Affiliations: Department of Orthopedics and Rheumatology, University Hospital Marburg, Marburg, Germany
Correspondence:
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Corresponding author: Turgay Efe, Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043 Marburg, Germany. Tel.: +49 6421 5863790; Fax: +49 6421 5867007; E-mail:efet@med.uni-marburg.de
Abstract:
BACKGROUND: Tissue engineering has provided the orthopedic surgeon with a
vast portfolio of methods for replacement or regeneration of articular
cartilage or meniscal tissue. On the one hand cell based techniques such as
autologous chondrocyte transplantation (ACT) are a main focus of interest.
On the other hand cell free techniques are rapidly evolving and gaining more
interest. The European Union regulation of November 2007, demanding proof of
efficacy in cases of autologous cell transplantation, additionally increased
the interest in cell-free techniques [1]. OBJECTIVE: The aim of this review was to discuss the advantages and
disadvantages of cell-based and cell-free procedures and to summarize the
clinical evidence for cell-free, tissue engineering procedures in orthopedic
surgery for meniscal and cartilage defects. METHODS: A systematic review was performed searching for clinical human
studies evaluating cell-free repair procedures for cartilage and meniscus
defects. All human study reports with English or German language abstracts
were included. RESULTS: The search revealed 82 studies of which only 12 met the inclusion
criteria. Overall good clinical results for the use of cell-free meniscal
and cartilage scaffolds were reported. CONCLUSION: With improved understanding of the healing process in cartilage-
and meniscal-defects, acellular, off the shelf products might gain more
importance.
