title: The role of growth factors in cartilage repair.
abstract: BACKGROUND
  Full-thickness chondral defects and early osteoarthritis continue to present major challenges for the patient and the orthopaedic surgeon as a result of the limited healing potential of articular cartilage. The use of bioactive growth factors is under consideration as a potential therapy to enhance healing of chondral injuries and modify the arthritic disease process.
  
  
  OBJECTIVE
  We reviewed the role of growth factors in articular cartilage repair and identified specific growth factors and combinations of growth factors that have the capacity to improve cartilage regeneration. Additionally, we discuss the potential use of platelet-rich plasma, autologous-conditioned serum, and bone marrow concentrate preparations as methods of combined growth factor delivery.
  
  
  METHODS
  A PubMed search was performed using key words cartilage or chondrocyte alone and in combination with growth factor. The search was open for original manuscripts and review papers and open for all dates. From these searches we selected manuscripts investigating the effects of growth factors on extracellular matrix synthesis and excluded those investigating molecular mechanisms of action.
  
  
  RESULTS
  By modulating the local microenvironment, the anabolic and anticatabolic effects of a variety of growth factors have demonstrated potential in both in vitro and animal studies of cartilage injury and repair. Members of the transforming growth factor-β superfamily, fibroblast growth factor family, insulin-like growth factor-I, and platelet-derived growth factor have all been investigated as possible treatment augments in the management of chondral injuries and early arthritis.
  
  
  CONCLUSIONS
  The application of growth factors in the treatment of local cartilage defects as well as osteoarthritis appears promising; however, further research is needed at both the basic science and clinical levels before routine application.
authors.affiliation: Department of Clinical Sciences, VMC C3-181, Cornell University, Ithaca, NY 14853, USA. laf4@cornell.edu
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Fortier
authors.forename: Joseph U
authors.initials: JU
authors.lastname: Barker
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Strauss
authors.forename: Taralyn M
authors.initials: TM
authors.lastname: McCarrel
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
mesh_terms: D000818:Animals; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use; D002357:Cartilage Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D002358:Cartilage, Articular / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D020219:Chondrogenesis / Q000187:drug effects*; D004359:Drug Therapy, Combination; D005346:Fibroblast Growth Factors / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000627:therapeutic use; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism / Q000627:therapeutic use*; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use; D012038:Regeneration / Q000187:drug effects*; D015291:Transforming Growth Factors / Q000627:therapeutic use
chemical_list: D019485:Bone Morphogenetic Proteins; D036341:Intercellular Signaling Peptides and Proteins; D010982:Platelet-Derived Growth Factor; D005346:Fibroblast Growth Factors; D007334:Insulin-Like Growth Factor I; D015291:Transforming Growth Factors