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Review
. 2011 Oct;469(10):2706-15.
doi: 10.1007/s11999-011-1857-3.

The role of growth factors in cartilage repair

Lisa A Fortier  1 , Joseph U Barker, Eric J Strauss, Taralyn M McCarrel, Brian J Cole
Affiliations
Review

The role of growth factors in cartilage repair

Lisa A Fortier et al. Clin Orthop Relat Res. 2011 Oct.

Abstract

Background: Full-thickness chondral defects and early osteoarthritis continue to present major challenges for the patient and the orthopaedic surgeon as a result of the limited healing potential of articular cartilage. The use of bioactive growth factors is under consideration as a potential therapy to enhance healing of chondral injuries and modify the arthritic disease process.

Questions/purposes: We reviewed the role of growth factors in articular cartilage repair and identified specific growth factors and combinations of growth factors that have the capacity to improve cartilage regeneration. Additionally, we discuss the potential use of platelet-rich plasma, autologous-conditioned serum, and bone marrow concentrate preparations as methods of combined growth factor delivery.

Methods: A PubMed search was performed using key words cartilage or chondrocyte alone and in combination with growth factor. The search was open for original manuscripts and review papers and open for all dates. From these searches we selected manuscripts investigating the effects of growth factors on extracellular matrix synthesis and excluded those investigating molecular mechanisms of action.

Results: By modulating the local microenvironment, the anabolic and anticatabolic effects of a variety of growth factors have demonstrated potential in both in vitro and animal studies of cartilage injury and repair. Members of the transforming growth factor-β superfamily, fibroblast growth factor family, insulin-like growth factor-I, and platelet-derived growth factor have all been investigated as possible treatment augments in the management of chondral injuries and early arthritis.

Conclusions: The application of growth factors in the treatment of local cartilage defects as well as osteoarthritis appears promising; however, further research is needed at both the basic science and clinical levels before routine application.

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Figures

Fig. 1
Fig. 1
Bone marrow concentrate (BMC) enhances articular cartilage regeneration. In an equine model of 15 mm diameter, full-thickness cartilage defects on the lateral trochlear ridge of the femur, BMC resulted in improved cartilage tissue formation at 8 months compared with microfracture treated defects.
Fig. 2A–C
Fig. 2A–C
Clinical application of bone marrow concentrate (BMC) to treat a (A) large medial femoral condylar osteochondral cyst (arrows). Arthroscopic image (B) of the cyst after débridement and (C) transarthroscopic BMC administration under gas arthroscopy using an 18-gauge spinal needle.
See this image and copyright information in PMC

References

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