Cartilage Repair Using Mesenchymal Stem Cells

ABSTRACT

Articular cartilage defect rarely heals spontaneously due to its avascularity and low cellularity. Even small articular cartilage defects can develop into osteoarthritis, and subsequently, its management has been a major clinical concern. Although there are several treatment options for cartilage defect, no treatment has been established as a gold standard procedure. Bone marrow stimulation techniques which is equivalent to microfracture these days has been adapted as first line treatment, attributed to their technical easiness and minimal invasiveness to patients. However, this procedure has limitation in reproducing hyaline cartilage, so recent cell-based therapies using autologous chondrocytes or mesenchymal stem cells have drawn particular attention. MSCs regardless of its origin have shown significant potential for chondrogenesis. Novel approaches using MSCs as an alternative cell source for patient derived chondrocytes are currently on trial. In this review, stem cells from various origins considered as cell sources and potential application of mesenchymal stem cells to promote cartilage repair will be discussed. While differentiation of stem cell can be well controlled in vitro, it is not easy to predict the course of differentiation when the stem cell is transplanted. Some novel methods using physical stimulation and material based techniques for differentiation control are introduced in this context. Such differentiation control will be beneficial when it is adapted before transplantation. We call it preconditioning.