Chen Rouyan, Pye Jasmine Sarah, Li Jiarong, Little Christopher B, Li Jiao Jiao
Kolling Institute, Faculty of Medicine and Health, The University of Sydney, NSW, 2065, Australia.
School of Electrical and Mechanical Engineering, Faculty of Sciences, Engineering and Technology, The University of Adelaide, SA, 5005, Australia.
Bioact Mater. 2023 Apr 28;27:505-545. doi: 10.1016/j.bioactmat.2023.04.016. eCollection 2023 Sep.
Osteochondral defects are caused by injury to both the articular cartilage and subchondral bone within skeletal joints. They can lead to irreversible joint damage and increase the risk of progression to osteoarthritis. Current treatments for osteochondral injuries are not curative and only target symptoms, highlighting the need for a tissue engineering solution. Scaffold-based approaches can be used to assist osteochondral tissue regeneration, where biomaterials tailored to the properties of cartilage and bone are used to restore the defect and minimise the risk of further joint degeneration. This review captures original research studies published since 2015, on multiphasic scaffolds used to treat osteochondral defects in animal models. These studies used an extensive range of biomaterials for scaffold fabrication, consisting mainly of natural and synthetic polymers. Different methods were used to create multiphasic scaffold designs, including by integrating or fabricating multiple layers, creating gradients, or through the addition of factors such as minerals, growth factors, and cells. The studies used a variety of animals to model osteochondral defects, where rabbits were the most commonly chosen and the vast majority of studies reported small rather than large animal models. The few available clinical studies reporting cell-free scaffolds have shown promising early-stage results in osteochondral repair, but long-term follow-up is necessary to demonstrate consistency in defect restoration. Overall, preclinical studies of multiphasic scaffolds show favourable results in simultaneously regenerating cartilage and bone in animal models of osteochondral defects, suggesting that biomaterials-based tissue engineering strategies may be a promising solution.
骨软骨缺损是由关节软骨和骨骼关节内的软骨下骨损伤引起的。它们会导致不可逆转的关节损伤，并增加发展为骨关节炎的风险。目前针对骨软骨损伤的治疗方法无法治愈，且仅针对症状，这凸显了组织工程解决方案的必要性。基于支架的方法可用于协助骨软骨组织再生，即使用根据软骨和骨特性定制的生物材料来修复缺损，并将进一步关节退变的风险降至最低。本综述收录了自2015年以来发表的关于用于治疗动物模型骨软骨缺损的多相支架的原创性研究。这些研究使用了广泛的生物材料来制造支架，主要包括天然和合成聚合物。采用了不同的方法来创建多相支架设计，包括整合或制造多层、创建梯度，或通过添加矿物质、生长因子和细胞等因素。这些研究使用了多种动物来模拟骨软骨缺损，其中兔子是最常选用的动物，并且绝大多数研究报告的是小动物模型而非大动物模型。少数报告无细胞支架的临床研究在骨软骨修复方面已显示出有前景的早期结果，但需要长期随访来证明缺损修复的一致性。总体而言，多相支架的临床前研究在骨软骨缺损动物模型中同时再生软骨和骨方面显示出良好结果，这表明基于生物材料的组织工程策略可能是一种有前景的解决方案。
