Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model
Purpose: The purpose of the study was to determine whether postoperative intra-articular injections of autologous marrow aspirate (MA) and hyaluronic acid (HA) after subchondral drilling resulted in better cartilage repair as assessed histologically by Gill scoring. Methods: In a goat model...
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2009
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my.upm.eprints.132742017-10-27T02:43:13Z http://psasir.upm.edu.my/id/eprint/13274/ Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model Saw, Khay Yong Hussin, Paisal Loke, Seng Cheong Goriman Khan, Mohd Azam Khan Chen, Hui Cheng Tay, Yong Guan Low, Sharon Wallin, Keng Ling Ragavanaidu, Kunaseegaran Purpose: The purpose of the study was to determine whether postoperative intra-articular injections of autologous marrow aspirate (MA) and hyaluronic acid (HA) after subchondral drilling resulted in better cartilage repair as assessed histologically by Gill scoring. Methods: In a goat model we created a 4-mm full-thickness articular cartilage defect in the stifle joint (equivalent to 1.6 cm in the human knee) and conducted subchondral drilling. The animals were divided into 3 groups: group A (control), no injections; group B (HA), weekly injection of 1 mL of sodium hyaluronate for 3 weeks; and group C (HA + MA), similar to group B but with 2 mL of autologous MA in addition to HA. MA was obtained by bone marrow aspiration, centrifuged, and divided into aliquots for cryopreservation. Fifteen animals were equally divided between the groups and sacrificed 24 weeks after surgery, when the joint was harvested, examined macroscopically and histologically. Results: Of the 15 animals, 2 from group A had died of non-surgery-related complications and 1 from group C was excluded because of a joint infection. In group A the repair constituted mainly scar tissue, whereas in group B there was less scar tissue, with small amounts of proteoglycan and type II collagen at the osteochondral junction. In contrast, repair cartilage from group C animals showed almost complete coverage of the defect with evidence of hyaline cartilage regeneration. Histology assessed by Gill scoring was significantly better in group C with 1-way analysis of variance yielding an F statistic of 10.611 with a P value of .004, which was highly significant. Conclusions: Postoperative intra-articular injections of autologous MA in combination with HA after subchondral drilling resulted in better cartilage repair as assessed histologically by Gill scoring in a goat model. Clinical Relevance: After arthroscopic subchondral drilling, this novel technique may result in better articular cartilage regeneration. Elsevier 2009-12 Article PeerReviewed application/pdf en http://psasir.upm.edu.my/id/eprint/13274/1/Articular%20cartilage%20regeneration%20with%20autologous%20marrow%20aspirate%20and%20hyaluronic%20acid%20an%20experimental%20study%20in%20a%20goat%20model.pdf Saw, Khay Yong and Hussin, Paisal and Loke, Seng Cheong and Goriman Khan, Mohd Azam Khan and Chen, Hui Cheng and Tay, Yong Guan and Low, Sharon and Wallin, Keng Ling and Ragavanaidu, Kunaseegaran (2009) Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 25 (12). pp. 1391-1400. ISSN 0749-8063; ESSN: 1526-3231 http://www.sciencedirect.com/science/article/pii/S0749806309006100?via%3Dihub#! 10.1016/j.arthro.2009.07.011 |
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Purpose:
The purpose of the study was to determine whether postoperative intra-articular injections of autologous marrow aspirate (MA) and hyaluronic acid (HA) after subchondral drilling resulted in better cartilage repair as assessed histologically by Gill scoring.
Methods:
In a goat model we created a 4-mm full-thickness articular cartilage defect in the stifle joint (equivalent to 1.6 cm in the human knee) and conducted subchondral drilling. The animals were divided into 3 groups: group A (control), no injections; group B (HA), weekly injection of 1 mL of sodium hyaluronate for 3 weeks; and group C (HA + MA), similar to group B but with 2 mL of autologous MA in addition to HA. MA was obtained by bone marrow aspiration, centrifuged, and divided into aliquots for cryopreservation. Fifteen animals were equally divided between the groups and sacrificed 24 weeks after surgery, when the joint was harvested, examined macroscopically and histologically.
Results:
Of the 15 animals, 2 from group A had died of non-surgery-related complications and 1 from group C was excluded because of a joint infection. In group A the repair constituted mainly scar tissue, whereas in group B there was less scar tissue, with small amounts of proteoglycan and type II collagen at the osteochondral junction. In contrast, repair cartilage from group C animals showed almost complete coverage of the defect with evidence of hyaline cartilage regeneration. Histology assessed by Gill scoring was significantly better in group C with 1-way analysis of variance yielding an F statistic of 10.611 with a P value of .004, which was highly significant.
Conclusions:
Postoperative intra-articular injections of autologous MA in combination with HA after subchondral drilling resulted in better cartilage repair as assessed histologically by Gill scoring in a goat model.
Clinical Relevance:
After arthroscopic subchondral drilling, this novel technique may result in better articular cartilage regeneration. |
format |
Article |
author |
Saw, Khay Yong Hussin, Paisal Loke, Seng Cheong Goriman Khan, Mohd Azam Khan Chen, Hui Cheng Tay, Yong Guan Low, Sharon Wallin, Keng Ling Ragavanaidu, Kunaseegaran |
spellingShingle |
Saw, Khay Yong Hussin, Paisal Loke, Seng Cheong Goriman Khan, Mohd Azam Khan Chen, Hui Cheng Tay, Yong Guan Low, Sharon Wallin, Keng Ling Ragavanaidu, Kunaseegaran Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model |
author_facet |
Saw, Khay Yong Hussin, Paisal Loke, Seng Cheong Goriman Khan, Mohd Azam Khan Chen, Hui Cheng Tay, Yong Guan Low, Sharon Wallin, Keng Ling Ragavanaidu, Kunaseegaran |
author_sort |
Saw, Khay Yong |
title |
Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model |
title_short |
Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model |
title_full |
Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model |
title_fullStr |
Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model |
title_full_unstemmed |
Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model |
title_sort |
articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model |
publisher |
Elsevier |
publishDate |
2009 |
url |
http://psasir.upm.edu.my/id/eprint/13274/1/Articular%20cartilage%20regeneration%20with%20autologous%20marrow%20aspirate%20and%20hyaluronic%20acid%20an%20experimental%20study%20in%20a%20goat%20model.pdf http://psasir.upm.edu.my/id/eprint/13274/ http://www.sciencedirect.com/science/article/pii/S0749806309006100?via%3Dihub#! |
_version_ |
1643825282180710400 |