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The aim of the study was to develop a technology for repairing an osteomyelitic bone defect using autologous adipose tissue mesenchymal stromal cells (MSCs) bound to a collagen matrix and to test the efficacy of this technique. Materials and Methods. The study was carried out with 17 rabbits. A bone defect was created using a milling cutter applied to the proximal third of the leg. The wound (8.0×4.0 mm and a depth of 4.0 mm) involved the periosteum, cortical layer, and cancellous substance. Staphylococcus aureus strain was used as an infectious agent. After the development of chronic osteomyelitis, the animals underwent osteonecrectomy. In the study group, autologous MSCs in Collatamp EG collagen carrier were placed into the bone defect. MSCs were obtained from adipose tissue and cultured in the matrix for 5 days. In control, the defect was filled with the collagen matrix without cells. Results. On day 14 upon the initiation of chronic osteomyelitis, bacteriological examination of the discharge from the fistula showed the presence of mixed bacterial flora (Staphylococcus aureus and Escherichia coli) in all operated animals. Results of X-ray, laboratory, and histological tests confirmed the formation of a focus of chronic osteomyelitis. Two months after the treatment (collagen with or without MSCs) began, all animals of the study group showed mature bone tissue regenerated in the affected zone. In the control group, proliferation of osteoblasts on the surface of the bone trabeculae was also observed; however, mature osteoid tissue was more often detected in the study group (35.0 vs 20.0% in control). In the study group (MSCs + collagen matrix), there was a decrease in bone marrow fibrosis (50.0 vs 100.0% in control) and cartilage formation (30.0 and 66.7%, respectively). After full treatment, newly formed bone trabeculae were detected more often (100.0 vs 60.0% in control); they were more mature and filled the defect area more efficiently. Conclusion. Our results indicate that the use of a collagen matrix with autologous MSCs is a promising plastic material for repairing osteomyelitic defects following necrectomy. The MSCs were able to increase the density of the filling material in the bone cavity, significantly accelerate the formation of bone beams around the matrix, and increase the tissue volume around the implant. The presence of MSCs significantly decreased the interference of a connective tissue component with osteogenesis and chondrogenesis.

The modern complex of regenerative technologies in the treatment of patients with intraarticular osteochondral defects includes surgical methods in combination with the use of cellular and tissue technologies, which promotes acceleration of poliferation and differentiation of cells, activation of their metabolism, creation of conditions for the restoration of blood supply in adjacent bone tissue and optimization of functional conditions of the newly formed regenerate. However, the insufficient evidence base on the impact of these treatments (transplantation of PRP, platelet rich plasma and BMDC, bone marrow-derived cell) leads to conflicting views on their use, as well as numerous discussions about treatment outcomes using these treatments. Purpose of the study. According to the morphological study in an experiment in laboratory animals to evaluate the effectiveness of the use of PRP and BMDCT in the treatment of intra-articular osteochondral injuries. Object and methods. Experimental studies were performed on 32 rabbits. An osteochondral defect in the medial part of the femur of a critical size with a diameter of 3 mm in a depth of 5 mm was reproduced by the dental boron. The defect was not filled (1st series), filled with collagen-fibrin matrix (2nd series), collagen-fibrin matrix with PRP (3rd series) or with BMDCT (4th series). Animals were killed at 40 days. After histological procedures the material was examined under a microscope Olympus ÂÕ 63 and Micros. Morphometric analysis was performed to determine the nature and structure of the regenerate, its integration with surrounding tissues, the evaluation of the content of cell structures and non-cellular elements that were formed in the defect in different series of the experiment using scale recommended by the Committee of the International Cartilage Regeneration Union (SCRS) with our modifications. Research results and discussion. An analysis of the results of the study using a modified histological evaluation scale showed that hyaline cartilage was present only in the regenerate of experimental animals of series No. 3 and No. 4, they did not show significant stratification of the surface of the cartilage. In the experimental group of animals of the series No. 3 receiving PRP, the formation of hyaline cartilaginous tissue with chondroblast, chondrocytes and fibrochondrocytes, which densely filled the bone and cartilage defect, was recorded in the area of the bone and cartilage defect. In the experimental group of animals No. 4, where mesenchymal stem cells of the bone marrow punctate were used, defects located in the articular cartilage were filled with a dense, well developed hyaline cartilaginous tissue with a high degree of its integration with the edges of the defect. The bony trabeculae of the spongiform bone adjacent to the cartilaginous defect formed a network. The comparison of the components of regenerate the morphometric scale in the control and experimental groups was performed and a significant difference was found for all the parameters in the PRP and BMDCT groups compared with the control animals. A statistical difference between PRP and BMDCT was found for the indicator of tissue regenerate and cellular composition, with the use of BMDCT, these indicators prevailed by 1.4 times. Compared with the regeneration indices between the series No. 1 and the series No. 2, statistically significant differences were noted connection of the regenerate with the edges of the articular cartilage defect, elevated in the series No. 2. Conclusion. In this case, the technique involving the use of bone marrow mesenchymal stem cells (BMDCT) was significantly more effective than using PRP