Articular Cartilage's Struggle with Regeneration

Tissue Engineering is the Up-and-Coming Solution 



The simple clash of the knee with the opponent's helmet  can result in severe damage. The severe damage may gradually heal over time, giving the athlete yet another chance in competition.

However, if the contact results in damage of the knee's articular cartilage, it could be the end of the athlete's career.  This is largely due to the fact that articular cartilage lacks the capacity to self-heal the damaged site.

For years, articular cartilage healing has been considered one of the most difficult problems in medicine.  However, the relatively new discipline of tissue engineering is promising ways to achieve cartilage repair and provide these injured players with another chance on the field.

A Strong Need for Tissue Engineering

The need for tissue engineering arises primarily from the prevalence of joint injuries in both adolescents and adults. In terms of the former, there exists an increased vulnerability to stress in children and adolescents due to the fact that their skeletons are still growing. With approximately 30 million children participating in organized sports activities, yearly costs for injuries within this group have been estimated to be $1.8 billion. Elbow and shoulder injuries are quite common, but adolescent knee injuries are ubiquitous. In young patients with knee injuries, 75% exhibit superficial cartilage defects whereas the rest have deep cartilage defects. Professional athletes, but also weekend athletes, often run into the same issues. These injuries require surgery to be performed, something the injured children or adults, are often skeptical about considering that long-term relief is not often obtained. For this reason, it is exciting to know that tissue engineering is emerging as an approach that can allow the formation of articular cartilage either in vivo by directing cells to the site of injury, or through controlled manipulation of cells and materials in vitro in order to form implantable cartilage.

Understanding How Many Injuries Need the Perfect Treatment 

Cartilage Damage: Athletics 

During a randomly selected week in the National Football League season (September 2006), out of the 32 teams, the following were the injury statistics:

-Two players had concussions, 13 had hamstring injuries, 7 had groin injuries, plus numerous players had rib, shoulder, neck, leg, knee, elbow, ankle, wrist, toe, finger, abdomen injuries and one had an appendectomy.
-16 were out, 79 were questionable, 11 were doubtful, and 29 were probable.

If these were the statistics for only one week in the season, one can only imagine the statistics corresponding to a full season.

Section "Injuries" provides additional information.

Cartilage Damage: Osteoarthritis

Nearly 1 in 2 people may develop symptomatic knee osteoarthritis by the age of 85 years old.

An estimated 294,000 children under age 18 have some form of arthritis; this represents approximately 1 in every 250 children in the U.S.

By 2030, an estimated 67 million Americans ages 18 years or older are projected to have doctor-diagnosed arthritis.

The average direct costs per person for osteoarthritis are about $2,600 per year of out-of-pocket expenses. 

The aggregate hospital costs for musculoskeletal procedures in 2004 were $31.5 billion—representing over 10% of the total cost of hospital care in the U.S.

Please see section "Osteoarthritis" for more details.

Project prepared by:

Aristos Athanasiou Athens, 11th grade, Davis Senior High School

Ines Guinard, 11th grade, Davis Senior High School

Sponsor: Ms. Ann Moriarty, Science Teacher, Davis Senior High School

 
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