title: Early loss of subchondral bone following microfracture is counteracted by bone marrow aspirate in a translational model of osteochondral repair.
abstract: Microfracture of cartilage defects may induce alterations of the subchondral bone in the mid- and long-term, yet very little is known about their onset. Possibly, these changes may be avoided by an enhanced microfracture technique with additional application of bone marrow aspirate. In this study, full-thickness chondral defects in the knee joints of minipigs were either treated with (1) debridement down to the subchondral bone plate alone, (2) debridement with microfracture, or (3) microfracture with additional application of bone marrow aspirate. At 4 weeks after microfracture, the loss of subchondral bone below the defects largely exceeded the original microfracture holes. Of note, a significant increase of osteoclast density was identified in defects treated with microfracture alone compared with debridement only. Both changes were significantly counteracted by the adjunct treatment with bone marrow. Debridement and microfracture without or with bone marrow were equivalent regarding the early cartilage repair. These data suggest that microfracture induced a substantial early resorption of the subchondral bone and also highlight the potential value of bone marrow aspirate as an adjunct to counteract these alterations. Clinical studies are warranted to further elucidate early events of osteochondral repair and the effect of enhanced microfracture techniques.
authors.affiliation: Center of Experimental Orthopaedics, Saarland University, Homburg, Germany.
authors.forename: Liang
authors.initials: L
authors.lastname: Gao
authors.affiliation: Center of Experimental Orthopaedics, Saarland University, Homburg, Germany.|Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Orth
authors.affiliation: Center of Experimental Orthopaedics, Saarland University, Homburg, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Müller-Brandt
authors.affiliation: Center of Experimental Orthopaedics, Saarland University, Homburg, Germany.|Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg, Germany.
authors.forename: Lars K H
authors.initials: LK
authors.lastname: Goebel
authors.affiliation: Center of Experimental Orthopaedics, Saarland University, Homburg, Germany.
authors.forename: Magali
authors.initials: M
authors.lastname: Cucchiarini
authors.affiliation: Center of Experimental Orthopaedics, Saarland University, Homburg, Germany.|Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Madry
mesh_terms: D000818:Animals; D000069237:Arthrocentesis / Q000379:methods*; D016026:Bone Marrow Transplantation; D001862:Bone Resorption / Q000209:etiology / Q000517:prevention & control*; D002357:Cartilage Diseases / Q000601:surgery*; D003646:Debridement; D004195:Disease Models, Animal; D005260:Female; D015775:Fractures, Stress / Q000150:complications*; D013552:Swine; D013556:Swine, Miniature; D057170:Translational Research, Biomedical; D016896:Treatment Outcome