An overview on Tissue Engineered Cartilage Products
An overview on Tissue Engineered Cartilage Products
Mohsen Safaei,1Zahra Abpeikar,2,*
1. Department of Medical Biotechnology, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran 2. Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran
Introduction: Articular cartilage has no blood vessels, nerves and lymph vessels accordingly, has a limited ability to repair itself after damage. Osteoarthritis is one of the most common joint diseases that result from the breakdown of articular cartilage and underlying bone and imposes high costs on countries' health care; thus, it is important to identify methods that stop or slow the progression of osteoarthritis. The Traditional strategies of surgery such as microfracture (MF), osteochondral autologous transplantation (OAT), osteochondral allograft transplantation (OCA), particulated articular cartilage implantation (PACI), and autologous chondrocyte implantation (ACI) have a limited ability for tissue repair and regeneration and have some limitations. Tissue engineering strategies as alternative approaches to current surgical procedures have raised new hopes for the repair and regeneration of articular cartilage.
Methods: This review information was accumulated from published papers, websites of companies and related patents.
Results: The tissue-engineered cartilage products can be divided into scaffold-free and scaffold-based approaches. Two products in the group of scaffold-free constructs include Chondrospheres®, also called ACT3D-CS or ARTHROCELL 3D®, and DeNovo® ET or RevaFlex™. Chondrospheres® are small spheroids formed by the proliferation of autologous chondrocytes and their associated ECM (Extra Cellular Matrix). RevaFlex™ is a disc composed of young allogeneic chondrocytes and their associated ECM. Studies have shown that young chondrocytes are better able to proliferate and secrete matrix than adult chondrocytes. Scaffold-based products can be divided into hydrogels and macroporous scaffolds. Cartipatch® and CaReS® are hydrogel scaffolds. Cartipatch® is an agarose-alginate hydrogel loaded with autologous chondrocytes. The CaReS® implant consists of type I collagen hydrogel containing autologous chondrocytes. The following can be mentioned from the category of macroporous scaffold: Matrix-induced Autologous Chondrocyte Implantation (MACI) is obtained from decellularized porcine peritoneal tissue loaded with expanded autologous chondrocytes. NeoCart® consists of a honeycomb bovine type I collagen scaffold loaded with expanded autologous chondrocytes. Thus, MACI and NeoCart® are both decellularized xenogeneic grafts. Biocart™II is a fibrinogen/hyaluronic acid scaffold that is seeded with expanded autologous chondrocytes. NOVOCART®3D comprises a biphasic type I collagen scaffold loaded with autologous chondrocytes. Biocart™II and NOVOCART®3D scaffolds are fabricated using the freeze-dried technique. Hyalograft®C is a scaffold based on hyaluronic acid that is seeded with expanded autologous chondrocytes. Bioseed®-C comprises a polyglactin 910/poly-p-dioxanone fleece scaffold loaded with a fibrin solution and expanded autologous chondrocytes. Hyalograft® C and Bioseed®-C scaffolds both consist of woven and non-woven microfiber meshes. INSTRUCT is a poly (ethylene oxide-terephtalate)/poly (butylene terephtalate) (PEOT/PBT) scaffold loaded with bone marrow cells and primary autologous chondrocytes. Albeit, the details of this scaffold are unknown. A study explained the application of a Bioplotter device to fabricate a porous lattice construct with fibers approximately 170 μm in diameter, 200 μm pore size, and 56% of porosity. TruFit® and MaioRegen are among the cell-free scaffolds that have gone through the clinical trial phases and are now on the market. The TruFit® scaffold consists of a copolymer of polylactidecoglycolide, polyglycolide fibers, 10% calcium sulfate and surfactant. The MaioRegen scaffold is a three-layer biomimetic construct composed of collagen I and hydroxyapatite.
Conclusion: Cartilage tissue engineering is advancing with the identification of new scaffold fabrication techniques, the discovery of new stimuli, and improved surgical techniques that enable better regeneration of cartilage tissue. Comprehensive identification of current cartilage tissue engineering products provides a good basis for promotion the next generation of products.