SLR - April 2010 - Aaron Bean
Reference:
Kaplan, Lee D. (2009). The effect of early hyaluronic acid delivery on the development of an acute articular cartilage lesion in a sheep model. The American Journal of Sports Medicine, 37, 12, 2323-2327.
Scientific Literature Reviews
Reviewed by: Aaron Bean, DPM
Residency Program: Detroit Medical Center
Podiatric Relevance:
Podiatric surgeons encounter cartilaginous injuries frequently. Injuries to the cartilaginous surface of the talus, tibial plafond, and metatarsal heads are common and can be difficult to treat effectively. Methods that may help to improve healing time of cartilage injuries and lead to non-surgical treatments would be a beneficial option to the treating podiatric physician.
Methods:
A 10 x 10 mm partial-thickness articular cartilage lesion was created on the medial condyle of 16 adult sheep
stifles (hindlimbs). Eight sheep received intra-articular hyaluronic acid injections at days 0, 8, and 15, and 8 controls received saline. Contralateral stifles were nonoperated controls. All sheep were sacrificed at 12 weeks after surgery. Synovial fluid was drawn before surgery and after euthanasia for collagen II, nitric oxide, and interleukin-1 beta analysis. The medial condyle was analyzed by gross appearance, confocal laser microscopy for cell viability, histologic analysis for cartilage morphology, and dimethylmethylene blue assay for proteoglycan.
Results:
At 12 weeks, histologic analysis revealed that the hyaluronic acid group had significantly better scores than the saline group (P = .001). The hyaluronic acid group had significantly greater glycosaminoglycan content than the saline group (P = .011), and showed a trend of reduced chondrocyte death compared with the saline group (P =0.07). Synovial fluid showed no significant differences between the groups in collagen II, nitric oxide, and interleukin-1 beta levels.
Conclusions:
The results demonstrated that early administration of hyaluronic acid shows a significant improvement in cartilage histologic analysis and increased glycosaminoglycan content after acute traumatic cartilage injury.