Review of injectable cartilage engineering using fibrin gel in mice and swine models

More than a decade of work has been devoted to engineering cartilage for articular surface repair. This review covers the use of fibrin gel polymer as an injectable scaffold for generating new cartilage matrix from isolated articular chondrocytes beginning with studies in mice and culminating in an applied study in swine joints. These studies began with developing a formulation of fibrin that was injectable and promoted cartilage matrix formation. Subsequent studies addressed the problems of volume loss after the scaffolds were placed in vivo by adding lyophilized cartilage matrix. Additional studies focused on the ability of isolated chondrocytes to heal and repair cartilage in a model that could be biomechanically tested. In conclusion, this series of studies demonstrated that fibrin gel is a suitable polymer gel for generating new cartilage matrix from articular chondrocytes. The new matrix is capable of forming mechanical bonds between cartilage disks and can lead to healing and integration. Armed with these results, implantation of fibrin-cell constructs into defects in swine knees showed new cartilage formation and filling of the defects. Continuing work in these models with fibrin and other polymerizable hydrogels could result in a suitable cell-based therapy for articular cartilage lesions.