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REVIEW
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Osteochondral scaffolds for early treatment of cartilage defects in osteoarthritic joints: from bench to clinic

Maryam Tamaddon1 ,  Helena Gilja1 ,  Ling Wang2 ,  J. Miguel Oliveira3,4,5 ,  Xiaodan Sun6 ,  Rongwei Tan7 ,  Chaozong Liu1*
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1 Institute of Orthopaedic & Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, London, UK
2 State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, Shaanxi Province, China
3 3B’s Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Portugal
4 ICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal
5 The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Portugal
6 School of Materials Science and Engineering, Tsinghua University, Beijing, China
7 Shenzhen Lando Biomaterials Co. Ltd. Merchants Guangming Science Park, Shenzhen, Guangdong Province, China
BMT 2020 , 1(1), 3–17; https://doi.org/10.3877/cma.j.issn.2096-112X.2020.01.002
Submitted: 30 June 2020 | Revised: 14 September 2020 | Accepted: 25 September 2020 | Published: 28 December 2020
Copyright © 2020 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution–NonCommercial–ShareAlike 4.0 License.
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Abstract

Osteoarthritis is a degenerative joint disease, typified by the loss in the quality of cartilage and bone at the interface of a synovial joint, resulting in pain, stiffness and reduced mobility. The current surgical treatment for advanced stages of the disease is joint replacement, where the non-surgical therapeutic options or less invasive surgical treatments are no longer effective. These are major surgical procedures which have a substantial impact on patients’ quality of life and lifetime risk of requiring revision surgery. Treatments using regenerative methods such as tissue engineering methods have been established and are promising for the early treatment of cartilage degeneration in osteoarthritis joints. In this approach, 3-dimensional scaffolds (with or without cells) are employed to provide support for tissue growth. However, none of the currently available tissue engineering and regenerative medicine products promotes satisfactory durable regeneration of large cartilage defects. Herein, we discuss the current regenerative treatment options for cartilage and osteochondral (cartilage and underlying subchondral bone) defects in the articulating joints. We further identify the main hurdles in osteochondral scaffold development for achieving satisfactory and durable regeneration of osteochondral tissues. The evolution of the osteochondral scaffolds - from monophasic to multiphasic constructs - is overviewed and the osteochondral scaffolds that have progressed to clinical trials are examined with respect to their clinical performances and their potential impact on the clinical practices. Development of an osteochondral scaffold which bridges the gap between small defect treatment and joint replacement is still a grand challenge. Such scaffold could be used for early treatment of cartilage and osteochondral defects at early stage of osteoarthritis and could either negate or delay the need for joint replacements.

Keywords
cartilage injury ; osteoarthritis ; osteochondral scaffold ; regenerative medicine ; subchondral defect ; tissue engineering
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Conflict of interest
The authors declare they have no competing interests.
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