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Using apheresis-derived cells to augment microdrilling in the treatment of chondral defects in an ovine model.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Birch, Mark 
Brooks, Roger 

Abstract

The treatment of chondral defects using microdrilling often results in a mechanically weak fibrocartilagenous repair, rather than a more robust hyaline cartilage repair. Many different microfracture/microdrilling augmentation techniques have been described, including the use of cellular products to enhance healing. Autologous peripheral blood progenitor cells can be obtained via apheresis after administration of granulocyte colony-stimulating factor (G-CSF) and have been used successfully to augment microdrilling in clinical patients. The objective of this study was to use apheresis-derived mononuclear blood cells to augment microdrilling treatment of a cartilage defect in an ovine model to determine the effect on healing. Forty adult female sheep were used in this study and were divided into a control group (microdrilling alone) and a treatment group (microdrilling, hyaluronic acid, and apheretic product). Outcome measurements included weight-bearing on the operated limb, macroscopic scoring of the joint, histology, and immunohistochemistry. In addition, magnetic resonance imaging was used to attempt to identify SPION-labeled cells from the apheretic product in the operated limbs. The results showed a significant increase in healing as measured by the modified O'Driscoll sore in the treated group. No evidence of homing of SPION-labeled cells to the defect was found and no correlation was found between the response to G-CSF administration or concentration of CD34+  and outcome. A correlation was found between healing and the concentration of white blood cells and peripheral blood mononuclear cell numbers in the apheretic product.

Description

Keywords

apheresis, cartilage healing, chondral defect, ovine, Animals, Arthroplasty, Subchondral, Blood Component Removal, Female, Granulocyte Colony-Stimulating Factor, Peripheral Blood Stem Cell Transplantation, Sheep, Transplantation, Autologous

Journal Title

J Orthop Res

Conference Name

Journal ISSN

0736-0266
1554-527X

Volume Title

39

Publisher

Wiley

Rights

All rights reserved
Sponsorship
Arthritis Research Uk (None)
ARTHRITIS RESEARCH UK (21156)
Medical Research Council (MR/R015635/1)