Tissue engineered cartilage constructs have potential clinical applications in human healthcare. Their effective utilization is, however, hampered by the lack of an optimal cryopreservation procedure that ensures their availability as and when required at the patient’s bedside. Cryopreservation-induced stress represents a major barrier towards the cryopreservation of such tissue constructs, and they remain a scientific challenge despite the significant progress in the long-term storage and banking of isolated chondrocytes and thin cartilage tissue slices. These stresses are caused by intra- and extracellular ice crystallization, cryoprotectant (CPA) toxicity, suboptimal rates of cooling and warming, osmotic imbalance, and altered intracellular pH that might cause cellular death and/or a disruption of extracellular matrix (ECM). This paper reviews the cryopreservation-induced stresses on tissue engineered cartilages and discusses how they influence the integrity of the tissue during its long-term preservation. We have also reported how various antioxidants, vitamins, and plant extracts have been used to inhibit and overcome the stress during cryopreservation and provide promising results. Based on the reviewed information, the paper has also proposed some novel ways which might help in increasing the postthawing cell viability of cryopreserved cartilage. 1. Introduction Defects and diseases of articular cartilage are common ailments in humans. Osteoarthritis, the most common form of arthritis involving the inflammation of the articular cartilage, is observed in 60–70% of the people above the age of 65 [1]. In the USA alone, over 27 million people are known to be suffering from these articular defects [2]. Cartilage also has a limited regeneration capacity, and hence, available therapeutic modalities provide a temporary relief and have a limited clinical success. In recent years, with the rapid advancement in the tissue engineering, artificial cartilages engineered from biopolymers and stem cells have shown promising clinical results, and therefore, they have been envisaged as a future therapy for an effective and long-term clinical outcome. Preservation of tissue engineered articular cartilage is also essential for their widespread commercialisation so that they can be provided to patients as and when required. The growing need and limited availability of viable transplantable cartilaginous tissues have necessitated the development and optimization of the preservation techniques and banking of tissue engineered cartilage constructs. Preservation of
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