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The Journal of bone and joint surgery. American volume2010; 92(10); 1927-1937; doi: 10.2106/JBJS.I.01284

Concentrated bone marrow aspirate improves full-thickness cartilage repair compared with microfracture in the equine model.

Abstract: The purpose of this study was to compare the outcomes of treatment with bone marrow aspirate concentrate, a simple, one-step, autogenous, and arthroscopically applicable method, with the outcomes of microfracture with regard to the repair of full-thickness cartilage defects in an equine model. Methods: Extensive (15-mm-diameter) full-thickness cartilage defects were created on the lateral trochlear ridge of the femur in twelve horses. Bone marrow was aspirated from the sternum and centrifuged to generate the bone marrow concentrate. The defects were treated with bone marrow concentrate and microfracture or with microfracture alone. Second-look arthroscopy was performed at three months, and the horses were killed at eight months. Repair was assessed with use of macroscopic and histological scoring systems as well as with quantitative magnetic resonance imaging. Results: No adverse reactions due to the microfracture or the bone marrow concentrate were observed. At eight months, macroscopic scores (mean and standard error of the mean, 9.4 + or - 1.2 compared with 4.4 + or - 1.2; p = 0.009) and histological scores (11.1 + or - 1.6 compared with 6.4 + or - 1.2; p = 0.02) indicated improvement in the repair tissue in the bone marrow concentrate group compared with that in the microfracture group. All scoring systems and magnetic resonance imaging data indicated that delivery of the bone marrow concentrate resulted in increased fill of the defects and improved integration of repair tissue into surrounding normal cartilage. In addition, there was greater type-II collagen content and improved orientation of the collagen as well as significantly more glycosaminoglycan in the bone marrow concentrate-treated defects than in the microfracture-treated defects. Conclusions: Delivery of bone marrow concentrate can result in healing of acute full-thickness cartilage defects that is superior to that after microfracture alone in an equine model. Conclusions: Delivery of bone marrow concentrate to cartilage defects has the clinical potential to improve cartilage healing, providing a simple, cost-effective, arthroscopically applicable, and clinically effective approach for cartilage repair.
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Publication Date: 2010-08-20 PubMed ID: 20720135DOI: 10.2106/JBJS.I.01284Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study examines the effect of bone marrow aspirate concentrate on the repair of cartilage defects compared to traditional methods, specifically in horses. The research suggests that the use of bone marrow concentrate improves not only the speed and quality of repair, but also results in better integration of the repaired cartilage with the surrounding tissue than microfracture methods.

Study Design and Methodology

  • The study was aimed at comparing the effectiveness of bone marrow aspirate concentrate and microfracture in repairing full-thickness cartilage defects using an equine model.
  • Large, full-thickness defects (15mm in diameter) were created in the lateral trochlear ridge of the femur in twelve test subjects (horses).
  • Bone marrow was aspirated from the sternum of the equine subjects, which was then processed through centrifugation to create concentrated bone marrow extracts.
  • The defects were then treated using either the bone marrow concentrate or the microfracture technique (or both techniques in some cases).
  • A follow-up examination was conducted after three months using arthroscopy, and the animals were euthanized for further study at the eight-month mark.
  • The quality of the repair was assessed using both macroscopic and histological scoring systems as well as with the help of quantitative Magnetic Resonance Imaging (MRI).

Findings and Results

  • The study did not observe any adverse reactions associated with either the microfracture or bone marrow concentrate treatments.
  • At the end of the eight-month period, both the macroscopic score (mean ± standard error of the mean, 9.4 ± 1.2 vs. 4.4 ± 1.2; p = 0.009) and histological score (11.1 ± 1.6 vs.6.4 ± 1.2; p = 0.02) demonstrated marked improvement in the repair tissue in the group treated with bone marrow concentrate compared to the group treated using microfracture.
  • Further, the MRI data, as well as all scoring systems, indicated that the application of bone marrow concentrate resulted in better filling of the defects and improved integration of the repair tissue with the surrounding normal cartilage.
  • Additionally, the treatment with bone marrow concentrate led to higher levels of collagen type-II content within the defects, a superior orientation of collagen, as well as a significant increase in the amounts of glycosaminoglycan.

Conclusions

  • The results of the study suggested that bone marrow concentrate could be superior to microfracture for healing acute full-thickness cartilage defects.
  • The study concluded that the application of such a treatment method to cartilage defects has the potential to improve the viability and effectiveness of clinical cartilage healing. This approach is advantageous as it is simple, cost-effective, can be applied arthroscopically and would be a clinically effective method for cartilage repair and healing.

Cite This Article

APA
Fortier LA, Potter HG, Rickey EJ, Schnabel LV, Foo LF, Chong LR, Stokol T, Cheetham J, Nixon AJ. (2010). Concentrated bone marrow aspirate improves full-thickness cartilage repair compared with microfracture in the equine model. J Bone Joint Surg Am, 92(10), 1927-1937. https://doi.org/10.2106/JBJS.I.01284

Publication

The Journal of bone and joint surgery. American volume
ISSN: 1535-1386
NlmUniqueID: 0014030
Country: United States
Language: English
Volume: 92
Issue: 10
Pages: 1927-1937

Researcher Affiliations

Fortier, Lisa A
  • Departments of Clinical Sciences, VMC C3-181, Cornell University, Ithaca, NY 14853, USA. laf4@cornell.edu
Potter, Hollis G
    Rickey, Ellen J
      Schnabel, Lauren V
        Foo, Li Foong
          Chong, Leroy R
            Stokol, Tracy
              Cheetham, Jon
                Nixon, Alan J

                  MeSH Terms

                  • Animals
                  • Arthroplasty, Subchondral
                  • Bone Marrow Transplantation
                  • Cartilage, Articular / injuries
                  • Cartilage, Articular / surgery
                  • Flow Cytometry
                  • Horses
                  • Magnetic Resonance Imaging
                  • Treatment Outcome
                  • Wound Healing / physiology

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