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Review
. 2018 Aug 11;19(8):2366.
doi: 10.3390/ijms19082366.

Repair of Damaged Articular Cartilage: Current Approaches and Future Directions

Ekaterina V Medvedeva  1 , Ekaterina A Grebenik  2 , Svetlana N Gornostaeva  3 , Vladimir I Telpuhov  4 , Aleksey V Lychagin  5 , Peter S Timashev  6   7   8 , Andrei S Chagin  9   10
Affiliations
Review

Repair of Damaged Articular Cartilage: Current Approaches and Future Directions

Ekaterina V Medvedeva et al. Int J Mol Sci. .

Abstract

Articular hyaline cartilage is extensively hydrated, but it is neither innervated nor vascularized, and its low cell density allows only extremely limited self-renewal. Most clinical and research efforts currently focus on the restoration of cartilage damaged in connection with osteoarthritis or trauma. Here, we discuss current clinical approaches for repairing cartilage, as well as research approaches which are currently developing, and those under translation into clinical practice. We also describe potential future directions in this area, including tissue engineering based on scaffolding and/or stem cells as well as a combination of gene and cell therapy. Particular focus is placed on cell-based approaches and the potential of recently characterized chondro-progenitors; progress with induced pluripotent stem cells is also discussed. In this context, we also consider the ability of different types of stem cell to restore hyaline cartilage and the importance of mimicking the environment in vivo during cell expansion and differentiation into mature chondrocytes.

Keywords: articular hyaline cartilage; autologous chondrocyte implantation (ACI); cell-based therapy; matrix-induced autologous chondrocyte implantation (MACI); micro-fracture; mosaicplasty; regenerative medicine approaches; stem cells; tissue-engineered constructs.

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Conflict of interest statement

The authors declare no conflict of interest. The funding agencies played no role in the design, writing, or publication of the manuscript.

Figures

Figure 1
Figure 1
Structure of human articular cartilage. Articular cartilage from a 57-year-old man is stained with Safranin O/Fast Green (images were made by E. V. Medvedeva).
Figure 2
Figure 2
Illustration of approaches to the restoration of cartilage. Abbreviations: autologous chondrocyte implantation (ACI); matrix-induced autologous chondrocyte implantation (MACI); mesenchymal stem cells (MSCs); embryonic stem cells (ESCs); induced pluripotent stem cells (iPSCs); chondrogenic stem/progenitor cells (CSPCs).
Figure 3
Figure 3
Illustration of the clinically approved approaches to restoration of cartilage tissue.
See this image and copyright information in PMC

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