Biomedical Engineering Reference
In-Depth Information
Cartilage Regeneration
2.3 Needs for Cartilage and Bone Regeneration
Articular cartilage can be damaged by trauma or disease, such as
osteoarthritis and rheumatoid arthritis, which affect many people
worldwide: 9.6% of men and 18% of women over 60 years of age
show signs of osteoarthritis [31, 32]. Furthermore, due to the inherent
properties of cartilage, an avascular, aneural, and alymphatic tissue,
self-renewal and healing often does not occur. In contrast, bone
does have regenerative capacity; however, there is still a need for
treatments to repair non-healing fractures caused by extensive trauma
or underlying disease states. For example, each year in the United
States, over 1.3 million craniofacial bone procedures and 230,000
dental bone grafts are performed [33]. Osteoporosis, an age-related
decrease in bone density, leads to fractures in the weakened bones,
affecting approximately one million Americans each year at a cost
of over $14 billion [1].
As a method to stimulate cartilage and bone regeneration, one avenue
that is gaining traction is the use of tissue engineered constructs,
which combine cells, biological factors, and a biomaterial scaffold.
The scaffold used in these constructs should not only provide a
mechanically supportive structure and allow nutrient transport but also
be degradable to promote tissue regeneration. For cartilage, HA is an
attractive material choice due its overall function in chondrogenesis and
its chondroinductive properties [34]. An early study demonstrated the
value of HA as a material for supporting chondrogenic differentiation
by culturing mesenchymal stem cells (MSC) on surfaces coated with
HA. The MSC showed improved chondrogenic differentiation,
observed by phenotype retention and cartilage nodule production,
when cultured on these HA-coated surfaces [35]. For bone, an HA
scaffold would mimic elements of the ECM of the cartilaginous
template in the growth plate during development. In addition to these
properties, HA can be chemically modified and functionalised, thus
allowing it to serve as a scaffold, either alone or in combination with
other materials as described below.
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