Use of Acellular Matrices as Scaffolds in Cartilage Regeneration: A Systematic Review.

Significance: Cartilage regeneration remains a significant challenge in the field of regenerative medicine. Acellular matrix (AM)-based cartilage tissue regeneration offers an innovative approach to repairing cartilage defects by providing a scaffold for new tissue growth. Its significance lies in its potential to restore joint function, mitigate pain, and improve the quality of life for patients suffering from cartilage-related injuries and conditions. Recent Advances: Recent advances in AM-based cartilage regeneration have focused on enhancing scaffold properties for improved cell adhesion, proliferation, and differentiation. Moreover, several scaffold techniques such as combining acellular dermal matrix (ADM) and acellular cartilage matrix (ACM) with cartilage tissue, as well as biphasic scaffolding, enjoy rising research activity. Incorporating bioactive factors and advanced manufacturing techniques holds promise for producing more biomimetic scaffolds, advancing efficient cartilage repair and regeneration. Critical Issues: Obstacles in AM-based cartilage regeneration include achieving proper integration with the surrounding tissue and ensuring long-term durability of the regenerated cartilage. Furthermore, issues such as high costs and limited availability of suitable cells for scaffold seeding must be considered. The heterogeneity and limited regenerative capabilities of cartilage need to be addressed for successful clinical translation. Future Directions: Research should focus on exploring advanced biomaterials and developing new techniques, regarding easily reproducible scaffolds, ideally constructed from clinically validated and readily available commercial products. Findings underline the potential of AM-based approaches, especially the rising exploration of tissue-derived ADM and ACM. In future, the primary objective should not only be the regeneration of small cartilage defects but rather focus on fully regenerating a joint or larger cartilage defect.