The modern regenerative procedures demonstrated to offer the replacement of the articular surface with a hyaline-like tissue, but the properties of healthy cartilage tissue are still unmatched by any available substitute. Moreover, the treatment of osteochondral lesions is even more biologically challenging since two different tissues are involved (bone and articular cartilage) with a distinctly different intrinsic healing capacity. For the repair of the entire osteochondral unit, several authors have highlighted the need for biphasic scaffolds, to reproduce the different biological and functional requirements for guiding the growht of the two tissues, and different specific scaffolds have been developed for the treatment of large chondral or osteochondral articular defects.
At the time being, among these only two scaffols used for osteochondral regeneration are commercialized for clinical application. One is a bilayer porous PLGA-calcium-sulphate biopolymer. The second osteochondral scaffold is a nanostructured biomimetic HA-collagen scaffold with a porous 3-D tri-layer composite structure, mimicking the whole osteochonfral anatomy. Other osteochondral scaffolds are still under preclinical investigation. In this chapter we focus on reviewing the available evidence on the clinical outcome of these osteochondral scaffolds, as well as on reporting the new biomaterials developed and tested in preclinical studies that show to be promising for osteochondral regeneration
