Silk fibroin scaffolds for common cartilage injuries: Possibilities for future clinical applications

Regenerating chondral and osteochondral injuries is a main challenge in orthopedics. Some therapeutic strategies such as joint preservation operations, non-operative management, palliative surgery, and arthroplasty are the common clinical methods for repairing the cartilage defects. These treatments show often satisfactory as short-term outcomes and without clear long-term prospects. Over the past decade, the development of tissue engineering technologies offers a new therapeutic option to treat patients suffering from chondral lesions. Silk fibroin is a potent and advanced biomaterial for regenerating both soft and hard tissues. Fibroin scaffolds possess superior mechanical strength, suitable bioactivity, elasticity, degradability, and tailorable chemical structure. Due to the important properties as natural biomaterials, the fabrications of various types of scaffolds/matrices for regenerating the tissues like cartilage for regeneration and repairing the defects are possible. This review highlights the investigations on silk-based biomaterials for cartilage tissue engineering. The possibilities for future clinical application of silk fibroin based constructs in repairing intervertebral disk, anterior cruciate ligament, meniscus, and osteochondral defects are evaluated in detail.