Cartilage Repair in 2025: Hope, Hype, or Horizon?

Document Type : EDITORIAL

Authors

1 Trauma and Surgery Research Center, AJA University of Medical Sciences, Tehran, Iran

2 Medical Biotechnology Research Center, AJA University of Medical Sciences, Tehran, Iran

10.22038/abjs.2025.90121.4089

Abstract

Cartilage degeneration remains a global challenge, driving innovation in repair strategies. Traditional approaches such as autografts and stem cell therapies face limitations in efficacy and translation. Recent advances, including 3D bioprinting, engineered exosomes, and smart biomaterials, offer promise for personalized, minimally invasive treatments. Although early clinical results are encouraging, significant hurdles in safety, standardization, and long-term efficacy persist. Realizing transformative care requires continued rigorous research, clinical validation, and regulatory clarity to move from hope to genuine regeneration.

Keywords

Main Subjects

References

  1. Li HZ, Liang XZ, Sun YQ, Jia HF, Li JC, Li G. Global, regional, and national burdens of osteoarthritis from 1990 to 2021: findings from the 2021 global burden of disease study. Front Med (Lausanne).2024:11:1476853. doi: 10.3389/fmed.2024.147685.
  2. Ghadamzadeh M, Mohsenzadeh SA, Bagheri SM, et al. MRI Findings after Injection of Single and Double Centrifuged Platelet-Rich Plasma and Placebo (Normal Saline) in Patients with Knee Osteoarthritis: A Randomized Double-Blind Clinical Trial with Six-Month Follow-Up. Arch Bone Jt Surg. 2025:-. doi:10.22038/abjs.2025.80109.3658
  3. RODRIGUEZ-MERCHAN EC, De la Corte-Rodriguez H. The Role of Intraarticular Injections of Hyaluronic Acid and Platelet Rich Plasma for the Treatment of Articular Pain in Knee Osteoarthritis. Arch Bone Jt Surg. 2025;13(1):54-61. doi:10.22038/abjs.2024.78852.3621
  4. Karami P, Laurent A, Philippe V, Applegate LA, Pioletti DP, Martin R. Cartilage Repair: Promise of Adhesive Orthopedic Hydrogels. Int J Mol Sci. 2024;25(18):9984. doi: 10.3390/ijms25189984.
  5. Akhlaghpasand M, Tavanaei R, Hosseinpoor M, et al. Effects of Combined Intrathecal Mesenchymal Stem Cells and Schwann Cells Transplantation on Neuropathic Pain in Complete Spinal Cord Injury: A Phase II Randomized Active-Controlled Trial. Cell Transplant. 2025:34:9636897241298128. doi: 10.1177/09636897241298128.
  6. Akbariqomi M, Heidari R, Gargari SS, et al. Evaluation and statistical optimization of a method for methylated cell-free fetal DNA extraction from maternal plasma. J Assist Reprod Genet. May 2019;36(5):1029-1038. doi:10.1007/s10815-019-01425-w
  7. Longfei H, Wenyuan H, Weihua F, et al. Exosomes in cartilage microenvironment regulation and cartilage repair. Front Cell Dev Biol. 2025:13:1460416. doi: 10.3389/fcell.2025.1460416.
  8. Jahani A, Nourbakhsh MS, Ebrahimzadeh MH, Mohammadi M, Yari D, Moradi A. Biomolecules-loading of 3D-printed alginate-based scaffolds for cartilage tissue engineering applications: a review on current status and future prospective. Arch Bone Jt Surg. 2024;12(2):92-101. doi: 10.22038/ABJS.2023.73275.3396.
  9. Di Bella MA. Overview and Update on Extracellular Vesicles: Considerations on Exosomes and Their Application in Modern Medicine. Biology (Basel). 2022;11(6):804. doi: 10.3390/biology11060804.
  10. Chen Z, Zhou T, Luo H, et al. HWJMSC-EVs promote cartilage regeneration and repair via the ITGB1/TGF-β/Smad2/3 axis mediated by microfractures. J Nanobiotechnology. 2024;22(1):177. doi: 10.1186/s12951-024-02451-2.

 

  1. Wu X, Tao W, Lan Z, et al. pH-Responsive Engineered Exosomes Enhance Endogenous Hyaluronan Production by Reprogramming Chondrocytes for Cartilage Repair. Adv Healthc Mater. 2025;14(10):e2405126. doi: 10.1002/adhm.202405126.
  2. Liao H-J, Yang Y-P, Liu Y-H, et al. Harnessing the potential of mesenchymal stem cells–derived exosomes in degenerative diseases. Regen Ther. 2024:26:599-610. doi: 10.1016/j.reth.2024.08.001.
  3. Tandon R, Srivastava N. Unravelling exosome paradigm: Therapeutic, diagnostic and theranostics application and regulatory consideration. Life Sci. 2025:366-367:123472. doi: 10.1016/j.lfs.2025.123472.
  4. Mamachan M, Sharun K, Banu SA, et al. Mesenchymal stem cells for cartilage regeneration: Insights into molecular mechanism and therapeutic strategies. Tissue Cell. 2024:88:102380. doi: 10.1016/j.tice.2024.102380.

 

 

 

The Archives of Bone and Joint Surgery
Volume 13, Issue 9
September 2025
Pages 532-534

Files

History

  • Receive Date: 02 August 2025
  • Revise Date: 30 August 2025
  • Accept Date: 11 August 2025

Share

How to cite

Statistics