title: Steroids and Platelet-Rich Plasma as Coadjuvants to Microfracture for the Treatment of Chondral Lesions in an Animal Model: Can the Healing Be Enhanced?
abstract: OBJECTIVE
  The aim of this study was to evaluate the contribution to hyaline cartilage regeneration of the microfracture (MFx) technique plus intraarticular betamethasone (BMS) or platelet-rich plasma (PRP).
  
  
  METHODS
  Full-thickness chondral defects of 3 × 6 mm(2) were surgically performed in both femoral condyles of each knee in 13 New Zealand rabbits and then treated with MFx associated with intraarticular BMS or PRP. At 12 weeks postimplantation, the animals were killed and the condyles were characterized macroscopically, molecularly according to collagen type II and I gene expression (quantitative reverse transcriptase-polymerase chain reaction), and histologically (hematoxylin-eosin staining). For the latter, samples were scored using the International Cartilage Repair Society visual histological scale. Data of MFx/BMS-treated and MFx/PRP-treated condyles were compared against untreated, MFx-treated, or normal condyles without lesions.
  
  
  RESULTS
  Our macroscopic findings showed that in MFx/BMS-treated and MFx/PRP-treated groups, the defects were filled with an irregular, partially rough tissue similar to the MFx-treated group. No differences in the ratio between collagen type II versus collagen type I expression were observed among groups. Histological changes were observed between MFx/BMS-treated and MFx/PRP-treated groups versus untreated defects mainly in surface regularity and cell distribution. However, International Cartilage Repair Society score analysis did not support statistical differences between MFx/BMS-treated and MFx/PRP-treated groups versus MFx-treated group.
  
  
  CONCLUSIONS
  These results provide evidence that the use of intraarticular BMS or PRP as coadjuvants to the microfracture technique in the treatment of acute chondral lesions is not associated with a significant improvement of hyaline cartilage regeneration.
authors.affiliation: Orthopedic Surgery Department, Clínica Alemana de Santiago, Chile ; Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo.
authors.forename: Alex
authors.initials: A
authors.lastname: Vaisman
authors.affiliation: Orthopedic Surgery Department, Clínica Alemana de Santiago, Chile ; Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo.
authors.forename: David
authors.initials: D
authors.lastname: Figueroa
authors.affiliation: Orthopedic Surgery Department, Clínica Alemana de Santiago, Chile ; Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo.
authors.forename: Rafael
authors.initials: R
authors.lastname: Calvo
authors.affiliation: Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo.
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Espinosa
authors.affiliation: Orthopedic Surgery Department, Hospital Padre Hurtado, Santiago, Chile.
authors.forename: Patricio
authors.initials: P
authors.lastname: Melean
authors.affiliation: Pathology Department, Clínica Alemana de Santiago, Chile.
authors.forename: Marcela
authors.initials: M
authors.lastname: Gallegos
authors.affiliation: Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo.
authors.forename: Paulette
authors.initials: P
authors.lastname: Conget
keywords: betamethasone; cartilage; microfracture; platelet-rich plasma; tissue engineering