Singer Jacob, Knezic Noah, Layne Jonathan, Gohring Greta, Christiansen Jeff, Rothrauff Ben, Huard Johnny
Linda and Mitch Hart Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO 81657, USA.
Life (Basel). 2024 Sep 11;14(9):1149. doi: 10.3390/life14091149.
Treating cartilage damage is challenging as its ability for self-regeneration is limited. Left untreated, it can progress to osteoarthritis (OA), a joint disorder characterized by the deterioration of articular cartilage and other joint tissues. Surgical options, such as microfracture and cell/tissue transplantation, have shown promise as techniques to harness the body's endogenous regenerative capabilities to promote cartilage repair. Nonetheless, these techniques have been scrutinized due to reported inconsistencies in long-term outcomes and the tendency for the defects to regenerate as fibrocartilage instead of the smooth hyaline cartilage native to joint surfaces. Orthobiologics are medical therapies that utilize biologically derived substances to augment musculoskeletal healing. These treatments are rising in popularity because of their potential to enhance surgical standards of care. More recent developments in orthobiologics have focused on the role of exosomes in articular cartilage repair. Exosomes are nano-sized extracellular vesicles containing cargo such as proteins, lipids, and nucleic acids, and are known to facilitate intercellular communication, though their regenerative potential still needs to be fully understood. This review aims to demonstrate the advancements in cartilage regeneration, highlight surgical and biological treatment options, and discuss the recent strides in understanding the precise mechanisms of action involved.
治疗软骨损伤具有挑战性，因为其自我再生能力有限。若不进行治疗，软骨损伤会发展为骨关节炎（OA），这是一种以关节软骨和其他关节组织恶化为特征的关节疾病。诸如微骨折和细胞/组织移植等手术方法，作为利用人体自身再生能力促进软骨修复的技术已展现出前景。尽管如此，由于长期疗效存在报道不一致的情况，且缺损倾向于再生为纤维软骨而非关节表面天然的光滑透明软骨，这些技术受到了严格审查。骨科生物制剂是利用生物衍生物质增强肌肉骨骼愈合的医学疗法。由于其提升手术护理标准的潜力，这些治疗方法越来越受欢迎。骨科生物制剂的最新进展集中在外泌体在关节软骨修复中的作用。外泌体是纳米级的细胞外囊泡，含有蛋白质、脂质和核酸等物质，已知其有助于细胞间通讯，不过其再生潜力仍有待充分了解。本综述旨在展示软骨再生的进展，突出手术和生物治疗方案，并讨论在理解所涉及的精确作用机制方面的最新进展。
