Articular cartilage tissue engineering by K A Athanasiou; Eric M Darling; Jerry C Hu

By K A Athanasiou; Eric M Darling; Jerry C Hu

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Vertical and sometimes horizontal fissures can be seen in the cartilage. Proteoglycans start to leave from the fissures and an absence of staining will spread from these areas to the rest of the tissue. These patterns of increased tissue fragmentation and decreased staining continues until the cartilage, completely robbed of its abilities to withstand load, is worn away to expose the subchondral bone. During these cartilage changes, bone and synovium remodeling occurs as described previously. When considering this cascade of events, it is not surprising to note that OA cartilage possesses inferior mechanical properties.

34 CHAPTER 3. IN VITRO TISSUE ENGINEERING Due to limits on the availability of human tissue, some have suggested that cross-species cell implantations might be an alternative option. Xenogeneic transplants have been successfully used in sheep [296], goats [297], and rabbits [298]. However, similar difficulties exist with xenogeneic transplants as with allogeneic transplants, namely immunogenicity concerns. Further complications could arise with cross-species compatibility issues at the cellular and molecular level.

Osteoarthritis (OA) affects over one fifth of the US population over 45 and almost one half of those over 65. • OA cartilage loses proteoglycans and possesses lower mechanical properties. Wear of the cartilage can lead to complete destruction of the articular surface and significant pain. • In the US alone, costs of OA are in excess of $65 billion per year (both medical costs and lost wages). Comorbidities are common with OA and are also costly to manage. • In addition to the elderly, cartilage injuries in children and adolescents are increasingly observed, with roughly 20% of knee injuries in adolescents requiring surgery.

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