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Articular Cartilage
Published in Manoj Ramachandran, Tom Nunn, Basic Orthopaedic Sciences, 2018
Tim S. Waters, Nima Heidari, George Bentley
A variety of growth factors are produced by chondrocytes, including FGF, IGF-1, transforming growth factor (TGF), platelet-derived growth factor (PDGF) and bone morphogenetic proteins (BMPs). There have been limited studies into the effect of these factors on articular cartilage repair. Although promising, none of these studies has shown any overall efficacy in human trials.
Tissue Engineering of Articular Cartilage
Published in Kyriacos A. Athanasiou, Eric M. Darling, Grayson D. DuRaine, Jerry C. Hu, A. Hari Reddi, Articular Cartilage, 2017
Kyriacos A. Athanasiou, Eric M. Darling, Grayson D. DuRaine, Jerry C. Hu, A. Hari Reddi
The characteristics of the in vivo system present many difficulties when pursuing articular cartilage repair strategies. However, the joint environment may provide some beneficial aspects as well. For instance, it has long been thought that articular cartilage is immunoprivileged, meaning transplanted cells and tissues are less likely to induce a sustained immune response from the body. This is directly related to the avascular and alymphatic nature of articular cartilage. Some amount of immune response is still expected, since almost all procedures will require surgical access to the joint through the capsule or otherwise exposing the synovial space. While the acute inflammation response to surgery or implantation can be severe, it can be limited by the use of arthroscopic or minimally invasive procedures. The immune characteristics of the joint space have allowed for successful outcomes using allograft tissue, for example, osteochondral grafts and anterior cruciate ligament transplants (Barber et al. 2010; Bedi et al. 2010; Bhumiratana et al. 2014). However, it needs to be demonstrated conclusively how xenogeneic tissues fare in a diarthrodial joint environment. A discussion about immunogenicity in response to xenogeneic and allogeneic materials is provided in greater depth in Section 6.2.
The knee
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Andrew Price, Nick Bottomley, William Jackson
Osteotomy above or below the joint used to be a popular method of treating arthritis of the knee, especially when articular destruction was more or less limited to one compartment and the knee had developed a varus or valgus deformity. With the development of joint replacement techniques, the operation gradually fell into disuse, or at best was seen as a temporizing measure to buy time for patients who would ultimately undergo some form of arthroplasty. However, improvements in technique and the introduction of operations for meniscal and articular cartilage repair have led to renewed interest in this procedure.
IGF-1-releasing PLGA nanoparticles modified 3D printed PCL scaffolds for cartilage tissue engineering
Published in Drug Delivery, 2020
Peiran Wei, Yan Xu, Yue Gu, Qingqiang Yao, Jiayin Li, Liming Wang
As cartilage is a tissue with poor capacity of regeneration, cartilage tissue engineering offers the ability to repair cartilage by combining cells, scaffolds, and signals (Armiento et al., 2018; Li et al., 2019). Insulin‐like growth factor‐1 (IGF‐1) has been extensively researched for its ability to encourage cell proliferation, inhibition of cell apoptosis, and anabolic effects on musculoskeletal tissues (Huat et al., 2014; Ramos et al., 2019). It has been demonstrated that IGF-1 is an anabolic growth factor that is very important in cartilage development and homeostasis (Tuncel et al., 2005). And Many studies have demonstrated the efficacy of IGF-1 for articular cartilage repair, but it is dose-dependent (Tuncel et al., 2005; Mullen et al., 2010). Thus, sustained release of IGF-1 is required.
An overview of thermal necrosis: present and future
Published in Current Medical Research and Opinion, 2019
Mohamed Mediouni, Theodore Kucklick, Sébastien Poncet, Riadh Madiouni, Amine Abouaomar, Henning Madry, Magali Cucchiarini, Bohdan Chopko, Neil Vaughan, Manit Arora, Kemal Gökkuş, Mario Lozoya Lara, Lorenlay Paiva Cedeño, Alexander Volosnikov, Mohamed Hesmati, Kevin Ho
Osteonecrosis potentially results in catastrophic failures of orthopaedic screw–bone constructs and sometimes even promotes infection7. In summary, the essential shortcomings of buttress threads include the risk of stripping, screw loosening, induction of stress risers, bone micro-fracturing, heat necrosis, with subsequent failure of fixation and risk of creating fracture nonunions and malunions8. In the field of articular cartilage repair, bone marrow stimulation is often performed using either a surgical twist drill bit or a Kirschner wire to introduce defined holes in the subchondral bone plate following meticulous removal of the calcified cartilage layer at the bottom of the defect. The subchondral bone plate is penetrated by the cutting tip of the instrument at a high speed9. Due to the heat generation during cartilage and bone drilling, the chondrocytes and osteoblasts are at risk. The use of a coolant such as saline during drilling is well established, as it avoids such heat necroses9. In the study by Chen et al.10, drilling with cooling did not cause greater osteocyte death than microfracture at one day postoperatively. Drill speed and drill diameter are other factors affecting the increase in temperature as a result of the bone drilling process10,11.
Histological study of costal cartilage after transplantation and reasons for avoidance of postoperative resorption and retention of cartilage structure in rats
Published in Journal of Plastic Surgery and Hand Surgery, 2018
Yukiko Rikimaru-Nishi, Hideaki Rikimaru, Shinichiro Hashiguchi, Tomonoshin Kanazawa, Keisuke Ohta, Kei-Ichiro Nakamura, Kensuke Kiyokawa
In the orthopedic surgery field, attempts have been made to create hyaline cartilage with normal mechanical properties by using bone marrow-derived mesenchymal stem cells (BM-MSC) or other methods. However, the wound bed for implanted cells tends to be a highly inflammatory or osteogenic microenvironment, which affects the viability of the implanted cells. It has been proven that the microenvironment regulates the mechanisms of cell integration. Accordingly, it is important to recognize that the tissue microenvironment may be involved in regulating the articular cartilage repair response [20]. Therefore, accumulation of more knowledge about the subcutaneous tissue microenvironment surrounding hyaline cartilage and cellular dynamics in that tissue may be necessary to improve the outcome of cartilage transplantation for plastic surgery.