1000/1000
Hot
Most Recent
Cartilage is frequently damaged with a limited capacity for repair. Current treatment strategies are insufficient as they form fibrocartilage as opposed to hyaline cartilage, and do not prevent the progression of degenerative changes. There is increasing interest in the use of autologous mesenchymal stem cells (MSC) for tissue regeneration. MSCs that are used to treat articular cartilage defects must not only present a robust cartilaginous production capacity, but they also must not cause morbidity at the harvest site. In addition, they should be easy to isolate from the tissue and expand in culture without terminal differentiation. The source of MSCs is one of the most important factors that may affect treatment. The infrapatellar fat pad (IPFP) acts as an important reservoir for MSC and is located in the anterior compartment of the knee joint in the extra-synovial area.
Technique | Effect | Reference |
---|---|---|
Non-operative Methods | Pharmacotherapy drugs (steroidal and non-steroid anti-inflammatory drugs, glucosamine, chondroitin sulphates, etc.) to control symptoms | [9] |
Abrasion Arthroplasty | Creation of a rough surface in the damaged area in order to form fibrocartilage (subchondral bone is not directly accessed) | [10] |
Arthroscopic Debridement | Removal of the damaged part of the tissue, allowing the subchondral bone to initiate the healing process | [11] |
Autologous Chondrocyte Implantation (ACI) | Transplantation of isolated and expanded chondrocytes from healthy cartilage to the defected area | [12] |
Chondroplasty | Utilizes laser or radiofrequency-based probes to smooth the damaged edges of cartilage | [13] |
Matrix-assisted ACI (MACI) | Isolated and expanded autologous chondrocytes are combined with a scaffold which is implanted into the defect site | [14] |
Microfracture (subchondral drilling) | Subchondral bone is stimulated by drilling, allowing the bone marrow MSCs to migrate to the damaged area and form fibrocartilage | [15] |
Mosaicplasty | Osteochondral autografts or allografts are transferred from a donor site to the defect site | [16] |
Adipose Tissue-Derived MSCs | Bone Marrow-Derived MSCs | Umbilical Cord-Derived MSCs | |
---|---|---|---|
Ease of Harvest and Isolation | +++ | + | ++ |
Amounts of Tissue Obtained | +++ | ++ | + |
Capacity for Proliferation and Colony Formation | ++ | + | +++ |
Maintenance of Function Irrespective of Donor Age | ++ | + | +++ |
Suitability for Soft Tissue Regeneration (e.g., skin, cartilage, etc.) | +++ | ++ | + |
Suitability for Hard Tissue Re-generation (e.g., bone, tooth, etc.) | + | ++ | +++ |