Articular cartilage regeneration with microfracture and hyaluronic acid.
ABSTRACT Microfracture used to treat articular cartilage injuries can facilitate access to stem cells in the bone marrow and stimulate cartilage regeneration. However, the regenerated cartilage is fibrocartilage as opposed to hyaline articular cartilage and is thinner than native cartilage. Following microfracture in rabbit knee cartilage defects, application of hyaluronic acid gel resulted in regeneration of a thicker, more hyaline-like cartilage. The addition of transforming growth factor-beta3, an inducer of chondrogenic differentiation in mesenchymal stem cells, to the treatment with microfracture and hyaluronic acid did not significantly benefit cartilage regeneration.
- SourceAvailable from: InTech12/2011; , ISBN: 978-953-307-771-0
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ABSTRACT: Repairing articular cartilage by combining microfracture and various scaffolds has been performed extensively in in vivo animal models. We previously described a novel extracellular matrix (ECM) scaffold for cartilage tissue engineering. The aim of this study was to investigate the effect of a BMSC-derived ECM (BMSC-dECM) scaffold on the chondrogenic differentiation of marrow clots following microfracture in vitro. In this study, we manufactured the BMSC-dECM scaffold using a freeze-drying method. To obtain the marrow clots, a full-thickness cartilage defect was established and microholes were created in the trochlear groove of New Zealand white rabbits. The samples were divided and cultured in vitro for 1, 2, 4, and 8 weeks. The samples included a culture of the marrow clot alone (Group 1), a culture of the marrow clot with TGF-β 3 (Group 2), a culture of the composite of the BMSC-dECM scaffold and the marrow clot alone (Group 3), and a culture of the composite with TGF-β 3 (Group 4). A smooth and glossy surface was observed in Group 2 and Group 4 over time, but the surface for Group 4 was larger from week 1 onward. Compressive strength gradually increased in Groups 2 and 4, and greater increases were observed in Group 4 during the 8-week culture period. Enhanced cartilage-like matrix deposition of GAG and type II collagen were confirmed by Safranin O and immunohistochemistry staining, respectively, in Groups 2 and 4. The GAG and collagen contents also increased gradually over time in Groups 2 and 4; the increase was greater in Group 4. In addition, RT-PCR demonstrated that the expression of chondrogenic genes, such as COL2, ACAN, and SOX9, was gradually upregulated in Groups 2 and 4. However, greater increases in the expression of these cartilage-like genes were observed in Group 4 from week 4 onward. Our results suggest that the BMSC-dECM scaffold may favor the chondrogenesis of marrow clots following microfracture in vitro. In conclusion, these tissue engineering-like constructs could be potential candidates for cartilage repair.Tissue Engineering Part A 03/2014; · 4.64 Impact Factor
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ABSTRACT: Because articular hyaline cartilage has low potential for regeneration, numerous methods and techniques have been proposed to induce the reparation process. Microfracture is a convenient procedure for this purpose. However, the quality of the new cartilage after microfracture is still not as proper as original. In this experimental study, we used microfracture in combination with intraarticular application of hyaluronan in rabbit knee articular defect. Bilateral knee arthrotomies, chondral defects, and microfracture were created on each intercondylar notch in thirty rabbits. Rabbits received intraarticular injections of hyaluronan once a week for 3 weeks in the right knee, started from 1 week after injury. The left knees, which served as controls, were injected with normal saline. Biopsy was taken from both knees at the 4th and 6th weeks. In comparison with the control group, after 6 weeks we observed a higher potential for healing in the experimental group, with thicker and more organized repair tissue filling the defect. The current study reveals that application of hyaluronan after the microfracture might be beneficial in inducing articular cartilage defect reparation.European Journal of Orthopaedic Surgery & Traumatology 09/2012; · 0.18 Impact Factor