Healing of Circular Defects in the Rabbit Medial Meniscus Can Occur Spontaneously and Is not Improved by Intra-Articular Hyaluronic Acid

S. Collier; N. Hope; P. Ghosh

doi:10.1055/s-0038-1632504

Veterinary and Comparative Orthopaedics and Traumatology, Inhaltsverzeichnis

Vet Comp Orthop Traumatol 1996; 09(02): 60-5
DOI: 10.1055/s-0038-1632504

Original Research

Schattauer GmbH

Healing of Circular Defects in the Rabbit Medial Meniscus Can Occur Spontaneously and Is not Improved by Intra-Articular Hyaluronic Acid

S. Collier

¹From the Raymond Purves Bone and Joint Research Laboratories, University of Sydney, Royal North Shore Hospital, St Leonards, NSW, Australia

,

N. Hope

¹From the Raymond Purves Bone and Joint Research Laboratories, University of Sydney, Royal North Shore Hospital, St Leonards, NSW, Australia

,

P. Ghosh

¹From the Raymond Purves Bone and Joint Research Laboratories, University of Sydney, Royal North Shore Hospital, St Leonards, NSW, Australia

› Institutsangaben

Abstract

Summary

The aim of this study was to determine the effects of intra-articular hyaluronic acid on meniscal healing. Circular defects, 1.0 mm in diameter, were made in the anterior third of the medial meniscus in rabbits. In one joint, 0.4 ml hyaluronic acid (Healon^®) was instilled, and in the contralateral (control) joint, 0.4 ml Ringer’s saline. Four rabbits were killed after four, eight and 12 weeks and the menisci examined histologically. By eight weeks most of the lesions had healed by filling with hyaline-like cartilage. Healing was not improved by hyaluronic acid treatment. The repair tissue stained strongly with alcian blue, and the presence of type II collagen, keratan sulphate, and chondroitin sulphate was demonstrated by immunohistochemical localisation. In contrast to the circular defects, longitudinal incisions made in the medial menisci of a further six rabbits did not show any healing after 12 weeks, indicating that the shape of the lesion largely determined the potential for healing.

The effect of hyaluronic acid on meniscal healing was tested in a rabbit model. With one millimeter circular lesions in the medial meniscus, healing by filling with hyalinelike cartilage was not significantly affected by the application of hyaluronic acid intra-articularly at the time of surgery, compared to saline controls, as assessed histologically four, eight and 12 weeks after the operation.

Keywords

Meniscal repair - hyaluronic acid - type II collagen

Volltext

Referenzen

REFERENCES
1 Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med 1982; 10: 90-5.
2 King D. The healing of semilunar cartilages. J Bone Jt Surg 1936; 18: 333-42.
3 Cox JS, Nye CE, Schaeffer WW. Woodstein IJ: The degenerative effects of partial and total resection of the medial meniscus in dogs′ knees. Clin Orthop 1975; 109: 178-83.
4 King DL. The function of semilunar cartilages. J Bone Joint Surg 1936; 18 A 1069-76.
5 Kawai Y, Fukubayashi T, Nishino J. Meniscal suture - an experimental-study in the dog. Clin Orthop 1989; 243: 286-93.
6 Gershuni DH, Skyhar MJ, Danzig LA, Camp J, Hargens AR, Akeson WH. Experimental models to promote healing of tears in the avascular segment of canine knee menisci. J Bone Joint Surg 1989; 71 A (09) 1363-70.
7 Ghadially FN, Wedge JH, Lalonde J. Experimental methods of repairing injured menisci. J Bone Joint Surg 1986; 68 B 106-10.
8 Veth RPH, Den Heeten GJ, Jansen HWB, Nielsen HKL. An experimental study of reconstructive procedures in lesions of the meniscus. Use of synovial flaps and carbon fiber implants for artificially made lesions in the meniscus of the rabbit. Clin Orthop Rel Res 1983; 181: 250-4.
9 Hede A, Svalasto E, Reimann I. Repair of 3-monthold experimental meniscal lesions in rabbits. Clin Orthop 1991; 266: 238-43.
10 Arnoczky SP, Warren RF. The microvas-culature of the meniscus and its response to injury. Am J Sports Med 1983; 11: 131-41.
11 Arnoczky SP, Warren RF, Spivak JM. Meniscal r epair using an exogenous fibrin clot - an experimental- study in dogs. J Bone Joint Surg 1988; 70 A 1209-17.
12 Wiig ME, Amiel D, VandeBerg J, Kitabayashi L, Harwood FL, Arfors KE. The early effect of high molecular weight hyaluronan (hyaluronic acid) on anterior cruciate ligament healing – an experimental study in rabbits. J Orthop Res 1990; 8: 425-34.
13 Hede A, Svalastoga E, Reimann I. Articular cartilage changes following meniscal lesions. Repair and meniscectomy studied in the rabbit knee. Acta Orthop Scand 1991; 62: 319-22.
14 Huang TL, Lin GT, O’Connor S, Chen DY, Barmada R. Healing potential of experimental meniscal tears in the rabbit – Preliminary results. Clin Orthop 1991; 267: 299-305.
15 Veth RPH, Den Heeten GJ, Jansen HWB, Nielsen HKL. Repair of the meniscus An experimental investigation in rabbits. Clin Orthop Rel Res 1983; 175: 258-62.
16 Sayers DCJ, Volpin G, Bentley G. The demonstration of bone and cartilage remodelling using alcian blue and hematoxylin. Stain Technol 1987; 63: 59-63.
17 Ye XJ, Terato K, Nakatani H, Cremer MA, Yoo TJ. Monoclonal-antibodies against bovine type-IX collagen (LMW fragment) – production, characterization, and use of immunohistochemical localization studies. J Hist Cyto 1991; 39: 265-71.
18 Visco DM, Johnstone B, Hill MA, Jolly GA, Caterson B. Immunohistochemical analysis of 3-B-3(-) and 7-D-4 epitope expression in canine osteoarthritis. Arthritis Rheum 1993; 36: 1718-25.
19 Caterson B, Christner JE, Baker JR. Identification of monoclonal antibody that specifically recognizes corneal and skeletal keratan sulfate – monoclonal antibodies to cartilage proteoglycan. J Biol Chem 1983; 258 (14) 8848-54.
20 Kongtawelert P, Ghosh P. A monoclonal antibody that recognizes 2,3-, 2,6-, and 4,6-disulphate ester ring substitution in pyranose-containing polysaccharides. J Immunol Methods 1990; 126: 39-49.
21 Pickvanc EA, Oegema TR, Thompson RC. Immunolocalization of selected cytokines and proteases in canine articular cartilage after transarticular loading. J Orthop Res 1993; 11: 313-23.
22 Roughley PJ, McNicol D, Santer V, Buckwalter J. The presence of a cartilage-like proteoglycan in the adult human meniscus. Biochem J 1981; 197: 77-83.
23 Meyers SA, Seaber AV, Glisson RR, Nunley JA. Effect of hyaluronic acid/chondroitin sulfate on healing of full-thickness tendon lacerations in rabbits. J Orthop Res 1989; 7: 683-9.
24 Olsen EB, Trier K, Jørgensen B, Brok K-E, Ammitzbøll T. The effect of hyaluronic acid on cartilage in the immobilized rabbit knee. Acta Orthop Scand 1991; 62: 323-6.
25 Abatangelo G, Botti P, Del Bue M, Gei G, Samson JC, Cortivo R, De Galateo A, Martelli M. Intraarticular sodium hyaluronate injections in the Pond- Nuki experimental-model of osteoarthritis in dogs 1: Biochemical results. Clin Orthop 1989; 241: 278-85.
26 Ayad S, Marriott A, Brierley VH, Grant ME. Mammalian cartilage synthesizes both proteoglycan and non-proteoglycan forms of type-IX collagen. Biochem J 1991; 278: 441-5.
27 Yoshimi T, Kikuchi T, Obara T, Yamaguchi T, Sakakibara Y, Itoh H, Iwata H, Miura T. Effects of high-molecular-weight sodium hyaluronate on experimental osteoarthrosis induced by the resection of rabbit anterior cruciate ligament. Clin Orthop 298.
28 Barr AR, S, Duance VC, Wotton SF, Waterman AE. Influence of intra-articular sodium hyaluronate and polysulfated glycosamino-glycans on the biochemical composition of equine articular surface repair tissue. Equine Vet J 1994; 26: 40-2.
29 Iwata H. Pharmacological and clinical aspects of intraarticular injection of hyaluronate. Clin Orthop. 1993: 285-91.
30 Cheung HS. Distribution of type I, II, III, and V in the pepsin solubilized collagens in bovine menisci. Connect Tissue Res 1987; 16: 343-56.
31 Klompmaker J, Jansen HWB, Veth RPH, Nielsen HKL, de Groot JH, Pennings AJ, Kuijer R. Meniscal repair by fibrocartilage? An experimental study in the dog. J Orthop Res 1992; 10: 359-70.
32 Karube S, Shoji H. Compositional changes of the human meniscus with age and degenerative joint disease. J Jpn Orthop Ass 1982; 56: 51-7.