Canine articular cartilage regeneration using mesenchymal stem cells seeded on platelet rich fibrin: Macroscopic and histological assessments

Abstract

Objectives: Mesenchymal stem cells have the ability to differentiate into various cell types, and thus have emerged as promising alternatives to chondrocytes in cell-based cartilage repair methods. The aim of this experimental study was to investigate the effect of bone marrow derived mesenchymal stem cells combined with platelet rich fibrin on osteochondral defect repair and articular cartilage regeneration in a canine model.

Methods: Osteochondral defects were created on the medial femoral condyles of 12 adult male mixed breed dogs. They were either treated with stem cells seeded on platelet rich fibrin or left empty. Macroscopic and histological evaluation of the repair tissue was conducted after four, 16 and 24 weeks using the International Cartilage Repair Society macroscopic and the O'Driscoll histological grading systems. Results were reported as mean and standard deviation (sd) and compared at different time points between the two groups using the Mann-Whitney U test, with a value < 0.05 considered statistically significant.

Results: Higher cumulative macroscopic and histological scores were observed in stem cell treated defects throughout the study period with significant differences noted at four and 24 weeks (9.25, sd 0.5 vs 7.25, sd 0.95, and 10, sd 0.81 vs 7.5, sd 0.57; p < 0.05) and 16 weeks (16.5, sd 4.04 vs 11, sd 1.15; p < 0.05), respectively. Superior gross and histological characteristics were also observed in stem cell treated defects.

Conclusion: The use of autologous culture expanded bone marrow derived mesenchymal stem cells on platelet rich fibrin is a novel method for articular cartilage regeneration. It is postulated that platelet rich fibrin creates a suitable environment for proliferation and differentiation of stem cells by releasing endogenous growth factors resulting in creation of a hyaline-like reparative tissue.Cite this article: D. Kazemi, K. Shams Asenjan, N. Dehdilani, H. Parsa. Canine articular cartilage regeneration using mesenchymal stem cells seeded on platelet rich fibrin: Macroscopic and histological assessments. Bone Joint Res 2017;6:98-107. DOI: 10.1302/2046-3758.62.BJR-2016-0188.R1.

Keywords: Articular cartilage; Mesenchymal stem cells; Platelet rich fibrin.

Fig. 1

Platelet-rich fibrin (PRF) seeded with stem cells. Bone marrow derived mesenchymal stem cells were seeded onto PRF in the laboratory and incubated for 6 hours (left) before being press fitted inside the cartilage defects (right).

Fig. 2

Macroscopic appearance of defects in the condylar regions at four (left), 16 (middle) and 24 (right) weeks after surgery. Control as well as stem cell treated (bone-marrow derived mesenchymal stem cell) defects are represented (scale bar, 3 mm).

Fig. 3

Mean International Cartilage Repair Society macroscopic scores for control and stem cell treated (bone-marrow derived mesenchymal stem cell (BM-MSC)) groups at four, 16 and 24 weeks after surgery. Error bars indicate standard deviation and the p-values (Mann Whitney U test) represent the statistical differences between the two treatment groups.

Fig. 4

Histological appearance of defects in the condylar region at four weeks after surgery. Control as well as stem cell treated (bone-marrow derived mesenchymal stem cell) defects are represented. Magnified views of the boxes are presented in the middle and right side. SafraninO staining; original magnification 40x (left side) and 100x (middle and right side).

Fig. 5

Histological appearance of defects in the condylar region at 16 weeks after surgery. Control as well as stem cell treated (bone-marrow derived mesenchymal stem cell) defects are represented. Magnified views of the boxes are presented in the middle and right side. Safranin O staining; original magnification 40x (left side) and 100x (middle and right side).

Fig. 6

Histological appearance of defects in condylar region at 24 weeks after surgery. Control as well as stem cell treated (bone-marrow derived mesenchymal stem cell) defects are represented. Magnified views of the boxes are presented in the middle and right side. Safranin O staining; original magnification 40x (left side) and 100x (middle and right side).

Fig. 7

Mean O’Driscoll histological scores for control and stem cell treated (bone-marrow derived mesenchymal stem cell (BM-MSC)) groups at four, 16 and 24 weeks after surgery. Error bars indicate standard deviation and the p-values (Mann Whitney U test) represent the statistical differences between the two treatment groups.