Cartilage Repair in the Inflamed Joint: Considerations for Biological Augmentation Toward Tissue Regeneration

Celeste Scotti, Alberto Gobbi, Georgios Karnatzikos, Ivan Martin, Kazunori Shimomura, John G. Lane, Giuseppe Michele Peretti, Norimasa Nakamura

Research output: Contribution to journalArticle

Abstract

Cartilage repair/regeneration procedures (e.g., microfracture, autologous chondrocyte implantation [ACI]) typically result in a satisfactory outcome in selected patients. However, the vast majority of patients with chronic symptoms and, in general, a more diseased joint, do not benefit from these surgical techniques. The aims of this work were to (1) review factors negatively influencing the joint environment; (2) review current adjuvant therapies that can be used to improve results of cartilage repair/regeneration procedures in patients with more diseased joints, (3) outline future lines of research and promising experimental approaches. Chronicity of symptoms and advancing patient age appear to be the most relevant factors negatively affecting clinical outcome of cartilage repair/regeneration. Preliminary experience with hyaluronic acid, platelet-rich plasma, and mesenchymal stem cell has been positive but there is no strong evidence supporting the use of these products and this requires further assessment with high-quality, prospective clinical trials. The use of a Tissue Therapy strategy, based on more mature engineered tissues, holds promise to tackle limitations of standard ACI procedures. Current research has highlighted the need for more targeted therapies, and (1) induction of tolerance with granulocyte colony-stimulating factor (G-CSF) or by preventing IL-6 downregulation; (2) combined IL-4 and IL-10 local release; and (3) selective activation of the prostaglandin E2 (PGE2) signaling appear to be the most promising innovative strategies. For older patients and for those with chronic symptoms, adjuvant therapies are needed in combination with microfracture and ACI.

Original languageEnglish
Pages (from-to)149-159
Number of pages11
JournalTissue Engineering - Part B: Reviews
Volume22
Issue number2
DOIs
Publication statusPublished - Apr 1 2016

Fingerprint

Tissue regeneration
Cartilage
Regeneration
Repair
Joints
Chondrocytes
Stress Fractures
Tissue
Joint Diseases
Hyaluronic acid
Granulocyte Colony-Stimulating Factor
Hyaluronic Acid
Platelets
Stem cells
Dinoprostone
Interleukin-4
Interleukin-10
Interleukin-6
Chemical activation
Platelet-Rich Plasma

ASJC Scopus subject areas

  • Biomedical Engineering
  • Biomaterials
  • Bioengineering
  • Biochemistry

Cite this

Scotti, C., Gobbi, A., Karnatzikos, G., Martin, I., Shimomura, K., Lane, J. G., ... Nakamura, N. (2016). Cartilage Repair in the Inflamed Joint: Considerations for Biological Augmentation Toward Tissue Regeneration. Tissue Engineering - Part B: Reviews, 22(2), 149-159. https://doi.org/10.1089/ten.teb.2015.0297

Cartilage Repair in the Inflamed Joint : Considerations for Biological Augmentation Toward Tissue Regeneration. / Scotti, Celeste; Gobbi, Alberto; Karnatzikos, Georgios; Martin, Ivan; Shimomura, Kazunori; Lane, John G.; Peretti, Giuseppe Michele; Nakamura, Norimasa.

In: Tissue Engineering - Part B: Reviews, Vol. 22, No. 2, 01.04.2016, p. 149-159.

Research output: Contribution to journalArticle

Scotti, Celeste ; Gobbi, Alberto ; Karnatzikos, Georgios ; Martin, Ivan ; Shimomura, Kazunori ; Lane, John G. ; Peretti, Giuseppe Michele ; Nakamura, Norimasa. / Cartilage Repair in the Inflamed Joint : Considerations for Biological Augmentation Toward Tissue Regeneration. In: Tissue Engineering - Part B: Reviews. 2016 ; Vol. 22, No. 2. pp. 149-159.
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