Regeneration of Articular Cartilage: Opportunities, Challenges, and Perspectives

Regeneration of Articular Cartilage: Opportunities, Challenges, and Perspectives

Ali Mobasheri (University of Nottingham, UK)
DOI: 10.4018/978-1-4666-2506-8.ch007
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Abstract

This chapter reviews the structure and function of articular cartilage and the pathogenesis of Osteoarthritis (OA) before exploring the challenges associated with cartilage repair and regeneration. Surgical techniques for cartilage repair are critically reviewed and special emphasis is placed upon arthroscopic lavage and debridement, microfracture, bone marrow stimulation, and autologous osteochondral allografting. Biomimetic models of cartilage relevant to cartilage regeneration and tissue engineering research are reviewed along with microenvironmental approaches that preserve the chondrocyte phenotype using a combination of biomimetic 3-dimensional cell culture systems and growth factor supplementation. Future refinement of tissue-engineering approaches for cartilage repair will benefit significantly from advances in cell-based repair strategies. The authors provide their own perspectives by highlighting and prioritizing areas for future investigation.
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Structure And Function Of Articular Cartilage

Articular cartilage (also known as hyaline cartilage) is a tough yet flexible and mechanically compliant connective tissue. It is a load-bearing tissue with unique biological and biomechanical characteristics (Figure 1).

Figure 1.

Histology of articular cartilage. a) This figure illustrates a sample of human cartilage from a tissue microarray developed by the cooperative human tissue network (CHTN) of the National Cancer Institute (http://www.chtn.nci.nih.gov/). Cartilage is predominantly an avascular, aneural and alymphatic load-bearing connective tissue consisting of a single cell type known as the chondrocyte. Chondrocytes are cytoplasmically isolated and their energy requirements are derived through glycolysis (Archer & Francis-West, 2003). They possess a high matrix/cell volume ratio. They do not divide after skeletal maturity unless the cartilage becomes diseased. Blood vessels are only present in subchondral bone. The unicellular nature of cartilage and the absence of blood vessels, nerves, and lymph vessels highlight its architecturally simple design, making it particularly attractive for tissue engineering and regenerative medicine. b) Superficial zone of equine articular cartilage. c) Middle zone of equine articular cartilage. The sections are 7 μm thick and were stained with hematoxylin and eosin.

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