Management of knee osteoarthritis. Current status and future trends

Abstract

Osteoarthritis (OA) affects a large number of the population, and its incidence is showing a growing trend with the increasing life span. OA is the most prevalent joint condition worldwide, and currently, there is no functional cure for it. This review seeks to briefly overview the management of knee OA concerning standardized pharmaceutical and clinical approaches, as well as the new biotechnological horizons of OA treatment. The potential of biomaterials and state of the art of advanced therapeutic approaches, such as cell and gene therapy focused primarily on cartilage regeneration are the main subjects of this review. Biotechnol. Bioeng. 2017;114: 717-739. © 2016 Wiley Periodicals, Inc.

Gene therapy for chondral and osteochondral regeneration: is the future now?

“…Different genes have been transfected into MSCs, chondrocytes or FBs to improve or modify their phenotypic properties [5]. Usually, the strategy developed for cartilage gene therapy has been to deliver genes which mainly codify for GFs, inducing a chondrogenic differentiation.…”

“…In addition, the association of gene therapy to tissue engineering might represent a promising strategy for the treatment of chondral and osteochondral lesions, balancing the management of temporary joint mechanical incompetence with altered metabolic and inflammatory homeostasis [5].…”

Functionally graded additive manufacturing to achieve functionality specifications of osteochondral scaffolds

“…In addition, the biodegradation of scaffolds during in vivo treatment should closely match tissue growth rates [13]. Facilitating regeneration of cartilage requires that the implanted scaffold remains stable for at least 2-3 weeks.…”

Cell Therapy for Osteoarthritis

“…OA is characterized mainly by loss or damage of articular cartilage [3]. Cartilage acts as a soft cushion between the bones and provides a smooth surface for joint movement.…”