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Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model


Citation

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

Abstract

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.


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Additional Metadata

Item Type: Article
Divisions: Faculty of Medicine and Health Science
Faculty of Veterinary Medicine
DOI Number: https://doi.org/10.1016/j.arthro.2009.07.011
Publisher: Elsevier
Keywords: Arthroscopic subchondral drilling; Articular cartilage; Hyaline cartilage; Hyaluronic acid; Mesenchymal stem cells; Microfracture
Depositing User: Raja Norazlinda Raja Azenam
Date Deposited: 04 Dec 2014 08:08
Last Modified: 27 Oct 2017 02:43
Altmetrics: http://www.altmetric.com/details.php?domain=psasir.upm.edu.my&doi=10.1016/j.arthro.2009.07.011
URI: http://psasir.upm.edu.my/id/eprint/13274
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