Orthopaedic Research Group, Coimbatore, Tamil Nadu, India.
Department of Biotechnology, School of Engineering and Technology, Sharda University, New Delhi, India.
Nat Rev Rheumatol. 2023 Jul;19(7):403-416. doi: 10.1038/s41584-023-00979-5. Epub 2023 Jun 9.
Osteoarthritis (OA) is a disabling condition that affects billions of people worldwide and places a considerable burden on patients and on society owing to its prevalence and economic cost. As cartilage injuries are generally associated with the progressive onset of OA, robustly effective approaches for cartilage regeneration are necessary. Despite extensive research, technical development and clinical experimentation, no current surgery-based, material-based, cell-based or drug-based treatment can reliably restore the structure and function of hyaline cartilage. This paucity of effective treatment is partly caused by a lack of fundamental understanding of why articular cartilage fails to spontaneously regenerate. Thus, research studies that investigate the mechanisms behind the cartilage regeneration processes and the failure of these processes are critical to instruct decisions about patient treatment or to support the development of next-generation therapies for cartilage repair and OA prevention. This Review provides a synoptic and structured analysis of the current hypotheses about failure in cartilage regeneration, and the accompanying therapeutic strategies to overcome these hurdles, including some current or potential approaches to OA therapy.
骨关节炎（OA）是一种致残性疾病，影响着全球数十亿人，由于其普遍性和经济成本，给患者和社会带来了相当大的负担。由于软骨损伤通常与 OA 的进行性发病有关，因此需要有强大有效的方法来促进软骨再生。尽管进行了广泛的研究、技术开发和临床实验，但目前基于手术、基于材料、基于细胞或基于药物的治疗方法都不能可靠地恢复透明软骨的结构和功能。这种缺乏有效治疗的情况部分是由于对关节软骨为何不能自发再生的基本机制缺乏了解。因此，研究探讨软骨再生过程背后的机制以及这些过程失败的原因的研究对于指导患者治疗决策或支持下一代治疗软骨修复和 OA 预防的疗法的开发至关重要。本综述对软骨再生失败的现有假说以及克服这些障碍的伴随治疗策略进行了综合和结构化分析，包括 OA 治疗的一些当前或潜在方法。
