Table 5.

Clinical study of tissue engineering strategies in the repair of articular cartilage injury

Intervening measure	Research type	Studies/patients(n)	Treatment outcomes	Disease type	References
A cell-free collagen-hydroxyapatite osteochondral scaffold	Case series	27 patients	This study highlights the safety and potential of the scaffold for the treatment of osteochondral knee defects with good clinical results and stable interim follow-up results	Cartilaginous lesions of the knee joint	Kon et al. [139]
The MaioRegen(®) scaffold is a cell-free biomimetic scaffold consisting of type I collagen and hydroxyapatite	Prospective therapeutic study	10 patients	Treatment of osteochondral defects with biomimetic scaffolds resulted in incomplete cartilage repair and poor subchondral bone repair at 2.5 years of follow-up	Cartilaginous lesions of the knee and talus bones	Christensen et al., [145]
Cell-free osteochondral scaffold	Case series	27 patients	Cell-free osteochondral scaffold implantation in the treatment of osteochondritis dissecans has shown good and stable results	Knee osteochondritis dissecans	Perdisa et al., [140]
A cell-free collagen type I scaffold	Case series	28 patients	The application of this scaffold for large defects showed increased wear of the repair tissue and clinical failure in 18% of cases at 5-year follow-up	Cartilage defects of the knee	Schüttler et al., [146]
Scaffolds with hyaluronan and CS-based structure	retrospective comparative study	81 patients	Both scaffolds are effective for cartilage healing, but neither has clinical or radiological advantage	Talus osteochondral lesions	Akmeşe et al., [147]
A cell-free aragonite-based scaffold	Case series	13 patients	This scaffold is a safe and clinically effective implant for the treatment of small and medium-sized joint surface lesion in the distal femur. The implants showed satisfactory bone integration and osteochondral recovery for up to 3 years	Joint surface lesion of the knee	Van Genechten et al., [150]
The Igor scaffold	Case series	21 patients	Patients using Igor scaffold reported reduced pain and increased activity, with most reporting good results	Locally restricted cartilage defects	Zak et al., [143]
Two scaffolds with hyaluronan-based and CS-based structure	Retrospective comparative study	69 patients	Both scaffolds are useful for cartilage regeneration, but have no clinical or radiological advantage	Symptomatic condylar osteochondral lesions	Akmeşe et al., [148]
Collagen scaffold	Retrospective cohort study	94 patients	The use of collagen scaffold may not affect clinical efficacy or imaging results	Osteochondral lesions of the talus	Gorgun et al., [149]
Scaffold-supported bone marrow-derived cells	Therapeutic case series	64 patients	The scaffold was used to repair osteochondral lesions of the talus, and the clinical effect was significant and lasted for a long time	Osteochondral lesions of the talus	Buda et al., [141]
The 3D scaffold based on a bilayered collagen type I sponge	Case series	23 patients	The use of this scaffold is a feasible method for the treatment of large focal osteochondral defects, and the recent clinical and imaging results are good	Cartilage damage and OA of the knee	Zak et al., [151]
MSCs-loaded fibrin glue scaffold	Retrospective cohort study	54 patients	The International Cartilage Repair Society (ICRS) score was higher after the treatment of knee joint with fibrin glue loaded with MSCs	Osteoarthritic (OA) knees	Kim et al., [142]
Implant of hydrogel	Systematic review and meta-analysis	50 studies/ 2846 patients	There were clinically and statistically significant improvements in pain scores (VAS and WOMAC) and functional scores (IKDC and Lysholm) after treatment of knee cartilage injury with hydrogels compared to before treatment	Knee joint cartilage regeneration	Hosseini et al., [144]

MSCs: marrow mesenchymal stem cells; CS: chitosan