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


CONCLUSIONS
After arthroscopic subchondral drilling, this novel technique may result in better articular cartilage regeneration.
Saw
Khay-Yong
KY
Kuala Lumpur Sports Medicine Centre, Kuala Lumpur, Malaysia. sportsclinic@hotmail.com
Hussin
Paisal
P
Loke
Seng-Cheong
SC
Azam
Mohd
M
Chen
Hui-Cheng
HC
Tay
Yong-Guan
YG
Low
Sharon
S
Wallin
Keng-Ling
KL
Ragavanaidu
Kunaseegaran
K
D000818:Animals; D016026:Bone Marrow Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000166:cytology / Q000187:drug effects / Q000502:physiology*; D004195:Disease Models, Animal; D006041:Goats; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D008297:Male; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods*; D012038:Regeneration / Q000502:physiology*; D014182:Transplantation, Autologous; D055675:Viscosupplements / Q000008:administration & dosage
D055675:Viscosupplements; D006820:Hyaluronic Acid