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.
Key Words
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Article info
Publication history
Published online: September 18, 2009
Accepted:
July 7,
2009
Received:
January 24,
2009
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2009 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
