Ai Chengchong, Lee Yee Han Dave, Tan Xuan Hao, Tan Si Heng Sharon, Hui James Hoi Po, Goh James Cho-Hong
Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore.
Department of Biomedical Engineering, National University of Singapore, Singapore.
J Orthop Translat. 2021 Oct 11;30:93-102. doi: 10.1016/j.jot.2021.07.008. eCollection 2021 Sep.
The treatment of osteochondral defects (OCD) remains challenging. Among currently available surgical treatments for OCDs, scaffold-based treatments are promising to regenerate the osteochondral unit. However, there is still no consensus regarding the clinical effectiveness of these scaffold-based therapies for OCDs. Previous reviews have described the gradient physiological characteristics of osteochondral tissue and gradient scaffold design for OCD, tissue engineering strategies, biomaterials, and fabrication technologies. However, the discussion on bridging the gap between the clinical need and preclinical research is still limited, on which we focus in the present review, providing an insight into what is currently lacking in tissue engineering methods that failed to yield satisfactory outcomes, and what is needed to further improve these techniques. Currently available surgical treatments for OCDs are firstly summarized, followed by a comprehensive review on experimental animal studies in recent 5 years on osteochondral tissue engineering. The review will then conclude with what is currently lacking in these animal studies and the recommendations that would help enlighten the community in developing more clinically relevant implants.
This review is attempting to summarize the lessons from clinical and preclinical failures, providing an insight into what is currently lacking in TE methods that failed to yield satisfactory outcomes, and what is needed to further improve these implants.
骨软骨缺损(OCD)的治疗仍然具有挑战性。在目前可用的OCD手术治疗方法中,基于支架的治疗方法有望使骨软骨单元再生。然而,对于这些基于支架的OCD治疗方法的临床有效性仍未达成共识。以往的综述描述了骨软骨组织的梯度生理特征以及用于OCD的梯度支架设计、组织工程策略、生物材料和制造技术。然而,关于弥合临床需求与临床前研究之间差距的讨论仍然有限,我们在本综述中聚焦于此,深入探讨组织工程方法目前未能产生满意结果的原因,以及进一步改进这些技术所需的条件。首先总结目前可用的OCD手术治疗方法,随后全面综述近5年骨软骨组织工程的实验动物研究。然后,本综述将总结这些动物研究目前存在的不足以及有助于启发该领域开发更具临床相关性植入物的建议。
本综述试图总结临床和临床前失败的教训,深入探讨目前未能产生满意结果的组织工程方法所缺乏的内容,以及进一步改进这些植入物所需的条件。