Abstract
Articular cartilage is a highly organized avascular tissue composed of chondrocytes embedded within an extracellular matrix of collagens, proteoglycans and noncollagenous proteins. Its primary function is to enable the smooth articulation of joint surfaces, and to cushion compressive, tensile, and shearing forces. Hyaline cartilage has one of the lowest coefficients of friction known for any surface to surface contact. Cartilage is frequently injured, often as a result of sports related trauma, but due to its avascular nature, articular cartilage has very limited capacity for repair. Unfortunately, limited awareness of chondral and osteochondral injuries and difficulty in diagnosing these injuries makes it impossible to accurately determine their incidence. A survey of 31,616 knee arthroscopies performed in the US between 1991 and 1995, revealed that chondral lesions were present in 63% of arthroscopies, with an average of 2.7 hyaline cartilage lesions per knee (1). In 1995 there were approximately 385,000 procedures performed in the USA for repairing hyaline articular cartilage defects. This number is probably much higher now, following an explosion of international interest in articular cartilage repair in 1996, and recent scientific and technological advances. A technology superior to bone marrow stimulation in repairing the articular cartilage has an annual potential market up to $980 million in the USA. New technologies, like tissue engineered cartilage, are expected to be utilized in 27,700 procedures in the USA in 2006, generating product revenues of $178 million. The market is forecast to increase to 44,300 procedures by 2009, generating product revenues of $285 million (2).
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