Modern technologies for replacement of cartilage defects
Authors: Buryanov O.A. , Chornyi V.S. , Bazarov M.O. , Mohilnytskyy A.О. , Hutsailiuk V.І. , Kusyak А.P. , Honchar K.V. 
Published: August 2024

Background. The prevalence of joint diseases affecting cartilage tissue and all components of the joint due to trauma and degenerative-dystrophic conditions has notably risen in recent years. Despite an extensive body of research, addressing large bone and cartilage defects remains a significant clinical challenge. This reality underscores the imperative to innovate treatment methods and enhance existing approaches. In this review, we will examine and analyse contemporary materials and techniques for replacing cartilage defects, including hydrogels, nanofibers, 3D membranes, and BioCartilage. Additionally, it explores key aspects of orthobiology, specifically the utilisation of mesenchymal stem cells and exosomes. The article also considers instances of employing modern methods to replace cartilage defects in both experimental and clinical studies. The purpose was to investigate, analyse, and interpret data on the application of contemporary materials and methods for cartilage defect replacement as described in experimental, clinical, and review studies. Materials and methods. A comprehensive literature search was conducted using terms such as osteochondral defect, BioCartilage, nanofiber, allograft cartilage, mesenchymal stem cell, hydrogel, and nonwoven membranes. The search was conducted on the basis of Google Scholar, CrossRef, PubMed databases for the last 5 years. Logical analysis and evaluation were performed on the results of studies encompassing diverse modern technologies and principles for replacing cartilage tissue defects. Results. Microfracturing and tunneling are quite effective methods in replacing cartilage defects with cartilage-like regenerate. Their effectiveness reduces with increa-sing mechanical and axial loads on the formed regenerate. Experimental studies show that physical properties of hydrogel can be compared to native cartilage tissue. Moreover, hydrogel can be used as a matrix for the delivery of anti-inflammatory and some biological drugs. However, this method needs more specific clinical and experimental studies to be put into practice. The use of exosomes to replace osteochondral defects is a simple method, but rapid degradation limits its effectiveness. Combining exosomes with hydrogel or hyaluronic acid can solve these problems by prolonging their release and degradation, enhancing biological activity and biocompatibility. Bioprinting and nanofiber sponge (3D membrane) have reasonable theoretical and experimental value for replacing cartilage defects and require further clinical studies. Promising methods of cartilage tissue regeneration are the implantation of autologous chondrocytes, the use of ChondroFiller and BioCartilage. For a wider assessment of the results of using these treatment methods, longer clinical studies are needed. ­Conclusions. An analysis of more than 36 literature sources, including review, experimental, and clinical studies, reveals a structured summary of the latest research and developments in cartilage tissue defect repair. There is no universal technology for replacing cartilage defects that would be suitable for all patients. Therefore, this review highlights the advantages of different methods for cartilage defect repair adapted to specific clinical cases. Based on the analysis of literature data regarding the use of implant materials to correct cartilage defects in orthopaedics and traumatology, it can be concluded that the chosen direction of scientific research is relevant and significant. Additionally, certain aspects of the development of this issue can be outlined, and questions requiring further study and resolution can be identified.