Effects of growth factors on articular cartilage.
Articular cartilage has limited intrinsic repair potential. The relative failure of many synthetic solutions has led to the growing interest in the development of cell-based repair systems for solving a number of clinical problems to articular cartilage. Many factors will dictate the success of these approaches, namely surgical technique and the repair method used, the patient's genetic make up and compliance with postoperative regimen.<br /> Many growth factors have been shown to have effects on chondrocytes and articular cartilage. Normal articular cartilage expresses insulin-like growth factor-I (IGF-I), basic fibroblast growth factor (bFGF) and transforming growth factor-b (TGFb) and these seem to be the most important local regulators of chondrocyte function. A complete understanding of the pathogenesis of osteoarthritis requires an understading of these growth factors. The role of cytokines and growth factors and the complex interactions that exist between them needs to be understood and at the moment our knowledge is incomplete. The advances of gene therapy however are promising and with further research patients may be offered not only a solution to their problem but also ways of preventing the disease in the first place.
Goldberg
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The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.