Biology of Cartilage Repair Over the past several decades, much has been learned about joint cartilage and its physiological capacity to restore itself. While joint cartilage does appear to have some regenerative capabilities, it appears to lose this capacity with age, making restoration of joint surfaces more and more difficult. Several studies have shown the important influence of mechanical loading on the healing of joint cartilage. Recent experimental and preliminary clinical studies have revealed that transplanted cells or tissue, synthetic matrices, and growth factors have the potential to stimulate the formation of new cartilage. However, to date, no technique has been completely successful in achieving exactly normal regenerative articular cartilage.
Additional research is needed to develop new approaches for the repair of cartilage.
Optimum methods for the restoration of cartilage may require a number of different strategies combined with the right mechanical stimuli. Osteoarthritis takes decades to develop and progress. Identifying novel therapies to prevent or delay joint destruction is a common goal for NIH, FDA, and the pharmaceutical industry. Therapies to prevent, delay, or repair joint destruction have not been tested despite major advances in understanding of the disease in large part because of the inability to accurately measure disease progression and response to candidate therapies. A collaborative arrangement to evaluate biomarkers as potential surrogate endpoints for structural change in osteoarthritis that meets the needs of the private sector and the regulatory agencies has the potential to significantly advance the discovery and transfer new osteoarthritis therapies into patient care.