Enhanced subchondroplasty treatment for post-traumatic cartilage and subchondral bone marrow lesions in a canine model. Journal of orthopaedic research : official publication of the Orthopaedic Research Society Oliver, H. A., Bozynski, C. C., Cook, C. R., Kuroki, K., Sherman, S. L., Stoker, A. M., Cook, J. L. 2019


This study characterizes outcomes associated with subchondroplasty (SCP) versus SCP enhanced with platelet rich plasma (PRP) or bone marrow aspirate concentrate (BMC) treatment of impact-induced subchondral bone marrow lesions (BML) using a validated pre-clinical canine model. With IACUC approval, purpose-bred research hounds (n=24) underwent arthroscopic impact injury (40N) to both medial femoral condyles. At 3 months, functional assessments, arthroscopy, and MRI were performed. One knee in each dog (n=24; n=12 per endpoint) was randomly assigned to SCP with the other knee randomly assigned to SCP+PRP, SCP+BMC or sham injection (Control) (n=8 per group; n=4 per endpoint). Dogs were evaluated at 6 and 12 months after treatment using functional assessments, radiography, arthroscopy, and MRI and humanely euthanatized at 6 or 12 months after treatment for histologic assessments. At 6 months post-treatment, comfortable range-of-motion (CROM) was higher (p<0.04) in SCP+PRP and SCP+BMC knees compared to Controls. At 1 year post-treatment, %-Total Pressure Index was higher (p=0.036) in SCP+BMC compared to Controls, pain was lower (p<0.05) in SCP+BMC and SCP+PRP compared to SCP and Controls, and CROM was higher (p<0.05) in SCP+BMC and SCP+PRP compared to SCP and Controls. Knees treated with SCP+PRP and SCP+BMC had better (p<0.05) MRI grades than SCP and Controls. No statistically significant differences in arthroscopic or histologic pathology were noted. Clinical significance: Biologics added to SCP treatment may further enhance its beneficial effects by improving range-of-motion, pain severity, and limb loading through 1 year after treatment. However, these benefits must be considered alongside cost, logistics, and treatment availability. This article is protected by copyright. All rights reserved.

View details for DOI 10.1002/jor.24508

View details for PubMedID 31692048