scholarly journals Effect of Autologous Platelet Rich Fibrin on the Healing of Experimental Articular Cartilage Defects of the Knee in an Animal Model

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Davoud Kazemi ◽  
Ashraf Fakhrjou ◽  
Vahid Mirzazadeh Dizaji ◽  
Majid Khanzadeh Alishahi
Keyword(s):  
Animal Model ◽  
Articular Cartilage ◽  
Hind Limb ◽  
Weight Bearing ◽  
Cartilage Defects ◽  
Platelet Rich Fibrin ◽  
Cartilage Lesions ◽  
Hind Limbs ◽  
The Right ◽  
Autologous Platelet

The effect of autologous platelet rich fibrin (PRF), a second generation platelet product, on the healing of experimental articular cartilage lesions was evaluated in an animal model. Full thickness cartilage lesions with a diameter of 6 mm and depth of 5 mm were created in the weight bearing area of femoral condyles of both hind limbs in 12 adult mixed breed dogs. Defects in the left hind limb of each dog were repaired by PRF implantation whereas those in the right hind limb were left empty. The animals were euthanized at 4, 16, and 24 weeks following surgery and the resultant repair tissue was investigated macroscopically and microscopically. The results of macroscopic and histological evaluations indicated that there were significant differences between the PRF treated and untreated defects. In conclusion, the present study indicated that the use of platelet rich fibrin as a source of autologous growth factors leads to improvement in articular cartilage repair.

Cartilage Restoration: Microfracture and Osteochondral Autograft Transplantation

2018 ◽  
Vol 31 (03) ◽  
pp. 231-238 ◽  
Author(s):  
Michael Redondo ◽  
Adam Beer ◽  
Adam Yanke
Keyword(s):  
Articular Cartilage ◽  
Weight Bearing ◽  
Symptomatic Relief ◽  
Autologous Transplantation ◽  
Cartilage Defects ◽  
Osteochondral Autograft ◽  
Cartilage Lesions ◽  
Chondral Defects ◽  
Osteochondral Autograft Transplantation ◽  
Cartilage Restoration

AbstractThe treatment of patellofemoral cartilage defects presents several distinct challenges when compared with cartilage restoration techniques used for other compartments of the knee due to the unique anatomy and distribution of forces. The etiologies of patellofemoral articular cartilage lesions include acute traumatic instability injuries, such as dislocation and subluxation, osteochondritis dissecans, and chronic degenerative changes. Regardless of the etiology, untreated patellofemoral cartilage lesions can contribute to activity-limiting anterior knee pain. The goal of patellofemoral cartilage restoration procedures is to impart symptomatic relief and improve quality of life by repairing the articular cartilage surface and any comorbid malalignment or maltracking.Microfracture and osteochondral autograft transplantation (OAT) are two cartilage restoration procedures to consider when treating full-thickness patellofemoral chondral defects. Considered by some experts to be the gold standard therapy, microfracture is one of the most common procedures used for cartilage restoration. The technique involves the perforation of the subchondral bone plate for the release of marrow elements, filling the defect with a fibrocartilage clot repair. Though less commonly used, OAT allows defect replacement with native hyaline cartilage via autologous transplantation from a non-weight bearing area. The purpose of this article is to discuss the indication, technical considerations, and outcomes of microfracture and OAT when used for treating chondral lesions of the patellofemoral joint.

scholarly journals POS0277 ANABOLIC EFFECT OF LNA043, A NOVEL DISEASE-MODIFYING OSTEOARTHRITIS DRUG CANDIDATE: RESULTS FROM AN IMAGING-BASED PROOF-OF-CONCEPT TRIAL IN PATIENTS WITH FOCAL ARTICULAR CARTILAGE LESIONS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 363.2-363
Author(s):  
S. Trattnig ◽  
C. Scotti ◽  
D. Laurent ◽  
V. Juras ◽  
S. Hacker ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Weight Bearing ◽  
Cartilage Lesion ◽  
Cartilage Volume ◽  
Lesion Volume ◽  
Proof Of Concept ◽  
T2 Relaxation Time ◽  
T2 Relaxation ◽  
Cartilage Lesions ◽  
Articular Cartilage Lesions

Background:LNA043 is a modified, recombinant version of the human angiopoietin-like 3 (ANGPTL3) protein acting directly on cartilage-resident cells to transmit its cartilage anabolic effect. A first-in-human study previously demonstrated the favourable safety profile and the modulation of several pathways involved in cartilage homeostasis and osteoarthritis (OA)1. A previous proof-of-mechanism imaging study used high field (7 Tesla) magnetic resonance imaging (MRI) to show formation of hyaline-like tissue after a single injection of 20 mg LNA043 (unpublished data).Objectives:To evaluate non-invasively the chondro-regenerative capacity of multiple intra-articular (i.a.) injections of LNA043 in patients with articular cartilage lesions in the knee (NCT03275064).Methods:This was a randomised, double-blind, placebo (PBO)-controlled, proof-of-concept study in patients with a partial thickness cartilage lesion. In total, 58 patients (43 [20 mg LNA043]; 15 [PBO]), stratified by lesion type (condylar or patellar) were treated with 4 weekly i.a. injections. The primary endpoint was T2 relaxation time measurement as a marker of collagen fiber network, and cartilage lesion-volume was a secondary endpoint, both using 3-Tesla MRI. Assessments were performed at baseline, weeks (wks) 8, 16, 28 and 52 (the latter in 23/58 patients). While lesion-volume for the secondary endpoint was determined from manually segmented images, the cartilage volume of 21 sub-regions spanning the entire knee was also measured from 3D isotropic MR images employing an automated segmentation prototype software (MR Chondral Health 2.1 [MRCH], Siemens Healthcare)2. An exploratory analysis evaluated the treatment effect for the additive volume of the 3 subregions in the weight-bearing area of the medial femur.Results:No change in T2 relaxation time was detected between treatment and PBO groups. Manual segmentation showed continuous filling of the cartilage lesions up to wk 28 in LNA043-treated patients with femoral lesions (p=0.08, vs PBO) while no effect was detected for patients with patellar lesions. Given the limitations of measuring small, irregularly shaped lesions with manual image-analysis, the MRCH approach was used (Figure 1). In the medial femoral weight-bearing region, refilling was detected over time (Δ=123 mm3 at wk 28, N= 37, p= 0.05). No overgrowth was detected in the lateral femoral condyles without cartilage damage. The overall safety profile was favourable; only mild/moderate local reactions were reported, including a higher incidence of joint swelling (9.3% vs 0%) and arthralgia (11.6% vs 6.7%) for LNA043 vs PBO resolving spontaneously or with paracetamol/NSAIDs. No anti-drug antibodies were detected.Conclusion:Treatment with 4 weekly i.a. injections of 20 mg LNA043 resulted in regeneration of damaged cartilage in patients with femoral articular cartilage lesions. Automated measurement of cartilage volume in the femoral index region was able to detect a relevant treatment effect and was found to be more sensitive than the manual segmentation method. No sign of cartilage overgrowth was observed in healthy femoral regions. A Phase 2b study in patients with mild to moderate knee OA is in preparation.References:[1]Scotti et al. ACR Convergence 2020; Abstract #1483[2]Juras et al. Cartilage 2020; Sep 29:1-12Disclosure of Interests:Siegfried Trattnig: None declared, Celeste Scotti Shareholder of: Novartis, Employee of: Novartis, Didier Laurent Shareholder of: Novartis, Employee of: Novartis, Vladimir Juras: None declared, Scott Hacker Grant/research support from: Novartis, Brian Cole: None declared, Libor Pasa: None declared, Roman Lehovec: None declared, Pavol Szomolanyi: None declared, Esther Raithel Employee of: Siemens Healthcare GmbH, Franziska Saxer Shareholder of: Novartis, Employee of: Novartis, Jens Praestgaard Shareholder of: Novartis, Employee of: Novartis, Fabiola La Gamba Shareholder of: Novartis, Employee of: Novartis, José L. Jiménez Employee of: Novartis, David Sanchez Ramos Shareholder of: Novartis, Employee of: Novartis, Ronenn Roubenoff Shareholder of: Novartis, Employee of: Novartis, Matthias Schieker Shareholder of: Novartis, Employee of: Novartis

scholarly journals Tenorrhaphy of the Common Calcaneal Tendon in Dogs and Cats

2016 ◽  
Vol 44 (1) ◽  
pp. 7
Author(s):  
ísis Dos Santos Dal-Bó ◽  
Cássio Ricardo Auada Ferrigno ◽  
Aline Schafrum Macedo ◽  
Fernanda Paes ◽  
Jaqueline França Dos Santos ◽  
...  
Keyword(s):  
Body Weight ◽  
Hind Limb ◽  
Weight Bearing ◽  
Tendon Repair ◽  
Distal Portion ◽  
Bovine Pericardium ◽  
Calcaneal Tendon ◽  
The Common ◽  
The Right ◽  
Locking Screw

Background: Common calcaneal tendon (CCT) is usually affected by injuries in dogs and less frequently in cats. The Achilles mechanism consists of the convergence of three distinct structures: the tendons of the gastrocnemius muscle, superficial digital flexor muscle and the common tendons of the biceps femoris, gracilis, and semitendinosus muscles. Classification of lesions is based upon their location, severity and chronicity. Clinical signs include lameness, plantigrade stance and various degrees of tarsal hyperflexion according to the injury’s severity. The purpose of this study is to report four cases of reconstruction of the common calcaneus in three dogs and a cat.Cases: Case 1. A 10-year-old male canine, Brazilian Terrier, 7.7 kg of body weight, with a 6-month history of nonweightbearing lameness of the right hind limb attended consultation. Orthopedic examination showed plantigrade stance, hyperflexion of the right tibial-tarsal joint (TTJ) and swelling with fibrous thickening of the distal portion of the CCT. Surgical tendon repair was achieved through insertion of a locking screw on the calcaneo-tibial, tenorrhaphy and suture of a titanium plate on the caudal aspect of the CCT. Case 2. A 2-year-old female mongrel canine, with 13.3 kg of body weight was presented with the complaint of chronic left hind leg lameness. The owner described trauma at the area of the hock six months prior to consultation. On orthopedic exam, severe lameness was noted, swelling with fibrous thickening of the distal portion of the common calcaneal tendon and hyperflexion of the left TTJ (plantigrade position) were visible. Tendon repair was performed in the same manner as in case 1, except that in this case a bovine pericardium graft preserved in glycerin 98% was sutured over the tendon/plate conjunction. Case 3. A 6-year-old female mongrel canine, with 18.6 kg of body weight was attended with a 22-day history of right hind limb lameness. On physical exam intermittent lameness during gait performance and non-weight-bearing position in stance were noted. The distal portion of the limb was internally rotated with plantigrade stance and discontinuity of the CCT was palpable. Tenorrhaphy was performed similarly to case 2. Case 4. A 6 kg, 3-year-old, mixed breed male feline was admitted with a wound on the CCT region for 7 days. The wound was originated after animal interaction with a stray feline. On clinical examination the animal was non-weight bearing on the right hind limb, with plantigrade posture and with a 1 cm wound on the caudal portion of the CCT with tendon exposure. Surgical repair was performed by tenorrhaphy with placement of a surgical steel plate on the caudal aspect of the CCT. A bovine pericardium graft preserved in glycerin 98% was sutured on top of the plate. The TTJ was immobilized with a type II transarticular external fixator.Discussion: Ultrasonography is the test of choice to monitor tendon healing after tenorrhaphy. At this report, this exam was crucial to determine when the calcaneal-tibial screw could be removed. Two dogs and the cat from this report received an association of plate and bovine pericardium preserved in glycerin 98%. The purpose of this association was to increase the strength of the tenorrhaphy, and the pericardium graft had also the function of reducing the formation of peritendinous adhesions. Immobilization of the TTJ has the purpose of opposing muscle forces to avoid stress at tenorrhaphy suture increasing the strength of the healed tendon allowing early weight bear while minimizing the recurrence risk and avoiding limb contracture. We chose to perform the procedure with hyperextension of the TTJ in order to promote greater relaxation of the tendon since there was need to remove large portions of calcaneal fibrous tissues of the dogs and devitalized tissue in the cat from this report. Surgical treatment of injuries of the Achilles mechanism has good prognosis in complete closed lesions treated by tenorrhaphy associated with suture of a plate, suture of bovine pericardial graft preserved in 98% glycerin, calcaneal-tibial locking screw and splint for six weeks.Keywords: Achilles tendon, rupture, calcaneo-tibial screw, locking-loop suture pattern.

Displacement of a Functional Femoral Pseudoarthrosis in a Dog

1992 ◽  
Vol 05 (04) ◽  
pp. 176-178
Author(s):  
Gretchen Flo ◽  
R. L. Stickle ◽  
D. J. Jevens
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Hind Limb ◽  
Dynamic Compression ◽  
Weight Bearing ◽  
Acute Onset ◽  
Bone Plate ◽  
Cancellous Bone Graft ◽  
Mixed Breed ◽  
The Right

A mature mixed breed dog was evaluated for acute onset of non-weight-bearing lameness involving the right hind limb. The dog had, reportedly, walked normally for the previous three years. A diagnosis of acute displacement of a functional femoral pseudoarthrosis was made. The pseudoarthrosis was stabilized using a dynamic compression bone plate and an autogenous cancellous bone graft. The dog was walking normally five months after the operation.

Bilateral Stifle Osteochondritis Dissecans in a Cat

2005 ◽  
Vol 41 (1) ◽  
pp. 78-80 ◽  
Author(s):  
S. Christopher Ralphs
Keyword(s):  
Physical Examination ◽  
Osteochondritis Dissecans ◽  
Hind Limb ◽  
Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Similar Lesion ◽  
Hind Limbs ◽  
The Right

A 9-month-old, castrated male, domestic shorthaired cat was presented for progressive right hind-limb lameness. A diagnosis of osteochondritis dissecans of the lateral femoral condyle was made based on radiographs and physical examination, and was confirmed by right lateral stifle arthrotomy. The cartilage flap was removed, and the underlying bone was curetted. Seven months later, the cat was sound on the right leg but developed a left hind-limb lameness. A similar lesion was found in the left leg and was treated identically. Fourteen months after presentation, the cat was sound on both hind limbs.

Clinical, Functional, and Radiographic Assessment of Arthroscopic Abrasion Chondroplasty of the Knee

1996 ◽  
Vol 5 (2) ◽  
pp. 127-142
Author(s):  
Michael Ra ◽  
Michael Sitler ◽  
Jeff Ryan ◽  
Raymond Moyer ◽  
Paul Marchetto ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Rating Scale ◽  
Weight Bearing ◽  
Cartilage Defects ◽  
Radiographic Assessment ◽  
Radiographic Outcome ◽  
Bearing Loads ◽  
Articular Cartilage Defects ◽  
Complex Injuries

Chondral lesions often occur in the knee as isolated defects or part of more complex injuries. Articular cartilage defects decrease the ability of the knee to sustain weight-bearing loads and may accelerate degeneration of the joint when left untreated. The purpose of this study was to determine the clinical, functional, and radiographic outcome of arthroscopic abrasion chondroplasty of the knee. The Articular Cartilage Rating System was used to assess the location, size, depth, and description of the articular lesion. The Standard Knee Evaluation Form and Cincinnati Knee Rating Scale were used to assess the clinical, functional, and radiographic outcome of the procedure. Average time to postsurgery follow-up was 46 ± 26.69 months. Within the constraints of the present study, arthroscopic abrasion chondroplasty of the knee had a favorable clinical, functional, and radiographic outcome. However, more study is needed with larger samples and longer follow-up before definitive conclusions about the efficacy of the procedure can be made.

Experimental Studies on Repair of Large Osteochondral Defects at a High Weight Bearing Area of the Knee Joint: A Tissue Engineering Study

1991 ◽  
Vol 113 (2) ◽  
pp. 198-207 ◽  
Author(s):  
V. C. Mow ◽  
A. Ratcliffe ◽  
M. P. Rosenwasser ◽  
J. A. Buckwalter
Keyword(s):  
Animal Model ◽  
Growth Factors ◽  
Articular Cartilage ◽  
High Weight ◽  
Weight Bearing ◽  
Osteochondral Defects ◽  
Repair Tissue ◽  
Weight Bearing Area ◽  
Grafting Procedure

There is a vast clinical need for the development of an animal model to study the fundamentals of healing of injured or diseased diarthrodial joints (knee, hip, shoulder, wrist, etc). Current prosthetic replacements do not offer acceptable treatment for injuries and diseases of these joints in young active individuals. New clinical treatment modalities, based on sound biologic principles, are sought for the development of repair or healing tissues engineered to have similar biomechanical properties as normal articular cartilage. In this paper we present a brief review of this need, and propose a grafting procedure which may lead to a successful animal model for studies of long term repair of major osteochondral defects. This grafting procedure uses an autologous periosteum-bone graft or an autologous-synthetic bone replacement graft. We have applied these grafts for in vivo repair of large surgically created defects in the high weight bearing area of the distal femoral condyle of mature New Zealand white rabbits. Further, an interdisciplinary study, including histochemistry, biochemistry (composition and metabolic activities), and biomechanics (biphasic properties), was performed to assess the feasibility of our animal model to generate viable repair tissues. We found our grafting procedure produced, 8 weeks postoperatively, tissues which were very similar to those found in normal articular cartilage. However, our histological studies indicate incomplete bonding between the repair tissue and the adjacent cartilage, and lack of an appropriate superficial zone at the articular surface. These deficiencies may cause long term failure of the repair tissue. Further studies must be undertaken to enhance development of a strong bond and a collagen-rich surface zone. This may require the use of growth factors (e.g., transforming growth factors β) capable of simulating extra collagen production, or the use of serum derived tissue glue for bonding. At present, we are pursuing these studies.

scholarly journals Heating produced by therapeutic ultrasound in the presence of a metal plate in the femur of canine cadavers

2014 ◽  
Vol 66 (5) ◽  
pp. 1343-1350 ◽  
Author(s):  
A.O. Andrades ◽  
A. Mazzanti ◽  
D.V. Beckmann ◽  
G. Aiello ◽  
R.O. Chaves ◽  
...  
Keyword(s):  
Hind Limb ◽  
Therapeutic Ultrasound ◽  
Test Group ◽  
Metal Plate ◽  
Control Group ◽  
Continuous Mode ◽  
Control Groups ◽  
Hind Limbs ◽  
Adjacent Structures ◽  
The Right

The present study aimed to assess the heat generated by a therapeutic ultrasound (TUS) in a metal bone plate and adjacent structures after fixation to the femur of canine cadavers. Ten pairs of hind limbs were used, and they were equally distributed between groups that were subjected to 1- and 3-MHz frequencies, with each frequency testing 1- and 2-W/cm² intensities. The right hind limb was defined as the control group (absence of the metal plate), and the left hind limb was the test group (presence of the metal plate). Therefore, the control groups (CG) were denominated CGI, using TUS with 1-MHz frequency and 1-W/cm² intensity; CGII, using 1-MHz frequency and 2-W/cm² intensity; CGIII, using 3-MHz frequency and 1-W/cm² intensity; and CGIV, using 3-MHz frequency and 2-W/cm² intensity. For each control group, its respective test group (TG) was denominated TGI, TGII, TGIII and TGIV. The TUS was applied to the lateral aspect of the thigh using the continuous mode and a 3.5-cm² transducer in a 6.25-cm² area for 2 minutes. Sensors were coupled to digital thermometers that measured the temperature in different sites before (t0) and after (t1) of the TUS application. The temperatures in t1were higher in all tested groups. The intramuscular temperature was significantly higher (P<0.05) in the groups used to test the 3-MHz frequency in the presence of the metal plate. The therapeutic ultrasound in the continuous mode using frequencies of 1 and 3 MHz and intensities of 1 and 2 W/cm2 for 2 minutes caused heating of the metal plate and adjacent structures after fixation to the femur of canine cadavers.

scholarly journals Arthroscopic utilization of ChondroFiller gel for the treatment of hip articular cartilage defects: a cohort study with 12- to 60-month follow-up

2021 ◽  
Author(s):  
Jacek Mazek ◽  
Maciej Gnatowski ◽  
Antonio Porthos Salas ◽  
John M O’Donnell ◽  
Marcin Domżalski ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Long Term Results ◽  
Cartilage Tissue ◽  
Cartilage Defects ◽  
Type I ◽  
Treatment Technique ◽  
Acetabular Cartilage ◽  
Cartilage Lesions ◽  
Post Surgery

Abstract ChondroFiller gel is an absorbable collagen implant. It serves as a protective cover for the cartilage defects, allowing chondrocyte migration into the lesion. The implant consists of collagen (Type I) and is derived from veterinary monitored rats. This study evaluates the use of ChondroFiller gel in the treatment of cartilage lesions during hip joint arthroscopy. A prospective study was conducted on a group of 26 adult patients. All patients had an existing femoroacetabular impingement together with acetabular cartilage lesions &gt;2 cm2. All patients underwent hip arthroscopic surgery and the lesions were treated using ChondroFiller gel. The cartilage tissue healing was evaluated postoperatively using MRI. A total of 26 patients, including 5 females and 21 males, all with articular cartilage lesions, were included in the study. Cartilage healing conditions were evaluated for all patients, and the difference between pre- and post-surgery conditions was statistically significant. The follow-up scores have been acquired from 21 out of initial 26 patients (2 were disqualified after receiving THR, 3 could not be reached by researchers) after 3, 4 and 5 years consecutively with 17/21 patients having good/excellent results. The use of ChondroFiller gel during arthroscopy of the hip for acetabular cartilage lesions is an effective treatment technique. Encouraging long-term results have been observed, but further research on larger group of patient is required to better assess the full value of this technique. Patients with pre-existing osteoarthritis (Tönnis 2–3) have poor results.

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