»JointPromise«: Concept of a multi-step, automated platform for precision manufacturing of joint implants

Osteoarthritis (OA) is the most frequently encountered chronic joint disease worldwide affecting more than 25% of the adult population. Joint injury, as a result of trauma, inflammation or infection, leads to superficial and deep joint surface defects, which are risk factors in the development and progression of OA. Engineering precise osteochondral/joint tissues for the regeneration of such defects could mitigate this clinical and societal challenge. However, engineering suitable implants remains a challenge due to the complex structural organization and functionality of native joint tissue. »JOINTPROMISE« aims to develop an automated process pipeline for precision manufacturing of functional 3D living implants of the required structural complexity, paving the way for the creation of a tissue-engineered prosthesis to treat patients suffering from end-stage osteoarthritis. The »JOINTPROMISE« platform will additionally boost productivity by transforming existing laboratory-scale Tissue Engineering processes into robust, large-scale and cost-effective production methods. We elaborated the concept of a multistep automated platform for manufacturing high-complexity Joint-ATMPs by the production of progenitor cell aggregates and their subsequent maturation into microtissues, functioning as building blocks for the assembly of joint implants by multi-step 3D bio-printing. This concept will be implemented by building up an end-to-end automated production pipeline for Joint-ATMPs. After proving feasibility, safety and indications of clinical efficacy in large animal models, our Joint-ATMPs open up new possibilities in treatment of deep joint surfaces to building a biological prosthesis for end-stage OA.