• Injection therapy
• Knee osteoarthritis
• Stromal stem cells

• Agency For Defense Development

• artificial intelligence
• cryopreservation
• hematopoietic stem cells
• mesenchymal stem cells
• umbilical cord biobanking

• Hydrogel
• cartilage repair
• chitosan
• in vivo studies
• review.
• tissue engineering

• Chitosan/chemistry
• Hydrogels
• Animals
• Tissue Engineering/methods
• Humans
• Disease Models, Animal
• Cartilage/drug effects
• Cartilage/metabolism
• Models, Animal

• 2019/10228-5, 2021/02974-9 São Paulo Research Foundation

• Cartilage Regeneration
• Collagen
• Hydrogel
• Stem Cells

• Humans
• Hydrogels/chemistry
• Hydrogels/metabolism
• Hydrogels/pharmacology
• Chondrocytes
• Collagen
• Cartilage, Articular
• Regeneration
• Tissue Engineering

• 20230204077YY Jilin Scientific and Technological Development Program
• Jilin Scientific and Technological Development Program

• Injectable implant
• Neural tissue engineering
• Neurodegenerative disease
• Self-healing hydrogel
• Stroke
• Translation medicine
• Traumatic brain injury

• NSTC 111-2221-E-002-052-MY3 National Science and Technology Council
• NTU-CC-112L890801 National Taiwan University

Patellar dislocation may cause cartilage defects of various sizes. Large defects commonly require surgical treatment; however, conventional treatments are problematic.

A 15-year-old male with a large patellar cartilage defect due to patellar dislocation was treated via human umbilical cord blood-derived mesenchymal stem cell (hUCB-MSC) implantation. To our knowledge, this is the first report of this treatment for this purpose. The patient recovered well as indicated by good visual analog scale, International Knee Documentation Committee and McMaster Universities Osteoarthritis Index scores. Magnetic resonance imaging showed cartilage regeneration 18 mo postoperatively.

Umbilical cord blood-derived hUCB-MSCs may be a useful treatment option for the repair of large patellar cartilage defects.

• Cartilage defect
• Umbilical cord
• Mesenchymal stem cells
• Patellar dislocation
• Magnetic resonance imaging
• Case report

• Cartilage acellular matrix injection
• Human umbilical cord blood-mesenchymal stem cells
• Osteoarthritis

• Animals
• Cartilage, Articular/pathology
• Goats
• Mesenchymal Stem Cell Transplantation/methods
• Mesenchymal Stem Cells
• Osteoarthritis/pathology
• Osteoarthritis/therapy
• Rabbits

• Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea

• 3D printing
• Pluronic F127
• hydrogels
• regenerative medicine
• tissue reconstruction

There is currently no optimal method for cartilage restoration in large, full-thickness cartilage defects in older patients.

To determine whether implantation of a composite of allogeneic umbilical cord blood–derived mesenchymal stem cells and 4% hyaluronate (UCB-MSC-HA) will result in reliable cartilage restoration in patients with large, full-thickness cartilage defects and whether any clinical improvements can be maintained up to 5 years postoperatively.

Randomized controlled trial; Level of evidence, 1.

A randomized controlled phase 3 clinical trial was conducted for 48 weeks, and the participants then underwent extended 5-year observational follow-up. Enrolled were patients with large, full-thickness cartilage defects (International Cartilage Repair Society [ICRS] grade 4) in a single compartment of the knee joint, as confirmed by arthroscopy. The defect was treated either with UCB-MSC-HA implantation through mini-arthrotomy or with microfracture. The primary outcome was proportion of participants who improved by ≥1 grade on the ICRS Macroscopic Cartilage Repair Assessment (blinded evaluation) at 48-week arthroscopy. Secondary outcomes included histologic assessment; changes in pain visual analog scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and International Knee Documentation Committee (IKDC) score from baseline; and adverse events.

Among 114 randomized participants (mean age, 55.9 years; 67% female; body mass index, 26.2 kg/m²), 89 completed the phase 3 clinical trial and 73 were enrolled in the 5-year follow-up study. The mean defect size was 4.9 cm² in the UCB-MSC-HA group and 4.0 cm² in the microfracture group (P = .051). At 48 weeks, improvement by ≥1 ICRS grade was seen in 97.7% of the UCB-MSC-HA group versus 71.7% of the microfracture group (P = .001); the overall histologic assessment score was also superior in the UCB-MSC-HA group (P = .036). Improvement in VAS pain, WOMAC, and IKDC scores were not significantly different between the groups at 48 weeks, however the clinical results were significantly better in the UCB-MSC-HA group at 3- to 5-year follow-up (P < .05). There were no differences between the groups in adverse events.

In older patients with symptomatic, large, full-thickness cartilage defects with or without osteoarthritis, UCB-MSC-HA implantation resulted in improved cartilage grade at second-look arthroscopy and provided more improvement in pain and function up to 5 years compared with microfracture.

NCT01041001, NCT01626677 (ClinicalTrials.gov identifier).

• cartilage restoration
• full-thickness cartilage defect
• mesenchymal stem cells
• microfracture
• umbilical cord blood

• Bone
• Cartilage
• Mesenchymal stem cells
• Regeneration

• Cartilage
• Cartilage Diseases/therapy
• Cell Differentiation
• Female
• Humans
• Mesenchymal Stem Cells
• Pregnancy
• Umbilical Cord
• Wharton Jelly

• Mesenchymal stem cells
• cartilage tissue engineering
• chondrocytes
• chondrogenic differentiation
• co-culture
• mechanical stimulation.

This study is aimed at investigating the effect of combined transplantation of umbilical cord mesenchymal stem cells (UCMSCs) and umbilical cord blood-derived endothelial colony-forming cells (ECFCs) on diabetic foot ulcer healing and at providing a novel therapy for chronic diabetic foot ulcer.

We reported the treatment of refractory diabetic foot ulcers in twelve patients. Among them, five patients had two or more wounds; thus, one wound in the same patient was treated with cell injection, and other wounds were regarded as self-controls. The remaining seven patients had only one wound; therefore, the difference between the area of wound before and after treatment was estimated. The UCMSCs and ECFCs were injected into the wound along with topically applied hyaluronic acid (HA).

In this report, we compared the healing rate of multiple separate wounds in the same foot of the same patient: one treated with cell injection combined with topically applied HA-based hydrogel and was later covered by the hydrocolloid dressings, while the self-control wounds were only treated with conventional therapy and covered by the hydrocolloid dressings. The wound underwent cell injection showed accelerated healing in comparison to control wound within the first week after treatment. In other diabetic patients with only one refractory wound, the healing rate after cell transplantation was significantly faster than that before injection. Two large wounds healed without needing skin grafts after combination therapy of cell injection and HA. After four weeks of combination treatment, wound closure was reached in six patients, and the wounds of the other six patients were significantly reduced in size.

Our study suggests that the combination of UCMSCs, ECFCs, and HA can safely synergize the accelerated healing of refractory diabetic foot ulcers.

• animal models
• articular cartilage
• cartilage repair
• chondral defect
• in vivo
• stem cells

• Animals
• Cartilage/cytology
• Cartilage/injuries
• Cartilage/surgery
• Computational Biology
• Humans
• Machine Learning
• Mesenchymal Stem Cell Transplantation
• Mesenchymal Stem Cells/cytology
• Mesenchymal Stem Cells/physiology
• Models, Biological
• Rabbits
• Rats
• Swine
• Tissue Engineering/methods

High tibial osteotomy (HTO) is a well-established method for the treatment of medial compartment osteoarthritis of the knee with varus deformity. However, HTO alone cannot adequately repair the arthritic joint, necessitating cartilage regeneration therapy. Cartilage regeneration procedures with concomitant HTO are used to improve the clinical outcome in patients with varus deformity.

To evaluate cartilage regeneration after implantation of allogenic human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) with concomitant HTO.

Data for patients who underwent implantation of hUCB-MSCs with concomitant HTO were evaluated. The patients included in this study were over 40 years old, had a varus deformity of more than 5°, and a full-thickness International Cartilage Repair Society (ICRS) grade IV articular cartilage lesion of more than 4 cm² in the medial compartment of the knee. All patients underwent second-look arthroscopy during hardware removal. Cartilage regeneration was evaluated macroscopically using the ICRS grading system in second-look arthroscopy. We also assessed the effects of patient characteristics, such as trochlear lesions, age, and lesion size, using patient medical records.

A total of 125 patients were included in the study, with an average age of 58.3 ± 6.8 years (range: 43-74 years old); 95 (76%) were female and 30 (24%) were male. The average hip-knee-ankle (HKA) angle for measuring varus deformity was 7.6° ± 2.4° (range: 5.0-14.2°). In second-look arthroscopy, the status of medial femoral condyle (MFC) cartilage was as follows: 73 (58.4%) patients with ICRS grade I, 37 (29.6%) with ICRS grade II, and 15 (12%) with ICRS grade III. No patients were staged with ICRS grade IV. Additionally, the scores [except International Knee Documentation Committee (IKDC) at 1 year] of the ICRS grade I group improved more significantly than those of the ICRS grade II and III groups.

Implantation of hUCB-MSCs with concomitant HTO is an effective treatment for patients with medial compartment osteoarthritis and varus deformity. Regeneration of cartilage improves the clinical outcomes for the patients.

• Allogeneic
• Human umbilical cord blood-derived mesenchymal stem cells
• Cartilage regeneration
• High tibial osteotomy
• Osteoarthritic knees
• Arthroscopy

• cartilage repair
• chondrogenic differentiation
• human amniotic mesenchymal cells
• hyaluronic acid
• osteoarthritis

Clinical outcomes after the implantation of allogenic human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) in osteoarthritic knees have been rarely reported. Our study aimed to investigate clinical outcomes of osteoarthritic patients who underwent hUCB-MSC implantation.

In this case series (level of evidence: 4), from January 2014 to December 2015, 128 patients with full-thickness cartilage lesions (International Cartilage Repair Society grade 4 and Kellgren–Lawrence grade ≤3) who underwent hUCB-MSC implantation were retrospectively evaluated with a minimum of 2-year follow-up. After removing the sclerotic subchondral bone with an arthroscopic burr, 4-mm-diameter holes were created at 2-mm intervals, and hyaluronic acid and hUCB-MSCs were subsequently mixed and implanted in the holes and other articular defect sites.

Clinical outcomes were evaluated preoperatively, 1 year postoperatively, and 2 years postoperatively (minimum) using visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and International Knee Documentation Committee (IKDC) scores. To assess clinical outcomes, patients were divided into two or three groups according to the lesion size, lesion location, number of lesions, body mass index, and age; statistical analyses were performed using these data.

The mean (±standard deviation) VAS, WOMAC, and IKDC scores at 1 and 2 years after surgery including hUCB-MSC implantation improved significantly compared to the preoperative scores (P < 0.001). There were significant differences in the lesion location (P < 0.05). Medial femoral condyle lesions resulted in worse outcomes compared with lateral femoral condyle and trochlea lesions. No adverse reactions or postoperative complications were noted.

Implantation of hUCB-MSCs is effective for treating knee osteoarthritis based on a follow-up lasting a minimum of 2 years.

• ACI, autologous chondrocyte implantation
• AT-MSCs, adipose tissue-derived MSCs
• Allogenic
• BM-MSCs, bone marrow-derived MSCs
• BMI, body mass index
• HA, hyaluronic acid
• Human umbilical cord blood
• IKDC, International Knee Documentation Committee
• KL, Kellgren–Lawrence
• Knee osteoarthritis
• LFC, lateral femoral condyle
• MFC, medial femoral condyle
• MRI, magnetic resonance imaging
• Mesenchymal stem cells
• OA, osteoarthritis
• OAT, osteochondral autologous transplantation
• VAS, visual analog scale
• WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index
• hUCB-MSCs, human umbilical cord blood-derived mesenchymal stem cells

• Cord blood
• cord blood banks
• regenerative medicine
• stem cells
• tissue engineering
• transplantation.

Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) possess great promise as a therapeutic to repair damaged cartilage. Direct intra-articular injection of mesenchymal stem cells has been shown to reduce cartilage damage and is advantageous as surgical implantation and associated side effects can be avoided using this approach. However, the efficacy of stem cell-based therapy for cartilage repair depends highly on the direct interactions of these stem cells with chondrocytes in the joint. In this study, we have carried out an in vitro cell-to-cell contact coculture study with human articular chondrocytes (hACs) and hUC-MSCs, with the goal of this study being to evaluate interactions between hACs and hUC-MSCs.

Low-density monolayer cultures of hUC-MSCs and hACs were mixed at a ratio of 1 : 1 in direct cell-to-cell contact groups. Results were analyzed using quantitative reverse transcription polymerase chain reaction (qRT-PCR), western blot, enzyme-linked immunosorbent assay (ELISA), and immunofluorescence.

A mixed coculture of hUC-MSCs and hACs was found to exhibit synergistic interactions with enhanced differentiation of hUC-MSCs and reduced dedifferentiation of chondrocytes. Mixed cultures after 21 days were found to exhibit sufficient chondrogenic induction.

The results from this study suggest the presence of mutual effects between hUC-MSCs and hACs even culture at low density and provide further support for the use of intra-articular injection strategies for cartilage defect treatment.

• chondrocytes
• coculture techniques
• cord blood stem cell transplantation
• tissue engineering

• Animals
• Biocompatible Materials
• Bone and Bones
• Cartilage, Articular/physiology
• China
• Chondrocytes/physiology
• Chondrocytes/transplantation
• Cord Blood Stem Cell Transplantation/methods
• Durapatite/pharmacology
• Female
• Mesenchymal Stem Cells/physiology
• Models, Animal
• Osteochondritis/therapy
• Polyesters/pharmacology
• Printing, Three-Dimensional
• Rabbits
• Tissue Engineering/methods
• Tissue Scaffolds

• Mesenchymal stem cells
• Osteochondral defect
• Osteochondritis dissecans
• Umbilical cord blood

• cartilage repair
• chondrogenic predifferentiation
• human umbilical cord blood
• hyaluronic acid
• mesenchymal stem cells

• Adipose Tissue/cytology
• Bone Marrow Cells
• Cartilage, Articular/injuries
• Cartilage, Articular/surgery
• Humans
• Injections, Intra-Articular
• Knee Joint/surgery
• Mesenchymal Stem Cell Transplantation/methods
• Osteoarthritis, Knee/surgery
• Treatment Outcome

Regeneration of articular cartilage is of great interest in cartilage tissue engineering since articular cartilage has a low regenerative capacity. Due to the difficulty in obtaining healthy cartilage for transplantation, there is a need to develop an alternative and effective regeneration therapy to treat degenerative or damaged joint diseases. Stem cells including various adult stem cells and pluripotent stem cells are now actively used in tissue engineering. Here, we provide an overview of the current status of cord blood cells and induced pluripotent stem cells derived from these cells in cartilage regeneration. The abilities of these cells to undergo chondrogenic differentiation are also described. Finally, the technical challenges of articular cartilage regeneration and future directions are discussed.

• cartilage
• chondrogenesis
• cord blood
• differentiation
• induced pluripotent stem cell
• tissue regeneration

• Animal trial
• Cartilage regeneration
• Secretome
• Stem cells
• Systematic review

• cartilage
• cell concentrate
• entity
• mesenchymal stem cells
• repair
• stromal vascular fraction

• Osteoarthritis
• cartilage regeneration
• cell therapy
• growth factors
• mesenchymal stem cells
• scaffolds/hydrogels

• amniotic membrane
• placenta
• regenerative medicine
• stem cells
• umbilical cord

• cartilage regeneration
• hybrid hydrogels
• hybrid scaffolds
• polymeric hydrogels
• polysaccharides

• cartilage tissue engineering
• chondrogenesis
• hypoxia
• mesenchymal stem cells
• umbilical cord blood

• Arthroplasty
• Articular cartilage
• Stem cells
• Tissue engineering

• Cartilage repair
• Cell transplantation
• Human umbilical cord blood
• Hyaluronic acid
• Mesenchymal stem cells
• Paracrine action

The treatment of articular cartilage defects is a therapeutic challenge for orthopaedic surgeons. Furthermore, large osteochondral defects needs restoration of the underlying bone for sufficient biomechanical characteristics as well as the overlying cartilage.

A symptomatic large osteochondral defect in the knee joint was restored using a composite of umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) 0.5 x 10⁷/ml and 4% hyaluronic acid (HA) hydrogel. Significant improvements in pain and function of the knee joint were identified by the evaluation at 12 months after surgery. A hyaline-like cartilage completely filled the defect and was congruent with the surrounding normal cartilage as revealed by magnetic resonance imaging (MRI), a second-look arthroscopy and histological assessment. The improved clinical outcomes maintained until 5.5 years. MRI also showed the maintenance of the restored bony and cartilaginous tissues.

This case report suggests that the composite of allogeneic UCB-MSCs and HA hydrogel can be considered a safe and effective treatment option for large osteochondral defects of the knee.

• Hyaluronic acid
• Knee
• Large osteochondral defect
• Mesenchymal stem cell
• Umbilical cord blood

Mesenchymal stem cells (MSCs) are known to have therapeutic potential for cartilage repair. However, the optimal concentration of MSCs for cartilage repair remains unclear. Therefore, we aimed to explore the feasibility of cartilage repair by human umbilical cord blood-derived MSCs (hUCB-MSCs) and to determine the optimal concentrations of the MSCs in a rabbit model.

Osteochondral defects were created in the trochlear groove of femur in 55 rabbits. Four experimental groups (11 rabbits/group) were treated by transplanting the composite of hUCB-MSCs and HA with various MSCs concentrations (0.1, 0.5, 1.0, and 1.5 x 10⁷ cells/ml). One control group was left untreated. At 4, 8, and 16 weeks post-transplantation, the degree of cartilage repair was evaluated grossly and histologically.

Overall, transplanting hUCB-MSCs and HA hydrogel resulted in cartilage repair tissue with better quality than the control without transplantation (P = 0.015 in 0.1, P = 0.004 in 0.5, P = 0.004 in 1.0, P = 0.132 in 1.5 x 10⁷ cells/ml). Interestingly, high cell concentration of hUCB-MSCs (1.5×10⁷ cells/ml) was inferior to low cell concentrations (0.1, 0.5, and 1.0 x 10⁷ cells/ml) in cartilage repair (P = 0.394,P = 0.041, P = 0.699, respectively). The 0.5 x 10⁷ cells/ml group showed the highest cartilage repair score at 4, 8 and 16 weeks post transplantation, and followed by 0.1x10⁷ cells/ml group or 1.0 x 10⁷ cell/ml group.

The results of this study suggest that transplantation of the composite of hUCB-MSCs and HA is beneficial for cartilage repair. In addition, this study shows that optimal MSC concentration needs to be determined for better cartilage repair.

• Animals
• Cartilage, Articular/drug effects
• Cartilage, Articular/physiology
• Fetal Blood/physiology
• Humans
• Hyaluronic Acid/therapeutic use
• Hydrogel, Polyethylene Glycol Dimethacrylate/therapeutic use
• Male
• Mesenchymal Stem Cell Transplantation/methods
• Mesenchymal Stem Cells/physiology
• Rabbits
• Tissue Engineering/methods
• Wound Healing/physiology

• Ministry of Health and Welfare

Few methods are available to regenerate articular cartilage defects in patients with osteoarthritis. We aimed to assess the safety and efficacy of articular cartilage regeneration by a novel medicinal product composed of allogeneic human umbilical cord blood‐derived mesenchymal stem cells (hUCB‐MSCs). Patients with Kellgren‐Lawrence grade 3 osteoarthritis and International Cartilage Repair Society (ICRS) grade 4 cartilage defects were enrolled in this clinical trial. The stem cell‐based medicinal product (a composite of culture‐expanded allogeneic hUCB‐MSCs and hyaluronic acid hydrogel [Cartistem]) was applied to the lesion site. Safety was assessed by the World Health Organization common toxicity criteria. The primary efficacy outcome was ICRS cartilage repair assessed by arthroscopy at 12 weeks. The secondary efficacy outcome was visual analog scale (VAS) score for pain on walking. During a 7‐year extended follow‐up, we evaluated safety, VAS score, International Knee Documentation Committee (IKDC) subjective score, magnetic resonance imaging (MRI) findings, and histological evaluations. Seven participants were enrolled. Maturing repair tissue was observed at the 12‐week arthroscopic evaluation. The VAS and IKDC scores were improved at 24 weeks. The improved clinical outcomes were stable over 7 years of follow‐up. The histological findings at 1 year showed hyaline‐like cartilage. MRI at 3 years showed persistence of the regenerated cartilage. Only five mild to moderate treatment‐emergent adverse events were observed. There were no cases of osteogenesis or tumorigenesis over 7 years. The application of this novel stem cell‐based medicinal product appears to be safe and effective for the regeneration of durable articular cartilage in osteoarthritic knees. Stem Cells Translational Medicine2017;6:613–621

• Cartilage regeneration
• Human umbilical cord blood
• Hyaluronic acid
• Mesenchymal stem cells
• Osteoarthritis

• Aged
• Arthroscopy
• Cartilage, Articular/diagnostic imaging
• Cartilage, Articular/physiopathology
• Cartilage, Articular/surgery
• Cells, Cultured
• Chondrogenesis
• Cord Blood Stem Cell Transplantation/adverse effects
• Cord Blood Stem Cell Transplantation/methods
• Female
• Humans
• Hyaluronic Acid/administration & dosage
• Hyaluronic Acid/adverse effects
• Hydrogels
• Knee Joint/diagnostic imaging
• Knee Joint/physiopathology
• Knee Joint/surgery
• Magnetic Resonance Imaging
• Male
• Mesenchymal Stem Cell Transplantation/adverse effects
• Mesenchymal Stem Cell Transplantation/methods
• Middle Aged
• Osteoarthritis, Knee/diagnostic imaging
• Osteoarthritis, Knee/physiopathology
• Osteoarthritis, Knee/surgery
• Pain Measurement
• Pain, Postoperative/etiology
• Proof of Concept Study
• Recovery of Function
• Regeneration
• Seoul
• Time Factors
• Transplantation, Homologous
• Treatment Outcome

Umbilical cord blood (UCB) is a promising alternative source of mesenchymal stem cells (MSCs), because UCB-MSCs are abundant and harvesting them is a painless non-invasive procedure. Potential clinical applications of UCB-MSCs have been identified, but their ability for chondrogenic differentiation has not yet been fully evaluated. The aim of our work was to characterize and determine the chondrogenic differentiation potential of human UCB-MSCs (hUCB-MSCs) for cartilage tissue engineering using an approach combining 3D culture in type I/III collagen sponges and chondrogenic factors. Our results showed that UCB-MSCs have a high proliferative capacity. These cells differentiated easily into an osteoblast lineage but not into an adipocyte lineage. Furthermore, BMP-2 and TGF-β1 potentiated chondrogenic differentiation, as revealed by a strong increase in mature chondrocyte-specific mRNA (COL2A1, COL2B, ACAN) and protein (type II collagen) markers. Although growth factors increased the transcription of hypertrophic chondrocyte markers such as COL10A1 and MMP13, the cells present in the neo-tissue maintained their phenotype and did not progress to terminal differentiation and mineralization of the extracellular matrix after subcutaneous implantation in nude mice. Our study demonstrates that our culture model has efficient chondrogenic differentiation, and that hUCB-MSCs can be a reliable source for cartilage tissue engineering.

• Cartilage repair
• Knee
• Stem cell

• Cartilage
• Human umbilical cord blood
• Hyaluronic acid
• Mesenchymal stem cell
• Regeneration

• Animals
• Bone and Bones/drug effects
• Bone and Bones/injuries
• Cartilage/drug effects
• Cartilage/injuries
• Cell Differentiation
• Cell Line
• Cell- and Tissue-Based Therapy/methods
• Chondrogenesis/physiology
• Fetal Blood/cytology
• Fetal Blood/physiology
• Humans
• Hyaluronic Acid/chemistry
• Hyaluronic Acid/metabolism
• Hyaluronic Acid/pharmacology
• Hydrogels/chemistry
• Hydrogels/metabolism
• Male
• Mesenchymal Stem Cell Transplantation
• Mesenchymal Stem Cells/cytology
• Mesenchymal Stem Cells/physiology
• Regeneration/physiology
• Swine
• Swine, Miniature
• Tarsal Joints/drug effects
• Tarsal Joints/injuries
• Tissue Engineering/methods
• Transplantation, Heterologous