2021 Guest Nation

The successful clinical report of ACI in 1994 has paved way for tremendous advances in cell therapy for cartilage repair.

What started from autologous chondrocytes, we can now utilize allogenic stem cells thanks to the advances in stem cell biology. Technological advances in biomaterials has also led to utilization of various natural material scaffolds.

Despite these progresses, it is still difficult to say that cell therapy is an ideal treatment modality for cartilage defects. Many questions remain unanswered, such as the survivorship of implanted cells. Furthermore, there is little evidence that scaffolds provide the ideal environment for cells to differentiate and secrete appropriate extracellular matrices, and some evidence even suggest that scaffolds interfere with the repair process overall. Not surprisingly, recent research reveals that cartilage repair depends more on the migration of host cells rather than the differentiation of implanted cells.

The ideal mode of action of cell therapy would involve the survival and subsequent production of extracellular matrix of implanted cells. Ideal scaffolds would be of cartilage extracellular matrix material that would serve as vehicles of cell delivery and participate in cartilage repair and host remodeling without degradation.

Scaffold free cartilage engineering has recently proved to improve many limitations of previous cartilage repair strategies and preserve the intended mode of action of cartilage repair.