Articular Cartilage's Struggle with Regeneration

The Future of Tissue Engineering

Starting in the 1980’s tissue engineering has gradually grown as a new discipline, also exhibiting a significant market potential. Technical advances and the identification of new cell types for use in tissue regeneration contribute to the growth of this field. In the future, the main focus of the biological aspect will be development of tissue-engineered products under consensus safety standards (testing of materials, sourcing of cells and tissue, preclinical and clinical trials and evaluations, etc.). Though extremely promising, the outcomes of tissue engineering research have not fully tranlsated into clinical products.

The Biological Aspect

Despite treatments mentioned in the surgery portion of the website, a variety of new procedures and techniques are emerging. Rather than using in vitro tissue engineering, the implantation of a scaffold in vivo, with or without cells, is a new concept that would allow regeneration to occur with little or no additional manipulation. Healing time for this method is anticipated to be less than in vitro. However, scientists keep in mind the rigorous mechanical environment in active joints that makes cartilage regeneration challenging.

Several bioactive molecules exist in living bodies that cannot be modeled well in vitro, which is another reason to use in vivo techniques where the cartilage will be regenerating in its natural environment. While the new methods that have been researched have their pros and cons, complete regeneration comparable to the healthy tissue has not yet been achieved. With time and research, the future of tissue engineering’s focus on obtaining total regeneration could result in a successful breakthrough, bringing relief to approximately one quarter of the adult population with cartilage injuries and disease.

In Vivo Implantation

In vivo implantation of a tissue engineered construct into a cylindrical defect on the articular surface.

The Business Aspect

Apart from the biological aspect of tissue engineering, the business aspect is often considered a speed bump. Biological products, such as blood, vaccines, tissues, and cellular and gene therapies derived from humans, animals, and microorganisms are regulated by the FDA's Center for Biologics Evaluation and Research (CBER). There is no doubt that new products related to articular cartilage will require the use of biological materials, such as cells and various chemicals, that are regulated by CBER. As a result, the pathway to approval is expected to be long and difficult because CBER requires an extensive series of pre-clinical and clinical studies. 

Also, the manufacturing of medical devices, those often used in implantation and as in vitro reagents, are regulated by the Center for Devices and Radiological Health (CDRH). Tissue engineered cartilage, as an implant, may also be regulated by the CDRH. A medical product intended to promote public health must undergo several checkpoints in order to be both safe and effective, and reaching this stage is not easy, especially if a potential product is regulated by both CBER and CDRH.

Though current surgical procedures are inadequate for providing a long-term biological solution, the Department of Biomedical Engineering at UC Davis envisions a day when both autologous and allogeneic cell sources can be used to tissue engineer biological constructs to replace diseased articular cartilage.  The cells can be stem cells originating from either the patient's own skin or from stem cell banks. The idea is to replace the use of artificial components with biological tissue engineered in the lab.

While tissue engineered products of articular cartilage are currently not available in the US, unlike Europe and Asia, it is expected that valuable lessons learned in Europe and Asia will help the filed in the US. Though a difficult pathway, there is no doubt that there is a bright future toward treating cartilage afflictions using tools from tissue engineering.


Make a Free Website with Yola.