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Current Molecular Medicine 2021High incidence of articular cartilage defects is still a major challenge in orthopedic and trauma surgery worldwide. It also has great socioeconomic effects as it is the... (Review)
Review
High incidence of articular cartilage defects is still a major challenge in orthopedic and trauma surgery worldwide. It also has great socioeconomic effects as it is the major cause of disability in industrialized countries. This highlights the essential need for new treatments. Knowledge about the factors that have been implicated in the pathogenesis of cartilage diseases, including changes in the composition and structure of cartilaginous extracellular matrix (ECM), molecular factors and environmental signaling pathways could help the development of innovative therapeutic strategies. It is consensuses that the success of any technology aiming to repair chondral defects will be dependent upon its ability to produce tissues that most closely replicate the mechanical and biochemical properties of native cartilage. Increasing the knowledge about cartilage tissue and its molecular biomarkers could help find new and useful therapeutic approaches in cartilage damage. This review tries to describe cartilage tissue biology in detail and discuss different available therapeutic modalities with their pros and cons. New cartilage regeneration strategies and therapies, focusing on cellbased therapy and tissue engineering, and their underlying molecular and cellular bases will be pointed out as well.
Topics: Animals; Cartilage Diseases; Cartilage, Articular; Extracellular Matrix; Humans; Regeneration; Tissue Engineering; Tissue Scaffolds
PubMed: 32520688
DOI: 10.2174/1566524020666200610170646 -
Radiologie (Heidelberg, Germany) Apr 2023Acute and chronic cartilage injuries are often encountered in professional and recreational athletes. They can compromise the athlete's performance and career and are... (Review)
Review
BACKGROUND
Acute and chronic cartilage injuries are often encountered in professional and recreational athletes. They can compromise the athlete's performance and career and are considered a potential risk factor for early joint degeneration.
OBJECTIVES
Incidence of cartilage injury in athletes, understanding of cartilage composition, injury mechanism and suitable diagnostic imaging are summarized and established therapeutic procedures, postoperative imaging including detection of relevant complications and assessment of reasonable indications for follow-up examinations are described.
METHODS
Original research and review articles were analyzed.
RESULTS
Cartilage injury can mimic meniscal or ligamentous injury and cannot be ruled out by clinical examination alone. Magnetic resonance imaging (MRI) is the method of choice to (1) detect (sensitivity 87-93%, specificity 94-99%) and grade cartilage lesions to facilitate choice of therapy and (2) to exclude concomitant injuries that require treatment to improve the prognosis of the chosen cartilage therapy. Postoperatively MRI allows noninvasive assessment of the repaired cartilage tissue and is an appropriate method to detect therapeutically relevant complications.
CONCLUSIONS
Knowledge of mechanisms and appearance of cartilage injuries, current cartilage repair techniques and their imaging is crucial for the medical care of athletes.
Topics: Humans; Cartilage, Articular; Knee Joint; Knee Injuries; Cartilage Diseases; Athletes
PubMed: 36877296
DOI: 10.1007/s00117-023-01128-5 -
Biomedical Materials (Bristol, England) Jun 2021Articular cartilage has an avascular structure with a poor ability for self-repair; therefore, many challenges arise in cases of trauma or disease. It is of utmost... (Review)
Review
Articular cartilage has an avascular structure with a poor ability for self-repair; therefore, many challenges arise in cases of trauma or disease. It is of utmost importance to identify the proper biomaterial for tissue repair that has the capability to direct cell recruitment, proliferation, differentiation, and tissue integration by imitating the natural microenvironment of cells and transmitting an orchestra of intracellular signals. Cartilage extracellular matrix (cECM) is a complex nanostructure composed of divergent proteins and glycosaminoglycans (GAGs), which regulate many functions of resident cells. Numerous studies have shown the remarkable capacity of ECM-derived biomaterials for tissue repair and regeneration. Moreover, given the importance of biodegradability, biocompatibility, 3D structure, porosity, and mechanical stability in the design of suitable scaffolds for cartilage tissue engineering, demineralized bone matrix (DBM) appears to be a promising biomaterial for this purpose, as it possesses the aforementioned characteristics inherently. To the best of the authors' knowledge, no comprehensive review study on the use of DBM in cartilage tissue engineering has previously been published. Since so much work is needed to address DBM limitations such as pore size, cell retention, and so on, we decided to draw the attention of researchers in this field by compiling a list of recent publications. This review discusses the implementation of composite scaffolds of natural or synthetic origin functionalized with cECM or DBM in cartilage tissue engineering. Cutting-edge advances and limitations are also discussed in an attempt to provide guidance to researchers and clinicians.
Topics: Animals; Bone Substitutes; Bone and Bones; Cartilage, Articular; Decellularized Extracellular Matrix; Extracellular Matrix; Humans; Mice; Regeneration; Tissue Engineering
PubMed: 34102624
DOI: 10.1088/1748-605X/ac094b -
Bulletin of the Hospital For Joint... Mar 2024Osteochondral lesions (OCL) of the knee are a common pathology that can be challenging to address. Due to the innate characteristics of articular cartilage, OCLs... (Review)
Review
Osteochondral lesions (OCL) of the knee are a common pathology that can be challenging to address. Due to the innate characteristics of articular cartilage, OCLs generally do not heal in adults and often progress to involve the subchondral bone, ultimately resulting in the development of osteoarthritis. The goal of articular cartilage repair is to provide a long-lasting repair that replicates the biological and mechanical properties of articular cartilage, but there is no widely adopted technique that results in true pre-injury state hyaline cartilage. Current treatment modalities have seen reasonable clinical success, but significant limitations remain. Microfracture provides short-term benefit with a fibrocartilage-based repair. While osteochondral autograft or allograft and autologous chondrocyte implantation can be effective, each have their strengths and shortcomings. Emerging concepts in cartilage repair, including scaffold engineering and one stage cell-based options, are continually advancing. These have the benefits of reduced surgical morbidity and potentially improved integration with surrounding articular cartilage but have not yet reached widespread clinical application. Tissue engineering strategies and gene therapy have the potential to advance the field, however, they remain in the early stages. The current article reviews the structure and physiology of articular cartilage, the strengths and limitations of present treatment modalities, and the newer ongoing innovations that may change the way we approach osteochondral lesions and osteoarthritis.
Topics: Adult; Humans; Cartilage, Articular; Knee Joint; Osteoarthritis; Orthopedic Procedures
PubMed: 38431983
DOI: No ID Found -
Connective Tissue Research Sep 2017Osteoarthritis (OA) is a degenerative joint condition characterized by painful cartilage lesions that impair joint mobility. Current treatments such as lavage,... (Review)
Review
Osteoarthritis (OA) is a degenerative joint condition characterized by painful cartilage lesions that impair joint mobility. Current treatments such as lavage, microfracture, and osteochondral implantation fail to integrate newly formed tissue with host tissues and establish a stable transition to subchondral bone. Similarly, tissue-engineered grafts that facilitate cartilage and bone regeneration are challenged by how to integrate the graft seamlessly with surrounding host cartilage and/or bone. This review centers on current approaches to promote cartilage graft integration. It begins with an overview of articular cartilage structure and function, as well as degenerative changes to this relationship attributed to aging, disease, and trauma. A discussion of the current progress in integrative cartilage repair follows, focusing on graft or scaffold design strategies targeting cartilage-cartilage and/or cartilage-bone integration. It is emphasized that integrative repair is required to ensure long-term success of the cartilage graft and preserve the integrity of the newly engineered articular cartilage. Studies involving the use of enzymes, choice of cell source, biomaterial selection, growth factor incorporation, and stratified versus gradient scaffolds are therefore highlighted. Moreover, models that accurately evaluate the ability of cartilage grafts to enhance tissue integrity and prevent ectopic calcification are also discussed. A summary and future directions section concludes the review.
Topics: Aging; Animals; Cartilage, Articular; Humans; Osteoarthritis; Tissue Engineering; Wounds and Injuries
PubMed: 27599801
DOI: 10.1080/03008207.2016.1231180 -
Experimental & Molecular Medicine Nov 2022The mitochondrial unfolded protein response (UPR) is a mitochondrial-to-nuclear signaling pathway that is activated to maintain mitochondrial function when there is an...
The mitochondrial unfolded protein response (UPR) is a mitochondrial-to-nuclear signaling pathway that is activated to maintain mitochondrial function when there is an accumulation of misfolded proteins within mitochondria. Mitochondrial function is essential for chondrocyte homeostasis, and mitochondrial dysfunction is a characteristic of osteoarthritis (OA). However, the role of the UPR in OA remains unclear. In the present study, the level of the UPR was examined in primary mouse chondrocytes subjected to different stresses and in the articular cartilage of OA model mice and OA patients. The relationship between UPR activation and OA progression was studied. The UPR was induced in primary mouse chondrocytes subjected to diverse stresses and in the cartilage of OA mice. Enhancement of the UPR with nicotinamide riboside (NR) significantly improved mitochondrial function, reduced chondrocyte death, attenuated OA pain, and ameliorated OA progression, and the protective effects decreased significantly in chondrocyte-specific Atf5 knockout (ATF5Col2a1-CreER) mice. UPR induction was also identified in the articular cartilage of OA patients and was associated with reduced chondrocyte death, less severe hip pain, and lower levels of inflammation in synovial fluid. These findings identify the induction of the UPR in primary mouse chondrocytes exposed to pathological stresses and in the articular cartilage of OA model mice and OA patients. Enhancement of the UPR ameliorates OA progression, suggesting that the UPR exerts a protective effect against OA and may be a potential diagnostic and therapeutic strategy for OA.
Topics: Mice; Animals; Unfolded Protein Response; Osteoarthritis; Chondrocytes; Cartilage, Articular; Pain
PubMed: 36380018
DOI: 10.1038/s12276-022-00885-y -
Matrix Biology : Journal of the... Oct 2014Limb synovial joints are intricate structures composed of articular cartilage, synovial membranes, ligaments and an articular capsule. Together, these tissues give each... (Review)
Review
Limb synovial joints are intricate structures composed of articular cartilage, synovial membranes, ligaments and an articular capsule. Together, these tissues give each joint its unique shape, organization and biomechanical function. Articular cartilage itself is rather complex and organized in distinct zones, including the superficial zone that produces lubricants and contains stem/progenitor cells. For many years there has been great interest in deciphering the mechanisms by which the joints form and come to acquire such unique structural features and diversity. Decades ago, classic embryologists discovered that the first overt sign of joint formation at each prescribed limb site was the appearance of a dense and compact population of mesenchymal cells collectively called the interzone. Work carried out since then by several groups has provided evidence that the interzone cells actively participate in joint tissue formation over developmental time. This minireview provides a succinct but comprehensive description of the many important recent advances in this field of research. These include studies using various conditional reporter mice to genetically trace and track the origin, fate and possible function of joint progenitor cells; studies on the involvement and roles in signaling pathways and transcription factors in joint cell determination and functioning; and studies using advanced methods of gene expression analyses to uncover novel genetic determinants of joint formation and diversity. The overall advances are impressive, and the findings are not only of obvious interest and importance but also have major implications in the conception of future translational medicine tools to repair and regenerate defective, overused or aging joints.
Topics: Animals; Cartilage, Articular; Cell Differentiation; Chondrogenesis; Embryonic Stem Cells; Humans; Joint Capsule; Joints; Morphogenesis
PubMed: 25172830
DOI: 10.1016/j.matbio.2014.08.006 -
The Journal of Knee Surgery Jan 2021The return to play outcome is an important measure for orthopaedic sports medicine treatments. This variable is especially important when discussing cartilage treatments... (Review)
Review
The return to play outcome is an important measure for orthopaedic sports medicine treatments. This variable is especially important when discussing cartilage treatments because there are many different cartilage options available to athletes with articular injuries and this population is particularly interested in the ability to return to activities. Although many outcome variables are considered in any surgical procedure, the return-to-sport variable is focused on an active population and can be tailored to that patient's sport-specific goals. In this article, we will review some of the most recent and up-to-date articles describing return-to-sport outcomes for various knee cartilage treatments. This article will focus on the most common current knee cartilage treatments including microfracture, autologous chondrocyte implantation, osteochondral autograft transplant, and osteochondral allograft transplantation.
Topics: Arthroplasty, Subchondral; Athletic Injuries; Bone Transplantation; Cartilage, Articular; Chondrocytes; Humans; Intra-Articular Fractures; Knee Injuries; Knee Joint; Return to Sport; Transplantation, Autologous; Transplantation, Homologous
PubMed: 33389739
DOI: 10.1055/s-0040-1721669 -
Clinics in Podiatric Medicine and... Jan 2015Hyaline cartilage is avascular in nature, relying on surrounding synovial fluid for its nutrient supply. Lacking an inflammatory response, hyaline cartilage is unable to... (Review)
Review
Hyaline cartilage is avascular in nature, relying on surrounding synovial fluid for its nutrient supply. Lacking an inflammatory response, hyaline cartilage is unable to be repaired itself after injury. BMS technique allows reparative cartilage to be produced, taking the form of fibrocartilage. Fibrocartilage is weaker than hyaline cartilage. Various cartilage allograft materials are available for reparative techniques. The cartilage allograft materials discussed herein include fresh allograft transplantation, ACEM, and particulated juvenile articular cartilage.
Topics: Allografts; Cartilage Diseases; Cartilage, Articular; Extracellular Matrix; Guided Tissue Regeneration; Humans; Tissue Transplantation
PubMed: 25440420
DOI: 10.1016/j.cpm.2014.09.012 -
Tissue Engineering. Part B, Reviews Dec 2015Articular cartilage is the load-bearing tissue found inside all articulating joints of the body. It vastly reduces friction and allows for smooth gliding between... (Review)
Review
Articular cartilage is the load-bearing tissue found inside all articulating joints of the body. It vastly reduces friction and allows for smooth gliding between contacting surfaces. The structure of articular cartilage matrix and cellular composition is zonal and is important for its mechanical properties. When cartilage becomes injured through trauma or disease, it has poor intrinsic healing capabilities. The spectrum of cartilage injury ranges from isolated areas of the joint to diffuse breakdown and the clinical appearance of osteoarthritis. Current clinical treatment options remain limited in their ability to restore cartilage to its normal functional state. This review focuses on the evolution of biomaterial scaffolds that have been used for functional cartilage tissue engineering. In particular, we highlight recent developments in multiscale biofabrication approaches attempting to recapitulate the complex 3D matrix of native articular cartilage tissue. Additionally, we focus on the application of these methods to engineering each zone of cartilage and engineering full-thickness osteochondral tissues for improved clinical implantation. These methods have shown the potential to control individual cell-to-scaffold interactions and drive progenitor cell differentiation into a chondrocyte lineage. The use of these bioinspired nanoengineered scaffolds hold promise for recreation of structure and function on the whole tissue level and may represent exciting new developments for future clinical applications for cartilage injury and restoration.
Topics: Animals; Biomimetic Materials; Cartilage, Articular; Cell Differentiation; Extracellular Matrix; Humans; Osteoarthritis; Stem Cells; Tissue Engineering
PubMed: 26200439
DOI: 10.1089/ten.TEB.2015.0142