulnerable structure. Due to the limited regeneration ability of the GP, current clinical treatment strategies (e.g., bone bridge resection and fat engraftment) always result in bone bridge formation, which will cause length discrepancy and angular deformity, thus making satisfactory outcomes difficult to achieve. The introduction of cartilage repair theory and cartilage tissue engineering technology may encourage novel therapeutic approaches for GP repair using tissue engineered GPs, including biocompatible scaffolds incorporated with appropriate seed cells and growth factors. In this review, we summarize the physiological structure of GPs, the pathological process, and repair phases of GP injuries, placing greater emphasis on advanced tissue engineering strategies for GP repair. Furthermore, we also propose that three-dimensional printing technology will play a significant role in this field in the future given its advantage of bionic replication of complex structures. We predict that tissue engineering strategies will offer a significant alternative to the management of GP injuries.

Highlights

The growth plate (GP), or the physis, is a cartilaginous region situated between the epiphysis and metaphysis at the end of immature long bones
Porous PLGA scaffolds loaded with insulin-like growth factor-1 (IGF-1) were used in the treatment of a rabbit model with proximal tibial GP defects, after implantation in the GP defects, regenerated cartilage was observed in the IGF-1 releasing group, while there was only bone formation in the empty group and in the scaffolds alone group (Figure 4), all the results indicated that IGF-1 was suitable for GP regeneration (Sundararaj et al, 2015)
Previous studies have shown that GP-derived extracellular matrix (ECM) containing diverse growth factors, such as vascular endothelial growth factor (VEGF) and IGF-β1, supported vascularization, and enhanced the regeneration of bone marrow mesenchymal stem cells (BMSCs) (Cunniffe et al, 2017). These results suggested that this type of ECM was a multipotential substrate and its function would change based on the transplantation site

Summary

Introduction

The growth plate (GP), or the physis, is a cartilaginous region situated between the epiphysis and metaphysis at the end of immature long bones. The major problem with GP injuries is that the injured GP cartilage will be replaced by undesirable bony tissue, forming a bone bridge, which may cause length discrepancies and angular deformities (Gigante and Martinez, 2019). This result can be detrimental to children who are still in the growth phase. Current clinical treatments often include the use of interpositional materials as fillers at the site of the defect after resection of the bone bridge, these materials include autogenous fat, muscle, and Review of Growth Plate Regeneration cement. It is critical to identify new approaches to prevent bone bridge formation and to promote tissue regeneration

Methods

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Conclusion