Rawojć Kamila, Tadeusiewicz Ryszard, Zych-Stodolak Ewa
Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland.
Department of Biomaterials and Composites, Faculty of Materials Science and Ceramics, AGH University of Science and Technology, 30-059 Krakow, Poland.
Bioengineering (Basel). 2025 Jul 7;12(7):740. doi: 10.3390/bioengineering12070740.
Cartilage damage, particularly in the knee joint, presents a significant challenge in regenerative medicine due to its limited capacity for self-repair. Conventional treatments like microfracture surgery, autologous chondrocyte implantation (ACI), and osteochondral allografts often fall short, particularly in cases of larger defects or degenerative conditions. This has led to a growing interest in tissue engineering approaches that utilize biomaterial scaffolds to support cartilage regeneration. Among the many materials explored, chitosan-a naturally derived polysaccharide-has gained attention for its biocompatibility, biodegradability, and structural resemblance to the extracellular matrix (ECM) of cartilage. Recent advances in scaffold design have focused on modifying chitosan to improve its mechanical properties and enhance its biological performance. These modifications include chemical crosslinking, the incorporation of bioactive molecules, and the development of composite formulations. Such enhancements have allowed chitosan-based scaffolds to better support mesenchymal stem cell (MSC) differentiation into chondrocytes, paving the way for improved regenerative strategies. This review explores the latest progress in chitosan scaffold fabrication, preclinical findings, and the transition toward clinical applications. It also discusses the challenges that need to be addressed, such as mechanical stability, degradation rates, and the successful translation of research into viable therapeutic solutions.
软骨损伤，尤其是膝关节的软骨损伤，由于其自我修复能力有限，在再生医学中构成了重大挑战。像微骨折手术、自体软骨细胞植入（ACI）和骨软骨异体移植等传统治疗方法往往效果不佳，特别是在较大缺损或退行性病变的情况下。这使得利用生物材料支架来支持软骨再生的组织工程方法越来越受到关注。在探索的众多材料中，壳聚糖——一种天然衍生的多糖——因其生物相容性、可生物降解性以及与软骨细胞外基质（ECM）的结构相似性而受到关注。支架设计的最新进展集中在对壳聚糖进行改性，以改善其机械性能并增强其生物学性能。这些改性包括化学交联、生物活性分子的掺入以及复合配方的开发。这些改进使得基于壳聚糖的支架能够更好地支持间充质干细胞（MSC）向软骨细胞分化，为改进的再生策略铺平了道路。本综述探讨了壳聚糖支架制造、临床前研究结果以及向临床应用过渡的最新进展。它还讨论了需要解决的挑战，如机械稳定性、降解速率以及将研究成功转化为可行的治疗方案。
