Chondrogenesis and the Anti-catabolic Protection of Orthobiological Intervention
Articular cartilage defects have long-term progressive impacts on functional impairment and pain, this, as a consequence of poor healing and progressive degradation. The existing methods for bone cartilage regeneration involving minimally invasive intervention are microfracture, intra-articular injection or bio-scaffold implantation. But still, hyaline cartilage with appropriate mechanical properties needs further investigation.
The following characteristics including cost-effectiveness and easy accessibility of cartilage repair techniques for the increasingly required applied clinical use. Endogenous bio-repair of cartilage has been to stimulate the repair potential of endogenous tissue with exogenous substances, such as autologous platelet concentrate and hydrated hydrogel implantation.
Specifically, platelet concentrate is rich in bioactive protein growth factors and cytokines, and is understood to initiate and facilitate cartilage healing and repair regulation by stimulating chondrogenesis via cell proliferation. In addition to the effectiveness, platelet concentrate is a good biocompatibility for cartilage repair and has been increasingly demonstrated.
Hyaluronic acid has another good biocompatibility with chemical and physical relational properties. Hyaluronic acid is also very well hydrated and has the capability to slow the progression of degradative changes and simulate the extracellular matrix. Hyaluronic acid provides matrix for cell adhesion, proliferation and differentiation. This, promoting the stimulation of chondrogenic and osteogenic stem cells that act to aid cartilage repair as well as subchondral bone. However, although having very good benefits, it has been identified that the application of singular hyaluronic acid stimulated insufficient cartilage repair. It is the addition of bioactive protein growth factors which enable facilitation and progression of chondrogenesis. Autologous platelet concentrate provides an essential role here in providing facilitation of chondrogenesis and bone repair. This providing far superior clinical outcomes in repair of localised defects using hyaluronic acid in combination with platelet concentrate – in interventional methods known as orthobiologics. Furthermore, hyaluronic acid and platelet concentrate have the ability to provide chondroprotection, hereby, reducing friction, catabolic changes and inflammatory cytokines like tumor necrosis factor.
Regenerative orthobiologics aims for joint preservation and articular regeneration in order to reduce pain and inflammation and to slow the progression of degenerative changes. Regenerative methods are continuing to be increasingly adopted due to the physiological structure of articular cartilage, having limited self repair capacity. This clinical need leads to the ongoing development of therapies to promote chondrogenesis and osteogenesis.
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