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Zhang H, Wang M, Wu R, Guo J, Sun A, Li Z, Ye R, Xu G, Cheng Y. From materials to clinical use: advances in 3D-printed scaffolds for cartilage tissue engineering. Phys Chem Chem Phys 2023; 25:24244-24263. [PMID: 37698006 DOI: 10.1039/d3cp00921a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Osteoarthritis caused by articular cartilage defects is a particularly common orthopedic disease that can involve the entire joint, causing great pain to its sufferers. A global patient population of approximately 250 million people has an increasing demand for new therapies with excellent results, and tissue engineering scaffolds have been proposed as a potential strategy for the repair and reconstruction of cartilage defects. The precise control and high flexibility of 3D printing provide a platform for subversive innovation. In this perspective, cartilage tissue engineering (CTE) scaffolds manufactured using different biomaterials are summarized from the perspective of 3D printing strategies, the bionic structure strategies and special functional designs are classified and discussed, and the advantages and limitations of these CTE scaffold preparation strategies are analyzed in detail. Finally, the application prospect and challenges of 3D printed CTE scaffolds are discussed, providing enlightening insights for their current research.
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Affiliation(s)
- Hewen Zhang
- School of the Faculty of Mechanical Engineering and Mechanic, Ningbo University, Ningbo, Zhejiang Province, 315211, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, P. R. China
- Zhejiang Key Laboratory of Additive Manufacturing Materials, Ningbo Institute of Materials Technology & Engineering, Chinese Academy of Sciences, Ningbo 315201, P. R. China.
| | - Meng Wang
- Department of Joint Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, 315020, China.
| | - Rui Wu
- Department of Orthopedics, Ningbo First Hospital Longshan Hospital Medical and Health Group, Ningbo 315201, P. R. China
| | - Jianjun Guo
- Zhejiang Key Laboratory of Additive Manufacturing Materials, Ningbo Institute of Materials Technology & Engineering, Chinese Academy of Sciences, Ningbo 315201, P. R. China.
| | - Aihua Sun
- Zhejiang Key Laboratory of Additive Manufacturing Materials, Ningbo Institute of Materials Technology & Engineering, Chinese Academy of Sciences, Ningbo 315201, P. R. China.
| | - Zhixiang Li
- Zhejiang Key Laboratory of Additive Manufacturing Materials, Ningbo Institute of Materials Technology & Engineering, Chinese Academy of Sciences, Ningbo 315201, P. R. China.
| | - Ruqing Ye
- Department of Joint Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, 315020, China.
| | - Gaojie Xu
- Zhejiang Key Laboratory of Additive Manufacturing Materials, Ningbo Institute of Materials Technology & Engineering, Chinese Academy of Sciences, Ningbo 315201, P. R. China.
| | - Yuchuan Cheng
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, P. R. China
- Zhejiang Key Laboratory of Additive Manufacturing Materials, Ningbo Institute of Materials Technology & Engineering, Chinese Academy of Sciences, Ningbo 315201, P. R. China.
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Lafuente-Merchan M, Ruiz-Alonso S, Zabala A, Gálvez-Martín P, Marchal JA, Vázquez-Lasa B, Gallego I, Saenz-Del-Burgo L, Pedraz JL. Chondroitin and Dermatan Sulfate Bioinks for 3D Bioprinting and Cartilage Regeneration. Macromol Biosci 2022; 22:e2100435. [PMID: 35029035 DOI: 10.1002/mabi.202100435] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/28/2021] [Indexed: 11/11/2022]
Abstract
Cartilage is a connective tissue which a limited capacity for healing and repairing. In this context, osteoarthritis disease may be developed with high prevalence in which the use of scaffolds may be a promising treatment. In addition, three-dimensional (3D) bioprinting has become an emerging additive manufacturing technology because of its rapid prototyping capacity and the possibility of creating complex structures. This study was focused on the development of nanocellulose-alginate (NC-Alg) based bioinks for 3D bioprinting for cartilage regeneration to which it was added chondroitin sulfate (CS) and dermatan sulfate (DS). First, rheological properties were evaluated. Then, sterilisation effect, biocompatibility and printability on developed NC-Alg-CS and NC-Alg-DS inks were evaluated. Subsequently, printed scaffolds were characterized. Finally, NC-Alg-CS and NC-Alg-DS inks were loaded with murine D1-MSCs-EPO and cell viability and functionality, as well as the chondrogenic differentiation ability were assessed. Results showed that the addition of both CS and DS to the NC-Alg ink improved its characteristics in terms of rheology and cell viability and functionality. Moreover, differentiation to cartilage was promoted on NC-Alg-CS and NC-Alg-DS scaffolds. Therefore, the utilization of MSCs containing NC-Alg-CS and NC-Alg-DS scaffolds may become a feasible tissue engineering approach for cartilage regeneration. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Markel Lafuente-Merchan
- NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain.,Bioaraba Health Research Institute, Jose Atxotegi, s/n, Vitoria-Gasteiz, 01009, Spain
| | - Sandra Ruiz-Alonso
- NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain.,Bioaraba Health Research Institute, Jose Atxotegi, s/n, Vitoria-Gasteiz, 01009, Spain
| | - Alaitz Zabala
- Mechanical and Industrial Manufacturing Department, Mondragon Unibertsitatea, Loramendi 4, Mondragón, 20500, Spain
| | | | - Juan Antonio Marchal
- Biopathology and Regenerative Medicine Institute (IBIMER), Centre for Biomedical Research, University of Granada, Granada, 18100, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Andalusian Health Service (SAS), University of Granada, Granada, Spain.,Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, 18016, Spain.,BioFab i3D Lab - Biofabrication and 3D (bio)printing singular Laboratory, University of Granada, Granada, 18100, Spain
| | - Blanca Vázquez-Lasa
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain.,Institute of Polymer Science and Technology, ICTP-CSIC, Juan de la Cierva 3, Madrid, 28006, Spain
| | - Idoia Gallego
- NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain.,Bioaraba Health Research Institute, Jose Atxotegi, s/n, Vitoria-Gasteiz, 01009, Spain
| | - Laura Saenz-Del-Burgo
- NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain.,Bioaraba Health Research Institute, Jose Atxotegi, s/n, Vitoria-Gasteiz, 01009, Spain
| | - Jose Luis Pedraz
- NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain.,Bioaraba Health Research Institute, Jose Atxotegi, s/n, Vitoria-Gasteiz, 01009, Spain
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Kaufman G, Whitescarver RA, Nunes L, Palmer XL, Skrtic D, Tutak W. Effects of protein-coated nanofibers on conformation of gingival fibroblast spheroids: potential utility for connective tissue regeneration. ACTA ACUST UNITED AC 2018; 13:025006. [PMID: 29364821 DOI: 10.1088/1748-605x/aa91d9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Deep wounds in the gingiva caused by trauma or surgery require a rapid and robust healing of connective tissues. We propose utilizing gas-brushed nanofibers coated with collagen and fibrin for that purpose. Our hypotheses are that protein-coated nanofibers will: (i) attract and mobilize cells in various spatial orientations, and (ii) regulate the expression levels of specific extracellular matrix (ECM)-associated proteins, determining the initial conformational nature of dense and soft connective tissues. Gingival fibroblast monolayers and 3D spheroids were cultured on ECM substrate and covered with gas-blown poly-(DL-lactide-co-glycolide) (PLGA) nanofibers (uncoated/coated with collagen and fibrin). Cell attraction and rearrangement was followed by F-actin staining and confocal microscopy. Thicknesses of the cell layers, developed within the nanofibers, were quantified by ImageJ software. The expression of collagen1α1 chain (Col1α1), fibronectin, and metalloproteinase 2 (MMP2) encoding genes was determined by quantitative reverse transcription analysis. Collagen- and fibrin- coated nanofibers induced cell migration toward fibers and supported cellular growth within the scaffolds. Both proteins affected the spatial rearrangement of fibroblasts by favoring packed cell clusters or intermittent cell spreading. These cell arrangements resembled the structural characteristic of dense and soft connective tissues, respectively. Within three days of incubation, fibroblast spheroids interacted with the fibers, and grew robustly by increasing their thickness compared to monolayers. While the ECM key components, such as fibronectin and MMP2 encoding genes, were expressed in both protein groups, Col1α1 was predominantly expressed in bundled fibroblasts grown on collagen fibers. This enhanced expression of collagen1 is typical for dense connective tissue. Based on results of this study, our gas-blown, collagen- and fibrin-coated PLGA nanofibers are viable candidates for engineering soft and dense connective tissues with the required structural characteristics and functions needed for wound healing applications. Rapid regeneration of these layers should enhance healing of open wounds in a harsh oral environment.
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Affiliation(s)
- Gili Kaufman
- Volpe Research Center, American Dental Association Foundation, Gaithersburg, MD 20899, United States of America
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Nazempour A, Van Wie BJ. Chondrocytes, Mesenchymal Stem Cells, and Their Combination in Articular Cartilage Regenerative Medicine. Ann Biomed Eng 2016; 44:1325-54. [PMID: 26987846 DOI: 10.1007/s10439-016-1575-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/17/2016] [Indexed: 01/05/2023]
Abstract
Articular cartilage (AC) is a highly organized connective tissue lining, covering the ends of bones within articulating joints. Its highly ordered structure is essential for stable motion and provides a frictionless surface easing load transfer. AC is vulnerable to lesions and, because it is aneural and avascular, it has limited self-repair potential which often leads to osteoarthritis. To date, no fully successful treatment for osteoarthritis has been reported. Thus, the development of innovative therapeutic approaches is desperately needed. Autologous chondrocyte implantation, the only cell-based surgical intervention approved in the United States for treating cartilage defects, has limitations because of de-differentiation of articular chondrocytes (AChs) upon in vitro expansion. De-differentiation can be abated if initial populations of AChs are co-cultured with mesenchymal stem cells (MSCs), which not only undergo chondrogenesis themselves but also support chondrocyte vitality. In this review we summarize studies utilizing AChs, non-AChs, and MSCs and compare associated outcomes. Moreover, a comprehensive set of recent human studies using chondrocytes to direct MSC differentiation, MSCs to support chondrocyte re-differentiation and proliferation in co-culture environments, and exploratory animal intra- and inter-species studies are systematically reviewed and discussed in an innovative manner allowing side-by-side comparisons of protocols and outcomes. Finally, a comprehensive set of recommendations are made for future studies.
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Affiliation(s)
- A Nazempour
- Gene and Linda Voiland School of Chemical Engineering and Bioengineering, Washington State University, Pullman, WA, 99164-6515, USA
| | - B J Van Wie
- Gene and Linda Voiland School of Chemical Engineering and Bioengineering, Washington State University, Pullman, WA, 99164-6515, USA.
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Ryan CNM, Sorushanova A, Lomas AJ, Mullen AM, Pandit A, Zeugolis DI. Glycosaminoglycans in Tendon Physiology, Pathophysiology, and Therapy. Bioconjug Chem 2015; 26:1237-51. [DOI: 10.1021/acs.bioconjchem.5b00091] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Foldager CB, Nyengaard JR, Lind M, Spector M. A Stereological Method for the Quantitative Evaluation of Cartilage Repair Tissue. Cartilage 2015; 6:123-32. [PMID: 26069715 PMCID: PMC4462253 DOI: 10.1177/1947603514560655] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To implement stereological principles to develop an easy applicable algorithm for unbiased and quantitative evaluation of cartilage repair. DESIGN Design-unbiased sampling was performed by systematically sectioning the defect perpendicular to the joint surface in parallel planes providing 7 to 10 hematoxylin-eosin stained histological sections. Counting windows were systematically selected and converted into image files (40-50 per defect). The quantification was performed by two-step point counting: (1) calculation of defect volume and (2) quantitative analysis of tissue composition. Step 2 was performed by assigning each point to one of the following categories based on validated and easy distinguishable morphological characteristics: (1) hyaline cartilage (rounded cells in lacunae in hyaline matrix), (2) fibrocartilage (rounded cells in lacunae in fibrous matrix), (3) fibrous tissue (elongated cells in fibrous tissue), (4) bone, (5) scaffold material, and (6) others. The ability to discriminate between the tissue types was determined using conventional or polarized light microscopy, and the interobserver variability was evaluated. RESULTS We describe the application of the stereological method. In the example, we assessed the defect repair tissue volume to be 4.4 mm(3) (CE = 0.01). The tissue fractions were subsequently evaluated. Polarized light illumination of the slides improved discrimination between hyaline cartilage and fibrocartilage and increased the interobserver agreement compared with conventional transmitted light. CONCLUSION We have applied a design-unbiased method for quantitative evaluation of cartilage repair, and we propose this algorithm as a natural supplement to existing descriptive semiquantitative scoring systems. We also propose that polarized light is effective for discrimination between hyaline cartilage and fibrocartilage.
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Affiliation(s)
- Casper Bindzus Foldager
- Orthopaedic Research, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA,Tissue Engineering, VA Boston Healthcare System, Boston, MA, USA,Orthopaedic Research Lab, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Randel Nyengaard
- Stereology and EM Laboratory, Centre for Stochastic Geometry and Advanced Bioimaging, Aarhus University, Aarhus, Denmark
| | - Martin Lind
- Sports Trauma Clinic, Aarhus University Hospital, Aarhus, Denmark
| | - Myron Spector
- Orthopaedic Research, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA,Tissue Engineering, VA Boston Healthcare System, Boston, MA, USA
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Herrero-Mendez A, Palomares T, Castro B, Herrero J, Granado MH, Bejar JM, Alonso-Varona A. HR007: a family of biomaterials based on glycosaminoglycans for tissue repair. J Tissue Eng Regen Med 2015; 11:989-1001. [PMID: 25728195 DOI: 10.1002/term.1998] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 12/05/2014] [Accepted: 12/12/2014] [Indexed: 01/19/2023]
Abstract
Most new advances in tissue engineering (TE) focus on the creation of adequate microenvironments that may accelerate the repair processes of damaged tissues. Extracellular matrix (ECM) of Wharton's jelly (WJ) from umbilical cords is very rich in sulphated GAGs (sGAGs) and hyaluronic acid (HA), components which have special properties that could positively influence the regeneration of several types of tissue. Previously, we described the methodology for the extraction and purification of GAGs from WJ and, importantly, the separation of sGAGs and HA to develop various scaffolds for regenerative medicine. In this new study we hypothesized that the biomaterials obtained, called HR007s, would be excellent candidates for two different applications, chondral and dermal repair. First, we have confirmed that the GAGs obtained are biocompatible, as they do not cause cytotoxicity, haemolysis or an inflammatory response. Second, we have developed three-dimensional (3D) structures through the combination of different ratios of GAGs and their subsequent stabilization, which can be properly adapted to target tissues, cartilage or skin. Finally, we have combined these scaffolds with adipose mesenchymal stem cells (ASCs) or fibroblasts for application to chondral or dermal defects, respectively, with the goal of promoting fast reparative processes. The results show that HR007 scaffolds induce cell proliferation, enhance the expression of specific gene markers, increase the production of tissue ECM proteins and have chemotactic effects over the studied cells. In summary, the bioactive properties of HR007 scaffolds make them promising candidates for use in regenerative medicine, at least for chondral and dermal repair. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - T Palomares
- Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - B Castro
- Histocell, Bizkaia Technology Park, Derio, Bizkaia, Spain
| | - J Herrero
- Histocell, Bizkaia Technology Park, Derio, Bizkaia, Spain
| | - M H Granado
- Histocell, Bizkaia Technology Park, Derio, Bizkaia, Spain
| | - J M Bejar
- Department of Plastic Surgery, Cruces Hospital, Barakaldo, Bizkaia, Spain
| | - A Alonso-Varona
- Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
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Sakata R, Kokubu T, Mifune Y, Inui A, Nishimoto H, Fujioka H, Kuroda R, Kurosaka M. A new bioabsorbable cotton-textured synthetic polymer scaffold for osteochondral repair. INTERNATIONAL ORTHOPAEDICS 2014; 38:2413-20. [PMID: 24384940 DOI: 10.1007/s00264-013-2253-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 12/06/2013] [Indexed: 11/24/2022]
Abstract
PURPOSE We have previously reported that a cylindrical bioabsorbable synthetic polymer scaffold made of poly (DL-lactide-co-glycolide) (PLG) can be used to repair osteochondral defects without using cultured cells in a rabbit model. This cylindrical scaffold has a solid and pre-formed design, which limits its widespread application. Therefore, we created a cotton-textured PLG scaffold, which would be superior to other scaffolds in terms of plastic property and operability. The purpose of the present study was to examine the efficacy of the cotton-textured PLG scaffold in the repair of osteochondral defects. METHODS Cotton-textured PLG scaffolds were prepared using the electrospinning method and used to repair osteochondral defects produced on the right femoral condyle in 36 rabbits. As a control, the defect was left untreated. The outcomes of repair were examined histologically at postoperative weeks four, eight, and 12. RESULTS In the untreated control group, the surface of the defect remained concave and the regenerated cartilaginous tissue partially covered the articular surface even at postoperative week 12. In the scaffold group, cartilaginous tissue covered the surface of the defect at postoperative week four, and the surface was smooth and the cartilaginous tissue was well regenerated and integrated with the native cartilage at postoperative week 12. CONCLUSIONS The cotton-textured PLG scaffold could repair the osteochondral defect with good outcomes similar to those previously reported for the cylindrical scaffold, with its characteristic advantages of better plasticity and operability. We conclude that the cotton-textured PLG scaffold has potential for clinical application in comminuted osteochondral injury.
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Affiliation(s)
- Ryosuke Sakata
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
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Liu M, Yu X, Huang F, Cen S, Zhong G, Xiang Z. Tissue engineering stratified scaffolds for articular cartilage and subchondral bone defects repair. Orthopedics 2013; 36:868-73. [PMID: 24200433 DOI: 10.3928/01477447-20131021-10] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Due to their good biocompatibility and mechanical integrity, tissue engineering scaffolds have become a principal method of repair and regeneration of osteochondral defects. To improve their intrinsic properties, control their degenerative times, and enhance their cell adhesion and differentiation, numerous scaffold architectures and formation methods have been developed and tested, but the ideal scaffold design is still controversial. Moreover, scaffold fixation has a significant influence on repair and regeneration after implantation. The authors analyzed relative studies to address the latest scaffold designs, including biphasic scaffold, multilayered scaffold, and continuous nonstratified scaffold, and this article compares their advantages and disadvantages. In addition, the authors introduce a novel modified method for scaffold fixation known as magnetic fixation. Both stratified and nonstratified scaffolds can repair osteochondral defects, but continuous nonstratified scaffolds are more biomimetic compared with the native osteochondral structures, and they lead to a better regeneration of hyaline-like cartilage and structured bone tissue. Therefore, the authors suggest continuous nonstratified scaffolds are an effective option for treating osteochondral defects.
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