Overview of existing cartilage repair technology.
Currently, autologous chondrocyte implantation and osteochondral grafting bridge the gap between palliation of cartilage injury and resurfacing via arthroplasty. Emerging technologies seek to advance first generation techniques and accomplish several goals including predictable outcomes, cost-effective technology, single-stage procedures, and creation of durable repair tissue. The biologic pipeline represents a variety of technologies including synthetics, scaffolds, cell therapy, and cell-infused matrices. Synthetic constructs, an alternative to biologic repair, resurface a focal chondral defect rather than the entire joint surface. Scaffolds are cell-free constructs designed as a biologic "net" to augment marrow stimulation techniques. Minced cartilage technology uses stabilized autologous or allogeneic fragments in 1-stage transplantation. Second and third generation cell-based methods include alternative membranes, chondrocyte seeding, and culturing onto scaffolds. Despite the promising early results of these products, significant technical obstacles remain along with unknown long-term durability. The vast array of developing technologies has exceptional promise and the potential to revolutionize the cartilage treatment algorithm within the next decade.
McNickle
Allison G
AG
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA.
Provencher
Matthew T
MT
Cole
Brian J
BJ
D001178:Arthroplasty / Q000379:methods; D001182:Arthroscopy / Q000379:methods; D002356:Cartilage / Q000637:transplantation*; D002357:Cartilage Diseases / Q000503:physiopathology / Q000601:surgery*; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D011379:Prognosis; D012680:Sensitivity and Specificity; D023822:Tissue Engineering; D054457:Tissue Scaffolds; D014184:Transplantation, Homologous