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Front. Surg. | doi: 10.3389/fsurg.2018.00070

Cartilage Tissue Engineering using Stem Cells and Bioprinting Technology – Barriers to Clinical Translation

  • 1The University of Melbourne, Australia
  • 2Department of surgery, The University of Melbourne, Australia
  • 3Department of Orthopaedics, St Vincent's Hospital (Melbourne), Australia
  • 4Department of Orthopaedics, St Vincent's Hospital (Melbourne), Australia
  • 5Australian Research Council, Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, University of Wollongong, Australia

Abstract
There is no long-term treatment strategy for young and active patients with cartilage defects. Early and effective joint preserving treatments in these patients are crucial in preventing the development of osteoarthritis.

Tissue engineering over the past few decades has presented hope in overcoming issues involved with current treatment strategies. Novel advances in 3D bioprinting technology have promoted more focus on efficient delivery of engineered tissue constructs. There have been promising in-vitro studies and several animal studies looking at 3D bioprinting of engineered cartilage tissue. However, to date there are still no human clinical trials using 3D printed engineered cartilage tissue.

This review begins with discussion surrounding the difficulties with articular cartilage repair and the limitations of current clinical management options which have led to research in cartilage tissue engineering. Next, the major barriers in each of the 4 components of cartilage tissue engineering; cells, scaffolds, chemical and physical stimulation will be reviewed. Strategies that may overcome these barriers will be discussed. Finally, we will discuss the barriers surrounding intraoperative delivery of engineered tissue constructs and possible solutions.

Keywords: Cartilage, Stem Cells, scaffolds, Hydrogels, Tissue Engineering, Bioprinting, Biofabrication

Received: 31 Aug 2018; Accepted: 08 Nov 2018.

Edited by:

Zsolt J. Balogh, University of Newcastle, Australia

Reviewed by:

KONSTANTINOS MARKATOS, Biomedical Research Foundation of the Academy of Athens, Greece
Holly T. Pilson, Independent researcher  

Copyright: © 2018 Francis, Di Bella, Wallace and Choong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Sam L. Francis, The University of Melbourne, Melbourne, Australia, sam2703@gmail.com