Hydrogels for the Repair of Articular Cartilage Defects
Hydrogels for the Repair of Articular Cartilage Defects
复制标题
DOI：
10.1089/ten.teb.2011.0077
复制
发表时间：
2011-08-01
影响因子：
6.4
通讯作者：
Lowman, Anthony M.
中科院分区：
文献类型：
--
作者：
Spiller, Kara L.;Maher, Suzanne A.;Lowman, Anthony M.
关节软骨缺损的修复仍然是骨科医学的一个重大挑战。水凝胶，在水中溶胀的三维聚合物网络，提供了一个独特的机会，以产生一个功能性软骨替代品。水凝胶可以表现出与关节软骨相似的机械、溶胀和润滑行为，并通过包封的细胞促进软骨形成表型。水凝胶已经由天然衍生的和合成的聚合物制备，作为无细胞植入物和作为组织工程支架，并且具有受控的降解特性和刺激生长因子的释放。使用水凝胶，软骨组织已经在体外工程化，具有与天然软骨相似的机械性能。本文综述了在确定水凝胶替代受损软骨或支持新组织形成的潜力方面所取得的进展，这些进展取决于特定的设计参数，如聚合物类型、降解特性、机械性能和加载方案、细胞来源、细胞接种密度、生长因子的受控释放以及与周围组织整合的策略。临床转化的一些关键挑战仍然存在，包括恢复关节功能所需的水凝胶植入物或工程组织的机械性能信息有限，以及缺乏对植入物以稳定方式与周围组织整合的能力的强调。未来的研究应该解决影响这些问题的因素，同时使用临床相关的细胞来源和严格的修复模型。
The repair of articular cartilage defects remains a significant challenge in orthopedic medicine. Hydrogels, three-dimensional polymer networks swollen in water, offer a unique opportunity to generate a functional cartilage substitute. Hydrogels can exhibit similar mechanical, swelling, and lubricating behavior to articular cartilage, and promote the chondrogenic phenotype by encapsulated cells. Hydrogels have been prepared from naturally derived and synthetic polymers, as cell-free implants and as tissue engineering scaffolds, and with controlled degradation profiles and release of stimulatory growth factors. Using hydrogels, cartilage tissue has been engineered in vitro that has similar mechanical properties to native cartilage. This review summarizes the advancements that have been made in determining the potential of hydrogels to replace damaged cartilage or support new tissue formation as a function of specific design parameters, such as the type of polymer, degradation profile, mechanical properties and loading regimen, source of cells, cell-seeding density, controlled release of growth factors, and strategies to cause integration with surrounding tissue. Some key challenges for clinical translation remain, including limited information on the mechanical properties of hydrogel implants or engineered tissue that are necessary to restore joint function, and the lack of emphasis on the ability of an implant to integrate in a stable way with the surrounding tissue. Future studies should address the factors that affect these issues, while using clinically relevant cell sources and rigorous models of repair.