Abstract
Regenerative therapy in orthopaedic applications has the burden to compete with already successful treatment options for joint diseases. Today, localized cartilage defects can effectively be treated by matrix-assisted autologous chondrocyte transplantation. However, this requires chondrocyte harvesting from healthy parts of the joint and makes the surgical performance a two-stage procedure. Mesenchymal stem cells (MSC) would offer the possibility to spare the first step. But there are differences between chondrocytes and MSC that still put their suitability for this task under question.
In tissue engineering, cells have to complete steps in chondrogenic differentiation. Current studies suggest that there exist major differences in quality, speed and quantity between chondrocytes and MSC passing the chondrogenic pathway. Chondrogenic hypertrophy still poses a major problem in the usage of MSC.
End stage degenerative joint disease, osteoarthritis, is currently being treated with endoprosthesis implantation. Due to the multi-faceted nature of the disease it seems unlikely to become solely treated by a regenerative approach. However, there might be certain aspects, like inflammation, that could possibly be targeted by MSC therapy. Other possible indications and their clinical limitations will be discussed. All regenerative approaches will be under the surveillance of drug laws, that require a high standard in preclinical and clinical data. It will be the task for the future to develop a set of tools in order to meet those demands.
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Bernstein, P. (2012). Chondrocytes and Mesenchymal Stem Cells in Cartilage Tissue Engineering and in the Regenerative Therapy of Joint Diseases. In: Hayat, M. (eds) Stem Cells and Cancer Stem Cells, Volume 5. Stem Cells and Cancer Stem Cells, vol 5. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2900-1_28
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