Intra-osseous infiltration of adipose mesenchymal stromal cells and plasma rich in growth factors to treat acute full depth cartilage defects in a rabbit model: Serum osteoarthritis biomarkers and macroscopical assessment

Abstract

IntroductionIntra-articular infiltration of plasma rich in growth factors (PRGF) and adipose mesenchymal stromal cells (AMSCs) are known to inhibit osteoarthritis progression. However, in severely affected patients, the treatment cannot reach the deeper layers of the articular cartilage; thus, its potential is limited. To overcome this limitation, intra-osseous infiltrations have been suggested. The purpose of this study is to assess the impact of intra-osseous infiltration therapies on serum biomarkers of osteoarthritis and to assess cartilage regeneration macroscopically.Materials and methodsA total of 80 rabbits were divided into four groups based on the intra-osseous treatment administered on the day of surgery: control, PRGF, AMSCs and a combination of PRGF + AMSCs. In addition, all groups received a single intra-articular administration of PRGF on the same day. Serum biomarker levels were measured before infiltration and 28-, 56-, and 84-days post infiltration, and macroscopical assessment was conducted at 56- and 84-days follow-up post infiltration.ResultsIn the PRGF + AMSCs group, significantly lower concentrations of hyaluronic acid and type II collagen cleavage neoepitope were recorded at all time points during the study, followed by PRGF, AMSCs and control groups. Regarding macroscopical assessment, lower scores were obtained in PRGF + AMSCs group at all study times.DiscussionThe results suggest that the combination of intra-articular PRGF with intra-osseous PRGF or AMSCs achieves better results in rabbits with acute chondral defects and that intra-osseous infiltration is a safe procedure.

Intra-osseous plasma rich in growth factors enhances cartilage and subchondral bone regeneration in rabbits with acute full thickness chondral defects: Histological assessment

“…However, for the criteria “vascularity” at 56- days follow up, the rabbits in TRT group showed significantly lower score, thus meaning greater presence of blood vessels, compared to CT group. These results agree with the ones previously published by our research team, in which a higher macroscopical presence of blood vessels was reported in the IO treated rabbits ( 38 ). This angiogenic activity showed in the TRT group is mainly modulated by the presence of pro-angiogenic platelet-derived vascular endothelial growth factor within the PRGF, and other mediators such as transforming growth factor-β and fibroblast growth factor-2, which produce new blood vessels by stimulating endothelial cells ( 52 – 54 ).…”

“…Accordingly, several authors have proposed IA combined with IO infiltration of PRP to provide a more comprehensive treatment to patients severely affected, and previous results have already showed that this infiltration methodology is secure and provides better and longer functional and clinical improvements compared with IA injections alone ( 28 , 34 – 37 , 48 – 51 ). Moreover, our research team has recently reported that rabbits with acute full depth chondral defect treated with IA together with IO PRGF infiltrations showed better macroscopical AC repair than those treated with single IA injections of PRGF at 56- and 84-days follow-up ( 38 ).…”

“…Various research groups have already showed that the IO approach is safe and provides longer-term functional and clinical benefits compared to IA injections of PRP alone ( 34 – 37 ). Moreover, our research team has previously investigated the efficacy of the IO infiltration technique in acute chondral lesions in rabbits, and better macroscopical and serum biomarkers results were obtained in animals in which IA PRP was combined with IO infiltration ( 38 , 39 ).…”