Current Surgical Options for Articular Cartilage Repair

Abstract

The articular cartilage lesions represent one of the major unsolved problems in the orthopaedic surgery. This is because articular cartilage has a limited capacity of self-repair following trauma. The aim of this study is to review the different surgical options for articular cartilage repair. They can be divided into three groups: techniques without transplant of cells or tissues; techniques based on the transplantation of tissues; the tissue engineering techniques.The first group includes the joint debridement and the techniques based on the bone marrow-stimulation principle.The second group includes the transplantation of periosteum and the transplantation of autologous or allogeneic osteochondral plugs. The tissue engineering techniques could be further divided as follows: methods based on the transplantation of cells either in solution, or in the form of microspheres, or carried on a biocompatible scaffold; the transplant of cartilage fragments; the cell-free techniques, based on the use of an acellular scaffold, able to entrap the reparative cells recruited from the host tissue and to guide their differentiation toward a chondral phenotype.In this work we present various options for the treatment of chondral or osteochondral lesions. Today, however, due to the lack of comparative studies, it is not always possible to define the best treatment choice for the different cartilage pathologies.

Effects of polymerization degree on recovery behavior of PVA/PVP hydrogels as potential articular cartilage prosthesis after fatigue test

“…The surgical techniques, including microfracture, autologous chondrocyte implantation (ACI), osteochondral autograft transfer (OAT) etc. [3], have been widely used to ease pain and regenerate tissue function. However, all of these techniques cannot reconstruct natural function to the cartilage.…”

DAPT inhibits the chondrogenesis of human umbilical cord mesenchymal stem cells

“…Due to the lack of nerves and vessels, articular cartilage has little ability for self-repair, and the limited source of chondrocytes has become the major obstacle for healing [30]. In recent years, cartilage tissue engineering has been considered one of the methods that may solve this medical issue.…”

Terapias Celulares y Productos de Ingeniería de Tejidos para el Tratamiento de Lesiones Condrales de Rodilla

“…En consecuencia, las mejorías que se observan son transitorias y generalmente la exacerbación de los síntomas que ocurre con el tiempo, conduce a que los pacientes terminen necesitando un reemplazo de rodilla (Paschos et al, 2015). La alta incidencia de lesiones del cartílago y las dificultades descritas, han llevado a que en el mundo se investiguen nuevos tratamientos; entre ellos, los basados en la aplicación de células, factores de crecimiento y productos de ingeniería de tejidos obtenidos a partir de soportes o matrices elaborados con diferentes materiales (Peretti, et al, 2011;Stein et al, 2013;Ondrésik et al, 2016). El uso independiente de cada uno de ellos o como terapia que combina células-soportes o células-factores de crecimiento-soportes (figura 1), puede conducir a la reparación o regeneración parcial o total del cartílago dañado y constituye un pilar importante de lo que hoy se denomina medicina regenerativa; campo multidisciplinario cuyo objetivo es inducir la capacidad de regenerar de los órganos y tejidos humanos mediante intervenciones que hagan que el cuerpo recambie los tejidos lesionados por nuevos iguales en morfología y función a los originales (Langer et al, 1993;Witten et al, 2015).…”