Challenging for cartilage repair

Excerpt

When we look back on the past 15-year history of cartilage repair, it is clear that remarkable progress has been made in this area. There is no doubt that a lot of studies have been carried out on cartilage repair and chondrocytes since Brittebergs' report on ACI in 1994 [1]. I would like to introduce our multi-pronged approach to cartilage repair. After the 1994 report [1], we performed implantation of tissue-engineered cartilage made ex vivo for the treatment of osteochondral defects of the joints, to avoid the leakage of grafted cultured chondrocytes in suspension [2, 3]. Sixty knees of 57 patients with full-thickness cartilage defects were followed-up over 5 years. The clinical rating improved significantly after implantation of tissue-engineered cartilage and was maintained for an average of 8.3 years. The arthroscopic findings 2 years after implantation were graded as normal or nearly normal according to the ICRS scale in more than 90% of patients. Biomechanically, stiffness of the graft almost equaled the surrounding normal cartilage (87.9 ~102.5%) 2 years after implantation. …