title: Delivering rhFGF-18 via a bilayer collagen membrane to enhance microfracture treatment of chondral defects in a large animal model.
abstract: Augmented microfracture techniques use growth factors, cells, and/or scaffolds to enhance the healing of microfracture-treated cartilage defects. This study investigates the effect of delivering recombinant human fibroblastic growth factor 18 (rhFHF18, Sprifermin) via a collagen membrane on the healing of a chondral defect treated with microfracture in an ovine model. Eight millimeter diameter chondral defects were created in the medial femoral condyle of 40 sheep (n = 5/treatment group). Defects were treated with microfracture alone, microfracture + intra-articular rhFGF-18 or microfracture + rhFGF-18 delivered on a membrane. Outcome measures included mechanical testing, weight bearing, International Cartilage Repair Society repair score, modified O'Driscoll score, qualitative histology, and immunohistochemistry for types I and II collagen. In animals treated with 32 μg rhFGF-18 + membrane and intra-articularly, there was a statistically significant improvement in weight bearing at 2 and 4 weeks post surgery and in the modified O'Driscoll score compared to controls. In addition, repair tissue stained was more strongly stained for type II collagen than for type I collagen. rhFGF-18 delivered via a collagen membrane at the point of surgery potentiates the healing of a microfracture treated cartilage defect.
authors.affiliation: Orthopaedics Research Unit, University of Cambridge, Box 180, Addenbrooke's Hospital, Hill's Road, Cambridge, United Kingdom.
authors.forename: Daniel
authors.initials: D
authors.lastname: Howard
authors.affiliation: Orthopaedics Research Unit, University of Cambridge, Box 180, Addenbrooke's Hospital, Hill's Road, Cambridge, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Wardale
authors.affiliation: Merck, Darmstadt, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Guehring
authors.affiliation: Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, United Kingdom.
authors.forename: Frances
authors.initials: F
authors.lastname: Henson
mesh_terms: D000818:Animals; D054544:Arthroplasty, Subchondral / Q000379:methods*; D001696:Biomechanical Phenomena; D002356:Cartilage / Q000473:pathology; D003094:Collagen; D004195:Disease Models, Animal; D005260:Female; D005346:Fibroblast Growth Factors / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use*; D012756:Sheep
chemical_list: D011994:Recombinant Proteins; C113569:fibroblast growth factor 18; D005346:Fibroblast Growth Factors; D003094:Collagen
keywords: FGF18; cartilage; chondral repair; growth factor; microfracture