| Résumé | Current operative and non-operative treatments for articular cartilage (AC) defect repair still fail to meet clinical expectations. These treatment options and challenges will be reviewed from a clinical perspective. Various polymeric and naturally occurring materials serving as scaffolds have shown promising neocartilage formation, but few studies are able to draw good clinical correlations. While tissue and organ engineering have generated public demand and expectations that engineered tissues will soon be available, there are still several critical hurdles that need to be overcome. There is a general preference for (1) avoiding the harvesting of normal tissues, (2) a single minimally invasive operative procedure for material insertion, and (3) a durable material that reproduces normal hyaline cartilage and will provide a good lifetime warranty. To avoid harvesting normal tissues, alternative cell sourcing is considered. On the materials front, there is a demand for molecular diversity and synthetic flexibility. For minimally invasive surgery, injectable materials have been actively researched. While initial studies are promising, there still remain a few challenges to overcome before injectable scaffolds will become clinically relevant. Key considerations are reviewed in this article. Advances in nanotechnology have enabled us to employ bottom-up approaches to scaffold design, fabrication, and characterization to better mimic the biological dimensions of matter. One approach involves self-assembly of small DNA-like molecules into larger superaggregates with nanoscale dimensions. One such self-assembling organic system is the rosette nanotubes. The design and properties are highlighted as they are related to solving orthopedic problems. |
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