Augmentation of osteochondral repair with hyperbaric oxygenation: a rabbit study.
BACKGROUND
Current treatments for osteochondral injuries often result in suboptimal healing. We hypothesized that the combination of hyperbaric oxygen (HBO) and fibrin would be superior to either method alone in treating full-thickness osteochondral defects.


METHODS
Osteochondral repair was evaluated in 4 treatment groups (control, fibrin, HBO, and HBO+fibrin groups) at 2-12 weeks after surgical injury. Forty adult male New Zealand white rabbits underwent arthrotomy and osteochondral surgery on both knees. Two osteochondral defects were created in each femoral condyle, one in a weight-bearing area and the other in a non-weight-bearing area. An exogenous fibrin clot was placed in each defect in the right knee. Left knee defects were left empty. Half of the rabbits then underwent hyperbaric oxygen therapy. The defects in the 4 treatment groups were then examined histologically at 2, 4, 6, 8, and 12 weeks after surgery.


RESULTS
The HBO+fibrin group showed more rapid and more uniform repair than the control and fibrin only groups, but was not significantly different from the group receiving HBO alone. In the 2 HBO groups, organized repair and good integration with adjacent cartilage were seen at 8 weeks; complete regeneration was observed at 12 weeks.


CONCLUSIONS
HBO significantly accelerated the repair of osteochondral defects in this rabbit model; however, the addition of fibrin produced no further improvement.
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital & Chang Gung University; 5, Fu-Hsin St,, Kweishan, Taoyuan 333, Taiwan, Republic of China. alvinchen@adm.cgmh.org.tw.
Alvin Chao-Yu
AC
Chen
Mel S
MS
Lee
Song-Shu
SS
Lin
Leou-Chuan
LC
Pan
Steve Wen-Neng
SW
Ueng