title: Articular cartilage regeneration with autologous marrow aspirate and hyaluronic Acid: an experimental study in a goat model.
abstract: 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.
authors: Kuala Lumpur Sports Medicine Centre, Kuala Lumpur, Malaysia. sportsclinic@hotmail.com
authors: Khay-Yong
authors: KY
authors: Saw
authors: Paisal
authors: P
authors: Hussin
authors: Seng-Cheong
authors: SC
authors: Loke
authors: Mohd
authors: M
authors: Azam
authors: Hui-Cheng
authors: HC
authors: Chen
authors: Yong-Guan
authors: YG
authors: Tay
authors: Sharon
authors: S
authors: Low
authors: Keng-Ling
authors: KL
authors: Wallin
authors: Kunaseegaran
authors: K
authors: Ragavanaidu
mesh_terms: 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
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid