Cartilage repair: 2013 Asian update

Area of Science:

• Regenerative Medicine
• Biomaterials Science
• Orthopedic Surgery

Background:

• Asian scientists and clinicians have significantly contributed to cartilage repair research, overcoming financial and regulatory challenges.
• This review highlights recent Asian progress (2005-present) in cartilage repair, focusing on research and clinical studies.

Purpose of the Study:

• To review and highlight Asian advancements in cartilage repair research and clinical studies.
• To focus on stem cell sources, growth factors, and scaffold applications in cartilage repair.
• To summarize findings from in vitro, animal, and clinical studies on cartilage repair.

Main Methods:

• Review of in vitro studies on stem cell sources (mesenchymal stem cells [MSCs] from marrow, cord blood, synovium, mobilized peripheral blood) and use of growth factors and scaffolds.
• Summary of animal studies evaluating surgical procedures, cell administration routes, matrices, and scaffolds in various animal models (rats, rabbits, pigs, dogs).
• Analysis of published Asian clinical studies on cartilage repair, despite their limited number.

Main Results:

• In vitro studies identified MSCs and growth factors/scaffolds as key for cartilage repair.
• Animal studies demonstrated successful osteochondral defect repair using techniques like local adherent technique, microfracture enhancement with scaffolds, gene therapy (BMP), and various MSC applications (magnetically labeled, hyaluronic acid suspended, TGF-β immobilized).
• Clinical studies, though few, provide insights into the application of laboratory-derived MSCs, with recent progress in cord blood, mobilized peripheral blood, and injectable bone marrow-derived stem cells.

Conclusions:

• Mesenchymal stem cells (MSCs) from diverse sources, combined with advanced scaffolds and growth factors, show significant potential for cartilage repair.
• Recent advancements indicate the utility of cord blood, mobilized peripheral blood, and injectable bone marrow-derived stem cells for cartilage regeneration.
• Future research and development should focus on collaborative approaches involving regulatory agencies to advance cartilage repair therapies.