Healing Joints with Stem Cells: Future of Surgical Cartilage Repair

From every action, to walking to school, waving to a friend, or even to the movement in your fingers while writing, that fluid movement is all due to your cartilage. When you really think about it, joints are just two solid bones rubbing against each other. Therefore, what should be happening is intense decreased mobility and pain in your movement, due to friction between the bones. But it doesn’t, our movements are fluid and smooth, and that's because of our cartilage. It’s essentially a thin film of lubrication that lets our bones smoothly rub against each other. Think of it like a thin layer of slippery gel in between two pieces of sandpaper, and without the gel, the sandpaper would have intense friction. But what happens if the cartilage is damaged? One aspect of cartilage is that it’s avascular. That essentially means that it doesn’t have a blood supply, and if damaged, it can’t regrow itself.

So the affected person would have a difficult time moving, which could heavily debilitate them and decrease their quality of life. So what have we done to solve this problem? Some traditional treatments, like microfracture surgery, grafts, or joint replacement, can provide temporary relief, however, stem cell-based treatments (stem cell treatment - regenerative cells that can turn into other types of specialized cells) act to fully restore the damaged cartilage instead of fully replacing the joint. So how do these cell-based treatments work?

First, they use stem cell differentiation. They extract Mesenchymal stem cells from bone marrow, adipose (fat) tissue, or synovium, which are manipulated to become chondrocytes, the specialized cells produced in cartilage. When these new chondrocytes are directly replaced and put into the joint, they release growth factors and anti-inflammatory signals that encourage the body to repair the tissue and reduce degeneration. This direct replacement is delivered through a surgical procedure called arthroscopy.

So what makes this treatment helpful to people? By being able to artificially generate cartilage, it can calm inflammation and reduce extreme pain that would initially occur before the transplant. Also, they would have increased mobility, being able to walk and move faster/ more easily.  And finally, since they are deriving these stem cells from the same person, there is a small chance of rejection and a higher chance of this outcome being long-term. So essentially, they would have permanent and painless mobility.

Stem cell therapies are a major innovation in orthopedics as well as all of medicine. If we unlock the full potential of these stem cells, we wouldn’t be subject to just generating cartilage, we’d be able to create real living biological organoids (miniature copies of organs). These could then be used to replace the organ and its function, as well as act as a biological model, and use them to test drugs that would seem unethical to a human. 

Cartilage damage is a global and disabling problem because of its limited ability to heal. Stem cell-based surgical solutions give us a way to regenerate cartilage rather than replace it, which provides pain relief, mobility, and permanent outcomes. This marks a stepping stone in orthopedics and medicine as a whole.

By Nathan Clemente at Incisionary

References:

Barua, S., & Rege, K. (2010). The influence of mediators of intracellular trafficking on transgene expression efficacy of polymer–plasmid DNA complexes. Biomaterials, 31(22), 5894–5902. https://doi.org/10.1016/j.biomaterials.2010.04.007

Boden, K. A., Weinberg, D. S., & Vallier, H. A. (2017). Complications and Functional Outcomes After Pantalar Dislocation. Journal of Bone and Joint Surgery, 99(8), 666–675. https://doi.org/10.2106/jbjs.16.00986

Nagelli, C. V., Korpershoek, J. V., Lydon, K., Vonk, L., Custers, R., Krych, A. J., & Saris, D. (2025). From IMPACT to RECLAIM: A Single-Stage Cell Therapy for Articular Cartilage Repair and a Platform for Musculoskeletal Tissue Regeneration. Current Reviews in Musculoskeletal Medicine. https://doi.org/10.1007/s12178-025-09949-8