Abstract
For more than 250 years, physicians and scientists have been seeking ways to repair or regenerate synovial-joint articular surfaces following articular-cartilage loss or degeneration (1–3). (Repair refers to restoring a damaged articular surface with new tissue that resembles but does not duplicate the structure, composition, and function of articular cartilage; regeneration refers to forming new tissue indistinguishable from normal articular cartilage [4–6].) They made little progress for the majority of these 250 years, but in the last three decades clinical and basic scientific investigations have shown that implantation of artificial matrices, growth factors, perichondrium, periosteum and transplanted chondrocytes, and mesenchymal stem cells can stimulate formation of cartilaginous tissue in synovial-joint osteochondral defects (6–10). Other work has demonstrated that joint loading and motion can influence articular cartilage and joint healing (11–13) , and that mechanical-loading influences the repair process in all of the tissues that form parts of synovial joints (5,14,15). In addition, review of several operative procedures used to treat osteoarthrosis (OA), including osteotomies, penetration of subchondral bone, and joint distraction and motion, has shown that these procedures can stimulate formation of new articular surfaces (9).The apparent potential of these multiple methods for stimulating formation of cartilaginous-articular surfaces has created great interest on the part of patients, physicians, and scientists, however the wide variety of methods and approaches to assessing their results have made it difficult to evaluate their success in restoring joint function and to define their most appropriate current clinical applications.
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Buckwalter, J.A., Martin, J.A. (2002). Promoting Articular Cartilage Repair. In: Tsokos, G.C. (eds) Modern Therapeutics in Rheumatic Diseases. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-239-5_14
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