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Repeated platelet concentrate injections enhance reparative response of microfractures in the treatment of chondral defects of the knee: an experimental study in an animal model

Milano, Giuseppe and Deriu, Laura and Sanna Passino, Eraldo and Masala, Gerolamo and Manunta, Andrea Fabio and Postacchini, Roberto and Saccomanno, Maristella Francesca and Fabbricciani, Carlo (2012) Repeated platelet concentrate injections enhance reparative response of microfractures in the treatment of chondral defects of the knee: an experimental study in an animal model. Arthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 28 (5), p. 688-701. eISSN 1526-3231. Article.

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DOI: 10.1016/j.arthro.2011.09.016

Abstract

Purpose: To assess the histology and biomechanics of repair cartilage after microfractures with and without repeated local injections of platelet concentrate for the treatment of full-thickness focal chondral defects of the knee.
Methods: A full-thickness chondral lesion on the medial femoral condyle was created in 30 sheep and treated with microfractures. Animals were divided into 2 groups, according to postoperative treatment: in group 1 we performed 5 weekly injections of autologous conditioned plasma, whereas group 2 did not undergo further treatments. Animals were killed at 3, 6, and 12 months after treatment. Macroscopic, histologic, and biomechanical evaluations were performed. Differences between groups at each time interval and differences over time within groups were analyzed for each outcome. Significance was set at P < .05.
Results: Group 1 showed significantly better macroscopic, histologic, and biomechanical results than group 2 at each time interval. Analysis of time effect within groups showed that in group 1, quality of repair tissue significantly improved from 3 to 6 months after treatment and remained stable over time for all the outcomes; in group 2 a significant histologic and mechanical deterioration was observed between 6 and 12 months' follow-up.
Conclusions: Five repeated local injections of autologous conditioned plasma after microfractures in the treatment of full-thickness cartilage injuries promoted a better and more durable reparative response than isolated microfractures, although they did not produce hyaline cartilage.
Clinical Relevance: Periodical intra-articular injections of platelet concentrate after microfractures may improve cartilage repair and prevent further degenerative changes.

Item Type:Article
ID Code:8644
Status:Published
Refereed:Yes
Uncontrolled Keywords:Cartilage, microfractures, platelet concentrate platelet concentrate (PC) injections, defects of the knee
Subjects:Area 07 - Scienze agrarie e veterinarie > VET/09 Clinica chirurgica veterinaria
Area 06 - Scienze mediche > MED/33 Malattie apparato locomotore
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Chirurgiche, Microchirurgiche e Mediche
001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Medicina Veterinaria
Publisher:Saunders / Elsevier
eISSN:1526-3231
Copyright Holders:© 2012 by the Arthroscopy Association of North America
Deposited On:20 Feb 2013 10:44

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