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Summary and Conclusions

The current landscape of cartilage repair techniques showcases a variety of methods, including microfracture, stem cell therapy, and different types of chondrocyte implantation. Future strategies harness stem cells from sources such as bone marrow, fat, synovium, and even cartilage, combined with innovative scaffolding techniques and growth factors like TGF-beta. Gene therapy and molecular organization approaches highlight the complexity of cartilage regeneration. Although animal models present hurdles, they remain essential for studying adult-onset osteoarthritis and focal lesions.

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Summary and Conclusions

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  1. Summary and Conclusions Peter Roughley

  2. Repair Techniques • Current Microfracture – stem cell ACI MACI – articular chondrocyte + stem cell AMIC • Future Chondrocytes from stem cell Source – BM, fat, synovium, cartilage Conditions – TGFbeta, TGFbeta/BMP6 Oxygen – 5% High density Scaffold - Membrane – 2D Matrix – 3D Loading - Cyclic compression Gene therapy - ex vivo in situ

  3. Molecular Organization • Endochondral ossification – wnt, PTHRP, Ihh, site 1 proteinase • Matrix – regulated – COMP/collagen integrated – Col6, biglycan, matrillin, Col2, fibromodulin, PRELP, HSPG, cell stable – X-links • Surface - Lubricin Shear loading Lost in OC graft • Degardation - Proteases workhorse, cathepsin K sophisticated – MMPs, ADAMTSs hyaluronidase NO – IL-1 – 5% oxygen

  4. Animal Models • None Ideal –quadrupeds – primates (human) Age – cost, young Size – cost, MRI/arthroscopy Cartilage thickness Cartilage cell density Functional assessment – pain Too emotive – dogs, horses, primates • Purpose - Adult onset OA Focal lesions • Predisposition - limb deformity Genetic

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