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Volume 29, Issue 1, Pages 113-121 (January 2013)
Marrow Stimulation Improves Meniscal Healing at Early Endpoints in a Rabbit Meniscal Injury Model Matthew D. Driscoll, M.D., Brett N. Robin, M.D., Masafumi Horie, M.D., Ph.D., Zachary T. Hubert, B.S., H. Wayne Sampson, Ph.D., Daniel C. Jupiter, Ph.D., Binu Tharakan, Ph.D., Robert E. Reeve, M.D. Arthroscopy Volume 29, Issue 1, Pages (January 2013) DOI: /j.arthro Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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Fig 1 Reproducible avascular zone meniscal injury. The left and right knee joints of each rabbit were approached through a medial parapatellar arthrotomy, and the anterior horn of the medial meniscus was identified. A 1.5-mm punch biopsy was used to create a reproducible defect in the avascular inner two-thirds of the anterior horn of the medial meniscus in all knees. Arthroscopy , DOI: ( /j.arthro ) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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Fig 2 MS technique. In the right knees, a 2.4-mm Steinman pin was introduced 2 cm into the intramedullary canal of the distal femur from an entry point just anterior to the apex of the intercondylar notch. This resulted in a standardized entry portal for marrow contents to spill into the knee joint. Arthroscopy , DOI: ( /j.arthro ) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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Fig 3 Method for calculating the quantity of reparative tissue. Using radial sections taken through the center of the defect, the area of the entire defect (D, black dotted line, left) and the area of the reparative tissue (R, black dotted line, right) were measured. The reparative tissue area/defect area ratio (R/D) was used to quantify the amount of meniscal tissue bridging the defect in each knee. Complete full-thickness bridging would result in a value of 100% and incomplete or partial-thickness bridging would result in a value less than 100%. Arthroscopy , DOI: ( /j.arthro ) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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Fig 4 MS promotes early healing (macroscopic observation). Macroscopic photographs show the appearance of defects within the anterior horn of the medial meniscus from each control (left) and MS (right) knee 1 week after injury. The specimens in which full-thickness grossly visible defects remained are denoted by an asterisk. Arthroscopy , DOI: ( /j.arthro ) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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Fig 5 MS promotes early meniscal healing (microscopic observation). (A) Representative low- and high-power images of regenerated meniscus sections stained with Safranin-O at 1, 4, and 12 weeks after meniscus injury. Scale bar: 200 μm. (B) Representative low- and high-power images of normal rabbit meniscus section stained with Safranin-O. Scale bar: 200 μm. (C) Reparative tissue area/defect area ratios are displayed as mean with SD (error bars) for MS and control groups at each endpoint. *P < .05 between MS and control groups at each period. (D) Results of histological scoring system for repaired meniscus. The scores are displayed as mean with SD (error bars). *P < .05, **P < .10 between MS and control groups at each endpoint. Arthroscopy , DOI: ( /j.arthro ) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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Fig 6 Immunohistochemistry for proregenerative cytokines. In both MS and control knees, immunohistochemistry assays demonstrated positive staining for TGFβ-1, IGF-1, and PDGF-A, in meniscal tissue bordering the site of injury and within the reparative tissue 1 week after injury. Staining for TGFβ-1 is shown here in sections from a knee treated with MS and a control knee, with each image including intact tissue on the left and healing tissue within the meniscal defect on the right. Arrows indicate defect border. Scale bar: 100 μm. Arthroscopy , DOI: ( /j.arthro ) Copyright © 2013 Arthroscopy Association of North America Terms and Conditions
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