FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
The Journal of bone and joint surgery. American volume2018; 100(2); 138-146; doi: 10.2106/JBJS.17.00132

Minimally Manipulated Bone Marrow Concentrate Compared with Microfracture Treatment of Full-Thickness Chondral Defects: A One-Year Study in an Equine Model.

Abstract: Microfracture is commonly performed for cartilage repair but usually results in fibrocartilage. Microfracture augmented by autologous bone marrow concentrate (BMC) was previously shown to yield structurally superior cartilage repairs in an equine model compared with microfracture alone. The current study was performed to test the hypothesis that autologous BMC without concomitant microfracture improves cartilage repair compared with microfracture alone. Methods: Autologous sternal bone marrow aspirate (BMA) was concentrated using a commercial system. Cells from BMC were evaluated for chondrogenic potential in vitro and in vivo. Bilateral full-thickness chondral defects (15-mm diameter) were created on the midlateral trochlear ridge in 8 horses. Paired defects were randomly assigned to treatment with BMC without concomitant microfracture, or to microfracture alone. The repairs were evaluated at 1 year by in vitro assessment, arthroscopy, morphological magnetic resonance imaging (MRI), quantitative T2-weighted and ultrashort echo time enhanced T2* (UTE-T2*) MRI mapping, and histological assessment. Results: Culture-expanded but not freshly isolated cells from BMA and BMC underwent cartilage differentiation in vitro. In vivo, cartilage repairs in both groups were fibrous to fibrocartilaginous at 1 year of follow-up, with no differences observed between BMC and microfracture by arthroscopy, T2 and UTE-T2* MRI values, and histological assessment (p > 0.05). Morphological MRI showed subchondral bone changes not observed by arthroscopy and improved overall outcomes for the BMC repairs (p = 0.03). Differences in repair tissue UTE-T2* texture features were observed between the treatment groups (p < 0.05). Conclusions: When BMC was applied directly to critical-sized, full-thickness chondral defects in an equine model, the cartilage repair results were similar to those of microfracture. Our data suggest that, given the few mesenchymal stem cells in minimally manipulated BMC, other mechanisms such as paracrine, anti-inflammatory, or immunomodulatory effects may have been responsible for tissue regeneration in a previous study in which BMC was applied to microfractured repairs. While our conclusions are limited by small numbers, the better MRI outcomes for the BMC repairs may have been related to reduced surgical trauma to the subchondral bone. Conclusions: MRI provides important information on chondral defect subsurface repair organization and subchondral bone structure that is not well assessed by arthroscopy.
Get Full Text
Publication Date: 2018-01-18 PubMed ID: 29342064PubMed Central: PMC6819026DOI: 10.2106/JBJS.17.00132Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Comparative Study
  • 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.

The research investigates the effectiveness of minimally manipulated bone marrow concentrate (BMC) in repairing full-thickness cartilage defects, comparing it to the common practice of microfracturing. The exploration shows that the usage of autologous BMC, without accompanying microfracture, yields results similar to microfracture treatment alone. However, additional findings suggest potential benefits of BMC, likely due to less surgical impact on subchondral bone.

Methodology

  • The study used eight horses with full-thickness chondral defects. The ailment was treated using either autologous BMC without concomitant microfracture or microfracturing alone.
  • The BMC, derived from sternal bone marrow aspirate (BMA) of the horses, was processed through a commercial system for the purpose of this study.
  • The cells extracted from BMC were assessed for their chondrogenic potential both in vitro and in vivo.
  • The effectiveness of both treatments was analyzed using various techniques such as in vitro assessment, arthroscopy, morphological magnetic resonance imaging (MRI), quantitative T2-weighted and ultrashort echo time enhanced T2* (UTE-T2*) MRI mapping, and histological assessment.

Results and Findings

  • The results showed that cells extracted from BMA and BMC showcased cartilage differentiation capability in vitro after culture expansion but not in the freshly isolated state.
  • One year after treatment, the repaired cartilage in both BMC and microfracture conditions were fibrous to fibrocartilaginous without any significant difference between the two methods as validated by arthroscopy, T2 and UTE-T2* MRI values, and histological assessment.
  • Morphological MRI revealed changes in subchondral bone not registered by arthroscopy and an overall improved outcome for BMC repairs. Differences in UTE-T2* texture features of the repair tissue were noticed between the treatment groups.

Implications and Conclusions

  • The data indicates that minimally manipulated BMC delivers similar cartilage repair results as microfracture. The paucity of mesenchymal stem cells in BMC suggests other mechanisms like paracrine, anti-inflammatory, or immunomodulatory effects could be instrumental in facilitating tissue regeneration, as observed in an earlier study where BMC was applied to a microfractured repair site.
  • Better MRI results for BMC repairs were possibly the result of reduced surgical trauma to subchondral bone. However, this inference is restricted by the study’s limited numbers.
  • The study concludes that MRI is a valuable tool in providing detailed information about subsurface repair organization and subchondral bone structure in chondral defects, data that arthroscopy fails to assess thoroughly.

Cite This Article

APA
Chu CR, Fortier LA, Williams A, Payne KA, McCarrel TM, Bowers ME, Jaramillo D. (2018). Minimally Manipulated Bone Marrow Concentrate Compared with Microfracture Treatment of Full-Thickness Chondral Defects: A One-Year Study in an Equine Model. J Bone Joint Surg Am, 100(2), 138-146. https://doi.org/10.2106/JBJS.17.00132

Publication

The Journal of bone and joint surgery. American volume
ISSN: 1535-1386
NlmUniqueID: 0014030
Country: United States
Language: English
Volume: 100
Issue: 2
Pages: 138-146

Researcher Affiliations

Chu, Constance R
  • Department of Orthopedic Surgery, Stanford University, Stanford, California.
  • VA Palo Alto Health Care System, Palo Alto, California.
Fortier, Lisa A
  • College of Veterinary Medicine, Cornell University, Ithaca, New York.
Williams, Ashley
  • Department of Orthopedic Surgery, Stanford University, Stanford, California.
Payne, Karin A
  • Department of Orthopedics, University of Colorado, Aurora, Colorado.
McCarrel, Taralyn M
  • College of Veterinary Medicine, University of Florida, Gainesville, Florida.
Bowers, Megan E
  • George Washington University, Washington, DC.
Jaramillo, Diego
  • VA Palo Alto Health Care System, Palo Alto, California.
  • Nicklaus Children's Hospital, Miami, Florida.

MeSH Terms

  • Animals
  • Arthroscopy
  • Bone Marrow Transplantation
  • Cartilage, Articular / injuries
  • Cartilage, Articular / surgery
  • Disease Models, Animal
  • Horses
  • Magnetic Resonance Imaging
  • Random Allocation
  • Stifle / injuries
  • Stifle / surgery
  • Transplantation, Autologous
  • Wound Healing / physiology

Grant Funding

  • R01 AR051963 / NIAMS NIH HHS
  • R01 AR052784 / NIAMS NIH HHS
  • RC2 AR058929 / NIAMS NIH HHS

References

This article includes 45 references
  1. Martin JA, Brown T, Heiner A, Buckwalter JA. Post-traumatic osteoarthritis: the role of accelerated chondrocyte senescence.. Biorheology 2004;41(3-4):479-91.
    pubmed: 15299279
  2. Squires GR, Okouneff S, Ionescu M, Poole AR. The pathobiology of focal lesion development in aging human articular cartilage and molecular matrix changes characteristic of osteoarthritis.. Arthritis Rheum 2003 May;48(5):1261-70.
    pubmed: 12746899doi: 10.1002/art.10976google scholar: lookup
  3. Widuchowski W, Widuchowski J, Trzaska T. Articular cartilage defects: study of 25,124 knee arthroscopies.. Knee 2007 Jun;14(3):177-82.
    pubmed: 17428666doi: 10.1016/j.knee.2007.02.001google scholar: lookup
  4. Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94.. J Rheumatol 2006 Nov;33(11):2271-9.
    pubmed: 17013996
  5. Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II.. Arthritis Rheum 2008 Jan;58(1):26-35.
    pmc: PMC3266664pubmed: 18163497doi: 10.1002/art.23176google scholar: lookup
  6. Mankin HJ. The response of articular cartilage to mechanical injury.. J Bone Joint Surg Am 1982 Mar;64(3):460-6.
    pubmed: 6174527
  7. Shapiro F, Koide S, Glimcher MJ. Cell origin and differentiation in the repair of full-thickness defects of articular cartilage.. J Bone Joint Surg Am 1993 Apr;75(4):532-53.
    pubmed: 8478382doi: 10.2106/00004623-199304000-00009google scholar: lookup
  8. 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
  9. 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
  10. Magnussen RA, Dunn WR, Carey JL, Spindler KP. Treatment of focal articular cartilage defects in the knee: a systematic review.. Clin Orthop Relat Res 2008 Apr;466(4):952-62.
    pmc: PMC2504649pubmed: 18196358doi: 10.1007/s11999-007-0097-zgoogle scholar: lookup
  11. Zaslav K, Cole B, Brewster R, DeBerardino T, Farr J, Fowler P, Nissen C. A prospective study of autologous chondrocyte implantation in patients with failed prior treatment for articular cartilage defect of the knee: results of the Study of the Treatment of Articular Repair (STAR) clinical trial.. Am J Sports Med 2009 Jan;37(1):42-55.
    pubmed: 18927254doi: 10.1177/0363546508322897google scholar: lookup
  12. Bae DK, Yoon KH, Song SJ. Cartilage healing after microfracture in osteoarthritic knees.. Arthroscopy 2006 Apr;22(4):367-74.
    pubmed: 16581448doi: 10.1016/j.arthro.2006.01.015google scholar: lookup
  13. Kreuz PC, Erggelet C, Steinwachs MR, Krause SJ, Lahm A, Niemeyer P, Ghanem N, Uhl M, Südkamp N. Is microfracture of chondral defects in the knee associated with different results in patients aged 40 years or younger?. Arthroscopy 2006 Nov;22(11):1180-6.
    pubmed: 17084294doi: 10.1016/j.arthro.2006.06.020google scholar: lookup
  14. Kreuz PC, Steinwachs MR, Erggelet C, Krause SJ, Konrad G, Uhl M, Südkamp N. Results after microfracture of full-thickness chondral defects in different compartments in the knee.. Osteoarthritis Cartilage 2006 Nov;14(11):1119-25.
    pubmed: 16815714doi: 10.1016/j.joca.2006.05.003google scholar: lookup
  15. Mithoefer K, Williams RJ 3rd, Warren RF, Potter HG, Spock CR, Jones EC, Wickiewicz TL, Marx RG. The microfracture technique for the treatment of articular cartilage lesions in the knee. A prospective cohort study.. J Bone Joint Surg Am 2005 Sep;87(9):1911-20.
    pubmed: 16140804doi: 10.2106/jbjs.d.02846google scholar: lookup
  16. Cerynik DL, Lewullis GE, Joves BC, Palmer MP, Tom JA. Outcomes of microfracture in professional basketball players.. Knee Surg Sports Traumatol Arthrosc 2009 Sep;17(9):1135-9.
    pubmed: 19296083doi: 10.1007/s00167-009-0765-5google scholar: lookup
  17. 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.
    pubmed: 24051505doi: 10.1007/s00167-013-2676-8google scholar: lookup
  18. Mithoefer K, Williams RJ 3rd, Warren RF, Wickiewicz TL, Marx RG. High-impact athletics after knee articular cartilage repair: a prospective evaluation of the microfracture technique.. Am J Sports Med 2006 Sep;34(9):1413-8.
    pubmed: 16735588doi: 10.1177/0363546506288240google scholar: lookup
  19. 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
  20. Minas T, Gomoll AH, Rosenberger R, Royce RO, Bryant T. Increased failure rate of autologous chondrocyte implantation after previous treatment with marrow stimulation techniques.. Am J Sports Med 2009 May;37(5):902-8.
    pubmed: 19261905doi: 10.1177/0363546508330137google scholar: lookup
  21. Madry H, Orth P, Cucchiarini M. Role of the Subchondral Bone in Articular Cartilage Degeneration and Repair.. J Am Acad Orthop Surg 2016 Apr;24(4):e45-6.
    pubmed: 26990714doi: 10.5435/jaaos-d-16-00096google scholar: lookup
  22. Mithoefer K, Venugopal V, Manaqibwala M. Incidence, Degree, and Clinical Effect of Subchondral Bone Overgrowth After Microfracture in the Knee.. Am J Sports Med 2016 Aug;44(8):2057-63.
    pubmed: 27190069doi: 10.1177/0363546516645514google scholar: lookup
  23. Fortier LA, Potter HG, Rickey EJ, Schnabel LV, Foo LF, Chong LR, Stokol T, Cheetham J, Nixon AJ. Concentrated bone marrow aspirate improves full-thickness cartilage repair compared with microfracture in the equine model.. J Bone Joint Surg Am 2010 Aug 18;92(10):1927-37.
    pubmed: 20720135doi: 10.2106/jbjs.i.01284google scholar: lookup
  24. Wilke MM, Nydam DV, Nixon AJ. Enhanced early chondrogenesis in articular defects following arthroscopic mesenchymal stem cell implantation in an equine model.. J Orthop Res 2007 Jul;25(7):913-25.
    pubmed: 17405160doi: 10.1002/jor.20382google scholar: lookup
  25. Gobbi A, Karnatzikos G, Sankineani SR. One-step surgery with multipotent stem cells for the treatment of large full-thickness chondral defects of the knee.. Am J Sports Med 2014 Mar;42(3):648-57.
    pubmed: 24458240doi: 10.1177/0363546513518007google scholar: lookup
  26. Gobbi A, Karnatzikos G, Scotti C, Mahajan V, Mazzucco L, Grigolo B. One-Step Cartilage Repair with Bone Marrow Aspirate Concentrated Cells and Collagen Matrix in Full-Thickness Knee Cartilage Lesions: Results at 2-Year Follow-up.. Cartilage 2011 Jul;2(3):286-99.
    pmc: PMC4300809pubmed: 26069587doi: 10.1177/1947603510392023google scholar: lookup
  27. Gobbi A, Whyte GP. One-Stage Cartilage Repair Using a Hyaluronic Acid-Based Scaffold With Activated Bone Marrow-Derived Mesenchymal Stem Cells Compared With Microfracture: Five-Year Follow-up.. Am J Sports Med 2016 Nov;44(11):2846-2854.
    pubmed: 27474386doi: 10.1177/0363546516656179google scholar: lookup
  28. Sams AE, Minor RR, Wootton JA, Mohammed H, Nixon AJ. Local and remote matrix responses to chondrocyte-laden collagen scaffold implantation in extensive articular cartilage defects.. Osteoarthritis Cartilage 1995 Mar;3(1):61-70.
    pubmed: 7719955doi: 10.1016/s1063-4584(05)80038-xgoogle scholar: lookup
  29. Radcliffe CH, Flaminio MJ, Fortier LA. Temporal analysis of equine bone marrow aspirate during establishment of putative mesenchymal progenitor cell populations.. Stem Cells Dev 2010 Feb;19(2):269-82.
    pmc: PMC3138180pubmed: 19604071doi: 10.1089/scd.2009.0091google scholar: lookup
  30. Payne KA, Didiano DM, Chu CR. Donor sex and age influence the chondrogenic potential of human femoral bone marrow stem cells.. Osteoarthritis Cartilage 2010 May;18(5):705-13.
    pmc: PMC2862807pubmed: 20171308doi: 10.1016/j.joca.2010.01.011google scholar: lookup
  31. Grogan SP, Barbero A, Winkelmann V, Rieser F, Fitzsimmons JS, O'Driscoll S, Martin I, Mainil-Varlet P. Visual histological grading system for the evaluation of in vitro-generated neocartilage.. Tissue Eng 2006 Aug;12(8):2141-9.
    pubmed: 16968155doi: 10.1089/ten.2006.12.2141google scholar: lookup
  32. Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair.. J Bone Joint Surg Am 2003;85-A Suppl 2:58-69.
    pubmed: 12721346doi: 10.2106/00004623-200300002-00008google scholar: lookup
  33. Qian Y, Boada FE. Acquisition-weighted stack of spirals for fast high-resolution three-dimensional ultra-short echo time MR imaging.. Magn Reson Med 2008 Jul;60(1):135-45.
    pubmed: 18581326doi: 10.1002/mrm.21620google scholar: lookup
  34. Williams A, Qian Y, Chu CR. UTE-T2∗ mapping of human articular cartilage in vivo: a repeatability assessment.. Osteoarthritis Cartilage 2011 Jan;19(1):84-8.
    pmc: PMC3098496pubmed: 21035556doi: 10.1016/j.joca.2010.10.018google scholar: lookup
  35. Chu CR, Williams AA, West RV, Qian Y, Fu FH, Do BH, Bruno S. Quantitative Magnetic Resonance Imaging UTE-T2* Mapping of Cartilage and Meniscus Healing After Anatomic Anterior Cruciate Ligament Reconstruction.. Am J Sports Med 2014 Aug;42(8):1847-56.
    pmc: PMC5278879pubmed: 24812196doi: 10.1177/0363546514532227google scholar: lookup
  36. Haralick RM, Shanmugam K, Dinstein I. Texture features for image classification. IEEE Transactions on Systems, Man, and Cybernetics 1973 November;SMC-3(6):610-21.
  37. Williams A, Winalski CS, Chu CR. Early articular cartilage MRI T2 changes after anterior cruciate ligament reconstruction correlate with later changes in T2 and cartilage thickness.. J Orthop Res 2017 Mar;35(3):699-706.
    pmc: PMC5823014pubmed: 27381512doi: 10.1002/jor.23358google scholar: lookup
  38. Mainil-Varlet P, Aigner T, Brittberg M, Bullough P, Hollander A, Hunziker E, Kandel R, Nehrer S, Pritzker K, Roberts S, Stauffer E. Histological assessment of cartilage repair: a report by the Histology Endpoint Committee of the International Cartilage Repair Society (ICRS).. J Bone Joint Surg Am 2003;85-A Suppl 2:45-57.
    pubmed: 12721345
  39. Dominici M, Le Blanc K, Mueller I, Slaper-Cortenbach I, Marini F, Krause D, Deans R, Keating A, Prockop Dj, Horwitz E. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement.. Cytotherapy 2006;8(4):315-7.
    pubmed: 16923606doi: 10.1080/14653240600855905google scholar: lookup
  40. Cassano JM, Kennedy JG, Ross KA, Fraser EJ, Goodale MB, Fortier LA. Bone marrow concentrate and platelet-rich plasma differ in cell distribution and interleukin 1 receptor antagonist protein concentration.. Knee Surg Sports Traumatol Arthrosc 2018 Jan;26(1):333-342.
    pubmed: 26831858doi: 10.1007/s00167-016-3981-9google scholar: lookup
  41. Frisbie DD, Bowman SM, Colhoun HA, DiCarlo EF, Kawcak CE, McIlwraith CW. Evaluation of autologous chondrocyte transplantation via a collagen membrane in equine articular defects: results at 12 and 18 months.. Osteoarthritis Cartilage 2008 Jun;16(6):667-79.
    pubmed: 18042409doi: 10.1016/j.joca.2007.09.013google scholar: lookup
  42. Du J, Carl M, Bae WC, Statum S, Chang EY, Bydder GM, Chung CB. Dual inversion recovery ultrashort echo time (DIR-UTE) imaging and quantification of the zone of calcified cartilage (ZCC).. Osteoarthritis Cartilage 2013 Jan;21(1):77-85.
    pmc: PMC4051156pubmed: 23025927doi: 10.1016/j.joca.2012.09.009google scholar: lookup
  43. Welsch GH, Mamisch TC, Domayer SE, Dorotka R, Kutscha-Lissberg F, Marlovits S, White LM, Trattnig S. Cartilage T2 assessment at 3-T MR imaging: in vivo differentiation of normal hyaline cartilage from reparative tissue after two cartilage repair procedures--initial experience.. Radiology 2008 Apr;247(1):154-61.
    pubmed: 18372466doi: 10.1148/radiol.2471070688google scholar: lookup
  44. 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
  45. Chen H, Sun J, Hoemann CD, Lascau-Coman V, Ouyang W, McKee MD, Shive MS, Buschmann MD. Drilling and microfracture lead to different bone structure and necrosis during bone-marrow stimulation for cartilage repair.. J Orthop Res 2009 Nov;27(11):1432-8.
    pubmed: 19402150doi: 10.1002/jor.20905google scholar: lookup

Citations

This article has been cited 28 times.
  1. Pezzanite LM, Timkovich AE, Sikes KJ, Chow L, Hendrickson DA, Becker JR, Webster A, Santangelo KS, Dow S. Erythrocyte removal from bone marrow aspirate concentrate improves efficacy as intra-articular cellular therapy in a rodent osteoarthritis model. Ann Transl Med 2023 Jun 30;11(9):311.
    doi: 10.21037/atm-22-4256pubmed: 37404993google scholar: lookup
  2. Hoang LQ, Vaish B, Izuagbe S, Co CM, Borrelli J Jr, Millett PJ, Tang L. Histological Analysis of Regenerative Properties in Human Glenoid Labral Regions. Am J Sports Med 2023 Jul;51(8):2030-2040.
    doi: 10.1177/03635465231171680pubmed: 37235877google scholar: lookup
  3. Liu TP, Ha P, Xiao CY, Kim SY, Jensen AR, Easley J, Yao Q, Zhang X. Updates on mesenchymal stem cell therapies for articular cartilage regeneration in large animal models. Front Cell Dev Biol 2022;10:982199.
    doi: 10.3389/fcell.2022.982199pubmed: 36147737google scholar: lookup
  4. Browe DC, Burdis R, Díaz-Payno PJ, Freeman FE, Nulty JM, Buckley CT, Brama PAJ, Kelly DJ. Promoting endogenous articular cartilage regeneration using extracellular matrix scaffolds. Mater Today Bio 2022 Dec;16:100343.
    doi: 10.1016/j.mtbio.2022.100343pubmed: 35865410google scholar: lookup
  5. Menarim BC, El-Sheikh Ali H, Loux SC, Scoggin KE, Kalbfleisch TS, MacLeod JN, Dahlgren LA. Transcriptional and Histochemical Signatures of Bone Marrow Mononuclear Cell-Mediated Resolution of Synovitis. Front Immunol 2021;12:734322.
    doi: 10.3389/fimmu.2021.734322pubmed: 34956173google scholar: lookup
  6. Estrada McDermott J, Pezzanite L, Goodrich L, Santangelo K, Chow L, Dow S, Wheat W. Role of Innate Immunity in Initiation and Progression of Osteoarthritis, with Emphasis on Horses. Animals (Basel) 2021 Nov 13;11(11).
    doi: 10.3390/ani11113247pubmed: 34827979google scholar: lookup
  7. Yan J, Liu C, Tu C, Zhang R, Tang X, Li H, Wang H, Ma Y, Zhang Y, Wu H, Sheng G. Hydrogel-hydroxyapatite-monomeric collagen type-I scaffold with low-frequency electromagnetic field treatment enhances osteochondral repair in rabbits. Stem Cell Res Ther 2021 Nov 13;12(1):572.
    doi: 10.1186/s13287-021-02638-6pubmed: 34774092google scholar: lookup
  8. Tamaddon M, Blunn G, Xu W, Alemán Domínguez ME, Monzón M, Donaldson J, Skinner J, Arnett TR, Wang L, Liu C. Sheep condyle model evaluation of bone marrow cell concentrate combined with a scaffold for repair of large osteochondral defects. Bone Joint Res 2021 Oct;10(10):677-689.
    doi: 10.1302/2046-3758.1010.BJR-2020-0504.R1pubmed: 34665001google scholar: lookup
  9. Nino-Fong R, Esparza Gonzalez BP, Rodriguez-Lecompte JC, Montelpare W, McD￮ L. Development of a biologically immortalized equine stem cell line. Can J Vet Res 2021 Oct;85(4):293-301.
    pubmed: 34602734
  10. Menarim BC, MacLeod JN, Dahlgren LA. Bone marrow mononuclear cells for joint therapy: The role of macrophages in inflammation resolution and tissue repair. World J Stem Cells 2021 Jul 26;13(7):825-840.
    doi: 10.4252/wjsc.v13.i7.825pubmed: 34367479google scholar: lookup
  11. Kruel AVS, Ribeiro LL, Gusmão PD, Huber SC, Lana JFSD. Orthobiologics in the treatment of hip disorders. World J Stem Cells 2021 Apr 26;13(4):304-316.
    doi: 10.4252/wjsc.v13.i4.304pubmed: 33959220google scholar: lookup
  12. Taghiyar L, Jahangir S, Khozaei Ravari M, Shamekhi MA, Eslaminejad MB. Cartilage Repair by Mesenchymal Stem Cell-Derived Exosomes: Preclinical and Clinical Trial Update and Perspectives. Adv Exp Med Biol 2021;1326:73-93.
    doi: 10.1007/5584_2021_625pubmed: 33629260google scholar: lookup
  13. Commins J, Irwin R, Matuska A, Goodale M, Delco M, Fortier L. Biological Mechanisms for Cartilage Repair Using a BioCartilage Scaffold: Cellular Adhesion/Migration and Bioactive Proteins. Cartilage 2021 Dec;13(1_suppl):984S-992S.
    doi: 10.1177/1947603519900803pubmed: 31965816google scholar: lookup
  14. Fugazzola MC, van Weeren PR. Surgical osteochondral defect repair in the horse-a matter of form or function?. Equine Vet J 2020 Jul;52(4):489-499.
    doi: 10.1111/evj.13231pubmed: 31958175google scholar: lookup
  15. Iseki T, Rothrauff BB, Kihara S, Sasaki H, Yoshiya S, Fu FH, Tuan RS, Gottardi R. Dynamic Compressive Loading Improves Cartilage Repair in an In Vitro Model of Microfracture: Comparison of 2 Mechanical Loading Regimens on Simulated Microfracture Based on Fibrin Gel Scaffolds Encapsulating Connective Tissue Progenitor Cells. Am J Sports Med 2019 Jul;47(9):2188-2199.
    doi: 10.1177/0363546519855645pubmed: 31307219google scholar: lookup
  16. Apostolakos JM, Lazaro L, Williams RJ. The Use of Bone Marrow Concentrate in the Treatment of Full-Thickness Chondral Defects. HSS J 2019 Feb;15(1):96-99.
    doi: 10.1007/s11420-018-9647-zpubmed: 30863240google scholar: lookup
  17. De la Vega RE, Scheu M, Brown LA, Evans CH, Ferreira E, Porter RM. Specific, Sensitive, and Stable Reporting of Human Mesenchymal Stromal Cell Chondrogenesis. Tissue Eng Part C Methods 2019 Mar;25(3):176-190.
    doi: 10.1089/ten.TEC.2018.0295pubmed: 30727864google scholar: lookup
  18. Stelzer JW, Martin SD. Use of Bone Marrow Aspirate Concentrate with Acetabular Labral Repair for the Management of Chondrolabral Junction Breakdown. Arthrosc Tech 2018 Oct;7(10):e981-e987.
    doi: 10.1016/j.eats.2018.06.003pubmed: 30377577google scholar: lookup
  19. Chu CR, Rodeo S, Bhutani N, Goodrich LR, Huard J, Irrgang J, LaPrade RF, Lattermann C, Lu Y, Mandelbaum B, Mao J, McIntyre L, Mishra A, Muschler GF, Piuzzi NS, Potter H, Spindler K, Tokish JM, Tuan R, Zaslav K, Maloney W. Optimizing Clinical Use of Biologics in Orthopaedic Surgery: Consensus Recommendations From the 2018 AAOS/NIH U-13 Conference. J Am Acad Orthop Surg 2019 Jan 15;27(2):e50-e63.
    doi: 10.5435/JAAOS-D-18-00305pubmed: 30300216google scholar: lookup
  20. Martinello T, Gomiero C, Perazzi A, Iacopetti I, Gemignani F, DeBenedictis GM, Ferro S, Zuin M, Martines E, Brun P, Maccatrozzo L, Chiers K, Spaas JH, Patruno M. Allogeneic mesenchymal stem cells improve the wound healing process of sheep skin. BMC Vet Res 2018 Jun 25;14(1):202.
    doi: 10.1186/s12917-018-1527-8pubmed: 29940954google scholar: lookup
  21. Bogers SH. Cell-Based Therapies for Joint Disease in Veterinary Medicine: What We Have Learned and What We Need to Know. Front Vet Sci 2018;5:70.
    doi: 10.3389/fvets.2018.00070pubmed: 29713634google scholar: lookup
  22. Azain CM, Santamaría Durán AN, Castañeda TC, Useche LF, Garcia EL, Valero JM, Quintero RJ, Jaramillo LF, Franco JA, Salazar RC, Ulloa JC, Rojas IG, Palacios RS, Patiño CC, Rodríguez-Pardo VM. Interaction Between Human Skeletal and Mesenchymal Stem Cells Under Physioxia Enhances Cartilage Organoid Formation: A Phenotypic, Molecular, and Functional Characterization. Cells 2025 Sep 11;14(18).
    doi: 10.3390/cells14181423pubmed: 41002388google scholar: lookup
  23. Chu CR, Hochberg M, White D, Rodeo S, Huard J, Shapiro S, Lattermann C, Guilak F. Transformative approaches for effective clinical trials to reduce the disease burden of osteoarthritis. Semin Arthritis Rheum 2025 Apr;71:152652.
    doi: 10.1016/j.semarthrit.2025.152652pubmed: 39970622google scholar: lookup
  24. Menarim BC, Mok CH, Scoggin KE, Gornik A, Adam EN, Loux SC, MacLeod JN. Fetal Cartilage Progenitor Cells in the Repair of Osteochondral Defects. JB JS Open Access 2025 Jan-Mar;10(1).
    doi: 10.2106/JBJS.OA.24.00043pubmed: 39817152google scholar: lookup
  25. Carmona JU, Carmona-Ramírez LH, López C. Platelet-Rich Plasma and Related Orthobiologics for the Treatment of Equine Musculoskeletal Disorders-A Bibliometric Analysis from 2000 to 2024. Vet Sci 2024 Aug 21;11(8).
    doi: 10.3390/vetsci11080385pubmed: 39195839google scholar: lookup
  26. Casula V, Kajabi AW. Quantitative MRI methods for the assessment of structure, composition, and function of musculoskeletal tissues in basic research and preclinical applications. MAGMA 2024 Dec;37(6):949-967.
    doi: 10.1007/s10334-024-01174-7pubmed: 38904746google scholar: lookup
  27. Li H, Xiong S, Masieri FF, Monika S, Lethaus B, Savkovic V. Mesenchymal Stem Cells Isolated from Equine Hair Follicles Using a Method of Air-Liquid Interface. Stem Cell Rev Rep 2023 Nov;19(8):2943-2956.
    doi: 10.1007/s12015-023-10619-wpubmed: 37733199google scholar: lookup
  28. Chu CR, Williams AA, Erhart-Hledik JC, Titchenal MR, Qian Y, Andriacchi TP. Visualizing pre-osteoarthritis: Integrating MRI UTE-T2* with mechanics and biology to combat osteoarthritis-The 2019 Elizabeth Winston Lanier Kappa Delta Award. J Orthop Res 2021 Aug;39(8):1585-1595.
    doi: 10.1002/jor.25045pubmed: 33788306google scholar: lookup
Subscribe to our newsletter
Join 106,180 horse owners like you who receive our email updates on horse health and nutrition.