No abstract

BackgroundTo evaluate the clinical results of arthroscopic repair with or without platelet-rich plasma (PRP) for tears of the discoid lateral meniscus (DLM).MethodsTwenty-nine patients with DLM tears within a stable knee were arthroscopically treated with meniscal suture repair. Of those, 14 were augmented with platelet-rich plasma (PRP), and 15 were performed without PRP augmentation. Patients were evaluated at baseline (the day before surgery) and then 12 and 24 months after the last injection. Evaluation included the Lysholm score, and Ikeuchi grade, Visual analogue score (VAS) for pain and failure rate. Failure was defined by patients developing symptoms of joint line pain, locking, swelling or requiring repeat arthroscopy.ResultsThere was no difference in the failure rate in the PRP group (1 of 14) compared with the non-PRP group (2 of 15) (P = 0.58). Statistically significant improvement in Lysholm score, Ikeuchi grade and VAS for pain was documented at the last follow-up compared with baseline in both PRP and non-PRP group. No significantly difference was found between the PRP group and non-PRP group on Lysholm score, Ikeuchi grade and VAS for pain at the last follow-up. In the univariate analysis of each variable, younger age (P = 0.036) and longer follow-up duration (P = 0.043) were statistically associated with a better function improvement. Whereas in multivariate analysis, only younger age (P = 0.004) was significantly associated with a better function improvement.ConclusionWith regard to clinical evaluations in arthroscopic repair for DLM tears, PRP group had similar effect in pain relief and functional improvement to non-PRP group at mid-term follow-up. Future larger prospective studies with a longer follow-up are needed to determine whether PRP should be used with DLM repair.

Bone marrow-derived mesenchymal stem cells (MSCs) are dominant seed cell sources for bone regeneration. Bone morphogenetic proteins (BMPs) initiate cartilage and bone formation in a sequential cascade. Vascular endothelial growth factor (VEGF) is an essential coordinator of extracellular matrix remodeling, angiogenesis and bone formation. In the present study, the effects of the vascular endothelial growth factor 165 (VEGF165) and bone morphogenetic protein 2 (BMP2) genes on bone regeneration were investigated by the lentivirus-mediated cotransfection of the two genes into rat bone marrow-derived MSCs. The successful co-expression of the two genes in the MSCs was confirmed using quantitative polymerase chain reaction (qPCR) and western blot analysis. The results of alizarin red and alkaline phosphatase (ALP) staining at 14 days subsequent to transfection showed that the area of staining in cells transfected with BMP2 alone was higher than that in cells transfected with BMP2 and VEGF165 or untransfected control cells, while the BMP2 + VEGF165 group showed significantly more staining than the untransfected control. This indicated that BMP2 alone exhibited a stronger effect in bone regeneration than BMP2 in combination with VEGF165. Similarly, in inducing culture medium, the ALP activity of the BMP2 + VEGF165 group was notably suppressed compared with that of the BMP2 group. The overexpression of VEGF165 inhibited BMP2-induced MSC differentiation and osteogenesis in vitro. Whether or not local VEGF gene therapy is likely to affect bone regeneration in vivo requires further investigation.