Review
Major biological obstacles for persistent cell-based regeneration of articular cartilage
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* Corresponding author: Andre F Steinert a-steinert.klh@mail.uni-wuerzburg.de
1 Orthopaedic Center for Musculoskeletal Research, König-Ludwig-Haus, Julius-Maximilians-University, Würzburg, Germany
2 Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
3 Institut für Virologie und Immunbiologie, Julius-Maximilians-University, Würzburg, Germany
4 Cartilage Biology and Orthopaedics Branch, National Institute of Arthritis, and Musculoskeletal and Skin Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
5 Center for Molecular Orthopaedics, Harvard Medical School, Boston, MA, USA
Arthritis Research & Therapy 2007, 9:213 doi:10.1186/ar2195
Published: 5 June 2007Abstract
Hyaline articular cartilage, the load-bearing tissue of the joint, has very limited repair and regeneration capacities. The lack of efficient treatment modalities for large chondral defects has motivated attempts to engineer cartilage constructs in vitro by combining cells, scaffold materials and environmental factors, including growth factors, signaling molecules, and physical influences. Despite promising experimental approaches, however, none of the current cartilage repair strategies has generated long lasting hyaline cartilage replacement tissue that meets the functional demands placed upon this tissue in vivo. The reasons for this are diverse and can ultimately result in matrix degradation, differentiation or integration insufficiencies, or loss of the transplanted cells and tissues. This article aims to systematically review the different causes that lead to these impairments, including the lack of appropriate differentiation factors, hypertrophy, senescence, apoptosis, necrosis, inflammation, and mechanical stress. The current conceptual basis of the major biological obstacles for persistent cell-based regeneration of articular cartilage is discussed, as well as future trends to overcome these limitations.