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This manuscript addresses the critical need for standardization in CO research and aims to establish a structured framework for their classification, construction, application, and quality assessment. We systematically summarize the defining features of COs and distinguish them from related cartilage models, then review major cell sources, including embryonic stem cells, induced pluripotent stem cells, mesenchymal stem cells, and periosteum-derived cells, together with scaffold-free and scaffold-assisted fabrication strategies, stepwise induction protocols, bioprinting approaches, bioreactor systems, and key microenvironmental regulators such as hypoxia, mechanical stimulation, and multicellular interactions. Based on this, we propose a literature-informed conceptual framework termed COSS (Cartilage Organoid Standardization System). COSS comprises a three-tier standardization framework encompassing input control, process standardization, and output evaluation. It further defines minimum reporting items and a tiered evaluation framework for disease modeling, drug screening, and regenerative repair, with the aim of harmonizing terminology, reporting requirements, quality attributes, and priorities for future validation. This framework cannot yet be regarded as an experimentally validated production standard or a regulatory-endorsed system. Further work is required to refine the framework and establish reliable quantitative thresholds and specific numerical criteria. Collectively, this work provides an application-oriented roadmap for improving reproducibility, comparability, and translational relevance in CO studies. These recommendations could serve as an initial framework for multicenter benchmarking and for supporting future determination of reproducibility for mechanistic studies, preclinical evaluation, or repair-oriented applications.<\/jats:p>","DOI":"10.1088\/1758-5090\/ae9ef4","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T22:50:56Z","timestamp":1787784656000},"page":"042001","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A provisional and evolving framework for standardizing cartilage organoid construction: toward consistency, reproducibility, and clinical translation"],"prefix":"10.1088","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4975-7205","authenticated-orcid":false,"given":"Hefei","family":"Zhang","sequence":"first","affiliation":[{"name":"Shandong Provincial Hospital affiliated to Shandong First Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengdong","family":"Yang","sequence":"additional","affiliation":[{"name":"FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9924-9839","authenticated-orcid":true,"given":"Junyou","family":"Li","sequence":"additional","affiliation":[{"name":"School of Mechanical Engineering, Sungkyunkwan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinjie","family":"Wu","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Sun","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongjie","family":"Feng","sequence":"additional","affiliation":[{"name":"Shandong Provincial Hospital affiliated to Shandong First Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1823-6516","authenticated-orcid":true,"given":"Fuqiang","family":"Gao","sequence":"additional","affiliation":[{"name":"China-Japan Friendship Hospital"},{"name":"Osteonecrosis and Developmental Dysplasia of the Hip, China-Japan Friendship Hospital"},{"name":"China-Japan Friendship Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0497-3630","authenticated-orcid":true,"given":"Qingyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shandong Provincial Hospital affiliated to Shandong First Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"bfae9ef4bib1","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.arr.2015.03.002","type":"journal-article","article-title":"Muscle and bone, two interconnected tissues","volume":"21","author":"Tagliaferri","year":"2015","journal-title":"Ageing Res. 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