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Marrow Stimulation Improves Meniscal Healing at Early Endpoints in a Rabbit Meniscal Injury Model
- Source :
- Arthroscopy: The Journal of Arthroscopic & Related Surgery. 29:113-121
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- Purpose To critically evaluate the effect of marrow stimulation (MS) on the extent of healing and the local biological environment after meniscal injury in ligamentously stable knees in a rabbit model. Methods A reproducible 1.5-mm cylindrical defect was created in the avascular portion of the anterior horn of the medial meniscus bilaterally in 18 New Zealand White rabbits (36 knees). In right knees (MS knees), a 2.4-mm Steinman pin was drilled into the apex of the femoral intercondylar notch and marrow contents were observed spilling into the joint. Left knees served as controls. Rabbits were killed in 3 groups (n = 6 rabbits each) at 1, 4, and 12 weeks with meniscal harvest and blinded histomorphometric and histologic evaluation using an established 3-component tissue quality score (range, 0 to 6). One-week specimens were also evaluated for the presence of proregenerative cytokines using immunohistochemistry. Results The mean proportion of the avascular zone defect bridged by reparative tissue was greater in MS knees than in controls at each endpoint (1 week, 55% v 30%, P = .02; 4 weeks, 71% v 53%, P = .047; 12 weeks, 96% v 77%, P = .16). Similarly, there was a consistent trend toward superior tissue quality scores in knees treated with MS compared with controls (1 week, 1.8 v 0.3, P = .03; 4 weeks, 4.3 v 2.8, P = .08; 12 weeks, 5.9 v 4.5, P = .21). No statistically significant differences, however, were observed at the 12-week endpoint. Increased staining for insulin-like growth factor I, transforming growth factor-β, and platelet-derived growth factor was observed in regenerated tissue, compared with native meniscal tissue, in all specimens at 1 week. Staining density for all growth factors was similar, however, in reparative tissue of MS and control knees. Conclusions The results of this study suggest that marrow stimulation leads to modest improvements in quality and quantity of reparative tissue bridging a meniscal defect, particularly during the early recovery period. Clinical Relevance Clinical evaluation of marrow stimulation techniques designed to enhance healing in isolated meniscus repair surgery may be indicated.
- Subjects :
- medicine.medical_specialty
Time Factors
Arthroplasty, Subchondral
medicine.medical_treatment
Menisci, Tibial
Chondrocytes
Bone Marrow
medicine
Animals
Regeneration
Marrow stimulation
Single-Blind Method
Orthopedics and Sports Medicine
Clinical significance
Wound Healing
Staining and Labeling
business.industry
Growth factor
Fibroblasts
Arthroplasty
Tibial Meniscus Injuries
Staining
Surgery
medicine.anatomical_structure
Models, Animal
Cytokines
Intercellular Signaling Peptides and Proteins
Immunohistochemistry
Female
Rabbits
business
Medial meniscus
Subjects
Details
- ISSN :
- 07498063
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- Arthroscopy: The Journal of Arthroscopic & Related Surgery
- Accession number :
- edsair.doi.dedup.....ba4b2043c550db293995a5acd4758ced