An overview of various treatment strategies, especially tissue engineering for damaged articular cartilage

Abstract

Many traditional procedures, including surgical methods such as microfracture of subchondral bone and soft tissue transplantation, have been widely used to treat damaged cartilage. However, there is still no definitive cure for cartilage defects. In recent decades, tissue engineering has raised hopes for the repair of defective cartilage. Different approaches are used for cartilage engineering, in which cells, scaffolds, and biological signals or growth factors may be used alone or in combination. Additionally, the imitation of the mechanical properties of the natural cartilage tissue by bioreactors is also helpful in this regard. It should be noted that in the transplantation of engineered cartilage tissue, there are challenges such as poor integration, inflammation and phenotypic instability that may lead to failure of neo-cartilage transplantation. Therefore, a comprehensive understanding of the multiple therapeutic approaches, including surgical procedures, cell-based methods and tissue engineering, should be obtained. The present review article provides this information, along with a variety of factors, including cells, materials, and biological/biomechanical factors required for the engineering of cartilage tissue, as well as the challenges ahead and their solutions.

Integrins, cadherins and channels in cartilage mechanotransduction: perspectives for future regeneration strategies

“…Bone marrow stimulating (BMS) (Ref. 38) treatments such as microfracture, one of the most commonly performed surgical articular cartilage repair procedures, rely on the influx of MSCs from the surgically penetrated subchondral bone, to initiate (fibro-)cartilaginous repair (Refs 39-42) of small localised articular cartilage defects (Ref. 27).…”

Is Extracellular Vesicle-Based Therapy the Next Answer for Cartilage Regeneration?

“…Cartilage repair can be enhanced by surgery as described hereinafter. Conventional surgical approaches include methods such as subchondral bone microfracture, soft tissue transplantation with an autograft of periosteum/perichondrium, osteochondral allograft/autograft transplantation, and autologous chondrocyte implantation (Bakhshayesh et al, 2020). When effective, these methods often lead to the production of fibrocartilage instead of hyaline cartilage.…”

“…Regenerative medicine strategies have been initiated as a new opportunity to treat cartilage defects and bring regeneration along. Numerous tissue engineering approaches have been developed by using biomaterials as ECM derivatives or mesenchymal stem cells (MSCs) as chondrogenic precursors to alleviate the lack of accessibility for primary chondrocytes (Bakhshayesh et al, 2020;Tsiapalis and O'Driscoll, 2020). Because of their promising results in vitro or on animal models, these approaches are currently investigated to be transferred to clinic practice (Borić et al, 2019;Kim et al, 2020;Kyriakidis et al, 2020;Lehoczky et al, 2020;Mendes et al, 2020).…”

A Comparison of the Capacity of Mesenchymal Stromal Cells for Cartilage Regeneration Depending on Collagen-Based Injectable Biomimetic Scaffold Type

“…The major problem of healthcare in the industrial community is the damage of joint cartilage, which is associated with the limited capacity of the tissue to regenerate [ 1 ]. The gold standard in cell therapy of cartilage diseases today is the method of autologous chondrocyte implantation which has some disadvantages [ 2 ]. These include the traumatic biopsy of the healthy area of cartilage, the difficulty of expansion, and the possibility of cell dedifferentiation [ 3 ].…”