Introductory Chapter: Cartilage Disorders

1. Introduction

This book demonstrates the pathological changes of cartilage degeneration at the molecular level and during the early stages of osteoarthritis, biochemical changes that precede the later structural changes.

Hyaline Articular Cartilage is critical for the proper functioning of the joint as it provides a smooth and low-friction surface for bone movement. However, hyaline cartilage has a limited ability to repair itself, making it vulnerable to damage and degeneration. In recent years, researchers have developed various techniques for the regeneration of hyaline cartilage, including Confocal Raman Microscopy for identifying tissue damage, tissue engineering for cartilage regeneration and autologous chondral implantations.

2. Confocal Raman microscopy

Confocal Raman Microscopy (CRM) is a promising tool for the characterisation of the collagen and proteoglycan content, as well as for monitoring the tissue damage and repair [1]. CRM can detect subtle changes in the Extra-Cellular Matrix (ECM) of articular cartilage, such as variations in collagen cross-linking, proteoglycan content and mineralisation. Thus, CRM has the potential to be used as a non-invasive diagnostic tool for early detection and monitoring of cartilage degeneration and repair.

3. Tissue engineering for cartilage regeneration

Tissue engineering approaches for cartilage regeneration aim to overcome the limitations of current treatments by providing functional and long-lasting repair tissue [2]. The most commonly used biomaterials for cartilage tissue engineering are hydrogels, which are highly hydrated and have a similar composition to the native ECM [3]. Hydrogels can provide mechanical support and act as a template for cell growth, differentiation and matrix deposition. They can also be modified with bioactive molecules, such as growth factors and cytokines, to promote cell proliferation and matrix synthesis [4].

4. Autologous chondral implantation

Autologous Chondral Implantation (ACI) is a cell-based therapy that involves harvesting healthy chondrocytes from a non-weight-bearing area of the patient’s joint and growing them in vitro. The expanded chondrocytes are then implanted into the damaged area of the joint using a periosteal or collagen membrane. ACI has shown promising results in the treatment of osteochondral defects, especially in the knee joint, with a reported success rate of 75–90% [5].

5. Conclusion

In conclusion, cartilage is a highly specialised tissue that is critical for joint function, but its limited self-repair capacity and the prevalence of joint disorders have created a critical need for advanced cartilage repair therapies. Confocal Raman microscopy, tissue engineering and autologous chondral implantation are among the latest scientific methods that show promise in advancing the field of cartilage regeneration. Although these approaches have shown significant progress, further research is needed to optimise their efficacy and long-term outcomes [6].

We endeavour that this book will update the current Orthopaedic Sports Surgeon on these advances in technique and technology, with explorations of future research and technique modalities.