High incidence of articular cartilage defects is still a major challenge in
orthopedic and trauma surgery worldwide. It also has great socioeconomic effects as it is
the major cause of disability in industrialized countries. This highlights the essential need
for new treatments. Knowledge about the factors that have been implicated in the
pathogenesis of cartilage diseases, including changes in the composition and structure
of cartilaginous extracellular matrix (ECM), molecular factors and environmental
signaling pathways could help the development of innovative therapeutic strategies.
It is consensuses that the success of any technology aiming to repair chondral defects
will be dependent upon its ability to produce tissues that most closely replicate the
mechanical and biochemical properties of native cartilage. Increasing the knowledge
about cartilage tissue and its molecular biomarkers could help find new and useful
therapeutic approaches in cartilage damage. This review tries to describe cartilage
tissue biology in detail and discuss different available therapeutic modalities with their
pros and cons. New cartilage regeneration strategies and therapies, focusing on cellbased
therapy and tissue engineering, and their underlying molecular and cellular bases
will be pointed out as well.