Department of Orthopedics, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
Nat Rev Rheumatol. 2009 Nov;5(11):599-607. doi: 10.1038/nrrheum.2009.204. Epub 2009 Sep 29.
Lesions in articular cartilage can result in significant musculoskeletal morbidity and display unique biomechanical characteristics that make repair difficult, at best. Several surgical procedures have been devised in an attempt to relieve pain, restore function, and delay or stop the progression of cartilaginous lesions. Advanced MRI and ultrasonography protocols are currently used in the evaluation of tissue repair and to improve diagnostic capability. Other nonoperative modalities, such as injection of intra-articular hyaluronic acid or supplementary oral glucosamine and chondroitin sulfate, have shown potential efficacy as anti-inflammatory and symptom-modifying agents. The emerging field of tissue engineering, involving the use of a biocompatible, structurally and mechanically stable scaffold, has shown promising early results in cartilage tissue repair. Scaffolds incorporating specific cell sources and bioactive molecules have been the focus in this new exciting field. Further work is required to better understand the behavior of chondrocytes and the variables that influence their ability to heal articular lesions. The future of cartilage repair will probably involve a combination of treatments in an attempt to achieve a regenerative tissue that is both biomechanically stable and, ideally, identical to the surrounding native tissues.
关节软骨损伤可导致严重的肌肉骨骼疾病，并表现出独特的生物力学特征，使得修复变得非常困难。为了缓解疼痛、恢复功能以及延缓或阻止软骨损伤的进展，已经设计了几种手术方法。目前，高级 MRI 和超声检查方案用于评估组织修复情况并提高诊断能力。其他非手术方法，如关节内注射透明质酸或补充口服葡萄糖胺和硫酸软骨素，已显示出作为抗炎和症状改善剂的潜在疗效。组织工程学这一新兴领域涉及使用生物相容性、结构和机械稳定的支架，在软骨组织修复方面取得了有希望的早期结果。支架中包含特定的细胞来源和生物活性分子，这是这一令人兴奋的新领域的重点。需要进一步的工作来更好地了解软骨细胞的行为以及影响其修复关节损伤能力的变量。软骨修复的未来可能涉及多种治疗方法的组合，以试图获得一种生物力学稳定的再生组织，并且在理想情况下与周围的天然组织相同。
