In Vivo Cartilage Regeneration with Cell-Seeded Natural Biomaterial Scaffold Implants: 15-Year Study

Articular cartilage can be easily damaged from human's daily activities, leading to inflammation and to osteoarthritis, a situation that can diminish the patients' quality of life. For larger cartilage defects, scaffolds are employed to provide cells the appropriate three-dimensional environment to proliferate and differentiate into healthy cartilage tissue. Natural biomaterials used as scaffolds, attract researchers' interest because of their relative nontoxic nature, their abundance as natural products, their easy combination with other materials, and the relative easiness to establish Marketing Authorization. The last 15 years were chosen to review, document, and elucidate the developments on cell-seeded natural biomaterials for articular cartilage treatment in vivo. The parameters of the experimental designs and their results were all documented and presented. Considerations about the newly formed cartilage and the treatment of cartilage defects were discussed, along with difficulties arising when applying natural materials, research limitations, and tissue engineering approaches for hyaline cartilage regeneration. Impact statement This review includes information from the literature and has never been complied before. The last 15 years were chosen to document and elucidate the developments on in vivo, articular cartilage treatment with cell-seeded natural biomaterials. The parameters of the experimental designs and their results were all documented and presented thoroughly. Natural materials overall seem to have a positive role in the recovery of cartilage defects. We expect that the knowledge from this review will be very useful to researchers organizing experimental protocols on critical analysis of advanced therapy medicinal products for human use.