Experimental substantiation of the use of platelet-rich plasma in combination with microfracturing in the treatment of local osteochondral defects of the hyaline cartilage of the knee joint: non-randomized controlled study

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Abstract

BACKGROUND: Dissecting osteochondritis of the knee joint is one of the common diseases accompanied by damage to the articular cartilage. Existing conservative and surgical methods of treating osteochondral defects of the hyaline cartilage do not give full satisfactory results of restorative treatment.

OBJECTIVE: This study aimed to evaluate the effectiveness of the combined method proposed for the treatment of full-layer osteochondral defects of the knee joint.

MATERIALS AND METHODS: The experiment was conducted on 27 Romanov sheep aged 5 months to 1 year and weighing 20–35 kg. All animals were conditionally divided into three experimental groups of nine animals, each of which intraoperatively modeled the osteochondral defect of the medial condyle of both hind limbs. Moreover, the left knee joint was assigned to the experimental group, whereas the right knee joint was assigned to the control group. Thus, in first experimental group, microfracturing was performed on the left knee joint in addition to the osteochondral defect of the femoral condyle; in the second experimental groups, microfracturing and platelet-rich plasma (PRP) administration; in the third experimental group, microfracturing, and PRP administration after 3 weeks. From each group, three animals were sacrificed at 1, 3, and 6 months. Results were evaluated by macro- and microscopic examination.

RESULTS: In the first experimental group, cartilage regeneration was slow. In the second experimental group using PRP, more intensive regeneration of cartilage tissue occurred. In the third experimental group, cartilage tissue regeneration occurred more intensively.

CONCLUSION: During the experiment, in which several methods of treating osteochondral defects of the knee joint were employed, the most effective was the combined method of microfracturization and PRP administration 3 weeks after surgery.

About the authors

Vyacheslav A. Vasyukov

Stavropol State Medical University

Author for correspondence.
Email: vasykov1234@gmail.com
ORCID iD: 0000-0001-9862-1726
SPIN-code: 5286-7347

Department Assistant, Traumatologist-Orthopedist

Russian Federation, Stavropol

Alexander A. Vorotnikov

Stavropol State Medical University

Email: vorotnikov@mail.ru
ORCID iD: 0000-0002-2453-3675
SPIN-code: 4291-8443

MD, Dr. Sci. (Med.), Department Professor, Traumatologist-Orthopedist

Russian Federation, Stavropol

Georgy A. Airapetov

Stavropol State Medical University; Saint-Petersburg State Research Institute of Phthisiopulmonology

Email: airapetovga@yandex.ru
ORCID iD: 0000-0001-7507-7772
SPIN-code: 7333-6640

MD, Dr. Sci. (Med.), Traumatologist-Orthopedist

Russian Federation, Stavropol; Saint Petersburg

Sergey Yu. Chekrygin

Stavropol State Medical University

Email: Evrocheka@yandex.ru
ORCID iD: 0000-0002-6931-0344
SPIN-code: 2516-9707

Department Assistant, Traumatologist-Orthopedist

Russian Federation, Stavropol

Valentina S. Botasheva

Stavropol State Medical University

Email: botach@mail.ru
SPIN-code: 2047-3762

MD, Dr. Sci. (Med.), Professor, Pathologist

Russian Federation, Stavropol

References

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  2. Vorotnikov AA, Airapetov GA, Vasyukov VA, Yagubov VG. Modern aspects of the treatment of Koenig’s disease in children. N.N. Priorov Journal of Traumatology and Orthopedics. 2020;27(3):79–86. (In Russ). doi: 10.17816/vto202027379-86
  3. Airapetov GA, Zagorodniy NV, Vorotnikov AA. Experimental method replacement of the osteo-chondral defects of the large joints (first results). Medical Herald of the South of Russia. 2019;10(2):71–76. (In Russ). doi: 10.21886/2219-8075-2019-10-2-71-76
  4. Lazishvili GD, Egiazaryan КA, Akhpashev AA, et al. Study of the platelet-rich plasma clinical efficacy in the treatment of knee osteoarthritis. Journal of Clinical Practice. 2016;7(3):54–60. (In Russ). doi: 10.17816/clinpract7354-60
  5. Maluk BV, Eismont OL, Beletsky AV, et al. Subchondral bone osteoperforation on the processes of chondro- and osteoregeneration in osteochondritis dissecans of the femoral condyles. Proceedings of the National Academy of Sciences of Belarus, Medical series. 2014;(3):38–44. (In Russ).
  6. Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62(4):489–496. doi: 10.1016/j.joms.2003.12.003
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  8. Mastykau AN, Deykalo VP, Samsonova IV, Balaboshka KB. Efficacy of platelet-rich plasma application in treatment of traumatic defects of articular surfaces. Novosti Khirurgii. 2013;21(4):3–9. (In Russ).

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Copyright (c) 2023 Vasyukov V.A., Vorotnikov A.A., Airapetov G.A., Chekrygin S.Y., Botasheva V.S.

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