Cell-Based Regenerative Strategies for Knee Cartilage Repair: A Scoping Review of Autologous Cartilage, Mesenchymal Stromal Cells, and Hybrid Approaches.

Authors

Birzhan Suiindik, Kazybek Baktybergen, Yerik Raimagambetov, Gulzhanat Korganbekova, Dina Saginova, Arman Batpen, Karlygash Suiindik

Published in

Cartilage. Pages 19476035261499465. Oct 18, 2026. Epub Oct 18, 2026.

Abstract

BackgroundCell-based approaches for focal knee cartilage repair include cartilage- and chondrocyte-based procedures, mesenchymal stromal cell (MSC)-based strategies, and combinations of these approaches. However, the amount and type of evidence available for these treatments differ considerably.ObjectiveTo map the clinical and preclinical evidence for cell-based regenerative strategies used for focal chondral and osteochondral defects of the knee, compare cartilage-based, MSC-based, and hybrid approaches, and identify areas where evidence remains limited.MethodsThis scoping review was prospectively registered on the Open Science Framework and reported according to PRISMA-ScR. PubMed, Scopus, and Web of Science were searched for studies published from January 2000 to December 2025. Eligible studies evaluated in vivo cartilage-derived, MSC-based, or hybrid regenerative interventions for focal knee chondral or osteochondral defects. Two reviewers independently screened the records and charted study characteristics and outcomes using a standardized form. Because of substantial heterogeneity in interventions, study designs, models, outcomes, and follow-up periods, the findings were summarized descriptively rather than pooled.ResultsSeventy-five publications met the eligibility criteria. Cartilage-based approaches were evaluated in 29 publications, including 21 clinical and 8 preclinical studies. MSC-based approaches were evaluated in 43 publications, including 12 clinical and 31 preclinical studies. Three publications examined hybrid strategies, including two clinical reports from the same 35-patient cohort and one preclinical study. Cartilage-based evidence was therefore mainly clinical (72.4%), whereas MSC-based evidence was mainly preclinical (72.1%). Clinical studies used a wide range of outcome measures, and comparative studies did not show a consistent advantage of one more complex cell-based approach over another. Evidence for hybrid strategies remained limited to one preclinical study and one clinical programme reported at 18 months and 5 years.ConclusionThe available evidence differs considerably across cartilage-based, MSC-based, and hybrid approaches. Cartilage-based techniques have been studied more extensively in clinical settings, whereas most MSC research remains preclinical. Hybrid cartilage and MSC strategies have been investigated in only a small number of studies. A framework based on structural or chondrogenic input, biological signaling, and the combination of these components may be useful for organizing future research, but it should currently be considered a hypothesis rather than a validated treatment model.

PMID:
42893411
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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