21st Century Sports by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030508012
Publisher: Springer International Publishing

8 Cartilage Tissue Engineering

The highest number of sports injuries seen by sports medicine professionals are chondral and osteochondral defects (OCD) in the knee and ankle. In addition, there is high incidence of overuse conditions, i.e., injuries produced along a continuum, without identification of any punctual event responsible for the condition. These sports injuries are the result of an imbalance caused by continuous mechanical load-induced tissue fatigue and ultimately damage and the inability of cartilage to remodel and repair itself. Unfortunately, most overuse injuries have little capacity for reversibility once a threshold of tissue degeneration is surpassed.

The affected body region is often sport specific and particularly affects athletes competing at the highest levels. A systematic review of 11 studies revealed 36% (2.4–75%) prevalence of full-thickness focal chondral defects. The analysis included a total of 931 subjects, of whom 40% athletes were former players in the National Basketball Association (NBA) and the National Football League (NFL). The prevalence of secondary knee and hip osteoarthritis (OA) in former professional soccer players is 2–3 higher. Likewise, hip OA is more common in elite athletes competing in impact sports (i.e., soccer, handball, track and field, or hockey) than in those participating in high-level long-distance running.

Osteoarthritis (OA), the predominant cartilage disease, is characterized by a loss of cartilage, typically progressing from superficial cartilage fibrillation to complete erosion of the subchondral bone. OA causes pain and debilitation in more than two million sports patients in the United States with comparable incidence in Europe and Asia. Furthermore, the numbers affected by this age-associated disease are projected to increase dramatically with the aging of the population. The most common treatment for advanced OA is joint replacement surgery, in which not only the damaged hip or knee joint tissues but also healthy bone is surgically cut off and replaced with so-called artificial joint replacements. This operation is performed in millions of patients around the world every year; more than 90% of the patients see an immediate reduction of pain and an increase in daily mobility and potential to exercise. However, implants fail over time and require revision surgeries, which are highly invasive, complicated, and costly. Thus, alternative treatment strategies are being investigated, including cartilage tissue engineering, where biomaterials and cells are combined to rebuilt dynamic tissues to repair and regenerate damaged articular cartilage. With the emergence of tissue engineering, the prospect of replacing the damaged cartilage with cartilaginous tissue constructs has been translated to the clinic.

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