![]() This review discusses the potential use of ECM-based biomaterials for AC defect repair ( Figure 1). As a result of these unique characteristics, cartilage ECM has superior advantages as a potential scaffold material for the repair of AC defects. However, the highly unique, complex structure of AC ECM, as well as its multiple components mean that it cannot be simulated by any material. This promotes regeneration of the structure and function of the AC ( Swinehart and Badylak, 2016). The use of ECM-based AC biological scaffolds as cartilage repair scaffold materials provides mechanically supportive macroscopic and microscopic environment. Currently, scaffolds used in tissue engineering are biomimetic prepared from natural materials and synthetic materials according to the structure and composition characteristics of AC ECM ( Li et al., 2021). Tissue engineering technology is mainly to obtain seed cells through in vitro isolation and culture, and then inoculate them into scaffolds to construct tissue engineering repair materials and implant AC defects for repair ( Krafts, 2010 Eftekhari et al., 2020). Contrastingly, tissue-engineered AC shows superior benefits ( Fu et al., 2020). Although widely used and effective, these methods all possess various limitations and disadvantages ( Richter et al., 2016) ( Table 1). And there are three common AC regeneration techniques used in clinics including microfracture (MF) ( Kraeutler et al., 2020), autologous chondrocyte implantation (ACI) ( Gille et al., 2016) and autologous/allogeneic cartilage transplantation ( Hangody et al., 1997 Frank et al., 2018). Conservative treatment is mainly to relieve pain and inflammation through drugs, including nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase 2-selective (COX-2) inhibitors and articular cavity injection of corticosteroids ( Yang et al., 2020). Currently, the repair of AC injury includes conservative treatment and surgical treatment. ![]() As a result, AC rarely regenerates or repairs itself after damage or degeneration caused by common diseases such as osteoarthritis ( Camarero-Espinosa et al., 2016). These chondrocytes are extremely poor at proliferating at a rate of almost zero. It is composed of low levels of chondrocytes (∼1–5% of the total tissue volume), which are surrounded by compact anti-adhesion extracellular matrix (ECM). In addition, the future development of ECM-based biomaterials is hypothesized.Īrticular cartilage (AC) is a hydrated viscoelastic connective tissue that does not have innervation, lymphatic contraction or blood flow. ![]() This review systematically investigates the following: the characteristics of cartilage ECM, repair mechanisms, decellularization method, source of ECM, and various ECM-based cartilage repair methods. These scaffolds mimic the versatility of the native ECM in function, composition and dynamic properties and some of which are designed to improve cartilage regeneration. In recent years, with advances in medicine, biochemistry and materials science, to meet the regenerative requirements of the heterogeneous and layered structure of native articular cartilage (AC) tissue, a series of tissue engineering scaffolds based on ECM materials have been developed. Whereas, little progress has been made in this field. Techniques facilitating the repair and/or regeneration of articular cartilage pose a significant challenge for orthopedic surgeons. To date, traditional tissue engineering methods by using natural and synthetic materials have not been able to replicate the physiological structure (biochemical composition and biomechanical properties) of natural cartilage. Natural ECM plays a role in mechanical and chemical cell signaling and promotes stem cell recruitment, differentiation and tissue regeneration in the absence of biological additives, including growth factors and peptides.
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