Cell and Tissue Transplant Strategies for Joint Lesions

Abstract

Articular cartilage lesions that do not disrupt the integrity of subchondral bone are not capable of spontaneous repair. The asymptomatic nature of these lesions leads to articular cartilage degeneration and development of the osteoarthritic process. To avoid joint replacement surgery, several cellular therapies have been developed. These therapies focus on the regeneration of a new tissue, whose structure, biochemistry composition and function should be the same as those of endogenous articular cartilage. Current approaches for interrupting the osteoarthritic process produce a fibrocartilaginous tissue, not articular cartilage. The implantation of autologous chondrocytes and autologous mosaicplasty induces a better quality of articular cartilage; however, both techniques damage the existing cartilage because of the need to harvest large numbers of chondrocytes or to extract an osteochondral cylinder for implantation. While stem cells are a promising tool for repairing articular cartilage, their use is in an early experimental stage at this time. Although studies of cell therapy have shown clinical and functional improvement in joints, the ability to regenerate articular cartilage that resists the degeneration process remains elusive.

Biotechnological Chondroitin a Novel Glycosamminoglycan With Remarkable Biological Function on Human Primary Chondrocytes

“…Cartilage injuries are highly prevalent in both young and elderly patient populations; hormonal, genetic, and inflammatory factors are known to increase the risk of osteoarthritis and influence the course of the disease. Cell‐based cartilage tissue engineering could provide permanent solutions in therapeutic applications to treat cartilage lesions and osteo‐chondral pathologies [Saadeh et al, ; Fuentes‐Boquete et al, ; Do Amaral et al, ]. Advances in alternative approaches, such as the optimization of chondrocyte isolation and characterization in vitro, represent the potential prospective to translate the in vitro models of cartilage regeneration into clinical practice [Shafiee et al, ; Oseni et al, ].…”

Ovine Mesenchymal Stromal Cells: Morphologic, Phenotypic and Functional Characterization for Osteochondral Tissue Engineering

“…This agrees with clinical studies that demonstrate that cartilage repair is a slow process [ 65 ]. However, longer culture times considerably increase the risk of culture contamination and cartilage degradation [ 66 ]. Likewise, the absence of mechanical stimuli may impact adversely on the quality of newly formed repair tissue.…”

Human amniotic membrane as an alternative source of stem cells for regenerative medicine

“…Articular cartilage receives its nourishment through diffusion from the synovial fluid. The capacity for the self-repair of articular cartilage is very limited, mainly because it is an avascular tissue (Steinert et al, 2007, Mankin, 1982, Resinger et al, 2004and Fuentes-Boquete et al, 2008. Consequently, progenitor cells in blood and marrow cannot enter the damaged region to influence or contribute to the reparative process (Steinert et al, 2007).…”