Prostaglandin E2 and hyaluronic acid facilitates treatment of osteochondral deffects

Barış Birinci; Akif Muhtar Öztürk; Abdullah Yalçın Tabak; Cem Nuri Aktekin; Petek Korkusuz; Feza Korkusuz

Barış Birinci¹, Akif Muhtar Öztürk², Abdullah Yalçın Tabak¹, Cem Nuri Aktekin¹, Petek Korkusuz³, Feza Korkusuz⁴

¹Ankara Numune Research and Training Hospital, 5th Orthopaedics and Traumatology Clinic, Ankara, Turkey
²Gazi University, Faculty of Medicine, Department of Orthopedic Surgery and Traumatology, Ankara, Turkey
³Hacettepe University Medical Faculty, Department of Histology and Embryology, Ankara, Turkey
⁴Middle East Technical Univeristy, Department of Biomedical Engineering and Medical Center, Ankara, Turkey

Keywords: PGE2, Hyaluronic acid, Cartilage healing, Bone marrow, Fibrin clot

Abstract

Objectives: Restoration of the articular hyaline cartilage is the basic prerequisite to preserve normal function of the synovial joint after injury. We have assumed combining hyaluronic acid with prostaglandin E2 (PGE2) will enhance hyaline cartilage formation by stimulating mesenchymal stem cells on fibrin clot scaffold. Material and methods: Rat knee joint osteochondral defects were treated by (a) bone marrow on fibrin clot, (b) hyaluronic acid alone, © bone marrow on fibrin clot combined with PGE2, (d) bone marrow on fibrin clot combined with hyaluronic acid, (e) bone marrow on fibrin clot with hyaluronic acid and PGE2, and (f) a control group left without treatment.
Results: Evaluations were carried out at week six in all groups by radiology and histology. Coverage of defective area with various grades of fibrous or hyaline cartilage was noticed in all groups. All treatment groups presented better healing patterns than the control group. Hyaline cartilage with normal matrix staining pattern was observed on Safranin-O stained sections from (1) bone marrow on fibrin clot with PGE2 and (2) bone marrow on fibrin clot with hyaluronic acid and PGE2. Healing response at these groups was statistically better then the control group.
Conclusion: This study demonstrates beneficial effects of PGE2 and hyaluronic acid during chondrocyte differentiation. These properties of PGE2 and hyaluronic acid will have a role during the development of new strategies in osteochondral defect treatment.