| Many literatures reported articular hyaline cartilage regeneration with arthroscopic subchondral drilling followed by postoperative intraarticular injections of autologous mesenchymal stem cell. However, some previous literatures reported mesenchymal stem cell formed fibrocartilage mainly instead of hyaline cartilage. The difference between the literatures is “intraarticular environment”. How to prepare “environment” to induce hyaline cartilage formation had been discussed. Current literatures suggested well bone bed is essential to provide nutrition and space for stem cell nesting. Hyaluronic acid could lubricate cartilage. Temporary limitation of loading joint could decrease wearing of new formed cartilage. Most osteoarthritis of knee occurred in medial compartment. In patients with varus deformity, high tibia osteotomy will be suggested to shift loading from medial to lateral compartment. Loading shift could prevent excessive wearing of new formed cartilage. The activity of stem cell is influenced by the donor’s age. Stem cell derived from young adults is more active than that from senile adults. However, most patients of osteoarthritis were senile. Therefore, allo-stem cell derived from younger adults may provide higher bioactivity and enhance hyaline cartilage formation. In future, we will establish the protocol of allo-stem cell therapy. |
