Abstract

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