The life quality of patients with craniofacial malformations is severely affected by the physical disabilities caused by the malformation itself, but also by being subjected to bullying, which leads to a series of relevant psychological and societal effects that have an economic impact on the health sector. Orofacial clefts, notably cleft lip (CL), cleft palate, and microtia, are the most common craniofacial birth defects in humans and represent a substantial burden, both personal and societal. On the other hand, osteoarthritis is a widespread degenerative disease that is becoming more common due to the extension of the human lifespan and to an increase in injuries in young people as a result of their lifestyle. Advances in tissue engineering as a part of regenerative medicine offer new hope to patients that can benefit from new tissue engineering therapies based on the supportive action of tailored 3D biomaterials and the synergic action of stem cells that can be driven to the process of bone and cartilage regeneration. This review provides an update on recent considerations for stem cells and studies on the use of advanced biomaterials and cell therapies for the regeneration of craniofacial congenital malformations and articular degenerative diseases.

Objective. To evaluate minimum biosecurity parameters (MBP) for arthroscopic matrix-encapsulated autologous chondrocyte implantation (AMECI) based on patients’ clinical outcomes, magnetic resonance imaging (MRI) T2-mapping, Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, and International Cartilage Repair Society (ICRS) second-look arthroscopic evaluation, laying the basis for a future multicenter study. Design. Pilot clinical study. We analyzed the logistics to perform AMECI to treat focal chondral lesions in different hospitals following strict biosecurity parameters related to tissue and construct transportation, chondrocyte isolation, and cell expansion. Patient progress was analyzed with patient-reported outcome measures, MRI T2-mapping, MOCART, and ICRS arthroscopic second-look evaluation. Results. Thirty-five lesions in 30 patients treated in 7 different hospitals were evaluated. Cell viability before implantation was >90%. Cell viability in construct remnants was 87% ± 11% at 24 hours, 75% ± 17.1% at 48 hours, and 60% ± 8% at 72 hours after implantation. Mean final follow-up was 37 months (12-72 months). Patients showed statistically significant improvement in all clinical scores and MOCART evaluations. MRI T2-mapping evaluation showed significant decrease in relaxation time from 61.2 ± 14.3 to 42.9 ± 7.2 ms (P < 0.05). Arthroscopic second-look evaluation showed grade II “near normal” tissue in 83% of patients. Two treatment failures were documented. Conclusions. It was feasible to perform AMECI in 7 different institutions in a large metropolitan area following our biosecurity measures without any implant-related complication. Treated patients showed improvement in clinical, MRI T2-mapping, and MOCART scores, as well as a low failure rate and a favorable ICRS arthroscopic evaluation at a mid-term follow-up. Level of Evidence. 2b.

(1) Background: Currently, there are no pharmacological treatments that can modify the course of osteoarthritis (OA). For this reason, the present work is focused on generating knowledge for the development of new therapeutic alternatives for the treatment of OA. The objective of this work was to develop an articular hybrid implant with mesenchymal stem cells (MSCs) from sheep. The cells were differentiated into cartilage and bone using a bioabsorbable polymer with 3D printing Technology. (2) Methods: MSCs pre-differentiated to chondrocytes and osteoblasts were seeded on the 3D-printed scaffolds using polylactic acid (PLA). These were later implanted for 3 months in the thoracic ribs area and for 6 months inside the femoral head and outside of the joint capsule. After recovery, we analyzed the expressions of specific markers for bone and cartilage in the implants (3) Results: After 3 months, in lateral implants, the expression for bone markers (OPN, RUNX2) was similar to that of the control; at 6 months, we obtained a higher expression of bone markers in the implants with pre-differentiated MCS to osteoblasts outside and inside the joint. For cartilage markers, three months after the placement of the lateral implant, the expressions of Aggrecan and SOX9 COL2A1 were similar to those of the control, but the expression of COL2A1 was less; at 6 months, the three cartilage markers SOX9, Aggrecan, and COL2A1 showed significant expressions in the implant inside joint with pre-differentiated MCS to chondrocytes. (4) Conclusions: In this study, we demonstrated that the presence of pre-differentiated MSCs in the implants was a determinant factor for the expression of bone- and cartilage-specific markers at three and six months. We managed to generate a practical and easy-to-implement articular surface repair model.