What are the important issues when it comes to cartilage repair and stem cells?

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What are the important issues when it comes to cartilage repair and stem cells?



What are the important issues when it comes to cartilage repair? The first is to know that whatever method is used is effective in building articular cartilage. There are two types of cartilage. The first is hyaline cartilage which is the tough gristle that caps the ends of long bones. The second is fibrocartilage which is the softer cartilage which is found in knee meniscus, and the labral tissue of the shoulder and hip. The second issue is what type of cell to use. Adult autologous mesenchymal stem cells – the ones that come from the patient- are the ones that are easiest to harvest and to use. But are they the most effective? Allogeneic donor cells may prove to be a more viable source, providing graft versus host reactions will not be an issue. How do we ensure stem cell survival in the hostile environment of an arthritic joint? The use of growth factors and other “protective” factors need to be considered. What are the optimal conditions that will ensure a good outcome? Stem cells should be viewed as if they were vulnerable infants. Much work has been done in the field of biomaterial scaffolding. Is it really necessary? While in vitro studies and small animal studies appear promising, no definitive human studies have been done. It will be important to make sure that whatever new cartilage is made with stem cells adheres to the underlying bone. And probably most important is the answer to the question… What will be the longevity and durability of the new cartilage?
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