Nanofracturing: a new technique for bone marrow stimulation in equine cartilage repair

 

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Autores: Cokelaere, Stefan M., Vindas Bolaños, Rafael, Both, Sanne K., Vullers, Mariëlle, Korthagen, Nicoline, van Weeren, René, de Grauw, Janny
Formato: artículo
Fecha de Publicación:2020
Descripción:Microfracture is the current standard in treatment of focal full-thickness cartilage lesions in horses, but clinical outcome may vary. Nanofracture is a novel technique that uses a commercially developed device to yield smaller diameter perforations with deeper penetration into the subchondral bone. Experimentally, in rabbits and sheep, nanofracture has been shown to result in superior repair compared to microfracture. The objective was to study the feasibility and preliminary outcome of nanofracture using a commercial device for treatment of cartilage defects in horses. Nanofracture was tested ex vivo in n=2 cadaveric equine stifle joints and in vivo in n=8 horses with experimental partial thickness cartilage defects in the medial femoral trochlear ridge. These were treated with an experimental biomaterial or nanofracture, and repair tissue was studied macroscopically (ICRS-I score) and microscopically (histological ICRS-II score and micro-CT) after 7 months. Both in cadaveric equine stifle joints and in vivo, the nanofracture device could readily be applied and allowed easy penetration of the subchondral bone. Repair tissue after 7 months was graded ‘near-normal’ macroscopically, while histologically, the abundant repair tissue proved mainly fibrocartilaginous in nature. Micro-CT revealed near-full restoration of mid-lesion cartilage layer thickness but altered subchondral bone microarchitecture. The in vivo study did not include a control group treated with conventional microfracture for comparison. To our knowledge, this is the first report on bone marrow stimulation using nanofracture as a potential method to enhance chondral defect repair in horses. In the in vivo study, no clinical adverse effects were observed, and promising good defect filling with fibrocartilaginous tissue was seen 7 months after treatment.
País:Repositorio UNA
Institución:Universidad Nacional de Costa Rica
Repositorio:Repositorio UNA
Lenguaje:Inglés
OAI Identifier:oai:https://repositorio.una.ac.cr:11056/18094
Acceso en línea:http://hdl.handle.net/11056/18094
Palabra clave:COSTA RICA
CABALLOS
EQUINOS
ENFERMEDADES OSEAS
BONE MARROW STIMULATION
NANOFRACTURE
CARTILAGE REPAIR