关节软骨和半月板修复的外科和组织工程策略。
Surgical and tissue engineering strategies for articular cartilage and meniscus repair.
机构信息
Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA.
Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, CA, USA.
出版信息
Nat Rev Rheumatol. 2019 Sep;15(9):550-570. doi: 10.1038/s41584-019-0255-1. Epub 2019 Jul 11.
Injuries to articular cartilage and menisci can lead to cartilage degeneration that ultimately results in arthritis. Different forms of arthritis affect ~50 million people in the USA alone, and it is therefore crucial to identify methods that will halt or slow the progression to arthritis, starting with the initiating events of cartilage and meniscus defects. The surgical approaches in current use have a limited capacity for tissue regeneration and yield only short-term relief of symptoms. Tissue engineering approaches are emerging as alternatives to current surgical methods for cartilage and meniscus repair. Several cell-based and tissue-engineered products are currently in clinical trials for cartilage lesions and meniscal tears, opening new avenues for cartilage and meniscus regeneration. This Review provides a summary of surgical techniques, including tissue-engineered products, that are currently in clinical use, as well as a discussion of state-of-the-art tissue engineering strategies and technologies that are being developed for use in articular cartilage and meniscus repair and regeneration. The obstacles to clinical translation of these strategies are also included to inform the development of innovative tissue engineering approaches.
关节软骨和半月板损伤可导致软骨退化，最终导致关节炎。仅在美国，就有 5000 万人受到不同类型关节炎的影响，因此，确定阻止或减缓关节炎进展的方法至关重要，从软骨和半月板缺陷的初始事件开始。目前使用的手术方法对组织再生的能力有限，只能短期缓解症状。组织工程方法正在成为替代当前软骨和半月板修复手术方法的一种选择。目前有几种基于细胞的和组织工程的产品正在进行软骨损伤和半月板撕裂的临床试验，为软骨和半月板的再生开辟了新的途径。本综述总结了目前临床应用的手术技术，包括组织工程产品，并讨论了用于关节软骨和半月板修复和再生的最先进的组织工程策略和技术。还包括这些策略临床转化的障碍，以告知创新的组织工程方法的发展。
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