Bioprinting is a revolutionary technology within the field of tissue engineering that enables the precise fabrication of three-dimensional (3D) tissue constructs. It combines the principles of engineering and biology to create structures that closely mimic the complexity of native human tissues, facilitating advancements in regenerative medicine and personalized healthcare. This review paper systematically explores the challenges and design requirements in the fabrication of 3D biomimetic tissue constructs, emphasizing the need for advanced bioprinting strategies. Achieving biomimicry involves creating 3D anatomically relevant structures, biomimetic microenvironments, and vascularization. The focus is on overcoming existing bottlenecks through advancements in both fabrication techniques and bio-inks. Future directions in bioprinting are outlined, including multi-modal bioprinting systems, in-situ bioprinting, and the integration of machine learning into bioprinting processes. The critical role of bio-inks and printing methodologies in influencing cell viability is highlighted, providing insights into strategies for enhancing cellular functionality throughout the bioprinting process. Furthermore, the paper addresses post-fabrication considerations, particularly in accelerating tissue maturation, as a pivotal component for advancing the clinical applicability of bioprinted tissues. By navigating through the challenges, innovations, and prospects of advanced bioprinting strategies, this review highlights the transformative impact on tissue engineering. Pushing the boundaries of technological capabilities, these strategies hold the promise of groundbreaking advancements in regenerative medicine and personalized healthcare. Ultimately, the integration of these advanced techniques into bioprinting processes will pave the way for the development of more highly biomimetic and functional bioprinted tissues.

Articular cartilage damage caused by trauma or degenerative pathologies such as osteoarthritis can result in significant pain, mobility issues, and disability. Current surgical treatments have a limited capacity for efficacious cartilage repair, and long-term patient outcomes are not satisfying. Three-dimensional bioprinting has been used to fabricate biochemical and biophysical environments that aim to recapitulate the native microenvironment and promote tissue regeneration. However, conventional in vitro bioprinting has limitations due to the challenges associated with the fabrication and implantation of bioprinted constructs and their integration with the native cartilage tissue. In situ bioprinting is a novel strategy to directly deliver bioinks to the desired anatomical site and has the potential to overcome major shortcomings associated with conventional bioprinting. In this review, we focus on the new frontier of robotic-assisted in situ bioprinting surgical systems for cartilage regeneration. We outline existing clinical approaches and the utilization of robotic-assisted surgical systems. Handheld and robotic-assisted in situ bioprinting techniques including minimally invasive and non-invasive approaches are defined and presented. Finally, we discuss the challenges and potential future perspectives of in situ bioprinting for cartilage applications.