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REVIEW ARTICLE

Advanced 3D-Printing Bioinks for Articular Cartilage

Repair

Qiushi Liang 1,2† , Yuanzhu Ma , Xudong Yao *, Wei Wei *
1,3
2†
1,3
1 International Institutes of Medicine, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
2 Zhejiang University-University of Edinburgh Institute, Zhejiang University, Hangzhou, 310000, China
3 Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of
Medicine, Hangzhou, 310000, China.
† These authors contributed equally to this work

Abstract: Chondral lesions caused by stressors, such as injury or inflammation, lead to osteoarthritis (OA). OA is a degenerative
joint disease that has become a challenge worldwide. As the articular cartilage is incapable of self-regeneration due to the
absence of vessels and nerves, novel cartilage repair techniques are urgently needed. Three-dimensional (3D) bioprinting,
which allows the precise control of internal architecture and geometry of printed scaffolds, has stepped up to be a promising
strategy in cartilage restoration. With regards to 3D bioprinting, bioinks with proper chemical and mechanical properties play
one of the most critical roles in designing successful cartilage tissue constructs. In particular, hydrogels as 3D hydrophilic
cross-linked polymer networks are highly recommended as bioinks because of their fine biocompatibility, easy fabrication,
and tunable mechanical strength. Herein, we highlight the widely used polymers for hydrogel preparation and further provide
a non-exhaustive overview of various functional modified additives (such as cells, drugs, bioactive factors and ceramic) to
exploit the unique properties suitable for bioprinted cartilage. Finally, a prospective on future development for 3D-bioprinting
in cartilage repair is elucidated in this review.

Keywords: Osteoarthritis; Hydrogels; Silk fibroin; Collagen; Polyethylene glycol

*Correspondence to: Xudong Yao, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No. N1, Shangcheng Avenue, Yiwu,
322000, China; 0617555@zju.edu.cn; Wei Wei, International Institutes of Medicine, the Fourth Affiliated Hospital, Zhejiang University School of
Medicine, Yiwu, China 322000; zjewwei@zju.edu.cn
Received: January 30, 2022; Accepted: March 11, 2022; Published Online: April 22, 2022

(This article belongs to the Special Issue: Composite/Multi-component Biomaterial Inks and Bioinks)
Citation: Liang Q, Ma Y, Yao X, et al., 2022, Advanced 3D-Printing Bioinks for Articular Cartilage Repair. Int J Bioprint, 8(3):511. http://doi.
org/10.18063/ijb.v8i3.511

1. Introduction in the synovial joints caused by the progressive loss of
articular cartilage . Briefly, stressors such as cartilage
[4]
Articular cartilage is an avascular connective tissue
that works to lubricate the friction between the joint injury or inflammation may cause the hypersecretion of
surfaces . The only cell constituting this hyaline pro-inflammatory cytokines. It promotes the expression
[1]
tissue is the chondrocyte. It is usually embedded in the of metalloproteinases (MMPs) and a disintegrin and
extracellular matrix (ECM) mainly consisting of type II an MMPs with thrombospondin motifs (ADAMTS)
collagen (COL II) network and aggrecan proteoglycan (Table 4). MMP and ADAMTS enzymes then contribute
(Table 4) . The damage of cartilage may lead to to the decomposition of aggrecan proteoglycan, which
[2]
osteoarthritis (OA) (Table 4), which is the most common is regarded as a significant early event contributing to
[2]
degenerative joint disease that affects over 303 million the deconstruction of cartilage tissue . In addition,
people worldwide . OA is characterized by severe collagenases of the MMP family, such as MMP-13,
[3]
joint pain, swelling, and sound or sensation of grating lead to the degradation of ECM COL. In turn, the defect
© 2022 Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution License, permitting distribution and
reproduction in any medium, provided the original work is properly cited.
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