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Review Article

Considerations for translation of tissue engineered fibrocartilage from bench to bedside

[+] Author and Article Information
Ryan P. Donahue

Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697
rpdonahu@uci.edu

Erik A. Gonzalez-Leon

Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697
eagonza2@uci.edu

Jerry C. Hu

Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697
jerryhu@uci.edu

Kyriacos Athanasiou

ASME Fellow, Distinguished Professor, Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697
athens@uci.edu

1Corresponding author.

ASME doi:10.1115/1.4042201 History: Received June 28, 2018; Revised November 27, 2018

Abstract

Fibrocartilage is found in the knee meniscus, the temporomandibular joint (TMJ) disc, the pubic symphysis, the annulus fibrosus of intervertebral disc, tendons, and ligaments. These tissues are notoriously difficult to repair due to their avascularity, and limited clinical repair and replacement options exist. Tissue engineering has been proposed as a route to repair and replace fibrocartilages. Using the knee meniscus and TMJ disc as examples, this review describes how fibrocartilages can be engineered toward translation to clinical use. Presented are fibrocartilage anatomy, function, epidemiology, pathology, and current clinical treatments because they inform design criteria for tissue engineered fibrocartilages. Methods for how native tissues are characterized histomorphologically, biochemically, and mechanically to set gold standards are described. Then, provided is a review of fibrocartilage-specific tissue engineering strategies, including the selection of cell sources, scaffold or scaffold-free methods, and biochemical and mechanical stimuli. In closing, the Food and Drug Administration paradigm is discussed to inform researchers of both the guidance that exists and the questions that remain to be answered with regard to bringing a tissue engineered fibrocartilage product to the clinic.

Copyright (c) 2018 by ASME
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