Enhancement of cartilage repair through the addition of growth plate chondrocytes in an immature skeleton animal model

Abstract

Background The treatment of articular cartilage damage is a major clinical problem. More often, this clinical issue affects children, which forces doctors to find the best treatment method. Methods The aim of this experimental study on 2-month-old Landrace pigs was to compare the results of two cartilage defect treatments: (1) filling the cartilage defect with a scaffold incubated with bone marrow aspirate supplemented with growth plate chondrocytes (the CELLS group) and (2) filling the cartilage defect with an empty scaffold implanted after drilling the subchondral bone (the CTRL group). The treatment outcomes were assessed macroscopically and microscopically. Results Based on the macroscopic evaluation, all animals showed a nearly normal morphology, with an average of 9.66/12 points (CTRL) and 10.44/12 points (CELLS). Based on the microscopic evaluation, 1 very good result and 8 good results were obtained in the CTRL group, with an average of 70.44%, while 5 very good results and 4 good results were obtained in the CELLS group, with an average of 79.61%. Conclusions (1) Growth plate chondrocytes have high chondrogenic potential and thus offer new possibilities for cartilage cell therapy. (2) The implantation of a scaffold loaded with bone marrow-derived MSCs (mesenchymal stem cells) and growth plate chondrocytes into a cartilage defect is a good therapeutic method in immature patients. (3) Cartilage repair based on a scaffold with bone marrow aspirate-derived cells supplemented with autologous growth plate chondrocytes achieves better results than repair with marrow stimulation and a hyaluronic acid-based scaffold (overall microscopic rating). (4) Chondrocyte clustering is a manifestation of the cartilage repair process but requires further observation. Electronic supplementary material The online version of this article (10.1186/s13018-019-1302-y) contains supplementary material, which is available to authorized users.

Statistical image analysis and escort histograms in characterization of articular cartilage repair in a skeleton animal model

“…We analyze optical images of the histological preparations which (for an evaluation conducted by pathologists reported in Ref. [3]) were stained with either (i) haematoxylin and eosin (abbreviated as 'H' below) or (ii) Safranin O (abbreviated as 'S' below) or (iii) Masson's trichrome (abbreviated as 'M' below) resulting in images of different colour, cf. Fig 1 where we present three examples.…”

“…In response, regenerative medicine develops new techniques and methods for cartilage defect treatments involving cell therapy when isolated and specially cultured cells become injected into the joint or via tissue engineering techniques and can be implanted on special substrates. The authors of a recent medical study [3], using histological animal samples (immature pigs), compare the effectiveness of two types of treatment of cartilage damage repair: (i) bone marrow stimulation (chosen as a reference) and (ii) autologous growth plate chondrocytes therapy. The results showed that addition of immature chondrocytes provides new possibilities for articular cartilage treatment.…”

“…The results showed that addition of immature chondrocytes provides new possibilities for articular cartilage treatment. Moreover, the presence of chondrocyte clusters formed during cartilage regeneration was emphasised in the paper [3] as an interesting and not fully explained manifestation of the cartilage response to the stress factor. Both the medical importance of the problem of damage to articular cartilage and the existence of open, still unsolved problems justifies using a statistical approach complementing the recent investigations [3].…”

“…In this paper we analyze optical images of the histological preparations used in the above mentioned study [3] using statistical methods based on histograms related to the digital images. Image histograms contain useful information which can be extracted and utilized to verify, support or question the effectiveness of medical treatment [4,5].…”

A Technique Using a Low-Cost, Accessible Cannula to Aid Scaffold Passage in Dry Arthroscopic Cartilage Repair in the Knee

“…1,7,13 As Hyalofast releases hyaluronic acid upon degradation, has been shown promote formation of hyaline-like cartilage in histological studies, and has good early clinical results, it is particularly attractive as a scaffold in the treatment of osteoarticular lesions of the knee. 3,6,14,15 Although surgeons in the literature have opted to extend the standard arthroscopic portal incisions or perform a mini-arthrotomy to enable direct access to the cartilage lesions, maintaining a fully minimally invasive approach is preferred to avoid excessive wound site morbidity and enable earlier postoperative recovery.…”