Articular cartilage defect repair with particulated juvenile cartilage allograft: existing problems and prospects / 中国组织工程研究

ABSTRACT

BACKGROUND: Particulated juvenile cartilage allograft is simple and easy to obtain, and chondrocytes can migrate and proliferate as confirmed by in vitro culture.In the Unite States,this technique has been used in the repair of cartilage defects in the hip, knee, ankle, and elbow joints. OBJECTIVE: To review the present situation, application, and value of particulated juvenile cartilage allograft transplantation for articular cartilage repair. METHODS: A computer-based search of CNKI, PubMed, and Elsevier was performed for retrieving articles concerning particulated juvenile cartilage allograft transplantation for articular cartilage repair published from October 1983 to June 2017. The keywords were "allogeneic juvenile cartilage particles; cartilage tissue engineering; articular cartilage defects;repair" in Chinese and English, respectively. After initial screening of titles and abstracts and exclusion of irrelevant articles, 48 eligible articles were included in final analysis. RESULTS AND CONCLUSION: (1) Although a variety of treatments for cartilage repair have achieved good clinical outcomes in short-term follow-up, improving the motor function of patients and relieving pain, patients eventually develop progressive degeneration of the articular cartilage and suffer from osteoarthritis. (2) Chondrocytes from allogeneic juvenile cartilage particles have stronger ability of proliferating and repairing cartilage defects in vitro than mature chondrocytes,and have low antigenicity,which cannot cause a strong rejection after in vivo transplantation.What's more, particulated juvenile cartilage allograft transplantation can be performed as one-stage surgery if cartilage defects are confirmed under arthroscopy. (3) Particulated juvenile cartilage allograft transplantation has achieved good outcomes in basic and clinical studies in the United States. Its potential superiority has gradually been accepted by doctors and patients. (4) There are also risks for being contaminated and spreading diseases during the preparation of particulated juvenile cartilage allograft. This technology has been widely used in the United States, but there are rare data concerning its follow-up studies. Therefore, an investigation on its long-term follow-up is indispensable for the objective assessment of its long-term efficacy, with a view to the extensive promotion of this technology in the clinical practice.