Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleArticular Cartilage Regeneration With Autologous Peripheral Blood Progenitor Cells and Hyaluronic Acid After Arthroscopic Subchondral Drilling: A Report of 5 Cases With Histology
Section snippets
Patient Selection
Five patients underwent second-look arthroscopy with chondral core biopsy. These 5 patients are part of a larger pilot study in which 180 patients who presented with chondral defects of the knee joint were recruited. Postoperatively, the clinical course of these 5 patients presented an opportunity for a second-look arthroscopy. Two patients underwent contralateral knee surgery, and one patient had removal of a Tomofix plate and screw construct (Synthes, West Chester, PA), providing an opportune
Second-Look Arthroscopy With Chondral Core Biopsy
Five patients underwent second-look arthroscopy, and a 2-mm chondral core biopsy specimen was procured and examined. Arthroscopically, the regenerated articular cartilage appeared smooth and had excellent integration to the surrounding native cartilage without any delamination or hypertrophy. The exception was case 2, in which the drill holes over the lateral patellofemoral joint were too far apart with resultant tufts of cartilage seen between areas devoid of regenerated cartilage (Fig 3).
Histology
Discussion
It was possible to replicate our preclinical animal model8 in the human knee joint using postoperative intra-articular injections of autologous PBPCs in combination with HA after arthroscopic subchondral drilling. This method uses marrow stimulation to create an autologous scaffold that is subsequently seeded with postoperative intra-articular injections of autologous PBPCs and in situ progenitor cells from the marrow (Fig 10).
Histologic results after microfracture and autologous chondrocyte
Conclusions
Articular hyaline cartilage regeneration is possible with arthroscopic subchondral drilling followed by postoperative intraarticular injections of autologous PBPCs in combination with HA.
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2021, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :A significant decrease in CD34+ was also observed 24 hours after processing with DMSO (Mdiff = 0.20 × 106/4 mL vial; P = .017; 95%CI: 0.05, 0.35). Similar results and trend of CD34+ has been observed and reported.22 The data from samples shipped to and from the United States test site are presented in Tables 2 and 3.
Arthroscopic Subchondral Drilling Followed by Injection of Peripheral Blood Stem Cells and Hyaluronic Acid Showed Improved Outcome Compared to Hyaluronic Acid and Physiotherapy for Massive Knee Chondral Defects: A Randomized Controlled Trial
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The authors report no conflict of interest.