Professor Luyten about his lecture on “Reconstruction of the Joint: from Development to Engineering”

“When we seek to repair damaged joints, two major approaches are possible, i.e. enhancing endogenous repair mechanisms and/or extrinsic repair. Endogenous (intrinsic) repair may be targeted in different phases of tissue healing including the use of methods/surgical procedures or compounds affecting inflammation, debris removal and cell recruitment, followed by stimulation of cell proliferation, differentiation and tissue formation. When intrinsic repair is insufficient or inappropriate, in the latter case leading to scar tissue formation, extrinsic repair, i.e. tissue engineering approaches, needs to be considered. These include growth factor formulations, smart biomaterials, cell populations and more powerful combination products that drive tissue repair and support and guide locally the tissue regeneration processes. Much of the success of these strategies is also dependent on the microenvironment, and thus on the understanding of the local cellular and molecular processes in the affected joint.

An overview will be presented of the existing and evolving strategies seeking to repair damaged joints. They include cell-based treatments such as autologous chondrocyte implantation, and variations thereof, and the use of stem cell populations. Major challenges are encountered in the case of deeper osteochondral defects and the reconstruction of full joints, triggering novel avenues for tissue engineered solutions. We still lack understanding of the developmental, cell and molecular biology of the diarthrodal joint, preventing us to take a scientifically sound developmental engineering approach. New enabling technologies are required to translate this into robust manufacturing processes of these 3D products classified as Advanced Therapeutic Medicinal Products (ATMP). The lecture will also discuss some future trends, including ongoing efforts to make biological joints.”