Table 5.

Strategies for enhancing lateral integration in cartilage repair.

Parameter	Potential Strategy	Examples/Previous Evidence
Cellular factors	Promote chondrocyte viability: Use of caspase inhibitors to inhibit apoptotic cell death	Inhibition of apoptotic cell death using caspase inhibitors such as ZVAD-fmk has shown partial rescue of cell death and enhancing lateral integration [110].
Utilization of young tissues	Utilizing tissues from younger donors: Higher biosynthetic capacities and integration potential	Transplantation of embryonic tissues into defects in mature animals has shown improved restoration of surface continuity and lateral integration [111].
External stimuli and treatments	Use of growth factors: Controlled release to promote chondrogenesis and tissue integration	Use of platelet-rich plasma (PRP) as a growth factor blend, induced better graft integration [112].
	Mechanical stimulation	Spinner bioreactor stimulation enhanced integration, boosting collagen content and gene expression related to integration. Early loading post-surgery could improve cartilage integration [113].
Extracellular matrix factors	Modulate collagen network: Use of collagen crosslinking inhibitors to enhance fusion.	Inhibition of lysyl-oxidase-mediated collagen crosslinking accelerated collagen maturation and increased adhesive strength, promoting integration [114].
	Manipulate proteoglycan content: Enzymatic removal of proteoglycans to promote chondrocyte mobility.	Enzymatic removal of proteoglycans increased chondrocyte mobility and enhanced integration [115].
Biomaterials and scaffold integration	Scaffold adhesion	An intrinsically adhesive hydrogel demonstrated tissue integration after two days of in vivo implantation in cartilage defects [44].
	Optimal porosity	Allowing better cell infiltration and nutrient exchange, enhancing integration [116].
Surface modification	Bioadhesive glues and bridging polymers (e.g., fibrin, etc.)	Employing chondroitin sulfate (CS) functionalized with methacrylate and aldehyde groups facilitated mechanical stability for tissue repair [117].