Articular cartilage lesions that may be limited (focal defects) or generalized
like in osteoarthritis (OA) constitute a key, unsolved clinical problem as a result of the
inadequate ability of this tissue to self-repair. Thus far, none of the pharmacological
treatments and surgical options allow to reproduce the original cartilage integrity in
patients, resulting instead in the formation of a fibrocartilaginous reparative tissue with
poor mechanical function that is unable to withstand natural loading and stresses
throughout life. Approaches based on the administration of mesenchymal stem cells
(MSCs) provide attractive tools to enhance the repair of cartilage lesions as such cells
are easy to acquire, expand, and can specifically commit towards the chondrocyte
phenotype. This chapter aims at providing an overview of the most current and
innovative strategies based on the implantation of MSCs as a means to enhance
cartilage repair both in focal defects and in OA lesions in vivo. These approaches
include scaffold-free and scaffold-guided procedures as well as gene-based strategies to
stimulate the cell chondrogenic activities as a means to restore the natural structure and
mechanical integrity in sites of cartilage damage.
Keywords: Focal defect, Osteoarthritis, Mesenchymal stem cells, Chondrocyte
phenotype, Scaffolds, Hydrogels, Solid scaffolds, Multiphasic scaffolds, Gene
therapy, Cartilage repair.
