BACKGROUND: Articular cartilage repair has been a challenge in orthopedic practice due to the limited self-regenerative capability. Optimal treatment method for cartilage defects has not been defined. We investigated the effect of decellularized human placental (DHP) scaffold, mesenchymal stem cells (MSC) and platelet-rich plasma (PRP) on hyaline cartilage regeneration in a rat model. METHODS: An osteochondral defect was created in trochlea region of the femur in all groups, bilaterally. No additional procedure was performed in control group (n = 14). Only the DHP scaffold was applied to the P group (n = 14). The DHP scaffold and 1 9 10 6 MSCs were applied to the PS group (n = 14). The DHP scaffold and PRP were applied to the PP group (n = 14). The DHP scaffold, 1 9 10 6 MSCs and PRP were applied to the PSP group (n = 14). Outcome measures at 12 weeks included Pineda histology score and qualitative histology. RESULTS: The mean Pineda scores of P, PS, PP, and PSP groups were significantly better than the control group (p = 0.031, p = 0.002, p \ 0.001, p \ 0001, respectively). There was no statistically difference in mean Pineda scores of P, PS, PP, and PSP groups (p [ 0.05). CONCLUSION: In conclusion, the DHP scaffold appears to be a promising scaffold on hyaline cartilage regeneration. The augmentation of DHP scaffold with MSCs and PRP combinations did not enhance its efficacy on articular cartilage regeneration.

Background. Epidermal Growth Factor (EGF) stimulates epidermis cell growth, proliferation and differentiation in skin regeneration. The aim of this study was to pre-clinically investigation of the role of EGF in tendon healing. Methods. One cm defects were created at the right Achilles tendons of 30 New Zealand White rabbits. Ten rabbits were allocated to one of three groups: Group-1-(Sham) tendon defect with a gap that was splinted with a non-absorbable suture; Group-2-(EGF +) tendon defect with a gap that was splinted with a non-absorbable suture and a 25 µg/kg EGF injection into the defect; Group-3-(Scaffold + EGF) tendon defect was grafted with a biodegradable, porous Polycaprolactone (PCL) scaffold loaded with 25 µg/kg EGF and stabilized with a non-absorbable suture. Animals were sacrificed at 8 weeks post-surgery and Achilles tendon repair and healing status was investigated using histopathologic and biomechanical analysis methods. Results. Group-2-(EGF +) had greater adipocyte development (moderate) than Group-1-(Sham) and Group-3-(Scaffold + EGF). Group-2-(EGF +) and Group-3-(Scaffold + EGF) had greater peripheral nerve development (weak) than Group-1-(Sham). Group-2-(EGF +) had greater vascularization (moderate) than Group-1-(Sham) and Group-3-(Scaffold + EGF). Group-2-(EGF +) had greater collagen Type-III development (moderate) than Group-1-(Sham) and Group-3-(Scaffold + EGF). Group-3-(Scaffold + EGF) had greater collagen Type-I development (moderate) than Group-1-(Sham) and Group-2-(EGF +). Groups did not display statistically significant differences for load to failure or elongation at failure. Group-2-(EGF +) and Group-3-(Scaffold + EGF) displayed less stiffness that the control (healthy contralateral Achilles tendon) (p < 0.05), however, experimental groups did not differ (p > 0.05). Conclusions. The application of EGF and scaffold displayed superior histological tendon healing evidence, but there was no significant difference in terms of biomechanics.

Osteoarthritis (OA) is the most common progressive condition affecting joints. It mainly affects the knees and hips as predominant weight-bearing joints. Knee osteoarthritis (KOA) accounts for a large proportion of osteoarthritis and presents numerous symptoms that impair quality of life, such as stiffness, pain, dysfunction, and even deformity. For more than two decades, intra-articular (IA) treatment options for managing knee osteoarthritis have included analgesics, hyaluronic acid (HA), corticosteroids, and some unproven alternative therapies. Before effective disease-modifying treatments for knee osteoarthritis, treatments are primarily symptomatic, mainly including intra-articular corticosteroids and hyaluronic acid, so these agents represent the most frequently used class of drugs for managing knee osteoarthritis. But research suggests other factors, such as the placebo effect, have an essential role in the effectiveness of these drugs. Several novel intra-articular therapies are currently in the clinical trial processes, such as biological therapies, gene and cell therapies. Besides, it has been shown that the development of novel drug nanocarriers and delivery systems could improve the effectiveness of therapeutic agents in osteoarthritis. This review discusses the various treatment methods and delivery systems for knee osteoarthritis and the new agents that have been introduced or are in development.

The high costs and extensive time needed for the treatment of critical-sized bone defects are still major clinical concerns in orthopedic surgery; therefore, researchers continue to look for more cost and time-effective methods. This study aims to investigate the effects of a decellularized omentum scaffold with a combination of platelet-rich plasma (PRP) and mesenchymal stem cells on the healing of critical-sized bone defects. Wistar albino rats (n = 30) were investigated in five groups. Critical-sized bone defects were formed on bilateral radius shafts. No scaffold, decellularized omentum, omentum with PRP and omentum + mesenchymal stem cells was used in group 1 (control group), 2, 3 and 4, respectively. In addition, omentum with a combination of mesenchymal stem cells +PRP was used in group 5. After 6 weeks, both radiological and histological healing were evaluated comparatively among the groups. After the use of a decellularized omentum scaffold, vitality of new cells was maintained, and new bone formation occurred. When compared to the control group, radiological healing was significantly better (p = 0.047) in the omentum and omentum + PRP-treated groups. Furthermore, histological healing was better in the omentum and omentum + PRP-treated groups than the control group (p = 0.001). The use of a decellularized omentum scaffold is suitable in the healing of critical bone defects.

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