[Biomaterials and cell therapy in cartilage disorders]

Joint cartilage has a poor intrinsic ability to heal. Common surgical treatments for traumatic lesions, after debridement of the chondral defect, include stimulation of subchondral bone (microfracture), perichondrial or periosteal grafting, and mosaicplasty (osteochondral cylinder transplantation). Autologous chondrocyte transplantation (ACT) was the first application of cell therapy to orthopaedic surgery. Despite promising results, several groups have tested tissue engineering protocols based on ex vivo colonization of biodegradable polymer matrices that are subsequently transplanted to the target site. Tissue engineering as a treatment for osteoarthritis is even more challenging. Transplantation of genetically modified cells is an interesting concept, based on the production of therapeutic proteins directly at the target site.