RESUMO
BACKGROUND: Although desired cartilage repair has been realized via tissue engineering technology, these achievements mainly focus on small-size defect under a normal physical condition. However, cartilage defects are always accompanied by the underlying diseases in clinical practice, such as osteoarthritis and rheumatoid arthritis. Meanwhile, the location, scope, and depth of cartilage defects are uncertain, which brings a great challenge in cartilage tissue repair. OBJECTIVE: To summarize the methods of repairing articular cartilage defects at different locations and under inflammatory condition. METHODS: We searched PubMed and CNKI with the search terms “cartilage defect regeneration, osteochondral, growth plate, weight-bearing area, inflammatory” in Chiense and English to retrieve related papers published before March 2019. A total of 209 papers were retrieved and 86 were included in the final analysis according to inclusion and exclusion criteria. RESULTS AND CONCLUSION: For articular cartilage defects under different special conditions, the repair goals and strategies are different. For repair of full-layer cartilage defects and osteochondral structure defects, multi-layered scaffolds are often used to repair the unique stratified cartilage structure and subchondral bone structure, while avoiding the problem of heterotopic ossification in neonatal cartilage. To avoid deformity after long bone maturation, growth factors such as insulin-like growth factor and bone morphogenetic protein 7 should be added to continuously stimulate the repair of the growth plate and promote bone growth. For cartilage repair in the weight-bearing area, the scaffolds should have good mechanical property, which ensure not to undergo severe deformation and structural damage when loaded. In addition, the new cartilage tissue has sufficient mechanical strength to support sustained longitudinal pressure and wear. For cartilage defects in the inflammatory state, both inflammation management and cartilage defect repair should be considered, and introduction of mesenchymal stem cells can regulate immune function and promote tissue regeneration, such that articular cartilage defect can be completely repaired.
RESUMO
Osteoarthritis is a chronic progressive disease characterized by cartilage degenerative diseases. Due to the lack of vascular supply of articular cartilage and poor regeneration of chondrocytes, it is difficult to repair the cartilage with degenerative wear. A large number of studies have confirmed that bone marrow mesenchymal stem cells, adipose-derived mesenchymal stem cells, umbilical cord blood mesenchymal stem cells, umbilical cord mesenchymal stem cells, synovial mesenchymal stem cells, osteoarthritis joint fluid-derived mesenchymal stem cells, etc. can be effective to relieve osteoarthritis and repair damaged cartilage. Mesenchymal stem cells can directly differentiate into chondrocytes under appropriate microenvironment, and they also have immunosuppressive, anti-inflammatory and paracrine effects. In this paper, the research progress of basic experiments and clinical application of mesenchymal stem cells from different sources in osteoarthritis is reviewed to better promote the research progress of stem cell therapy for osteoarthritis.
RESUMO
We repaired articular cartilage defect in 13 cases using free periosteal autografting. and followed up for 15～29 months with average of 22.4 months. Good results were obtained in 76.9%. The operation method and factors of influencing free periosteal autografting are discussed in the paper.