Tratamiento de lesiones del cartílago articular con terapia celular

Abstract

Articular cartilage lesions which do not affect the integrity of subchondral bone, they are not able to repair it expontaneously. The asymptomatic nature of these lesions induces articular cartilage degeneration and development of an arthrosic process. To avoid the necessity to receive joint replacement surgery, it has been developed different treatments of cellular therapy which are focused to create new tissues whose structure, biochemistry composition and function will be the same than native articular cartilage. Approaches used to access the stream produce a fibrocartilaginose tissue which is not an articular cartilage. Implantation of autologous chondrocytes and autologous mosaicplasties induces a quality better articular cartilage. Furthermore both techniques involve damage in the sane cartilage; because of trying to get a big amount of chondrocytes or because of extraction osteochondral cylinder which will be implanted in the injured joint. The stem cells are a promising toll to repair articular cartilage, however they are in a previous experimentation step yet. Although the present studies using cellular therapy improves clinically and functionally, it is not able to regenerate an articular cartilage which offer resistance the degeneration process.

Cryopreservation Effect on Proliferative and Chondrogenic Potential of Human Chondrocytes Isolated from Superficial and Deep Cartilage

“…The first clinical application of this method was performed by the group of Brittberg [16], which also demonstrated the successful repair of articular cartilage in rabbits transplanted with autologous chondrocytes [42]. Currently the ACI is proving to be one of the most safe and effective therapies for treatment of focal defects in articular cartilage [7-16, 43, 44]. Cell therapy is most successful in young people, yielding repair tissue of high quality [13, 16].…”

“…Previous in vitro studies demonstrated a marked decrease of chondrocyte proliferation and lowered phenotypic stability to be a function of increasing donor age [28, 46], resulting in a tissue that is less able to maintain homeostasis when stressed, leading to a breakdown and loss of articular cartilage, a hallmark of osteoarthritis [47]. The capacity for cell proliferation of chondrocytes is the most important limitation of ACI [7, 18-27, 48]. This proliferative capacity depends not only on donor age, but also on the conditions used to preserve the chondrocytes until the time of implant [49].…”

“…However, these techniques generate a fibrocartilaginous repair tissue that lacks both the structure and function of natural hyaline articular cartilage. To avoid the need for prosthetic replacement, cell treatments have been developed that attempt to generate repair tissue with the structure, biochemical composition and function similar to natural articular cartilage [7]. …”

“…Cell therapy using autologous chondrocyte implantation (ACI) to repair focal defects of articular cartilage, obtains a repair tissue of higher quality compared to fibrocartilage tissue [7-16]. This therapeutic procedure is used clinically in combination with a periostial cover to treat chondral or osteochondral defects of the knee, with good clinical results [4].…”

Cell Therapy and Tissue Engineering for Cartilage Repair

“…Different cell treatments have been developed with the aim of forming a repair tissue with structural, biochemical, and functional characteristics equivalent to those of native articular cartilage (Figure 2). Scientists have sought several different ways to repair articular cartilage after traumatic damage, which can lead to secondary OA or degeneration of the cartilage [13,[15][16][17].…”