Saving the Joint: Biological Strategies to Preserve Cartilage

Abstract

Articular cartilage is the white, shiny layer that covers the ends of long bones and absorbs weight and shocks. As a result, the joint moves smoothly and without pain. Damage to articular cartilage is a common problem that limits the patient’s function and increases the risk of osteoarthritis. Replacement of the knee joint in young patients in turn increases the chances of a second surgery, which is generally less successful than the first artificial joint.

The first part of this thesis focuses on improving cartilage regeneration through the use of (stem) cells, and also investigates the communication between these cells. It is demonstrated that a precursor cell that is present in cartilage can be isolated and successfully used for the production of cartilage in the laboratory. In addition, the communication between stem cells and cartilage cells to stimulate the formation of cartilage was specifically examined.

Subsequently, several blood-derived products, such as platelet-rich plasma, have been used in the laboratory to stimulate cartilage formation by cartilage cells. Finally, the last chapter of this thesis brings together a combination of disciplines to create a patient-specific, bone-growth-stimulating implant, which can be used in the treatment for leg corrections (osteotomy).

Regeneration of articular cartilage remains a bottleneck to date, both clinically and in the laboratory. The results of this thesis show that this problem can be approached from different angles. These results can be used in the future to improve existing cartilage treatments or to develop new regenerative treatments.