title: Cartilage regeneration.
abstract: Cartilage damaged by trauma has a limited capacity to regenerate. Current methods of managing small chondral defects include palliative treatment with arthroscopic débridement and lavage, reparative treatment with marrow-stimulation techniques (eg, microfracture), and restorative treatment, including osteochondral grafting and autologous chondrocyte implantation. Larger defects are managed with osteochondral allograft or total joint arthroplasty. However, the future of managing cartilage defects lies in providing biologic solutions through cartilage regeneration. Laboratory and clinical studies have examined the management of larger lesions using tissue-engineered cartilage. Regenerated cartilage can be derived from various cell types, including chondrocytes, pluripotent stem cells, and mesenchymal stem cells. Common scaffolding materials include proteins, carbohydrates, synthetic materials, and composite polymers. Scaffolds may be woven, spun into nanofibers, or configured as hydrogels. Chondrogenesis may be enhanced with the application of chondroinductive growth factors. Bioreactors are being developed to enhance nutrient delivery and provide mechanical stimulation to tissue-engineered cartilage ex vivo. The multidisciplinary approaches currently being developed to produce cartilage promise to bring to fruition the desire for cartilage regeneration in clinical use.
authors: Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA.
authors: Rocky S
authors: RS
authors: Tuan
authors: Antonia F
authors: AF
authors: Chen
authors: Brian A
authors: BA
authors: Klatt
mesh_terms: D000818:Animals; D019149:Bioreactors; D002358:Cartilage, Articular / Q000293:injuries* / Q000502:physiology*; D002454:Cell Differentiation; D019902:Chondrocytes / Q000637:transplantation; D005346:Fibroblast Growth Factors / Q000502:physiology; D006801:Humans; D059630:Mesenchymal Stem Cells; D053657:Platelet-Rich Plasma; D011474:Prosthesis Design; D012038:Regeneration / Q000502:physiology*; D023822:Tissue Engineering; D054457:Tissue Scaffolds; D016212:Transforming Growth Factor beta / Q000502:physiology; D014182:Transplantation, Autologous
chemical_list: D016212:Transforming Growth Factor beta; D005346:Fibroblast Growth Factors
references: Annu Rev Cell Dev Biol. 1996;12:697-715
references: 8970741
references: N Engl J Med. 1994 Oct 6;331(14):889-95
references: 8078550
references: Knee. 2012 Dec;19(6):812-7
references: 22503303
references: Tissue Eng. 2006 Dec;12(12):3405-16
references: 17518677
references: Arthritis Res Ther. 2008;10(5):223
references: 18947375
references: Instr Course Lect. 2008;57:563-71
references: 18399610
references: Am J Sports Med. 2011 Jun;39(6):1180-90
references: 21310939
references: Clin Orthop Relat Res. 2011 Oct;469(10):2706-15
references: 21403984
references: Cell Transplant. 2004;13(5):595-600
references: 15565871
references: Curr Opin Rheumatol. 2006 Jan;18(1):64-73
references: 16344621
references: Am J Sports Med. 2012 Jan;40(1):75-82
references: 21960559
references: Am J Sports Med. 2011 Oct;39(10):2153-60
references: 21803978
references: Injury. 2008 Apr;39 Suppl 1:S97-113
references: 18313477
references: J Am Acad Orthop Surg. 2008 Jun;16(6):306-11
references: 18524981
references: Arthritis Rheum. 2006 Oct;54(10):3075-8
references: 17009225
references: Stem Cells Dev. 2013 Jan 1;22(1):102-13
references: 22817676
references: J Bone Joint Surg Am. 2006 Mar;88(3):503-7
references: 16510814
references: Stem Cell Rev Rep. 2011 Sep;7(3):544-59
references: 21188652
references: Clin Orthop Relat Res. 2010 Sep;468(9):2530-40
references: 20625952
references: Osteoarthritis Cartilage. 2002 Mar;10(3):199-206
references: 11869080
references: J Tissue Eng Regen Med. 2011 Apr;5(4):e36-51
references: 21413156
references: Biomaterials. 2005 Feb;26(6):599-609
references: 15282138
references: Rheumatology (Oxford). 2012 Jan;51(1):144-50
references: 22075062
references: J Bone Joint Surg Br. 2007 May;89(5):672-85
references: 17540757
references: Am J Sports Med. 2012 Jun;40(6):1289-95
references: 22491793
references: Am J Sports Med. 2010 Jul;38(7):1324-33
references: 20423988
references: Stem Cells. 2007 Nov;25(11):2964-71
references: 17656639
references: Tissue Eng Part B Rev. 2011 Oct;17(5):301-5
references: 21595612
references: Blood. 2009 May 28;113(22):5476-9
references: 19299331
references: J Bone Joint Surg Am. 2012 Jun 6;94(11):979-89
references: 22637204
references: Cytotherapy. 2012 Feb;14(2):247-56
references: 22242865
references: Am J Phys Med Rehabil. 2012 May;91(5):411-7
references: 22513879
references: Osteoarthritis Cartilage. 2006 May;14(5):403-12
references: 16413799
references: Cell Tissue Res. 2007 Mar;327(3):449-62
references: 17053900
references: Am J Sports Med. 2006 Nov;34(11):1763-73
references: 16832129
references: Arthritis Rheum. 2009 Jul;60(7):2019-27
references: 19565481
references: Arthritis Rheum. 2008 Jan;58(1):26-35
references: 18163497
references: Genes Dev. 2005 May 15;19(10):1129-55
references: 15905405
references: J Bone Joint Surg Am. 2010 Aug 18;92(10):1927-37
references: 20720135
references: Proc Natl Acad Sci U S A. 2005 Jun 14;102(24):8698-703
references: 15939878