title: Intraarticular Hyaluronic Acid Injection after Microfracture Technique for the Management of Full-Thickness Cartilage Defects Does Not Improve the Quality of Repair Tissue.
abstract: OBJECTIVE
  Tissue repair that occurs after microfracture does not include hyaline-like cartilage. Therefore, other treatment modalities must be combined with microfracture to improve repair tissue quality. In this study, we combined exogenous hyaluronic acid with microfracture.
  
  
  METHODS
  Thirty mature New Zealand rabbits were randomly divided into 3 groups as control, microfracture (MF), and microfracture and hyaluronic acid (MFHA). Four-millimetre full-thickness cartilage defects were created in the medial femoral condyle of each rabbit. Microfracture was performed on defects in the MF and MFHA groups. At 1 week following surgery, 1 mL of saline was injected into the knees of the control and MF groups, whereas 1 mL (15 mg/mL) hyaluronic acid was injected into the knees of the MFHA group 3 times weekly. At 6 months postsurgery, defects were evaluated according to the ICRS (International Cartilage Repair Society) and Wakitani scales.
  
  
  RESULTS
  According to the ICRS and Wakitani scales, the quality of repair tissue was improved in MF and MFHA groups as compared the control group (P = 0.001 and 0.001, respectively). No significant difference was observed between the MF and MFHA groups (P = 0.342).
  
  
  CONCLUSIONS
  According to the model in this study, no beneficial effect was obtained when HA injection was combined with microfracture in the treatment of full-thickness cartilage defects.
authors.affiliation: Department of Orthopedics and Traumatology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Gunes
authors.affiliation: Department of Orthopedics and Traumatology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey.
authors.forename: Bora
authors.initials: B
authors.lastname: Bostan
authors.affiliation: Department of Orthopedics and Traumatology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erdem
authors.affiliation: Department of Pathology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey.
authors.forename: Resid Dogan
authors.initials: RD
authors.lastname: Koseoglu
authors.affiliation: Department of Orthopedics and Traumatology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Asci
authors.affiliation: Department of Orthopedics and Traumatology, Bezmi Alem Vakif University, School of Medicine, Istanbul, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Sen
keywords: articular cartilage; hyaluronic acid; intraarticular delivery; microfracture; repair issues