Current Concepts and Challenges in Osteochondral Tissue Engineering and Regenerative Medicine

Area of Science:

• Biomedical Engineering
• Regenerative Medicine
• Orthopedics

Background:

• Significant progress in tissue engineering for osteochondral defect regeneration via preclinical and clinical studies.
• Biomimetic/bioactive scaffolds, growth factors, and stem cells are key strategies in preclinical research.
• Emerging trends include modulating stem cell differentiation and enhancing bone/cartilage interface regeneration.

Purpose of the Study:

• To review advancements in osteochondral tissue engineering at both preclinical and clinical levels.
• To identify current challenges and future perspectives in the field.
• To highlight promising approaches such as physical stimuli and novel biomaterials.

Main Methods:

• Review of preclinical studies and clinical trials on osteochondral defect regeneration.
• Analysis of strategies involving scaffolds, growth factors, and stem cells.
• Examination of clinical procedures like matrix-associated autologous chondrocyte implantation (MACI) and matrix-associated stem cell implantation (MASI).

Main Results:

• Tissue engineering strategies have shown considerable validation in preclinical and clinical settings.
• Scaffold-based approaches, often combined with cells or growth factors, are dominant.
• Bone/cartilage interface regeneration and physical stimuli show significant potential.
• Clinical applications include MACI, MASI, and layered scaffolds.

Conclusions:

• Osteochondral tissue engineering has made substantial progress, with several strategies validated clinically.
• Challenges remain in achieving complete bone-cartilage integration and optimizing cell behavior.
• Future directions include extracellular matrix-like biomaterials, CAD/CAM implants, and cell reprogramming for enhanced regeneration.