Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.
Cell Tissue Res. 2012 Mar;347(3):613-27. doi: 10.1007/s00441-011-1243-1. Epub 2011 Oct 27.
Osteoarthritis is a degenerative joint disease characterized by pain and disability. It involves all ages and 70% of people aged >65 have some degree of osteoarthritis. Natural cartilage repair is limited because chondrocyte density and metabolism are low and cartilage has no blood supply. The results of joint-preserving treatment protocols such as debridement, mosaicplasty, perichondrium transplantation and autologous chondrocyte implantation vary largely and the average long-term result is unsatisfactory. One reason for limited clinical success is that most treatments require new cartilage to be formed at the site of a defect. However, the mechanical conditions at such sites are unfavorable for repair of the original damaged cartilage. Therefore, it is unlikely that healthy cartilage would form at these locations. The most promising method to circumvent this problem is to engineer mechanically stable cartilage ex vivo and to implant that into the damaged tissue area. This review outlines the issues related to the composition and functionality of tissue-engineered cartilage. In particular, the focus will be on the parameters cell source, signaling molecules, scaffolds and mechanical stimulation. In addition, the current status of tissue engineering of cartilage will be discussed, with the focus on extracellular matrix content, structure and its functionality.
骨关节炎是一种退行性关节疾病，其特征为疼痛和残疾。它涉及所有年龄段，70%的>65 岁人群都有一定程度的骨关节炎。由于软骨细胞密度和新陈代谢低，软骨没有血液供应，因此天然软骨修复能力有限。关节保留治疗方案（如清创术、马赛克成形术、软骨膜移植和自体软骨细胞移植）的结果差异很大，平均长期结果并不令人满意。临床成功率有限的一个原因是，大多数治疗方法都需要在缺陷部位形成新的软骨。然而，这些部位的力学条件不利于修复原始受损的软骨。因此，在这些部位形成健康的软骨是不太可能的。规避这个问题的最有前途的方法是在体外工程化机械稳定的软骨，并将其植入受损组织区域。这篇综述概述了与组织工程软骨的组成和功能相关的问题。特别是，重点将放在细胞来源、信号分子、支架和机械刺激等参数上。此外，还将讨论软骨组织工程的现状，重点是细胞外基质的含量、结构及其功能。
