Tissue engineering Involves the ex vivo production of replacement organs and tissues using cell precursors and natural products and/or synthetic biomaterials as scaffolds to support the repair, regeneration, remodelling and eventual structural and/or functional replacement of injured, diseased and pathological tissues. In the USA there are currently over 500000 arthroplastic and joint replacements performed each year which include over 100000 knee joint replacements and 50,000 other joint surgical procedures to treat defects of the knee. Many of these procedures result from arthritis and other degenerative joint diseases but also many are derived from sporting and everyday activity-related injuries.
Tissue engineering offers a means of treating joint injuries and defects prior to the need for joint replacement surgery. The procedure of autologous chondrocyte implantation (ACI) has been highly successful in aiding cartilage repair of trauma injuries but the outcomes are inconsistent.
The 2 major problems that are encountered are:
- Altered chondrocyte phenotype results in the formation of fibrocartilage not hyaline cartilage
- Poor integration of newly synthesised cartilage with the endogenous articular cartilage
Poor integration of newly synthesised cartilage in the ACI procedure is due to 2 principal factors:
1. Cell death at the cut (debrided) surface
2. Lack of chondrocyte migration
This lecture will cover some recent research we have undertaken to overcome these 2 factors as well as presenting data on the use of Pulsed Low Intensity Ultrasound (PLIUS) treatment in enhancing cartilage repair strategies.