Clinical Results of Transplantation of Tissue-Engineered Cartilage and Future Direction of Cartilage Repair: Novel Approach with Minimally Invasive Procedure

ABSTRACT

Articular cartilage has very limited potential to spontaneously heal, because it lacks vessels and is isolated from systemic regulation. No treatment has repaired the defects with long-lasting hyaline cartilage. Recently, a regenerative medicine by a tissue-engineering technique for cartilage repair has been given much attention in the orthopaedic field. In 1994, Brittberg et al. introduced a new technology in which chondrocytes expanded in monolayer culture were transplanted into the cartilage defect of the knee. As a second generation of chondrocyte transplantation, we have been performing transplantation of tissue-engineered cartilage made ex vivo for the treatment of osteochondral defects of the joints since 1996. This signifies a concept shift from cell transplantation to tissue transplantation made ex vivo using tissue-engineering technique. We have reported good clinical results with this surgical treatment. However, extensive basic research is vital to achieve better clinical results with this tissue-engineering technique. I would like to describe our recent research using a minimally invasive tissue-engineering technique to promote cartilage regeneration.