Advances in Scaffolds and Additives for Infection Control in Autologous Chondrocyte Transplantation

Cartilage tissue engineering (CTE) has revolutionized the field of regenerative medicine, offering significant advancements in surgeries such as autologous chondrocyte transplantation. However, despite these advancements, infections associated with cartilage implants remain a persistent challenge, compromising the success of surgeries and patient recovery. To address these challenges, this review provides a comprehensive foundation for researchers interested in addressing infections in CTE. It begins by briefly outlining the major scaffolds currently used in CTE and distinguishing those with antimicrobial properties. Among the antimicrobial scaffolds identified, chitosan and chondroitin sulfate stand out for their promising compatibility and antibacterial properties. The review then explores additives that meet three essential criteria: compatibility with chondrocytes, suitability for use in CTE scaffolds, and antibacterial efficacy. Chitosan, zinc oxide, silver, and copper emerge as leading candidates due to their compatibility with chondrocytes and proven antibacterial capabilities. Importantly, the criteria used in this review were chosen to provide researchers with a practical and reliable starting point for immediate application. However, it is acknowledged that other promising antibacterial modifications such as fabrication processes and additives such as bioactive glass and graphene oxide, which may not fit these criteria, also hold potential for future research and innovation. This review underscores the need for further research and development to enhance infection control measures and improve patient outcomes.