Cell-based Approaches to Joint Surface Repair: A Research Perspective

A. J. Roelofs, J. P. J. Rocke, C. De Bari

Research output: Contribution to journalReview article

56 Citations (Scopus)
6 Downloads (Pure)

Abstract

Repair of lesions of the articular cartilage lining the joints remains a major clinical challenge. Surgical interventions include osteochondral autograft transfer and microfracture. They can provide some relief of symptoms to patients, but generally fail to durably repair the cartilage. Autologous chondrocyte implantation has thus far shown the most promise for the durable repair of cartilage, with long-term follow-up studies indicating improved structural and functional outcomes. However, disadvantages of this technique include the need for additional surgery, availability of sufficient chondrocytes for implantation, and maintenance of their phenotype during culture-expansion. Mesenchymal stem cells offer an attractive alternative cell-source for cartilage repair, due to their ease of isolation and amenability to ex vivo expansion while retaining stem cell properties. Preclinical and clinical studies have demonstrated the potential of mesenchymal stem cells to promote articular cartilage repair, but have also highlighted several key challenges. Most notably, the quality and durability of the repair tissue, its resistance to endochondral ossification, and its effective integration with the surrounding host tissue. In addition, challenges exist related to the heterogeneity of mesenchymal stem cell preparations and their quality-control, as well as optimising the delivery method. Finally, as our knowledge of the cellular and molecular mechanisms underlying articular cartilage repair increases, promising studies are emerging employing bioactive scaffolds or therapeutics that elicit an effective tissue repair response through activation and mobilisation of endogenous stem and progenitor cells.
Original languageEnglish
Pages (from-to)892-900
Number of pages9
JournalOsteoarthritis and Cartilage
Volume21
Issue number7
Early online date15 Apr 2013
DOIs
Publication statusPublished - Jul 2013

Keywords

  • cartilage
  • osteoarthritis
  • cell therapy
  • mesenchymal stem cell
  • chondrocyte

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