Clinical application of scaffolds for cartilage tissue engineering

Abstract

The purpose of this paper is to review the basic science and clinical literature on scaffolds clinically available for the treatment of articular cartilage injuries. The use of tissue-engineered grafts based on scaffolds seems to be as effective as conventional ACI clinically. However, there is limited evidence that scaffold techniques result in homogeneous distribution of cells. Similarly, few studies exist on the maintenance of the chondrocyte phenotype in scaffolds. Both of which would be potential advantages over the first generation ACI. The mean clinical score in all of the clinical literature on scaffold techniques significantly improved compared with preoperative values. More than 80% of patients had an excellent or good outcome. None of the short-or mid-term clinical and histological results of these tissue-engineering techniques with scaffolds were reported to be better than conventional ACI. However, some studies suggest that these methods may reduce surgical time, morbidity, and risks of periosteal hypertrophy and post-operative adhesions. Based on the available literature, we were not able to rank the scaffolds available for clinical use. Firm recommendations on which cartilage repair procedure is to be preferred is currently not known on the basis of these studies. Randomized clinical trials and longer follow-up periods are needed for more widespread information regarding the clinical effectiveness of scaffold-based, tissue-engineered cartilage repair.

Repair of articular cartilage defects in rabbits through tissue-engineered cartilage constructed with chitosan hydrogel and chondrocytes

“…This technique reconstructed living tissue by associating cells with threedimensional biomaterials which provided a scaffold for cells to proliferate under physiological conditions (Iwasa et al, 2009). The application of new materials in tissue-engineered scaffolds has received much more and more attention (Fong et al, 2012;Mallick and Cox, 2013).…”

Application of cell and biomaterial-based tissue engineering methods in the treatment of cartilage, menisci and ligament injuries

“…Collagen as the major component of cartilage, menisci as well as the ligaments and ECM has long been used in TE as a natural biomaterial [58,59]. Nowadays, a wide range of collagen-based biomaterials are commercially available.…”

Cell Therapy and Tissular Engeenering to Regenerate Articular Cartilage

“…Recent research efforts have focused on tissue engineering as a promising approach for cartilage regeneration and repair (Kuo et al, 2006). Tissue engineering is a technique by which a living tissue can be reconstructed by associating the cells with biomaterials that provide a scaffold on which they can proliferate three-dimensionally, under physiological conditions (Iwasa et al, 2009). A biomaterial is any pharmacologically inert compound designed to be implanted or incorporated into the living system.…”

“…A number of scaffolds have been developed and investigated, in vitro and in vivo, for potential use in tissue engineering and in particular for in vitro regeneration of cartilage tissues (Vinatier et al, 2009). Carries have been marketed and various tissue-engineering techniques have been developed using chondrocytes seeded on biological matrices (Iwasa et al, 2009). For cartilage tissue engineering, scaffolding has been fabricated from both natural and synthetic polymers (Tuli et al, 2003), such as fibrous structures, porous sponges, woven or non-woven meshes and hydrogels (Kuo et al, 2006).…”

“…Collagen and hyaluronan-based matrices are among the most popular natural scaffolds in clinical use nowadays, since they contain natural components of the hyaline cartilage. On the contrary, there is no clinical experience using scaffolds such as alginate, agarose and chitosan (Iwasa et al, 2009). Within each kind of biomaterial (natural and synthetic) there are many types of biomaterials that are being studied, with controversial results.…”