Regeneration Mechanism of Full Thickness Cartilage Defect Using Combination of Freeze Dried Bovine Cartilage Scaffold - Allogenic Bone Marrow Mesenchymal Stem Cells - Platelet Rich Plasma Composite (SMPC) Implantation

Abstract

Cartilage defect has become serious problem for orthopaedic surgeon and patients because of its difficult healing that might occur when articular cartilage damage never reach subchondral layer. In this study, we used combination of freeze dried bovine cartilage (FDBC) scaffold, bone marrow mesenchymal stem cells (BM-MSCs), and platelet rich plasma (PRP) composite (SMPC) implanted in full thickness cartilage defect. This study is to explain its regeneration mechanism. This is true experimental research with post-test only control group design using New Zealand White Rabbit. 50 rabbits is divided into three groups of SMPC, BM-MSCs and FDBC. 37 rabbits evaluated after twelve weeks. Histopathologic examination showed the number of chondrocytes, collagen thickness and cartilage width are highest on SMPC group. Immunohistochemical examination showed SMPC group has the highest number of chondroprogenitor cells express FGF-2R, Sox-9, and MAPK. Brown Forsythe test resulted in significant increase the number of chondrocytes (p=0,010), collagen thickness (p=0,000), and cartilage surface width (p=0,015), and increase FGF-2R (p=0,000), MAPK (p=0,000), and Sox-9 (p=0,000) on SMPC group. Using path analysis, there is strong influence from FGF-2R, MAPK, and Sox-9 to the increase of chondrocytes, collagen thickness, and cartilage surface width. Hence, SMPC implantation mechanism of full thickness cartilage defect regeneration can be explained.

Macroscopic and histologic evaluation of cartilage regeneration treated using xenogenic biodegradable porous sponge cartilage scaffold composite supplemented with allogenic adipose derived mesenchymal stem cells (ASCs) and secretome: An in vivo experimental study

“…This process is estimated to work with the mechanism of differentiation of intrinsic stem cells that occur when there is a defect in an organ. 25,32 This was consistent with a meta-analysis study conducted by Muhammad, et.al. where the study found that the efficacy of stem cell and secretome administration was obtained. 15 This is due to the way stem cells work through the paracrine mechanism so that with the right secretome it can work as if there was a stem cell itself.…”

“…33 This study was also in line with previous studies conducted by Utomo, et.al. which was a progenitor of scaffold material used in this study. 25 The results from this study so far has favorable results compared with similar studies using synthesized scaffolds. 34,35 Figure 6.…”

“…This process is estimated to work with the mechanism of differentiation of intrinsic stem cells that occur when there is a defect in an organ. 25,32…”

“…Earlier studies using scaffolds and the manufacturing of the scaffold have produced excellent outcomes. 21–25…”

Physicobiochemical Characteristics and Chondrogenic Differentiation of Bone Marrow Mesenchymal Stem Cells (hBM-MSCs) in Biodegradable Porous Sponge Bovine Cartilage Scaffold

“…This biomaterial is cheap and easy to acquire. Bovine cartilage scaffold will not damage the stem cell [12].…”