Chapter 42 - Articular Cartilage

Abstract

Publisher Summary Cell-based therapies are employed significantly in regenerating the damaged cartilage tissue. One of the therapies is periosteal transplantation in which periosteal flap is used to cover the defects and the defects are repaired and filled after 4 weeks with a hyaline-like cartilage whereas the empty control defect shows fibrocartilage-like repair tissue. Another is perichondrial transplantation that involves placing perichondrium, taken from the cartilaginous covering of the rib, into the chondral defect of the affected joint. An array of marrow-stimulation techniques, including abrasion arthroplasty, drilling, and microfracture, are used to treat cartilage defects. Microfracture, a technique commonly used in the clinic, involves the creation of small holes in the underlying bone to allow blood, bone marrow, and marrow-derived mesenchymal stem cells (MSCs) into the cartilage defect site. The minced cartilage technique is a recent development and in its procedure, autologous cartilage tissue is minced into small pieces, placed on a scaffold carrier, and applied to the defect site. By mincing the tissue and spreading it evenly on the scaffold, a larger surface area compared to autologous chondrocyte implantation (ACI) could be created and implanted for cartilage repair in the same surgical session. Mesenchymal stem cells (MSCs) isolated from the bone marrow and other sources could provide an alternative and abundant supply of cells for cartilage repair procedures. Adult marrow stromal cells are investigated for the treatment of defects in connective tissues using cell and gene therapy and tissue-engineering approaches.