Mahmut Özdemir1, Barış Birinci1, Bahtiyar Haberal2, Alev Ok Atılgan3, İsmail Demirkale4

1Department of Orthopedics and Traumatology, Yüksek Ihtisas University, Ankara, Türkiye
2Department of Orthopedics and Traumatology, Başkent University Faculty of Medicine, Ankara, Türkiye
3Department of Pathology, Başkent University Faculty of Medicine, Ankara, Türkiye
4Department of Orthopedics and Traumatology, University of Health Sciences, Ankara, Türkiye

Keywords: Actovegin, cartilage injury, hyaluronic acid, N-Acetyl cysteine, osteoarthritis.


Objectives: The aim of this study was to compare the effects of hyaluronic acid (HA), N-acetyl cysteine (NAC), and deproteinized calf serum on cartilage healing after the creation of traumatic cartilage injury in a rat model.

Materials and methods: A total of 48 rats, each weighing an average of 350 g, were randomly separated into four groups of 12. An osteochondral defect was created, 2-mm-wide and 3-mm deep in each rat. Injections were made to the knees of the rats as saline solution in Group 1, deproteinized calf serum in Group 2, NAC in Group 3, and HA in Group 4. At the end of 12 weeks, all rats were sacrificed and tissues were evaluated histologically.

Results: The HA group had a better cell morphology, tissue morphology, surface architecture, and vascularity than the other groups (p<0.001). Matrix staining, chondrocyte clustering, and the assessment scores of the mid, deep, superficial zones, and overall were higher in the HA group than in the other groups (p<0.001). The NAC showed a better tissue morphology, cell morphology, and vascularity than the control group (p=0.003, p<0.001, and p<0.001, respectively).

Conclusion: Hyaluronic acid was the most effective agent in cartilage healing compared to NAC and deproteinized calf serum. In addition, the NAC was more effective compared to the control group.

Citation: Özdemir M, Birinci B, Haberal B, Ok Atılgan A, Demirkale İ. In vivo study of the role of hyaluronic acid, N-acetyl cysteine, and deproteinized calf serum on injury-induced cartilage degeneration. Jt Dis Relat Surg 2023;34(1):158-165. doi: 10.52312/ jdrs.2023.863

Ethics Committee Approval

This study was approved by Başkent University Animal Experimentation Ethics Committee (date: 06.05.2021, no: DA 21/05). National Institutes of Health guidelines for the care and use of laboratory animals (NIH Publication No. 8023, revised 1978).

Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.

Author Contributions

Idea/concept: M.Ö.; Design: M.Ö., B.H.; Control/supervision: B.B., İ.D.; Data collection and/or processing: M.Ö., B.H., A.O.A.; Analysis and/or interpretation: M.Ö., B.H., B.B., İ.D. A.O.A.; Literature review: M.Ö., B.H., İ.D., A.O.A.; Writing the article: M.Ö., B.H., İ.D.; Critical review: İ.D.; References and fundings: M.Ö., B.H., B.B.; Materials: B.H., A.O.A.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.