Sodium butyrate-induced changes in cultured rabbit articular chondrocyte transmembrane electrical potentials. Relationship between these changes and the proliferative response

Smart biomaterials for tissue engineering of cartilage

Biological regeneration using cartilage tissue engineering in which cells are grown on biomaterial scaffolds and then implanted into the cartilage defects could provide new treatment options for articular cartilage defects. This review aims to give an overview of the wide variety of biomaterials that are currently developed as scaffolds for cartilage tissue engineering. Emphasis will be placed on the current development of the materials that are able to direct cell differentiation and metabolism. These so-called "smart" biomaterials are produced by modifying the physical properties of the scaffolds using peptide sequences and most importantly by developing materials that can deliver proteins to enhance tissue regeneration. Besides providing drug delivery systems, the materials respond to environmental stimuli or release their cargo on cellular demand. However, critical issues remain, such as the transferability of basic science insights to clinical products and the applicability of certain data sets to human patients.

Articular cartilage repair: basic science and clinical progress. A review of the current status and prospects

OBJECTIVE

To review the basic scientific status of repair in articular cartilage tissue and to assess the efficiency of current clinical therapies instigated for the treatment of structural lesions generated therein as a result of trauma or during the course of various diseases, notably osteoarthritis (OA). Current scientific trends and possible directions for the future will also be discussed.

DESIGN

A systematic and critical analysis is undertaken, beginning with a description of the spontaneous repair responses in different types of lesion. Surgical interventions aimed at inducing repair without the use of active biologics will then be considered, followed by those involving active biologics and those drawing on autogenic and allogeneic tissue transplantation principles. Cell transplantation approaches, in particular novel tissue engineering concepts, will be critically presented. These will include growth-factor-based biological treatments and gene transfection protocols. A number of technical problems associated with repair interventions, such as tissue integration, tissue retention and the role of mechanical factors, will also be analysed.

RESULTS

A critical analysis of the literature reveals the existence of many novel and very promising biologically-based approaches for the induction of articular cartilage repair, the vast majority of which are still at an experimental phase of development. But prospective, double-blinded clinical trials comparing currently practiced surgical treatments have, unfortunately, not been undertaken.

CONCLUSION

The existence of many new and encouraging biological approaches to cartilage repair justifies the future investment of time and money in this research area, particularly given the extremely high socio-economic importance of such therapeutic strategies in the prevention and treatment of these common joint diseases and traumas. Clinical epidemiological and prospective trials are, moreover, urgently needed for an objective, scientific appraisal of current therapies and future novel approaches.