Cartilage Engineering: Current Status and Future Trends
Articular cartilage provides the surface of articulating joints with frictionless movement while absorbing loading forces. The tissue’s extracellular matrix (ECM) is comprised mainly of type II collagen and proteoglycans which are maintained by chondrocyt
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Emily E. Coates and John P. Fisher
Contents 10.1
Cartilage Tissue: Structure, Function, and Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280 10.1.1 Cellular and Extracellular Matrix Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280 10.1.2 Proper Tissue Function and Response to Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282 10.1.3 Aged and Damaged Tissue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 284 10.1.4 Need for Repair and Regeneration Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285 10.2 Current Standards of Care and Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 10.2.1 Current Treatments in Cartilage Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 10.2.2 Limitations of Current Standard Practices and Need for Engineering Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 10.3 Cartilage Engineering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290 10.3.1 Requirements of an Engineered Construct . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290 10.3.2 Biomaterials and Cells for Cartilage Engineering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 10.3.3 Engineered Constructs in Clinical Trials and Early Applications . . . . . . . . . . . . . . 294 10.3.4 Current Research Efforts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296 10.4 Future Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298 10.4.1 Zonal Cartilage Engineering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298 10.4.2 Stem Cells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299 10.4.3 Dynamic Culture Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Abstract Articular cartilage provides the surface of articulating joints with frictionless movement while absorbing loading forces. The tissue’s extracellular matrix (ECM) is comprised mainly of type II collagen and proteoglycans which are maintained by chondrocytes, the resident cell population. Cartilage is a structurally complex tissue, with zones that exhibit different cell morphologies and extracellular matrix structure depending on distance from the articulating surface. The
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