Comparing PRP and bone marrow aspirate effects on cartilage defects associated with partial meniscectomy: a confocal microscopy study on animal model

Abstract

Aim: The aim of our study was to assess the therapeutic effects of platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) in an animal knee lesion complex associating a large osteochondral defect and meniscal defect resulted from partial meniscectomy, a clinical situation that occurs quite often in orthopedic practice.

Materials and methods: Twenty-one male rabbits were included in the study, and all underwent initial surgery on the right knee to create the osteochondral defect on the internal femoral condyle, and remove the anterior horn of the internal meniscus, simulating a clinical situation. Rabbits were separated in three study groups: control, PRP group, in which three PRP injections were administered, and BMAC group, in which one single BMAC injection was administered. At the end of the six months follow-up period, knees were harvested and further analyzed using confocal microscopy and three-dimensional (3D) reconstruction of the articular surface.

Results: Therapeutic groups had better results concerning articular surface remodeling and joint degeneration indicators in comparison to trauma group.

Conclusions: Our results suggest that using post-operative regenerative therapies does improve final results concerning surface contact remodeling that was investigated using confocal microscopy and should be considered a valid treatment adjuvant in managing patients with this type of lesion complex, as it improves global joint outcome.

Figure 1

Intraoperative aspect showing the technique we used to create the full thickness defect on the internal femoral condyle

Figure 2

Intraoperative aspect showing the partial meniscectomy with removal of the anterior horn of the internal meniscus

Figure 3

Subject 8352 from the Trauma+PRP group, macroscopic aspect: (A) Internal femoral condyle defect; (B) Residual meniscus after partial meniscectomy; (C) Resection line; (D) Newly formed tissue attached to the residual meniscus and to the anterior intercondylar area after the tibia. PRP: Platelet-rich plasma

Figure 4

Digital image obtained after 3D reconstruction from the data resulted from confocal microscopy study of Trauma+BMAC knee specimen. Defect was created on the internal femoral condyle. Image is showing surface defects of articular surface. 3D: Three-dimensional; BMAC: Bone marrow aspirate concentrate

Figure 5

Digital image obtained after 3D reconstruction from the data resulted from confocal microscopy study of Trauma+PRP knee specimen. Defect was created on the internal femoral condyle. Image is showing surface defects of articular surface and remodeling result after PRP therapy was applied, demonstrating a smooth remodeling pattern in the Trauma+PRP group. 3D: Three-dimensional; PRP: Platelet-rich plasma

Figure 6

Digital image obtained after 3D reconstruction from the data resulted from confocal microscopy study of Trauma knee specimen. Defect was created on the internal femoral condyle. Image is showing surface defects of articular surface and remodeling result with no therapeutic interventions, demonstrating advanced degeneration of contact surface

Figure 7

Digital image obtained after 3D reconstruction from the data resulted from confocal microscopy study of Control knee specimen (healthy joint). Osteochondral fragment was harvested from the internal femoral condyle. Image is demonstrating perfectly healthy articular surface, which is smooth and uniform

Figure 8

Values resulting from measurements on the defect area on the internal femoral condyle. BMAC: Bone marrow aspirate concentrate; PRP: Platelet-rich plasma

Figure 9

Values resulting from measurements on the external femoral condyle. BMAC: Bone marrow aspirate concentrate; PRP: Platelet-rich plasma

Figure 10

Values resulting from measurements on the internal femoral condyle, the area opposed to the cartilage defect created. BMAC: Bone marrow aspirate concentrate; PRP: Platelet-rich plasma