Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Arch Orthop Trauma Surg. 2020 Jan;140(1):77-84. doi: 10.1007/s00402-019-03292-7. Epub 2019 Oct 29.
Bone marrow stimulation (BMS) remains a dominant treatment strategy for symptomatic full thickness articular cartilage defects. Autologous platelet-rich plasma (PRP), may improve biological cartilage repair as an adjunct to BMS.
To assess the histological quality of cartilage repair after BMS with and without repeated local injections of PRP for the treatment of full-thickness focal chondral defects of the knee.
Two full-thickness chondral defects (Ø = 6 mm) were surgically performed in the medial and lateral trochlea of each knee in skeletally mature Göttingen minipigs. The two treatment groups with 12 defect for each groups were (1) BMS with one weekly PRP injection for 4 weeks, and (2) BMS alone. The animals were euthanized after 6 months. Samples of both whole blood and PRP were analysed with an automated hematology analyzer to determine the concentrations of platelets and nucleated cells. The composition of cartilage repair tissue was assessed using gross appearance assessment, histomorphometry and semi-quantitative scoring (ICRS II).
The average fold increase in platelets was 10.2 ± 2.2. Leukocyte concentration increased in PRP samples by an average fold change of 7.2 ± 1.3. Our macroscopic findings showed that the defects in the BMS + PRP-treated group, were filled with an irregular, partially rough tissue similar to the BMS-treated group. No significant difference in amount of hyalin cartilage, fibrocartilage or fibrous tissue content and ICRS II scores was found between the groups.
Four repeated local injections of leukocyte-rich PRP after BMS in the treatment of full-thickness cartilage injuries demonstrated no beneficial effects in terms of macroscopic and histological cartilage repair tissue quality.
骨髓刺激（BMS）仍然是治疗有症状的全层关节软骨缺损的主要治疗策略。富含血小板的血浆（PRP）自体可能作为 BMS 的辅助手段改善生物软骨修复。
评估 BMS 联合和不联合重复局部注射 PRP 治疗全层局灶性软骨缺损的膝关节软骨修复的组织学质量。
在成熟的哥廷根小型猪的每只膝关节的内侧和外侧滑车中进行了两个全层软骨缺损（Ø=6mm）。每个组有 12 个缺陷的两个治疗组分别为（1）BMS 每周 1 次 PRP 注射，共 4 周，和（2）BMS 单独治疗。6 个月后处死动物。对全血和 PRP 样本进行自动血液分析仪分析，以确定血小板和有核细胞的浓度。使用大体外观评估、组织形态计量学和半定量评分（ICRS II）评估软骨修复组织的组成。
血小板的平均倍数增加为 10.2±2.2。PRP 样本中的白细胞浓度平均增加了 7.2±1.3 倍。我们的宏观发现表明，BMS+PRP 治疗组的缺陷被一种不规则的、部分粗糙的组织填充，类似于 BMS 治疗组。两组之间在透明软骨、纤维软骨或纤维组织含量和 ICRS II 评分方面没有发现明显差异。
BMS 治疗全层软骨损伤后重复局部注射 4 次富含白细胞的 PRP，在宏观和组织学软骨修复组织质量方面没有显示出有益的效果。
