The autologous chondral platelet-rich plasma matrix implantation. A new therapy in cartilage repair and regeneration: macroscopic and biomechanical study in an experimental sheep model.

Introduction: Articular cartilage injuries are a severe problem, and the treatments for these injuries are complex. The present study investigates a treatment for full-thickness cartilage defects called Autologous Chondral Platelet Rich Plasma Matrix Implantation (PACI) in a sheep model. Methods: Chondral defects 8 mm in diameter were surgically induced in the medial femoral condyles of both stifles in eight healthy sheep. Right stifles were treated with PACI and an intraarticular injection with a plasma rich in growth factors (PRGF) solution [treatment group (TRT)], while an intraarticular injection of Ringer's lactate solution was administered in left stifles [Control group (CT)]. The limbs' function was objectively assessed with a force platform to obtain the symmetry index, comparing both groups. After 9 and 18 months, the lesions were macroscopically evaluated using the International Cartilage Repair Society and Goebel scales. Results: Regarding the symmetry index, the TRT group obtained results similar to those of healthy limbs at 9 and 18 months after treatment. Regarding the macroscopic assessment, the values obtained by the TRT group were very close to those of normal cartilage and superior to those obtained by the CT group at 9 months. Conclusion: This new bioregenerative treatment modality can regenerate hyaline articular cartilage. High functional outcomes have been reported, together with a good quality repair tissue in sheep. Therefore, PACI treatment might be a good therapeutic option for full-thickness chondral lesions.

Cartilage regeneration using a novel autologous growth factors-based matrix for full-thickness defects in sheep.

PURPOSE: To investigate the chondrogenic-regenerative properties of a novel autologous-made matrix composed of hyaline cartilage chips combined with a growth factors-based clot for full-thickness defects in sheep. METHODS: A full-thickness, 8-mm diameter cartilage defect was created in the weight-bearing area of the medial femoral condyle in 6 sheep. Treatment consisted of surgical implantation of an autologous-based matrix of hyaline cartilage chips combined with a clot of plasma poor in platelets and intraarticular injection of plasma rich in growth factors. Outcome measures at 1, 3 and 6 months included macroscopic International Cartilage Repair Society (ICRS) score, histological and immunohistochemical analysis for collagen expression, and transmission electron microscopy study. RESULTS: The 6-month macroscopic evaluation showed nearly normal (11.1 ± 0.7) cartilage repair assessment. The ICRS score was significantly higher at 6 months compared to 3 months (5.5 ± 1.3; p < 0.0001) and 1 (1.1 ± 0.4; p < 0.0001) month. At 6 months, hyaline cartilage tissue filling the defect was observed with adequate integration of the regenerated cartilage at the surrounding healthy cartilage margin. At 6 months, mature chondrons and cartilage matrix contained collagen fibers with masked fibrillary structure, and the expression of collagen in the newly formed cartilage was similar in intensity and distribution pattern compared to the healthy adjacent cartilage. CONCLUSIONS: This novel treatment enhanced chondrogenesis and regenerated hyaline cartilage at 6 months with nearly normal macroscopic ICRS assessment. Histological analysis showed equivalent structure to mature cartilage tissue in the defect and a collagen expression pattern in the newly formed cartilage similar to that found in adjacent healthy articular cartilage. The present technique may have clinical application for chondral injuries in humans because this procedure is cheap (no need for allograft, or expensive instrumentation/biomaterials/techniques), easy and fast-performing through a small arthrotomy, and safe (no rejection possibility because the patients' own tissue, cells, and plasma are used).

Cryoplasty versus angioplasty in the treatment of arterial restenosis in an experimental model of atherosclerosis in rabbits.

Cryoplasty may reduce the incidence of post-angioplasty restenosis in peripheral atherosclerotic arteries. Our study is looking to investigate the mid-term effects (4 weeks) of an FDA-approved cryoplasty catheter (PolarCath(®), Boston Scientific) compared to a conventional angioplasty catheter using a hypercholesterolemic rabbit model of arterial restenosis based on diet plus vessel injury. Thirty-six normolipidemic, 3-month old male New Zealand White rabbits were used. Balloon angioplasty was performed on left external iliac arteries on day 1. Animals were fed with a hypercholesterolemic diet for 60 days. On day 120, three groups of animals were established: conventional PTA (percutaneous transluminal angioplasty) was applied on the PTA group; the CRY group was treated with the PolarCath(®) cryoplasty system and no treatment was given to a control (CTR) group. A broad variety of atheromatous lesions were observed 30 days after treatment, presenting significant differences between groups. Most of the complicated lesions were found in the CRY group, while advanced and early lesions were more often appreciated in the CTR and PTA groups, respectively. The histomorphometric evaluation of the arteries showed significant differences between the CRY group and the other two groups, with the highest percentage of IEM (internal elastic membrane) injury, vascular stenosis and ratio intima/media being registered on animals treated with cryoplasty. Intravascular cryotherapy induces complicated lesions in arterial walls 30 days after treatment in a hypercholesterolemic rabbit model based on diet plus vessel injury. Cryoplasty leads to the production of severe fibrosis and mineralisation and stenosis compared to a conventional angioplasty.