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Home / Equine Research Bank / Cartilage / Microfracture: Basic Science Studies in the Horse.
Cartilage2010; 1(2); 87-95; doi: 10.1177/1947603510367427

Microfracture: Basic Science Studies in the Horse.

Abstract: The therapeutic value of microfracture has been demonstrated in clinical patients. The rationale is that focal penetration of the dense subchondral plate exposes cartilage defects to the benefits of cellular and growth factor influx in addition to improving anchorage of the new tissue to the underlying subchondral bone and, to some extent, the surrounding cartilage. While functional outcomes have been reported, there is a paucity of data on the histological, biochemical, and molecular changes in human patients. This paper reviews 4 basic science studies of microfracture using an equine chondral defect model that gave some insight into possible mechanisms of action and also how the microfracture response could be augmented. In study I, microfracture of full-thickness chondral defects in exercised horses significantly increased the repair tissue volume in the defects at both 4 and 12 months. No adverse effects were seen. In study II, an investigation of the healing of full-thickness chondral defects during the first 8 weeks with or without microfracture demonstrated that microfracture significantly increased type II collagen expression as early as 8 weeks after treatment compared to controls; aggrecan expression was progressively increased during the first 8 weeks but was not significantly enhanced by microfracture. In study III, it was demonstrated that removal of the calcified cartilage layer provided optimal amount and attachment of repair tissue, emphasizing that careful removal of calcified layer is critical during debridement prior to microfracture. Study IV assessed the ability of IL-1ra/IGF-1 combination gene therapy to further modulate repair of microfractured chondral defects. The repair tissue in gene therapy-treated joints demonstrated increased proteoglycan and type II collagen content compared to microfracture alone.
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Publication Date: 2010-04-01 PubMed ID: 26069539PubMed Central: PMC4297049DOI: 10.1177/1947603510367427Google Scholar: Lookup
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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.

The research paper presents four scientific studies carried out on horses that explore the tissue regeneration effects and potential augmentation strategies pertaining to microfracture therapy, a surgical technique used to treat cartilage defects.

Overview of the Four Studies on Microfracture Therapy

  • In the first study, the researchers evaluated the effect of microfracture on full-thickness cartilage defects in exercised horses. They observed that the therapy led to a significant increase in repair tissue volume in the defects after 4 and 12 months, and did not trigger any adverse effects.
  • The second study investigated the healing process of full-thickness cartilage defects over the initial 8 weeks, comparing defects treated with microfracture to control defects. The treatment was found to significantly boost the expression of type II collagen as early as 8 weeks post-surgery. Meanwhile, aggrecan expression increased progressively during the 8 weeks but was not significantly enhanced by the microfracture treatment.
  • In the third study, the focus was on the importance of removing the calcified cartilage layer before proceeding with microfracture. The removal of this layer was found to provide an optimal amount and attachment of repair tissue, underlining the crucial role of careful debridement.
  • The fourth study assessed the role of a combined IL-1ra/IGF-1 gene therapy in improving microfracture repairs. The findings showed that the repair tissue from the joints treated with gene therapy demonstrated higher proteoglycan and type II collagen content compared to microfractures repaired without gene therapy.

Significance of Research and Future Directions

  • The studies contribute valuable data supporting the effectiveness of microfracture therapy, demonstrating its potential in promoting the regeneration of cartilage and maximizing the quality of repair tissue.
  • The research also hints at innovative augmentation strategies, such as gene therapy, which can potentially further enhance the outcome of microfracture treatment.
  • The third study underscores the importance of meticulous surgical techniques during microfracture therapy, particularly during the debridement stage.
  • While this research was performed on horses, the findings may have implications and relevance to similar microfracture treatments in humans. However, further research is needed to fully understand the comparative physiological and histological effects.

Cite This Article

APA
McIlwraith CW, Frisbie DD. (2010). Microfracture: Basic Science Studies in the Horse. Cartilage, 1(2), 87-95. https://doi.org/10.1177/1947603510367427

Publication

Cartilage
ISSN: 1947-6035
NlmUniqueID: 101518378
Country: United States
Language: English
Volume: 1
Issue: 2
Pages: 87-95

Researcher Affiliations

McIlwraith, C Wayne
  • Colorado State University, Fort Collins, CO, USA.
Frisbie, David D
  • Colorado State University, Fort Collins, CO, USA.

Conflict of Interest Statement

The authors declared no potential conflicts of interest with respect to the authorship and/or publication of this article.

References

This article includes 24 references
  1. Cole BJ, Pascual-Garrido C, Grumet RC. Surgical management of articular cartilage defects in the knee.. J Bone Joint Surg Am 2009 Jul;91(7):1778-90.
    pubmed: 19571102
  2. Johnson LL. Arthroscopic abrasion arthroplasty historical and pathologic perspective: present status.. Arthroscopy 1986;2(1):54-69.
    pubmed: 3954840doi: 10.1016/s0749-8063(86)80012-3google scholar: lookup
  3. Magnusson PB. Technique of debridement of the knee joint for arthritis. Surg Clin North Am 1946;26:226-49.
  4. Ficat RP, Ficat C, Gedeon P, Toussaint JB. Spongialization: a new treatment for diseased patellae.. Clin Orthop Relat Res 1979 Oct;(144):74-83.
    pubmed: 535254
  5. Pridie KH. A method of resurfacing osteoarthritic knee joints (abstract). J Bone Joint Surg 1959;41B:618-9.
  6. Insall J. The Pridie debridement operation for osteoarthritis of the knee.. Clin Orthop Relat Res 1974 Jun;(101):61-7.
    pubmed: 4837919
  7. Rodrigo JJ, Steadman JR, Silliman JF, Fulstone HA. Improvement of full-thickness chondral defect healing in the human knee after debridement and microfracture using continuous passive motion. Am J Knee Surg 1994;7:109-16.
  8. Steadman JR, Briggs KK, Rodrigo JJ, Kocher MS, Gill TJ, Rodkey WG. Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up.. Arthroscopy 2003 May-Jun;19(5):477-84.
    pubmed: 12724676doi: 10.1053/jars.2003.50112google scholar: lookup
  9. Steadman JR, Rodkey WG, Briggs KK. Microfracture to treat full-thickness chondral defects: surgical technique, rehabilitation, and outcomes.. J Knee Surg 2002 Summer;15(3):170-6.
    pubmed: 12152979
  10. Steadman JR, Rodkey WG, Rodrigo JJ. Microfracture: surgical technique and rehabilitation to treat chondral defects.. Clin Orthop Relat Res 2001 Oct;(391 Suppl):S362-9.
    pubmed: 11603719doi: 10.1097/00003086-200110001-00033google scholar: lookup
  11. Steadman JR, Miller BS, Karas SG, Schlegel TF, Briggs KK, Hawkins RJ. The microfracture technique in the treatment of full-thickness chondral lesions of the knee in National Football League players.. J Knee Surg 2003 Apr;16(2):83-6.
    pubmed: 12741420
  12. Knutsen G, Engebretsen L, Ludvigsen TC, Drogset JO, Grøntvedt T, Solheim E, Strand T, Roberts S, Isaksen V, Johansen O. Autologous chondrocyte implantation compared with microfracture in the knee. A randomized trial.. J Bone Joint Surg Am 2004 Mar;86(3):455-64.
    pubmed: 14996869doi: 10.2106/00004623-200403000-00001google scholar: lookup
  13. Mithoefer K, McAdams T, Williams RJ, Kreuz PC, Mandelbaum BR. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis.. Am J Sports Med 2009 Oct;37(10):2053-63.
    pubmed: 19251676doi: 10.1177/0363546508328414google scholar: lookup
  14. OUTERBRIDGE RE. The etiology of chondromalacia patellae.. J Bone Joint Surg Br 1961 Nov;43-B:752-7.
    pubmed: 14038135doi: 10.1302/0301-620x.43b4.752google scholar: lookup
  15. Frisbie DD, Cross MW, McIlwraith CW. A comparative study of articular cartilage thickness in the stifle of animal species used in human pre-clinical studies compared to articular cartilage thickness in the human knee.. Vet Comp Orthop Traumatol 2006;19(3):142-6.
    pubmed: 16971996
  16. Frisbie DD, Trotter GW, Powers BE, Rodkey WG, Steadman JR, Howard RD, Park RD, McIlwraith CW. Arthroscopic subchondral bone plate microfracture technique augments healing of large chondral defects in the radial carpal bone and medial femoral condyle of horses.. Vet Surg 1999 Jul-Aug;28(4):242-55.
    pubmed: 10424704doi: 10.1053/jvet.1999.0242google scholar: lookup
  17. McIlwraith CW, Nixon AJ, Wright IM, Boening J. Diagnostic and surgical arthroscopy in the horse. 3rd ed. London: Mosby-Elsevier; 2005.
  18. Mithoefer K, Williams RJ 3rd, Warren RF, Potter HG, Spock CR, Jones EC, Wickiewicz TL, Marx RG. Chondral resurfacing of articular cartilage defects in the knee with the microfracture technique. Surgical technique.. J Bone Joint Surg Am 2006 Sep;88 Suppl 1 Pt 2:294-304.
    pubmed: 16951101doi: 10.2106/jbjs.f.00292google scholar: lookup
  19. Potter HG, Foo LF. Magnetic resonance imaging of articular cartilage: trauma, degeneration, and repair.. Am J Sports Med 2006 Apr;34(4):661-77.
    pubmed: 16365371doi: 10.1177/0363546505281938google scholar: lookup
  20. Frisbie DD, Oxford JT, Southwood L, Trotter GW, Rodkey WG, Steadman JR, Goodnight JL, McIlwraith CW. Early events in cartilage repair after subchondral bone microfracture.. Clin Orthop Relat Res 2003 Feb;(407):215-27.
    pubmed: 12567150doi: 10.1097/00003086-200302000-00031google scholar: lookup
  21. Frisbie DD, Morisset S, Ho CP, Rodkey WG, Steadman JR, McIlwraith CW. Effects of calcified cartilage on healing of chondral defects treated with microfracture in horses.. Am J Sports Med 2006 Nov;34(11):1824-31.
    pubmed: 16832126doi: 10.1177/0363546506289882google scholar: lookup
  22. Morisset S, Frisbie DD, Robbins PD, Nixon AJ, McIlwraith CW. IL-1ra/IGF-1 gene therapy modulates repair of microfractured chondral defects.. Clin Orthop Relat Res 2007 Sep;462:221-8.
    pubmed: 17534189doi: 10.1097/blo.0b013e3180dca05fgoogle scholar: lookup
  23. Haupt JL, Frisbie DD, McIlwraith CW, Robbins PD, Ghivizzani S, Evans CH, Nixon AJ. Dual transduction of insulin-like growth factor-I and interleukin-1 receptor antagonist protein controls cartilage degradation in an osteoarthritic culture model.. J Orthop Res 2005 Jan;23(1):118-26.
    pubmed: 15607883doi: 10.1016/j.orthres.2004.06.020google scholar: lookup
  24. Nixon AJ, Haupt JL, Frisbie DD, Morisset SS, McIlwraith CW, Robbins PD, Evans CH, Ghivizzani S. Gene-mediated restoration of cartilage matrix by combination insulin-like growth factor-I/interleukin-1 receptor antagonist therapy.. Gene Ther 2005 Jan;12(2):177-86.
    pubmed: 15578043doi: 10.1038/sj.gt.3302396google scholar: lookup

Citations

This article has been cited 2 times.
  1. Miller RE, Grodzinsky AJ, Barrett MF, Hung HH, Frank EH, Werpy NM, McIlwraith CW, Frisbie DD. Effects of the combination of microfracture and self-assembling Peptide filling on the repair of a clinically relevant trochlear defect in an equine model.. J Bone Joint Surg Am 2014 Oct 1;96(19):1601-9.
    doi: 10.2106/JBJS.M.01408pubmed: 25274785google scholar: lookup
  2. Gobbi A, Karnatzikos G, Kumar A. Long-term results after microfracture treatment for full-thickness knee chondral lesions in athletes.. Knee Surg Sports Traumatol Arthrosc 2014 Sep;22(9):1986-96.
    doi: 10.1007/s00167-013-2676-8pubmed: 24051505google scholar: lookup
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