Cartilage repair – an age-old problem in need of new ideas

Repairing cartilage lesions was thought to be an intractable problem, and time and money have shown this to be mostly true. Our problems stem from advances in materials science outpacing our understanding of cartilage biology, specifically chondrocytes, the cells that make and maintain this tissue. I want to describe the key challenges we face in designing solutions for people with small lesions in their joints, and how we have overcome three specific hurdles; discovery of a cell source for repair, understanding how to differentiate cells to efficiently produce cartilage, and, discovering the key molecules that control the process of cartilage maturation. It is feasible that with this knowledge, and in concert with materials scientists, we may be able to design implants that can withstand the tremendous forces in joints to produce durable and functional repair of cartilage lesions.