Cartilage Repair Techniques in Orthopedic Surgery
Summary
Articular cartilage is a specialised tissue that lines joint surfaces, providing low‐friction articulation and load distribution. Its limited intrinsic capacity for self‐repair has driven the development of diverse surgical and bioengineering approaches to restore cartilage integrity and function. Traditional marrow stimulation techniques such as microfracture aim to recruit progenitor cells by perforating the subchondral bone, yielding a fibrocartilaginous repair tissue. Cell‐based therapies, notably autologous chondrocyte implantation (ACI) and its matrix‐assisted variants, utilise expanded chondrocytes seeded on biomaterial scaffolds to produce hyaline‐like cartilage. Osteochondral grafting transfers native cartilage with underlying bone either from the patient (autograft) or a donor (allograft), offering immediate structural repair. More recently, tissue‐engineering strategies have combined three‐dimensional scaffolds composed of natural or synthetic polymers with mesenchymal stem cells and bioactive factors to direct chondrogenic differentiation. These approaches have been enhanced by novel delivery systems—such as extracellular vesicles derived from stem cells—that modulate local cellular responses via paracrine signalling. Together, these techniques encompass a spectrum of regenerative strategies designed to improve long‐term joint function and delay osteoarthritic progression.
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Cartilage Repair Techniques in Orthopedic Surgery publication trend
The graph below shows the total number of articles in cartilage repair techniques in orthopedic surgery across all publications each year (not limited to Nature Index journals).
Technical terms
Microfracture: A surgical technique creating small perforations in subchondral bone to release marrow elements and stimulate cartilage repair.
Scaffold: A three-dimensional biomaterial matrix that provides structural support and a template for cell attachment, proliferation and tissue formation.
Mesenchymal stem cells: Multipotent progenitor cells capable of differentiating into chondrocytes, osteoblasts and other mesodermal lineages.
Extracellular vesicles: Nano-sized lipid vesicles released by cells, carrying proteins, lipids and nucleic acids that modulate recipient cell behaviour.
Chondrocyte: A specialised cell responsible for maintenance and synthesis of cartilage extracellular matrix, including collagen and proteoglycans.
References
- HWJMSC-EVs promote cartilage regeneration and repair via the ITGB1/TGF-β/Smad2/3 axis mediated by microfractures. Journal of Nanobiotechnology (2024).
- Rapid Recovery after Reparation of Full-Thickness Chondral Defects of the Knee with the Use of Hyaluronan (HA)-Based 3-D Scaffold. Journal of Functional Biomaterials (2023).
- Elastomeric Porous Poly(glycerol sebacate) Methacrylate (PGSm) Microspheres as 3D Scaffolds for Chondrocyte Culture and Cartilage Tissue Engineering. International Journal of Molecular Sciences (2023).
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