Abstract
Human synovial joints are remarkable as they can last for a lifetime. However, they can be affected by disease that may lead to destruction of the joint surface. The most common treatment in the advanced stages of joint disease is artificial joint replacement, where the diseased synovial joint is replaced with an artificial implant made from synthetic materials, such as metals and polymers. A new technique for repairing diseased synovial joints is tissue engineering where cells are used to grow replacement tissue. This paper explores the relative merits of synthetic and tissue-engineered implants, using joint replacement as an example. Synthetic joint replacement is a well-established procedure with the advantages of early mobilisation, pain relief and high patient satisfaction. However, synthetic implants are not natural tissues; they can cause adverse reactions to the body and there could be a mismatch in mechanical properties compared to natural tissues. Tissue-engineered implants offer great potential and have major advantages over synthetic implants as they are natural tissue, which should ensure that they are totally biocompatible, have the correct mechanical properties and integrate well with the existing tissue. However, there are still many limitations to be addressed in tissue engineering such as scaling up for production, bioreactor design, appropriate regulation and the potential for disease to attack the new tissue-engineered implant.
Highlights
Human synovial joints are remarkable as they can last for a lifetime
One of the major advances in healthcare in the 20th century was the introduction of artificial joint replacement, where the diseased synovial joint is replaced with an artificial implant made from synthetic materials
Synthetic versus tissue-engineered implants for joint replacement been investigated clinically and the results show clinical improvement (Behrens et al 2006; Nehrer et al 2006)
Summary
Human synovial joints are remarkable as they can last for a lifetime. they can be affected by disease that may lead to destruction of the joint surface, resulting in pain and disability for the sufferer. Tissue engineering is widely predicted to be a growth sector of biotechnology (Lysaght et al 1998) with the potential to supplant many synthetic joint replace- Human synovial joints, such as the hip, knee and fingers, enable articulation between two bone ends. Articular cartilage has a low capability for self-repair, since it has few cells (van der Kraan et al 2002) and, the most common treatment in the advanced stages of joint disease is artificial joint replacement with a synthetic implant. Conventional hip replacements have a cobalt chrome molybdenum alloy femoral component articulating against an ultra high molecular weight polyethylene acetabular cup (Park et al 2000) These implants can have a survivorship for 20 years or longer (Berry et al 2002). Synthetic versus tissue-engineered implants for joint replacement been investigated clinically and the results show clinical improvement (Behrens et al 2006; Nehrer et al 2006)
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