Fibrocartilage hyalinization: A potential therapeutic strategy for articular fibrocartilage

Articular fibrocartilage is commonly observed on the joint surface in osteoarthritis (OA) or cartilage injury, often seen as a result of cartilage degeneration. Compared to hyaline cartilage, fibrocartilage exhibits inferior mechanical properties and biological functions, which contribute to further cartilage degeneration and the progression of OA. Despite this, research on cartilage regeneration has not sufficiently addressed the specific challenges and strategies related to fibrocartilage. Although fibrocartilage formation is an unavoidable outcome during cartilage repair, it offers several benefits in the regeneration process, such as providing a natural cell source and establishing a strong integration with surrounding tissues. Recently, a therapeutic approach focused on the in-situ modification of fibrocartilage to promote hyaline cartilage regeneration, referred to as "fibrocartilage hyalinization", has been proposed. Our recent work has demonstrated the feasibility of converting existing fibrocartilage into hyaline cartilage in vivo within the injured area. Key elements of this strategy include modifying the extracellular matrix (ECM), targeting fibrotic chondrocytes, and altering the local microenvironment. This review summarizes the current understanding of articular fibrocartilage's characteristics and mechanisms, while also discussing potential approaches and the feasibility of fibrocartilage hyalinization for cartilage regeneration.