Bioactive factors for cartilage repair and regeneration: Improving delivery, retention, and activity

Abstract

Articular cartilage is a remarkable tissue whose sophisticated composition and architecture allow it to withstand complex stresses within the joint. Once injured, cartilage lacks the capacity to selfrepair, and injuries often progress to joint wide osteoarthritis (OA) resulting in debilitating pain and loss of mobility. Current palliative and surgical management provides short-term symptom relief, but almost always progresses to further deterioration in the long term. A number of bioactive factors, including drugs, corticosteroids, and growth factors, have been utilized in the clinic, in clinical trials, or in emerging research studies to stabilize the inflamed joint environment or to promote new cartilage tissue formation. However, these therapies remain limited in their duration and effectiveness. For this reason, current efforts are focused on improving the localization, retention, and activity of these bioactive factors. The purpose of this review is to highlight recent advances in drug delivery for the treatment of damaged or degenerated cartilage. First, we summarize material and modification techniques to improve the delivery of these factors to damaged tissue and enhance their retention and action within the joint environment. Second, we synthesize recent studies using novel methods to promote new cartilage formation via biofactor delivery, that have potential for improving future long-term clinical outcomes. Lastly, we review the emerging field of orthobiologics, using delivered and endogenous cells as drug-delivering "factories" to preserve and restore joint health. Enhancing drug delivery systems can improve both restorative and regenerative treatments for damaged cartilage.

Exosomes produced from 3D cultures of umbilical cord mesenchymal stem cells in a hollow-fiber bioreactor show improved osteochondral regeneration activity

“…In recent years, therapies based on stem cells have led to promising approaches for cartilage repair (Medvedeva et al 2018;Patel et al 2019). Laboratory and clinical studies have shown that mesenchymal stem cells (MSCs) can differentiate into chondrocytes and restore cartilage defects (Huang et al 2016;Driessen et al 2017;Ha et al 2019).…”

Treatment of Osteochondral Fracture of the Lateral Femoral Condyle with TWINFIX Ti Suture Anchor “X”‐Shaped Internal Fixation under Arthroscopy: A Surgical Technique and Three Cases Report

“…Intra‐articular osteochondral fracture has a certain ability for self‐repair. After acute articular surface fracture, the defect of bone and cartilage is filled with fibrin clot. The defect area of the cartilage surface is in excess of 4 to 16 mm 2 , which is usually not the result of self‐repair.…”

<p>Growth Factor and Its Polymer Scaffold-Based Delivery System for Cartilage Tissue Engineering</p>

“…They can also be easily functionalized for enhanced retention, and targeting. 88 Filova et al developed a cell-free hyaluronate/ type I collagen/fibrin composite scaffold containing polyvinyl alcohol (PVA) nanofibers. After taking advantage of enriching liposomes encapsulating bFGF and insulin, a time-controlled release of these two factors was observed; and successful stimulation for the cartilage regeneration was seen in vitro and in vivo.…”