New frontiers for cartilage repair, joint preservation and prevention

Abstract

Damaged cartilage is seen with increasing frequency after joint trauma, alone or in combination with other joint injuries. A poor healing of injured cartilage leads to great disability and pain and could by time develop into osteoarthritis (OA). During the last 50 years, new cartilage repair techniques have appeared with more or less satisfactory results. In this presentation, the focus is to present areas that we might see more of in the future. It is important to separate local cartilage repair from a generalized loss of cartilage as OA. For both conditions, a base is a non-operative treatment with focus on new techniques of physiotherapy. Intra-articular injections of stem cells are mainly for OA as a source of growth factors but also as an adjunct to improve repair quality when using intrinsic local repairs. The use of in vitro manipulated chondrogeneic cells has decreased during the last decade due to strict regulations and high production costs. Instead, the focus is now on 1 stage procedures with autologous chondrogeneic cells but also more use of allogeneic chondrogeneic cells either alone or combined with autologous cells. An area of interest is the 3D technology used for bio printing of the lesions. Concomitant injuries are taken care as part of joint preservation and we need to better use preventive means to avoid future injuries. The assembled knowledge of joint repair, preservation and joint damage prevention may help us to reach the goal of going from local repair to a local regeneration become feasible.