Generating autogenous cartilage on the basis of subperichondrial grafts of demineralized bone matrix with local stimulation by growth factors.

Cartilage tissue acquired de novo is a very attractive material for the surgical reconstruction of joint surfaces, trachea, and maxillofacial elements. One of the primary challenges for tissue engineering is to determine the procedures that lead to the creation of material meeting the established qualitative and quantitative criteria. The goal of this work was to determine whether and how growth factors (IGF-1 and FGF) and ethyl alcohol administered locally affect the course and final outcome of the chondrogenetic process under in vitro conditions in New Zealand rabbits. In order to generate cartilage, a collagen scaffold (demineralized ZMK bone matrix) was used, wrapped in a pedunculated flap of perichondrium (from the rabbit's ear), which, beginning on the 3rd day after the operation, was injected with growth factors every 3 days. Grafts were collected in the 3rd and 6th week after the ZMK implantation, and the silvers made from them were stained for the presence of collagen II, collagen I, and macrophages, and analyzed morphometrically. It was found that the application of growth factors only slighty, intensified the synthesis of collagen II, and had no effect on the degree of macrophage infiltration or collagen I contents, while the numerous injections exerted a negative impact on the architecture of the newly-formed tissue and contributed to an increased number of complications (hematomas, infections).

Tissue engineering in reconstructive surgery of bone and cartilage.

Molecular research has Bern the subject of considerable interest in recent years. The same can also be said for tissue engineering, which has ushered us into a world previously accessible only in science fiction. The possibility of creating human tissue opens the road for reconstructive surgery using biologically matched grafts. Some of the tissue engineering methods that pertain to orthopedics have already found application in the clinic. Among these are operations to reconstruct defects of joint cartilage, based on the in vitro multiplication of chondrocytes isolated from cartilage fragments previously collected arthroscopically. By applying tissue engineering technology we will soon be able to culture the patient's own bone tissue needed to fill defects in the bone bed. At some point in the not too distant future we will be able to graft entire joint ends, instead of the joint endoprosthesoplastic procedures currently in use. Tissue engineering, like every new field of science, prompts emotional reactions not only in medical circles, but also in many social groups. Let us hoper for fulfillment of the anticipation that a way will be found to overcome disabilities involving the locomotor apparatus.
The authors, who come from varying theoretical and clinical settings, present a short history of tissue engineering, based on their own experience and the available literature, the current possibilities to use tissue engineering in the reconstruction of bone and cartilage, and the prospects for development in the field in the near future.