The Role of Exosomes and Extracellular Vesicles in Joint Preservation and Articular Cartilage Regeneration: Where Are We Now?

Exosomes and extracellular vesicles (EVs) are an emerging technology in the field of orthobiology. This "cell-free" cell therapy can bring the potential of cell therapy into orthopedic surgery applications without the hassle of cell therapy logistics. However, the dream of producing an off-the-shelf regenerative therapy drug faces challenges, such as optimization of dosage, frequency, and consistency of therapy efficacy. In this review, we look at the role of exosomes and EVs in treating cartilage diseases, discuss the efficacy of these treatment modalities in the preclinic settings, and summarize current clinical state and challenges for this novel therapy in cartilage repair.