Injuries to the growth plate cartilage often lead to bony repair, resulting in bone growth defects such as limb length discrepancy and angulation
deformity in children. Currently utilised corrective surgeries are highly invasive and limited in their effectiveness, and there are no known
biological therapies to induce cartilage regeneration and prevent the undesirable bony repair. In the last 2 decades, studies have investigated the cellular and molecular events that lead to bony repair at the injured growth plate including the identification of the four phases of injury repair responses (inflammatory, fibrogenic, osteogenic and remodelling), the important role of inflammatory
cytokine tumour
necrosis factor alpha in regulating downstream repair responses, the role of chemotactic and mitogenic
platelet-derived growth factor in the fibrogenic response, the involvement and roles of bone morphogenic
protein and Wnt/B-
catenin signalling pathways, as well as
vascular endothelial growth factor-based angiogenesis during the osteogenic response. These new findings could potentially lead to identification of new targets for developing a future
biological therapy. In addition, recent advances in cartilage tissue engineering highlight the promising potential for utilising multipotent mesenchymal stem cells (MSCs) for inducing regeneration of injured growth plate cartilage. This review aims to summarise current understanding of the mechanisms for
growth plate injury repair and discuss some progress, potential and challenges of MSC-based
therapies to induce growth plate cartilage regeneration in combination with chemotactic and chondrogenic
growth factors and supporting scaffolds.