Growth factors in cartilage repair

The articular cartilage does not heal completely after injury, predisposing patients to accelerated progression of degenerative joint disease. While surgical intervention can address chondral defects and yield positive functional outcomes, substantial research has gone into the use of growth factors to augment cartilage repair and preclude or postpone the need for operative management. This chapter describes the growth factors with the most promising in vitro and in vivo data in cartilage repair, namely, bone morphogenetic protein-7, transforming growth factor-B, fibroblast growth factor-18, connective tissue growth factor, insulin-like growth factor-1, and recent advancements with autologous solutions of growth factors, such as platelet-rich plasma. Each section provides a background on mechanism of action, summarizes pivotal basic science research, and describes the results of clinical application in animal and human models of chondral disease.